Full Text Available Abstract Background This study sought to identify the extent to which employee level and work stressors were associated with mental health problems experienced by Australian government employees, and with their use of primary care services. Methods 806 government employees aged between 40 and 44 years were surveyed as part of an epidemiological study conducted in Australia. Data collected from participants included sociodemographic attributes, physical health, psychological measures and work stressors relating to job control, job demands, job security and skills discretion at work. For 88% of these participants, information on visits made to general practitioners (GPs for the six months before and after their survey interview was obtained from health insurance records. Results When work stress and personal factors were taken into account, men at more junior levels reported better mental health, more positive affect and used fewer GP services. Women at middle-management levels obtained less GP care than their more senior counterparts. Both men and women who reported higher levels of work stress were found to have poorer mental health and well-being. The impact of such stressors on GP service use, however, differed for men and women. Conclusion Measures of work stress and not employee level affect the mental health and well-being of government employees. For governments with responsibility for funding health care services, reducing work stress experienced by their own employees offers potential benefits by improving the health of their workforce and reducing outlays for such services.
Parslow, Ruth A; Jorm, Anthony F; Christensen, Helen; Broom, Dorothy H; Strazdins, Lyndall; D' Souza, Rennie M
This study sought to identify the extent to which employee level and work stressors were associated with mental health problems experienced by Australian government employees, and with their use of primary care services. 806 government employees aged between 40 and 44 years were surveyed as part of an epidemiological study conducted in Australia. Data collected from participants included sociodemographic attributes, physical health, psychological measures and work stressors relating to job control, job demands, job security and skills discretion at work. For 88% of these participants, information on visits made to general practitioners (GPs) for the six months before and after their survey interview was obtained from health insurance records. When work stress and personal factors were taken into account, men at more junior levels reported better mental health, more positive affect and used fewer GP services. Women at middle-management levels obtained less GP care than their more senior counterparts. Both men and women who reported higher levels of work stress were found to have poorer mental health and well-being. The impact of such stressors on GP service use, however, differed for men and women. Measures of work stress and not employee level affect the mental health and well-being of government employees. For governments with responsibility for funding health care services, reducing work stress experienced by their own employees offers potential benefits by improving the health of their workforce and reducing outlays for such services.
Díaz-Castro, Lina; Arredondo, Armando; Pelcastre-Villafuerte, Blanca Estela; Hufty, Marc
To analyze the conceptualization of the term governance on public mental health programs. In this systematic review, we analyzed the scientific literature published in the international scenario during 15 years (from 2000 to 2015). The databases analyzed were: Medline, CINAHL, PsycINFO and PubMed. Governance and mental health were the descriptors. We included relevant articles according to our subject of study and levels of analysis: (i) the concept of governance in mental health; (ii) process and decision spaces; (iii) strategic and pertinent actors who operate in the functioning of the health system, and (iv) social regulations. We excluded letters to the editor, news articles, comments and case reports, incomplete articles and articles whose approach did not include the object of study of this review. We have found five conceptualizations of the term governance on mental health in the area of provision policies and service organization. The agents were both those who offer and those who receive the services: we identified several social norms. The concept of governance in mental health includes standards of quality and attention centered on the patient, and incorporates the consumers of mental healthcare in the decision-making process. Analizar la conceptualización del término gobernanza en las políticas de salud mental. En esta revisión sistemática se analizó literatura científica publicada en el ámbito internacional durante 15 años (de 2000 hasta 2015). Las bases de datos analizadas fueron: Medline, CINAHL, PsycINFO y PubMed. Los descriptores fueron gobernanza y salud mental. Fueron incluidos artículos relevantes de acuerdo a nuestro objeto de estudio y niveles de análisis: (i) concepto de gobernanza en salud mental; (ii) proceso y espacios de decisión; (iii) actores estratégicos y de interés que intervienen en el funcionamiento del sistema de salud, y (iv) normas sociales. Se excluyeron cartas al editor, noticias, comentarios y reporte de caso
Díaz-Castro, Lina; Arredondo, Armando; Pelcastre-Villafuerte, Blanca Estela; Hufty, Marc
To analyse the role of Mexico's mental health system governance in the development of mental health policies and programmes, from the perspective of its own actors. A map was developed for identifying the actors in Mexico's mental health system. A guide was designed for in-depth interviews, which were recorded and arranged in categories for their analysis. The Atlas-ti v.7 software was used for the organisation of qualitative data and Policy Maker v.4 was used to determine the position and influence of actors within the health system. The actors were identified according to their level of influence in mental health policies: high, medium and low. Actors with a high level of influence participate in national policies, actors with medium influence are involved in regional or local policies and the participation of actors with a low level of influence is considered marginal. This study facilitated understanding of governance in mental health. The level of influence of the actors directly affects the scope of governance indicators. Relevant data were obtained to improve policies in mental health care. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Funk, Michelle; Minoletti, Alberto; Drew, Natalie; Taylor, Jacob; Saraceno, Benedetto
The World Health Organization urges countries to become more active in advocacy efforts to put mental health on governments' agendas. Health policy makers, planners and managers, advocacy groups, consumer and family organizations, through their different roles and actions, can move the mental health agenda forward. This paper outlines the importance of the advocacy movement, describes some of the roles and functions of the different groups and identifies some specific actions that can be adopted by Ministries of Health. The mental health advocacy movement has developed over the last 30 years as a means of combating stigma and prejudice against people with mental disorders and improving services. Consumer and family organizations and related NGOs have been able to influence governments on mental health policies and laws and educating the public on social integration of people with mental disorders. Governments can promote the development of a strong mental health advocacy sector without compromising this sector's independence. For instance, they can publish and distribute a directory of mental health advocacy groups, include them in their mental health activities and help fledgling groups become more established. There are also some advocacy functions that government officials can, and indeed, should perform themselves. Officials in the ministry of health can persuade officials in other branches of government to make mental health more of a priority, support advocacy activities with both general health workers and mental health workers and carry out public information campaigns about mental disorders and how to maintain good mental health. In conclusion, the World Health Organization believes mental health advocacy is one of the pillars to improve mental health care and the human rights of people with mental disorders. It is hoped that the recommendations in this article will help government officials and activists to strengthen national advocacy movements.
Abdulmalik, J; Kola, L; Gureje, O
A health systems approach to understanding efforts for improving health care services is gaining traction globally. A component of this approach focuses on health system governance (HSG), which can make or mar the successful implementation of health care interventions. Very few studies have explored HSG in low- and middle-income countries, including Nigeria. Studies focusing on mental health system governance, are even more of a rarity. This study evaluates the mental HSG of Nigeria with a view to understanding the challenges, opportunities and strategies for strengthening it. This study was conducted as part of the project, Emerging Mental Health Systems in Low and Middle Income Countries (Emerald). A multi-method study design was utilized to evaluate the mental HSG status of Nigeria. A situational analysis of the health policy and legal environment in the country was performed. Subsequently, 30 key informant interviews were conducted at national, state and district levels to explore the country's mental HSG. The existing policy, legislative and institutional framework for HSG in Nigeria reveals a complete exclusion of mental health in key health sector documents. The revised mental health policy is however promising. Using the Siddiqi framework categories, we identified pragmatic strategies for mental health system strengthening that include a consideration of existing challenges and opportunities within the system. The identified strategies provide a template for the subsequent activities of the Emerald Programme (and other interventions), towards strengthening the mental health system of Nigeria.
Petersen, Inge; Marais, Debbie; Abdulmalik, Jibril; Ahuja, Shalini; Alem, Atalay; Chisholm, Dan; Egbe, Catherine; Gureje, Oye; Hanlon, Charlotte; Lund, Crick; Shidhaye, Rahul; Jordans, Mark; Kigozi, Fred; Mugisha, James; Upadhaya, Nawaraj; Thornicroft, Graham
Poor governance has been identified as a barrier to effective integration of mental health care in low- and middle-income countries. Governance includes providing the necessary policy and legislative framework to promote and protect the mental health of a population, as well as health system design and quality assurance to ensure optimal policy implementation. The aim of this study was to identify key governance challenges, needs and potential strategies that could facilitate adequate integration of mental health into primary health care settings in low- and middle-income countries. Key informant qualitative interviews were held with 141 participants across six countries participating in the Emerging mental health systems in low- and middle-income countries (Emerald) research program: Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda. Data were transcribed (and where necessary, translated into English) and analysed thematically using framework analysis, first at the country level, then synthesized at a cross-country level. While all the countries fared well with respect to strategic vision in the form of the development of national mental health policies, key governance strategies identified to address challenges included: strengthening capacity of managers at sub-national levels to develop and implement integrated plans; strengthening key aspects of the essential health system building blocks to promote responsiveness, efficiency and effectiveness; developing workable mechanisms for inter-sectoral collaboration, as well as community and service user engagement; and developing innovative approaches to improving mental health literacy and stigma reduction. Inadequate financing emerged as the biggest challenge for good governance. In addition to the need for overall good governance of a health care system, this study identifies a number of specific strategies to improve governance for integrated mental health care in low- and middle-income countries. © The
Charbit, Claire; Michalun, Varinia
E-government Partnerships across Levels of Government, is an overview of the challenges and approaches to creating a collaborative and cooperative partnership across levels of government for e-government development and implementation.
Callaly, Tom; Arya, Dinesh; Minas, Harry
To consider the origin, current emphasis and relevance of the concepts of quality, risk management and clinical governance in mental health. Increasingly, health service boards and management teams are required to give attention to clinical governance rather than corporate governance alone. Clinical governance is a unifying quality concept that aims to produce a structure and systems to assure and improve the quality of clinical services by promoting an integrated and organization-wide approach towards continuous quality improvement. Many psychiatrists will find the reduction in clinical autonomy, the need to consider the welfare of the whole population as well as the individual patient for whom they are responsible, and the requirement that they play a part in a complex systems approach to quality improvement to be a challenge. Avoiding or ignoring this challenge will potentially lead to conflict with modern management approaches and increased loss of influence on future developments in mental health services.
Robert Sternberg's mental self-government theory and its contribution to our understanding of first-year distance learners' multiple thinking style preferences. ... This intelligence (the perception we have of information systems and the way we manage them) will influence the way we think and learn. This also applies to ...
Gehring, Nicole D; McGrath, Patrick; Wozney, Lori; Soleimani, Amir; Bennett, Kathryn; Hartling, Lisa; Huguet, Anna; Dyson, Michele P; Newton, Amanda S
Researchers, healthcare planners, and policymakers convey a sense of urgency in using eMental healthcare technologies to improve pediatric mental healthcare availability and access. Yet, different stakeholders may focus on different aspects of implementation. We conducted a systematic review to identify implementation foci in research studies and government/organizational documents for eMental healthcare technologies for pediatric mental healthcare. A search of eleven electronic databases and grey literature was conducted. We included research studies and documents from organization and government websites if the focus included eMental healthcare technology for children/adolescents (0-18 years), and implementation was studied and reported (research studies) or goals/recommendations regarding implementation were made (documents). We assessed study quality using the Mixed Methods Appraisal Tool and document quality using the Appraisal of Guidelines for Research & Evaluation II. Implementation information was grouped according to Proctor and colleagues' implementation outcomes-acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability-and grouped separately for studies and documents. Twenty research studies and nine government/organizational documents met eligibility criteria. These articles represented implementation of eMental healthcare technologies in the USA (14 studies), United Kingdom (2 documents, 3 studies), Canada (2 documents, 1 study), Australia (4 documents, 1 study), New Zealand (1 study), and the Netherlands (1 document). The quality of research studies was excellent (n = 11), good (n = 6), and poor (n = 1). These eMental health studies focused on the acceptability (70%, n = 14) and appropriateness (50%, n = 10) of eMental healthcare technologies to users and mental healthcare professionals. The quality of government and organizational documents was high (n = 2), medium (n = 6
Kern, K.; Bulkeley, H.
This article focuses on a variant of multi-level governance and Europeanization, i.e. the transnational networking of local authorities. Focusing on local climate change policy, the article examines how transnational municipal networks (TMNs) govern in the context of multi-level European governance.
Full Text Available The idea of this paper is to determine the mental models of actors in the fi rm with respect to the cognitive approach of corporate governance. The paper takes a corporate governance perspective, discusses mental models and uses the cognitive map to view the diagrams showing the ways of thinking and the conceptualization of the cognitive approach. In addition, it employs a cognitive mapping technique. Returning to the systematic exploration of grids for each actor, it concludes that there is a balance of concepts expressing their cognitive orientation.
Shomad, Z. A.; Kusmayadi, T. A.; Riyadi
This research is to investigate the level of mild mental retardation geometry students thinking. This research focuses on the geometry thinking level based on Van Hiele theory. This study uses qualitative methods with case study strategy. Data obtained from observation and tests result. The subjects are 12 mental retardation students. The result show that ability of mild mental retardation students with each other is different but have same level of level thinking geometry. The geometry thinking level of mental retardation students was identified in level 1 of the Van Hiele theory. Based on the level thinking geometry of mental retardation students simplify geometry thinking teachers in selecting appropriate learning methods, choose the materials in accordance with ability, and can modify the material following the geometry thinking level of mental retardation students.
Leung, Janni; Hall, Wayne; Head, Brian W; Whiteford, Harvey
Background Growing evidence attests to the efficacy of e-mental health services. There is less evidence on how to facilitate the safe, effective, and sustainable implementation of these services. Objective We conducted a systematic review on e-mental health service use for depressive and anxiety disorders to inform policy development and identify policy-relevant gaps in the evidence base. Methods Following the PRISMA protocol, we identified research (1) conducted in Australia, (2) on e-mental health services, (3) for depressive or anxiety disorders, and (4) on e-mental health usage, such as barriers and facilitators to use. Databases searched included Cochrane, PubMed, PsycINFO, CINAHL, Embase, ProQuest Social Science, and Google Scholar. Sources were assessed according to area and level of policy relevance. Results The search yielded 1081 studies; 30 studies were included for analysis. Most reported on self-selected samples and samples of online help-seekers. Studies indicate that e-mental health services are predominantly used by females, and those who are more educated and socioeconomically advantaged. Ethnicity was infrequently reported on. Studies examining consumer preferences found a preference for face-to-face therapy over e-therapies, but not an aversion to e-therapy. Content relevant to governance was predominantly related to the organizational dimensions of e-mental health services, followed by implications for community education. Financing and payment for e-services and governance of the information communication technology were least commonly discussed. Conclusions Little research focuses explicitly on policy development and implementation planning; most research provides an e-services perspective. Research is needed to provide community and policy-maker perspectives. General population studies of prospective treatment seekers that include ethnicity and socioeconomic status and quantify relative preferences for all treatment modalities are necessary
Jollands, Nigel; Gasc, Emilien; Pasquier, Sara Bryan
Despite creating a plethora of national and international regulations and voluntary programmes to improve energy efficiency, countries are far from achieving full energy efficiency potential across all sectors of the economy. One major challenge, among numerous barriers, is policy implementation. One strategy that many national governments and international organisations have used to address the implementation issue is to engage regional and local authorities. To that end, many programmes have been created that foster energy efficiency action and collaboration across levels of government. The aim of this report is to identify trends and detail recent developments in multi-level governance in energy efficiency (MLGEE). By sharing lessons learned from daily practitioners in the field, the IEA hopes energy efficiency policy makers at all levels of government will be able to identify useful multilevel governance (MLG) practices across geographical and political contexts and use these to design robust programmes; modify existing programmes, and connect and share experiences with other policy makers in this field.
Full Text Available Multi-level governance may facilitate learning and adaptation in complex social-ecological circumstances. Such arrangements should connect community-based management with regional/national government-level management, link scientific management and traditional management systems, encourage the sharing of knowledge and information, and promote collaboration and dialogue around goals and outcomes. Governance innovations of this type can thus build capacity to adapt to change and manage for resilience. However, critical reflection on the emergence of adaptive, multi-level governance for the commons is warranted. Drawing on examples from the North and South, the purpose of this review is to connect three complementary bodies of scholarship with insights for commons governance in a multi-level world: common property theory, resilience thinking and political ecology. From the commons and resilience literature, normative principles of adaptive, multi-level governance are synthesized (e.g., participation, accountability, leadership, knowledge pluralism, learning and trust. Political ecological interpretations, however, help to reveal the challenge of actualizing these principles and the contextual forces that make entrenched, top-down management systems resilient to change. These forces include the role of power, scale and levels of organization, knowledge valuation, the positioning of social actors and social constructions of nature. Also addressed are the policy narratives that shape governance, and the dialectic relationship among ecological systems and social change. tekst
Full Text Available Despite no shortage of thoughtful analysis concerning how to more democratically develop and assess new technologies, practical progress toward democratized innovation has been paltry. This state of affairs suggests that the barriers to such democratic ends merit more attention. Building upon calls to more seriously examine citizens’ understandings of technology as autonomous or deterministic, this paper characterizes the assumptions, beliefs, and patterns of thought undergirding technological determinism and permissionless innovation as technocratic governing mentalities. That is, they contribute to the biasing of political discourses, practices, and organizations toward non-decision making and adaptation with regards to technological change. Indeed, permissionless innovation is quickly becoming the motto of those aiming to legitimate a “hands-off” approach to the sociotechnical “disruptions” sought by Silicon Valley entrepreneurs. Moreover, this paper explores how STS, as both an academic and political endeavor, might better respond to the challenges these modes of thinking present. Drawing upon relevant work within social psychology and communications, several fruitful avenues for engaged research regarding undermining technocratic governing mentalities become apparent. Not only is there a pressing need for accessible and parsimonious counternarratives to technological determinism and permissionless innovation but also rhetorical strategies for making the democratization of technological appear continuous with aspects of status quo systems. Finally, given that technocratic governing mentalities are likely to have practical and material roots, inquiry should be directed toward understanding how different sociotechnical arrangements impact citizens’ perception of the desirability and feasibility of democratizing technology.
Full Text Available Purpose: study of mental health level of university student, athletes and non-athletes. Material: The tested group consisted of 160 male and female undergraduates from Ouargla University, Algeria; 80 students-athletes from Institute of Physical Education and Sports and 80 students-non-athletes from Department of Psychology, English and Mathematics. In the study we used health mental scale, adapted by Diab (2006 to Arab version scale, formed from five dimensions (Competence and self-confidence, Capacity for social interaction, Emotional maturity, Freedom from neurotic symptoms, self rating and aspects of natural deficiencies. Results: the findings indicated that university students have high level of mental health. And the mean of the responses of students-athletes group by mental health scale reached (M = 32.40, with standard deviation (STD =5.83, while the mean of the responses of students-non athletes group by mental health scale has reached (M=27.47, with standard deviation (STD=7.88. T-value, required to know significance of differences between means of students-athletes and students-non athletes has reached (T=4.51, (DF=185, p -0.01. So there are significant statistical differences between student athletes and non-athletes in their responses by mental health scale in favor of the student athletes. Conclusion:sports are beneficial in respect to mental health among university students and emphasizing the importance of the mental health of university students through its integration in the various recreational and competitive activities. Future qualitative research, covering multi-variables’ tests on mental health and others psychological characteristics could be performed in sports area.
Gabrielle Cerqueira da Silva
Full Text Available Introduction: The regular practice of physical activity is fundamental to the health of children, it has been cited as factor of protection for mental disorders in school age. Objective: To verify the relation between mental health and physical activity levels in schoolchildren of the city Jacobina, Bahia. Method: Sample composed of 55 students between the ages 08 to 10 and their parents, who participated as secondary informants in this study. The Child Behavior Checklist (CBCL was used for evaluation of mental health problems of the schoolchildren, Physical Activity Questionnaire for Older Children (PAQ-C, for evaluation of the physical activity levels of the subject, and a social-demographic questionnaire. Results: Most children were classified as sedentary (80% and only 7.3% of the sample showed positive for trace of mental disorder. No significant association was found between mental disorders and physical activity levels among the group, or between these variables and socio-demographic characteristics of children. It was observed that the girls were more sedentary than boys, with significant difference (p < 0.01. Conclusion: Despite the low prevalence of mental health problems among schoolchildren and the non-association with physical activity levels, special attention is necessary with this audience, aiming to strengthen physical activity as a protective factor for children’s mental health, with investments in actions aimed at the encouragement of regular practice of physical activity, combining family and school. Studies with a larger number of samples need to be conducted and its findings must be thoroughly analyzed.
Robinson, Lance W; Ontiri, Enoch; Alemu, Tsegaye; Moiko, Stephen S
Landscape approaches can be subjected to mistakenly targeting a single "best" level of governance, and paying too little attention to the role that cross-scale and cross-level interactions play in governance. In rangeland settings, resources, patterns of use of those resources, and the institutions for managing the resources exist at multiple levels and scales. While the scholarship on commons offers some guidance on how to conceptualize governance in rangeland landscapes, some elements of commons scholarship-notably the "design principles" for effective governance of commons-do not seem to apply neatly to governance in pastoralist rangeland settings. This paper examines three cases where attempts have been made to foster effective landscape governance in such settings to consider how the materiality of commons influences the nature of cross-scale and cross-level interactions, and how these interactions affect governance. In all three cases, although external actors seemed to work appropriately and effectively at community and landscape levels, landscape governance mechanisms have been facing great challenges arising from relationships beyond the landscape, both vertically to higher levels of decision-making and horizontally to communities normally residing in other landscapes. The cases demonstrate that fostering effective landscape-level governance cannot be accomplished only through action at the landscape level; it is a task that must be pursued at multiple levels and in relation to the connections across scales and levels. The paper suggests elements of a conceptual framework for understanding cross-level and cross-scale elements of landscape governance, and offers suggestions for governance design in pastoralist rangeland settings.
Robinson, Lance W.; Ontiri, Enoch; Alemu, Tsegaye; Moiko, Stephen S.
Landscape approaches can be subjected to mistakenly targeting a single "best" level of governance, and paying too little attention to the role that cross-scale and cross-level interactions play in governance. In rangeland settings, resources, patterns of use of those resources, and the institutions for managing the resources exist at multiple levels and scales. While the scholarship on commons offers some guidance on how to conceptualize governance in rangeland landscapes, some elements of commons scholarship—notably the "design principles" for effective governance of commons—do not seem to apply neatly to governance in pastoralist rangeland settings. This paper examines three cases where attempts have been made to foster effective landscape governance in such settings to consider how the materiality of commons influences the nature of cross-scale and cross-level interactions, and how these interactions affect governance. In all three cases, although external actors seemed to work appropriately and effectively at community and landscape levels, landscape governance mechanisms have been facing great challenges arising from relationships beyond the landscape, both vertically to higher levels of decision-making and horizontally to communities normally residing in other landscapes. The cases demonstrate that fostering effective landscape-level governance cannot be accomplished only through action at the landscape level; it is a task that must be pursued at multiple levels and in relation to the connections across scales and levels. The paper suggests elements of a conceptual framework for understanding cross-level and cross-scale elements of landscape governance, and offers suggestions for governance design in pastoralist rangeland settings.
Full Text Available Mentalizing is the ability to understand others’ mental state through external cues. It consists of two networks, namely low-level and high-level metalizing. Although it is an essential function in our daily social life, surgical resection of right cerebral hemisphere disturbs mentalizing processing with high possibility. In the past, little was known about the white matter related to high-level mentalizing, and the conservation of high-level mentalizing during surgery has not been a focus of attention. Therefore, the main purpose of this study was to examine the neural networks underlying high-level mentalizing and then, secondarily, investigate the usefulness of awake surgery in preserving the mentalizing network. A total of 20 patients with glioma localized in the right hemisphere who underwent awake surgery participated in this study. All patients were assigned to two groups: with or without intraoperative assessment of high-level mentalizing. Their high-level mentalizing abilities were assessed before surgery and 1 week and 3 months after surgery. At 3 months after surgery, only patients who received the intraoperative high-level mentalizing test showed the same score as normal healthy volunteers. The tract-based lesion symptom analysis was performed to confirm the severity of damage of associated fibers and high-level mentalizing accuracy. This analysis revealed the superior longitudinal fascicles (SLF III and fronto-striatal tract (FST to be associated with high-level mentalizing processing. Moreover, the voxel-based lesion symptom analysis demonstrated that resection of orbito-frontal cortex (OFC causes persistent mentalizing dysfunction. Our study indicates that damage of the OFC and structural connectivity of the SLF and FST causes the disorder of mentalizing after surgery, and assessing high-level mentalizing during surgery may be useful to preserve these pathways.
Jorm, Anthony; Sawyer, Michael; Gillett, Joy
Australian Rotary Health (ARH) was established in 1981 with the goal of supporting family health research in Australia. Since 2000, ARH has supported research relevant to mental health and mental illness. This article describes the early history of the fund, the reasons for the move to mental illness research, some examples of research projects that have had a beneficial impact and the branching out into mental health community awareness raising and stigma reduction. ARH has emerged as a major non-government supporter of mental illness research. It has also effectively engaged Rotary clubs at a local level to increase community awareness of mental illness and to reduce stigma.
Stanley-Clarke, Nicky; Sanders, Jackie; Munford, Robyn
To explore the relationship between government policy and service development in a New Zealand statutory mental health provider, Living Well. An organisational case study utilising multiple research techniques including qualitative interviews, analysis of business and strategic documents and observation of meetings. Staff understood and acknowledged the importance of government policy, but there were challenges in its implementation. Within New Zealand's statutory mental health services staff struggled to know how to implement government policy as part of service development; rather, operational concerns, patient need, local context and service demands drove the service development process. © The Royal Australian and New Zealand College of Psychiatrists 2014.
Asugeni, James; MacLaren, David; Massey, Peter D; Speare, Rick
There is little published research about mental health and climate change in the Pacific, including Solomon Islands. Solomon Islands has one of the highest rates of sea-level rise globally. The aim of this research was to document mental health issues related to sea-level rise for people in East Malaita, Solomon Islands. A cross-sectional study was carried out in six low-lying villages in East Malaita, Solomon Islands. The researcher travelled to villages by dugout canoe. In addition to quantitative, closed-ended questions, open-ended questions with villagers explored individual and community responses to rising sea level. Of 60 people asked, 57 completed the questionnaire. Of these, 90% reported having seen a change in the weather patterns. Nearly all participants reported that sea-level rise is affecting them and their family and is causing fear and worry on a personal and community level. Four themes emerged from the qualitative analysis: experience of physical impacts of climate change; worry about the future; adaptation to climate change; government response needed. Given predictions of ongoing sea-level rise in the Pacific it is essential that more research is conducted to further understand the human impact of climate change for small island states which will inform local, provincial and national-level mental health responses. © The Royal Australian and New Zealand College of Psychiatrists 2015.
Gray, Andrew Paul; Richer, Faisca; Harper, Sam
Following the onset of intensive colonial intervention and rapid social change in the lives of Inuit people, youth in Nunavik have experienced high rates of mental health problems and suicide. Inuit people describe a broad range of contextual influences on mental wellness based on lived experience, but most epidemiological studies have focused on individual risk factors and pathologies. This study aimed to assess the influence of multiple determinants of mental wellness among Inuit youth in Nunavik, including culturally meaningful activities, housing and community social characteristics. Mental wellness was measured in the form of two primary outcomes: self-esteem and suicidal ideation. Using cross-sectional data from the 2004 Nunavik Inuit Health Survey and multilevel regression modelling, we estimated associations between these two outcomes and various independent individual- and community-level explanatory factors among Inuit youth. All variables were selected to reflect Inuit perspectives on determinants of mental wellness. The study design and interpretation of results were validated with Inuit community representatives. Pride in Inuit identity, traditional activities, community-level social support and community-level socio-economic status were found to be protective. Barriers to participating in traditional activities, household crowding and high community rates of violence were risk factors. These findings support Inuit perspectives, expand the scope of epidemiological analysis of Inuit mental wellness and reinforce the need for locally informed, community-wide approaches to mental wellness promotion for Inuit youth.
Davoren, Martin P
Much research on the health and well-being of third level students is focused on poor mental health leading to a dearth of information on positive mental health and well-being. Recently, the Warwick Edinburgh Mental Well-being scale (WEMWBS) was developed as a measurement of positive mental health and well-being. The aim of this research is to investigate the distribution and determinants of positive mental health and well-being in a large, broadly representative sample of third level students using WEMWBS.
Khan, Nusrat N; Yahya, Badi'ah; Abu Bakar, Abd Kadir; Ho, Roger C
The Malaysian Mental Health Act 2001 did not come into effect until the Mental Health Regulations 2010 came into force. The Act provides a framework for the delivery of comprehensive care, treatment, control, protection and rehabilitation of those with mental disorders. The Act governs the establishment of private and government psychiatric hospitals, psychiatric nursing homes and community mental health centres. This paper outlines the provisions of the Act and the Regulations.
Thiago Lavras Trapé
Full Text Available ABSTRACT OBJECTIVE This study aims to analyze the current status of the mental health care model of the Brazilian Unified Health System, according to its funding, governance processes, and mechanisms of assessment. METHODS We have carried out a documentary analysis of the ordinances, technical reports, conference reports, normative resolutions, and decrees from 2009 to 2014. RESULTS This is a time of consolidation of the psychosocial model, with expansion of the health care network and inversion of the funding for community services with a strong emphasis on the area of crack cocaine and other drugs. Mental health is an underfunded area within the chronically underfunded Brazilian Unified Health System. The governance model constrains the progress of essential services, which creates the need for the incorporation of a process of regionalization of the management. The mechanisms of assessment are not incorporated into the health policy in the bureaucratic field. CONCLUSIONS There is a need to expand the global funding of the area of health, specifically mental health, which has been shown to be a successful policy. The current focus of the policy seems to be archaic in relation to the precepts of the psychosocial model. Mechanisms of assessment need to be expanded.
Full Text Available This paper attempts to empirically investigate the determinants of choices of corporate governance practices by corporations in a transition market. The study offers firm-level evidence benefiting from unique financial and governance data on Ukraine. In particular, we analyze the factors that affect overall level as well as individual elements of corporate governance. We consider such governance elements as shareholder rights, transparency, board independence, chairman independence and ownership. Overall we found that regulatory, industry and firm level factors are important, which is consistent with previous literature for other countries. Combining our results with the results of Zheka (20063 we conclude that it is possible for the government to implement and enforce better corporate governance practices in the economy that would make Ukrainian enterprises more attractive for foreign investment.
Vedder, Hans; Woerdman, Edwin; Roggenkamp, Martha; Holwerda, Marijn
This chapter analyses the multi-level governance in EU climate law; it connects the international arena, with EU and national decision-making and relates climate change considerations to competitiveness concerns.
Full Text Available Abstract There exists a disconnection between evolving policies in the policy arenas of mental health, housing, and income support in Canada. One of the complexities associated with analysing the intersection of these policies is that federal, provincial, and municipal level policies are involved. Canada is one of the few developed countries without a national mental health policy and because of the federal policy reforms of the 1970s, the provincial governments now oversee the process of deinstitutionalization from the hospital to the community level. During this same period the availability of affordable housing has decreased as responsibility for social housing has been transfered from the federal government to the provincial and/or municipal levels of government. Canada also stands alone in terms of being a developed nation without national housing policy instead what is considered "affordable" housing is partially dependant upon individuals' personal economic resources. As well, over the past decade rates of income supports have also been reduced. Psychiatric survivors have long been identified as being at risk for homelessness, with the disconnection existing between housing, income and mental health policies and the lack of a national policy in any of these policies areas further contributing to this risk.
Stanley-Clarke, Nicky; Sanders, Jackie; Munford, Robyn
Purpose - The purpose of this paper is to discuss the lessons learnt from the process of implementing a new model of governance within Living Well, a New Zealand statutory mental health agency. Design/methodology/approach - It presents the findings from an organisational case study that involved qualitative interviews, meeting observations and document analysis. Archetype theory provided the analytical framework for the research enabling an analysis of both the formal structures and informal value systems that influenced the implementation of the governance model. Findings - The research found that the move to a new governance model did not proceed as planned. It highlighted the importance of staff commitment, the complexity of adopting a new philosophical approach and the undue influence of key personalities as key determining factors in the implementation process. The findings suggest that planners and managers within statutory mental health agencies need to consider the implications of any proposed governance change on existing roles and relationships, thinking strategically about how to secure professional commitment to change. Practical implications - There are ongoing pressures within statutory mental health agencies to improve the efficiency and effectiveness of organisational structures and systems. This paper has implications for how planners and managers think about the process of implementing new governance models within the statutory mental health environment in order to increase the likelihood of sustaining and embedding new approaches to service delivery. Originality/value - The paper presents insights into the process of implementing new governance models within a statutory mental health agency in New Zealand that has relevance for other jurisdictions.
Martin P Davoren
Full Text Available INTRODUCTION: Much research on the health and well-being of third level students is focused on poor mental health leading to a dearth of information on positive mental health and well-being. Recently, the Warwick Edinburgh Mental Well-being scale (WEMWBS was developed as a measurement of positive mental health and well-being. The aim of this research is to investigate the distribution and determinants of positive mental health and well-being in a large, broadly representative sample of third level students using WEMWBS. METHODS: Undergraduate students from one large third level institution were sampled using probability proportional to size sampling. Questionnaires were distributed to students attending lectures in the randomly selected degrees. A total of 2,332 self-completed questionnaires were obtained, yielding a response rate of 51% based on students registered to relevant modules and 84% based on attendance. One-way ANOVAs and multivariate logistic regression were utilised to investigate factors associated with positive mental health and well-being. RESULTS: The sample was predominantly female (62.66%, in first year (46.9% and living in their parents' house (42.4% or in a rented house or flat (40.8%. In multivariate analysis adjusted for age and stratified by gender, no significant differences in WEMWBS score were observed by area of study, alcohol, smoking or drug use. WEMWBS scores were higher among male students with low levels of physical activity (p=0.04. Men and women reporting one or more sexual partners (p<0.001 were also more likely to report above average mental health and well-being. CONCLUSION: This is the first study to examine positive mental health and well-being scores in a third level student sample using WEMWBS. The findings suggest that students with a relatively adverse health and lifestyle profile have higher than average mental health and well-being. To confirm these results, this work needs to be replicated across
Full Text Available A major challenge for many researchers and practitioners relates to how to recognize and address cross-scale dynamics in space and over time in order to design and implement effective governance arrangements. This editorial provides an overview of the concept of multi-level governance (MLG. In particular we highlight definitional issues, why the concept matters as well as more practical concerns related to the processes and structure of multi-level governance. It is increasingly clear that multi-level governance of forest resources involves complex interactions of state, private and civil society actors at various levels, and institutions linking higher levels of social and political organization. Local communities are increasingly connected to global networks and influences. This creates new opportunities to learn and address problems but may also introduce new pressures and risks. We conclude by stressing the need for a much complex approach to the varieties of MLG to better understand how policies work as instruments of governance and to organize communities within systems of power and authority.
Cox Sullivan, Sheila; Norris, Mitzi R; Brown, Lana M; Scott, Karen J
To examine the nurse manager perspective surrounding implementation of unit level shared governance in one Veterans Health Administration facility. Nursing shared governance is a formal model allowing nursing staff decision-making input into clinical practice, quality improvement, evidence-based practice and staff professional development. Unit level shared governance is a management process where decision authority is delegated to nursing staff at the unit level. Convenience sampling was used to recruit ten nurse managers who participated in face-to-face semi-structured interviews. Data were analysed using content analysis and constant comparison techniques. Demographic data were described using descriptive statistics. The participants included seven female and three male nurse managers with seven Caucasian and three African American. Participant quotes were clustered to identify sub-themes that were then grouped into four global themes to describe unit level shared governance. The global themes were: (1) motivation, (2) demotivation, (3) recommendations for success, and (4) outcomes. These research findings resonate with previous studies that shared governance may be associated with increased nurse empowerment, self-management, engagement, and satisfaction. These findings reflect the need for nurse managers to promote and recognize staff participation in unit level shared governance. © 2017 John Wiley & Sons Ltd.
Wilkoszewski, Harald; Sundby, Eli
Decision-making in educations systems has become more complex: while decentralisation has moved the locus of power to lower governance levels, the central level still is held responsible for the quality of outcomes. As a consequence, new steering strategies have emerged that tend to apply softer modes of governance as opposed to harder ones in the…
Full Text Available The purpose of this article is to gain a deeper understanding of the management of social me-dia at the local government level, the availability of opportunities for citizen dialogue on govern-ment websites, and the impact that social net-working applications have on e-government. The results of the current study converge with prior research on the growing awareness amongst government practitioners regarding the relevance of social media, the use of social media for feed-back on service quality, and privacy and security commitments in e-government. The literature on the use of information technology to transform government, the potential for online government information to contribute to citizen engagement, and the rapid growth in local government use of social media is relevant to this discussion.
Urban governance and its impact on contentious politics have received remarkably little attention in existing studies on mental health. Drawing on a measure of neighborhood conflicts developed in a survey of thirty-nine urban neighborhoods in Guangzhou, China, this article investigates the potential link between urban governance and mental health. Net of sociodemographic, relational, and environmental measures, it finds that among residents' conflicts with different entities of urban governance, only those with local/grassroots governments are significantly associated with more depressive symptoms. Moreover, these subgroups of government-oriented conflicts associated with more depressive symptoms are related to neighborhood planning and communal properties, reflecting a dilemma in the Chinese model of urban governance. By offering a relational interpretation of neighborhood conflicts, this study not only challenges the previous view that community building in China improves mental health, but calls attention to the significance of urban governance in research on mental health. Copyright © 2017 Elsevier Ltd. All rights reserved.
Kapungwe, A; Cooper, S; Mwanza, J; Mwape, L; Sikwese, A; Kakuma, R; Lund, C; Flisher, A J
The aim of this qualitative study was to explore the presence, causes and means of addressing individual and systemic stigma and discrimination against people with mental illness in Zambia. This is to facilitate the development of tailor-made antistigma initiatives that are culturally sensitive for Zambia and other low-income African countries. This is the first in-depth study on mental illness stigma in Zambia. Fifty semi-structured interviews and 6 focus group discussions were conducted with key stakeholders drawn from 3 districts in Zambia (Lusaka, Kabwe and Sinazongwe). Transcripts were analyzed using a grounded theory approach. Mental illness stigma and discrimination is pervasive across Zambian society, prevailing within the general community, amongst family members, amid general and mental health care providers, and at the level of government. Such stigma appears to be fuelled by misunderstandings of mental illness aetiology; fears of contagion and the perceived dangerousness of people with mental illness; and associations between HIV/AIDS and mental illness. Strategies suggested for reducing stigma and discrimination in Zambia included education campaigns, the transformation of mental health policy and legislation and expanding the social and economic opportunities of the mentally ill. In Zambia, as in many other low-income African countries, very little attention is devoted to addressing the negative beliefs and behaviours surrounding mental illness, despite the devastating costs that ensue. The results from this study underscore the need for greater commitment from governments and policy-makers in African countries to start prioritizing mental illness stigma as a major public health and development issue.
