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The uncertainty of climate change is a significant challenge prompting Australian farmers to create different thinking and different management systems that ensure sustained farm business viability and continuity, particularly in extreme environments. The purpose of this study was to explore the conditions and adaptive processes for managing farm resilience and cyclic adaptation pathways, in response to climate change. A positive deviance sample of farmers was interviewed, and data was collected from a cohort of twenty-two climate change innovators across Eastern Australia. Grounded theory analysis of data identified three processes and two transactional maps of climate change adaptation, in this under studied farmer cohort. The development of the transactional maps found the resilience and preparedness processes as adaptive learning responses to the stressors of climate change. The processes of managing the business and resources were identified as markers of preparedness and resilience that ensured business viability and continuity. Farmers prepared for climate change through transforming make-over processes as an adaptive learning response to climate challenges. Mapping the cycle of adaptation identified the processes of socio-cognitive agency, learning from feedback and consequences, and contextual variables as critical elements of adaptation. The intervening socio-ecological processes of intelligence gathering and influencing, and socio-cognitive precursors, were found to regulate the adaptation cycle. The cycle was found to have both incremental and transformative transmission processes, and intervening processes of climate and contextual variables. The changing patterns and extremes of climate change were found to impact the growing season, and its potential, as unique variables that demand farm adaptation. Ultimately, this study identified potential points of influence for leveraging preparedness behaviours., (© 2023. The Author(s).)

In the absence of a vaccine, nonpharmaceutical interventions such as social distancing and travel reductions were the only strategies for slowing the spread of the COVID-19 pandemic. Using survey data from Hawaii ( n  = 22,200) collected in March through May of 2020 at the onset of the pandemic, the differences between traveler spreaders who brought the disease into the state and community spreaders were investigated. In addition to describing the demographic attributes and comparing them with attributes of those who were vulnerable to COVID-19, logit models explaining travel behaviors were developed and tested. Traveler spreaders were likely to be male, younger, and returning students. Community spreaders were more likely to be male, essential workers, first responders, and medical personnel at the highest risk of exposure. Using spatial statistics, clusters and hotspot locations of high-risk individuals were mapped. As transportation researchers are in a position to combine their critical analytical capabilities and experience with relevant databases on mobility and the spread of infectious diseases, this analysis could support efforts to respond to and slow the spread of the pandemic., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© National Academy of Sciences: Transportation Research Board 2021.)

Earthquake early warning (EEW) is becoming a popular tool for mitigating earthquake-induced losses. However, the current literature separates EEW technical components and their operational and behavioural implications. This paper investigates how EEW can be integrated into business continuity practices, organisational resilience, and disaster risk reduction (DRR). A mixed methods approach is applied to analyse EEW perceptions in the case-study context of Mexico City, Mexico, which is characterised by a high level of seismic hazard and social and physical exposure/vulnerability. The dataset includes evidence from 15 semi-structured interviews with representatives of the public and private sectors, such as governments and enterprises, and 78 valid questionnaires compiled by local organisations, including civil protection and education institutions. The results reveal inconsistencies between technical EEW methodologies and their integration into three core domains of organisational practice: accountability, governance, and jurisdiction; standardisation of plans and procedures; training and education. Finally, open challenges for future research are highlighted., (© 2022 The Authors Disasters © 2022 ODI.)

The COVID-19 pandemic has created significant challenges but also unprecedented opportunities for transportation researchers and practitioners. In this article, the major lessons and gaps in knowledge for those working in the transportation sector are identified, including the following: (1) integration between public health and transportation; (2) technology to support contact tracing and tracking of travelers; (3) focus on vulnerable, at-risk operators, patrons, and underserved members of society; (4) re-engineering of travel demand models to support social distancing, quarantine, and public health interventions; (5) challenges with Big Data and information technologies; (6) trust relationships between the general public, government, private sector, and others in disaster management; (7) conflict management during disasters; (8) complexities of transdisciplinary knowledge and engagement; (9) demands for training and education; and (10) transformative change to support community resilience. With a focus on transportation planning and community resilience, the lessons from the pandemic need to be shared and customized for different systems, services, modalities, and users. While many of the interventions during the pandemic have been based on public health, the management, response, recovery, adaptation, and transformation of transportation systems resulting from the crisis require multi-disciplinary, multi-jurisdictional communications and coordination, and resource sharing. Further research to support knowledge to action is needed., Competing Interests: The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© National Academy of Sciences: Transportation Research Board 2022.)

