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ER doctors: We’re no strangers to violence but we try to de-escalate without anyone dying

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Dr. Onyeka Otugo, Dr. Adaira Landry, Dr. Al’ai Alvarez and Dr. Italo Brown

As emergency medicine physicians of color, we are yelled at and called profane names. We have been spat on, pushed and kicked. One patient has landed a staff member in the ICU. A patient recently had a knife in his pocket. We have routinely experienced psychological and physical trauma. But we choose nonviolent de-escalation strategies — not just because they work but because they are humane.

We are disappointed at the inconsistent use of de-escalation strategies revealed by emerging footage of black men and women interacting with law enforcement. This lack of respect for humanity has led to the loss of countless lives of black men and women. We are distressed by the continued use of force despite literature supporting nonviolent de-escalation.

In emergency departments across the country, threats of intimidation, harassment and physical and emotional trauma are prevalent. There have been several documented cases of non-lethal and lethal violence in or around EDs. Patients have made threats to us, waited in nearby hospital facilities, and returned to the ED to harm hospital staff. According to 2015 data from the U.S. Department of Labor, the rate of violence in the health care workplace is higher than any other industry.

Agitated patients need safe handling

The ED staff, especially our nursing colleagues, frequently encounters workplace violence. In a survey of over 7,000 ED nurses, from May 2009 to January 2011,12% experienced some form of physical violence, while 55% experienced both verbal and physical abuse.  More recently, a 2018 poll showed 47% of Emergency Medicine physicians reporting physical assault at work, with 60% of responders reporting similar occurrences the previous year.

Physicians, nurses, technicians, and hospital security receive training to safely de-escalate agitated patients. The goal of crisis management is clear: employ verbal de-escalation primarily with physical restraint as the last resort. Nonviolent communication and similar conflict management strategies have been successful in mitigating severe levels of agitation commonly seen in the ED. Consequently, physician training programs and multidisciplinary teams have incorporated formal de-escalation training to ensure patient safety.

Training is necessary to manage our physiologic and behavioral reactions to perceived threats. As with any other responder, we experience fight or flight responses when our sense of safety is compromised. We must prioritize the safety of our patients and our team as our guiding principles even when we perceive violence or threat. Applying nonviolent communication is the first critical step in verbal de-escalation.

In Charlottesville, Virginia, in 2020.

When unsuccessful, physical restraints are employed. This process requires adhering to clear guidance in safe positioning. Prone positioning, or placing a patient on their chest, is not safe in agitated patients as it limits the movement of the chest wall and diaphragm, which may restrict breathing leading to asphyxiation. Finally, the use of sedative medications may be administered when all else fails.

I could have been George Floyd:I was beaten by police at 14, then stopped by my own officer when I was a police chief. We need change at all levels.

In all of these situations, we must maintain our primary responsibility for harm prevention in patients and staff. We understand and are grateful for our law enforcement officers who protect the community from violent, criminal behaviors. However, in none of our violent ED encounters do we use lethal control of the patient.

When viewing the footage of Mr. George Floyd, the overwhelming feelings of pain, trauma and anger emerge at the inappropriate use of force. Prone positioning and neck holds are known lethal forms of restraint. For 8 minutes and 46 seconds, Mr. Floyd suffered. In our profession, the words, “I can’t breathe” trigger rapid medical response. To neglect these words, as said by Mr. Floyd, while struggling in a prone position, goes beyond malpractice.

Our de-escalation tactics avoid death 

His plea went unacknowledged as the officer continued to exert his authority and force onto Mr. Floyd’s lifeless body. This was no accident. Mr. Floyd’s death was a consequence of racism and abuse of power. We must not harm patients in order to keep them or ourselves safe; once we do, we cross the line between being a physician and an assailant. Just like the police, we are not above the law.

Mr. Floyd deserved better. Our communities deserve more.

Inhumane:Lack of humanity makes justice system more dangerous for blacks long before cops interact

In medicine, many others share these sentiments. We acknowledge room for improvement regarding health disparities that disproportionately impact black patients. Like the criminal justice system, our health care system lacks equity — as evidenced by long-standing disparities in maternal care, management of pain and cardiac emergencies, and recently highlighted by the COVID-19 pandemic. And despite standardized training in de-escalation, racial bias exists in the management of agitated patients. Notwithstanding, there are no patient care algorithms that support the use of lethal force in restraining any patient.

We acknowledge the harm that law enforcement may face. However, as EM physicians, we are no strangers to violence. We care for agitated patients from all backgrounds. In order to treat every patient with dignity, we prioritize de-escalation strategies that avoid death.