Yen, Cheng-Fang; Yang, Pinchen; Wang, Peng-Wei; Lin, Huang-Chi; Liu, Tai-Ling; Wu, Yu-Yu; Tang, Tze-Chun
Few studies have compared the risks of mental health problems among the adolescents with different levels and different types of bullying involvement experiences. Bullying involvement in 6,406 adolescents was determined through use of the Chinese version of the School Bullying Experience Questionnaire. Data were collected regarding the mental health problems, including depression, suicidality, insomnia, general anxiety, social phobia, alcohol abuse, inattention, and hyperactivity/impulsivity. The association between experiences of bullying involvement and mental health problems was examined. The risk of mental health problems was compared among those with different levels/types of bullying involvement. The results found that being a victim of any type of bullying and being a perpetrator of passive bullying were significantly associated with all kinds of mental health problems, and being a perpetrator of active bullying was significantly associated with all kinds of mental health problems except for general anxiety. Victims or perpetrators of both passive and active bullying had a greater risk of some dimensions of mental health problems than those involved in only passive or active bullying. Differences in the risk of mental health problems were also found among adolescents involved in different types of bullying. This difference in comorbid mental health problems should be taken into consideration when assessing adolescents involved in different levels/types of bullying. © 2014.
Gabrielle Cerqueira da Silva
Full Text Available Introduction: the regular practice of physical activity has been cited as a mental health protection factor during childhood and adulthood. However, few investigations were carried out on the associations between mental disorder and levels of physical activity in children. Objective: To analyze, by systematic review, the association the association between mental health and physical activity levels in children. Method: Search for articles published in the CAPES Journal Portal databases, LILACS, PubMed, SciELO and Scopus. We adopted the following inclusion criteria: original articles in English or Portuguese, performed with humans, with free full-text. We initially found a total of 2,467 articles, which were analyzed by titles, abstracts, followed by reading of the full article. We selected 05 papers for the final result. Results: The results of the articles show that more active children, participating in physical activity, had better mental health compared children who had no physical activities and were sedentary. Conclusion: Further studies are needed related to the mental health of children, addressing mainly the importance of practicing physical activity to treat and prevent mental illness and promote mental health of these individuals.
Seifert, Bruce; Gonenc, Halit
We examine the effects of both country and firm-level governance on cash holdings and the value of cash for a large international sample during the period 2002-2013. We find that both strong country and strong firm-level governance reduce the amount of cash holdings. We observe that a number of the
Starace, Fabrizio; Mungai, Francesco; Barbui, Corrado
In mental healthcare, one area of major concern identified by health information systems is variability in antipsychotic prescribing. While most studies have investigated patient- and prescriber-related factors as possible reasons for such variability, no studies have investigated facility-level characteristics. The present study ascertained whether staffing level is associated with antipsychotic prescribing in community mental healthcare. A cross-sectional analysis of data extracted from the Italian national mental health information system was carried out. For each Italian region, it collects data on the availability and use of mental health facilities. The rate of individuals exposed to antipsychotic drugs was tested for evidence of association with the rate of mental health staff availability by means of univariate and multivariate analyses. In Italy there were on average nearly 60 mental health professionals per 100,000 inhabitants, with wide regional variations (range 21 to 100). The average rate of individuals prescribed antipsychotic drugs was 2.33%, with wide regional variations (1.04% to 4.01%). Univariate analysis showed that the rate of individuals prescribed antipsychotic drugs was inversely associated with the rate of mental health professionals available in Italian regions (Kendall's tau -0.438, p = 0.006), with lower rates of antipsychotic prescriptions in regions with higher rates of mental health professionals. After adjustment for possible confounders, the total availability of mental health professionals was still inversely associated with the rate of individuals exposed to antipsychotic drugs. The evidence that staffing level was inversely associated with antipsychotic prescribing indicates that any actions aimed at decreasing variability in antipsychotic prescribing need to take into account aspects related to the organization of the mental health system.
Phillip T. Slee
Full Text Available Although there is increasing recognition internationally of the significance of social and emotional health and wellbeing for the healthy development of young people, the levels of support that governments provide for mental health policy and programme initiatives vary widely. In this paper, consideration is given to Australia's approach to mental health promotion from early years to secondary school, including specific reference to the KidsMatter Primary mental health promotion, prevention and early intervention initiative. Although it is now well established that schools provide important settings for the promotion of mental health initiatives, there are significant challenges faced in effectively implementing and maintaining the delivery of evidence-based practice in school settings, including concerns about quality assurance in processes of implementation, translation, dissemination and evaluation.
Full Text Available The climate change response policy gives the mandate to all municipalities and other levels of government to develop and implement climate chnage adaptation response. The availability of appropriate information is essential for this process...
Chisholm, Daniel; Stewart, Alan
BACKGROUND: Both economic and ethical perspectives are exerting increasing influence at all levels of mental health policy and practice; yet there is little consensus on how these two different perspectives are to be reconciled or explicitly incorporated into decision-making. AIM: This review article is directed towards a fuller understanding of the complex trade-offs and compromises that are or may be made by clinicians, managers and policy-makers alike in the context of mental health care planning and delivery. METHOD: We briefly outline a number of key principles of health care economics and ethics, and then focus on the particular incentives and trade-offs that are raised by these principles at three levels of the mental health system: government and society; purchasers and providers; and users and carers. RESULTS: At the level of government and society, we find (economically influenced) attempts to reform mental health care offset by concerns revolving around access to care: whether society is prepared to forgo economic benefits in exchange for improved equity depends to a considerable extent on the prevailing ethical paradigm. The implementation of these reforms at the level of purchasers and providers has helped to focus attention on evaluation and prioritization, but has also introduced "perverse incentives" such as cost-shifting and cream-skimming, which can impede access to or continuity of appropriate care for mentally ill people. Finally, we detect opportunities for moral hazard and other forms of strategic behaviour that are thrown up by the nature of the carer:user relationship in mental health care. CONCLUSION: We conclude by highlighting the need to move towards a more open, accountable and evidence-based mental health care system. Acknowledgement of and progress towards these three requirements will not deliver ideal levels of efficiency or equity, but will foster a greater understanding of the relevance of ethical considerations to mental health
Kato, Noriko; Yanagawa, Toshihiko; Fujiwara, Takeo; Morawska, Alina
The prevalence of mental health problems among children and adolescents is of growing importance. Intervening in children's mental health early in life has been shown to be more effective than trying to resolve these problems when children are older. With respect to prevention activities in community settings, the prevalence of problems should be estimated, and the required level of services should be delivered. The prevalence of children's mental health disorders has been reported for many countries. Preventive intervention has emphasized optimizing the environment. Because parents are the primary influence on their children's development, considerable attention has been placed on the development of parent training to strengthen parenting skills. However, a public-health approach is necessary to confirm that the benefits of parent-training interventions lead to an impact at the societal level. This literature review clarifies that the prevalence of mental health problems is measured at the national level in many countries and that population-level parenting interventions can lower the prevalence of mental health problems among children in the community.
Runhaar, H.A.C.; Driessen, P.P.J.; Bree, L. van; Sluijs, J.P. van der
Internationally but also within countries, large differences exist regarding how environmental health risks (EHRs) are governed. Despite these differences, at a meta-level some general trends can be discerned that may point to a convergence of EHR governance regimes. One, EHR governance regimes are
Keyes, Corey L. M.; Eisenberg, Daniel; Perry, Geraldine S.; Dube, Shanta R.; Kroenke, Kurt; Dhingra, Satvinder S.
Objective: To investigate whether level of positive mental health complements mental illness in predicting students at risk for suicidal behavior and impaired academic performance. Participants: A sample of 5,689 college students participated in the 2007 Healthy Minds Study and completed an Internet survey that included the Mental Health…
Hewitt, J L
Mental health policy development in the UK has become increasingly dominated by the assumed need to prevent violence and alleviate public concerns about the dangers of the mentally ill living in the community. Risk management has become the expected focus of contemporary mental health services, and responsibility has increasingly been devolved to individual service professionals when systems fail to prevent violence. This paper analyses the development of mental health legislation and its impact on services users and mental health professionals at the micro level of service delivery. Historical precedence, media influence and public opinion are explored, and the reification of risk is questioned in practical and ethical terms. The government's newest proposals for compulsory treatment in the community are discussed in terms of practical efficacy and therapeutic impact. Dangerousness is far from being an objectively observable phenomenon arising from clinical pathology, but is a formulation of what is partially knowable through social analysis and unknowable by virtue of its situation in individual psychic motivation. Risk assessment can therefore never be completely accurate, and the solution of a 'better safe than sorry' approach to mental health policy is ethically and pragmatically flawed.
Trapé, Thiago Lavras; Campos, Rosana Onocko
This study aims to analyze the current status of the mental health care model of the Brazilian Unified Health System, according to its funding, governance processes, and mechanisms of assessment. We have carried out a documentary analysis of the ordinances, technical reports, conference reports, normative resolutions, and decrees from 2009 to 2014. This is a time of consolidation of the psychosocial model, with expansion of the health care network and inversion of the funding for community services with a strong emphasis on the area of crack cocaine and other drugs. Mental health is an underfunded area within the chronically underfunded Brazilian Unified Health System. The governance model constrains the progress of essential services, which creates the need for the incorporation of a process of regionalization of the management. The mechanisms of assessment are not incorporated into the health policy in the bureaucratic field. There is a need to expand the global funding of the area of health, specifically mental health, which has been shown to be a successful policy. The current focus of the policy seems to be archaic in relation to the precepts of the psychosocial model. Mechanisms of assessment need to be expanded. Analisar o estágio atual do modelo de atenção à saúde mental do Sistema Único de Saúde, segundo seu financiamento, processos de governança e mecanismos de avaliação. Foi realizada uma análise documental de portarias, informes técnicos, relatórios de conferência, resoluções e decretos de 2009 a 2014. Trata-se de um momento de consolidação do modelo psicossocial, com ampliação da rede assistencial, inversão de financiamento para serviços comunitários com forte ênfase na área de crack e outras drogas. A saúde mental é uma área subfinanciada dentro do subfinanciamento crônico do Sistema Único de Saúde. O modelo de governança constrange o avanço de serviços essenciais, havendo a necessidade da incorporação de um
Full Text Available The objective of this study was to explore generational differences on work engagement levels of employees in a South African government healthcare institution. The Ultrech Work Engagement Scale measured the participants’ levels of work engagement and it was administered to a random sample size of government healthcare institution employees (n=289. Statistical analyses of the data were conducted and the results of ANOVA indicated that the levels of work engagement significantly differ depending on the employees’ generational cohort or group for the dimensions vigour, dedication and absorption. In terms of contributions and practical implications, recommendations are made regarding proposed organisational development interventions to enhance employees’ work engagement levels in a healthcare institution context as well as to conduct future research.
Song, Hong-Tao; Sun, Xin-Yang; Yang, Ting-Shu; Zhang, Li-Yi; Yang, Jia-Lin; Bai, Jing
This study aimed to investigate the effects of sleep deprivation on serum cortisol level and mental health and explore the correlations between them in servicemen. A total of 149 out of the 207 Chinese servicemen were randomly selected to go through 24hour sleep deprivation, leaving the rest (58) as the control group, before and after which their blood samples were drawn for cortisol measurement. Following the procedure, all the participants were administered the Military Personnel Mental Disorder Prediction Scale, taking the military norm as baseline. The results revealed that the post-deprivation serum cortisol level was positively correlated with the factor score of mania in the sleep deprivation group (rSp=0.415, pSleep deprivation could significantly increase serum cortisol level and may affect mental health in servicemen. The increase of serum cortisol level is significantly related to mania disorder during sleep deprivation. Copyright © 2015 Elsevier B.V. All rights reserved.
Nyboe, Lene; Lund, H
Background: Physical inactivity is an independent risk factor for cardiovascular diseases and Type 2 diabetes, both being highly prevalent in patients with severe mental illness. Though physical activity has become an important issue in psychiatric treatment and rehabilitation in the past decade......, systematic evaluations of physical activity level in psychiatric populations could be more disseminated. Aim: The primary aim of the study was to investigate the physical activity level of psychiatric patients in comparison with healthy controls. Methods: Patients with severe mental illness (n =47......) and a group of healthy controls (n =28) matched on sex and age reported their physical activity level using the Physical Activity Scale (PAS). PAS was administered as an interview in relation to patients and as a questionnaire in relation to healthy controls. Results: Patients had statistically significant...
Wahlbeck, Kristian; Cresswell-Smith, Johanna; Haaramo, Peija; Parkkonen, Johannes
To review psychosocial and policy interventions which mitigate the effects of poverty and inequality on mental health. Systematic reviews, controlled trials and realist evaluations of the last 10 years are reviewed, without age or geographical restrictions. Effective psychosocial interventions on individual and family level, such as parenting support programmes, exist. The evidence for mental health impact of broader community-based interventions, e.g. community outreach workers, or service-based interventions, e.g. social prescribing and debt advice is scarce. Likewise, the availability of evidence for the mental health impact of policy level interventions, such as poverty alleviation or youth guarantee, is quite restricted. The social, economic, and physical environments in which people live shape mental health and many common mental disorders. There are effective early interventions to promote mental health in vulnerable groups, but it is necessary to both initiate and facilitate a cross-sectoral approach, and to form partnerships between different government departments, civic society organisations and other stakeholders. This approach is referred to as Mental Health in All Policies and it can be applied to all public policy levels from local policies to supranational.
Cheung, Kristene; Taillieu, Tamara; Turner, Sarah; Fortier, Janique; Sareen, Jitender; MacMillan, Harriet L; Boyle, Michael H; Afifi, Tracie O
Research on factors associated with good mental health following child maltreatment is often based on unrepresentative adult samples. To address these limitations, the current study investigated the relationship between individual-level factors and overall mental health status among adolescents with and without a history of maltreatment in a representative sample. The objectives of the present study were to: 1) compute the prevalence of mental health indicators by child maltreatment types, 2) estimate the prevalence of overall good, moderate, and poor mental health by child maltreatment types; and 3) examine the relationship between individual-level factors and overall mental health status of adolescents with and without a history of maltreatment. Data were from the National Comorbidity Survey of Adolescents (NCS-A; n = 10,123; data collection 2001-2004); a large, cross-sectional, nationally representative sample of adolescents aged 13-17 years from the United States. All types of child maltreatment were significantly associated with increased odds of having poor mental health (adjusted odds ratios ranged from 3.2 to 9.5). The individual-level factors significantly associated with increased odds of good mental health status included: being physically active in the winter; utilizing positive coping strategies; having positive self-esteem; and internal locus of control (adjusted odds ratios ranged from 1.7 to 38.2). Interventions targeted to adolescents with a history of child maltreatment may want to test for the efficacy of the factors identified above. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Kalisova, Lucie; Michalec, Jiri; Hadjipapanicolaou, Demetra; Raboch, Jiri
The aim of this study was to assess sociodemographic factors and factors connected with treatment of mental illness and to decide whether they can influence the level of self-stigma. Sociodemographic characteristics (age, gender, family status, level of employment, level of education) and characteristics related to illness and treatment (diagnosis, length of treatment, adherence to treatment) were gathered in a group of patients in stable mental condition, without acute symptoms of mental illness. Self-stigma was measured using the Self-stigma of Mental Illness Scale - short form (SSMIS-SF). The sample included 197 patients: 99 patients in group 1 (G1) with psychosis and 98 in group 2 (G2) with anxious and affective disorders. The average age was 44.15 ± 12.91 years, the length of illness was 11.67 ± 9.21 years and 48% of patients were men. The total average SSMIS-SF score was 61.54 ± 23.34. We found no statistically significant difference in the total level of self-stigmatisation between these groups ( t(197) = 0.77; p = .441). The level of self-stigmatisation (total score of SSMIS-SF) in patients in G1 (psychosis) increased with the length of illness r(99) = .253; p = .011. Employment status seems to correlate with the level of self-stigmatisation ( F(3, 184) = 5.27; p = .002). Patients unemployed and on disability pension had higher levels of self-stigmatisation than patients working full-time. Patients who took medication regularly (full medical adherence) had lower scores of SSMIS-SF total scores in comparison with patients with lower compliance ( t(195) = 3.476; p = .001; Cohen's d = .25). According to our results, with regard to the factors that were followed, self-stigmatisation correlates with the presence of employment (social inclusion), duration of illness in patients with psychosis and treatment adherence. We did not find a statistically significant influence of age, gender, marital status or clinical diagnosis on the level of self-stigma.
Pien, Li-Chung; Chen, Duan-Rung; Chen, Chiou-Jong; Liang, Kuei-Min; Cheng, Yawen
Workplace violence is known to pose mental health risks. However, whether or not workplace violence in a surrounding area might further increase the risk of mental distress in workers has rarely been examined. The study subjects were 9,393 male and 7,716 female employees who participated in a nationwide survey in 2010. Their personal experiences of workplace violence over the past 1 year were ascertained by a standardized questionnaire. Also assessed were their psychosocial work characteristics and mental distress problems. Neighborhood-level workplace violence was computed based on aggregated data at the county level and was categorized into low-, medium-, and high-level categories. Multilevel logistic regression models were constructed to examine the associations between neighborhood-level workplace violence and individual-level mental distress problems, with adjustment of individual-level experience of workplace violence. The neighborhood-level prevalence of workplace violence ranged from 4.7 to 14.7% in men and from 6.4 to 14.8% in women across 22 counties. As compared with those who live in counties of the lowest tertile of workplace violence, female workers who lived in counties of the highest tertile of workplace violence had a 1.72-fold increased risk for mental distress problems after controlling for individual experience of workplace violence and other psychosocial work characteristics. Neighborhood-level workplace violence was associated with poor mental health in female workers. Preventative strategies targeting workplace violence should pay attention to neighborhood factors and gender-specific effects that might influence societal tolerance of abusive work practices and workers' vulnerability to mental health impacts of workplace violence.
The purpose of this study was to compare the relative effectiveness of three "mental" practice strategies: 1) silent, motionless mental practice, 2) singing/vocalizing, and 3) playing "air cello." Traditional physical practice was used as a control condition. Twelve collegiate-level cellists participated in the experiment, from which improvement…
Full Text Available In the context of contemporary society, characterized by the information users’ growing and differentiated needs, the way country-level governance and social responsibility contribute to the ensuring of sustainable economic development is a concern for all the actors of the economic sphere. The aim of this paper is to test the causal linkages between the quality of country-level governance, economic growth and a well-known indicator of economic sustainable development, for a large panel of world-wide countries for a period of 10 years (2006–2015. While there are some prior studies that have argued the bidirectional causality between good public governance and economic development, this study intends to provide a new focus on the relationship between country-level governance and economic growth, on one hand, and between country-level governance and adjusted net savings, as a selected indicator of economic sustainable development, on the other hand. Four hypotheses on the causal relationship between good governance, economic growth and sustainable development were tested by using Granger non-causality tests. Our findings resulting from Granger non-causality tests provide reasonable evidence of Granger causality from country-level governance to economic growth, but from economic growth to country-level governance, the causality is not confirmed. In what regards the relationship between country-level governance and adjusted net savings, the bidirectional Granger causality is not confirmed. The main implication of our study is that improving economic growth and sustainable development is a very challenging issue, and the impact of macro-level factors such as country-level governance should not be neglected.
Government support is a popular instrument to foster technology innovation. It can take various forms such as financial aid, tax credits, and technological assistance. Along with the firm characteristics, strategic behavior of the project team, characteristics of the technology and the market, and the regulatory environment, government support influences firms' research and development (R&D) motivations, decision making process, and hence technology development performance. How government support influences the performance in different industries is an important policy and research question. There are many studies on the effectiveness and impacts of government support, mostly at program-level or industry-level. Government Championship is a form of government support distinct from direct financial or technological assistance. Championship includes expressing confidence in the innovation, encouraging others to support the innovation, and persisting under adversity. Championship has been studied as a critical inside factor for innovation success, particularly at project-level. Usually a champion emerged within the organization responsible for the innovation project. However, with the intention to encourage technology development, governments can also play a championship role. Government championship, besides government financial and technological assistance (hereafter "government F&T"), could be one major category of government support to facilitate high-technology innovation. However, there are few studies focusing on the effectiveness of government championship, and how it influences the innovation process. This thesis addresses this question through two studies on high-technology development projects. The first study has tested the effectiveness of government championship on the performance of 431 government sponsored technology innovation projects. Government championship and government F&T, as well as project team strategic behavior, are hypothesized to influence
Hann, Katrina; Pearson, Heather; Campbell, Doris; Sesay, Daniel; Eaton, Julian
Mental health advocacy groups are an effective way of pushing the mental health agenda and putting pressure on national governments to observe the right to health; however, there is limited research that highlights best practices for such groups in low-resource settings. In an effort to improve the scaling up of mental health in Sierra Leone, stakeholders came together to form the country's first mental health advocacy group: the Mental Health Coalition - Sierra Leone. Since its inception, the group has worked towards raising the profile of mental health in Sierra Leone and developing as an advocacy organisation. The study's aim was to investigate views on enabling factors and barriers associated with mental health advocacy in a low-income country using a community-based participatory approach and qualitative methodology. Focus groups (N=9) were held with mental health stakeholders, and key informant interviews (N=15) were conducted with advocacy targets. Investigators analysed the data collaboratively using coding techniques informed by grounded theory. Investigators reveal viewpoints on key factors in networking, interacting with government actors, and awareness raising that enabled mental health advocacy aims of supporting policy, service delivery, service user rights, training for service delivery, and awareness raising. The investigators outline viewpoints on barriers for advocacy aims in framing the issue of mental health, networking, interacting with government actors, resource mobilization, and awareness raising. The findings outline enabling factors, such as networking with key stakeholders, and barriers, such as lack of political will, for achieving mental health advocacy aims within a low-resource setting, Sierra Leone. Stakeholder coalitions can further key policy development aims that are essential to strengthen mental health systems in low-resource settings.
Eaton, Julian; Nwefoh, Emeka; Okafor, Godwin; Onyeonoro, Ugochukwu; Nwaubani, Kenneth; Henderson, Claire
Mental health services in Nigeria consist mainly of large government psychiatric hospitals and there are very few mental health professionals to serve the large population of the country. However, more recently, community mental health services, which have been shown to improve access to care and clinical outcomes are beginning to develop in some locations. Despite efforts to promote more accessible services, low levels of knowledge about effective treatment of mental disorders means that even where these services are available, a very small proportion of people utilise these services. Therefore interventions to increase service use are an essential component of health system. This intervention was designed to increase use of a mental health services through the work of community-based Village Health Workers. Fifteen Village Health Workers in each Local Government Area (district) were selected and trained to create mental health awareness in communities. Their function also include identification and referral of persons with mental illness to trained mental health nurses in the clinics. Attendance data prior to and after intervention were collected and compared. The incident rate for initial period of intervention is five times higher than the baseline rate (95% CI; 3.42-7.56; p awareness raising using volunteers in communities as part of health programme implementation can increase services use by a population. Mechanisms such as informing populations of the existence of a service which they were previously lacking; explanation of causation of mental illness and achieving community leaders' support for a new service can make investment in services more efficient by increasing attendance.
Verrocchio, Maria Cristina; Ambrosini, Alessandra; Fulcheri, Mario
Mental disorders are associated with many difficulties in the activities of daily living, work, relationships and family, and they determine high social and economic costs that represent an important public health problem. The literature has shown that children of parents with mental disorders grow up in environments that are potentially harmful to their mental health and are at risk of neglect and maltreatment. Interventions to prevent mental disorders and psychological symptoms of children of parents with mental disorders are effective but supporting these families is a complex task which requires both cooperation between departments and an interdisciplinary knowledge. A greater knowledge of the responses provided to assist families with dependent children and a mentally ill parent, could stimulate reflections on critical issues and government actions aimed at promoting and protecting the mental health of children.
Hann, Katrina; Pearson, Heather; Campbell, Doris; Sesay, Daniel; Eaton, Julian
Background Mental health advocacy groups are an effective way of pushing the mental health agenda and putting pressure on national governments to observe the right to health; however, there is limited research that highlights best practices for such groups in low-resource settings. In an effort to improve the scaling up of mental health in Sierra Leone, stakeholders came together to form the country's first mental health advocacy group: the Mental Health Coalition – Sierra Leone. Since its inception, the group has worked towards raising the profile of mental health in Sierra Leone and developing as an advocacy organisation. Design The study's aim was to investigate views on enabling factors and barriers associated with mental health advocacy in a low-income country using a community-based participatory approach and qualitative methodology. Focus groups (N=9) were held with mental health stakeholders, and key informant interviews (N=15) were conducted with advocacy targets. Investigators analysed the data collaboratively using coding techniques informed by grounded theory. Results Investigators reveal viewpoints on key factors in networking, interacting with government actors, and awareness raising that enabled mental health advocacy aims of supporting policy, service delivery, service user rights, training for service delivery, and awareness raising. The investigators outline viewpoints on barriers for advocacy aims in framing the issue of mental health, networking, interacting with government actors, resource mobilization, and awareness raising. Conclusions The findings outline enabling factors, such as networking with key stakeholders, and barriers, such as lack of political will, for achieving mental health advocacy aims within a low-resource setting, Sierra Leone. Stakeholder coalitions can further key policy development aims that are essential to strengthen mental health systems in low-resource settings. PMID:26689456
Jegannathan, Bhoomikumar; Kullgren, Gunnar; Deva, Parameshvara
Cambodia had suffered enormously due to war and internecine conflict during the latter half of the twentieth century, more so during the Vietnam War. Total collapse of education and health systems during the Pol Pot era continues to be a challenge for developing the necessary infrastructure and human resources to provide basic minimum mental health care which is compounded by the prevailing cultural belief and stigma over mental, neurological and substance abuse disorders (MNSDs). The mental health research and services in Cambodia had been predominantly 'trauma focused', a legacy of war, and there is a need to move toward epidemiologically sound public health oriented mental health policy and service development. Integrating mental health program with primary health care services with specifically stated minimum package of activities at primary level and complementary package of activities at secondary level is an opportunity to meet the needs and rights of persons with mental, neurological and substance abuse disorders (PWMNSDs) in Cambodia, provided there is mental health leadership, government commitment and political will. Copyright © 2014 Elsevier B.V. All rights reserved.
Morlock, L L; Alexander, J A
This study utilizes data from a national survey of 159 multihospital systems in order to describe the types of governance structures currently being utilized, and to compare the policy making process for various types of decisions in systems with different approaches to governance. Survey results indicate that multihospital systems most often use one of three governance models. Forty-one percent of the systems (including 33% of system hospitals) use a parent holding company model in which there is a system-wide corporate governing board and separate governing boards for each member hospital. Twenty-two percent of systems in the sample (but 47% of all system hospitals) utilize what we have termed a modified parent holding company model in which there is one system-wide governing board, but advisory boards are substituted for governing boards at the local hospital level. Twenty-three percent of the sampled systems (including 11% of system hospitals) use a corporate model in which there is one system-wide governing board but no other governing or advisory boards at either the divisional, regional or local hospital levels. A comparison of systems using these three governance approaches found significant variation in terms of system size, ownership and the geographic proximity of member hospitals. In order to examine the relationship between alternative approaches to governance and patterns of decision-making, the three model types were compared with respect to the percentages of systems reporting that local boards, corporate management and/or system-wide corporate boards have responsibility for decision-making in a number of specific issue areas. Study results indicate that, regardless of model type, corporate boards are most likely to have responsibility for decisions regarding the transfer, pledging and sale of assets; the formation of new companies; purchase of assets greater than $100,000; changes in hospital bylaws; and the appointment of local board members. In
Talpur Shabana; Lizam Mohd; Keerio Nazia
This study examined the level of voluntary corporate governance disclosures and the influence of firm characteristics (i.e., firm size, firm age, and firm market listing) on the level of these disclosures among Malaysian property listed companies. The check-list to measure the voluntary corporate governance disclosures was adopted from Malaysian corporate governance index 2011 by Minority Shareholder Watchdog Group (MSWG). The voluntary corporate governance disclosure practices and firm speci...
Full Text Available This paper explores the concept of collaborative care, particularly in relation to a range of new models of organisation and service that are emerging in response to one of the most problematic areas of public policy – mental health. These emerging models of coordinated mental health care are testing the limits of the evidence supporting coordinated care, and require critical evaluation. Myriad concepts of collaborative or coordinated care in health, including mental health, have created multiple definitions. Once definitional issues have been surmounted, however, the evidence for coordination of health care is reasonably strong. There is considerable research about which treatments and programs are best for people with a mental illness. There are few areas seemingly as complex as mental health, given that responsibility for policy and service lies across all three tiers of Australian government and across multiple jurisdictions. It also engages public, private and non-government sectors. Co-morbidities are commonplace, particularly drug and alcohol problems among younger people. Governments in Australia have traditionally taken responsibility for policy, programs and services, either as direct service providers or through contracting outputs from others. Yet the evidence indicates that for people with a mental illness, the best solutions are often not found in government but in the community and in organisations outside of government. New organisations and new structures are attempting more holistic management approaches, combining clinical care, community support, housing, employment and other services. This paper considers some of these new models in the light of existing evidence. The key challenge facing continued reform in mental health is not uncertainty regarding programs or services, but rather how to drive coordinated care for consumers across departments, governments and providers. This review will highlight the key changes that
Full Text Available In most regions in West Africa, livelihoods depend heavily on forest ecosystem goods and services, often in interplay with agricultural and livestock production systems. Numerous drivers of change are creating a range of fundamental economic, ecological, social and political challenges for the governance of forest commons. Climate change and its impacts on countries’ and regions’ development add a new dimension to an already challenging situation. Governance systems are challenged to set a frame for formulating, financing and implementing adaptation strategies at multiple layers, often in a context of ongoing institutional changes such as decentralisation. A deeper understanding of actors, institutions and networks is needed to overcome barriers in socio-ecological systems to adaptation and enable or enhance adaptive capacity. In this paper, we explore the relationship between governance and adaptive capacity, and characterise and assess the effects of a set of variables and indicators related to two core variables: Institutional flexibility, and individual and organisational understandings and perceptions. We present a comparative analysis with multiple methods based on a number of case studies undertaken at different levels in Burkina Faso and Mali. One of the key findings indicates the importance and influence of discourses and narratives, and how they affect adaptive capacity at different levels. Revealing the ideological character of discourses can help to enable adaptive capacity, as it would break the influence of the actors that employ these narratives to pursuit their own interests.
Mental skill levels of South African male student field hockey players in different playing positions. ... African Journal for Physical Activity and Health Sciences ... The positional results were compared by means of effect sizes (expressed as ...
Upadhaya, Nawaraj; Jordans, Mark J D; Abdulmalik, Jibril; Ahuja, Shalini; Alem, Atalay; Hanlon, Charlotte; Kigozi, Fred; Kizza, Dorothy; Lund, Crick; Semrau, Maya; Shidhaye, Rahul; Thornicroft, Graham; Komproe, Ivan H; Gureje, Oye
Research on information systems for mental health in low and middle income countries (LMICs) is scarce. As a result, there is a lack of reliable information on mental health service needs, treatment coverage and the quality of services provided. With the aim of informing the development and implementation of a mental health information sub-system that includes reliable and measurable indicators on mental health within the Health Management Information Systems (HMIS), a cross-country situation analysis of HMIS was conducted in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda), participating in the 'Emerging mental health systems in low and middle income countries' (Emerald) research programme. A situation analysis tool was developed to obtain and chart information from documents in the public domain. In circumstances when information was inadequate, key government officials were contacted to verify the data collected. In this paper we compare the baseline policy context, human resources situation as well as the processes and mechanisms of collecting, verifying, reporting and disseminating mental health related HMIS data. The findings suggest that countries face substantial policy, human resource and health governance challenges for mental health HMIS, many of which are common across sites. In particular, the specific policies and plans for the governance and implementation of mental health data collection, reporting and dissemination are absent. Across sites there is inadequate infrastructure, few HMIS experts, and inadequate technical support and supervision to junior staff, particularly in the area of mental health. Nonetheless there are also strengths in existing HMIS where a few mental health morbidity, mortality, and system level indicators are collected and reported. Our study indicates the need for greater technical and resources input to strengthen routine HMIS and develop standardized HMIS indicators for mental health, focusing in
Full Text Available This study examined the level of voluntary corporate governance disclosures and the influence of firm characteristics (i.e., firm size, firm age, and firm market listing on the level of these disclosures among Malaysian property listed companies. The check-list to measure the voluntary corporate governance disclosures was adopted from Malaysian corporate governance index 2011 by Minority Shareholder Watchdog Group (MSWG. The voluntary corporate governance disclosure practices and firm specific characteristics were obtained from annual reports of property listed companies on Bursa Malaysia for the period of 2012 to 2015. The findings suggested an improving voluntary corporate governance reforms in Malaysia. However, the firm size was found as an inflicting factor in determining the level and quality of voluntary corporate governance disclosure practices. On the contrary, the results found were contradicting the hypothesis related to firm age and firm market listing, as no relation of voluntary corporate governance disclosures and firm age and firm market listing. The study has made an interesting contribution toward the disclosure and corporate governance by contributing in understanding the importance of quality disclosure and good governance practices.
Doyle, Louise; Ellilä, Heikki; Jormfeldt, Henrika; Lahti, Mari; Higgins, Agnes; Keogh, Brian; Meade, Oonagh; Sitvast, Jan; Skärsäter, Ingela; Stickley, Theo; Kilkku, Nina
Mental health promotion remains an important component of mental health nursing practice. Supporting wellness at both the individual and societal levels has been identified as one of the key tenets of mental health promotion. However, the prevailing biomedical paradigm of mental health education and practice has meant that many nurses have not been equipped to incorporate a wellness perspective into their mental health practice. In the present study, we report on an exploratory study which details the knowledge, skills, and attitudes required by master-level mental health nurses to practice within a wellness paradigm from the perspective of three groups of key stakeholders: (i) service users and family members (n = 23); (ii) experienced mental health nurses (n = 49); and (iii) master-level mental health nursing students (n = 37). The findings, which were reported from individual and focus group interviews across five European countries, suggested a need to reorientate mental health nursing education to include a focus on wellness and resilience to equip mental health nurses with the skills to work within a strengths-based, rather than a deficits-based, model of mental health practice. Key challenges to working within a wellness paradigm were identified as the prevailing dominance of the biomedical model of cause and treatment of mental health problems, which focusses on symptoms, rather than the holistic functioning of the individual, and positions the person as passive in the nurse-service user relationship. © 2017 Australian College of Mental Health Nurses Inc.
Maria Cristina Verrocchio
Full Text Available Mental disorders are associated with many difficulties in the activities of daily living, work, relationships and family, and they determine high social and economic costs that represent an important public health problem. The literature has shown that children of parents with mental disorders grow up in environments that are potentially harmful to their mental health and are at risk of neglect and maltreatment. Interventions to prevent mental disorders and psychological symptoms of children of parents with mental disorders are effective but supporting these families is a complex task which requires both cooperation between departments and an interdisciplinary knowledge. A greater knowledge of the responses provided to assist families with dependent children and a mentally ill parent, could stimulate reflections on critical issues and government actions aimed at promoting and protecting the mental health of children.
Sattler, Frank A; Wagner, Ulrich; Christiansen, Hanna
According to epidemiological studies, gay men are at a higher risk of mental disorders than heterosexual men. In the current study, the minority stress theory was investigated in German gay men: 1) it was hypothesized that minority stressors would positively predict mental health problems and that 2) group-level coping and social support variables would moderate these predictions negatively. Data from 1,188 German self-identified gay men were collected online. The questionnaire included items about socio-demographics, minority stress (victimization, rejection sensitivity, and internalized homonegativity), group-level coping (disclosure of sexual orientation, homopositivity, gay affirmation, gay rights support, and gay rights activism), and social support (gay social support and non-gay social support). A moderated multiple regression was conducted. Minority stressors positively predicted mental health problems. Group-level coping did not interact with minority stressors, with the exception of disclosure and homopositivity interacting marginally with some minority stressors. Further, only two interactions were found for social support variables and minority stress, one of them marginal. Gay and non-gay social support inversely predicted mental health problems. In addition, disclosure and homopositivity marginally predicted mental health problems. The findings imply that the minority stress theory should be modified. Disclosure does not have a relevant effect on mental health, while social support variables directly influence mental health of gay men. Group-level coping does not interact with minority stressors relevantly, and only one relevant interaction between social support and minority stress was found. Further longitudinal or experimental replication is needed before transferring the results to mental health interventions and prevention strategies for gay men.
Gao, Junling; Weaver, Scott R.; Dai, Junming; Jia, Yingnan; Liu, Xingdi; Jin, Kezhi; Fu, Hua
Background Whereas the majority of previous research on social capital and health has been on residential neighborhoods and communities, the evidence remains sparse on workplace social capital. To address this gap in the literature, we examined the association between workplace social capital and health status among Chinese employees in a large, multi-level, cross-sectional study. Methods By employing a two-stage stratified random sampling procedure, 2,796 employees were identified from 35 workplaces in Shanghai during March to November 2012. Workplace social capital was assessed using a validated and psychometrically tested eight-item measure, and the Chinese language version of the WHO-Five Well-Being Index (WHO-5) was used to assess mental health. Control variables included sex, age, marital status, education level, occupation status, smoking status, physical activity, and job stress. Multilevel logistic regression analysis was conducted to explore whether individual- and workplace-level social capital was associated with mental health status. Results In total, 34.9% of workers reported poor mental health (WHO-5workplace-level social capital were 0.95 (95% CI: 0.61–1.49), 1.14 (95% CI: 0.72–1.81) and 1.63 (95% CI: 1.05–2.53) for the third, second, and lowest quartiles, respectively. Conclusions Higher workplace social capital is associated with lower odds of poor mental health among Chinese employees. Promoting social capital at the workplace may contribute to enhancing employees’ mental health in China. PMID:24404199
In the past few years, the EU has been establishing a new regulatory framework for GMOs, a central issue in the governance of risk that came under fierce attack in the mid-1990s. The primary question addressed in this article is whether this new framework will be able to solve the legitimacy...... problem of GMO governance at the EU level. Focusing on theories concerning input–output legitimacy and democracy and the role of expertise, this article examines the level of involvement of stakeholders in the process leading to the new rules; the predominant mechanisms of representation that have been...