This paper estimates the impact of public guarantees on crisis predictive indicators among small and mid-size enterprises (SMEs). We use a confidential database provided by the Italian Ministry of Economic Development on the universe of guarantees granted by the Central Guarantee Fund. We apply difference-in-difference regressions and propensity-score matching estimators to a sample of approximately 40,000 SMEs over the 2010-2018 period. We find that obtaining a public guarantee improves profitability both in the short- and medium-term. On the other hand, SMEs' financial health worsens in the short run, but financial burdens are alleviated 2 years after the issuance of a guarantee. The economic and financial effects of government-backed loans are amplified for micro-sized firms, companies operating in the service sector and direct guarantees. Our results can thus support public authorities in designing credit guarantee schemes capable of preventing SMEs' zombification and protecting them from the risk of debt overhang., Competing Interests: Competing interestsThe authors declare no competing interests., (© The Author(s) 2023.)

Background: While African Swine Fever (ASF) virus has historically circulated in wild pigs and in Ornithodoros ticks in parts of South Africa, the virus has spread among domestic pigs throughout the country since 2019. South Africa's compartment system has been used as a mainstay approach to protecting the swine industry in the face of ASF. However, in 2020, two compartments broke down with ASF. The objectives of this study are to investigate the drivers for ASF introduction into the compartments, to categorize compartments by risk of ASF introduction, and to make corresponding recommendations. The relevance of risk factors for ASF introduction for each compartment were investigated among veterinarians and farm managers. The analysis of risk factors weighted according to an expert elicitation were used to categorize compartments into risk levels., Results: Drivers of disease related to human behaviors and to domestic pig management are perceived by farm managers and veterinarians of the compartments to be critical for ASF introduction into compartments in South Africa. Twenty-four units were categorized as high risk, forty-seven as medium risk, and twenty-four as low risk. "Insufficient boot and clothing biosecurity by animal health personnel" was identified as a relevant risk factor in all high risk units. Other prominent risk factors were "insufficient boot and clothing biosecurity by external people," "underreporting of suspect ASF cases," "improper hunting/ culling of wild suids inside the compartment," "un-tested introductions into the herd," and "entry and contact with free-roaming pigs." The roles of wild pigs and competent vectors are considered minimal. There is a need for revision of the compartment standards and training of compartment personnel on the standards. The major gaps identified in the standards were absence of a monitoring programme to assess biosecurity implementation and suboptimal surveillance testing and audit strategies., Conclusions: The results of our study confirm that ASF is increasingly an anthropogenic problem. Updating the compartment standards and addressing gaps in the knowledge of compartment personnel on ASF are most critical. To enhance compliance with biosecurity measures and thus control the disease, close engagement with all stakeholders linked to the compartments is needed., (© 2022. The Author(s).)

Business Continuity Management (BCM) encompasses effective planning to respond to business interruptions and relaunch business in the short term. This study follows the Design Science Research methodology and proposes a framework to systematise Business Continuity Management and streamline the Business Continuity Plan (BCP) design and implementation. The framework defines metrics providing strategical guidance and assessment of the Business Continuity Management initiatives. The framework provides a Business Continuity Management Model, an Implementation Guide, a Self-Assessment System, and a Measurement System. The model was developed based on a systematic literature review and guidelines from Business Continuity Management frameworks and standards. In the first iteration, we demonstrated and evaluated the framework through a Focus Group with experts in Business Continuity Management. In the second iteration, it was used and evaluated by professionals with responsibilities in Business Continuity Plan implementation, representing various business sectors. As a result, the framework is useful and complete, effective and enhances governance and is scalable and adaptable to organisations. This study concludes that the framework adds value to Business Continuity Management monitoring, gaps identification, and practitioner's guidance on what needs to be planned, done, checked and acted to manage continuity., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s).)

