Newark Trust for Education

Resilience is deeper than maintaining a company’s operations and services in the face of significant disruptions. It is the ability of a business to withstand, pivot and continue to grow in the face of a significant threat. To achieve resilience, companies must have an integrated, end-to-end understanding of how a specific threat magnifies the risks identified on their risk register, and what measures are needed across the enterprise to address the amplification of those risks. This paper details how the need for a holistic approach is especially important for cyber crises, compared with other types of crises, because they tend to have more broad-ranging impacts and complexities, such as: unclear timelines, lack of public empathy, unpredictable human threat actor(s), as well as a broader set of internal and external stakeholders that need to be engaged. Unlike other crises, cyber crises have the potential to magnify most — if not all — of the risks on the risk register. As such, cyber resilience requires ensuring that key stakeholders, whether shareholders, customers, regulators, business partners, employees, etc, stay resolute in their faith in a company and its leadership’s ability to navigate the increasingly complex issues related to cyber risks and how these issues are addressed enterprise-wide, not purely seen through the lens of technical or operational resilience. To achieve cyber resilience, organisations must develop and implement programmes that integrate both the technical and the broader business measures needed to limit fallout, demonstrate leadership through cyber crises, and deepen trust regardless of the potential severity of the impact.

Lynn S. Muller, JD, BA-HCM, RN, CCM, is currently a practicing Attorney and the managing partner of Muller & Muller. Her practice includes defense of health care professionals before the state licensing boards, case management litigation, family law, wills, trusts, and estates, as well as consulting representation of medical practitioners, facilities. She began her career at Pace University as a Registered Professional Nurse (RN), and went onto to earn her Bachelor of Arts Degree in Health Care Management at St. Peter's University of New Jersey and then her Juris Doctor from Quinnipiac University School of Law. She is a popular and sought-after keynote and session speaker at national and regional conferences. She is the Contributing Editor of Professional Case Management: The Official Journal of the Case Management Society of America (CMSA), she is a former member of the Board of Directors of CMSA of New York City. She is an adjunct Professor at Saint Peter's University School of Nursing in the MSN and (former) DNP Programs. She is the author of more than 80 articles in nursing and case management journals and listed on the NIH website. She is a contributor to the 2016 CMSA Standards of Practice and CMSA Career & Knowledge Pathways. She is the author of both legal chapters of the third edition of Case Management: A Practical Guide for Education and Practice and third edition of the CMSA Core Curriculum for Case Management. She is a former Commissioner for the Commission for Case Management Certification (CCMC), where she now serves on the Professional Development and Education Committee, is a Certified Facilitator for CCM CERTIFCATION 360 a Multiday Immersion Program and other special projects. She is a contributor to the CCMC Case Management Body of Knowledge (CMBOK) and a past President of the New Jersey Chapter of CMSA. She is the former Director of Social Services for the Borough of Bergenfield, New Jersey, a community-based case management program she developed and initiated. She has also served her community as public defender, municipal court judge, councilwoman, and chaired the Borough's Barrier Free Committee. Address correspondence to Lynn S. Muller, JD, BA-HCM, RN, CCM, Muller & Muller, P.O. Box 164, Bergenfield, NJ 07621 ([email protected]). Do you have a question or issue you would like addressed here? Questions are always welcome. We encourage ALL readers to submit questions and/or manuscripts, as well as topics you would like to see addressed in this department. Questions and other inquiries are accepted by e-mail at: [email protected]. If you have an idea you would like to discuss, send your contact information by e-mail and you will be contacted via your preferred method. The author reports no conflicts of interest.

The impact of anesthetic technique on perioperative outcomes remains controversial. We studied a large national sample of primary joint arthroplasty recipients and hypothesized that neuraxial anesthesia favorably influences perioperative outcomes. Data from approximately 400 hospitals between 2006 and 2010 were accessed. Patients who underwent primary hip or knee arthroplasty were identified and subgrouped by anesthesia technique: general, neuraxial, and combined neuraxial-general. Demographics, postoperative complications, 30-day mortality, length of stay, and patient cost were analyzed and compared. Multivariable analyses were conducted to identify the independent impact of choice of anesthetic on outcomes. Of 528,495 entries of patients undergoing primary hip or knee arthroplasty, information on anesthesia type was available for 382,236 (71.4%) records. Eleven percent were performed under neuraxial, 14.2% under combined neuraxial-general, and 74.8% under general anesthesia. Average age and comorbidity burden differed modestly between groups. When neuraxial anesthesia was used, 30-day mortality was significantly lower (0.10, 0.10, and 0.18%; P < 0.001), as was the incidence of prolonged (>75th percentile) length of stay, increased cost, and in-hospital complications. In the multivariable regression, neuraxial anesthesia was associated with the most favorable complication risk profile. Thirty-day mortality remained significantly higher in the general compared with the neuraxial or neuraxial-general group for total knee arthroplasty (adjusted odds ratio [OR] of 1.83, 95% CI 1.08-3.1, P = 0.02; OR of 1.70, 95% CI 1.06-2.74, P = 0.02, respectively). The utilization of neuraxial versus general anesthesia for primary joint arthroplasty is associated with superior perioperative outcomes. More research is needed to study potential mechanisms for these findings.

As public libraries are becoming e-government access points relied on by both patrons and government agencies, it is important for libraries to consider the implications of these roles. While providing e-government access serves to reinforce the tremendously important role of public libraries in the United States social infrastructure, it also creates new demands on libraries and opens up significant new opportunities. Drawing upon several different strands of research, this paper examines the nexus of public libraries, values, trust, and e-government, focusing on the ways in which the values of librarianship and the trust that communities place in their public libraries reinforce the role of public libraries in the provision of e-government. The unique values embraced by public libraries have not only shaped the missions of libraries, they have influenced popular opinion surrounding public libraries and fostered the confidence that communities place in them as a source of trusted information and assistance in finding information. As public libraries have embraced the provision of Internet access, these values and trust have become intertwined with their new social role as a public access point for e-government both in normal information activities and in the most extreme circumstances. This paper explores the intersections of these issues and the relation of the vital e-government role of public libraries to library funding, public policy, library and information science education, and research initiatives.

Effective management of environmental hazards requires knowledge of both physical environmental systems and the psychosocial processes affecting responses to environmental conditions. This journal issue focuses on understanding individual and social group responses to environmental hazards. This article suggests that hazard managers and others are often perplexed by the diversity of people's conclusions about environmental hazards because they adopt an objectivist perspective, which views risk only as a physical characteristic. The constructivist perspective adopted by the social sciences holds that risk assessment reflects human judgments, which are influenced by various psychological and social factors reviewed herein. We conclude that the effective management of many environmental hazards depends on reconciliation of the objectivist and constructivist perspectives. This can be accomplished by recognizing that risk communication, the exchange of information and opinions about hazards, should integrate technical information about hazards with the interests and values of affected parties including the public, in order to develop common solutions to environmental problems.