Frank A Sattler
Full Text Available According to epidemiological studies, gay men are at a higher risk of mental disorders than heterosexual men. In the current study, the minority stress theory was investigated in German gay men: 1 it was hypothesized that minority stressors would positively predict mental health problems and that 2 group-level coping and social support variables would moderate these predictions negatively.Data from 1,188 German self-identified gay men were collected online. The questionnaire included items about socio-demographics, minority stress (victimization, rejection sensitivity, and internalized homonegativity, group-level coping (disclosure of sexual orientation, homopositivity, gay affirmation, gay rights support, and gay rights activism, and social support (gay social support and non-gay social support. A moderated multiple regression was conducted.Minority stressors positively predicted mental health problems. Group-level coping did not interact with minority stressors, with the exception of disclosure and homopositivity interacting marginally with some minority stressors. Further, only two interactions were found for social support variables and minority stress, one of them marginal. Gay and non-gay social support inversely predicted mental health problems. In addition, disclosure and homopositivity marginally predicted mental health problems.The findings imply that the minority stress theory should be modified. Disclosure does not have a relevant effect on mental health, while social support variables directly influence mental health of gay men. Group-level coping does not interact with minority stressors relevantly, and only one relevant interaction between social support and minority stress was found. Further longitudinal or experimental replication is needed before transferring the results to mental health interventions and prevention strategies for gay men.
Hjorth, Cathrine F; Bilgrav, Line; Frandsen, Louise Sjørslev; Overgaard, Charlotte; Torp-Pedersen, Christian; Nielsen, Berit; Bøggild, Henrik
Education is a key determinant of future employment and income prospects of young people. Poor mental health is common among young people and is related to risk of dropping out of school (dropout). Educational level and gender might play a role in the association, which remains to be studied. Mental health was measured in 3146 Danish inhabitants aged 16-29 years using the 12-Item Short-Form Health Survey and examined across genders and educational levels. For students, educational level at baseline was used; for young people who were not enrolled in school at baseline (non-students), the highest achieved educational level was used. The risk of dropout in students was investigated in administrative registers over a 4.8-year period (1(st) March 2010-31(th) December 2014). Odds ratios (OR) and 95 % confidence intervals (CI) were calculated for mental health and in relation to dropout in logistic regression models, adjusting for age, gender, educational level, parental education, parental income and ethnicity. Poor mental health was present in 24 % (n = 753) of the participants, 29 % (n = 468) in females and 19 % (n = 285) in males (p mental health than males (OR = 1.8, CI = 1.5-2.2). Among the students the lowest risk was found at the elementary level (OR = 1.3, CI = 0.8-2.3), while students in higher education had a statistically significantly higher risk (OR = 1.9, CI = 1.2-2.9). The lowest-educated non-students had the highest OR of poor mental health (OR = 3.3, CI = 2.1-5.4). Dropout occurred in 8 % (n = 124) of the students. Poor mental health was associated to dropout in vocational (OR = 1.8, CI = 1.0-3.2) and higher education (OR = 2.0, CI = 1.0-4.2). For males in higher education, poor mental health was a predictor of dropout (OR = 5.2, CI = 1.6-17.3), which was not seen females in higher education (OR = 1.2, CI = 0.5-3.1). Poor mental health was significantly associated to
Hazizi, A S; Aina, Mardiah B; Mohd, Nasir M T; Zaitun, Y; Hamid, Jan J M; Tabata, I
A cross-sectional study was carried out to investigate accelerometer-determined physical activity level of 233 Malay government employees (104 men, 129 women) working in the Federal Government Building Penang, Malaysia. Body weight, height, waist and hip circumference, body fat percentage and blood pressure were measured for each respondent. All the respondents were asked to wear an accelerometer for 3 days. Body mass index (BMI) and waist-hip ratio (WHR) were calculated using a standard formulas. Fasting blood sample was obtained to determine the lipid profile and glucose levels of the respondents. Based on the accelerometer-determined physical activity level, almost 65% of the respondents were categorised as sedentary. Approximately 50.2% of the respondents were overweight or obese. There were negative but significant relationships between body mass index (BMI) (r = -0.353, p obesity in this study. The high prevalence of physical inactivity and obesity found among respondents of this study indicate a need for implementing intervention programmes among this population.
Full Text Available BACKGROUND: Whereas the majority of previous research on social capital and health has been on residential neighborhoods and communities, the evidence remains sparse on workplace social capital. To address this gap in the literature, we examined the association between workplace social capital and health status among Chinese employees in a large, multi-level, cross-sectional study. METHODS: By employing a two-stage stratified random sampling procedure, 2,796 employees were identified from 35 workplaces in Shanghai during March to November 2012. Workplace social capital was assessed using a validated and psychometrically tested eight-item measure, and the Chinese language version of the WHO-Five Well-Being Index (WHO-5 was used to assess mental health. Control variables included sex, age, marital status, education level, occupation status, smoking status, physical activity, and job stress. Multilevel logistic regression analysis was conducted to explore whether individual- and workplace-level social capital was associated with mental health status. RESULTS: In total, 34.9% of workers reported poor mental health (WHO-5<13. After controlling for individual-level socio-demographic and lifestyle variables, compared to workers with the highest quartile of personal social capital, workers with the third, second, and lowest quartiles exhibited 1.39 to 3.54 times greater odds of poor mental health, 1.39 (95% CI: 1.10-1.75, 1.85 (95% CI: 1.38-2.46 and 3.54 (95% CI: 2.73-4.59, respectively. Corresponding odds ratios for workplace-level social capital were 0.95 (95% CI: 0.61-1.49, 1.14 (95% CI: 0.72-1.81 and 1.63 (95% CI: 1.05-2.53 for the third, second, and lowest quartiles, respectively. CONCLUSIONS: Higher workplace social capital is associated with lower odds of poor mental health among Chinese employees. Promoting social capital at the workplace may contribute to enhancing employees' mental health in China.
Illicit drug policy has long been an area that has attracted international policy intervention, however, the European Union has declared it an area of subsidiarity, leaving ultimate control to national governments. Nevertheless, European Union preoccupation with the illicit drug issue and international drug trafficking and organised crime concerns have ensured that continued and increased cooperation in illicit drug policy is never off the agenda. This article examines the history of European integration in contrasting areas of policy and considers both the desirability and the viability of an increasingly harmonised drug policy for Europe. Finally, it proposes a model of integrated illicit drug policy that is strongly connected to developing patterns of European social policy, calling on multi-level governance and close involvement at the level of the citizen.
Vigo, Daniel; Thornicroft, Graham; Atun, Rifat
We argue that the global burden of mental illness is underestimated and examine the reasons for under-estimation to identify five main causes: overlap between psychiatric and neurological disorders; the grouping of suicide and self-harm as a separate category; conflation of all chronic pain syndromes with musculoskeletal disorders; exclusion of personality disorders from disease burden calculations; and inadequate consideration of the contribution of severe mental illness to mortality from associated causes. Using published data, we estimate the disease burden for mental illness to show that the global burden of mental illness accounts for 32·4% of years lived with disability (YLDs) and 13·0% of disability-adjusted life-years (DALYs), instead of the earlier estimates suggesting 21·2% of YLDs and 7·1% of DALYs. Currently used approaches underestimate the burden of mental illness by more than a third. Our estimates place mental illness a distant first in global burden of disease in terms of YLDs, and level with cardiovascular and circulatory diseases in terms of DALYs. The unacceptable apathy of governments and funders of global health must be overcome to mitigate the human, social, and economic costs of mental illness. Copyright © 2016 Elsevier Ltd. All rights reserved.
Aline Gabriela Simon
Full Text Available Este artigo analisa o papel dos estados na política de saúde mental no Brasil no período de 1990 a 2009. A metodologia incluiu a aplicação de questionário eletrônico nas coordenações estaduais de saúde mental de 24 estados brasileiros, revisão documental e análise de base de dados oficiais. Os resultados obtidos apontaram que os estados utilizam várias estratégias e instrumentos na condução da política de saúde mental, principalmente no monitoramento e na prestação de serviços. No entanto, percebeu-se que os estados ainda não desenvolvem de forma sistemática as funções de planejamento, coordenação federativa e coordenação da atenção. O financiamento em saúde mental representa um dos grandes desafios para a gestão dessa área nos estados. Os achados deste estudo sugerem que a superação dos desafios relacionados à condução estadual da política de saúde mental depende da articulação entre governo federal, estados e municípios na elaboração de políticas que atendam à especificidade de cada região, da promoção de um planejamento participativo e de investimentos para o setor.This article examines the role of States in mental health policy in Brazil from 1990 to 2009. The methods included the use of an electronic questionnaire on State coordination of mental health in 24 Brazilian States, document review, and analysis based on official data. The results showed that the States use various strategies and tools to conduct mental health policy, especially in monitoring and services delivery. However, the study showed that States have not developed systematic approaches to planning, coordination with other levels of government, or coordination of care. Funding poses a major challenge for management of mental health at the State level. The study suggests that overcoming the challenges in mental health policy depends on the relationship between the Federal government, States, and Municipalities in drafting
Full Text Available This paper analyses the response of the Municipality of Barcelona to the Syrian refugee crisis in Europe as an alternative solution that challenges the national government’s restrictive approach. This response introduces the Ciutat Refugi Plan with a city-to-city network at the municipal level that involves other European cities in creating safe routes for refugees at the local government level. In line with multi-level governance theory, I argue that central governments’ inaction has pressured local governments to take action during the Syrian refugee influx. Relying on the influence of local government networks, the Municipality of Barcelona uses discourse as a tool of action in opening discursive spaces for humanitarian political responses to the refugee crisis. Using critical discourse analysis, I test this argument by examining in-depth interviews, speeches of people in power that have appeared in news articles, and statements on official websites.
Full Text Available The corporate governance is a central and dynamic aspect of the businesses. The term governance comes from the latin “gubernare”, meaning to guide and supposes that the corporate governance imply equally both the leadership function and that of control. As is known there are more ways of defining the enterprise governance starting from the simple stones, which focus on the enterprise and its shareholders, to the most complex ones incorporating individual or departamental responsability to implement a given function of the companies and which implies many other groups of persons. Responsability is the consequence of the law and reglementation application or contract agreements.
Full Text Available The corporate governance is a central and dynamic aspect of the businesses. The term governance comes from the latin “gubernare”, meaning to guide and supposes that the corporate governance imply equally both the leadership function and that of control. As is known there are more ways of defining the enterprise governance starting from the simple stones, which focus on the enterprise and its shareholders, to the most complex ones incorporating individual or departamental responsability to implement a given function of the companies and which implies many other groups of persons. Responsability is the consequence of the law and reglementation application or contract agreements.
Havas, Jano; Bosma, Hans; Spreeuwenberg, Cor; Feron, Frans J
We studied the hypothesis of socioeconomic equalization regarding adolescents' mental health problems by examining whether a low educational level of adolescents and their parents shows independent (cumulative) or dependent (including interactive) associations with adolescents' mental health problems, or whether equalization occurred. Cross-sectional data were obtained from the preventive Youth Health Care Centre in a relatively deprived Dutch former mining area. Participants were 1861 adolescents aged 13 or 14 years (response rate 71.7%). The self-administered Dutch version of the Strengths and Difficulties Questionnaire (SDQ) was used to identify adolescents' mental health problems. Multiple logistic regression analyses were used to examine the associations, and linear regression models to check the robustness of the findings. A low educational level of adolescents was strongly related to their mental health problems (OR = 5.37; 95% CI: 3.31-8.70). The initially high odds ratios for adolescents with low-educated parents (OR = 1.72; 95% CI: 1.14-2.59) disappeared after controlling for the adolescents' own educational level (OR = 1.12; 95% CI: 0.73-1.74). In terms of interactions, no specifically increased odds were found, e.g. for low-educated adolescents with high-educated parents. There was no evidence for socioeconomic equalization regarding adolescents' mental health problems. Lower educated adolescents had substantially higher odds of having mental health problems, regardless of their parents' education. The odds may be affected by differences in intelligence and life events. Youth healthcare workers should collaborate closely with schools to intervene in time, particularly among low-educated adolescents. More interventions are probably needed to reduce these major inequities.
Cathrine F. Hjorth
Full Text Available Abstract Background Education is a key determinant of future employment and income prospects of young people. Poor mental health is common among young people and is related to risk of dropping out of school (dropout. Educational level and gender might play a role in the association, which remains to be studied. Methods Mental health was measured in 3146 Danish inhabitants aged 16–29 years using the 12-Item Short-Form Health Survey and examined across genders and educational levels. For students, educational level at baseline was used; for young people who were not enrolled in school at baseline (non-students, the highest achieved educational level was used. The risk of dropout in students was investigated in administrative registers over a 4.8–year period (1st March 2010–31th December 2014. Odds ratios (OR and 95 % confidence intervals (CI were calculated for mental health and in relation to dropout in logistic regression models, adjusting for age, gender, educational level, parental education, parental income and ethnicity. Results Poor mental health was present in 24 % (n = 753 of the participants, 29 % (n = 468 in females and 19 % (n = 285 in males (p < 0.0001. The prevalence differed from 19 to 39 % across educational levels (p < 0.0001. Females had a statistically significantly higher adjusted risk of poor mental health than males (OR = 1.8, CI = 1.5–2.2. Among the students the lowest risk was found at the elementary level (OR = 1.3, CI = 0.8–2.3, while students in higher education had a statistically significantly higher risk (OR = 1.9, CI = 1.2–2.9. The lowest-educated non-students had the highest OR of poor mental health (OR = 3.3, CI = 2.1–5.4. Dropout occurred in 8 % (n = 124 of the students. Poor mental health was associated to dropout in vocational (OR = 1.8, CI = 1.0–3.2 and higher education (OR = 2.0, CI = 1.0–4.2. For males in higher
Scorza, Pamela; Duarte, Cristiane S; Stevenson, Anne; Mushashi, Christine; Kanyanganzi, Fredrick; Munyana, Morris; Betancourt, Theresa S
Prevention of mental disorders worldwide requires a greater understanding of protective processes associated with lower levels of mental health problems in children who face pervasive life stressors. This study aimed to identify culturally appropriate indicators of individual-level protective factors in Rwandan adolescents where risk factors, namely poverty and a history of trauma, have dramatically shaped youth mental health. The sample included 367 youth aged 10-17 in rural Rwanda. An earlier qualitative study of the same population identified the constructs "kwihangana" (patience/perseverance) and "kwigirira ikizere" (self-esteem) as capturing local perceptions of individual-level characteristics that helped reduce risks of mental health problems in youth. Nine items from the locally derived constructs were combined with 25 items from an existing scale that aligned well with local constructs-the Connor-Davidson Resilience Scale (CD-RISC). We assessed the factor structure of the CD-RISC expanded scale using exploratory factor analysis and determined the correlation of the expanded CD-RISC with depression and functional impairment. The CD-RISC expanded scale displayed high internal consistency (α = 0.93). Six factors emerged, which we labeled: perseverance, adaptability, strength/sociability, active engagement, self-assuredness, and sense of self-worth. Protective factor scale scores were significantly and inversely correlated with depression and functional impairment (r = -0.49 and r = - 0.38, respectively). An adapted scale displayed solid psychometric properties for measuring protective factors in Rwandan youth. Identifying culturally appropriate protective factors is a key component of research associated with the prevention of mental health problems and critical to the development of cross-cultural strength-based interventions for children and families.
Gao, Junling; Weaver, Scott R; Dai, Junming; Jia, Yingnan; Liu, Xingdi; Jin, Kezhi; Fu, Hua
Whereas the majority of previous research on social capital and health has been on residential neighborhoods and communities, the evidence remains sparse on workplace social capital. To address this gap in the literature, we examined the association between workplace social capital and health status among Chinese employees in a large, multi-level, cross-sectional study. By employing a two-stage stratified random sampling procedure, 2,796 employees were identified from 35 workplaces in Shanghai during March to November 2012. Workplace social capital was assessed using a validated and psychometrically tested eight-item measure, and the Chinese language version of the WHO-Five Well-Being Index (WHO-5) was used to assess mental health. Control variables included sex, age, marital status, education level, occupation status, smoking status, physical activity, and job stress. Multilevel logistic regression analysis was conducted to explore whether individual- and workplace-level social capital was associated with mental health status. In total, 34.9% of workers reported poor mental health (WHO-5health, 1.39 (95% CI: 1.10-1.75), 1.85 (95% CI: 1.38-2.46) and 3.54 (95% CI: 2.73-4.59), respectively. Corresponding odds ratios for workplace-level social capital were 0.95 (95% CI: 0.61-1.49), 1.14 (95% CI: 0.72-1.81) and 1.63 (95% CI: 1.05-2.53) for the third, second, and lowest quartiles, respectively. Higher workplace social capital is associated with lower odds of poor mental health among Chinese employees. Promoting social capital at the workplace may contribute to enhancing employees' mental health in China.
Cities constitute the backbone of European historic development and provide the basis of its economic future. The near neglect of cities in existing European policies for sustainable growth and development such as the Europe 2020 strategy is untenable. The 2011 White Paper has sought to face...... seem essential to move cities beyond business as usual. Research-wise we need to understand in more detail the political and contextual background for successes - and failures - of European cities. This could help build an effective multi level governance framework for sustainable urban mobility...
Lee, Bang Hyun
Literature produced by the government and the private sector in the colonial era was reviewed to determine the knowledge of the people of colonial Chosun of mental illness and mental patients and the mental patient management system that they implemented or intended to implement. The results of this study show that the people of Chosun realized the need to sterilize mental patients because they considered mental patients very violent, dangerous and eugenically inferior and they believed that mental patients would eventually impede the prosperity of Chosun. The people of colonial Chosun had learned about the lifelong mental hygiene movement, which had knowledge of mental illness prevention. However, they also recognized that people who developed mental illness despite efforts to prevent such condition needed help from the modern system, especially from modern Western psychiatry. The primary responsibility to attend to mental patients was imposed on their family. The family had to understand the symptoms of mental illness according to the modern medical classification and how to deal with them. When the family could not afford to take care of its mentally ill family member due to the increase in the member's risk behavior such as frenzied-convulsive excitement, paranoia and delusion of jealousy, the family was also responsible for isolating him and connecting him with a mental hospital. The police and social workers were also responsible for observing and monitoring mental patients in their community and for connecting them with a mental hospital. The police made a list of mental patients within their area of jurisdiction and prohibited them from wandering based on the law. It was also considered desirable for mental patients who could not identify their family members to be sent to a mental hospital. Social workers were responsible for managing mental patient sanatoriums, and district commissioners sent to the police mental patients who had no family to look after
Barczyk, Amanda N
Disbelief exits that individuals who have a mental health condition are able to recover and fully function in life. This study analyzed 1,437 adults from the 2006 General Social Survey. Structural equation modeling (1) examined the relationship between respondents' level of prejudicial attitudes and social distance (i.e., stigma) toward individuals who have a mental health condition and their belief in the potential of recovery (2) tested whether previous contact with an individual who received treatment was a mediator. Findings indicated that the belief in recovery led to lower levels of social distance. Prejudicial attitudes were found to be a predictor of one's level of social distance. Previous contact was not a mediator however; males, minorities and those with less education were less likely to have had previous contact. Results indicated a need to emphasize the probability of recovering from a mental health condition when developing target-specific stigma reducing strategies.
Zhou, Wei; Yu, Yu; Yang, Mei; Chen, Lizhang; Xiao, Shuiyuan
Mental health policy can be an essential and powerful tool to improve a population's mental health. However, around one third of countries do not possess a mental health policy, and there are large disparities in population coverage rates between high- and low-income countries. The goal of this study is to identify the transition and implementation challenges of mental health policies in both high-income countries (HICs) as well as middle- and low-income countries (MLICs). PubMed, Cochrane Library and Campbell Library were searched from inception to 31 December 2017, for studies on implemented mental health policies at the national level. Abstracts and the main texts of papers were double screened, and extracted data were analysed through thematic synthesis. A total of 93 papers were included in this study, covering 24 HICs, 28 MLICs and 5 regions. Studies on mental health policies, especially those of MLICs, kept increasing, but MLICs were still underrepresented in terms of publication quantity and study frequency. Based on the included studies, nine policy domains were summarized: service organizing, service provision, service quality, human resources, legislation and human rights, advocacy, administration, surveillance and research, and financing and budgeting. HICs incrementally enriched their policy content in all domains over centuries of development; following HICs' experience, mental health policies in MLICs have boomed since the 1990s and quickly extended to all domains. Implementation problems in HICs were mainly related to service organizing and service provision; for MLICs, more severe implementation problems converged on financing and budgeting, administration and human resources. Mental health policy developments in both HICs and MLICs present a process of diversification and enrichment. In terms of implementation, MLICs are faced with more and greater challenges than HICs, especially in funding, human resources and administration. Therefore, future
Indah S. Widyahening
Full Text Available Civilian airline pilots have one of the most stressful occupations. The aim of this study was to identify the effect of work stressors and other factors on mental-emotional disturbances among airline pilots. A cross-sectional study was done by interviewing selected pilots of an airline using appropriate questionnaires, during their routine medical examination from May to July 1999 in Jakarta. Five aspects of work stressor were assessed: working conditions, physical conditions of working environment, career development, organization and interpersonal relationship. Mental-emotional disturbances were determined by using the Symptom Checklist 90 (SCL 90 questionnaire. Data analysis was carried out using relative risk by Cox regression with constant time. From 128 subjects interviewed, 109 could be analyzed. Most of the subjects were married (73.4% and college graduates (91.7%. The number of captains and first officers were almost equal. The prevalence of mental-emotional disturbances was 39.4%. Mental-emotional disturbances were significantly related to work stressors and moderately related to household tension (P = 0.184. Compared to pilots with low levels of work stressors, those with high or very high levels of work stressors had a risk of 4.6 times of mental-emotional disturbances [adjusted relative risk (RRa = 4.64; 95% confidence interval (CI = 1.01 – 19.65]. Adequate guides to cope work stressors and household tension which related to mental-emotional disturbance is recommended. (Med J Indones 2007; 16:117-21Keywords: mental-emotional disturbance, work stressors, household tension, airline pilots
Lerner, Paul P; Sharony, Laura; Miodownik, Chanoch
Vitamin D deficiency has been identified as a global problem. Approximately 14% of the world population has inadequate vitamin D levels. This vitamin has been usually associated with bone disorders such as rickets, osteomalacia, and osteoporosis. However, these disorders present only a small part of all the disturbances which can be induced by its deficiency. Low serum vitamin D is associated with development of cardiovascular diseases, hypertension, neurodegenerative diseases, diabetes mellitus, metabolic syndrome and even cancer. This vitamin may be an important factor in the development of psychiatric illnesses, therefore clinicians should not leave this serious issue unresolved. The aim of this review is to describe the current data concerning the association between vitamin D serum levels, cognition and mental disorders. We conducted a systematic bibliographical research, of PubMed, MedLine literature and Cochrane database without language restriction to identify all publications concerning this issue from 1995 to the first quarter of 2017. We found 48,937 articles concerning vitamin D, published during the last 22 years and 3 months (1995-2017). We selected only those publications focused on the association between vitamin D serum deficiency and mental disturbances (depression, schizophrenia, cognitive disturbances, attention deficit disorder, and autism). One hundred and sixty-seven papers were found suitable to our selection criteria. Careful evaluation of the relevant literature demonstrates that addition of vitamin D to conventional antidepressive agents can improve antidepressive effect in contrast to placebo. Regarding other mental conditions there are no clear-cut conclusions. An association between low vitamin D serum levels and different mental disorders was found. Yet, nonetheless there is no clear consensus that addition of vitamin D improves or is related to a beneficial effect on mental health. More randomized clinical control trials should be
C. Lin (Chunmei); M. Massa (Massimo); H. Zhang (Hong)
markdownabstract__Abstract__ We hypothesize that poor country-level governance, which makes public information less reliable, induces fund managers to increase their use of semi-public information. Utilizing data from international mutual funds and stocks over the 2000-2009 period, we find that
Nugrahaning Sani Dewi
Full Text Available The study focuses on psychological and physical effects of stress while performing community garden activities of various intensity levels. The aim of this study was to determine the psychological and physical effects in adults with (case group and without (control group mental disabilities. Salivary α-amylase (sAA levels and the stress response scale (SRS-18 were used for the psychological analysis (n = 42. For physical assessment (n = 13, electrocardiogram (ECG, surface electromyogram (sEMG, and respiration rate were continuously measured while performing the activities using a multichannel telemetry system. The results showed that following the activities, the case group exhibited decreasing sAA levels while control group exhibited increasing sAA levels. However, both groups exhibited lower SRS-18 results following the activities. Compared with the control group, the case group had a significantly lower increase in the ratio of the heart rate (IRHR (5.5% during low-intensity work (filling pots with soil, but a significantly higher IRHR (16.7% during high-intensity work (turning over soil. The case group experienced significantly higher levels of fatigue during high-intensity work (digging than during the rest condition. These findings indicate that appropriate workload allocation, according to health, is necessary in the community garden setting because reducing the intensity of work assignments for people with mental disabilities will reduce their physical stress.
Siqueira, Vinicius R; Oades, Lindsay G
Objective. This study examined the use of psychological acceptance and experiential avoidance, two key concepts of Acceptance and Commitment Therapy (ACT), in the psychological recovery process of people with enduring mental illness. Method. Sixty-seven participants were recruited from the metropolitan, regional, and rural areas of New South Wales, Australia. They all presented some form of chronic mental illness (at least 12 months) as reflected in DSM-IV Axis I diagnostic criteria. The Acceptance and Action Questionnaire (AAQ-19) was used to measure the presence of psychological acceptance and experiential avoidance; the Recovery Assessment Scale (RAS) was used to examine the levels of psychological recovery; and the Scales of Psychological Well-Being was used to observe if there are benefits in utilizing psychological acceptance and experiential avoidance in the recovery process. Results. An analysis of objectively quantifiable measures found no clear correlation between the use of psychological acceptance and recovery in mental illness as measured by the RAS. The data, however, showed a relationship between psychological acceptance and some components of recovery, thereby demonstrating its possible value in the recovery process. Conclusion. The major contribution of this research was the emerging correlation that was observed between psychological acceptance and positive levels of psychological well-being among individuals with mental illness.
Kokx, J.M.C.; Kempen, R. van
Many accounts of urban governance emphasize municipal and neighbourhood scales, featuring local participation, social cohesion and the relationship between local government and residents. By contrast, our focus is the vertical governance processes of integrated urban policies. We concentrate on the
Soderstrom, Irina R.
Prisons are increasingly being filled with inmates who suffer from mental illness. This paper examines the prevalence of mental illness in American jails and prisons, the duty government and society has to provide appropriate mental health treatment, and the implications for inmate safety, costs, recidivism, and community reintegration if…
Full Text Available This artcle’s aim is to examine a dependency between local government administraton at a municipal level and the level of local entrepreneurship. This paper atempts to answer the queston of whether the size of the local government administraton has features of stmulant or de-stmulant in the process of setng up a business. In other words, does the size of public administraton at a local level (municipal level have a positve or negatve impact on creatng new business enttes? This is important due to at least a couple of reasons. First of all, the current research achievements are not extensive, when it comes to the publicatons that link entrepreneurship and the size of local government administraton. Secondly, the problem of entrepreneurship determinants consttutes stll topical and not fully investgated (or explained aspects of local economy development. Thirdly and fnally, the authors of this artcle have proposed and copyrighted an approach to the quantfcaton of the size of local government administraton, modifying commonly used measures of local public administraton. Thus, this artcle fts not only into the explanaton of the entrepreneurship phenomenon and its determinants, but also contributes to the development of knowledge about dependencies between the size of local selfgovernment and the entrepreneurship level. It expands the knowledge resource on analyzed dependencies and re-orients current approaches to similar research.
Sluyter, G V
The principles and techniques of total quality management (TQM) have only recently been applied to the field of mental health. This article reviews issues and offers some preliminary observations, based on the author's consultation and training work with ten state-operated mental health organizations in Missouri (Jul 1, 1994-Jun 30, 1995). Since many mental health organizations have operated in the public sector as part of large, hierarchical state agencies, the legacy of bureaucratic structures and a command and control leadership style may pose additional challenges. Two types of training have proven helpful in the Missouri project: general overview or awareness training for all staff and specialized training for team leaders and facilitators. To be successful with TQM, mental health organizations should clearly delineate their governing ideas, continuously reinforce them with all staff, and use the ideas as a measuring stick for progress. Some of the organizations in the Missouri project link their governing ideas and strategic planning efforts with critical success factors and the measurement methodology to track them. This dimension, which may include a quality council, a quality department, and quality improvement (QI) teams, also extends to the way in which facilities are organized and function. The structure evolving from a team-oriented, time-limited, data-based, and problem-solving approach can facilitate the functioning of the entire organization. The philosophy and techniques of TQM are as applicable to mental health as to health care in general--the question is one more of motivation than of fit.
Diffusion of innovation in mental health policy adoption: what should we ask about the quality of policy and the role of stakeholders in this process? Comment on "Cross-national diffusion of mental health policy".
In his recent study, Gordon Shen analyses a pertinent question facing the global mental health research and practice community today; that of how and why mental health policy is or is not adopted by national governments. This study identifies becoming a World Health Organization (WHO) member nation, and being in regional proximity to countries which have adopted a mental health policy as supportive of mental health policy adoption, but no support for its hypothesis that country recipients of higher levels of aid would have adopted a mental health policy due to conditionalities imposed on aid recipients by donors. Asking further questions of each may help to understand more not only about how and why mental health policies may be adopted, but also about the relevance and quality of implementation of these policies and the role of specific actors in achieving adoption and implementation of high quality mental health policies. © 2015 by Kerman University of Medical Sciences.
Scott, Vera; Schaay, Nikki; Olckers, Patti; Nqana, Nomsa; Lehmann, Uta; Gilson, Lucy
Health system governance has been recognized as a critical element of the health system strengthening agenda. To date, health governance research often focuses at national or global levels, adopting a macro-perspective that deals with governance structures, forms and principles. Little attention has been given to a micro-perspective which recognizes the role of health system actors in governance, or to considering the operational level of the health system. This article presents a South African case study of an intervention to address conflict in roles and responsibilities between multiple actors supporting service delivery at the local level, and explores the broader insights this experience generates about the nature of local health system governance. In an embedded case study, action learning and reflection theory were used to design and implement the intervention. Data in this article were drawn from minutes, observations and recorded reflections of the meetings and workshops that comprised the intervention. A theoretical governance framework was used both to understand the context of the intervention and to analyse the dimensions of governance relevant in the experience. The study shows how, through action learning and reflection, local managers in two organizations came to understand how the higher level misalignment of organizational structures and processes imposed governance constraints on them, and to see the impact this had on their organizational relationships. By re-framing the conflict as organizational, they were then able to create opportunities for staff to understand their context and participate in negotiating principles for communication and collaborative work. The result reduced conflict between staff in the two organizations, leading to improved implementation of programme support. Strengthening relationships among those working at local level by building collaborative norms and values is an important part of local health system governance for
Yokoi, Toshiyuki; Itoh, Michimasa; Oguri, Koji
Most of the traffic accidents have been caused by inappropriate driver's mental state. Therefore, driver monitoring is one of the most important challenges to prevent traffic accidents. Some studies for evaluating the driver's mental state while driving have been reported; however driver's mental state should be estimated in real-time in the future. This paper proposes a way to estimate quantitatively driver's mental workload using heart rate variability. It is assumed that the tolerance to driver's mental workload is different depending on the individual. Therefore, we classify people based on their individual tolerance to mental workload. Our estimation method is multiple linear regression analysis, and we compare it to NASA-TLX which is used as the evaluation method of subjective mental workload. As a result, the coefficient of correlation improved from 0.83 to 0.91, and the standard deviation of error also improved. Therefore, our proposed method demonstrated the possibility to estimate mental workload.
Shuggi, Isabelle M; Oh, Hyuk; Shewokis, Patricia A; Gentili, Rodolphe J
The assessment of mental workload can inform attentional resource allocation during task performance that is essential for understanding the underlying principles of human cognitive-motor behavior. While many studies have focused on mental workload in relation to human performance, a modest body of work has examined it in a motor practice/learning context without considering individual variability. Thus, this work aimed to examine mental workload by employing the NASA TLX as well as the changes in motor performance resulting from the practice of a novel reaching task. Two groups of participants practiced a reaching task at a high and low nominal difficulty during which a group-level analysis assessed the mental workload, motor performance and motor improvement dynamics. A secondary cluster analysis was also conducted to identify specific individual patterns of cognitive-motor responses. Overall, both group- and cluster-level analyses revealed that: (i) all participants improved their performance throughout motor practice, and (ii) an increase in mental workload was associated with a reduction of the quality of motor performance along with a slower rate of motor improvement. The results are discussed in the context of the optimal challenge point framework and in particular it is proposed that under the experimental conditions employed here, functional task difficulty: (i) would possibly depend on an individuals' information processing capabilities, and (ii) could be indexed by the level of mental workload which, when excessively heightened can decrease the quality of performance and more generally result in delayed motor improvements. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.
Lu, Zhijian; Shao, Shuai
Highlights: • An ESCO optimal decision model considering governmental subsidies is proposed. • Optimal price and performance level are deduced via a two-stage model. • Demand, profit, and performance level increase with increasing subsidies. • ESCO’s market strategy should firstly focus on high energy consumption industries. • Governmental subsidies standard in different industries should be differentiated. - Abstract: Government subsidies generally play a crucial role in pricing and the choice of performance levels in Energy Performance Contracting (EPC). However, the existing studies pay little attention to how the Energy Service Company (ESCO) prices and chooses performance levels for EPC with government subsidies. To fill such a gap, we propose a joint optimal decision model of pricing and performance level in EPC considering government subsidies. The optimization of the model is achieved via a two-stage process. At the first stage, given a performance level, ESCOs choose the best price; and at the second stage, ESCOs choose the optimal performance level for the optimal price. Furthermore, we carry out a numerical analysis to illuminate such an optimal decision mechanism. The results show that both price sensitivity and performance level sensitivity have significant effects on the choice of performance levels with government subsidies. Government subsidies can induce higher performance levels of EPC, the demand for EPC, and the profit of ESCO. We suggest that ESCO’s market strategy should firstly focus on high energy consumption industries with government subsidies and that government subsidies standard adopted in different industries should be differentiated according to the market characteristics and energy efficiency levels of various industries.
Sun, Xinyang; Dai, Xuyan; Yang, Tingshu; Song, Hongtao; Yang, Jialin; Bai, Jing; Zhang, Liyi
The aim of this study was to investigate the effects of mental resilience on the changes of serum rennin, angiotensin, and cortisol level induced by sleep deprivation in servicemen. By random cluster sampling, a total of 160 servicemen, aged from 18 to 30, were selected to undergo 24-hour total sleep deprivation and administered the military personnel mental resilience scale after the deprivation procedure. The sleep deprivation procedure started at 8 a.m. on Day 8 and ended at 8 a.m. on Day 9 after 7 days of normal sleep for baseline preparation. Blood samples were drawn from the 160 participants at 8 a.m. respectively on Day 8 and Day 9 for hormonal measurements. All blood samples were analyzed using radioimmunoassay. As hypothesized, serum rennin, angiotensin II, and cortisol level of the participants after sleep deprivation were significantly higher than those before (P problem-solving skill and willpower were the leading influence factors for the increases of serum rennin and cortisol respectively induced by sleep deprivation. We conclude that mental resilience plays a significant role in alleviating the changes of neurohormones level induced by sleep deprivation in servicemen.
Ala-Nikkola, Taina; Pirkola, Sami; Kontio, Raija; Joffe, Grigori; Pankakoski, Maiju; Malin, Maili; Sadeniemi, Minna; Kaila, Minna; Wahlbeck, Kristian
Governances, structures and contents of mental health services are being reformed across countries. There is a need for data to support those changes. The aim of this study was to explore the quality, i.e., diversity and community orientation, and quantity, i.e., personnel resources, of mental health and substance abuse services (MHS) and evaluate correlation between population needs and quality and quantity of MHS. The European Service Mapping Schedule—Revised (ESMS-R) was used to classify mental health and substance abuse services in southern Finland. Municipal-level aggregate data, local data on unemployment rate, length of education, age of retirement, proportion of single households, alcohol sales and a composite mental health index were used as indicators of population mental health needs. Population size correlated strongly with service diversity, explaining 84% of the variance. Personnel resources did not associate with diversity or community orientation. The indicators of mental health services need did not have the expected association with quality and quantity of services. In terms of service organization, the results may support larger population bases, at least 150,000 adult inhabitants, when aiming for higher diversity. PMID:25153471
Varghese C. Antony
Full Text Available The study aims to compare the mental toughness attributes between medalist and non-medalist badminton players and between male and female players. Participants were 15 male and 15 female badminton players aged between 13-19 years (M= 15.71, SD=2.82. Mental toughness questionnaire of Tiwari and Sharma was administered and the data were analyzed by using descriptive statistics and t-test. Medalist players have exhibited higher mean values on self-confidence, attention control, motivation and goal setting attributes. Overall mental toughness of medalists was higher 180.80±17.15 than non-medalists 170.25±20.10. Comparison analysis showed significant difference between medalists and non-medalists on mental toughness attributes: Self-confidence (SCO: p=0.001<0.05, medalists scored (M±SD=31.33±2.10 higher than non-medalists; motivation (MOT: p=0.006<0.05, medalist scored higher (M±SD=33.50±4.07; goal setting (GSE: p=0.044<0.05, medalists scored significantly higher (M±SD=33.55±4.11 than non-medalists. Other attributes did not show any significant difference between medalist and non-medalist players. When compared with gender, no significant difference was observed on mental toughness attributes except attention control (ATNCON: p=0.044<0.05, female players scored (M±SD=38.97±3.08 higher than male players. The findings confirm that mental toughness is a desired attribute which differentiates a medalist and non-medalist player. Connaughton et al., (2007 stated that elite competitive athletes possess better mental toughness. Medalist players displayed better self-confidence than the non-medalists as supported by Kuan and Roy (2007, Loehr (1986. Motivation helps players to achieve their best and enhance mental toughness (Connaughton et al., 2008; Mohammad et al., 2009. Goal setting determines successful performance Weinberg and Weigand (1993, Weinberg (2003. It was concluded that medalist badminton players showed better mental toughness
Pradana, G. W.; Fanida, E. H.; Niswah, F.