Purpose: The COVID-19 pandemic poses an unprecedented threat to global business relationships and dynamics. The pharmacovigilance function of pharmaceutical companies is particularly susceptible to changing external pressures because of its highly structured compliance activities. We conducted an industry-wide survey to provide insights on how the pharmacovigilance function responded to the challenges posed by the pandemic. We compared smaller companies and larger companies regarding impact on portfolios and operational activity metrics., Methods: We conducted a survey through the Navitas Life Science annual benchmark of pvnet TM , a network of large enterprise (LE) companies, and pvconnect TM , a network of small and medium enterprise (SME) companies, using an online surveying tool during the first quarter of 2021. We collected information on pharmacovigilance activities, including quantitative measures of workload, costs, and key performance indicators, and qualitative data on the effects of the pandemic on product portfolios and operations., Findings: Survey questions were posed to LE (pvnet) network members (n = 12) and SME (pvconnect) network members (n = 18) for the period from January 1 through December 31, 2020. The date of data collection was March 26, 2021. Descriptive median values of parameter metrics included the following: revenue ($28.4 billion for LE companies and $1.6 billion for SME companies), number of products (127 for LE companies and 19 for SME companies), and volume of individual case safety reports (391,000 for LE companies and 13,000 for SME companies). SME companies reported a greater impact on 2 survey categories, remote working and employee well-being, than did LE companies. However, LE companies reported a greater impact than did SME companies on all other survey categories: effect on strategic priorities, shift in product focus, workload changes, changes in sourcing model, effect on case reporting compliance, effect on business continuity, changes in pharmacovigilance technology strategy, impact of interactions with health authorities, effect on resource capacity, and impact on recruitment., Implications: Four major themes emerge from this survey: (1) shift to remote working, (2) recognition of the impact on employee well-being, (3) shift in strategic priorities, and (4) newly recognized aspects of risk mitigation. The COVID-19 pandemic has had a marked effect on every aspect of pharmaceutical companies' pharmacovigilance functions, although the effects appear to be different for LE companies than for SME companies., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: The Indian government announced a nationwide lockdown as a preventive measure to control the prevailing COVID-19 pandemic. This survey was developed and conducted to assess the impact of lockdown on Indian optometry practice., Methods: A survey questionnaire was designed and circulated across the optometrists practicing in India through multiple social media platforms. All the data were extracted and only valid response were analyzed and reported., Results: A total of 691 optometrists participated in the survey. Most of the participants (22.25%) were in private practice followed by academics (14.89%). Among the valid responses collected, it was found that 43.37% of the respondents were consulting patients during the lockdown. Of these, 27.17% of optometrists were examining infectious cases and 48.68% were examining all the patients who came for consultation. Approximately 50.94% of the participated optometrist had begun telephonic/e‑mail/video consultations. In addition, 64.48% reported that optometrists were at an equal risk of clinching COVID‑19 on comparison with other domains during patient examination. Nearly 30.44% respondents felt that optometrists would face challenges in approaching the patient post COVID-19 considering the close working distance., Conclusion: A proportion of optometrist have switched to some form of teleconsultation in order to aid patients during this prevailing pandemic. Regulatory bodies should issue appropriate guidelines regarding the safe optometry practice for the betterment of both patient and practitioners during face-to-face consultation., (Copyright © 2020 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.)

Business continuity in disruptions like the COVID-19 pandemic involves sustainable supply chain management (SSCM) with limited resources and risks for the well-being and prosperity of stakeholders and customers involved with limited environmental effects. The purpose of the paper is to outline enablers in customer engagement that supports SSCM in times of disruption like the COVID-19 pandemic. This research uses an extensive literature review followed by academic and industry practitioners' opinions to identify customer engagement enablers in SSCM for business continuity. Hybrid stepwise weight assessment ratio analysis (SWARA) and rough set numbers rank customer engagement enablers that support SSCM in disruption. The research builds on stakeholder theory and the sustainability framework for economic performance through non-economic aspects. The research concludes that the focus on agility for target customers through collaboration and information sharing in SSCM will support business continuity. It shall support decision-making in the supply chain in uncertainties. Engagement with stakeholders leads to focused execution in response to customer demand through faster communication and crucial information sharing, thus eliminating bottlenecks for business continuity., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Anchored in the COVID-19 context, this research seeks to examine the role of business continuity practices in improving both disaster readiness and business performance. A survey of 322 French firms was conducted and data were analyzed using structural equation modelling. The findings corroborate the postulates of resource-based view and organizational information processing theories regarding business continuity practices in COVID-19 context. Firms that improve their disaster readiness ( B .243; p-value=.008**) and their business continuity practices ( = =.173; p-value=.038*) are more capable of enhancing their performance. The findings raise some questions regarding the validity of the preexisting knowledge on business continuity and disaster readiness in the context of COVID-19.B =.173; p-value=.038*) are more capable of enhancing their performance. The findings raise some questions regarding the validity of the preexisting knowledge on business continuity and disaster readiness in the context of COVID-19., (© 2019, IFAC (International Federation of Automatic Control) Hosting by Elsevier Ltd.)

The COVID-19 pandemic has had and is having devastating effects on the health of the population, but also on the economic health of companies and their supply chains. The old paradigms of the commercial and industrial world have been inevitably disrupted: global supply chains have shifted from a system based on efficiency to one oriented towards resilience. Business continuity has become a key activity to be considered in all business processes. Nevertheless, specific studies to train highly qualified professionals in Business Continuity are rare. Therefore, this paper suggests the topics and subjects to be included in a university educational programme proposal to train business continuity managers. This proposal can contribute into building digital education readiness supporting the business continuity manager training, as one of the most important weapons of responsiveness, adaptability, and flexibility to provide companies resilience during next black swan events., (© 2019, IFAC (International Federation of Automatic Control) Hosting by Elsevier Ltd.)

