Articles: pandemics.
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The threat of the H5N1-influenza virus prompts reflection on COVID-19 pandemic experiences. This paper integrates insights from a first responder using the Cynefin framework to advocate for an adaptive strategic approach to future pandemics. Balancing individual freedoms with containment measures serves to leverage the human capital needed for rapid learning and resource distribution. ⋯ Both operate within scale free human systems which must adapt to existential challenges such as pandemics. Experience leading to knowledge and understanding occurs simultaneously at all dimensions of human existence. Ultimately, adaptive leadership and decentralized decision-making, supported by the best available knowledge, enable effective pandemic management and restoration of normal societal functions.
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Anesthesia and analgesia · Jan 2025
The Association of the Coronavirus Disease-2019 Pandemic With Disparities in Maternal Outcomes.
In the United States, Black and Hispanic patients have substantially worse maternal outcomes than non-Hispanic White patients. The goals of this study were to evaluate the association between the coronavirus disease-2019 (COVID-19) pandemic and maternal outcomes, and whether Black and Hispanic patients were disproportionately affected by the pandemic compared to White patients. ⋯ In this national study of 2.5 million deliveries in the United States, the COVID-19 pandemic was associated with increases in maternal mortality and failure-to-rescue but not in severe maternal morbidity or cesarean deliveries. While the pandemic did not exacerbate disparities for Black and Hispanic patients with private or Medicaid insurance, uninsured Black patients experienced greater increases in mortality and failure-to-rescue compared to insured White patients.
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Future military conflicts are likely to involve peer or near-peer adversaries in large-scale combat operations, leading to casualty rates not seen since World War II. Casualty volume, combined with anticipated disruptions in medical evacuation, will create resource-limited environments that challenge medical responders to make complex, repetitive triage decisions. Similarly, pandemics, mass casualty incidents, and natural disasters strain civilian health care providers, increasing their risk for exhaustion, burnout, and moral injury. ⋯ These systems may help address both the anticipated scale of casualties in large-scale combat operations and the critical expertise gaps during future pandemics, mass casualty events, and natural disasters. This study advocates for urgent research at the intersection of high-stress, resource-limited care contexts that may cause moral injury in health care providers and the potential for AIDeSS to reduce that risk. Understanding these dynamics may yield strategies to mitigate psychological distress in medical responders, increase patient survival, and improve the health of our medical systems.
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Human milk is associated with positive short- and long-term health outcomes. Women's choice to breastfeed is influenced by personal, social, health, and economic factors. The COVID-19 pandemic impacted health care delivery, non-emergent health care services, and family lifestyles, primarily in the early months of 2020. The aim of this study was to determine if breastfeeding initiation rates differed during a global pandemic among women in the military health care system. ⋯ Overall breastfeeding initiation rates did not differ during the COVID-19 pandemic when rates in 2020 were compared to those in the year prior. Race, birth method, parity, and gestational age were associated with breastfeeding initiation rates in women cared for at military centers.