The demand for good governance is directed towards the realization of efficiency, effectiveness, and clean government. The move is demonstrated through national and regional levels to develop and implement electronic government concepts. Through the development of electronic government is done structuring management systems and work processes in the government environment by optimizing the utilization of information technology. One of the real forms of electronic government (e-Gov) implementation at the local level is the Intranet Sub-District program in Sukodono Sub-District, Sidoarjo. Intranet Sub-District is an innovation whose purpose is to realize the availability of information on the utilization of management, distribution, and storage of official scripts, and also the optimal delivery of information and communication in the implementation of guidance and supervision of local administration. The type of this paper is descriptive with a qualitative approach and focus on the implementation of the Intranet District Program in Sukodono District, Sidoarjo. The findings of the study are the limited number of human resources who have mastered ICT, the uneven network, the adequacy of institutional needs and the existence of budget support from the authorized institution and the information system has not accommodated all the service needs.
Doris, E.; Cochran, J.; Vorum, M.
This report catalogs by sector--buildings, transportation, industrial, and power--energy efficiency policies at the federal, state, and local levels, and identifies some prominent policy trends. Four key findings emerged from this report: 1) leadership on energy efficiency is necessary--and is found--at each level of government; 2) there is no widely accepted methodology for evaluating energy efficiency policies; 3) coordination among the three levels of government--and across sectors--is increasingly important, and there are opportunities to significantly improve policy performance through a unified strategy; and 4) there are efficiencies to be gained by informing policies in one sector with experience from others.
Doris, Elizabeth [National Renewable Energy Lab. (NREL), Golden, CO (United States); Cochran, Jaquelin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Vorum, Martin [National Renewable Energy Lab. (NREL), Golden, CO (United States)
This report catalogs by sector--buildings, transportation, industrial, and power--energy efficiency policies at the federal, state, and local levels, and identifies some prominent policy trends. Four key findings emerged from this report: 1) leadership on energy efficiency is necessary--and is found--at each level of government; 2) there is no widely accepted methodology for evaluating energy efficiency policies; 3) coordination among the three levels of government--and across sectors--is increasingly important, and there are opportunities to significantly improve policy performance through a unified strategy; and 4) there are efficiencies to be gained by informing policies in one sector with experience from others.
Public mental health deals with mental health promotion, prevention of mental disorders and suicide, reducing mental health inequalities, and governance and organization of mental health service provision. The full impact of mental health is largely unrecognized within the public health sphere, despite the increasing burden of disease attributable to mental and behavioral disorders. Modern public mental health policies aim at improving psychosocial health by addressing determinants of mental ...
Full Text Available stream_source_info Meissner_2016.pdf.txt stream_content_type text/plain stream_size 2853 Content-Encoding UTF-8 stream_name Meissner_2016.pdf.txt Content-Type text/plain; charset=UTF-8 Water Security at Local... Government Level: What do People Think? By Dr. Richard Meissner Integrated Water Assessment Group Natural Resources and the Environment Council for Scientific and Industrial Research Presented at the Sustainable Water Seminar 2016, CSIR ICC, 2...
This work identifies the interaction between corporate governance and project management in project governance. It begins with introduction of basics of corporate governance and various principles of corporate governance in chosen countries and organizations. Further it introduces theoretical background of project governance and its connection and to corporate governance. In practical part work analyzes the level of compliancy with Swiss codex of best praxis in chosen company. The results con...
Demissie, Zewditu; Brener, Nancy
Background: Mental health conditions among youth are a major concern. Schools can play an important role in supporting students affected by these conditions. This study examined district-level school health policies related to mental health and social services to determine if they varied by district demographic characteristics. Methods: The School…
Full Text Available Land use governance in the Brazilian Amazon has undergone significant changes in the last decade. At the national level, law enforcement capacity has increased and downstream industries linked to commodity chains responsible for deforestation have begun to monitor some of their suppliers’ impacts on forests. At the municipal level, local actors have launched a Green Municipality initiative, aimed at eliminating deforestation and supporting green supply chains at the territorial level. In this paper, we analyze the land use transition since 2001 in Paragominas—the first Green Municipality—and discuss the limits of the governance arrangements underpinning these changes. Our work draws on a spatially explicit analysis of biophysical variables and qualitative information collected in interviews with key private and public stakeholders of the main commodity chains operating in the region. We argue that, up to now, the emerging multi-level scheme of land governance has not succeeded in promoting large-scale land use intensification, reforestation and rehabilitation of degraded lands. Moreover, private governance mechanisms based on improved product standards, fail to benefit from potential successful partnerships between the public and private sector at the territorial level. We propose a governance approach that adopts a broader territorial focus as a way forward.
Full Text Available AbstractThe phenomenon and corruption action still becomes a fact that cannot be finished. One of causes is mentality of the world. It makes the cause why corruption becomes a massive culture. Beside restraining orientation of the world, good governance must become the priority. The result is that corruption does not become the culture anymore, and slowly but sure, it can be eliminated, or at least it can decrease.Kata-kata kuncikorupsi, budaya korupsi, indeks persepsi korupsi, good governance
Lu, Chunling; Frank, Richard G; Liu, Yuanli; Shen, Jian
Mental illnesses account for 20% of the total burden of disease in China. Yet, health policy in China has not devoted much attention to mental health problems and their impact on Chinese society. The objective of this paper is to investigate the impact of mental health status on labour market outcomes, such as employment and income, and provide evidence about some of the economic consequences of mental illnesses. Using the China Health Surveillance Baseline 2001 Survey and an instrumental variables estimation approach, we address possible reverse causation between work and mental health. To estimate the impact of self-reported mental health status, we use the two-part model, the first part estimating a logit equation for the probability of being employed and the second-part estimating an ordinary least squares (OLS) model on the log of individual income condition on being employed. We use a list of symptoms of mental disorders to constitute a measure of mental health status. Our identification strategy relies on instruments that measure average mental health status by zip code other than the observed individual to implement an instrumental variables model. Both men and women suffer a significant reduction in the employment rate and annual income if the average mental health deteriorates at a population level. The mental health index has a positive and significant effect on the likelihood of being employed. Our findings are consistent with what has been found in industrialised countries. This is the first empirical study that reveals that poor mental health status can be disruptive of labour market activities in China. A rapid rise of mental and behavioural problems in population reflects the transition to a market economy and indicates pressing problems that have gone unrecognised and unaddressed. The negative economic consequences in labour market outcomes suggest a potential gain from preventing and curing the mental disorder. Our study about the impact of mental
Furiak Nicolas M
Full Text Available Abstract Background Adherence to antipsychotics for schizophrenia is associated with favorable clinical outcomes. This study compared annual mental-health service utilization by recent medication adherence levels for patients treated for schizophrenia, and assessed whether adherence levels change from pre- to post-psychiatric hospitalization. Methods We analyzed data from a large prospective, non-interventional study of patients treated for schizophrenia in the United States, conducted between 7/1997 and 9/2003. Detailed mental-health resource utilization was systematically abstracted from medical records and augmented with patients' self report. Medication possession ratio (MPR with any antipsychotic in the 6 months prior to enrollment was used to categorize patients as: adherent (MPR ≥ 80%, N = 1758, partially adherent (MPR ≥ 60% Results Adherent patients had a lower rate of psychiatric hospitalization compared with partially adherent and non-adherent patients (p Conclusion Adherence is associated with lower utilization of acute care services and greater engagement in outpatient mental-health treatment. Adherence is a potentially dynamic phenomenon, which may improve, at least temporarily, following patients' psychiatric hospitalizations.
symbolic level of organization, either in circumscribed areas or more ubiquitously. And mutative action occurs through helping our patients attain or regain the symbolic level in regard to all mental functions. Such work is best accomplished in the transference. The concept of transference of defense is expanded to all mental structure, so that transference is seen as the interpersonalization of mental structure. That is, patients transfer their mental structure, including their various levels of mentalizing, into the analytic interaction. The analyst observes all levels of the patient's mental functioning and intervenes to raise them to a symbolic one. At times, this will require action interpretations, allowing oneself to be pulled into an enactment with the patient that is then reprocessed at a verbal, symbolic level. Such actions are not corrective emotional experiences but are interpretations and confrontations of the patient's transferred mental organization at a level affectively and cognitively consistent with the level of communication. Nonetheless, the goal becomes raising the communication to a symbolic level as being able to reflect symbolically on all aspects of one's mind with a minimum of restriction is the greatest guarantee of mental health.
Gevaert, Jessie; Moortel, Deborah De; Wilkens, Mathijn; Vanroelen, Christophe
Although many governments actively stimulate self-employment, their work-related mental well-being remains understudied. The aim of current study is to investigate the mental well-being of different types of self-employed, testing whether mental well-being differences among self-employed are explained by the presence of work characteristics that are in accordance with the ideal-typical image of the "successful entrepreneur" (e.g. creativity, willingness to take risks, innovativeness, high intrinsic motivation, skilfulness and the ability of recognizing opportunities). Moreover, we investigate the relation of country-level "entrepreneurial climate" and the individual mental well-being of self-employed. For this purpose, data from the European Working Conditions Survey, round 6 (2015) was analysed, including 5448 cases, originating from the 28 EU-member states. Multilevel random intercepts modelling was used to investigate associations of both individual- and country-level characteristics with mental well-being. We found that motivation, the ability to recognize opportunities, and finding it easy to be self-employed positively influences the mental well-being of self-employed. Respondents with these characteristics are often medium-big employers, while farmers, dependent freelancers and own account workers generally have less of these features and tend to have lower levels of mental well-being. At the country-level, positive entrepreneurship perception relates to more advantageous mental health scores in self-employed. These results implicate that policies promoting self-employment should be (more) concerned with the work-related characteristics of (future) self-employed.
Panter-Brick, Catherine; Grimon, Marie-Pascale; Eggerman, Mark
In humanitarian settings, family-level drivers of mental health are insufficiently documented; we examined the strength of caregiver-child associations with two-wave, family-level Afghan data. We recruited a gender-balanced sample of 681 caregiver-child dyads (n = 1,362 respondents) using stratified random-sampling in government schools in Kabul (364 dyads) and refugee schools in Peshawar (317 dyads). One year after baseline, we re-interviewed 64% of Kabul and 31% of Peshawar cohorts (n = 331 dyads, 662 respondents), retaining fewer Peshawar families due to refugee repatriation. In multivariable analyses adjusted for baseline, we assessed the extent to which caregiver mental health (Self-Report Questionnaire, SRQ-20) was associated with child symptom scores of post-traumatic stress (Child Revised Impact of Events Scale, CRIES), depression (Depression Self-Rating Scale, DSRS), psychiatric difficulties, impact, and prosocial strength (Strength and Difficulties Questionnaire, SDQ). Caregiver mental health was prospectively associated with all eight measures of child mental health at follow-up, adjusted for baseline. For post-traumatic stress, caregiver mental health had a predictive impact comparable to the child experiencing one or two lifetime trauma events. For depression, caregiver mental health approached the predictive impact of female gender. Thus a one SD change in caregiver SRQ-20 was associated with a 1.04 point change on CRIES and a 0.65 point change in DSRS. For multi-informant SDQ data, caregiver-child associations were strongest for caregiver ratings. For child-rated outcomes, associations were moderated by maternal literacy, a marker of family-level dynamics. Both adults and children identified domestic violence and quality of home life as independent risk and protective factors. In the context of violence and displacement, efforts to improve child mental health require a thoughtful consideration of the mental health cascade across generations and
Sugiura-Ogasawara, Mayumi; Suzuki, Sadao; Kitazawa, Masafumi; Kuwae, Chizuko; Sawa, Rintaro; Shimizu, Yukiko; Takeshita, Toshiyuki; Yoshimura, Yasunori
Career satisfaction level, degree of mental distress associated with certain work-related factors, and demographics were examined for the first time in obstetricians and gynecologists in Japan. Associations between the score on Kessler 6 screening scale, or the job satisfaction level, and the scores on the job content questionnaire, Social Support Questionnaire (SSQ), working conditions and demographics were examined in 1301 members of the Japan Society of Obstetrics and Gynecology. 8.4% of respondents were speculated to suffer from depression or anxiety disorder. Multivariate linear regression analysis identified a heavier workload, less personal control, lower satisfaction on the SSQ, and longer working hours as being independent risk factors for mental distress. Careful monitoring of the mental state is necessary for obstetricians and gynecologists with lower incomes, heavier workloads, lower degrees of personal control, and lower satisfaction scores on the SSQ. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.
Mental disorders are among the leading causes of nonfatal burden of disease globally. We used the global burden of diseases, injuries, and risk factors study 2015 to examine the burden of mental disorders in the Eastern Mediterranean region (EMR). We defined mental disorders according to criteria proposed in the diagnostic and statistical manual of mental disorders IV and the 10th International Classification of Diseases. Mental disorders contributed to 4.7% (95% uncertainty interval (UI) 3.7-5.6%) of total disability-adjusted life-years (DALYs), ranking as the ninth leading cause of disease burden. Depressive disorders and anxiety disorders were the third and ninth leading causes of nonfatal burden, respectively. Almost all countries in the EMR had higher age-standardized mental disorder DALYs rates compared to the global level, and in half of the EMR countries, observed mental disorder rates exceeded the expected values. The burden of mental disorders in the EMR is higher than global levels, particularly for women. To properly address this burden, EMR governments should implement nationwide quality epidemiological surveillance of mental disorders and provide adequate prevention and treatment services.
Luminiţa Maria Crăciun
Full Text Available Governance and governing are two distinct concepts, but they intertwine. “Good governing” exercises good influence on development. “Good governance” supposes first a relationship of power focused on a series of reforms structured at three levels: the political – administrative level, the economic level, and the level of civil society. As this dimension is difficult to measure, the qualitative evaluation of the governing act raised the interest of the World Bank researchers, who elaborated and monitored the dynamics of a set of indicators, which includes six major dimensions of the governing. A retrospective concerning the image of governing in Romania during the period from 1996 to 2005 suggests a modest increase of the score: from -0.138 (1996 to 0.008 (2002; that was partially achieved based on the voice and responsibility index and on the political stability index, not on those that measure more directly the administrative performance or the integrity of the governing act. For a comparative study, we chose seven countries for the purposes of analysis (two new European Union member states: Romania and Bulgaria; two older member countries of the European Union: Slovenia and Latvia; three non-member states: Moldova, Ukraine, and Georgia, which reveal the quality of the governing from a comparative perspective. Corruption control completes the image created by the analyzed indicators. The mere formal accomplishment of commitments made in the pre-accession activity, doubled by recent internal evolutions, bring doubts about the credibility of the anticorruption reforms, as Romania continues to be considered the country with the highest CPI in the European Union. The pessimism of public opinion and the fact that only 34% of the Romanian people consider that the level of corruption will decrease in the following three years constitutes an alarm signal addressed to the governance, in view of the real reformation of the administration system
Kiseleva N. V.
Full Text Available In the modern period of the development of statehood in Russia the significant increase of attention is attributed to the issue of effectiveness of state power and government not only on the federal and regional levels, but on the local level as well. In 2009 there was developed and implemented the system of indicators of the effectiveness’ estimates of the activity of local self-government. The system of effectiveness’ estimates included sociological indices of satisfaction of population. Implementation of sociological indices in the system of effectiveness’ estimates of the activity of local self-government brought positive responses from academic community, politicians, managers, and the public. In the article the analysis of influence of cognitive factor (being kept informed on the level of social contentment of the activity of local self-government’ bodies is done. We do this, based on the results of sociological studies of the major Russian research organizations and data from the aggregate reports, which deal with the monitoring of effectiveness of local self-government of some subjects in the Central federal district of Russia.
Full Text Available Abstract Background Although attention to human rights in Indonesia has been improving over the past decade, the human rights situation of persons with mental disorders is still far from satisfactory. The purpose of this paper is to examine the legal framework for protection of human rights of persons with mental disorder and the extent to which Indonesia's international obligations concerning the right to health are being met. Methods We examined the Indonesian constitution, Indonesian laws relevant to the right to health, the structure and operation of the National Human Rights Commission, and what is known about violations of the human rights of persons with mental illness from research and the media. Results The focus of the Indonesian Constitution on rights pre-dated the Universal Declaration, Indonesia has ratified relevant international covenants and domestic law provides an adequate legal framework for human rights protections. However, human rights abuses persist, are widespread, and go essentially unremarked and unchallenged. The National Human Rights Commission has only recently become engaged in the issue of protection of the rights of persons with mental illness. Conclusion More than legislation is needed to protect the human rights of persons with mental illness. Improving the human rights situation for persons with mental illness in Indonesia will require action by governments at national, provincial and district levels, substantial increases in the level of investment in mental health services, coordinated action by mental health professionals and consumer and carer organisations, and a central role for the National Human Rights Commission in protecting the rights of persons with mental illness.
Irmansyah, I; Prasetyo, YA; Minas, H
Background Although attention to human rights in Indonesia has been improving over the past decade, the human rights situation of persons with mental disorders is still far from satisfactory. The purpose of this paper is to examine the legal framework for protection of human rights of persons with mental disorder and the extent to which Indonesia's international obligations concerning the right to health are being met. Methods We examined the Indonesian constitution, Indonesian laws relevant to the right to health, the structure and operation of the National Human Rights Commission, and what is known about violations of the human rights of persons with mental illness from research and the media. Results The focus of the Indonesian Constitution on rights pre-dated the Universal Declaration, Indonesia has ratified relevant international covenants and domestic law provides an adequate legal framework for human rights protections. However, human rights abuses persist, are widespread, and go essentially unremarked and unchallenged. The National Human Rights Commission has only recently become engaged in the issue of protection of the rights of persons with mental illness. Conclusion More than legislation is needed to protect the human rights of persons with mental illness. Improving the human rights situation for persons with mental illness in Indonesia will require action by governments at national, provincial and district levels, substantial increases in the level of investment in mental health services, coordinated action by mental health professionals and consumer and carer organisations, and a central role for the National Human Rights Commission in protecting the rights of persons with mental illness. PMID:19545362
Abdi, Zeinab; Masih, Mansur
This Malaysia is a developing Islamic state that faced government budget deficit since 1998. It is undeniable that a budget deficit or inability to cover government spending is not positively seen by external parties. The optimum level of government budget is the state where government spending is totally offset by government revenue and that can be achieved through an increase in tax revenue or decrease in spending. The paper aims to discover the existence of a theoretical relationship betwe...
Song, Insu; Yellowlees, Peter; Diederich, Joachim
This book introduces approaches that have the potential to transform the daily practice of psychiatrists and psychologists. This includes the asynchronous communication between mental health care providers and clients as well as the automation of assessment and therapy. Speech and language are particularly interesting from the viewpoint of psychological assessment. For instance, depression may change the characteristics of voice in individuals and these changes can be detected by a special form of speech analysis. Computational screening methods that utilise speech and language can detect subtle changes and alert clinicians as well as individuals and caregivers. The use of online technologies in mental health, however, poses ethical problems that will occupy concerned individuals, governments and the wider public for some time. Assuming that these ethical problems can be solved, it should be possible to diagnose and treat mental health disorders online (excluding the use of medication).
Karim, Salman; Saeed, Khalid; Rana, Mowaddat Hussain; Mubbashar, Malik Hussain; Jenkins, Rachel
The Republic of Pakistan is a South East Asian country with a population of over 140.7 million. Its population is fast growing and the majority (70%) live in rural areas with a feudal or tribal value system. The economy is dependent on agriculture and 35% of the population live below the poverty line. Islam is the main religion and 'mental illnesses' are stigmatized and widely perceived to have supernatural causes. The traditional healers along with psychiatric services are the main mental health service providers. The number of trained mental health professionals is small as compared to the population demands and specialist services are virtually non-existent. Lack of data on prevalence of various mental illnesses and monitory constraints are the major hurdles in the development of mental health services. A number of innovative programmes to develop indigenous models of care like the 'Community Mental Health Programme' and 'Schools Mental Health Programme' have been developed. These programmes have been found effective in reducing stigma and increase awareness of mental illness amongst the adults and children living in rural areas. Efforts by the government and mental health professionals have led to the implementation of a 'National Mental Health Policy' and 'Mental Health Act' in 2001. These aim at integrating mental health services with the existing health services, improving mental health care delivery and safeguarding the rights of mentally ill people. A favourable political will and the help of international institutions like the World Health Organization are required to achieve these aims.
Full Text Available Resilience thinking has strongly influenced how people understand and pursue sustainability of linked social-ecological systems. Resilience thinking highlights the need to build capacity and manage general system properties in a complex, constantly changing world. I modified an analytical framework to address associations among cross-scale and cross-level dynamics, attributes of governance, and capacity to enhance resilience. The Danungdafu Forestation Area represents one of Taiwan’s most controvisal cases concerning land use, indigenous rights, and environmental issues. Analysis of this Taiwanese experience from a social-ecological perspective can show how current capacities for managing resilience are related to critical governance attributes. Analysis helped identify fundamental flaws in current governance and key issues needing to be addressed. The Danungdafu Forestation Area should transition towards a governance regime that is more participatory, deliberative, multi-layered, accountable, just, and networked. This can be done by developing an intermediate level institution that coordinates the cross-scale and cross-level interactions that better fit this social-ecological system.
Mental Health Stigma: What is being done to raise awareness and reduce ... need to find effective strategies to increase awareness about mental illnesses and ... Results: Numerous anti-stigma campaigns are in place in both government and ...
Fragar, Lyn; Kelly, Brian; Peters, Mal; Henderson, Amanda; Tonna, Anne
To describe the process and outcome of development of a framework for planning and implementation of a range of interventions aimed at improving the mental health and wellbeing of farmers and farm families in New South Wales (NSW). In response to a major drought in New South Wales (NSW), key agencies were invited to participate in a longer-term collaborative program aimed at improving the mental health and well-being of the people on NSW farms. These agencies became the NSW Farmers Mental Health Network. The Australian National Action Plan for Promotion, Prevention & Early Intervention for Mental Health 2000 proposed a population health approach base encompassing the range of risk and protective factors that determine mental health at the individual, family and community and society levels. It incorporated three traditional areas of health activity into programs aimed at achieving improved mental health for the Australian population - mental health promotion, prevention activities and early intervention. Although the farming population was not identified as a priority population, research has identified this population to be at high risk of suicide, and of having difficulty in coping with the range of pressures associated with life and work in this industry. Participants were agencies providing services across rural NSW in the fields of farmer and country women's organisations, financial counselling services, government departments of primary industries and health, mental health advisory and support services, charitable organisations and others. The NSW Farmers Blueprint for Mental Health (http://www.aghealth.org.au/blueprint) was developed to be 'a simplified summary of key issues that need to be addressed, and the major actions that we can be confident will be effective in achieving our purpose'. It has identified 'steps' along 'pathways to breakdown' from the range of known mental health and suicide risk factors that are relevant to the NSW farming population
Magalhaes, Antonio; Veiga, Amelia; Ribeiro, Filipa; Amaral, Alberto
This paper aims at looking at governance instruments beyond managerial technicality. It intends to do so by analysing the impact of governance reforms on the universities autonomy assumed as a regulation instrument to politically steer systems and institutions. The regulation efforts undertaken at the European and national levels reflect a trend…
Aziz, A A; Salina, A A; Abdul Kadir, A B; Badiah, Y; Cheah, Y C; Nor Hayati, A; Ruzanna, Z Z; Sharifah Suziah, S M; Chee, K Y
The National Mental Health Registry (NMHR) collects information about patients with mental disorder in Malaysia. This information allows us to estimate the incidence of selected mental disorders, and to evaluate risk factors and treatment in the country. The National Mental Health Registry (NMHR) presented its first report in 2004, a year after its establishment. The report focused on schizophrenia as a pioneer project for the National Mental Health Registry. The development of the registry has progressed with data collected from government-based facilities, the academia and the private sector. The 2003-2005 report was recently published and distributed. Since then the registry has progressed to include suicides and other mental illnesses such as depression. The NMHR Report 2003-2005 provides detailed information about the profile of persons with Schizophrenia who presented for the first time to various psychiatry and mental health providers throughout Malaysia. More detailed description regarding pharmacotherapy is reported and few cross tabulations done in an effort to provide better understanding and more clinically meaningful reports.
Khan, Muhammad Ehsan
FOUNDATION OF GOVERNANCEGovernanceDefining GovernanceGovernance at Multiple LevelsSummaryReferencesTransaction Cost EconomicsTransactions-Core Elements and Attributes Behavioral Assumptions Governance Structure AttributesHazards of Concern Incomplete Contracting Bilateral Dependency and Fundamental Transformation Adaptation or MaladaptationLinking Governance, Governance Structures, and ContractsThe Impact of Asset Specificity and Behavioral Assumptions on ContractsAp
Gao, Ji; Lv, Hexin; Jin, Zhiyong; Xu, Ping
This paper proposes the social-level macro-governance mode for innovating the popular centralized control for CoM (Collaborative Manufacturing) processes, and makes this mode depend on the support from three aspects of technologies standalone and complementary: social-level CoM process norms, CoM process supervision system, and rational agents as the brokers of enterprises. It is the close coupling of those technologies that redounds to removing effectively the uncontrollability obstacle confronted with by cross-management-domain CoM processes. As a result, this mode enables CoM applications to be implemented by uniting the centralized control of CoM partners for respective CoM activities, and therefore provides a new distributed CoM process control mode to push forward the convenient development and large-scale deployment of SME-oriented CoM applications.
Gouttebarge, Vincent; Aoki, Haruhito; Verhagen, Evert; Kerkhoffs, Gino
Mental disorders have become a topic of increasing interest in research due to their serious consequences for quality of life and functioning. The objective of this study was to explore the relationship of level of education, employment status and working hours with symptoms of common mental
Berg, S. L.; Sheridan, T. B.
Seven instrument-rated pilots with a wide range of backgrounds and experience levels flew four different scenarios on a fixed-base simulator. The Baseline scenario was the simplest of the four and had few mental and physical tasks. An activity scenario had many physical but few mental tasks. The Planning scenario had few physical and many mental taks. A Combined scenario had high mental and physical task loads. The magnitude of each pilot's altitude and airspeed deviations was measured, subjective workload ratings were recorded, and the degree of pilot compliance with assigned memory/planning tasks was noted. Mental and physical performance was a strong function of the manual activity level, but not influenced by the mental task load. High manual task loads resulted in a large percentage of mental errors even under low mental task loads. Although all the pilots gave similar subjective ratings when the manual task load was high, subjective ratings showed greater individual differences with high mental task loads. Altitude or airspeed deviations and subjective ratings were most correlated when the total task load was very high. Although airspeed deviations, altitude deviations, and subjective workload ratings were similar for both low experience and high experience pilots, at very high total task loads, mental performance was much lower for the low experience pilots.
Caroline L. Tait
Full Text Available Background. Over generations, government policies have impacted upon the lives of Indigenous peoples of Canada in unique and often devastating ways. In this context, Indigenous women who struggle with poverty, mental illness, trauma and substance abuse are among the most vulnerable, as are Indigenous children involved in child welfare systems. Objective. By examining the life history of Wanda, a First Nations woman, this article examines the intergenerational role that government policies play in the lives of impoverished Indigenous women and their families. Questions of moral governance and responsibility and the need for ethical policies are raised. Design. The life narrative presented in this article is part of a larger qualitative research programme that has collected over 100 life histories of Indigenous women with addictions and who have involvement with the child welfare system, as children or adults. Wanda’s life story exemplifies the impact of government policies that is characteristic of vulnerable Indigenous women and draws attention to the lack of ethical standards in government policymaking in child welfare, public health and mental health/addictions. Results. The path to recovery for Canadian Indigenous women in need of treatment for co-occurring mental disorders and substance addiction is too frequently characterized by an inadequate and ever shifting continuum of care. For those who feel intimidated, suspicious or have simply given up on seeking supports, a profound invisibility or forgetting of their struggle exists in areas of government policy and programming provision. Living outside the scope of mental health and addiction priorities, they become visible to the human service sector only if they become pregnant, their parenting draws the attention of child and family services (CFS, they need emergency health care, or are in trouble with the law. The intergenerational cycle of substance abuse, mental illness and poverty is
Tait, Caroline L
Over generations, government policies have impacted upon the lives of Indigenous peoples of Canada in unique and often devastating ways. In this context, Indigenous women who struggle with poverty, mental illness, trauma and substance abuse are among the most vulnerable, as are Indigenous children involved in child welfare systems. By examining the life history of Wanda, a First Nations woman, this article examines the intergenerational role that government policies play in the lives of impoverished Indigenous women and their families. Questions of moral governance and responsibility and the need for ethical policies are raised. The life narrative presented in this article is part of a larger qualitative research programme that has collected over 100 life histories of Indigenous women with addictions and who have involvement with the child welfare system, as children or adults. Wanda's life story exemplifies the impact of government policies that is characteristic of vulnerable Indigenous women and draws attention to the lack of ethical standards in government policymaking in child welfare, public health and mental health/addictions. The path to recovery for Canadian Indigenous women in need of treatment for co-occurring mental disorders and substance addiction is too frequently characterized by an inadequate and ever shifting continuum of care. For those who feel intimidated, suspicious or have simply given up on seeking supports, a profound invisibility or forgetting of their struggle exists in areas of government policy and programming provision. Living outside the scope of mental health and addiction priorities, they become visible to the human service sector only if they become pregnant, their parenting draws the attention of child and family services (CFS), they need emergency health care, or are in trouble with the law. The intergenerational cycle of substance abuse, mental illness and poverty is commonly associated with child welfare involvement
Francisca Guedes de Oliveira
Full Text Available We develop a Solow type growth model where firms produce a single homogenous good using labor, private capital and a public good. The "amount" of public good depends on current government spending and government quality. Quality is the result of the accumulation of public capital. Governments charge distortionary taxes and provide the public good, investing also in "quality" by accumulating public capital. We analyze how the composition of government spending between current expenditures and quality affects the equilibrium levels. We aim to understand the difference in terms of steady state levels between leviathan, quality driven and benevolent governments.
Ikkos, G; Sugarman, Ph; Bouras, N
The commissioning and provision of healthcare, including mental health services, must be consistent with ethical principles - which can be summarised as being "fair", irrespective of the method chosen to deliver care. They must also provide value to both patients and society in general. Value may be defined as the ratio of patient health outcomes to the cost of service across the whole care pathway. Particularly in difficult times, it is essential to keep an open mind as to how this might be best achieved. National and regional policies will necessarily vary as they reflect diverse local histories, cultures, needs and preferences. As systems of commissioning and delivering mental health care vary from country to country, there is the opportunity to learn from others. In the future international comparisons may help identify policies and systems that can work across nations and regions. However a persistent problem is the lack of clear evidence over cost and quality delivered by different local or national models. The best informed economists, when asked about the international evidence do not provide clear answers, stating that it depends how you measure cost and quality, the national governance model and the level of resources. The UK has a centrally managed system funded by general taxation, known as the National Health Service (NHS). Since 2010, the UK's new Coalition* government has responded by further reforming the system of purchasing and providing NHS services - aiming to strengthen choice and competition between providers on the basis of quality and outcomes as well as price. Although the present coalition government's intention is to maintain a tax-funded system, free at the point of delivery, introducing market-style purchasing and provider-side reforms to encompass all of these bring new risks, whilst not pursuing reforms of a system in crisis is also seen to carry risks. Competition might bring efficiency, but may weaken cooperation between providers
Full Text Available Although many governments actively stimulate self-employment, their work-related mental well-being remains understudied. The aim of current study is to investigate the mental well-being of different types of self-employed, testing whether mental well-being differences among self-employed are explained by the presence of work characteristics that are in accordance with the ideal-typical image of the “successful entrepreneur” (e.g. creativity, willingness to take risks, innovativeness, high intrinsic motivation, skilfulness and the ability of recognizing opportunities. Moreover, we investigate the relation of country-level “entrepreneurial climate” and the individual mental well-being of self-employed. For this purpose, data from the European Working Conditions Survey, round 6 (2015 was analysed, including 5448 cases, originating from the 28 EU-member states. Multilevel random intercepts modelling was used to investigate associations of both individual- and country-level characteristics with mental well-being. We found that motivation, the ability to recognize opportunities, and finding it easy to be self-employed positively influences the mental well-being of self-employed. Respondents with these characteristics are often medium-big employers, while farmers, dependent freelancers and own account workers generally have less of these features and tend to have lower levels of mental well-being. At the country-level, positive entrepreneurship perception relates to more advantageous mental health scores in self-employed. These results implicate that policies promoting self-employment should be (more concerned with the work-related characteristics of (future self-employed. Keywords: Self-employment, Mental well-being, Cross-national, Entrepreneurial characteristics, Entrepreneurial ecosystems, EU 28
Mental health legislation (MHL) is required to ensure a regulatory framework for mental health services and other providers of treatment and care, and to ensure that the public and people with a mental illness are afforded protection from the often-devastating consequences of mental illness. To provide an overview of evidence on the significance of MHL for successful primary care for mental health and community mental health servicesMethod: A qualitative review of the literature on the significance of MHL for successful primary care for mental health and community mental health services was conducted. In many countries, especially in those who have no MHL, people do not have access to basic mental health care and treatment they require. One of the major aims of MHL is that all people with mental disorders should be provided with treatment based on the integration of mental health care services into the primary healthcare (PHC). In addition, MHL plays a crucial role in community integration of persons with mental disorders, the provision of care of high quality, the improvement of access to care at community level. Community-based mental health care further improves access to mental healthcare within the city, to have better health and mental health outcomes, and better quality of life, increase acceptability, reduce associated social stigma and human rights abuse, prevent chronicity and physical health comorbidity will likely to be detected early and managed. Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.
Dijkman, A.; Terwoert, J.; Hollander, A.
This literature review on Risk Governance is part of a TNO research programme on the safety of innovative substances and technologies in the workplace. The purpose of this review is to investigate how risk governance can be applied in the workplace when dealing with uncertainties regarding the (health) risks of these technologies, and with the related responsibilities. The review gives an overview of the current state of affairs of risk governance as a concept, and more specifically examines ...
Eberlein, B.; Doern, G.B.; Exeter Univ.,
This book features essays by leading energy and public policy specialists from Canada and Germany. It originated in the Transatlantic Energy Conference which was hosted by the Canadian Centre for German and European Studies at Toronto's York University in September 2005. The conference was attended by leading energy scholars and experts from Canadian and European universities, research institutes and governmental and non-governmental organizations. The purpose of this book was to compare the dynamics of multi-level energy regulatory governance in Germany and Canada, notably the energy policy challenges that include energy security, environmental sustainability and a competitive resource economy. Many strategies to produce more efficient and sustainable energy are presented in the book. Part 1 of the book focuses on the energy industry, with particular emphasise on electricity, nuclear energy and natural gas. Part 2 of the book focuses on domestic patterns of multi-level energy governance and regulation in the two countries. As a member of the European Union, Germany is more advanced in dealing with multi-level governmental and sustainability constraints than Canada is as a member of the North American Free Trade Agreement (NAFTA). The book focuses on the influence that the energy sector and multi-level institutional arrangements have on energy governance, with particular attention to the link between environmental study, climate change issues and economic market reforms. The growing differences between NAFTA and European Union member countries were highlighted. refs., tabs., figs.
Underwood, Carlisa M; Hayne, Arlene N
The purpose was to identify and describe structures and processes of best practices for system-level shared governance in healthcare systems. Currently, more than 64.6% of US community hospitals are part of a system. System chief nurse executives (SCNEs) are challenged to establish leadership structures and processes that effectively and efficiently disseminate best practices for patients and staff across complex organizations, geographically dispersed locations, and populations. Eleven US healthcare SCNEs from the American Nurses Credentialing Center's repository of Magnet®-designated facilities participated in a 35-multiquestion interview based on Kanter's Theory of Organizational Empowerment. Most SCNEs reported the presence of more than 50% of the empowerment structures and processes in system-level shared governance. Despite the difficulties and complexities of growing health systems, SCNEs have replicated empowerment characteristics of hospital shared governance structures and processes at the system level.
Full Text Available SUMMARY AIM: This study was planned and carried out with the objective of determining stress coping levels and mental state of students attending Police Vocational Schools of Higher Education, in addition to factors effecting these. MATERIAL and METHOD: This desciptive and cross-sectional study consisted of 300 male students enrolled in the 2005-2006 academic year, at Police Vocational School of Higher Education, located in central Erzincan, Turkey. In this study, instead of random sampling, 281 (93.7% students who were present at the school at the time of the study and accepted to partipate in it were included. Data for this study was collected using a desciptive form created by the researchers, Rosenbaum’s Learned Resourcefulness Scale (RLRS and The Symptom Check List-90-R (SCL-90-R. During the data analysis, frequency distributions, Mann-Whitney U, Kruskal-Wallis and analysis of variance (one-way ANOVA were used; and for analysis of independent groups, t-test was used. RESULTS: Among the students, it was determined that 54.8% were 1. grade, 90.7% had their parents living together, 43.5% had a father and 60.5% had a mother who graduated from elementary school, fathers of 23.5% of students were retired, 93.6% of them had mothers who were home makers. In addition, it was found out that 78.6% of students chose their profession willingly, the average family income of 71.5% of students were at medium levels, 82.9% always believed in themselves and 63.3% of students did not smoke. Based on the results obtained, it was observed that second grade students, those with mothers who are highly educated and those who trusted themselved all the time had significantly high stress coping levels; students who chose their own profession, believed in themselves and did not smoke had significantly low levels of mental symptom indications. CONCLUSION: In this study, the students were determined to posess averge levels of stress coping skills and they were found
Park, Soo Kyung; Rhee, Min-Kyoung; Barak, Michàlle Mor
Although nonregular workers experience higher job stress, poorer mental health, and different job stress dimensions relative to regular workers, little is known about which job stress dimensions are associated with poor mental health among nonregular workers. This study investigated the association between job stress dimensions and mental health among Korean nonregular workers. Data were collected from 333 nonregular workers in Seoul and Gyeonggi Province, and logistic regression analysis was conducted. Results of the study indicated that high job insecurity and lack of rewards had stronger associations with poor mental health than other dimensions of job stress when controlling for sociodemographic and psychosocial variables. It is important for the government and organizations to improve job security and reward systems to reduce job stress among nonregular workers and ultimately alleviate their mental health issues.