The COVID-19 pandemic crisis has fundamentally changed the way we live and work forever. The business sector is forecasting and formulating different scenarios associated with the impact of the pandemic on its employees, customers, and suppliers. Various business retrieval models are under construction to cope with life after the COVID-19 Pandemic Crisis. However, the proposed plans and scenarios are static and cannot address the dynamic pandemic changes worldwide. They also have not considered the peripheral in-between scenarios to propel the shifting paradigm of businesses from the existing condition to the new one. Furthermore, the scenario drivers in the current studies are generally centered on the economic aspects of the pandemic with little attention to the social facets. This study aims to fill this gap by proposing scenario planning and analytics to study the impact of the Coronavirus pandemic on large-scale information technology-led Companies. The primary and peripheral scenarios are constructed based on a balanced set of business continuity and employee health drivers. Practical action plans are formulated for each scenario to devise plausible responses. Finally, a damage management framework is developed to cope with the mental disorders of the employees amid the disease., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Author(s).)

The COVID-19 emergency has urged companies to operate in new ways to face supply chain interruptions, shifts in customer demand, and risks to workforce health. The organizational ability to respond to critical contingencies is crucial for business leaders in the perspective of continuing business. In our research, we investigate the actions undertaken by 50 world-leading corporations to respond to the pandemic. Applying content analysis to web pages and social network posts, we extract 77 actions related to 13 sub-areas and integrate these into a five-level framework that encompasses operations, customer, workforce, leadership, and community-related responses. We also describe six illustrative company examples of how the emergency can generate opportunities for creating new value. The study advances the scholarly discussion on the impact of emergencies on business continuity and can help leaders define response strategies and actions in the current challenge., (© 2021 Kelley School of Business, Indiana University. Published by Elsevier Inc.)

The COVID-19 pandemic has delivered one of the worst economic shocks in modern history and the hospitality sector has been severely affected. Since small businesses from the hospitality sector are known to be relatively more susceptible to the economic complications arising from a crisis, we explore the underlying factors and management practices that influence their continuity of operations as they continue to struggle with the on-going COVID-19 crisis in Pakistan. Using a phenomenological approach, in-depth interviews were conducted to comprehend the experiences of owners-managers. The findings show that government support, cordial relationships with stakeholders, self-determination of entrepreneurs and formal planning are the most crucial factors that shaped the immediate adjustments of operational activities in response to COVID-19. These resilient practices are hygiene concerns, increased promotion through social media, innovative marketing practices (e.g., revised offerings), operational cost-cutting and employee training to comply with changing standard operating procedures from the government and industry. The practical and theoretical implications are also discussed., (© 2021 Elsevier Ltd. All rights reserved.)

Among the many repercussions of the COVID-19 emergency to be assessed, those on critical infrastructures and the associated businesses and professions are certainly important ones. In this paper, we document the conception, implementation and outcome of a survey organized by European Commission's Joint Research Centre and entitled "COVID-19: Emergency & Business Continuity" . This was conducted in April-May 2020 with the participation of critical infrastructure experts (including professionals from the academia and research institutions, infrastructure operators and industry representatives, public authorities and members of security agencies), involved as stakeholders in the European Reference Network for Critical Infrastructure Protection (ERNCIP). Themes explored through this study include an assessment of the business continuity status and the evaluation of emergency management and disaster recovery aspects, as experienced from the perspective of different sectors, organization types and personal perceptions of the respondents., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Authors.)

Infectious diseases at work can be endemic such as seasonal influenza and emerging such as the novel coronavirus 2019. Infectious diseases have an impact on employees and other types of workers. Compensation and benefits professionals are often at the forefront of preventing workplace infections, addressing workplace infections, and ensuring the continuity of talent when workplace outbreaks and business shutdowns occur. This article provides an overview of pertinent laws, key compensation decisions, and ways to refocus existing benefit programs to meet the challenge of not only just safety, health, and wellness but also infection prevention and control., (© The Author(s) 2020.)

In this paper we reflect on a number of IT related challenges during the COVID19 pandemic, primarily from a CIO and IT professionals perspective. We consider three time periods, namely the period before the pandemic, the response to the pandemic and the period after it. For each period we discuss the key challenges that practitioners faced and outline important areas to consider for the future. Hopefully, the lessons learnt and the experiences gained will positively inform future academic research and practice., (© 2020 Elsevier Ltd. All rights reserved.)

Scholars have highlighted the role of Digital Technologies (DT) in enhancing productivity and performance in Small and Medium Enterprises (SMEs). However, there is limited evidence on the use of DT for dealing with the consequences of extreme events, such as COVID-19. We discuss this gap by (i) outlining potential research avenues and (ii) reflecting on the managerial implications of using DT within SMEs to deal with the repercussions of COVID-19 and securing business continuity., (Crown Copyright © 2020 Published by Elsevier Ltd. All rights reserved.)

