Background
Well before the H1N1 influenza, health care organizations worldwide prepared for a pandemic of unpredictable impact. Planners anticipated the possibility of a pandemic involving high ...mortality, high health care demands, rates of absenteeism rising up to 20–30% among health care workers, rationing of health care, and extraordinary psychological stress.
Method
The intervention we describe emerged from the recognition that an expected influenza pandemic indicated a need to build resilience to maintain the health of individuals within the organization and to protect the capacity of the organization to respond to extraordinary demands. Training sessions were one component of a multifaceted approach to reducing stress through effective preparation and served as an evidence based platform for our hospital's response to the H1N1 pandemic.
Results
The training was delivered to more than 1250 hospital staff representing more than 22 departments within the hospital. The proportion of participants who felt better able to cope after the session (76%) was significantly higher than the proportion who felt prepared to deal confidently with the pandemic before the session (35%). Ten key themes emerged from our qualitative analysis of written comments, including family‐work balance, antiviral prophylaxis, and mistrust or fear towards health care workers.
Conclusions
Drawing on what we learned from the impact of SARS on our hospital, we had the opportunity to improve our organization's preparedness for the pandemic. Our results suggest that an evidence‐based approach to interventions that target known mediators of distress and meet standards of continuing professional development is not only possible and relevant, but readily supportable by senior hospital administration.
Background: Complex lung diseases are among the leading causes of death in Ethiopia. Access to thoracic surgery is limited, and before 2016, no thoracic surgeons were trained in minimally invasive ...surgery (MIS). A global academic partnership was formed between the University of Toronto and Addis Ababa University (AAU). Here, we describe implementation of the first MIS training program in sub-Saharan Africa and evaluate its safety. Methods: We conducted a retrospective cohort analysis of open v. MIS thoracic and upper gastrointestinal procedures performed at AAU from Jan. 1, 2016, to June 1, 2021. Baseline demographic, diagnostic, operative and postoperative outcomes, including length of stay (LOS) and complications, were compared. In our bilateral model of surgical education, training was provided in Ethiopia and Canada over 2 years with focus on capacity building through egalitarian forms of knowledge exchange. Program features included certification in fundamentals of laparoscopic surgery, highfidelity lobectomy simulation and hands-on training. Results: Overall, 41 open and 56 MIS cases were included in the final statistical analysis. The average LOS in the MIS group was 5.2 days v. 11.0 days in the open group (p < 0.001). The overall complication rate was 18% in the MIS group v. 39% open (p = 0.020). Conclusion: Here we demonstrated the successful initiation of sub-Saharan Africas first MIS program in thoracic and upper gastrointestinal surgery with a > 50% reduction in LOS and overall complications. We envision the MIS program as a template to continue expanding global partnerships and improving surgical care in other resourcelimited settings.
Educational partnerships between academic health sciences centers in high- and low-resource settings are often formed as attempts to address health care disparities. In this Perspective, the authors ...describe the Toronto Addis Ababa Academic Collaboration (TAAAC), an educational partnership between the University of Toronto and Addis Ababa University. The TAAAC model was designed to help address an urgent need for increased university faculty to teach in the massive expansion of universities in Ethiopia. As TAAAC has developed and expanded, faculty at both institutions have recognized that the need to understand contextual factors and to have clarity about funding, ownership, expertise, and control are essential elements of these types of collaborative initiatives. In describing the TAAAC model, the authors aim to contribute to wider conversations and deeper theoretical understandings about these issues.