Full Text Available INTRODUCTION: A number of studies have identified that gay, lesbian, bisexual, transgender, and intersex (GLBTI people have poorer mental health than the general population. This article describes current mental health promotion and service provision for GLBTI people in New Zealand, and the views of stakeholders on current service delivery and concerns facing the sector. METHODS: An email survey of service providers gathered descriptive data about mental health promotion and services provided for GLBTI people. Data obtained from interviews with key informants and online submissions completed by GLBTI individuals were analysed thematically. FINDINGS: Five organisations provide clear, specific and utilised services and programmes to some or all of the GLBTI populations. Twelve GLBTI-focused mental health promotion resources are identified. The analysis of data from key informants and GLBTI respondents identified factors affecting mental health for these populations occurring at three levels-macro-social environment, social acceptance and connection, and services and support. CONCLUSION: While GLBTI individuals have the same basic mental health promotion and service provision needs as members of the general population, they have additional unique issues. To enhance the mental health of GLBTI New Zealanders, a number of actions are recommended, including building sector capacity, allocating sufficient funding, ensuring adequate research and information is available, and reducing stigma, enhancing young people's safety, and supporting practitioners through training and resources. An important role for government, alongside GLBTI input, for improving mental health is noted.
Kamara, Stania; Walder, Anna; Duncan, Jennifer; Kabbedijk, Antoinet; Hughes, Peter; Muana, Andrew
Reported levels of mental health and psychosocial problems rose during the 2014-2015 Ebola virus disease outbreak in Sierra Leone. As part of the emergency response, existing plans to create mental health units within the existing hospital framework were brought forward. A nurse-led mental health and psychosocial support service, with an inpatient liaison service and an outpatient clinic, was set up at the largest government hospital in the country. One mental health nurse trained general nurses in psychological first aid, case identification and referral pathways. Health-care staff attended mental well-being workshops on coping with stigma and stress. Mental health service provision in Sierra Leone is poor, with one specialist psychiatric hospital to serve the population of 7 million. From March 2015 to February 2016, 143 patients were seen at the clinic; 20 had survived or had relatives affected by Ebola virus disease. Half the patients (71) had mild distress or depression, anxiety disorders and grief or social problems, while 30 patients presented with psychosis requiring medication. Fourteen non-specialist nurses received mental health awareness training. Over 100 physicians, nurses and auxiliary staff participated in well-being workshops. A nurse-led approach within a non-specialist setting was a successful model for delivering mental health and psychosocial support services during the Ebola outbreak in Sierra Leone. Strong leadership and partnerships were essential for establishing a successful service. Lack of affordable psychotropic medications, limited human resources and weak social welfare structures remain challenges.
Reifels, Lennart; Nicholas, Angela; Fletcher, Justine; Bassilios, Bridget; King, Kylie; Ewen, Shaun; Pirkis, Jane
Improving access to culturally appropriate mental healthcare has been recognised as a key strategy to address the often greater burden of mental health issues experienced by Indigenous populations. We present data from the evaluation of a national attempt at improving access to culturally appropriate mental healthcare for Indigenous Australians through a mainstream primary mental healthcare program, the Access to Allied Psychological Services program, whilst specifically focusing on the implementation strategies and perspectives of service providers. We conducted semi-structured interviews with 31 service providers (primary care agency staff, referrers, and mental health professionals) that were analysed thematically and descriptively. Agency-level implementation strategies to enhance service access and cultural appropriateness included: the conduct of local service needs assessments; Indigenous stakeholder consultation and partnership development; establishment of clinical governance frameworks; workforce recruitment, clinical/cultural training and supervision; stakeholder and referrer education; and service co-location at Indigenous health organisations. Dedicated provider-level strategies to ensure the cultural appropriateness of services were primarily aimed at the context and process of delivery (involving, flexible referral pathways, suitable locations, adaptation of client engagement and service feedback processes) and, to a lesser extent, the nature and content of interventions (provision of culturally adapted therapy). This study offers insights into key factors underpinning the successful national service implementation approach. Study findings highlight that concerted national attempts to enhance mainstream primary mental healthcare for Indigenous people are critically dependent on effective local agency- and provider-level strategies to optimise the integration, adaptation and broader utility of these services within local Indigenous community and
Buffel, Veerle; Beckfield, Jason; Bracke, Piet
In this study, we question (1) whether the relationship between unemployment and mental healthcare use, controlling for mental health status, varies across European countries and (2) whether these differences are patterned by a combination of unemployment and healthcare generosity. We hypothesize that medicalization of unemployment is stronger in countries where a low level of unemployment generosity is combined with a high level of healthcare generosity. A subsample of 36,306 working-age respondents from rounds 64.4 (2005-2006) and 73.2 (2010) of the cross-national survey Eurobarometer was used. Country-specific logistic regression and multilevel analyses, controlling for public disability spending, changes in government spending, economic capacity, and unemployment rate, were performed. We find that unemployment is medicalized, at least to some degree, in the majority of the 24 nations surveyed. Moreover, the medicalization of unemployment varies substantially across countries, corresponding to the combination of the level of unemployment and of healthcare generosity.
Perez-Cruzado, David; Cuesta-Vargas, Antonio I; Vera-Garcia, Elisa; Mayoral-Cleries, Fermín
Physical fitness is a crucial variable in people with severe mental illness as these people could be more independent and improve their job opportunities. The present study compared the physical fitness of physically active and inactive people with severe mental illness. Physical fitness was evaluated in sixty-two people with severe mental illness using 11 physical tests that include strength, flexibility, balance and aerobic condition. Significant differences were found between both groups in muscle strength (handgrip test) and balance (single leg balance test and functional reach) with better performance in the group of physically active people. The results of the present study suggest that physical fitness (strength and balance) is higher in people with severe mental illness who practise regular physical activity that those who are inactive people. Physical active people may have a reduced risk of falls and fractures due to their higher levels of physical fitness.
Kiima, David; Jenkins, Rachel
Although most donor and development agency attention is focussed on communicable diseases in Kenya, the importance of non-communicable diseases including mental health and mental illness is increasingly apparent, both in their own right and because of their influence on health, education and social goals. Mental illness is common but the specialist service is extremely sparse and primary care is struggling to cope with major health demands. Non health sectors e.g. education, prisons, police, community development, gender and children, regional administration and local government have significant concerns about mental health, but general health programmes have been surprisingly slow to appreciate the significance of mental health for physical health targets. Despite a people centred post colonial health delivery system, poverty and global social changes have seriously undermined equity. This project sought to meet these challenges, aiming to introduce sustainable mental health policy and implementation across the country, within the context of extremely scarce resources. A multi-faceted and comprehensive programme which combined situation appraisal to inform planning, sustained intersectoral policy dialogue at national and regional level; establishment of a health sector system for coordination, supervision and training of at each level (national, regional, district and primary care); development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at national, regional, district and local levels; public education; and integration of mental health into health management systems. The programme has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, annual operational plans, mental health policy guidelines to accompany the general health policy, tobacco
Full Text Available Purpose: In the transformation of health care systems, the introduction of integrated service networks is considered to be one of the main solutions for enhancing efficiency. In the last few years, a wealth of literature has emerged on the topic of services integration. However, the question of how integrated service networks should be modelled to suit different implementation contexts has barely been touched. To fill that gap, this article presents four models for the organization of mental health integrated networks. Data sources: The proposed models are drawn from three recently published studies on mental health integrated services in the province of Quebec (Canada with the author as principal investigator. Description: Following an explanation of the concept of integrated service network and a description of the Quebec context for mental health networks, the models, applicable in all settings: rural, urban or semi-urban, and metropolitan, and summarized in four figures, are presented. Discussion and conclusion: To apply the models successfully, the necessity of rallying all the actors of a system, from the strategic, tactical and operational levels, according to the type of integration involved: functional/administrative, clinical and physician-system is highlighted. The importance of formalizing activities among organizations and actors in a network and reinforcing the governing mechanisms at the local level is also underlined. Finally, a number of integration strategies and key conditions of success to operationalize integrated service networks are suggested.
... Minority Population Profiles > Black/African American > Mental Health Mental Health and African Americans Poverty level affects mental health ... compared to 120% of non-Hispanic whites. 1 MENTAL HEALTH STATUS Serious psychological distress among adults 18 years ...
Dawson, John B
How should the mental element be defined in the legal standards governing a person's 'sectioning' or placement under the Mental Health Act (MHA)? This article considers how this mental element is defined in many MHAs in Australasia: via a statutory list of disorders of mental function said to 'characterise' the necessary state of mind. This article assesses the assumptions behind the adoption of this approach. It discusses the views of several English law reform committees that have explored how the mental element should be defined. It examines the philosophy of psychiatry, expounded clearly by Aubrey Lewis, that lies behind the Australasian approach, one that emphasises the need to identify mental disturbance by reference to disorders of 'part-function of the mind', not by reference to behaviour alone. It considers how the Australasian statutes address the question of personality disorder's covered by the Act. In conclusion, it endorses cautiously the Australasian approach, principally on the ground that it may contribute positively to the conduct of review proceedings for compulsory patients under the Act. It may concentrate the attention of tribunals on particular features of the patient's mental state, on how those features are linked to associated dangers or risks, and on how the presence of those features may justify placing decisions about the patient's treatment in others' hands. Throughout, comparisons are made with the manner in which the mental element has been defined in mental health legislation for England and Wales. © The Author 2017. Published by Oxford University Press; all rights reserved. For Permissions, please email: firstname.lastname@example.org.
Full Text Available This article deals with questions of mental health among students of pedagogical universities. There were analysed differences in the level of mental health among sporting and non-sporting students. Two methods were used in the inquiry. Stepanov's questionnaire was used to estimate the level of mental health, Gundarov's questionnaire was used to evaluate psychical satisfaction. The sample consisted of 263 sporting students (athletes and 288 non-sporting students. Results have shown that the level of mental health among sporting students was higher than the level of mental health among non-sporting students.
McAneney, Helen; Tully, Mark A; Hunter, Ruth F; Kouvonen, Anne; Veal, Philip; Stevenson, Michael; Kee, Frank
It has been argued that though correlated with mental health, mental well-being is a distinct entity. Despite the wealth of literature on mental health, less is known about mental well-being. Mental health is something experienced by individuals, whereas mental well-being can be assessed at the population level. Accordingly it is important to differentiate the individual and population level factors (environmental and social) that could be associated with mental health and well-being, and as people living in deprived areas have a higher prevalence of poor mental health, these relationships should be compared across different levels of neighbourhood deprivation. A cross-sectional representative random sample of 1,209 adults from 62 Super Output Areas (SOAs) in Belfast, Northern Ireland (Feb 2010 - Jan 2011) were recruited in the PARC Study. Interview-administered questionnaires recorded data on socio-demographic characteristics, health-related behaviours, individual social capital, self-rated health, mental health (SF-8) and mental well-being (WEMWBS). Multi-variable linear regression analyses, with inclusion of clustering by SOAs, were used to explore the associations between individual and perceived community characteristics and mental health and mental well-being, and to investigate how these associations differed by the level of neighbourhood deprivation. Thirty-eight and 30 % of variability in the measures of mental well-being and mental health, respectively, could be explained by individual factors and the perceived community characteristics. In the total sample and stratified by neighbourhood deprivation, age, marital status and self-rated health were associated with both mental health and well-being, with the 'social connections' and local area satisfaction elements of social capital also emerging as explanatory variables. An increase of +1 in EQ-5D-3 L was associated with +1SD of the population mean in both mental health and well-being. Similarly, a
Cratsley, Kelso; Mackey, Tim K
Increased awareness of the importance of mental health for global health has led to a number of new initiatives, including influential policy instruments issued by the World Health Organization (WHO) and the United Nations (UN). This policy brief describes two WHO instruments, the Mental Health Action Plan for 2013-2020 (World Health Organization, 2013) and the Mental Health Atlas (World Health Organization, 2015), and presents a comparative analysis with the Sustainable Development Goals (SDGs) of the UN's 2030 Agenda for Sustainable Development (United Nations, 2015). The WHO's Action Plan calls for several specific objectives and targets, with a focus on improving global mental health governance and service coverage. In contrast, the UN's Sustainable Development Goals include only one goal specific to mental health, with a single indicator tracking suicide mortality rates. The discrepancy between the WHO and UN frameworks suggests a need for increased policy coherence. Improved global health governance can provide the basis for ensuring and accelerating progress in global mental health. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
... Locators Find treatment facilities and programs in the United States or U.S. Territories for mental and substance use ... Health Information Technology HIV, AIDS, and Viral Hepatitis Homelessness and ... and Local Government Partnerships Suicide Prevention Trauma and ...
Bouve, Joris; Steens, Herman-Peter; Ruebens, Martin
The Flemish government comprises a number of different departments and agencies with the autonomy to optimise their service level in a proactive and resilient manner. Recently, the Flemish government defined four organisational values: openness, decisiveness, trust and agility. In addition, the Internal Audit Agency developed guidelines concerning internal control and organisational management, in which risk management was emphasised. In combination with goal setting and process management, this paper considers risk management as a starting point for the overall management of Flemish government entities. The paper then develops tools to support the establishment of business continuity and risk management processes. These tools fit into the organisation's strategic framework and are easy to understand, pragmatically designed and flexible in their use. The paper goes on to illustrate how the Department of the Chancellery and Public Governance is implementing BCM and risk management, and how it is integrating BCM, risk management and crisis management. It will then focus on the Flemish government's long-term strategy across the boundaries between the different entities and the question of how risk management can become a useful tool for policy makers.
Nguyen, Dat Tan; Dedding, Christine; Pham, Tam Thi; Bunders, Joske
Secondary school can be a stressful period for adolescents, having to cope with many life changes. Very little research has been conducted on the mental health status of secondary school pupils in South East Asian countries, such as Vietnam.The study aimed to explore perceptions of mental health status, risk factors for mental health problems and strategies to improve mental health among Vietnamese secondary school students. A qualitative design was used to address the main study question including: six in-depth interviews conducted with professionals (with two researchers, two psychiatrists, and two secondary school teachers) to learn about their experience of mental health problems among secondary school pupils; 13 focus group discussions (four with teachers, four with parents, and five with pupils); and 10 individual in-depth interviews with pupils who did not take part in the FGDs, to reflect on the collected data and to deepen the authors' understanding. All interviews and FGDs were audio-taped, transcribed and analyzed for the identification of emerging issues using qualitative techniques of progressive coding, analytic memoing and ongoing comparison. Our study confirms the need to pay attention to mental health of pupils in Vietnam. Depression, anxiety, stress, suicidal thoughts and suicide attempts were seen as major problems by all stakeholders. Mental health problems were mainly associated with academic pressure, resulting from an overloaded curriculum and pressure from teachers and parents to succeed. The study found that pupils' mental health demands interventions at many levels, including at the level of government (Ministry of Education and Training), schools, communities, families and pupils themselves. Vietnamese secondary school pupils feel that their mental health status is poor, because of many risk factors in their learning and living environment. The need now is to investigate further to identify and apply strategies to improve students' mental
Background Secondary school can be a stressful period for adolescents, having to cope with many life changes. Very little research has been conducted on the mental health status of secondary school pupils in South East Asian countries, such as Vietnam. The study aimed to explore perceptions of mental health status, risk factors for mental health problems and strategies to improve mental health among Vietnamese secondary school students. Methods A qualitative design was used to address the main study question including: six in-depth interviews conducted with professionals (with two researchers, two psychiatrists, and two secondary school teachers) to learn about their experience of mental health problems among secondary school pupils; 13 focus group discussions (four with teachers, four with parents, and five with pupils); and 10 individual in-depth interviews with pupils who did not take part in the FGDs, to reflect on the collected data and to deepen the authors’ understanding. All interviews and FGDs were audio-taped, transcribed and analyzed for the identification of emerging issues using qualitative techniques of progressive coding, analytic memoing and ongoing comparison. Results Our study confirms the need to pay attention to mental health of pupils in Vietnam. Depression, anxiety, stress, suicidal thoughts and suicide attempts were seen as major problems by all stakeholders. Mental health problems were mainly associated with academic pressure, resulting from an overloaded curriculum and pressure from teachers and parents to succeed. The study found that pupils’ mental health demands interventions at many levels, including at the level of government (Ministry of Education and Training), schools, communities, families and pupils themselves. Conclusions Vietnamese secondary school pupils feel that their mental health status is poor, because of many risk factors in their learning and living environment. The need now is to investigate further to identify and
N. W. Chan
Full Text Available Water is one of the central issues in the 21st century in Malaysia. Of all the issues associated with water management, governance is considered of primary importance. This paper examines water governance in Malaysia and concludes that it is successful in the sense that water is served to more than 95 % of the population, water tariffs are some of the cheapest in the world, the poor is not denied access, and water supply is 24 hours per day. However, there are many areas that need improvement to achieve better governance in water management. One is to improve Government-controlled water departments by ensuring their workers are well-trained and committed to excellence, public service and integrity instead of the usual laid-back government-servant mentality. Another is to ensure politicians do not interfere in the water sector. Currently, it is widely believed that many water companies are linked to powerful politicians, making the awarding of contracts, tariffs and other management aspects non-transparent and ineffective. Ideally, politicians that govern should act on the professional advice of the water managers and not the other way around. Another area of water governance that needs to be intensified is the war against corruption. In the water sector, there should also be an all-out war on corruption at all levels of governance, in both the public and private sectors. Government should make all contracts in the water sector awarded through open tender with public consultation to ensure professionalism, fairness, transparency, accountability and good governance. Equally, all contracts and other relevant documents drawn up between the government and private companies should not be “classified” but instead be public documents available to the public for discussion, review and improvement. Another area to ensure better governance is for the government to engage and actively involved all stakeholders in the water sector, especially civil
Dijkman, A.; Terwoert, J.; Hollander, A.
This literature review on Risk Governance is part of a TNO research programme on the safety of innovative substances and technologies in the workplace. The purpose of this review is to investigate how risk governance can be applied in the workplace when dealing with uncertainties regarding the
Conclusion: Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.
Young, Peter; Gordon, Michael S
The poor mental health of asylum seekers and refugees in immigration detention has consistently been reported in peer-reviewed literature internationally; however, data on the mental health of asylum seekers and refugees detained in Australian immigration has been very limited. We re-analysed mental health screening data obtained by the Human Rights Commission. Longer time in detention was associated with higher self-reported depression scores, with female individuals being more vulnerable to time in detention than those of male gender. Approximately one-half of the refugee group who agreed to complete the Harvard Trauma Questionnaire had post-traumatic stress disorder symptoms. On clinician-rated measures, one-third of the children, adolescents and adults suffered with clinical symptoms requiring tertiary outpatient assessment. This paper consolidates the findings of the 2014 Australian Human Rights Commission report and it provides an argument for public reporting of refugee data. © The Royal Australian and New Zealand College of Psychiatrists 2016.
Stanojević Dragana Z.
Full Text Available The concept of positive mental health represents not merely the absence of mental disease but presence of high level of happiness and well-being. In this paper we mentioned shortly the earliest concept of mental health, presented by Marie Jahoda in the mid-twentieth century. After that, we described two traditions in understanding and researching of subjective well-being: hedonic and eudaimonic approach. First approach focuses on investigation of positive affects and happiness as emotional and life satisfaction as cognitive component of subjective well-being. Second tradition emphasizes potentials and competences that person develops to the highest level, in personal and social area. Both psychological and social well-being are core concept of positive mental health psychology, designated together as positive functioning. The psychological well-being comprises six dimensions: self-acceptance, positive relations with others, environmental mastery, autonomy, purpose of life and personal growth. Social well-being consists of five dimensions: social integration, social acceptance, social contribution, social actualization and social coherence. By integrating hedonic and eudaimonic well-being as well as absence of mental disease, Corey Keyes introduced concept of complete mental health. People with complete mental health have reported absence of disease during past year and presence of high level of emotional, psychological and social well-being (flourishing. People with incomplete mental health have also reported absence of mental disease but low level of positive functioning (languishing. Keyes thought there are people with complete and incomplete mental illness; both groups report presence of mental disease, but second group has high level of positive functioning. Models of positive mental health are widely used in research studies as well as in programs for prevention and promotion of mental health. .
Mellifont, Damian; Smith-Merry, Jennifer; Scanlan, Justin Newton
Accommodating mental health in the workplace is challenging. Despite policy efforts to encourage the availability of mental health accommodations in the workplace, employees experiencing mental illness are missing out on accommodations that they need. To inform vocational rehabilitation professionals and managers in the public service of best practice accommodations for government employees with anxiety disorders. Thematic analysis was applied to data collected from the online Accommodating Government Employees with Anxiety Disorders Survey undertaken by 71 Australian public service employees diagnosed with at least one anxiety disorder. Our research results include theme and sub-theme representations of accommodations received, accommodations reported as missing, accommodations that study participants felt they couldn't request, along with rejected accommodations. From the study participants' accounts, three key findings supporting desirable vocational outcomes become apparent. First, that the availability of 'standard' flexible work arrangements, along with personalised accommodations, can assist persons with anxiety disorders (where needed) to reach and retain government positions. Second, the chief barriers reported to making accommodation requests revolve around fears of being stigmatised and penalised. Finally, there is a need for managerial decision-makers to remain open-minded, particularly when assessing requests for accommodations that may break from government norms.
Teh, Lisa B; Hayashi, Kentaro; Latner, Janet; Mueller, Charles W
The Consumer Attitudes towards Evidence Based Services (CAEBS) scale is a 29-item questionnaire designed to assess public views on the role of science in helping to guide mental health treatment. The aim of the current study was to assess the Factor structure the CAEBS in an online sample of adults seeking information about mental health services. The CAEBS was administered to a nationwide sample of participants from websites offering classified advertisements for mental health related study participation (n = 312). An Exploratory Factor Analysis (EFA) suggested four factors based on 26 of the items: Beliefs Regarding Therapists' Practices, Attitudes about Mental Health Policy, Negative Personal-Level Attitudes toward EBPs, and Negative Societal-Level Attitudes towards EBPs. In order to increase consumer empowerment within the mental health-care system and develop policies supporting EBP usage, mental health professionals need to increase communication with the public to address these concerns and leverage positive attitudes. © 2016 Australian College of Mental Health Nurses Inc.
Full Text Available The concept of risk is now central to all areas of health and social welfare in the UK, although its exact character in relation to different groups varies. It has been argued that risk in mental health has been characterised by a preoccupation with the perceived risk of violence to others posed by those experiencing mental distress, particularly since the implementation of community care policies in the 1990s. The present paper draws on qualitative materials from semi-structured interviews with thirty-nine mental health social workers to demonstrate the significance for policy and practice of identifying where professionals see risk as being located. In the present study, three key sites were identified: firstly, risk was located in dangerous individuals, where the concept "high-risk" was particularly closely identified with young Black men with a diagnosis of schizophrenia. Secondly, social workers located risk in within-subject entities such as active psychotic illness, when it was the symptom rather than the whole individual that was subject to surveillance and control. Thirdly, social workers located risk in social context and regarded risk in multidimensional ways compared to their psychiatric colleagues. The paper highlights how a theory of risk location can be a useful conceptual tool. URN: urn:nbn:de:0114-fqs0601310
Stansfeld, Stephen Alfred; Rasul, F R; Head, J; Singleton, N
To measure the prevalence of common mental disorder (CMD) by occupation in a representative sample of Great Britain and to identify occupations with increased and decreased risk of CMD. A cross-sectional interview-based survey was carried out including 5,497 working male and female respondents, 16-64 years from a stratified random survey of private households in Britain. Occupations were classified by the Standard Occupational Classification (SOC) into four groups: major, sub-major, minor and constituent unit groups. Common Mental Disorder was measured by the Revised Clinical Interview Schedule. Major SOC groups with higher prevalence of common mental disorder included clerical and secretarial, sales, and personal and protective services whereas craft and related, 'other' professional occupations and plant and machine operatives had lower prevalence compared to 13% overall prevalence in all adults. In sub-major SOC groups managers and administrators, teaching professionals, clerical and secretarial, 'other' sales and personal service occupations had higher prevalence whereas many professional and skilled occupations had lower prevalence. Specific SOC unit groups with higher prevalence included primary and secondary teachers, welfare community, youth workers, security staff, waiters, bar staff, nurse auxiliaries and care assistants. General managers in government and large organizations (OR=2.79, 95% CI 1.41-5.54), managers in transport and storing (OR=2.44, 95% CI 1.18-5.03), buyers and mobile sales persons (OR=2.48, 95% CI 1.09-5.60), sales occupations (NES) (OR=2.78, 95% CI 1.25-6.19) and clerks (NES) (OR=2.71, 95% CI 1.59-4.61) had increased risk of common mental disorder relative to specialist managers adjusting for social and financial factors and physical ill-health. Occupations with higher risk of common mental disorder may be typified by high levels of job demands, especially emotional demands and lack of job security. The reasons why occupations have low
Harris, Meredith G; Buckingham, William J; Pirkis, Jane; Groves, Aaron; Whiteford, Harvey
To derive planning estimates for the provision of public mental health services in Queensland 2007-2017. We used a five-step approach that involved: (i) estimating the prevalence and severity of mental disorders in Queensland, and the number of people at each level of severity treated by health services; (ii) benchmarking the level and mix of specialised mental health services in Queensland against national data; (iii) examining 5-year trends in Queensland public sector mental health service utilisation; (iv) reviewing Australian and international planning benchmarks; and (v) setting resource targets based on the results of the preceding four steps. Best available evidence was used where possible, supplemented by value judgements as required. Recommended resource targets for inpatient service were: 20 acute beds per 100,000 population, consistent with national average service provision but 13% above Queensland provision in 2005; and 10 non-acute beds per 100,000, 65% below Queensland levels in 2005. Growth in service provision was recommended for all other components. Adult residential rehabilitation service targets were 10 clinical 24-hour staffed beds per 100,000, and 18 non-clinical beds per 100,000. Supported accommodation targets were 35 beds per 100,000 in supervised hostels and 35 places per 100,000 in supported public housing. A direct care clinical workforce of 70 FTE per 100,000 for ambulatory care services was recommended. Fifteen per cent of total mental health funding was recommended for community support services provided by non-government organisations. The recommended targets pointed to specific areas for priority in Queensland, notably the need for additional acute inpatient services for older persons and expansion of clinical ambulatory care, residential rehabilitation and supported accommodation services. The development of nationally agreed planning targets for public mental health services and the mental health community support sector were
Farooq, Saeed; Nazar, Zahid; Akhtar, Javaid; Akhter, Javed; Irfan, Muhammad; Irafn, Mohammad; Subhan, Fazal; Ahmed, Zia; Khan, Ejaz Hassan; Khatak, Ijaz Hassan; Naeem, Farooq
The Muslims fast every year during the month of Ramadan. A fasting day can last 12-17 h. The effects of fasting on serum lithium levels and the mood changes in patients suffering from bipolar affective disorder during Ramadan are not well studied. We aimed to compare the serum lithium levels, side effects, toxicity and mental state in patients suffering from bipolar affective disorder and on prophylactic lithium therapy before, during and after Ramadan. Sixty-two patients meeting the International Classification of Diseases, Tenth Revision, Research Diagnostic Criteria of bipolar affective disorder receiving lithium treatment for prophylaxis were recruited in a tertiary care teaching hospital in Peshawar, Pakistan. Serum lithium, electrolytes, Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS) were assessed at three points, 1 week before Ramadan, midRamadan and 1 week after Ramadan. The side effects and toxicity were measured by a symptoms and signs checklist. There was no significant difference in mean serum lithium levels at three time points (preRamadan=0.45±0.21, midRamadan=0.51±0.20 and postRamadan=0.44±0.23 milli equivalents/litre, P=0.116). The scores on HDRS and YMRS showed significant decrease during Ramadan (F=34.12, P=0.00, for HDRS and F=15.6, P=0.000 for YMRS). The side effects and toxicity also did not differ significantly at three points. In conclusion, the patients who have stable mental state and lithium levels before Ramadan can be maintained on lithium during Ramadan. Fasting in an average temperature of 28°C for up to 12 h per day did not result in elevated serum lithium levels or more side effects and did not have adverse effects on mental state of patients suffering from bipolar affective disorder.
White, James; Greene, Giles; Farewell, Daniel; Dunstan, Frank; Rodgers, Sarah; Lyons, Ronan A; Humphreys, Ioan; John, Ann; Webster, Chris; Phillips, Ceri J; Fone, David
Neighborhood-level interventions provide an opportunity to better understand the impact of neighborhoods on health. In 2001, the Welsh Government, United Kingdom, funded Communities First, a program of neighborhood regeneration delivered to the 100 most deprived of the 881 electoral wards in Wales. In this study, we examined the association between neighborhood regeneration and mental health. Information on regeneration activities in 35 intervention areas (n = 4,197 subjects) and 75 control areas (n = 6,695 subjects) was linked to data on mental health from a cohort study with assessments made in 2001 (before regeneration) and 2008 (after regeneration). Propensity score matching was used to estimate the change in mental health in intervention neighborhoods versus control neighborhoods. Baseline differences between intervention and control areas were of similar magnitude as produced by paired randomization of neighborhoods. Regeneration was associated with an improvement in the mental health of residents in intervention areas compared with control neighborhoods (β = 1.54, 95% confidence interval: 0.50, 2.59), suggesting a reduction in socioeconomic inequalities in mental health. There was a dose-response relationship between length of residence in regeneration neighborhoods and improvements in mental health (P-trend = 0.05). These results show that targeted regeneration of deprived neighborhoods can improve mental health. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.
Gouttebarge; Aoki; Verhagen; Kerkhoffs
Background Mental disorders have become a topic of increasing interest in research due to their serious consequences for quality of life and functioning. Objectives The objective of this study was to explore the relationship of level of education, employment status and working hours with symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance, adverse alcohol behaviour, smoking, adverse nutritional beh...
Hoogma, R.; Te Buck, S.
A healthy development of the BioBased Economy (BBE) requires government support to one application to not complicate the development of another application. It is important to have a level playing field. This report takes a closer look at the level playing field for biomass in transport. [nl
Spanger, Marlene; Dahl, Hanne Marlene; Petersson, Elin
discursive policy analysis with feminist state and multi-level governance theories. Paying attention to the role of the state, we focus on the framing of policy problems that are important for care chains and on potential tensions between different framings within a state and across the different levels...
Full Text Available Abstract Background National Health Service (NHS mental health workforce configuration is at the heart of successful delivery, and providers are advised to produce professional development strategies. Recent policy changes in England have sharpened the focus on competency based role development. We determined levels of intervention activities, engagement and competence and their influencing factors in a community-setting mental health workforce. Methods Using a modified questionnaire based on the Yorkshire Care Pathways Model we investigated 153 mental health staff working in Coventry and Warwickshire NHS Trust. A median score of competence was computed across 10 cluster activities. Low engagement and competence levels were examined in a logistic regression model. Results In 220 activities, Monitoring risk was the highest rate of engagement (97.6% and Group psychological therapy/Art/Drama therapy was the lowest engagement (3.6%. The median competence level based on all activities was 3.95 (proficient. There were significant differences in the competence level among professional groups; non-qualified support group (3.00 for competent, Counsellor/Psychologist/Therapist (3.38, Occupational therapists (3.76, Nurses (4.01, Medical staff (4.05, Social workers (4.25 and Psychologists (4.62 for proficient/expert. These levels varied with activity clusters; the lowest level was for Counsellor/Psychologist/Therapist in the accommodation activity (1.44 novice/advance beginner and the highest for Occupational therapists in personal activity (4.94 expert. In a multivariate analysis, low competence was significantly related to non-qualified community support professions, late time of obtaining first qualification, more frequencies of clinical training, and training of cognitive behavioural therapy. The associations were similar in the analysis for 10 activity clusters respectively. Conclusions There was a reasonable competence level in the community
Bobevski, I; Rosen, A; Meadows, G
While epidemiological surveys worldwide have found a considerable proportion of people using mental health services not to have a diagnosis of a mental disorder, with possible implications of service overuse, other work has suggested that most people without a current diagnosis who used services exhibited other indicators of need. The aims of the present study were, using somewhat different categorisations than previous work, to investigate whether: (1) Australians without a diagnosis of a mental disorder who used mental health services had other indicators of need; and (2) how rate and frequency of service use in Australia related to level of need, then to discuss the findings in light of recent developments in Australian Mental Health Policy and other epidemiological and services research findings. Data from the Australian National Survey of Mental Health and Wellbeing (NSMHWB) 2007 was analysed. Most people using mental health services had evident indicators of need for mental health care (MHC), and most of those with lower evident levels of need did not make heavy use of services. Only a small proportion of individuals without any disorders or need indicators received MHC (4%). Although this latter group comprises a fair proportion of service users when extrapolating to the Australian population (16%), the vast majority of these individuals only sought brief primary-care or counselling treatment rather than consultations with psychiatrists. Access and frequency of MHC consultations were highest for people with diagnosed lifetime disorders, followed by people with no diagnosed disorders but other need indicators, and least for people with no identified need indicators. Limitations include some disorders not assessed in interview and constraints based on survey size to investigate subgroups defined, for instance, by socioeconomic advantage and disadvantage individually or by characteristics of area. MHC for individuals with no recognised disorders or other
Rösche, J; Uhlmann, C; Weber, R; Fröscher, W
Folate deficiency is common in patients with epilepsy and also occurs in patients with depression or cognitive deficits. This study investigates whether low serum folate levels may contribute to depressive mood and difficulties in mental processing in patients with epilepsy treated with anti-epileptic drugs inducing the cytochrome P450. We analysed the serum folate levels, the score in the Self Rating Depression Scale (SDS) and the results of a bedside test in mental processing in 54 patients with epilepsy. There was a significant negative correlation between the serum folate levels and the score in SDS and significant positive correlations between the score in SDS and the time needed to process an interference task or a letter-reading task. Low serum folate levels may contribute to depressive mood and therefore to difficulties in mental processing. Further studies utilizing total plasma homocysteine as a sensitive measure of functional folate deficiency and more elaborate tests of mental processing are required to elucidate the impact of folate metabolism on depressive mood and cognitive function in patients with epilepsy.
Demoralization is a commonly observed feeling state that is characterized by a sense of loss of or threat to one's personal values or goals and a perceived inability to overcome obstacles toward achieving these goals. Demoralization has features in common with burnout and may precede or accompany it. Psychiatrists working in many mental health care organizational settings, be they in the public or private sectors, may be at particular risk for demoralization. This is due partly to stressors that threaten their own professional values because of factors such as programmatic cut backs, budgetary reductions and changing social emphases on the value of mental health treatments. They also may be at risk for demoralization because of the effects on them of the governance styles of the agencies in which they are employed. The leadership or governance style in large organizational settings often is authoritarian, hierarchical and bureaucratic, approaches that are antithetical to the more participative leadership styles favored by many mental health professionals in their clinical activities. Clinical leaders in mental health organizations must exhibit various competencies to successfully address demoralization in clinical staff and to provide a counterbalance to the effects of the governance style of many agencies in which they are employed. Appropriate leadership skills, sometimes too simplistically termed "social support", have been found to reduce burnout in various populations and are likely to lessen demoralization as well. This paper reviews these important leadership issues and the relationship of social support to recognized leadership competencies.
Full Text Available In many areas of the world, groundwater resources are increasingly stressed, and unsustainable use has become common. Where existing mechanisms for governing groundwater are ineffective or nonexistent, new ones need to be developed. Local level groundwater governance provides an intriguing alternative to top-down models, with the promise of enabling management to better match the diversity of physical and social conditions in groundwater basins. One such example is emerging in California, USA, where new state law requires new local agencies to self-organize and act to achieve sustainable groundwater management. In this article, we draw on insights from research on common pool resource management and natural resources governance to develop guidelines for institutional design for local groundwater governance, grounded in California’s developing experience. We offer nine criteria that can be used as principles or standards in the evaluation of institutional design for local level groundwater governance: scale, human capacity, funding, authority, independence, representation, participation, accountability, and transparency. We assert that local governance holds promise as an alternative to centralized governance in some settings but that its success will depend heavily on the details of its implementation. Further, for local implementation to achieve its promise, there remain important complementary roles for centralized governance. California’s developing experience with local level groundwater management in dozens of basins across the state provides a unique opportunity to test and assess the importance and influence of these criteria.
Caulfield, Laura S; Twort, Hannah
Stemming from substantial criticism during the late twentieth and early twenty-first century, the UK government and HM Prison Service developed a number of policies and protocols aimed at improving the state of prison mental healthcare. While it is difficult to fault the purpose of the government's intentions, criticism has continued relating to problems with the implementation of government led change within the prison system. Existing research leads people to question whether policies are being implemented as intended; and if not, why not? The only clear way to answer these questions is to ask those involved in the actual implementation of these recommendations within the prison service. This paper aims to answer these questions. This paper documents findings from a national survey of senior mental healthcare staff working in prisons in England and Wales. Staff were surveyed about their views on the implementation of recommendations from recent key government documents, their perceptions of prison mental healthcare versus community mental healthcare, and their views on the relationship between HM Prison Service and the National Health Service. While many staff report improvements in prison mental healthcare, many have struggled with the implementation of new ways of working and the findings here suggest there is still some way to go towards providing offenders in prison with effective and appropriate care. Where effective ways of implementing change were identified, these are discussed. Listening to the experiences of the staff involved in prison healthcare has helped identify where implementation of changes could be improved and thus highlights where support might best be targeted in future.