Emergency managers (EMs) and Emergency Social Services Directors (ESSDs) are essential service providers who fulfill critical roles in disaster risk reduction. Despite being positioned throughout all levels of government, and in the private sector, EMs and ESSDs fulfill roles which occur largely behind the scenes. The purpose of this phenomenological study was to explore the roles of EMs and ESSDs from different regions across Canada. Specifically, we wanted to understand their perceptions of barriers, vulnerabilities and capabilities within the context of their roles. EMs (n = 15) and ESSDs (n = 6) from six Canadian provinces participated in semi-structured telephone interviews. Through content analysis, five themes and one model were generated from the data: 1) Emergency management is not synonymous with first response, 2) Unrealistic expectations for a "side-of-desk" role, 3) Minding the gap between academia and practice with a 'whole-society' approach, 4) Personal preparedness tends to be weak, 5) Behind the scenes roles can have mental health implications. We present a model, based on these themes, which makes explicit the occupational risks that EMs and ESSDs may encounter in carrying out the skills, tasks, and roles of their jobs. Identification of occupational risks is a first step towards reducing vulnerabilities and supporting capability. This is particularly relevant in our current society as increased demands placed on these professionals coincides with the increasing frequency and severity of natural disasters due to climate change and the emergence of the world wide COVID-19 pandemic., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 Elsevier Ltd. All rights reserved.)

Pandemics, earthquakes, fire, war, and other disasters place universities at risk. Disasters can disrupt learning and teaching (L&T) for weeks to months or longer. Some institutions have developed business continuity plans to protect key organisational services and structures, allowing L&T to continue. However, little research touches on how academics, learners, and communities of practice might respond before, during, and after disasters and how their resilience to disruption can be fostered to reduce impacts on L&T. In this research, we investigated academics' perceptions of building resilience to major L&T disruptions in the New Zealand context. Specifically, we explored how academics characterise a resilient academic and institution, and identified the benefits, barriers, and incentives to building resilience. We used a pragmatic theoretical approach with a mixed methods methodology, to categorise the results within three distinct levels (individual, school/department, and institution), supporting the design and implementation of resilience-building strategies for academics and institutional leaders. We found that support, community, leadership, and planning at universities are critical in building and inhibiting resilience. Participants reported several 'high impact' incentives, addressing multiple barriers, that could be used to kick-start resilience. Online and flexible learning are key opportunities for resilience-building, but universities should not underestimate the importance of face-to-face interactions between staff and learners. Our results provide a strong starting point for practitioners and researchers aiming to understand how universities can foster resilience to major disruptions and disasters on university teaching., Competing Interests: There is no financial interest or benefit that has arisen from the direct applications of this research. There are no competing interests to declare. The researchers declare there are no personal relationships with people or organisations that could inappropriately influence this research., (© 2020 The Authors.)

Station staff may be at high risk for influenza due to high frequency contact with other people. We examined the risk of influenza by occupational group in a railway company. A retrospective observational study was conducted among employees at a branch office of a railway company in eastern Japan, located in a metropolitan area, for 2012/13, 2013/14, and 2014/15 influenza seasons. The study population included employees who had received influenza vaccination for the season in question and the previous season. Outcome was defined as self-reported influenza illness during the respective season, identified through the vaccine screening questionnaire in the following season. Study participants included employees whose outcome information could be obtained. Standardized morbidity ratios (SMRs) by occupational group (station staff, engineers, train crew) for each season were calculated. For 2012/13, 2013/14, and 2014/15 seasons, attack rates were 4.7% (19/403), 5.2% (21/407), and 7.8% (31/397), respectively. Among the participants, SMRs of station staff were lower in the 2012/13 (SMR = 57; 95% confidence intervals [CI] = 18-133) and 2014/15 (SMR = 75; 95%CI = 36-138) seasons and similar to other groups in the 2013/14 season. Enhanced countermeasures, regardless of occupational group, may be effective in preventing the spread of influenza infection.

The impact of the COVID-19 pandemic has been far-reaching and has profoundly affected the practice of otolaryngology in an unprecedented way. In this commentary, we draw from our experience in the first 90 days of the pandemic and discuss a set of workflow measures, personal protection equipment protocols, and strategic goals that can provide a safe environment for patients and staff to continue managing a significant proportion of patients in the otolaryngology service during the pandemic.

Businesses in urban areas have been required to accommodate stranded persons as temporary evacuation facilities during disasters. Regarding measures aimed at aiding stranded persons, aspects such as trust and the image of the business need to be considered. Therefore, in this study, a personnel training course was developed to smoothly take in stranded persons, and the outcomes of this training were evaluated by quizzes, entry sheets, and a questionnaire. This was a two-day and one-night course characterized by the use of role-play in which 20 participants experienced the series of processes that unfold during disasters, playing either the role of a stranded person or a facility member. This training included emergency food provision using real stockpiled food and accommodation training using actual bedding stored in a model facility. After the review, when the participants were taught the correct response for vulnerable people, their scores in the test regarding the points of caution in vulnerable people were significantly higher than those prior to the course, confirming that participants had acquired knowledge as a result. Furthermore, through training using real food and accommodation, the participants were able to understand victims' requirements by experiencing the need for satisfactory emergency rations and comfortable bedding., Competing Interests: The authors declare no conflict of interest. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

The coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented challenges to healthcare systems worldwide. Orthopaedic departments have adopted business continuity models and guidelines for essential and non-essential surgeries to preserve hospital resources as well as protect patients and staff. These guidelines broadly encompass reduction of ambulatory care with a move towards telemedicine, redeployment of orthopaedic surgeons/residents to the frontline battle against COVID-19, continuation of education and research through web-based means, and cancellation of non-essential elective procedures. However, if containment of COVID-19 community spread is achieved, resumption of elective orthopaedic procedures and transition plans to return to normalcy must be considered for orthopaedic departments. The COVID-19 pandemic also presents a moral dilemma to the orthopaedic surgeon considering elective procedures. What is the best treatment for our patients and how does the fear of COVID-19 influence the risk-benefit discussion during a pandemic? Surgeons must deliberate the fine balance between elective surgery for a patient's wellbeing versus risks to the operating team and utilization of precious hospital resources. Attrition of healthcare workers or Orthopaedic surgeons from restarting elective procedures prematurely or in an unsafe manner may render us ill-equipped to handle the second wave of infections. This highlights the need to develop effective screening protocols or preoperative COVID-19 testing before elective procedures in high-risk, elderly individuals with comorbidities. Alternatively, high-risk individuals should be postponed until the risk of nosocomial COVID-19 infection is minimal. In addition, given the higher mortality and perioperative morbidity of patients with COVID-19 undergoing surgery, the decision to operate must be carefully deliberated. As we ramp-up elective services and get "back to business" as orthopaedic surgeons, we have to be constantly mindful to proceed in a cautious and calibrated fashion, delivering the best care, while maintaining utmost vigilance to prevent the resurgence of COVID-19 during this critical transition period. Cite this article: Bone Joint Open 2020;1-6:222-228., (© 2020 Author(s) et al.)

Public and private actors with critical roles for ensuring societal safety need to work proactively to reduce risks and vulnerabilities. Traditionally, risk management activities have often been performed in order to ensure continuous functioning of key societal services. Recently, however, business continuity management (BCM), and its analytical subcomponent business impact assessment (BIA), has been introduced and used more extensively by both the private and public sector in order to increase the robustness and resilience of critical infrastructures and societal functions and services. BCM was originally developed in the business sector but has received a broader use during the last decade. Yet, BCM/BIA has gained limited attention in the scientific literature-especially when it comes to clarifying and developing its conceptual basis. First, this article examines and discusses the conceptual foundation of BCM concepts, including practical challenges of applying the concepts. Based on recent conceptual developments from the field of risk management, a developed conceptualization is suggested. Second, the article discusses challenges that arise when applying BCM in the societal safety area and provides some recommendations aiming to improve the clarity and quality of applications. Third, the article provides suggestions of how to integrate the overlapping approaches of BIA and risk assessment in order to improve efficiency and effectiveness of proactive, analytic processes. We hope that the article can stimulate a critical discussion about the key concepts of BCM, their wider use in societal safety, and their connection to other concepts and activities such as risk assessment., (© 2019 Society for Risk Analysis.)

Biobanking is a costly activity that manages valuable and sometimes irreplaceable specimens. These specimens must be managed and protected carefully as the loss of specimens can destroy years of research efforts, and potentially result in reputational damage to the institution. Therefore, risk management, mitigation, and disaster recovery plans must be in place for unexpected man-made or natural disaster events that will affect biobanking operations. In this chapter, we discuss the various aspects of disaster prevention, and recovery efforts during and after of a disaster event.

This article examines the contested area of the responsibility for destinations and tourists, within emergency settings. It incorporates a Delphi-Scenario technique to facilitate a structured discussion of emergency management for different destination stakeholders. The Delphi exercise engaged 123 senior international stakeholders, from 9 different industry sectors, across 34 countries to provide a global perspective. The study's principal focus is on the notion of emergency management, to identify the challenges that stakeholders would face within a disaster scenario. The exercise asked stakeholders to identify with whom the responsibility rests for 18 distinct disaster-related activities. The study proposes a responsibility allocation building-block framework that could help speed up the emergency management responses by "knowing who is going to do what" with a particular focus on dealing with international tourists as a community in a disaster zone., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

