Managing Pandemic Threats-The Need for Adaptive Leadership.

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.

Every problem is embedded in a greater whole.

Peter Drucker pointed out an important distinction between 'doing things right' and 'doing the right thing', which recognised that all problems are embedded in a context and thus can only be understood within their unique contextual setting. Contemporary research practices in clinical medicine often regards contextual factors as potential confounders that will bias effect estimates and thus must be avoided. However rigorous, research devoid of context ultimately deprives users of understanding of the support factors that make research transferable to policy decisions or managing care of individual patients-it stands in the way of 'doing the right thing' in 'real life' settings.

The Clinical Role of Heart Rate Variability Assessment in Cognitively Impaired Patients and Its Applicability in Community Care Settings: A Systematic Review of the Literature.

Heart rate variability (HRV) correlates well with a person's overall physiological function. Clinically, HRV is successfully used in acute care to identify impending infections, but little is known about its potential in the management of chronic diseases like cognitive decline/dementia. The aim of this study was to identify the best available knowledge about HRV in cognitively impaired populations that might be applied to improve clinical practice in community settings.