Full Text Available In England and Wales, the Mental Health Act 1983 (MHA 1983 provides the legal framework which governs decisions made concerning the care and treatment of those suffering from mental disorders, where they may pose a risk to themselves or others. The perspective of the patient and the care provider may conflict and can be a source of tension and challenge within mental health law. Through access to a mental health tribunal, patients are offered the apparatus to review and challenge their detention. With detention rates under the mental health legislation rising exponentially, this is having a knock-on effect upon tribunal application numbers. As there is a legal requirement to review all cases of individuals detained under the MHA 1983, understanding the key drivers for this increase in detention is essential in order to understand how to better manage both detention rates and the upsurge in tribunal caseloads. With the increase in overall activity, mental health tribunal workloads present significant practical challenges and has downstream cost implications.
Full Text Available Information and collaboration patterns embedded in social networks play key roles in multilevel and polycentric modes of governance. However, modeling the dynamics of such social networks in multilevel settings has been seldom addressed in the literature. Here we use an adaptive social network model to elaborate the interplay between a central and a local government in order to maintain a polycentric governance. More specifically, our analysis explores in what ways specific policy choices made by a central agent affect the features of an emerging social network composed of local organizations and local users. Using two types of stylized policies, adaptive co-management and adaptive one-level management, we focus on the benefits of multi-level adaptive cooperation for network management. Our analysis uses viability theory to explore and to quantify the ability of these policies to achieve specific network properties. Viability theory gives the family of policies that enables maintaining the polycentric governance unlike optimal control that gives a unique blueprint. We found that the viability of the policies can change dramatically depending on the goals and features of the social network. For some social networks, we also found a very large difference between the viability of the adaptive one-level management and adaptive co-management policies. However, results also show that adaptive co-management doesn’t always provide benefits. Hence, we argue that applying viability theory to governance networks can help policy design by analyzing the trade-off between the costs of adaptive co-management and the benefits associated with its ability to maintain desirable social network properties in a polycentric governance framework.
Full Text Available Little is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda participating in the PRogramme for Improving Mental health carE (PRIME. The purpose was to inform development and implementation of a comprehensive district plan to integrate mental health into primary care.A situation analysis tool was developed for the study, drawing on existing tools and expert consensus. Cross-sectional information obtained was largely in the public domain in all five districts.The PRIME study districts face substantial contextual and health system challenges many of which are common across sites. Reliable information on existing treatment coverage for mental disorders was unavailable. Particularly in the low-income countries, many health service organisational requirements for mental health care were absent, including specialist mental health professionals to support the service and reliable supplies of medication. Across all sites, community mental health literacy was low and there were no models of multi-sectoral working or collaborations with traditional or religious healers. Nonetheless health system opportunities were apparent. In each district there was potential to apply existing models of care for tuberculosis and HIV or non-communicable disorders, which have established mechanisms for detection of drop-out from care, outreach and adherence support. The extensive networks of community-based health workers and volunteers in most districts provide further opportunities to expand mental health care.The low level of baseline health system preparedness across sites underlines that interventions at the levels of health care organisation, health facility and community will all be essential
Y. M. Revenko
Full Text Available The paper maintains that for developing the educational pro- grams and technologies adequate to the different stages of students’ growth and maturity, there is a need for exploring the natural determinants of intel- lectual development as well as the students’ individual qualities affecting the cognition process. The authors investigate the differences of the intellect manifestations with the reference to the gender principle, and analyze the correlations be- tween verbal and non-verbal components in boys and girls’ mental activity depending on their general intellect potential. The research, carried out in Si- berian State Automobile Road Academy and focused on the first year stu- dents, demonstrates the absence of gender differences in students’ general in- tellect levels; though, there are some other conformities: the male students of different intellectual levels show the same correlation coefficient of verbal and non-verbal intellect while the female ones have the same correlation only at the high intellect level. In conclusion, the authors emphasize the need for the integral ap- proach to raising students’ mental abilities considering the close interrelation between the verbal and non-verbal component development. The teaching materials should stimulate different mental qualities by differentiating the educational process to develop students’ individual abilities.
Full Text Available This study adopts Ostrom’s Social-Ecological Systems (SES framework in empirical fieldwork to explain how local forestry institutions affect forest ecosystems and social equity in the community of Mawlyngbna in North-East India. Data was collected through 26 semi-structured interviews, participatory timeline development, policy documents, direct observation, periodicals, transect walks, and a concurrent forest-ecological study in the village. Results show that Mawlyngbna's forests provide important sources of livelihood benefits for the villagers. However, ecological disturbance and diversity varies among the different forest ownership types and forest-based livelihood benefits are inequitably distributed. Based on a bounded rationality approach, our analysis proposes a set of causal mechanisms that trace these observed social-ecological outcomes to the attributes of the resource system, resource units, actors and governance system. We analyse opportunities and constraints of interactions between the village, regional, and state levels. We discuss how Ostrom’s design principles for community-based resource governance inform the explanation of robustness but have a blind spot in explaining social equity. We report experiences made using the SES framework in empirical fieldwork. We conclude that mapping cross-level interactions in the SES framework needs conceptual refinement and that explaining social equity of forest governance needs theoretical advances.
Deacon, Joseph R.; Konarski, Edward A., Jr.
Results of a study comparing the outcome of a reinforcement (do only) procedure with correspondence (say/do) training indicated no apparent differences in generalization between two groups of mentally retarded adults (N=12). Rule-governed behavior, rather than verbal regulation of behavior, may best account for behavior changes seen in…
Cohen, Adam S; Sasaki, Joni Y; German, Tamsin C
Does theory of mind depend on a capacity to reason about representations generally or on mechanisms selective for the processing of mental state representations? In four experiments, participants reasoned about beliefs (mental representations) and notes (non-mental, linguistic representations), which according to two prominent theories are closely matched representations because both are represented propositionally. Reaction times were faster and accuracies higher when participants endorsed or rejected statements about false beliefs than about false notes (Experiment 1), even when statements emphasized representational format (Experiment 2), which should have favored the activation of representation concepts. Experiments 3 and 4 ruled out a counterhypothesis that differences in task demands were responsible for the advantage in belief processing. These results demonstrate for the first time that understanding of mental and linguistic representations can be dissociated even though both may carry propositional content, supporting the theory that mechanisms governing theory of mind reasoning are narrowly specialized to process mental states, not representations more broadly. Extending this theory, we discuss whether less efficient processing of non-mental representations may be a by-product of mechanisms specialized for processing mental states. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.
Zhuang, Xiao Yu; Wong, Daniel Fu Keung; Cheng, Chi-Wei; Pan, Shu-Man
Few studies have been performed to explore mental health literacy and stigmatising attitudes towards mental illness and their relationships with causal beliefs about mental illness among Chinese people in Taiwan. Using a comparative approach, this study attempted to compare the mental health literacy and stigmatising attitudes of Taiwanese Chinese with those found among Australian and Japanese participants in other studies and to explore how mental health literacy and stigmatising attitudes relate to different perceptions of causes of mental illness. A convenience sample of 287 participants completed a battery of standardised questionnaires. A much lower percentage of Taiwanese people than Australians could correctly identify depression and schizophrenia. The Taiwanese respondents rated psychiatrists and clinical psychologists as more helpful than social workers and general practitioners (GPs) and expressed more uncertainty about the usefulness of certain medications when compared to the Australian and Japanese samples. Interestingly, Taiwanese Chinese hold similarly high levels of stigma towards schizophrenia, but lower levels of stigma towards depression when compared to the Japanese respondents. Taiwanese respondents who have higher levels of mental health literacy about schizophrenia were less willing to interact with people with schizophrenia than those with lower levels of mental health literacy. This study underlines the need for public education programmes to improve knowledge of various mental illnesses and to reduce stigmatising attitudes among Taiwanese Chinese. The aforementioned socially and culturally driven beliefs must be taken into consideration so that culturally relevant education programmes can be developed.
Chinitz, David P
Richard Saltman and Antonio Duran take up the challenging issue of governance in their article "Governance, Government and the Search for New Provider Models," and use two case studies of health policy changes in Sweden and Spain to shed light on the subject. In this commentary, I seek to link their conceptualization of governance, especially its interrelated roles at the macro, meso, and micro levels of health systems, with the case studies on which they report. While the case studies focus on the shifts in governance between the macro and meso levels and their impacts on achievement of desired policy outcomes, they also highlight the need to better integrate the dynamics of day to day operations within micro organizations into the overall governance picture. © 2016 by Kerman University of Medical Sciences.
Rosenberg, Sebastian; Salvador-Carulla, Luis
Australia was one of the first countries to develop a national policy for mental health. A persistent characteristic of all these policies has been their reference to the importance of accountability. What does this mean exactly and have we achieved it? Can Australia tell if anybody is getting better? To review accountability for mental health in Australia and question whether two decades of Australian rhetoric around accountability for mental health has been fulfilled. This paper first considers the concept of accountability and its application to mental health. We then draw on existing literature, reports, and empirical data from national and state governments to illustrate historical and current approaches to accountability for mental health. We provide a content analysis of the most current set of national indicators. The paper also briefly considers some relevant international processes to compare Australia's progress in establishing accountability for mental health. Australia's federated system of government permits competing approaches to accountability, with multiple and overlapping data sets. A clear national approach to accountability for mental health has failed to emerge. Existing data focuses on administrative and health service indicators, failing to reflect broader social factors which reveal quality of life. In spite of twenty years of investment and effort Australia has been described as outcome blind, unable to demonstrate the merit of USD 8bn spent on mental health annually. While it may be prolific, existing administrative data provide little outcomes information against which Australia can genuinely assess the health and welfare of people with a mental illness. International efforts are evolving slowly. Even in high income countries such as Australia, resources for mental health services are constrained. Countries cannot afford to continue to invest in services or programs that fail to demonstrate good outcomes for people with a mental illness
We study the empirical consistency of survey based (micro level) indicators of social capital and local government performance on the one, and municipality based (aggregate level) measures of these two concepts on the other hand. Knowledge about the behavior of these indicators is helpful for
Abou-Saleh, Mohammed T; Christodoulou, George N
Refugees have high rates of mental health morbidity as a result of conflict. However, their needs for mental healthcare and psychosocial support are often unmet, despite the efforts of professional and humanitarian organisations. The war refugee crisis is a global challenge that needs a global solution. We call on all governments, regional and international organisations to take responsible humanitarian actions to intervene and support people affected by these disasters and for all humanity to unite against the forces of injustice and degradation. The thematic papers in this issue report on the Syrian crisis from a variety of perspectives.
Hoefnagel, E.W.J.; Vos, de B.I.; Buisman, F.C.
Marine governance involves interaction between networks and actors from different types and levels of organizations. The concept of multi-level or network governance steps away from the assumptions that supra-national and national government at the macro level is the dominant policy making unit. At
Full Text Available Abstract Background Although most donor and development agency attention is focussed on communicable diseases in Kenya, the importance of non-communicable diseases including mental health and mental illness is increasingly apparent, both in their own right and because of their influence on health, education and social goals. Mental illness is common but the specialist service is extremely sparse and primary care is struggling to cope with major health demands. Non health sectors e.g. education, prisons, police, community development, gender and children, regional administration and local government have significant concerns about mental health, but general health programmes have been surprisingly slow to appreciate the significance of mental health for physical health targets. Despite a people centred post colonial health delivery system, poverty and global social changes have seriously undermined equity. This project sought to meet these challenges, aiming to introduce sustainable mental health policy and implementation across the country, within the context of extremely scarce resources. Methods A multi-faceted and comprehensive programme which combined situation appraisal to inform planning, sustained intersectoral policy dialogue at national and regional level; establishment of a health sector system for coordination, supervision and training of at each level (national, regional, district and primary care; development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at national, regional, district and local levels; public education; and integration of mental health into health management systems. Results The programme has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, annual operational plans, mental health policy guidelines
Full Text Available This paper explores the relationship between governance regime and large-scale irrigation system design by investigating three cases: 1 protective irrigation design in post-independent South India; 2 canal irrigation system design in Khorezm Province, Uzbekistan, as implemented in the USSR period, and 3 canal design by the Madras Irrigation and Canal Company, as part of an experiment to do canal irrigation development in colonial India on commercial terms in the 1850s-1860s. The mutual shaping of irrigation infrastructure design characteristics on the one hand and management requirements and conditions on the other has been documented primarily at lower, within-system levels of the irrigation systems, notably at the level of division structures. Taking a 'social construction of technology' perspective, the paper analyses the relationship between technological structures and management and governance arrangements at irrigation system level. The paper finds qualitative differences in the infrastructural configuration of the three irrigation systems expressing and facilitating particular forms of governance and rule, differences that matter for management and use, and their effects and impacts.
Jang, Hyeongap; Lim, Jun-Tae; Oh, Juhwan; Lee, Seon-Young; Kim, Yong-Ik; Lee, Jin-Seok
While there have been many quantitative studies on the public's attitude towards mental illnesses, it is hard to find quantitative study which focused on the contextual effect on the public's attitude. The purpose of this study was to identify factors that affect the public's beliefs and attitudes including contextual effects. We analyzed survey on the public's beliefs and attitudes towards mental illness in Korea with multi-level analysis. We analyzed the public's beliefs and attitudes in terms of prejudice as an intermediate outcome and social distance as a final outcome. Then, we focused on the associations of factors, which were individual and regional socio-economic factors, familiarity, and knowledge based on the comparison of the intermediate and final outcomes. Prejudice was not explained by regional variables but was only correlated with individual factors. Prejudice increased with age and decreased by high education level. However, social distance controlling for prejudice increased in females, in people with a high education level, and in regions with a high education level and a high proportion of the old. Therefore, social distance without controlling for prejudice increased in females, in the elderly, in highly educated people, and in regions with a high education and aged community. The result of the multi-level analysis for the regional variables suggests that social distance for mental illness are not only determined by individual factors but also influenced by the surroundings so that it could be tackled sufficiently with appropriate considering of the relevant regional context with individual characteristics.
Jones, Martin; Kruger, Mellissa; Walsh, Sandra M
WHAT IS KNOWN ON THE SUBJECT?: People diagnosed with schizophrenia or bipolar disorder have a life expectancy 10-15 years less than the general population. In rural and remote Australia, there is a shortage of health care professionals to provide physical health care for people living with a serious mental illness (SMI). A large proportion of the care for people living with a SMI is provided by non-government organizations (NGOs), often employing workers without formal qualifications. There has been minimal research regarding the experiences of NGO workers who have been trained to complete health checks to help people living with SMI to access primary care services. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to examine the experiences of preparing NGO workers to use the health improvement profile (HIP) to support the physical health of people with SMI. It builds on previous studies that examined the use of the HIP by trained/qualified staff. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study highlights that NGO employees may have an important role in helping people with a SMI to address their physical health. Engaging lay workers to use the HIP increases their awareness of the importance of providing good physical health care for people with SMI. The use of a tool, such as the HIP, prepares NGO workers to support the physical health needs and enables them to describe meaningful improvements in the health of people with a SMI. Background The life expectancy of people living with a serious mental illness (SMI) is up to 10-15 years less than the general population. They experience difficulties in accessing timely and appropriate physical health care. People with SMI living in regional Australia experience additional barriers to accessing services. This is in part due to the difficulties associated with recruiting and retaining health professionals in regional Australia. Aim To explore the regional non-government organization (NGO
Walter, Garry; Soh, Nerissa Li-Wey; Norgren Jaconelli, Sanna; Lampe, Lisa; Malhi, Gin S; Hunt, Glenn
To descriptively assess medical students' concerns for their mental and emotional state, perceived need to conceal mental problems, perceived level of support at university, knowledge and use of student support services, and experience of stresses of daily life. From March to September 2011, medical students at an Australian university were invited to complete an anonymous online survey. 475 responses were received. Students rated study and examinations (48.9%), financial concerns (38.1%), isolation (19.4%) and relationship concerns (19.2%) as very or extremely stressful issues. Knowledge of available support services was high, with 90.8% indicating they were aware of the university's medical centre. Treatment rates were modest (31.7%). Students' concerns about their mental state were generally low, but one in five strongly felt they needed to conceal their emotional problems. Despite widespread awareness of appropriate support services, a large proportion of students felt they needed to conceal mental and emotional problems. Overall treatment rates for students who were greatly concerned about their mental and emotional state appeared modest, and, although comparable with those of similarly aged community populations, may reflect undertreatment. It would be appropriate for universities to address stressors identified by students. Strategies for encouraging distressed students to obtain appropriate assessment and treatment should also be explored. Those students who do seek healthcare are most likely to see a primary care physician, suggesting an important screening role for these health professionals.
of Denmark, and finally the third layer: the leadership used in Danish schools. The use of 'soft governance' is shifting the focus of governance and leadership from decisions towards influence and power and thus shifting the focus of the processes from the decision-making itself towards more focus......The governance and leadership at transnational, national and school level seem to be converging into a number of isomorphic forms as we see a tendency towards substituting 'hard' forms of governance, that are legally binding, with 'soft' forms based on persuasion and advice. This article analyses...... and discusses governance forms at several levels. The first layer is the global: the methods of 'soft governance' that are being utilised by transnational agencies. The second layer is the national and local: the shift in national and local governance seen in many countries, but here demonstrated in the case...
Full Text Available Culture plays an important role on human lives and it has been in four ancient civilizations of China, Iran, Egypt and Greece. The civilization achievements are normally categorized in two different groups of material and immaterial. Practical experience of the material, social objective is called as a civilization and the mental aspect of spiritual experiences, spiritual and personal is called culture. The purpose of this research is to find a framework for cross-cultural management. First, we define the cultural planning and we review the existing cultural examples in Iranian society and try to provide an overall analysis. The paper also investigates the role of government on creating adaptive culture within the society and explains that government must act as leadership in creating value added culture.
Stirling, Yolande; Higgins, Kate; Petrakis, Melissa
Objective Although Australia's service and policy context differs from that of the US, studies have highlighted potential for individual placement and support (IPS) to support competitive employment outcomes for people with severe and persistent mental illness. The aim of the present study was to explore why the model is not yet widely available. Methods A document analysis was conducted to discern reasons for challenges in implementation of IPS practice principles within the Australian service context. Results The document analysis illustrated that although policy acknowledges the importance of increasing employment rates for people with severe and persistent mental illness, consistent measures, change indicators, direction and time frames are lacking in policy and strategy documentation. Further, IPS principles are not consistently evident in guiding operational documentation that government-funded Disability Employment Services (DES) programs are mandated to adhere to. Conclusions For IPS to be readily implemented, it is necessary for government to offer support to agencies to partner and formal endorsement of the model as a preferred approach in tendering processes. Obligations and processes must be reviewed to ensure that model fidelity is achievable within the Australian Commonwealth policy and service context for programs to achieve competitive employment rates comparable to the most successful international programs. What is known about the topic? The IPS model has been established as the most efficacious approach to support people with severe and persistent mental ill health to gain and sustain employment internationally, yet little is known as to why this model has had very limited uptake in the Australian adult mental health service and policy context. What does this paper add? This paper provides an investigation into the achievability of IPS within DES philosophical and contractual arrangements. What are the implications for practitioners? Mental
Lund, C; Petersen, I; Kleintjes, S; Bhana, A
There is new policy commitment to mental health in South Africa, demonstrated in the national mental health summit of April 2012. This provides an opportunity to take stock of our mental health services. At primary care level key challenges include- training and supervision of staff in the detection and management of common mental disorders, and the development of community-based psychosocial rehabilitation programmes for people with severe mental illness (in collaboration with existing non-governmental organizations). At secondary level, resources need to be invested in 72-hour observation facilities at designated district and regional hospitals, in keeping with the Mental Health Care Act. At tertiary level, greater continuity of care with primary and secondary levels is required to prevent "revolving door" patterns of care. There are major challenges and also opportunities related to the high level of comorbidity between mental illness and a range of other public health priorities, notably HIV/AIDS, cardiovascular disease and diabetes. The agenda for mental health services research needs to shift to a focus on evaluating interventions. With current policy commitment, the time to act and invest in evidence-based mental health services is now.
Ben Natan, Merav; Drori, Tal; Hochman, Ohad
This study examined public perception of stigmas relating to mental illness six months after a reform, which integrated mental health care into primary care in Israel. The results reveal that the public feels uncomfortable seeking referral to mental health services through the public health system, with Arab Israelis and men expressing lower levels of comfort than did Jewish Israelis. The current reform has not solved the issue of public stigma regarding mental health care. The study suggests that the current reforms must be accompanied over time with appropriate public education regarding mental illness. Copyright © 2017 Elsevier Inc. All rights reserved.
Christine M. Sarteschi
Full Text Available This paper sought to synthesize what is currently known about mentally ill offenders in American jails and prisons based upon the most recent government and congressional reports and relevant literature review. The primary goal is to provide a detailed picture of the status of mentally ill offenders—including prevalence, basic demographic information, bio-psycho-social status, mental health, and family histories—and also to identify the problems, conditions, and obstacles faced while under the jurisdiction of the criminal justice system. Mentally ill offenders are constitutionally guaranteed basic mental health treatment. A review of the literature indicates that this constitutional guarantee is not being adequately fulfilled. Implications and suggestions for change are discussed.
Green, Jennifer Greif; McLaughlin, Katie A.; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A,; Kessler, Ronald C.
Objective Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to increase service use. This paper examines associations of school resources with past-year mental health service use among students with 12-month DSM-IV mental disorders. Method Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent mental health that included 4,445 adolescent-parent pairs in 227 schools in which principals and mental health coordinators completed surveys about school resources-policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported mental health service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school mental health resources and individual-level service use. Results Roughly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year mental health services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with mental health service use for adolescents with mild/moderate mental and behavior disorders. The ratio of students-to-mental health providers was not associated with overall service use, but was associated with sector of service use. Conclusions School mental health resources, particularly those related to early identification, may facilitate mental health service use and influence sector of service use for youths with DSM disorders. PMID:23622851
David P Chinitz
Full Text Available Richard Saltman and Antonio Duran take up the challenging issue of governance in their article “Governance, Government and the Search for New Provider Models,” and use two case studies of health policy changes in Sweden and Spain to shed light on the subject. In this commentary, I seek to link their conceptualization of governance, especially its interrelated roles at the macro, meso, and micro levels of health systems, with the case studies on which they report. While the case studies focus on the shifts in governance between the macro and meso levels and their impacts on achievement of desired policy outcomes, they also highlight the need to better integrate the dynamics of day to day operations within micro organizations into the overall governance picture.
Department of Veterans Affairs — VAMC-level statistics on the prevalence, mental health utilization, non-mental health utilization, mental health workload, and psychological testing of Veterans with...
Bilekli, Ilgun; Inozu, Mujgan
Mental contamination, which occurs in the absence of contact with a contaminant, has a moral element. Previous studies evoked feelings of mental contamination via listening to a scenario, which described a non-consensual kiss. Since mental contamination has a moral element, we tested the effects of the level of religiosity on feelings of mental contamination and related variables in an experimental design. Female undergraduates of high religiosity (n = 48) and low religiosity (n = 44) were randomly assigned to listen to one of two audio recordings involving a consensual or non-consensual kiss from a man described as moral. Mental contamination feelings were evoked successfully in both groups. Effects of scenario condition and religiosity level were seen in mental contamination and related negative feelings. Participants who imagined a non-consensual kiss reported greatest feelings of mental contamination, and internal and external negative feelings. More importantly, high religiosity resulted in greater feelings of mental contamination, internal negative feelings, as well as urges to wash and actual washing behaviors. The current study was conducted on non-clinical Muslim females. This limits the generalization of the findings to the wider population. Mental contamination and related feelings can be seen in different forms at different levels of religiosity. Copyright © 2017 Elsevier Ltd. All rights reserved.
Luitel, Nagendra P; Jordans, Mark Jd; Adhikari, Anup; Upadhaya, Nawaraj; Hanlon, Charlotte; Lund, Crick; Komproe, Ivan H
Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal. A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records. Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry
Yang, Julie; Kurdyak, Paul; Guttmann, Astrid
When the Government of Ontario launched a comprehensive mental health and addictions strategy, the Institute for Clinical Evaluative Sciences (ICES) was tasked with developing a scorecard for ongoing monitoring of the child and youth mental health system. Using existing administrative and survey-based healthcare and education data, researchers at ICES developed a scorecard consisting of 25 indicators that described at-risk populations, child and youth mental healthcare and relevant outcomes. This scorecard is the first in Canada to report on performance indicators for the child and youth mental health system and provides a model for monitoring child and youth mental health using routinely collected administrative data.
Grace, Francesca C; Meurk, Carla S; Head, Brian W; Hall, Wayne D; Carstensen, Georgia; Harris, Meredith G; Whiteford, Harvey A
Over the past two decades, mental health reform in Australia has received unprecedented government attention. This study explored how five policy levers (organisation, regulation, community education, finance and payment) were used by the Australian Federal Government to implement mental health reforms. Australian Government publications, including the four mental health plans (published in 1992, 1998, 2003 and 2008) were analysed according to policy levers used to drive reform across five priority areas:  human rights and community attitudes;  responding to community need;  service structures;  service quality and effectiveness; and  resources and service access. Policy levers were applied in varying ways; with two or three levers often concurrently used to implement a single initiative or strategy. For example, changes to service structures were achieved using various combinations of all five levers. Attempts to improve service quality and effectiveness were instead made through a single lever-regulation. The use of some levers changed over time, including a move away from prescriptive, legislative use of regulation, towards a greater focus on monitoring service standards and consumer outcomes. Patterns in the application of policy levers across the National Mental Health Strategy, as identified in this analysis, represent a novel way of conceptualising the history of mental health reform in Australia. An improved understanding of the strategic targeting and appropriate utilisation of policy levers may assist in the delivery and evaluation of evidence-based mental health reform in the future.
Gao, Ji; Lv, Hexin; Jin, Zhiyong; Xu, Ping
In order to adapt to the accelerative open tendency of collaborations between enterprises, this paper proposes a Social-level Norm-based methodology for Macro-Governing service collaboration processes, called SNMG, to regulate and control the social-level visible macro-behaviors of the social individuals participating in collaborations. SNMG not only can remove effectively the uncontrollability hindrance confronted with by open social activities, but also enables across-management-domain collaborations to be implemented by uniting the centralized controls of social individuals for respective social activities. Therefore, this paper provides a brand-new system construction mode to promote the development and large-scale deployment of service collaborations.
It is possible to merge datasets from school level to an individual level register data. The merged big data offers new possibilities to study questions related to the prevalence of mental health problems. The new linked data can be further analyzed to hierarchical model.
The Foucauldian sociologist Nikolas Rose has influentially argued that psychosocial technologies have offered means through which the ideals of democracy can be made congruent with the management of social life and the government of citizens in modern Western liberal democracies. This interpretation is contested here through an examination of the 1948 International Congress on Mental Health held in London and the mental hygiene movement that organised it. It is argued that, in Britain, this movement's theory and practice represents an uneasy and ambiguous attempt to reconcile visions of 'the modern' with 'the traditional'. The mental hygienist emphasis on the family is central. Here it appears as a forcing-house of the modern self-sustaining individual. Mental hygienists cast the social organisation of 'traditional' communities as static, with rigid authority frustrating both social progress and the full emergence of individual personality. Yet mental hygienists were also concerned about threats to social cohesion and secure personhood under modernity. If the social organisation of 'traditional' communities was patterned by the archetype of the family, with its personal relations of authority, mental hygienists compressed these relations into the 'private' family. Situated here they became part of a developmental process of mental adjustment through which 'mature', responsible citizens emerged. This reformulation of the family's centrality for the social order informed mental hygienist critiques of the growth of state power under existing forms of democracy, as well as suspicion of popular political participation or protest, and of movements towards greater egalitarianism.
Full Text Available Small-scale fisheries (SSFs in developing countries are expected to play a significant role in poverty alleviation and enhancing food security in the decades to come. To realize this expectation, a better understanding of their informal self-governance arrangements is critical for developing policies that can improve fishers' livelihoods and lead to sustainable ecosystem stewardship. The goal of this paper is to develop a more nuanced understanding of micro-level factors-such as fishers' characteristics and behavior-to explain observed differences in self-governance arrangements in Northwest Mexico. We focus on two ubiquitous forms of self-governance: hierarchical non-cooperative arrangements between fishers and fishbuyers, such as patron-client relationships (PCs, versus more cooperative arrangements amongst fishers, such as fishing cooperatives (co-ops. We developed an agent-based model of an archetypical SSF that captures key hypotheses from in-depth fieldwork in Northwest Mexico of fishers' day-to-day fishing and trading. Results from our model indicate that high diversity in fishers' reliability, and low initial trust between co-op members, makes co-ops' establishment difficult. PCs cope better with this kind of diversity because, in contrast to co-ops, they have more flexibility in choosing whom to work with. However, once co-ops establish, they cope better with seasonal variability in fish abundance and provide long-term security for the fishers. We argue that existing levels of trust and diversity among fishers matter for different self-governance arrangements to establish and persist, and should therefore be taken into account when developing better, targeted policies for improved SSFs governance.
Lindkvist, Emilie; Basurto, Xavier; Schlüter, Maja
Small-scale fisheries (SSFs) in developing countries are expected to play a significant role in poverty alleviation and enhancing food security in the decades to come. To realize this expectation, a better understanding of their informal self-governance arrangements is critical for developing policies that can improve fishers' livelihoods and lead to sustainable ecosystem stewardship. The goal of this paper is to develop a more nuanced understanding of micro-level factors-such as fishers' characteristics and behavior-to explain observed differences in self-governance arrangements in Northwest Mexico. We focus on two ubiquitous forms of self-governance: hierarchical non-cooperative arrangements between fishers and fishbuyers, such as patron-client relationships (PCs), versus more cooperative arrangements amongst fishers, such as fishing cooperatives (co-ops). We developed an agent-based model of an archetypical SSF that captures key hypotheses from in-depth fieldwork in Northwest Mexico of fishers' day-to-day fishing and trading. Results from our model indicate that high diversity in fishers' reliability, and low initial trust between co-op members, makes co-ops' establishment difficult. PCs cope better with this kind of diversity because, in contrast to co-ops, they have more flexibility in choosing whom to work with. However, once co-ops establish, they cope better with seasonal variability in fish abundance and provide long-term security for the fishers. We argue that existing levels of trust and diversity among fishers matter for different self-governance arrangements to establish and persist, and should therefore be taken into account when developing better, targeted policies for improved SSFs governance.
Basurto, Xavier; Schlüter, Maja
Small-scale fisheries (SSFs) in developing countries are expected to play a significant role in poverty alleviation and enhancing food security in the decades to come. To realize this expectation, a better understanding of their informal self-governance arrangements is critical for developing policies that can improve fishers’ livelihoods and lead to sustainable ecosystem stewardship. The goal of this paper is to develop a more nuanced understanding of micro-level factors—such as fishers’ characteristics and behavior—to explain observed differences in self-governance arrangements in Northwest Mexico. We focus on two ubiquitous forms of self-governance: hierarchical non-cooperative arrangements between fishers and fishbuyers, such as patron-client relationships (PCs), versus more cooperative arrangements amongst fishers, such as fishing cooperatives (co-ops). We developed an agent-based model of an archetypical SSF that captures key hypotheses from in-depth fieldwork in Northwest Mexico of fishers’ day-to-day fishing and trading. Results from our model indicate that high diversity in fishers’ reliability, and low initial trust between co-op members, makes co-ops’ establishment difficult. PCs cope better with this kind of diversity because, in contrast to co-ops, they have more flexibility in choosing whom to work with. However, once co-ops establish, they cope better with seasonal variability in fish abundance and provide long-term security for the fishers. We argue that existing levels of trust and diversity among fishers matter for different self-governance arrangements to establish and persist, and should therefore be taken into account when developing better, targeted policies for improved SSFs governance. PMID:28406935
Niaz, Mansoor; Lawson, Anton E.
Tested two hypotheses: (1) formal reasoning is required to balance simple one-step equations; and (2) formal reasoning plus sufficient mental capacity are required to balance many-step equations. Independent variables included intellectual development, mental capacity, and degree of field dependence/independence. With 25 subjects, significance was…
Bouty, A. A.; Koniyo, M. H.; Novian, D.
This study aims to determine the level of maturity of information technology governance in Gorontalo city government by applying the COBIT framework 4.1. The research method is the case study method, by conducting surveys and data collection at 25 institution in Gorontalo City. The results of this study is the analysis of information technology needs based on the measurement of maturity level. The results of the measurement of the maturity level of information technology governance shows that there are still many business processes running at lower level, from 9 existing business processes there are 4 processes at level 2 (repetitive but intuitive) and 3 processes at level 1 (Initial/Ad hoc). With these results, is expected that the government of Gorontalo city immediately make improvements to the governance of information technology so that it can run more effectively and efficiently.
Van Herk, S.; Rijke, J.S.; Zevenbergen, C.; Ashley, R.
This paper presents a case study of a new adaptive, multi-level governance approach that supported a transition in river basin management in the Netherlands. The floods of 1993 and 1995 in the Netherlands triggered a paradigm shift in flood management. The 2.3 billion Euro flood safety programme
Laidlaw, Anita; McLellan, Julie; Ozakinci, Gozde
Despite relatively high levels of psychological distress, many students in higher education do not seek help for difficulties. This study explored undergraduate student understanding of the concepts of mental health and mental well-being and where undergraduate students would seek help for mental well-being difficulties. Semi-structured interviews…
Shill, Jane; Mavoa, Helen; Crammond, Brad; Loff, Bebe; Peeters, Anna; Lawrence, Mark; Allender, Steven; Sacks, Gary; Swinburn, Boyd A
Policy and regulatory interventions aimed at creating environments more conducive to physical activity (PA) are an important component of strategies to improve population levels of PA. However, many potentially effective policies are not being broadly implemented. This study sought to identify potential policy/regulatory interventions targeting PA environments, and barriers/facilitators to their implementation at the Australian state/territory government level. In-depth interviews were conducted with senior representatives from state/territory governments, statutory authorities and non-government organisations (n = 40) to examine participants': 1) suggestions for regulatory interventions to create environments more conducive to PA; 2) support for preselected regulatory interventions derived from a literature review. Thematic and constant comparative analyses were conducted. POLICY INTERVENTIONS MOST COMMONLY SUGGESTED BY PARTICIPANTS FELL INTO TWO AREAS: 1) urban planning and provision of infrastructure to promote active travel; 2) discouraging the use of private motorised vehicles. Of the eleven preselected interventions presented to participants, interventions relating to walkability/cycling and PA facilities received greatest support. Interventions involving subsidisation (of public transport, PA-equipment) and the provision of more public transport infrastructure received least support. These were perceived as not economically viable or unlikely to increase PA levels. Dominant barriers were: the powerful 'road lobby', weaknesses in the planning system and the cost of potential interventions. Facilitators were: the provision of evidence, collaboration across sectors, and synergies with climate change/environment agendas. This study points to how difficult it will be to achieve policy change when there is a powerful 'road lobby' and government investment prioritises road infrastructure over PA-promoting infrastructure. It highlights the pivotal role of the
Moran, Valerie; Jacobs, Rowena
Provider payment systems for mental health care that incentivize cost control and quality improvement have been a policy focus in a number of countries. In England, a new prospective provider payment system is being introduced to mental health that should encourage providers to control costs and improve outcomes. The aim of this research is to investigate the relationship between costs and outcomes to ascertain whether there is a trade-off between controlling costs and improving outcomes. The main data source is the Mental Health Minimum Data Set (MHMDS) for the years 2011/12 and 2012/13. Costs are calculated using NHS reference cost data while outcomes are measured using the Health of the Nation Outcome Scales (HoNOS). We estimate a bivariate multi-level model with costs and outcomes simultaneously. We calculate the correlation and plot the pairwise relationship between residual costs and outcomes at the provider level. After controlling for a range of demographic, need, social, and treatment variables, residual variation in costs and outcomes remains at the provider level. The correlation between residual costs and outcomes is negative, but very small, suggesting that cost-containment efforts by providers should not undermine outcome-improving efforts under the new payment system.
Butler, Ashley M
There is growing emphasis on shared decision making (SDM) to promote family participation in care and improve the quality of child mental health care. Yet, little is known about the relationship of SDM with parental perceptions of child mental health treatment or child mental health functioning. The objectives of this preliminary study were to examine (a) the frequency of perceived SDM with providers among minority parents of children referred to colocated mental health care in a primary care clinic, (b) associations between parent-reported SDM and mental health treatment stigma and child mental health impairment, and (c) differences in SDM among parents of children with various levels of mental health problem severity. Participants were 36 Latino and African American parents of children (ages 2-7 years) who were referred to colocated mental health care for externalizing mental health problems (disruptive, hyperactive, and aggressive behaviors). Parents completed questions assessing their perceptions of SDM with providers, child mental health treatment stigma, child mental health severity, and level of child mental health impairment. Descriptive statistics demonstrated the majority of the sample reported frequent SDM with providers. Correlation coefficients indicated higher SDM was associated with lower stigma regarding mental health treatment and lower parent-perceived child mental health impairment. Analysis of variance showed no significant difference in SDM among parents of children with different parent-reported levels of child mental health severity. Future research should examine the potential of SDM for addressing child mental health treatment stigma and impairment among minority families.
Gilberto E. Arce; Edgar Robles C.
This paper examines corporate governance practices in Costa Rica. First, it estimates corporate governance charter measures using firm-level data for 87 Costa Rican firms and studies their impact on the firms` performance; here, the mean of the corporate governance charters for the publicly traded firms is equal to 56. 14. Second, new evidence is presented on de jure and de facto corporate governance charter measures at the firm level and on their effect on the performance of the firm. The re...