In the event of a foot-and-mouth disease (FMD) outbreak in the United States, local, state, and federal authorities will implement a foreign animal disease emergency response plan restricting the pork supply chain movements and likely disrupting the continuity of the swine industry business. To minimize disruptions of the food supply while providing an effective response in an outbreak, it is necessary to have proactive measures in place to ensure minimal disease spread and maximum continuation of business. Therefore, it is critical to identify candidate movements for proactive risk assessments: those that are both most likely to contribute to disease spread and most necessary for business continuity. To do this, experts from production, harvest, retail, and allied pork industries assessed 30 common pork supply movements for risk of disease spread and industry criticality. The highest priority movements for conducting a risk assessment included the movement of weaned pigs originating from multiple sow farm sources to an off-site nursery or wean to finish facility, the movement of employees or commercial crews, the movement of vaccination crews, the movement of dedicated livestock hauling trucks, and the movement of commercial crews such as manure haulers and feed trucks onto, off, or between sites. These critical movements, along with several others identified in this study, will provide an initial guide for prioritization of risk management efforts and resources to be better prepared in the event of a FMD outbreak in the United States. By specifically and proactively targeting movements that experts agree are likely to spread the disease and are critical to the continuity of business operations, potentially catastrophic consequences in the event of an outbreak can be limited.

Risk management decisions associated with live poultry movement during a highly pathogenic avian influenza (HPAI) outbreak should be carefully considered. Live turkey movements may pose a risk for disease spread. On the other hand, interruptions in scheduled movements can disrupt business continuity. The Secure Turkey Supply (STS) Plan was developed through an industry-government-academic collaboration to address business continuity concerns that might arise during a HPAI outbreak. STS stakeholders proposed outbreak response measure options that were evaluated through risk assessment. The developed approach relies on 1) diagnostic testing of two pooled samples of swabs taken from dead turkeys immediately before movement via the influenza A matrix gene real-time reverse transcriptase polymerase chain reaction (rRT-PCR) test; 2) enhanced biosecurity measures in combination with a premovement isolation period (PMIP), restricting movement onto the premises for a few days before movement to slaughter; and 3) incorporation of a distance factor from known infected flocks such that exposure via local area spread is unlikely. Daily exposure likelihood estimates from spatial kernels from past HPAI outbreaks were coupled with simulation models of disease spread and active surveillance to evaluate active surveillance protocol options that differ with respect to the number of swabs per pooled sample and the timing of the tests in relation to movement. Simulation model results indicate that active surveillance testing, in combination with strict biosecurity, substantially increased HPAI virus detection probability. When distance from a known infected flock was considered, the overall combined likelihood of moving an infected, undetected turkey flock to slaughter was predicted to be lower at 3 and 5 km. The analysis of different active surveillance protocol options is designed to incorporate flexibility into HPAI emergency response plans.

Progress in biomedical research is largely driven by improvements, innovations, and breakthroughs in technology, accelerating the research process, and an increasingly complex collaboration of both clinical and basic science. This increasing sophistication has driven the need for centralized shared resource cores ("cores") to serve the scientific community. From a biomedical research enterprise perspective, centralized resource cores are essential to increased scientific, operational, and cost effectiveness; however, the concentration of instrumentation and resources in the cores may render them highly vulnerable to damage from severe weather and other disasters. As such, protection of these assets and the ability to recover from a disaster is increasingly critical to the mission and success of the institution. Therefore, cores should develop and implement both disaster and business continuity plans and be an integral part of the institution's overall plans. Here we provide an overview of key elements required for core disaster and business continuity plans, guidance, and tools for developing these plans, and real-life lessons learned at a large research institution in the aftermath of Superstorm Sandy.

Background and Objectives: NHS Blood and Transplant (NHSBT) and the Australian Red Cross Blood Service (ARCBS) are national blood establishments providing blood components to England and North Wales, and Australia, respectively. In 2012, both services experienced potentially catastrophic challenges to key assets. NHSBT suffered a flood that closed the largest blood-manufacturing centre in Europe, whilst ARCBS experienced the failure of a data centre network switch that rendered the national blood management system inaccessible for 42 h. This paper describes both crisis events, including the immediate actions, recovery procedures and lessons learned., Materials and Methods: Both incidents triggered emergency response plans. These included hospital reprovisioning and recovery from the incident. Once normal services had been restored, both events were subjected to root cause analysis (RCA) and production of 'lessons learned' reports., Results: In both scenarios, the key enablers of rapid recovery were established emergency plans, clear leadership and the support of a flexible workforce. Product issues to hospitals were unaffected, and there were no abnormal trends in hospital complaints. RCA identified the importance of risk mitigations that require co-operation with external organizations. Reviews of both events identified opportunities to enhance business resilience through prior identification of external risks and improvements to contingency plans, for example by implementing mass messaging to staff and other stakeholders., Conclusions: Blood establishment emergency plans tend to focus on responding to mass casualty events. However, consolidation of manufacturing to fewer sites combined with a reliance on national IT systems increases the impact of loss of function. Blood services should develop business continuity plans which include prevention of such losses, and the maintenance of services and disaster recovery., (© 2014 International Society of Blood Transfusion.)