We describe an evidence-based approach to enhancing the resilience of healthcare workers in preparation for an influenza pandemic, based on evidence about the stress associated with working in ...healthcare during the SARS outbreak. SARS was associated with significant long-term stress in healthcare workers, but not with increased mental illness. Reducing pandemic-related stress may best be accomplished through interventions designed to enhance resilience in psychologically healthy people. Applicable models to improve adaptation in individuals include Folkman and Greer's framework for stress appraisal and coping along with psychological first aid. Resilience is supported at an organizational level by effective training and support, development of material and relational reserves, effective leadership, the effects of the characteristics of "magnet hospitals," and a culture of organizational justice. Evidence supports the goal of developing and maintaining an organizational culture of resilience in order to reduce the expected stress of an influenza pandemic on healthcare workers. This recommendation goes well beyond the provision of adequate training and counseling. Although the severity of a pandemic is unpredictable, this effort is not likely to be wasted because it will also support the health of both patients and staff in normal times. À la lumière des données sur le stress associé au travail dans le domaine des soins de santé pendant la crise du SRAS, nous décrivons une approche fondée sur les preuves qui vise à améliorer la resilience des travailleurs de la santé en prévision d'une pandémie de grippe. Le SRAS a été associé à un niveau significatif de stress de longue durée chez les travailleurs de la santé, mais pas à une hausse des maladies mentales. Le meilleur moyen de réduire le stress en cas de pandémie serait de prendre des mesures pour améliorer la resilience des personnes saines sur le plan psychologique. Entre autres modèles intéressants pour améliorer la resilience, citons le cadre d'évaluation et d'adaptation au stress de Folkman et Gréer, assorti de premiers soins psychologiques. À l'échelle organisationnelle, la resilience est assurée par une formation et un soutien efficaces, la constitution de réserves matérielles et relationnelles, un leadership efficace, les avantages attribuables aux « hôpitaux-aimants » et une culture de justice organisationnelle. Il est prouvé que la création et l'entretien d'une culture organisationnelle de resilience sont des objectifs valables si l'on veut réduire le stress attendu d'une pandémie de grippe sur les travailleurs de la santé. Cette recommandation va plus loin que la simple prestation d'une formation et d'un counseling adéquats. Il est impossible de prédire la gravité d'une pandémie, mais les efforts recommandés ne seront pas vains, car ils favoriseront aussi la santé des patients et du personnel en temps normal.
Complex lung diseases are among the leading causes of death in Ethiopia. Access to thoracic surgery is limited, and before 2016 no thoracic surgeons were trained in minimally invasive surgery. A ...global academic partnership was formed between the University of Toronto and Addis Ababa University. We describe implementation of the first minimally invasive surgery training program in sub-Sahara Africa and evaluate its safety.
We performed a retrospective cohort analysis of open versus minimally invasive thoracic and upper gastrointestinal procedures performed at Addis Ababa University from January 2016 to June 2021. Baseline demographic, diagnostic, operative, and postoperative outcomes including length of stay and complications were compared.
In our bilateral model of surgical education, training is provided in Ethiopia and Canada over 2 years with a focus on capacity building through egalitarian forms of knowledge exchange. Program features included certification in Fundamentals of Laparoscopic Surgery, high-fidelity lobectomy simulation, and hands-on training. Overall, 41 open and 56 minimally invasive surgery cases were included in the final statistical analysis. The average length of stay in the minimally invasive surgery group was 5.2 days versus 11.0 days in the open group (P < .001). The overall complication rate was 18% in the minimally invasive surgery group versus 39% in the open group (P = .020).
We demonstrated the successful initiation of sub-Sahara Africa's first minimally invasive surgery program in thoracic and upper gastrointestinal surgery and characterize its patient safety. We envision the minimally invasive surgery program as a template to continue expanding global partnerships and improving surgical care in other resource-limited settings.
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Ethiopia is the second most populous country in sub-Saharan Africa. While Ethiopia's health care system includes primary health centres, general, and specialised hospitals, allied health care like ...speech-language pathology was not available until 2003. This article was written with the aim of sharing the experience of establishing speech-language pathology as a profession and the first speech-language pathology training program in Ethiopia.PURPOSEEthiopia is the second most populous country in sub-Saharan Africa. While Ethiopia's health care system includes primary health centres, general, and specialised hospitals, allied health care like speech-language pathology was not available until 2003. This article was written with the aim of sharing the experience of establishing speech-language pathology as a profession and the first speech-language pathology training program in Ethiopia.In this paper, we retrospectively examine how the leadership of local stakeholders, a multidisciplinary team, and the development of a professional infrastructure led to the success of the program. The authorship group, who were involved in the program from inception to implementation, share their experiences.METHODIn this paper, we retrospectively examine how the leadership of local stakeholders, a multidisciplinary team, and the development of a professional infrastructure led to the success of the program. The authorship group, who were involved in the program from inception to implementation, share their experiences.The speech-language pathology undergraduate program at Addis Ababa University graduated its first class in 2019. Plans to grow the training program at the graduate level are ongoing.RESULTThe speech-language pathology undergraduate program at Addis Ababa University graduated its first class in 2019. Plans to grow the training program at the graduate level are ongoing.This novel program, grown from several international partnerships, is an example of how low- and middle-income countries can improve access to the service providers necessary to treat their populations.CONCLUSIONThis novel program, grown from several international partnerships, is an example of how low- and middle-income countries can improve access to the service providers necessary to treat their populations.