Enoka, Matamua Iokapeta Sina; Tenari, Aliilelei; Sili, Tupou; Peteru, Latama; Tago, Pisaina; Blignault, Ilse
Mental Health Care Services are part of the National Health Services for Samoa. Their function is to provide mental health care services to the population of Samoa, which numbers 180,000 people. However, like many other countries in the Pacific region, mental health is considered a low priority. The mental health budget allocation barely covers the operation of mental health care services. More broadly, there is a lack of political awareness about mental health care services and mental health rarely becomes an issue of deliberation in the political arena. This article outlines the recent development of mental health care services in Samoa, including the Mental Health Policy 2006 and Mental Health Act 2007. It tells the story of the successful integration of aiga (family) as an active partner in the provision of care, and the development of the Aiga model utilizing Samoan cultural values to promote culturally appropriate family-focused community mental health care for Samoa. Mental Health Care Services today encompass both clinical and family-focused community mental health care services. The work is largely nurse-led. Much has been achieved over the past 25 years. Increased recognition by government and increased resourcing are necessary to meet the future health care needs of the Samoan people. Copyright © 2012 Wiley Publishing Asia Pty Ltd.
Milner, Allison; Smith, Peter; LaMontagne, A D
This paper assesses the impact of working less than or more than standard full-time hours on mental health, as well as possible differences in this relationship by gender and skill level. The study design was a longitudinal cohort with 12 annual waves of data collection over the period 2001-2012, yielding a sample of 90,637 observations from 18,420 people. Fixed effects within-person regression was used to control for time invariant confounding. The Mental Component Summary of the Short Form 36 (SF-36) measure was used as the primary outcome measure. Working hours over the preceding year was measured in five categories with standard full-time hours (35-40 h/week) as the reference. Results indicated that when respondents were working 49-59 h (-0.52, 95% CI -0.74 to -0.29, pworking 35-40 h/week (reference). The difference in mental health when working 49-59 h was greater for women than for men. There were greater declines in mental health in relation to longer working hours among persons in higher compared to lower occupational skill levels. Study results suggest the need for employers and governments to regulate working hours to reduce the burden of mental ill health in the working population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Saxena, Shekhar; Sharan, Pratap; Saraceno, Benedetto
Very little information is available on budget and financing of mental health services in the world. During year 2001, WHO collected information from all countries on resources available for mental health care as a part of Project Atlas. The present report seeks to describe the situation regarding federal budgets and financing of mental health care at the country level. It also examines the association between relative allocation of health budget to mental health and mental health policy, programme and resource indicators in 89 countries. The information was collected through a questionnaire (with an accompanying glossary) that was sent to the mental health focal point in the Ministry of Health of each country. Eighty nine countries provided information on their mental health budget as a proportion of health budget. In addition, information was obtained on policy, programme and mental health resource indicators (beds, personnel, services to special population and availability of drugs). The results showed that 32% of 191 countries did not have a specified budget for mental health. Of the 89 countries that supplied the requisite information 36% spent less than 1% of their total health budget on mental health. Many countries from Africa (79%) and the South East Asia (63%) were in this subgroup. Comparison with the Global Burden of Disease data showed a marked disparity between burden and resources. Lower income countries allocated a lesser proportion of their health budget on mental health in comparison to higher income countries. The primary method of financing mental health care in most countries was tax-based (60.2%), but many low-income countries depended on out-of-pocket expenditure (16.4%). The presence of mental health policies and programmes in general was not associated with the proportion of health budget allocated to mental health. Counties categorized based on the proportion of mental health budget to health budget, differed significantly in terms of
Full Text Available City Managers came into being in the early 1900.s because of the corruption, waste, and lack of responsiveness of local governments in the United States. Business leaders in large cities had begun to recognise that major changes in their local governments were desperately needed for their businesses to grow and prosper. Andrew Carnegie, a founder of United States Steel, had indicated that business needed a stable society to prosper. Local government had to become responsive to the changing needs of the poor, abused and neglected children, the mentally ill and the elderly, to cite a few examples.
Michiel Christiaan Bekker
Full Text Available The terminology, definition and context of project governance have become a focal subject for research and discussions in project management literature. This article reviews literature on the subject of project governance and categorise the arguments into three schools of thought namely the single-firm school, multi-firm school and large capital school. The single-firm school is concerned with governance principles related to internal organisational projects and practice these principles at a technical level. The multi-firm school address the governance principles concerned with two of more organisations participating on a contractual basis on the same project and focus their governance efforts at the technical and strategic level. The large capital school consider projects as temporary organisations, forming their own entity and establishing governance principles at an institutional level. From these schools of thought it can be concluded that the definition of project governance is dependent on the type of project and hierarchical positioning in the organisation. It is also evident that further research is required to incorporate other governance variables and mechanisms such as transaction theory, social networks and agency theory. The development of project governance frameworks should also consider the complexity of projects spanning across international companies, across country borders and incorporating different value systems, legal systems, corporate governance guidelines, religions and business practices.
Fazel, Mina; Hoagwood, Kimberly; Stephan, Sharon; Ford, Tamsin
Mental health services embedded within school systems can create a continuum of integrative care that improves both mental health and educational attainment for children. To strengthen this continuum, and for optimum child development, a reconfiguration of education and mental health systems to aid implementation of evidence-based practice might be needed. Integrative strategies that combine classroom-level and student-level interventions have much potential. A robust research agenda is needed that focuses on system-level implementation and maintenance of interventions over time. Both ethical and scientific justifications exist for integration of mental health and education: integration democratises access to services and, if coupled with use of evidence-based practices, can promote the healthy development of children. PMID:26114092
Henry N. Bang
Full Text Available The impact of natural hazards and/or disasters in Cameroon continues to hit local communities hardest, but local government lacks the ability to manage disaster risks adequately. This is partly due to the fact that the necessity to mainstream disaster risk reduction into local governance and development practices is not yet an underlying principle of Cameroon’s disaster management framework. Using empirical and secondary data, this paper analyses the governance of disaster risks in Cameroon with particular focus on the challenges local government faces in implementing disaster risk reduction strategies. The hypothesis is that the governance of disaster risks is too centralised at the national level, with huge implications for the effective governance of disaster risks at the local level. Although Cameroon has reinvigorated efforts to address growing disaster risks in a proactive way, it is argued that the practical actions are more reactive than proactive in nature. The overall aim is to explore the challenges and opportunities that local government has in the governance of disaster risks. Based on the findings from this research, policy recommendations are suggested on ways to mainstream disaster risk reduction strategies into local governance, and advance understanding and practice in the local governance of disaster risks in the country.
Scholl , Hans ,; Kubicek , Herbert; Cimander , Ralf
Part 4: Architecture, Security and Interoperability; International audience; Government represents a unique, and also uniquely complex, environment for interoperation of information systems as well as for integration of workflows and processes across governmental levels and branches. While private-sector organizations by and large have the capacity to implement “enterprise architectures” in a relatively straightforward fashion, for notable reasons governments do not enjoy such luxury. For thi...
Chung, Alexandra; Shill, Jane; Swinburn, Boyd; Mavoa, Helen; Lawrence, Mark; Loff, Bebe; Crammond, Bradley; Sacks, Gary; Allender, Steven; Peeters, Anna
In Australia there have been many calls for government action to halt the effects of unhealthy food marketing on children's health, yet implementation has not occurred. The attitudes of those involved in the policy-making process towards regulatory intervention governing unhealthy food marketing are not well understood. The objective of this research was to understand the perceptions of senior representatives from Australian state and territory governments, statutory authorities and non-government organisations regarding the feasibility of state-level government regulation of television marketing of unhealthy food to children in Australia. Data from in-depth semi-structured interviews with senior representatives from state and territory government departments, statutory authorities and non-government organisations (n=22) were analysed to determine participants' views about regulation of television marketing of unhealthy food to children at the state government level. Data were analysed using content and thematic analyses. Regulation of television marketing of unhealthy food to children was supported as a strategy for obesity prevention. Barriers to implementing regulation at the state level were: the perception that regulation of television advertising is a Commonwealth, not state/territory, responsibility; the power of the food industry and; the need for clear evidence that demonstrates the effectiveness of regulation. Evidence of community support for regulation was also cited as an important factor in determining feasibility. The regulation of unhealthy food marketing to children is perceived to be a feasible strategy for obesity prevention however barriers to implementation at the state level exist. Those involved in state-level policy making generally indicated a preference for Commonwealth-led regulation. This research suggests that implementation of regulation of the television marketing of unhealthy food to children should ideally occur under the direction
Full Text Available Abstract Background In Australia there have been many calls for government action to halt the effects of unhealthy food marketing on children's health, yet implementation has not occurred. The attitudes of those involved in the policy-making process towards regulatory intervention governing unhealthy food marketing are not well understood. The objective of this research was to understand the perceptions of senior representatives from Australian state and territory governments, statutory authorities and non-government organisations regarding the feasibility of state-level government regulation of television marketing of unhealthy food to children in Australia. Method Data from in-depth semi-structured interviews with senior representatives from state and territory government departments, statutory authorities and non-government organisations (n=22 were analysed to determine participants' views about regulation of television marketing of unhealthy food to children at the state government level. Data were analysed using content and thematic analyses. Results Regulation of television marketing of unhealthy food to children was supported as a strategy for obesity prevention. Barriers to implementing regulation at the state level were: the perception that regulation of television advertising is a Commonwealth, not state/territory, responsibility; the power of the food industry and; the need for clear evidence that demonstrates the effectiveness of regulation. Evidence of community support for regulation was also cited as an important factor in determining feasibility. Conclusions The regulation of unhealthy food marketing to children is perceived to be a feasible strategy for obesity prevention however barriers to implementation at the state level exist. Those involved in state-level policy making generally indicated a preference for Commonwealth-led regulation. This research suggests that implementation of regulation of the television marketing of
Full Text Available There is inherent conflict of interests between owners and managers. They try to solve it in different ways. In this paper we have tried to briefly introduce the most important internal mechanisms of corporate governance (monitoring by the board of directors, incentive system for managers, internal audit and the importance of institutional investors. The financial scandals that included the world-famous corporations as well as current world economic crisis suggests that the protection of owners should continue to work to improve existing or new solutions that will improve the level of corporate governance.
Rickwood, Debra J; Telford, Nic R; Parker, Alexandra G; Tanti, Chris J; McGorry, Patrick D
To provide the first national profile of the characteristics of young people (aged 12-25 years) accessing headspace centre services - the Australian Government's innovation in youth mental health service delivery - and investigate whether headspace is providing early service access for adolescents and young adults with emerging mental health problems. Census of all young people accessing a headspace centre across the national network of 55 centres comprising a total of 21 274 headspace clients between 1 January and 30 June 2013. Reason for presentation, Kessler Psychological Distress Scale, stage of illness, diagnosis, functioning. Young people were most likely to present with mood and anxiety symptoms and disorders, self-reporting their reason for attendance as problems with how they felt. Client demographic characteristics tended to reflect population-level distributions, although clients from regional areas and of Aboriginal and Torres Strait Islander background were particularly well represented, whereas those who were born outside Australia were underrepresented. headspace centres are providing a point of service access for young Australians with high levels of psychological distress and need for care in the early stages of the development of mental disorder.
Kolar, Mike; Estefan, Jeff; Giovannoni, Brian; Barkley, Erik
Topics covered (1) Why Governance and Why Now? (2) Characteristics of Architecture Governance (3) Strategic Elements (3a) Architectural Principles (3b) Architecture Board (3c) Architecture Compliance (4) Architecture Governance Infusion Process. Governance is concerned with decision making (i.e., setting directions, establishing standards and principles, and prioritizing investments). Architecture governance is the practice and orientation by which enterprise architectures and other architectures are managed and controlled at an enterprise-wide level
Achir Yani S. Hamid
Full Text Available Introduction: Limited of government’s budget for psychiatric patients has contributed to the expenses should be paid from out of pocket of the poor patients. The purpose of this research was to describe the Government policy on health social security insurance for the poor people experiencing psychiatric problems in DKI Jakarta. Method: Qualitative research method was used with phenomenology approach to identify and describe the themes relevant to government public policy in providing health insurance for poor people with mental health problems. An in-depth interview and focus group discussion were used to collect data from different informants: service user, healthcare provider, local government policy maker. The qualitative data was analyzed using content analysis. Result: The study revealed the following themes: from user perspective (understanding of psychiatric disorder, social security network/JPKM, right and obligation, the advantage and barrier for receiving services, expectation from care provider, social support and expected future direction; from the perspective of healthcare provider (understanding of social security network/JPKM, types of provided health services, recording and reporting, referral system, cost, and the criteria of poor people, from local government and health office perspective (understanding of JPKM for poor family, scope of work, working procedure, recording and reporting, cost, accountability, poor people criteria, the relationship between central Government policy with local government policy. Discussion: The finding of this study recommend the need for leveling socialization of JPKM, the budget transparences, improving the healthcare providers’ knowledge on the mental health psychiatric problems and its needs.
Full Text Available Abstract Background Following a situation appraisal in 2001, a six year mental health reform programme (Egymen 2002-7 was initiated by an Egyptian-Finnish bilateral aid project at the request of a former Egyptian minister of health, and the work was incorporated directly into the Ministry of Health and Population from 2007 onwards. This paper describes the aims, methodology and implementation of the mental health reforms and mental health policy in Egypt 2002-2009. Methods A multi-faceted and comprehensive programme which combined situation appraisal to inform planning; establishment of a health sector system for coordination, supervision and training of each level (national, governorate, district and primary care; development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at each level; integration of mental health into health management systems; and dedicated efforts to improve forensic services, rehabilitation services, and child psychiatry services. Results The project has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, mental health masterplan (policy guidelines to accompany the general health policy, updated Egyptian mental health legislation, Code of Practice, adaptation of the WHO primary care guidelines, primary care training, construction of a quality system of roles and responsibilities, availability of medicines at primary care level, public education about mental health, and a research programme to inform future developments. Intersectoral liaison with education, social welfare, police and prisons at national level is underway, but has not yet been established for governorate and district levels, nor mental health training for police, prison staff and teachers. Conclusions The bilateral collaboration programme
Lee, Gyungjoo; Han, Kyungdo; Kim, Hyunju
Adolescents frequently skip meals, doing so even more than once per day. This is associated with more mental health problems. This study identified mental health problems' associations with skipping meals and the frequency thereof among adolescents. This cross-sectional population-based study used a data set of 1,413 adolescents from the 2010 to 2012 Korean National Health and Nutrition Examination Survey. Hierarchical multivariable logistic regression was conducted to determine the risk of mental health problems, including stress, depressive mood, and suicidal ideation in relation to skipping meals and the frequency thereof per day. Breakfast skipping significantly increased the risks of stress and depressive mood. Stress, depressive mood, and suicidal ideation were significantly prevalent as the daily frequency of skipping meals increased. Specific strategies should be developed at government or school level to decrease the frequency of skipping meals per day, associated with serious mental health problems in adolescents. Copyright © 2017 Elsevier Inc. All rights reserved.
Lira-Noriega, Andrés; Soberón, Jorge
At a global level, the relationship between biodiversity importance and capacity to manage it is often assumed to be negative, without much differentiation among the more than 200 countries and territories of the world. We examine this relationship using a database including terrestrial biodiversity, wealth and governance indicators for most countries. From these, principal components analysis was used to construct aggregated indicators at global and regional scales. Wealth, governance, and scientific capacity represent different skills and abilities in relation to biodiversity importance. Our results show that the relationship between biodiversity and the different factors is not simple: in most regions wealth and capacity varies positively with biodiversity, while governance vary negatively with biodiversity. However, these trends, to a certain extent, are concentrated in certain groups of nations and outlier countries. We discuss our results in the context of collaboration and joint efforts among biodiversity-rich countries and foreign agencies.
Brunnengraeber, Achim; Haefner, Daniel
The primary aim of the project is to conduct a detailed social and political analysis of the preconditions for the development of an acceptable strategy for nuclear waste disposal in Germany. This includes the identification of stakeholders and their interests, responsibilities, value systems, views and expectations as well as paths for a constructive approach to dialogue and problem-solving. A focus of the research project will be an international comparative multi-level governance analysis of acceptance patterns and steering mechanisms for conflict resolution.
Brunnengraeber, Achim; Haefner, Daniel
The primary aim of the project is to conduct a detailed social and political analysis of the preconditions for the development of an acceptable strategy for nuclear waste disposal in Germany. This includes the identification of stakeholders and their interests, responsibilities, value systems, views and expectations as well as paths for a constructive approach to dialogue and problem-solving. A focus of the research project will be an international comparative multi-level governance analysis of acceptance patterns and steering mechanisms for conflict resolution.
Smart grids should increase coordination on the distribution grid level and facilitate new market opportunities (I.e. competition on a level playing field). Information management is becoming a new task in the electricity supply chain. It is an enbaler for the development of smart grids. Therefore, the governance of information management should as well efficiently balance between coordination and competition. Within this paper we analyse which role from the energy sector could govern the inf...
Fitzsimons, Emla; Goodman, Alissa; Kelly, Elaine; Smith, James P
Using data from the British Millennium Cohort Study (MCS), an ongoing longitudinal study of a cohort of 18,827 children born in the UK in 2000-2001, we investigate important correlates of mental health issues during childhood. MCS respondents were sampled at birth, at age 9 months, and then when they were 3, 5, 7 and 11 years old. Each sweep contains detailed information on the family's SES, parenting activities, developmental indicators, parental relationship status, and indicators of parental mental health. The Strengths and Difficulties Questionnaire (SDQ) and the related Rutter scale were used to identify behavioral and emotional problems in children. In this paper, childhood problems are separated into four domains: hyperactivity, emotional symptoms, conduct problems, and peer problems. We focus on two aspects of this relationship at ages 5 and 11-the role of temporary and persistent poverty and the role of temporary and persistent mental health problems of mothers and fathers. At ages 11 and 5, without other controls in the model, persistent and transitory poverty have strong estimated associations with all four domains, with somewhat stronger estimated effects for persistent poverty. After a set of controls are added, we document that both persistent levels of poverty and transitions into poverty are strongly associated with levels of and transitions into childhood mental health problems. Similarly, sustained levels and transitions into mothers' mental health problems are strongly associated with levels and transitions into children's mental health problems. This is much less so for fathers. Copyright © 2016 Elsevier Ltd. All rights reserved.
Molina, Andrés Ríos
After the Mexican Revolution (1910-1920), an ambitious project of national reconstruction began in which education and health were two priorities in the consolidation of a new nation. In this context of social, cultural, and political transformation, mental hygiene was a field that made it possible to articulate the professional practice of psychiatrists with the project of the nation promoted by postrevolutionary governments. In Mexico, the mental hygiene movement was headed by the same doctors who professionalized the practice of psychiatry and made it a specialized field of knowledge. The first generation of psychiatrists managed to integrate mental hygiene into health and education policies during the socialist administration of president Lázaro Cárdenas; a phenomenon that made evident the articulation between mental hygiene, social medicine, and nationalist discourse. Discussion will focus on proposals made from the perspective of mental hygiene as a function of two social sectors regarded as priorities by the Cárdenas government: children and workers. © 2013 Wiley Periodicals, Inc.
Di Lucia, Lorenzo
Transport biofuels are currently the subject of heated debate in the EU. In the past decade the deployment of these technologies has been justified by claims of attractive environmental, geopolitical and rural development benefits. However, expectations have rapidly turned into deep criticism regarding the sustainability of these technologies and the desirability of pursuing the biofuel path. This situation has generated an on-going controversy and policy deadlock at EU level. This study explores these issues from a governance perspective. Employing the concept of system governability, derived from interactive governance theory, it attempts to shed some light on the problems facing the governance of biofuels and on how the quality of the governance system could be improved. The analysis showed that the governability of the system decreased substantially in the period 2003–2012 due to increasing governing needs and decreasing governing capacity. The quality of the governance system can be improved by (i) improving governing capacity by reducing conflicts among governing actors, advancing consistency among institutions and creating capacity at international and global level; and (ii) promoting advanced technologies and adjusting societal ambitions and expectations regarding biofuels. - highlights: • Biofuels in the EU are significantly more difficult to govern today than in 2003. • This is due to the qualities of the system to be governed and the governing system. • Sustainable biofuel systems are inherently difficult to govern
Lascorz, David; López, Victoria; Pinedo, Carmen; Trujols, Joan; Vegué, Joan; Pérez, Víctor
People with severe mental disorder have significant difficulties in everyday life that involve the need for continued support. These needs are not easily measurable with the currently available tools. Therefore, a multidimensional scale that assesses the different levels of need for care is proposed, including a study of its psychometric properties. One-hundred and thirty-nine patients (58% men) with a severe mental disorder were assessed using the Required Care Levels for People with Severe Mental Disorder Assessment Scale (ENAR-TMG), the Camberwell Assessment of Need scale, and the Health of the Nation Outcome Scales. ENAR-TMG's psychometric features were examined by: a) evaluating 2 sources of validity evidence (evidence based on internal structure and evidence based on relations to other variables), and b) estimating the internal consistency, temporal stability, inter-rater reliability, and sensitivity to change of scores of the ENAR-TMG's subscales. Exploratory factor analyses revealed a one-factor structure for each of the theoretical dimensions of the scale, in which all but one showed a significant and positive correlation with the Camberwell Assessment of Need (range of r: 0.143-0.557) and Health of the Nation Outcome Scales (range of r: 0.241-0.474) scales. ENAR-TMG subscale scores showed acceptable internal consistency (range of ordinal α coefficients: 0.682-0.804), excellent test-retest (range of intraclass correlation coefficients: 0.889-0.999) and inter-rater reliabilities (range of intraclass correlation coefficients: 0.926-0.972), and satisfactory sensitivity to treatment-related changes (range of η 2 : 0.003-0.103). The satisfactory psychometric behaviour of the ENAR-TMG makes the scale a promising tool to assess global functioning in people with a severe mental disorder. Copyright © 2016 SEP y SEPB. Published by Elsevier España. All rights reserved.
Galvin, J; Suominen, E; Morgan, C; O'Connell, E-J; Smith, A P
What is known on the subject? Stress can impact students on mental health nurse training. This can have implications at the individual level (e.g. their own mental health) and at the level of the organization (e.g. sickness absence and attrition). What this paper adds to existing knowledge? We interviewed 12 mental health nursing students regarding the stress they experienced during training. Participants described how the academic demands can at times be unbearable during clinical placements. There were also issues with 'being a student' on some placements, with participants describing negative attitudes towards them from staff. The younger participants reported feeling overwhelmed on their initial placements and described some of the main challenges of mental health work for them. Raising concerns about the quality of care on wards was also described as particularly challenging for the students. What are the implications for practice? This paper can be useful to help training providers support mental health nursing students. Recommendations include reducing academic demands during clinical placements and extending and promoting existing support services beyond normal 9 am-5 pm working hours, even if these services are limited. Younger students could be better supported by being allocated to the more well-resourced placements in the early stages of their training. Raising awareness among staff of the tasks students can and cannot perform can help improve staff/student relations. Finally, students should be educated about the issues around raising concerns on placements to help the government's drive for a more open and transparent National Health Service (NHS). Previous studies investigating stress in nursing students focus on general nursing students or adopt quantitative measures. A qualitative study focusing specifically on mental health nursing students is required. One-to-one interviews were carried out with mental health nursing students (n = 12). Data were
Loos, Gregory P
Globalization's profound influence on social and political institutions need not be negative. Critics of globalization have often referred to the "Impossible Trinity" because decision-making must 1. respect national sovereignty, 2. develop and implement firm regulation, and 3. allow capital markets to be as free as possible. To many, such goals are mutually exclusive because history conditions us to view policy-making and governance in traditional molds. Thus, transnational governance merely appears impossible because current forms of governance were not designed to provide it. The world needs new tools for governing, and its citizens must seize the opportunity to help develop them. The rise of a global society requires a greater level of generality and inclusion than is found in most policy bodies today. Politicians need to re-examine key assumptions about government. States must develop ways to discharge their regulatory responsibilities across borders and collaborate with neighboring jurisdictions, multilateral bodies, and business. Concepts such as multilateralism and tripartism show great promise. Governments must engage civil society in the spirit of shared responsibility and democratic decision-making. Such changes will result in a renewal of the state's purpose and better use of international resources and expertise in governance.
Oster, Candice; Henderson, Julie; Lawn, Sharon; Reed, Richard; Dawson, Suzanne; Muir-Cochrane, Eimear; Fuller, Jeffrey
Mental health care for older people is a significant and growing issue in Australia and internationally. This article describes how older people’s mental health is governed through policy discourse by examining Australian Commonwealth and South Australian State government policy documents, and commentaries from professional groups, advocacy groups and non-governmental organisations. Documents published between 2009 and 2014 were analysed using a governmentality approach, informed by Foucault. Discourses of ‘risk’, ‘ageing as decline/dependence’ and ‘healthy ageing’ were identified. Through these discourses, different neo-liberal governmental strategies are applied to ‘target’ groups according to varying risk judgements. Three policy approaches were identified where older people are (1) absent from policy, (2) governed as responsible, active citizens or (3) governed as passive recipients of health care. This fragmented policy response to older people’s mental health reflects fragmentation in the Australian policy environment. It constructs an ambiguous place for older people within neo-liberal governmental rationality, with significant effects on the health system, older people and their carers. PMID:27147440
Full Text Available Context: The increased demand on long-term old age care homes in urban India is a result of demographic transition together with the disintegration of joint family system and changing social values which make them increasingly vulnerable to mental health problems. Aims: This study attempted to find out an array of mental health problems and associated morbidity among inhabitant of government old age homes. Settings and Design: This was a cross-sectional study which included government run old age homes (OAHs in Delhi. Subjects and Methods: The sample comprised a total of 148 elderly in four OAHs with a mean age of 72.81 years. The World Health Organization Quality of Life-BREF Scale (QOL, Mini-Mental State Examination, Geriatric Depression Scale, Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, and Kesseler-10 Scale were administered. Statistical Analysis: Data were analyzed through SPSS version 20.0 version. Frequency distribution and cross-tabulation used to create summary tables and compare items. Results: Female constituted two-third of study population whereas one-third of subjects were illiterate and two-third without income. The study demonstrated psychiatric morbidity profile among OAH inhabitants and exhibited mild-moderate anxiety symptoms in almost 95% followed by mild-severe depression reported by 85%, mild-moderate psychotic illnesses, psychological distress, cognitive impairments, and poor QOL. Low income and education, low social connections and loss of spouse were key risk factors. Conclusions and Recommendation: Psychiatric morbidity profile and QOL among OAH residents is influenced by various psychological, social, and economic factors. This emphasized the need for better management of the government-run OAHs to ensure better overall mental health of the residents.
Kuruvilla, A; Jacob, K S
While there is increasing evidence of an association between poor mental health and the experience of poverty and deprivation, the relationship is complex. We discuss the epidemiological data on mental illness among the different socio-economic groups, look at the cause -effect debate on poverty and mental illness and the nature of mental distress and disorders related to poverty. Issues related to individual versus area-based poverty, relative poverty and the impact of poverty on woman's and child mental health are presented. This review also addresses factors associated with poverty and the difficulties in the measurement of mental health and illness and levels/impact of poverty.
The United Nations organisation and nuclear energy rose simultaneously, in 1945, to occupy an important place in the public eye. The spiritual succession of the League of Nations which had foundered during the war was taken up by the new organisation which sought to implant its political ideal in a more tangible reality, so that it might thereby be inspired by concrete and substantial objectives. This is one of the reasons for the existence of the dozen specialized agencies created by the family of the United Nations and dealing with Health, Culture, Agriculture, Finance, etc. Nuclear energy is one of these techniques. Becoming suddenly an important power factor and exploiting for itself the prestige of Science, it became the favorite domain for the growth of this new spirit, as much in its universal form in 1945 as in its more regional form which it was later to adopt. The achievements are numerous and of varying importance; they deserve te be studied carefully. (author) [fr
The Foucauldian sociologist Nikolas Rose has influentially argued that psychosocial technologies have offered means through which the ideals of democracy can be made congruent with the management of social life and the government of citizens in modern Western liberal democracies. This interpretation is contested here through an examination of the 1948 International Congress on Mental Health held in London and the mental hygiene movement that organised it. It is argued that, in Britain, this movement’s theory and practice represents an uneasy and ambiguous attempt to reconcile visions of ‘the modern’ with ‘the traditional’. The mental hygienist emphasis on the family is central. Here it appears as a forcing-house of the modern self-sustaining individual. Mental hygienists cast the social organisation of ‘traditional’ communities as static, with rigid authority frustrating both social progress and the full emergence of individual personality. Yet mental hygienists were also concerned about threats to social cohesion and secure personhood under modernity. If the social organisation of ‘traditional’ communities was patterned by the archetype of the family, with its personal relations of authority, mental hygienists compressed these relations into the ‘private’ family. Situated here they became part of a developmental process of mental adjustment through which ‘mature’, responsible citizens emerged. This reformulation of the family’s centrality for the social order informed mental hygienist critiques of the growth of state power under existing forms of democracy, as well as suspicion of popular political participation or protest, and of movements towards greater egalitarianism. PMID:26379371
Happell, Brenda; Wilson, Rhonda; McNamara, Paul
Mental Health First Aid training is designed to equip people with the skills to help others who may be developing mental health problems or experiencing mental health crises. This training has consistently been shown to increase: (1) the recognition of mental health problems; (2) the extent to which course trainees' beliefs about treatment align with those of mental health professionals; (3) their intentions to help others; and (4) their confidence in their abilities to assist others. This paper presents a discussion of the potential role of Mental Health First Aid training in undergraduate mental health nursing education. Three databases (CINAHL, Medline, and PsycINFO) were searched to identify literature on Mental Health First Aid. Although Mental Health First Aid training has strong benefits, this first responder level of education is insufficient for nurses, from whom people expect to receive professional care. It is recommended that: (1) Mental Health First Aid training be made a prerequisite of preregistration nurse education, (2) registered nurses make a larger contribution to addressing the mental health needs of Australians requiring care, and (3) current registered nurses take responsibility for ensuring that they can provided basic mental health care, including undertaking training to rectify gaps in their knowledge.
Cardiovascular Reactivity in Patients With Major Depressive Disorder With High- or Low-Level Depressive Symptoms: A Cross-Sectional Comparison of Cardiovascular Reactivity to Laboratory-Induced Mental Stress.
Wang, Mei-Yeh; Chiu, Chen-Huan; Lee, Hsin-Chien; Su, Chien-Tien; Tsai, Pei-Shan
Depression increases the risk of adverse cardiac events. Cardiovascular reactivity is defined as the pattern of cardiovascular responses to mental stress. An altered pattern of cardiovascular reactivity is an indicator of subsequent cardiovascular disease. Because depression and adverse cardiac events may have a dose-dependent association, this study examined the differences in cardiovascular reactivity to mental stress between patients with major depressive disorder (MDD) with high depression levels and those with low depression levels. Moreover, autonomic nervous system regulation is a highly plausible biological mechanism for the pattern of cardiovascular reactivity to mental stress. The association between cardiovascular reactivity and parameters of heart rate variability (HRV), an index for quantifying autonomic nervous system activity modulation, was thus examined. This study included 88 patients with MDD. HRV was measured before stress induction. The Stroop Color and Word Test and mirror star-tracing task were used to induce mental stress. We observed no significant association between depressive symptom level and any of the cardiovascular reactivity parameters. Cardiovascular reactivity to mental stress was comparable between patients with MDD with high-level depressive symptoms and those with low-level depressive symptoms. After adjusting for confounding variables, the high-frequency domain of HRV was found to be an independent predictor of the magnitude of heart rate reactivity (β = -.33, p = .002). In conclusion, the magnitude of cardiovascular reactivity may be independent of depression severity in patients with MDD. The autonomic regulation of cardiovascular responses to mental stress primarily influences heart rate reactivity in patients with MDD. © The Author(s) 2015.
Full Text Available While there is little doubt that social networks are essential for processes of implementing social innovations in community education such as Climate Change Education (CCE or Education for Sustainable Development (ESD, scholars have neglected to analyze these processes in the multilevel governance system using Social Network Analysis. In this article, we contribute to closing this research gap by exploring the implementation of CCE and ESD in education at the regional and global levels. We compare the way CCE is negotiated and implemented within and through the global conferences of the UN Framework Convention on Climate Change (UNFCCC with the way the UN Decade of ESD is put into practice through networks in five different German municipalities. We argue that the role of social networks is particularly strong in policy areas like CCE and ESD, which are best characterized as multi-level and multi-actor governance. Based on data derived from standardized surveys and from Twitter we analyze the complex interactions of public and private actors at different levels of governance in the two selected policy areas. We find, amongst others, that the implementation of CCE and ESD in community education depends in part on actors that had not been assumed to be influential at the outset. Furthermore, our analyses suggest the different levels of governance are not well integrated throughout the phases of the policy innovation cycle.
Stain, Helen J; Kelly, Brian; Lewin, Terry J; Higginbotham, Nick; Beard, John R; Hourihan, Fleur
The study investigated the associations between mental health and measures of community support, social support networks, sense of place, adversity, and perceived problems in a rural Australian population. There was a specific focus on farming communities due to previous qualitative research by the authors indicating distress by farmers in response to drought (Sartore et al. Aust Fam Phys 36(12), 990-993, 2007). A survey was mailed to adults randomly selected from the Australian Electoral Roll and residing within four local government areas (LGAs) of varying remoteness in rural New South Wales (NSW). Survey measures included: support networks and community attachment; recent stressors (including drought-related stress); and measures of health and related functioning. The Kessler-10 provided an index of current psychological distress. The sample (n = 449; response rate 24%) was predominantly female (58.4%) and 18.9% were farmers or farm workers. Moderate to very high psychological distress was reported for 20.7% of the sample. Half (56.1%) of all respondents, and specifically 71.8% of farmers or farm workers, reported high levels of perceived stress due to drought. Psychological distress was associated with recent adverse life events, increased alcohol use and functional impairment. Hierarchical regression analysis demonstrated an independent effect of the number of stressful life events including drought related stress, perceived social support (community and individual), alcohol use and physical functioning ability on levels of psychological distress. This model accounted for 43% of the variance in current levels of distress. Lower community support had a more marked impact on distress levels for non-farming than farming participants. This study has highlighted the association between unique rural community characteristics and rural stressors (such as drought) and measures of mental health, suggesting the important mediating role of social factors and community
Kawakami, Norito; Abdulghani, Emad Abdulrazaq; Alonso, Jordi; Bromet, Evelyn; Bruffaerts, Ronny; de Almeida, Jose Miguel Caldas; Chiu, Wai Tat; de Girolamo, Giovanni; de Graaf, Ron; Fayyad, John; Ferry, Finola; Florescu, Silvia; Gureje, Oye; Hu, Chiyi; Lakoma, Matthew D.; LeBlanc, William; Lee, Sing; Levinson, Daphna; Malhotra, Savita; Matschinger, Herbert; Medina-Mora, Maria Elena; Nakamura, Yosikazu; Browne, Mark A. Oakley; Okoliyski, Michail; Posada-Villa, Jose; Sampson, Nancy A.; Viana, Maria Carmen; Kessler, Ronald C.
Background Better information on the human capital costs of early-onset mental disorders could increase sensitivity of policy-makers to the value of expanding initiatives for early detection-treatment. Data are presented on one important aspect of these costs: the associations of early-onset mental disorders with adult household income. Methods Data come from the WHO World Mental Health (WMH) Surveys in eleven high income, five upper-middle income, and six low/lower-middle income countries. Information about 15 lifetime DSM-IV mental disorders as of age of completing education, retrospectively assessed with the WHO Composite International Diagnostic Interview, was used to predict current household income among respondents ages 18-64 (n = 37,741) controlling for level of education. Gross associations were decomposed to evaluate mediating effects through major components of household income. Results Early-onset mental disorders are associated with significantly reduced household income in high and upper-middle income countries but not low/lower-middle income countries, with associations consistently stronger among women than men. Total associations are largely due to low personal earnings (increased unemployment, decreased earnings among the employed) and spouse earnings (decreased probabilities of marriage and, if married, spouse employment and low earnings of employed spouses). Individual-level effect sizes are equivalent to 16-33% of median within-country household income, while population-level effect sizes are in the range 1.0-1.4% of Gross Household Income. Conclusions Early mental disorders are associated with substantial decrements in income net of education at both individual and societal levels. Policy-makers should take these associations into consideration in making healthcare research and treatment resource allocation decisions. PMID:22521149
Full Text Available When the level of trust in government is low, government cannot effectively provide services, since the policy goals and the process of implementations are not fully understood by the people. This study hypothesizes that the level of trust in government may increase if the level of social capital increases. It also hypothesizes that the impact of social capital on the level of trust in government may differ depending on the type of social capital. The study examined the relationship between the level of trust in government and types of social capital, including bonding social capital and bridging social capital. The result of multiple regression analysis showed that bonding social capital shows a negative relationship with the level of trust in government, while a bridging social capital has a positive relationship with the level of trust in government. In addition, the study examined the variances of the perceptions of each group based on the degree of social cohesion on the level of trust in government by employing ANOVA. It showed that there are no significant differences in bonding social groups, while bridging social capital groups showed variances in their perception of the level of trust in government.
Ali, Mana K; Hack, Samantha M; Brown, Clayton H; Medoff, Deborah; Fang, Lijuan; Klingaman, Elizabeth A; Park, Stephanie G; Dixon, Lisa B; Kreyenbuhl, Julie A
Black consumers with serious mental illness (SMI) face significant challenges in obtaining quality mental health care and are at risk for experiencing significant disparities in mental health care outcomes, including recovery from mental illness. Patient-provider interactions may partly contribute to this disparity. The purpose of the current study was to understand the effects of race, psychosis, and therapeutic alliance on mental health recovery orientation among Veterans with SMI. Participants were Veterans who had an SMI being treated at two Veteran Affairs outpatient mental health clinics by a psychiatrist or nurse practitioner. Participants completed the Behavior and Symptom Identification Scale (BASIS-24), Mental Health Recovery Measure, and patient-report Scale to Assess the Therapeutic Relationship (STAR-P) which includes three subscales: positive collaboration, positive clinician input, and non-supportive clinician input. Regression analyses were used to determine interactive effects of race, psychosis severity, and therapeutic alliance variables. The sample was 226 Veterans (50% black, 50% white). Black participants were slightly older (p mental health recovery (p mental health recovery orientation for black participants. Conversely, for white participants, positive collaboration had little effect on the negative relationship between psychosis severity and mental health recovery orientation. Increased levels of psychosis may inhibit patients' perceptions of their ability to recover from SMI. However, for black participants, positive collaboration with mental health providers may moderate the effects of psychotic symptomatology.