As well as providing a brief background of ISO 22301, this paper describes three practical uses of the standard, as well as ways to use the content to solve common challenges that business continuity professionals face every day.

An organisation's reputation is its most relevant asset. The perceptions of the various audiences with which an organisation interacts both directly and indirectly can enhance or destroy that reputation. Due to the critical role these audiences play in an organisation's reputation, they should be actively considered as a part of an organisation's reputation management strategy. This paper introduces the 360 analysis model, which considers the benefits, detriments and potential fallout in regard to different audiences when creating policy or making important organisational decisions. The model's goal is to foster well-considered policy and decisions that proactively protect an organisation's reputation. The model is also designed to be used as a research construct that can be utilised in the expansion of the reputation management literature in regard to heterogeneity and dynamics within and across audiences that can have an impact on an organisation's reputation.

Reports of health issues related to mass gatherings around the world have indicated a potential for public health and medical emergencies to occur on a scale that could place a significant impact on business continuity for national and international organisations. This paper describes a risk assessment process for business continuity management that was performed as part of the planning efforts related to the World Expo 2010 Shanghai China (Expo), the world's largest mass gathering to date. Altogether, 73 million visitors attended the Expo, generating over US$2bn of revenue. During 2008 to 2010, the Shanghai Municipal Center for Disease Control and Prevention performed a dynamic series of four disaster risk assessments before and during the Expo. The purpose of this assessment process was to identify, analyse and evaluate risks for public health security during different stages of the Expo. This paper describes an overview of the novel approach for this multiple and dynamic process of assessment of health security risk for ensuring business continuity.

Many major incidents have significant impacts on people's health, placing additional demands on health-care organisations. The main aim of this paper is to suggest a prioritised agenda for organisational and management research on emergency planning and management relevant to U.K. health care, based on a scoping study. A secondary aim is to enhance knowledge and understanding of health-care emergency planning among the wider research community, by highlighting key issues and perspectives on the subject and presenting a conceptual model. The study findings have much in common with those of previous U.S.-focused scoping reviews, and with a recent U.K.-based review, confirming the relative paucity of U.K.-based research. No individual research topic scored highly on all of the key measures identified, with communities and organisations appearing to differ about which topics are the most important. Four broad research priorities are suggested: the affected public; inter- and intra-organisational collaboration; preparing responders and their organisations; and prioritisation and decision making.

Business continuity planning often looks to preserving internal operations and focuses on customer retention as a marker for a successful outcome after a disaster. Building more resilient continuity plans also means planning for the survival of the community at large. As the national emphasis in the USA on 'whole community planning' becomes prominent guidance for emergency management planning, this paper examines the implications for businesses as members of the whole community and how they can increase their involvement in the whole community process. The paper will also discuss the impediments to and benefits of becoming a partner in planning for the community at large.

Physical dependencies are a fundamental consideration when assessing the resilience of an organisation and, ultimately, the resilience of a region. Every organisation needs specific resources for supporting its operations. A disruption in the supply of these resources can severely impact business continuity. It is important to characterise dependencies thoroughly when seeking to reduce the extent an organisation is directly affected by the missions, functions and operations of other organisations. The general protocol when addressing each critical resource is to determine the use for the resource, whether there are redundant services providing the resource, and what protections, backup equipment and arrangements are in place to maintain service. Finally, the criticality of the resource is determined by estimating the time it will take for the facility to experience a severe impact once primary service is lost and what percentage of facility operations can be maintained without backup service in place, as well as identifying whether any external regulations/policies are in place that require shutdown of the facility because of service disruption owing to lack of a critical resource. All of this information can be presented in the form of interactive dependency curves that help anticipate and manage the effect(s) of a disruption on critical resources supply.

Objectives: Continuity of operations planning focuses on an organization's ability to deliver essential services before, during and after an emergency. Public health leaders must make decisions based on information from many sources and their information needs are often facilitated or hindered by technology. The aim of this study is to provide a systematic review of studies of technology projects that address public health continuity of operations planning information needs and to discuss patterns, themes, and challenges to inform the design of public health continuity of operations information systems., Methods: To return a comprehensive results set in an under-explored area, we searched broadly in the Medline and EBSCOHost bibliographic databases using terms from prior work in public health emergency management and continuity of operations planning in other domains. In addition, we manually searched the citation lists of publications included for review., Results: A total of 320 publications were reviewed. Twenty studies were identified for inclusion (twelve risk assessment decision support tools, six network and communications-enabled decision support tools, one training tool and one dedicated video-conferencing tool). Levels of implementation for information systems in the included studies range from proposed frameworks to operational systems., Conclusion: There is a general lack of documented efforts in the scientific literature for technology projects about public health continuity of operations planning. Available information about operational information systems suggest inclusion of public health practitioners in the design process as a factor in system success.