Objective: Complex lung diseases are among the leading causes of death in Ethiopia. Access to thoracic surgery is limited, and before 2016 no thoracic surgeons were trained in minimally invasive ...surgery. A global academic partnership was formed between the University of Toronto and Addis Ababa University. We describe implementation of the first minimally invasive surgery training program in sub-Sahara Africa and evaluate its safety. Methods: We performed a retrospective cohort analysis of open versus minimally invasive thoracic and upper gastrointestinal procedures performed at Addis Ababa University from January 2016 to June 2021. Baseline demographic, diagnostic, operative, and postoperative outcomes including length of stay and complications were compared. Results: In our bilateral model of surgical education, training is provided in Ethiopia and Canada over 2 years with a focus on capacity building through egalitarian forms of knowledge exchange. Program features included certification in Fundamentals of Laparoscopic Surgery, high-fidelity lobectomy simulation, and hands-on training. Overall, 41 open and 56 minimally invasive surgery cases were included in the final statistical analysis. The average length of stay in the minimally invasive surgery group was 5.2 days versus 11.0 days in the open group (P < .001). The overall complication rate was 18% in the minimally invasive surgery group versus 39% in the open group (P = .020). Conclusions: We demonstrated the successful initiation of sub-Sahara Africa's first minimally invasive surgery program in thoracic and upper gastrointestinal surgery and characterize its patient safety. We envision the minimally invasive surgery program as a template to continue expanding global partnerships and improving surgical care in other resource-limited settings.
As Native Hawaiian Education continues to grow in our state, so does the need for educational leaders who are able to effectively guide and support the Native Hawaiian Education movement. However, ...little is known about how leadership in Native or Indigenous education in today’s contemporary setting is developed or fostered. Utilizing a qualitative multi-case study approach, this study aims to shed light on how three female Native Hawaiian Education leaders’ experiences and perspectives shaped their leadership trajectories. Transcripts from semistructured interviews with each of the participants were analyzed using cross-case comparative analysis and references to the Kumu Honua Mauli Ola, Native Hawaiian Education Philosophy Statement. While each individual’s leadership trajectory was unique, in every case their upbringing included .ohana (family) values and influences that led to high educational expectations and the practice of Hawaiian cultural values. Consequently, the leadership practices of each of these women are firmly grounded in Hawaiian culture and a commitment to the lahui Hawai.i, and have resulted in the setting of high expectations for the students attending their schools. Although each of these leaders characteristically understated the magnitude of their accomplishments, and the courage and persistence required of their positions, their conviction that the mission of Native Hawaiian Education is just and righteous led them to be strongly determined, persistent, and courageous in their actions, and enabled them to overcome major obstacles in pursuit of a cause that to this day has yet to gain popularity outside of Indigenous circles.
The purpose of this study was to investigate the relationship between cognitive disability and performance of daily living skills and stability of cognitive level after discharge in a sample of adult ...psychiatric inpatients (N = 40).
The Allen Cognitive Level Test-90 (ACL-90) was administered at time of discharge (Time I) and at 21 days to 28 days after discharge (Time II). The self-report version of the revised Routine Task Inventory (RTI-2) was also administered at Time II.
No significant correlation was found between the ACL-90 at Time I and the RTI-2 scores; however, significant correlations were found between the ACL-90 scores at both times and between the ACL-90 score at Time II and the RTI-2 scores.
The findings suggest that cognitive level remains relatively stable over a 1-month period in the postacute stage of a psychiatric illness. Cognitive level and performance of daily living skills are related, but the relationship is sensitive to time. Implications for occupational therapy assessment include recognizing the temporal constraints of functional assessments and refining instruments to be more sensitive to performance of familiar tasks, taking into consideration client adaptation to exigencies.
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