Engagement to collaboration ensures success.

Disruption to our daily business and functional lives is becoming more frequent, complex and costly. As leaders, what do we do with what we know, the support and tools we have, and our knowledge regarding the resources we need to acquire to navigate this disrupted world? One thing is clear: no one can do it alone. This is not a new concept - the ancient Greeks understood the power of the group. This paper argues that collaboration is the key to amplified knowledge, ability, energy, foresight and innovation, as there is obvious synergy when individuals, groups or organisations join together in a shared vision and with a dedicated purpose. This paper describes a process model developed by the Mid-Atlantic Center for Emergency Management & Public Safety to transform operational functions and spark quality engagement, the synergy of ideas and outcomes, and enhanced sustainability of purpose. This model uses a blend of new knowledge and experiences to build on collaboration models of the past, and has proven to be a success.

As the field of emergency management evolves, is it time to enhance its training methods?

Each year, millions of individuals participate in emergency management training courses. Training opportunities are plentiful and offered by a variety of governmental, public and private providers, in a variety of locations and teaching environments, using a multitude of different topics, styles and methodologies. Training opportunities are vast and often designed to support a broad audience of learners, including those seeking to attain new skills as well as those seeking to retrain or change career. Yet, despite the abundant opportunities for training, including education, instruction, exercises and drills (including training on how to train), in the period following the activation of the emergency operations centre, when the time has come to implement the tools and actions taught, there remain problems. With all this training available, what exactly are workers learning and what are they forgetting? This paper will look at the need for an evolution in traditional emergency management training methods, such as what is working, what is not working, and how methods could evolve to enhance training engagement, increase knowledge retention, and improve worker performance.

Retinal function assessment of trypan blue versus indocyanine green assisted internal limiting membrane peeling during macular hole surgery.

OBJECTIVE: To compare multifocal electroretinography (mfERG) retinal function and the anatomical and visual outcomes of macular hole surgery performed with indocyanine green (ICG) or trypan blue (TB). DESIGN: Prospective, randomized study. PARTICIPANTS: Twenty-five eyes of 24 patients. METHODS: Patients underwent a pars plana vitrectomy with removal of the internal limiting membrane. In 14 eyes, internal limiting membrane visualization during macular hole repair was performed using TB, and ICG was used in 11 eyes. The examination protocol (performed before surgery and at 3 weeks, 3 months, 6 months, and 12 months after surgery) included optical coherence tomography, mfERG (mfERG-103 hexagons), and assessment of best corrected visual acuity (BCVA) and contrast sensitivity (CS). RESULTS: Closure of macular hole was achieved in 100% of the cases. In the TB group, P1 amplitude and implicit time improved significantly at 12 months after surgery (P < 0.05), whereas in the ICG group, significant improvement occurred at both 6 (P < 0.05) and 12 months (P < 0.01). BCVA improved significantly in both groups at 6 and 12 months (P < 0.01). Both groups also showed a statistically significant CS improvement at spatial frequency of 6 cycles per degree (P = 0.01) 1 year postoperatively. At 12 months, improvement of P1 amplitude and implicit time, BCVA, and CS was not different between groups. CONCLUSIONS: In this study, the use of TB or ICG appears to yield similar improvement in terms of BCVA, CS, and mfERG amplitude and implicit time changes at 12 months.