While our roles and rate of risk differ, the communities that health professionals and members of law enforcement serve are the same. Through education and the sharing of effective strategies among pre-hospital services and law enforcement, we can promote a culture of nonviolent de-escalation. Most of all, we can champion accountability in safety, efficacy, compassion and humane care for our communities. In solidarity, we must.

Dr. Onyeka Otugo is an Emergency Medicine Health Policy Fellow, Brigham and Women’s Hospital, Harvard Medical School. Dr. Adaira Landry is Assistant Residency Program Director, Assistant Professor, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School. Dr. Al’ai Alvarez is Assistant Residency Program Director, Clinical Assistant Professor, Department of Emergency Medicine, Stanford School of Medicine. Dr. Italo Brown is a Social Emergency Medicine Fellow, Department of Emergency Medicine, Stanford School of Medicine. Follow them on Twitter: @OnyekaOtugo, @AdairaLandryMD, @alvarezzzy and @gr8vision

Source: http://rssfeeds.usatoday.com/~/627076802/0/usatoday-newstopstories~ER-doctors-Were-no-strangers-to-violence-but-we-try-to-deescalate-without-anyone-dying/

Publications

Security and Sustainability Forum-With Hazel Henderson and Claudine Schneider. 10/22/2020

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Steering Societies Beyond GDP to the SDGs

With Hazel Henderson and Claudine Schneider

October 22, 2020

1:15 pm to 2:15 pm EDT

The next webinar in the SSF series, with ecological economist and futurist Hazel Henderson, will address how the UN SDGs can and should replace GDP as the basis for valuing society leading to an economy based on planet protection and human wellbeing. Claudine Schneider is Hazel’s guest.

GDP accounts for all the public expenditures as “debt” while ignoring the value of the assets they created. If GDP were to be corrected by including the missing asset account, these debt-to-GDP ratios would be cut by up to 50% — with a few keystrokes! Learn why money isn’t what you think it is and why that matters to life on Earth in the next two webinars with Hazel and guests.

Register

Claudine Schneider is a former Republican U.S. representative from Rhode Island. She was the first, and to date only, woman elected to Congress from Rhode Island. She is founder of Republicans for Integrity, which describes itself as a network of “Republican former Members of Congress who feel compelled to remind Republican voters about the fundamentals of our party and to provide the facts about incumbents’ voting records.”

October 22nd webinar with Claudine Schneider and Hazel

Sincerely,

Ed.

Edward Saltzberg, PhD

Executive Director

Security and Sustainability Forum

www.ssfonline.org

[email protected]

Sincerely,

Ed.

Edward Saltzberg, PhD

Executive Director

Security and Sustainability Forum

www.ssfonline.org

Source: https://www.ethicalmarkets.com/63564-2/

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The Briefing: RVShare raises over $100M, Google disputes charges, and more

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Here’s what you need to know today in startup and venture news, updated by the Crunchbase News staff throughout the day to keep you in the know.

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RVShare raises over $100M for RV rentals

RVShare, an online marketplace for RV rentals, reportedly raised over $100 million in a financing led by private equity firms KKR and Tritium Partners.

Akron, Ohio-based RVShare has seen sharp growth in demand amid the pandemic, as more would-be travelers seek socially distanced options for hitting the road. Founded in 2013, the company matches RV owners with prospective renters, filtering by location, price and vehicle types.

Previously, RVShare had raised $50 million in known funding, per Crunchbase data, from Tritium Partners. The company is one of several players in the RV rental space, and competes alongside Outdoorsy, a peer-to-peer RV marketplace that has raised $75 million in venture funding.

Funding news

  • BrightFarms closes on $100M: Indoor farming company BrightFarms said it secured more than $100 million in debt and new equity capital to support expansion plans. The Series E round of funding was led by Cox Enterprises, which now owns a majority stake in the company, and includes a follow-on investment from growth equity firm Catalyst Investors.
  • Anyscale inks $40MAnyscale, the Berkeley-based company behind the Ray open source project for building applications, announced $40 million in an oversubscribed Series B funding round. Existing investor NEA led the round and was joined by Andreessen Horowitz, Intel Capital and Foundation Capital. The new funding brings Anyscale’s total funding to more than $60 million.
  • Klar deposits $15M: Mexican fintech Klar closed on $15 million in Series A funding, led by Prosus Ventures, with participation from new investor International Finance Corporation and existing investors Quona Capital, Mouro Capital and Acrew. The round brings total funding raised to approximately $72 million since the company was founded in 2019. The funds are intended to grow Klar’s engineering capabilities in both its Berlin and Mexico hubs.
  • O(1) Labs rakes in $10.9M: O(1) Labs, the team behind the cryptocurrency Mina, announced $10.9 million in a strategic investment round. Co-leading the round are Bixin Ventures and Three Arrows Capital with participation from SNZ, HashKey Capital, Signum Capital, NGC Ventures, Fenbushi Capital and IOSG Ventures.
  • Blustream bags $3M: After-sale customer engagement company Blustream said it raised $3 million in seed funding for product usage data and digital transformation efforts for physical goods companies via the Blustream Product Experience Platform. York IE led the round of funding for the Worcester, Massachusetts-based company with additional support from existing investors.Pillar secures another $1.5M: Pillar, a startup that helps families protect and care for their loved ones, raised $1.5 million in a seed extension to close at $7 million, The round was led by Kleiner Perkins.

Other news

  • Google rejects DOJ antitrust arguments: In the wake of a widely anticipated U.S. Justice Department antitrust suit against Google, the search giant disputed the charges in a statement, maintaining that: “People use Google because they choose to, not because they’re forced to, or because they can’t find alternatives.”
  • Facebook said to test Nextdoor rival: Facebook is reportedly testing a service similar to popular neighborhood-focused social Nextdoor. Called Neighborhoods, the feature reportedly suggests local neighborhood groups to join on Facebook.

Illustration: Dom Guzman

Venture investors and leaders in the fintech space can visualize a future where such startups will move toward again rebundling services.

Root Inc., the parent company of Root Insurance, launched its initial public offering and is looking at a valuation of as much as $6.34 billion.

Clover Health posted rising revenues and a narrower loss in its most recent financial results, published in advance of a planned public market debut.

Crunchbase News’ top picks of the news to stay current in the VC and startup world.

Source: https://news.crunchbase.com/news/briefing-10-21-20/

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Crunchbase

Syte Sees $30M Series C For Product Discovery

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Online shopping has become the norm for most people in 2020, even coaxing traditional retail brands to up their presence to stay competitive. However, now that shoppers can’t see and touch products like they used to, e-commerce discovery has become a crucial element for customer acquisition and retention.

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Enter Syte, an Israel-based company that touts creating the world’s first product discovery platform that utilizes the senses, such as visual, text and voice, and then leverages visual artificial intelligence and next-generation personalization to create individualized and memorable customer experiences, Syte co-founder and CEO Ofer Fryman told Crunchbase News.

To execute on this, the company raised $30 million in Series C funding and an additional $10 million in debt. Viola Ventures led the round and was joined by LG Technology Ventures, La Maison, MizMaa Ventures and Kreos Capital, as well as existing investors Magma, Naver Corporation, Commerce Ventures, Storm Ventures, Axess Ventures, Remagine Media Ventures and KDS Media Fund.

This brings the company’s total fundraising to $71 million since its inception in 2015. That includes a $21.5 million Series B, also led by Viola, in 2019, according to Crunchbase data.

Fryman intends for the new funding to be put to work on product enhancements and geographic expansion. Syte already has an established customer base in Europe, the Middle East and Africa, and will now focus expansion in the U.S. and Asia-Pacific.

Meanwhile, Syte has grown 22 percent quarter over quarter, as well as experienced a 38 percent expansion of its customer base since the beginning of 2020.

“Since we crossed $1 million annual recurring revenue, we have been tripling revenue while also becoming more efficient,” Fryman said. “We can accelerate growth as well as build an amazing technology and solution for a business that needs it right now. We plan to grow further, and even though our SaaS metrics are excellent right now, our goal is to improve them.”

Anshul Agarwal, managing director at LG Technology Ventures, said Syte was an attractive investment due in part to its unique technology.

“They have a deep-learning system and have created a new category, product discovery that will enable online shopping in a way we never had the ability to do before,” Agarwal said. “The product market fit was also unique. We believe in the strong execution by the team and the rapid growth in SaaS. We looked at many different companies, and the SaaS metrics that Syte showed are the strongest we’ve seen in a while.”

Illustration: Li-Anne Dias

Venture investors and leaders in the fintech space can visualize a future where such startups will move toward again rebundling services.

Root Inc., the parent company of Root Insurance, launched its initial public offering and is looking at a valuation of as much as $6.34 billion.

Clover Health posted rising revenues and a narrower loss in its most recent financial results, published in advance of a planned public market debut.

Crunchbase News’ top picks of the news to stay current in the VC and startup world.

Source: https://news.crunchbase.com/news/syte-sees-30m-series-c-for-product-discovery/

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