Hawk, Mary; Nimgaonkar, Vishwajit; Bhatia, Triptish; Brar, Jaspreet S; Elbahaey, Wafaa Abdelhakim; Egan, James E; Konasale, Prasad; Kumar, Supriya; McDonald, Margaret C; Singh, Ravinder; Swaminathan, Soumya; Wood, Joel; Deshpande, Smita N
There is a critical gap between needs and available resources for mental health treatment across the world, particularly in low- and middle-income countries (LMICs). In countries committed to increasing resources to address these needs it is important to conduct research, not only to assess the depth of mental health needs and the current provision of public and private mental health services, but also to examine implementation methods and evaluate mental health approaches to determine which methods are most effective in local contexts. However, research resources in many LMICs are inadequate, largely because conventional research training is time-consuming and expensive. Adapting a hackathon model may be a feasible method of increasing capacity for mental health services research in resource-poor countries. To explore the feasibility of this approach, we developed a 'grantathon', i.e. a research training workshop, to build capacity among new investigators on implementation research of Indian government-funded mental health programmes, which was based on a need expressed by government agencies. The workshop was conducted in Delhi, India, and brought together junior faculty members working in mental health services settings throughout the country, experienced international behavioural health researchers and representatives of the Indian Council for Medical Research (ICMR), the prime Indian medical research funding agency. Pre- and post-assessments were used to capture changes in participants' perceived abilities to develop proposals, design research studies, evaluate outcomes and develop collaborations with ICMR and other researchers. Process measures were used to track the number of single-or multi-site proposals that were generated and funded. Participants (n = 24) generated 12 single- or multi-site research grant applications that will be funded by ICMR. The grantathon model described herein can be modified to build mental health services research capacity in
Full Text Available Abstract Background Mental well-being now features prominently in UK and international health policy. However, progress has been hampered by lack of valid measures that are responsive to change. The objective of this study was to evaluate the responsiveness of the Warwick Edinburgh Mental Well-being Scale (WEMWBS at both the individual and group level. Methods Secondary analysis of twelve different interventional studies undertaken in different populations using WEMWBS as an outcome measure. Standardised response mean (SRM, probability of change statistic (P̂ and standard error of measurement (SEM were used to evaluate whether WEMWBS detected statistically important changes at the group and individual level, respectively. Results Mean change in WEMWBS score ranged from −0.6 to 10.6. SRM ranged from −0.10 (95% CI: -0.35, 0.15 to 1.35 (95% CI: 1.06, 1.64. In 9/12 studies the lower limit of the 95% CI for P̂ was greater than 0.5, denoting responsiveness. SEM ranged from 2.4 to 3.1 units, and at the threshold 2.77 SEM, WEMWBS detected important improvement in at least 12.8% to 45.7% of participants (lower limit of 95% CI>5.0%. Conclusions WEMWBS is responsive to changes occurring in a wide range of mental health interventions undertaken in different populations. It offers a secure base for research and development in this rapidly evolving field. Further research using external criteria of change is warranted.
A number of authors have recently developed and defended various versions of ‘normative essentialism’ about the mental, i.e. the claim that propositional attitudes are constitutively or essentially governed by normative principles. I present two arguments to the effect that this claim cannot be r...... essentially normative, propositional attitude ascriptions could not support normative rationality judgments, which would remove the central appeal of normative essentialism....
Pandey, Rahul; Goel, Sonu; Koushal, Vipin
The present study assessed the motivation level of nurses working in 3 highly decorated tertiary-level government hospitals of India and also underpins the factors attributing to motivation levels. A sequential mixed-method design was used in this study wherein 400 nurses working in 5 units of nursing care in the hospitals were enrolled based upon proportionate random stratified sampling techniques. A self-administered questionnaire with Likert scale was developed based upon scale used by Mbindyo et al. The attributes of motivation were then categorized into external and internal attributes. For the qualitative component, participants with varied responses in quantitative data were selected and interviewed. Overall mean motivation score of the nursing staff was found 3.57 ± 0.93, which was higher for extrinsic motivational attributes (3.67 ± 0.88) as compared with intrinsic attributes (3.47 ± 0.98). The intrinsic motivational attribute of organizational commitment was rated highest followed by general motivation, conscientiousness, and self-efficacy. Personal issues, timeliness, and burnout were prime discouraging attributes among study participants. Sociodemographic characteristics and work profile characteristics showed significant relationship with the attributes of motivation. This study underscores the significance of different attributes of motivation which needs to be considered while framing administrative strategies and policy guidelines by authorities. Copyright © 2018 John Wiley & Sons, Ltd.
Nielsen, Line; Koushede, Vibeke; Vinther-Larsen, Mathilde; Bendtsen, Pernille; Ersbøll, Annette Kjær; Due, Pernille; Holstein, Bjørn E
It seems that social capital in the neighbourhood has the potential to reduce socioeconomic differences in mental health among adolescents. Whether school social capital is a buffer in the association between socioeconomic position and mental health among adolescents remains uncertain. The aim of this study is therefore to examine if the association between socioeconomic position and emotional symptoms among adolescents is modified by school social capital. The Health Behaviour in School-aged Children Methodology Development Study 2012 provided data on 3549 adolescents aged 11-15 in two municipalities in Denmark. Trust in the school class was used as an indicator of school social capital. Prevalence of daily emotional symptoms in each socioeconomic group measured by parents' occupational class was calculated for each of the three categories of school classes: school classes with high trust, moderate trust and low trust. Multilevel logistic regression analyses with parents' occupational class as the independent variable and daily emotional symptoms as the dependent variable were conducted stratified by level of trust in the school class. The prevalence of emotional symptoms was higher among students in school classes with low trust (12.9%) compared to school classes with high trust (7.2%) (p social capital may reduce mental health problems and diminish socioeconomic inequality in mental health among adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.
Forman-Hoffman, Valerie L; Batts, Kathryn R; Hedden, Sarra L; Spagnola, Kathy; Bose, Jonaki
To examine the prevalence and correlates of mental disorder comorbidity in the adult U.S. household population. Data are from a nationally representative sample of noninstitutionalized, civilian adults aged 18 years or older (n = 5653) who participated in the 2008-2012 Mental Health Surveillance Study. Mental disorders, including substance use disorders, were assessed by clinical interviewers using a semistructured diagnostic instrument. Analyses examined co-occurrence of mental disorders and associations with sociodemographic, functional impairment, and treatment correlates. Approximately one-third of adults (31.1%, or more than 15 million) with a past-year mental disorder had a co-occurring mental disorder. Correlates of comorbidity in adjusted models included being of young age, being of non-Hispanic white race/ethnicity, having low family income, and living in a large metropolitan area. Adults with comorbid mental disorders had lower mean levels of functioning and were more likely to report past-year treatment than adults with a single disorder; they also had higher estimates of past-year perceived unmet need for care (21.7% vs. 11.6%, P mental disorder have a co-occurring mental disorder. Elucidating factors associated with co-occurrence may lend clues to shared etiologies, help improve prevention efforts, facilitate early identification, and improve treatment regimens. Copyright © 2018 Elsevier Inc. All rights reserved.
Tian, Tao; Chen, Yuhuai; Zhu, Jing; Liu, Pengling
China has become an aging society, and the mental health problem of the elderly is increasingly becoming prominent. This paper aimed to analyze the effect of air pollution and rural-urban difference on mental health of the elderly in China. Using the data from the China Health and Retirement Longitudinal Survey (CHARLS, 2013), after controlling the social demography variable via Tobit and Probit, a regression analysis of the effect of air pollution and rural-urban difference on mental health and psychological disorder was conducted on 6,630 old people (≧60 yr old) of China from February to April 2015. Mental health and psychological disorder of the elderly were measured by the CES-D score of respondents. Air pollution degree of counties and cities (n=123) were measured by SO2 emission. 27.8% of old people had psychological disorders. Air pollution significantly influenced the mental health of the elderly, showing a positive "U-shaped" curve (Phealth problems. Marriage, education, and social activities had positive effects on the mental health of the elderly. China's local governments should consider the influence of air pollution on the mental health of the elderly during economic development. This paper recommends paying attention to the difference in mental health between the urban and rural elderly when making public health policies. Governments could improve the mental health of the elderly by enriching social activities and increasing employment opportunities of the elderly.
Jenkins, Rachel; Othieno, Caleb; Okeyo, Stephen; Aruwa, Julyan; Kingora, James; Jenkins, Ben
Health system weaknesses in Africa are broadly well known, constraining progress on reducing the burden of both communicable and non-communicable disease (Afr Health Monitor, Special issue, 2011, 14-24), and the key challenges in leadership, governance, health workforce, medical products, vaccines and technologies, information, finance and service delivery have been well described (Int Arch Med, 2008, 1:27). This paper uses focus group methodology to explore health worker perspectives on the challenges posed to integration of mental health into primary care by generic health system weakness. Two ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 20 health workers drawn from a randomised controlled trial to evaluate the impact of a mental health training programme for primary care, 10 from the intervention group clinics where staff had received the training programme, and 10 health workers from the control group where staff had not received the training). These focus group discussions suggested that there are a number of generic health system weaknesses in Kenya which impact on the ability of health workers to care for clients with mental health problems and to implement new skills acquired during a mental health continuing professional development training programmes. These weaknesses include the medicine supply, health management information system, district level supervision to primary care clinics, the lack of attention to mental health in the national health sector targets, and especially its absence in district level targets, which results in the exclusion of mental health from such district level supervision as exists, and the lack of awareness in the district management team about mental health. The lack of mental health coverage included in HIV training courses experienced by the health workers was also striking, as was the intensive focus during district supervision on HIV to the detriment of other
The relationship between social class and mental illness stigma has received little attention in recent years. At the same time, the concept of mental health literacy has become an increasingly popular way of framing knowledge and understanding of mental health issues. British Social Attitudes survey data present an opportunity to unpack the relationships between these concepts and social class, an important task given continuing mental health inequalities. Regression analyses were undertaken which centred on depression and schizophrenia vignettes, with an asthma vignette used for comparison. The National Statistics Socio-economic Classification, education and income were used as indicators of class. A number of interesting findings emerged. Overall, class variables showed a stronger relationship with mental health literacy than stigma. The relationship was gendered such that women with higher levels of education, especially those with a degree, had the lowest levels of stigma and highest levels of mental health literacy. Interestingly, class showed more of an association with stigma for the asthma vignette than it did for both the depression and schizophrenia vignettes, suggesting that mental illness stigma needs to be contextualised alongside physical illness stigma. Education emerged as the key indicator of class, followed by the National Statistics Socio-economic Classification, with income effects being marginal. These findings have implications for targeting health promotion campaigns and increasing service use in order to reduce mental health inequalities. © The Author(s) 2014.
Park, Subin; Lee, Yeeun; Youn, Tak; Kim, Byung Soo; Park, Jong Ik; Kim, Haesoo; Lee, Hyo Chu; Hong, Jin Pyo
Past attempted suicide is a strong predictor of future suicide risk, but the risk varies among suicide attempters. Hence, it is important to clarify distinguishing features of lifetime attempters with a high level of current suicide risk for efficient preventive management. We compared characteristics of suicide attempts and clinical characteristics among high-, moderate-, and low-risk attempters. Among the total of 6022 participants in the Korean Epidemiologic Catchment Area study, 193 reported a suicide attempt in their lifetime, 36 of which had high, 126 moderate, and 30 low levels of current suicide risk (1 incomplete response). High-risk suicide attempters had more past attempts compared with moderate- and low-risk suicide attempters. Suicide attempts were closely linked to a wide range of psychiatric comorbidities regardless of degree of current level of suicide risk, but the relative risk for having at least one mental disorder was the highest in high-risk attempters. Specifically, the relative risks for depressive disorder, anxiety disorders including obsessive-compulsive disorder and post-traumatic stress disorder, and substance use disorders were higher in high-risk attempters, and relative risk for somatoform disorder was higher in low-risk attempters than others. Our findings indicated that special attention is required for suicide attempters with a history of repeated attempts and current mental disorders, particularly anxiety disorders.
Clark, Wayne; Welch, Stephanie N; Berry, Sandra H; Collentine, Ann M; Collins, Rebecca; Lebron, Dorthy; Shearer, Amy L
In a historic effort to reduce the stigma of mental illness, California voters approved the Mental Health Services Act in 2004. The law funds a comprehensive statewide prevention initiative that places stigma and discrimination reduction at its center, with 25 projects providing interventions at the institutional, societal, and individual levels. Stakeholders selected specific strategies from the research-based California Strategic Plan on Reducing Stigma and Discrimination. Strategies range from social marketing to increase public knowledge to capacity building at the local level, including training that emphasizes participation by consumers of mental health services and cultural competence. Collectively, these strategies aim to foster permanent change in the public perception of mental illness and in the individual experience of stigma. We examined the context, planning, programming, and evaluation of this effort.
Public mental health deals with mental health promotion, prevention of mental disorders and suicide, reducing mental health inequalities, and governance and organization of mental health service provision. The full impact of mental health is largely unrecognized within the public health sphere, despite the increasing burden of disease attributable to mental and behavioral disorders. Modern public mental health policies aim at improving psychosocial health by addressing determinants of mental health in all public policy areas. Stigmatization of mental disorders is a widespread phenomenon that constitutes a barrier for help-seeking and for the development of health care services, and is thus a core issue in public mental health actions. Lately, there has been heightened interest in the promotion of positive mental health and wellbeing. Effective programmes have been developed for promoting mental health in everyday settings such as families, schools and workplaces. New evidence indicates that many mental disorders and suicides are preventable by public mental health interventions. Available evidence favours the population approach over high-risk approaches. Public mental health emphasizes the role of primary care in the provision of mental health services to the population. The convincing evidence base for population-based mental health interventions asks for actions for putting evidence into practice. © 2015 World Psychiatric Association.
Wojciech Grabowski; Teoman Pamukcu; Krzysztof Szczygielski; Sinan Tandogan
The aim of the project is to analyze government support for innovation in a comparative perspective by first examining the main existing instruments of financial support for innovation in Turkey and Poland, and secondly to assess their effectiveness by applying recent econometric techniques to firm-level data for both countries obtained from the Community Innovation Survey (CIS). Comparing Turkey to Poland is both meaningful and promising from a policy-analysis point of view. Both countries a...
The combination of high prevalence of mental disorders and the scarcity of resources to care for them in sub-Saharan Africa underscores the need for good mental health literacy as a potential mental health resource. To conduct a systematic review of the findings of studies that have examined aspects of mental health literacy among community dwellers in sub-Saharan Africa. A search was conducted using local and international indexes like MEDLINE, EMBASE and PsychInfo. Only 19 studies from eight different countries met inclusion criteria. Key aspects of the functional mental health literacy that has been examined include recognition of mental disorders, knowledge about causation, and treatment preferences. The modes of seeking mental health information are yet to be examined. Some studies utilized a methodology that allowed for respondents to use local labels to describe their understanding of various mental disorders. Otherwise, respondents were largely unable to label orthodox psychiatry syndromes correctly. Supernatural and ultra-human views were rampant, and alternative mental health services were mostly preferred. Quantitative modes of assessment were the most common, and authors-especially those that adopted this mode of assessment-did not take full cognizance of socio-cultural underpinnings of the concept of mental health literacy in their conclusion and recommendations. There is need for more studies to adopt more comprehensive approaches to the assessment of mental health literacy. The outcomes of such studies will provide the right context for making profound statements on the level of knowledge and skills for mental health promotion in sub-Saharan Africa.
Hanafiah, Ainul Nadhirah; Van Bortel, Tine
Stigma of mental illness has been identified as a significant barrier to help-seeking and care. Basic knowledge of mental illness - such as its nature, symptoms and impact - are neglected, leaving room for misunderstandings on mental health and 'stigma'. Numerous researches have been conducted on stigma and discrimination of people with mental disorders. However, most of the literature investigates stigma from a cultural conception point of view, experiences of patients or public attitudes towards mental illness but little to none from the standpoint of mental health professionals. In Malaysia, this research on stigma is particularly limited. Therefore, the state of stigma and discrimination of people with mental illness was investigated from the perspectives of mental health professionals in Malaysia. In-depth, face-to-face, semi-structured interviews were conducted with 15 mental health professionals from both government and private sectors including psychiatrists, psychologists and counsellors. The interviews were approximately 45-minutes long. The data was subsequently analysed using the basic thematic approach. Seven principal themes, each with their own sub-themes, emerged from the analysis of 'stigma of mental illness' from mental health professionals' point of view, including: (1) main perpetrators, (2) types of mental illness carrying stigma, (3) demography and geography of stigma, (4) manifestations of stigma, (5) impacts of stigma, (6) causes of stigma and (7) proposed initiatives to tackle stigma. Stigma of mental illness is widespread in Malaysia. This is most evident amongst people suffering from conditions such as schizophrenia, bipolar disorder and depression. Stigma manifests itself most often in forms of labelling, rejection, social exclusion and in employment. Family, friends and workplace staff are reported to be the main perpetrators of discriminatory conducts. According to the perspectives of the mental health professionals, implications of
Laidlaw, Anita Helen; McLellan, Julie; Ozakinci, Gozde
Funding: Medical School, University of St Andrews Despite relatively high levels of psychological distress, many students in higher education do not seek help for difficulties. This study explored undergraduate student understanding of the concepts of mental health and mental well-being and where undergraduate students would seek help for mental well-being difficulties. Semi-structured interviews were carried out with 20 undergraduate students from 5 different subject areas. Interviews wer...
This paper will investigate the production of knowledge regarding the number of illegalized migrants. Estimation of the number has been the common frame for production of this kind of knowledge, performed by social scientists, government officials, NGOs and others, but now biometric technology...... by biometric technology will produce increased objectivity and depolitization in numbers of irregular migrants which could not be obtained in the field of estimation. The level of truth reflects the level of control and surveillance fixed as a strategy of government of mobility in the biometric technology....
Hamdiyati, Y.; Sudargo, F.; Redjeki, S.; Fitriani, A.
The purpose of this research was to describe students’ mental model in a mental model based-microbiology course using concept map as assessment tool. Respondents were 5th semester of undergraduate students of Biology Education of Universitas Pendidikan Indonesia. The mental modelling instrument used was concept maps. Data were taken on Bacteria sub subject. A concept map rubric was subsequently developed with a maximum score of 4. Quantitative data was converted into a qualitative one to determine mental model level, namely: emergent = score 1, transitional = score 2, close to extended = score 3, and extended = score 4. The results showed that mental model level on bacteria sub subject before the implementation of mental model based-microbiology course was at the transitional level. After implementation of mental model based-microbiology course, mental model was at transitional level, close to extended, and extended. This indicated an increase in the level of students’ mental model after the implementation of mental model based-microbiology course using concept map as assessment tool.
This paper reviews the key elements of the Nordic governance model, which include a distinct legal system, high governance ratings and low levels of corruption. Other characteristics include concentrated ownership, foundation ownership, semi two-tier board structures, employee representation...
Full Text Available Italian New Public Management (NPM has been mainly characterized by a political orientation toward power decentralization to local governments and privatization of public companies. Nowadays, local utilities in Italy are often run by joint stock companies controlled by public agencies such as Regional and Municipal Administrations. Due to this transformation, these companies must comply with a set of diverse expectations coming from a wide range of stakeholders, related to their financial, competitive and social performance. Such fragmented governance increases the presence of “wicked” problems in the decision-making sphere of these entities. Given this multi-level governance structure, how do these agents influence public services performance? In recent years, coordination and inter-institutional joint action have been identified as possible approaches for dealing with governance fragmentation and wicked problems deriving from it. How can we adapt a performance management perspective in order to help us reform the system and so have a better collaboration between the stakeholders involved? In order to address and discuss these research questions, a case study will be developed. The case concerns AMAT, the local utility providing the public transportation service in the Municipality of Palermo (Italy. The result of this study is a dynamic model including a set of performance indicators that help us in understanding the impact of the governing structure on the system’s performance.
I examine decentralization through the lens of the local dynamics that it unleashes. The national effects of decentralization are simply the sum of its local-level effects. Hence to understand decentralization we must first understand how local government works. This paper proposes a theory of local government as the confluence of two quasi-markets and one organizational dynamic. Good government results when these three elements - political, economic and civil - are in rough balance, and acto...
Daund, Muktesh; Sonavane, Sushma; Shrivastava, Amresh; Desousa, Avinash; Kumawat, Sanjay
Mental hospitals are an integral part of mental health services in India. It is an interesting story how mental hospitals have responded to the challenges of contemporary period they were built in. It is beyond doubt that it is a progressive journey along with advances in mental health both in India and internationally. As in other countries, mental hospitals in India have responded to the social challenges, disparities, and poor resources of workforce and fiscal investment. Historically, there have been changes and three major reforms are needed, namely attempt to facilitate discharge and placing patients back into the family, introducing teaching and research in mental hospitals, and accountability to civil rights as per the requirements of the National Human Rights Commission. In this review, we explore the brief history of mental hospitals in India and examine the reforms in the clinical, administrative, and psychosocial areas of these hospitals and progress in teaching and research. We finally summarize and conclude the necessity and the relevance of mental hospitals in India akin to modern psychiatric practice. We believe that mental hospitals have an important and perhaps a central role in mental health services in India. Its modernization to address issues of long-term stay, burden on caregivers, stigma, research and teaching including undergraduate and postgraduate training, new curriculum, and training for nonpsychiatric professionals and primary care physicians are necessary components of the role of mental hospitals and responsibilities of both government and nongovernmental sectors. Last but not the least, it is obligatory for mental hospitals to ensure that evidence-based treatments are implemented and that the standard of care and respect of civil and human rights of the patients and families are provided while involving the people's participation in its functioning.
Full Text Available The idea of this paper is to determine the mental models of actors in the firm with respect to the stakeholder approach of corporate governance. The use of the cognitive map to view these diagrams to show the ways of thinking and conceptualization of the stakeholder approach. The paper takes a corporate governance perspective, discusses stakeholder model. It takes also a cognitive mapping technique.
Eplov, Lene; Petersen, Kirsten Schultz; Jespersen, Ejgil
The Danish Government Committee on Psychiatry states that recovery-oriented rehabilitation is an important framework and direction in psychiatry. Recovery-oriented rehabilitation means that the intervention is based on best practice. It is also based on four values: self-determination, person inv...... involvement, self-determination/choice and growth potential. A comprehensive national plan of action on how to develop a recovery-oriented rehabilitation to Danish citizens with mental disorders is recommended....
Onnela, A M; Vuokila-Oikkonen, P; Hurtig, T; Ebeling, H
The purpose of this paper is to describe a participatory action research process on the development of a professional practice model of mental health nurses in mental health promotion in a comprehensive school environment in the city of Oulu, Finland. The developed model is a new method of mental health promotion for mental health nurses working in comprehensive schools. The professional practice model has been developed in workshops together with school staff, interest groups, parents and students. Information gathered from the workshops was analysed using action research methods. Mental health promotion interventions are delivered at three levels: universal, which is an intervention that affects the whole school or community; selective, which is an intervention focusing on a certain group of students; and indicated, which is an individually focused intervention. All interventions are delivered within the school setting, which is a universal setting for all school-aged children. The interventions share the goal of promoting mental health. The purposes of the interventions are enhancing protective factors, reducing risk factors relating to mental health problems and early identification of mental health problems as well as rapid delivery of support or referral to specialized services. The common effect of the interventions on all levels is the increase in the experience of positive mental health. © 2014 John Wiley & Sons Ltd.
Huang, Hui; Li, Yuyu; Huang, Bo; Pi, Xing
In order to recycle and dispose of all people's expired drugs, the government should design a subsidy policy to stimulate users to return their expired drugs, and drug-stores should take the responsibility of recycling expired drugs, in other words, to be recycling stations. For this purpose it is necessary for the government to select the right recycling stations and treatment stations to optimize the expired drug recycling logistics network and minimize the total costs of recycling and disposal. This paper establishes a tri-level programming model to study how the government can optimize an expired drug recycling logistics network and the appropriate subsidy policies. Furthermore, a Hybrid Genetic Simulated Annealing Algorithm (HGSAA) is proposed to search for the optimal solution of the model. An experiment is discussed to illustrate the good quality of the recycling logistics network and government subsides obtained by the HGSAA. The HGSAA is proven to have the ability to converge on the global optimal solution, and to act as an effective algorithm for solving the optimization problem of expired drug recycling logistics network and government subsidies.
Hani, Syafrida; UMSU, Hafsah
ABSTRACTThis study aims to develop a theory of determining the quality of financial statement reports that can increase investor confidence in financial information presented by management. This research would like to find the role of good corporate governance in improving the quality of financial statements as measured by accounting conservatism and earnings management, then it will be seen how the quality ability of financial statement can influence investor confidence level. The ...
Lambert, Martin; Härter, Martin; Brandes, Andreas; Hillebrandt, Bernd; Schlüter, Catarina; Quante, Susanne
The Hamburg Network for Mental Health belongs to the healthcare regions in Germany, funded by the Federal Ministry of Education and Research from 2011 to 2015. More than 330 partners from research, health care, health industry and government are promoting innovative health care models and products to improve mental health care in Hamburg. The main objectives comprise the sustained implementation of the Network itself and of successful health care models and products. The article describes current and future implementation possibilities and the present state of the implementation process. © Georg Thieme Verlag KG Stuttgart · New York.
Evert Pommer; Jedid-Jah Jonker
Original title: Profijt van de overheid. Income levels are determined to a considerable extent by the government, which exerts an influence through social security and taxation. The traditional purchasing power tables are a reflection of this. However, the influence of the government goes
Full Text Available The global financial crisis has posed challenges to financial institutions governance. Meeting these challenges requires an understanding of governance dynamics in relation to institutions’ performance within a changing environment. The nature and scope of institutional response to a changing environment depends upon inherited governance structures, including socioeconomic conventions and rules of behavior at the macro level and time, expertise and common commitment of directors at the micro level. Innovation and learning-by-doing in governance can be an effective reform strategy. Innovation in governance may include the establishment of new norms of economic behavior and the transformation of decision-making process and the reallocation of responsibilities to directors and senior management. This may also inform regulatory approaches in strengthening financial institutions governance, based on improved disclosure, independent and competent boards
Sports psychiatry has developed for the past 3 decades as an emerging field within psychiatry and sports medicine. An International society has been established in 1994 and also national interest groups were implemented, mostly within the national organizations for psychiatry, some also containing the topic of exercise treatment of mental disorders. Where are we now 30 years later? We systematically but also selectively review the medical literature on exercise, sport, psychiatry, mental health and mental disorders and related topics. The number of publications in the field has increased exponentially. Most topics keep remaining on the agenda, e.g., head trauma and concussion, drug abuse and doping, performance enhancement, overtraining, ADHD or eating disorders. Supported by the growing literature, evidence-based recommendations have become available now in many clinical areas. A relatively new phenomenon is muscle dysmorphia, observed in weightlifters, bodybuilders but also in college students and gym users. Further, sports therapy of mental disorders has been studied by more and more high-quality randomized controlled clinical trials. Mostly as a complementary treatment, however, for some disorders already with a 1a evidence level, e.g., depression, dementia or MCI but also post-traumatic stress disorder. Being grown up and accepted nowadays, sports psychiatry still represents a fast-developing field. The reverse side of the coin, sport therapy of mental disorders has received a scientific basis now. Who else than sports psychiatry could advance sport therapy of mental disorders? We need this enthusiasm for sports and psychiatry for our patients with mental disorders and it is time now for a broadening of the scope. Optimized psychiatric prevention and treatment of athletes and ideal sport-related support for individuals with mental disorders should be our main purpose and goal.
Lin, Ro-Ting; Chien, Lung-Chang; Chen, Ya-Mei; Chan, Chang-Chuan
Governance of a country may have widespread effects on the health of its population, yet little is known about the effect of governance on child mortality in a country that is undergoing urbanization, economic development, and disease control. We obtained indicators of six dimensions of governance (perceptions of voice and accountability, political stability and absence of violence, government effectiveness, regulatory quality, rule of law, and control of corruption) and national under-5 mortality rates for 149 countries between 1996 and 2010. We applied a semi-parametric generalized additive mixed model to examine associations after controlling for the effects of development factors (urbanization level and economy), disease control factors (hygienic conditions and vaccination rates), health expenditures, air quality, and time. Governance, development, and disease control showed clear inverse relations with the under-5 mortality rate (pcountry's need for better governance is as important as improvements in development and disease control. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
Hean, Sarah; Ødegård, Atle; Willumsen, Elisabeth
Purpose Interprofessional collaboration is necessary when supporting mentally ill offenders but little is understood of these interactions. The purpose of this paper is to explore prison officers' perceptions of current and desirable levels of interprofessional collaboration (relational coordination (RC)) to understand how collaboration between these systems can be improved. Design/methodology/approach Gittell's RC scale was administered to prison officers within the Norwegian prison system ( n=160) using an adaptation of the instrument in which actual and desired levels of RC are evaluated. This differentiates between prison officers' expectations of optimum levels of collaboration with other professional groups, dependent on the role function and codependence, vs actual levels of collaboration. Findings Prison officers reported different RC levels across professional groups, the lowest being with specialist mental health staff and prison doctors and highest with nurses, social workers and other prison officers. Significant differences between desired and actual RC levels suggest expertise of primary care staff is insufficient, as prison officers request much greater contact with mental health specialists when dealing with the mentally ill offender. Originality/value The paper contributes to limited literature on collaborative practice between prison and health care professionals. It questions the advisability of enforcing care pathways that promote the lowest level of effective care in the prison system and suggest ways in which mental health specialists might be better integrated into the prison system. It contributes to the continued debate on how mental health services should be integrated into the prison system, suggesting that the current import model used in Norway and other countries, may not be conducive to generating the close professional relationships required between mental health and prison staff.
Demedts, Dennis; Roelands, Marc; Libbrecht, Julien; Bilsen, Johan
Euthanasia because of unbearable mental suffering (UMS euthanasia) has been legal in Belgium since 2002, under certain circumstances that govern careful practice. Despite the legal framework, there are specific difficulties and concerns regarding UMS euthanasia. Mental health nurses are often involved in the process, but little is known about their attitudes towards UMS euthanasia, their role and their knowledge. To determine the attitudes, role and knowledge of mental health nurses regarding UMS euthanasia. A cross-sectional survey was performed at a convenience sample of four psychiatric hospitals in Belgium (n=133) as a pilot study. Self-administered questionnaires were provided to mental health nurses. Half the nurses in our sample had been involved at least once in the process of UMS euthanasia. A large majority of mental health nurses were supportive of UMS euthanasia. Nurses show differences in attitudes related to the different psychiatric pathologies of the patients, and in whether or not minors are involved. In some cases, they believed that the mental suffering of psychiatric patients can be unbearable and irreversible and that psychiatric patients can be competent to voluntarily request UMS euthanasia. Nurses stated that they have an important role in the UMS euthanasia process, but also demanded more knowledge and clear guidelines to implement the procedure. Nurses have a key role regarding UMS euthanasia but face several challenges: the recent process, resistance to a multidisciplinary approach by psychiatrists and an unclear role defined by the legal framework. Nurses do not appear to have a common voice on the topic and the development of clear guidelines appears to be essential. Social recovery can offer a way out of an UMS euthanasia request, but it will not always offer a solution. Sufficient attention must be paid to how mental health nurses can be involved in the process of UMS euthanasia at various levels: bedside practice, healthcare
This paper argues that the semantics of governance illustrates connections and provides a unifying view from which to understand much better its natural branches: corporate, public and global governance. In this regard, governance is presented from the point of view of a distinctive field of learning and practice. Further, three levels of analysis are carried out to drive the subject home. Firstly, it highlights the extent of corporate governance within an institutional framework, and also gi...
Full Text Available Human-induced causes of forest change occur at multiple scales. Yet, most governance mechanisms are designed at a single level – whether international, national, regional or local – and do not provide effective solutions for the overarching challenge of forest governance. Efforts to “decentralize” governmental arrangements frequently do not recognize the importance of complex, polycentric arrangements and are based on a presumption of a single government at one level taking charge of a policy arena, often ignoring the existence of many vibrant self-governed institutions. Polycentric institutions provide a useful framework for governance, enabling aspects of preferred solutions to be used together in efforts to protect the long-term sustainability of diverse forested social-ecological systems. By considering the interaction between actors at different levels of governance, polycentricity contributes to a more nuanced understanding of the variation in diverse governance outcomes in the management of common-pool resources based on the needs and interests of citizens and the complexity of resources and governance systems at local, regional, national, and global levels. In this paper, we discuss challenges to polycentricity such as the matching of the boundaries of those who benefit, those who contribute with the boundary of the resource. We describe some approaches that have been effectively utilized to address these challenges in forests in various parts of the world. We also provide a brief overview of how the concept of polycentricity helps in the analysis of climate change and the closely related international effort to reduce greenhouse gas emissions through degradation and deforestation (REDD.
Müller, Ralf; Pemsel, Sofia; Shao, Jingting
This study identifies the organizational enablers for governance in the realm of projects. We first conceptualize organizational enablers as comprising of process facilitators and discursive abilities, each with its own factors and mechanisms. Then we apply this concept to the literature on proje......, and through development of self-responsible, self-organizing people for governmentality in project settings. Questions for future research are indicated....... governance, governance of projects and governmentality. Outcomes indicate that governance is enabled through different forms of flexibility at different levels of governance, institutional setup and authority at the project level, flexible structures and mindsets of people at the organizational level...
rate of mental health in the substance dependents in Sari Township in 2011. Materials ... Keywords: Abuse and dependence, mental disorder, mental health, psychiatric research. Résumé ..... and education level among the drug addicts, as well. ... difference between mental health and being a single, .... employees of Arak.
Nap, Annelies; van Loon, Annelies; Peen, Jaap; van Schaik, Digna Jf; Beekman, Aartjan Tf; Dekker, Jack Jm
The level of acculturation of migrants varies and is associated with variations in mental health. However, this association is complex and may differ among migrant groups. The aim of this study is to explore the association between acculturation, mental health and treatment effect. In a longitudinal cohort study of patients treated in specialized mental health facilities, different dimensions of acculturation (skills, social integration, traditions, norms/values and feelings of loss) were explored for Moroccan, Turkish and Surinamese migrants in the Netherlands. Furthermore, the associations between acculturation status and symptom levels, quality of life, care needs and effects of mental health treatment were examined. Data were analyzed with analysis of covariance, correlation analysis and multiple regression analysis. Acculturation status differed among migrant groups. Turkish migrants showed most original culture maintenance (traditions, norms/values), Surinamese migrants showed most participation in Dutch society (skills, social integration), while Moroccan migrants were situated in between. Higher cultural adaptation was associated with less need for care, lower symptom levels and a higher quality of life. Participation significantly predicted lower symptom levels (p acculturation status is associated with symptom levels, quality of life and perceived need for care of migrants. Moreover, participation in Dutch society appears to be a favorable factor for treatment effect. It is of importance for professionals in clinical practice to be attentive to this. © The Author(s) 2014.
Full Text Available Trends in international human rights law have challenged States globally to rethink involuntary mental health interventions from a non-discrimination perspective. The United Nations Convention on the Rights of Persons with Disabilities (CRPD in particular prohibits laws that discriminate on the basis of disability. However, a key criterion for compulsory mental health treatment under typical mental health legislation is a psychiatric diagnosis (in conjunction with risk of harm and other criteria. Hence, for people with mental health disabilities, rights to liberty and consent in healthcare are held to a different standard compared to other citizens. A prominent law reform option being explored by some governments and commentators for achieving non-discrimination is to replace the diagnostic criterion for triggering involuntary intervention with an assessment of mental capacity. After all, every citizen is subject to restrictions on autonomy where they are deemed to lack mental capacity, such as where concussion necessitates emergency service. However, the use of mental capacity “testing” is seen by diverse commentators as wanting in key respects. A prominent criticism comes from the United Nations Committee on the Rights of Persons with Disabilities, which considers mental capacity assessments a form of disability-based discrimination. This article queries the call to replace the diagnostic criterion in mental health law with an assessment of mental capacity in the light of jurisprudence on equality and non-discrimination in international human rights law. Instead, we examine the doctrine of necessity as an area of law, which might help identify specific thresholds for overriding autonomy in emergency circumstances that can be codified in a non-discriminatory way. We also consider the need for deliberative law reform processes to identify such measures, and we suggest interim, short-term measures for creating a “supported decision
Xu, Junfang; Wang, Jian; Liu, Ruiyun; Xing, Jinshui; Su, Lei; Yu, Fenghua; Lu, Mingshan
hospitalization cost was 23.6%, with the inpatient cost reaching RMB 11,949 (US$ 1921.1) in 2012. The hospitalization cost was found to be strongly associated with hospital length of stay, level of care, age, employment status, admission diagnoses, and frequency of hospitalization. Our study found that mental health inpatient resources use, particularly hospitalization cost, has been growing at an increasing rate. In our sample, hospitalization cost nearly tripled from 2005 to 2012. Mental illnesses and the related economic burden on the population will continue to grow, making mental health a major public health issue in China. Hospital length of stay was found to be increasing in our sample, and positively correlated with hospitalization cost. Childhood and adolescence behavioral and emotional disorders were found to be significantly associated with higher inpatient cost. The policy implications generated from the results of this study are two-fold: first of all, in order to meet the growing need of mental health care in China, the government needs to significantly increase its spending in preventing and treating mental illnesses. Second, cost containment in inpatient care would become a major challenge for mental health policy makers in China. Government support, clinical practices and guideline development, as well as research are urgently needed to promote mental health prevention and improve the efficiency of mental health system in China. The current mental health system, like the overall healthcare system in China, relies heavily on hospital inpatient care. In order to build a sustainable mental health care system to meet increasing population need in China, it is crucial to integrate mental health care reform with the ongoing primary health care reform. Future mental health policy reform and research in China should put more focus on how to strengthen primary care system as well as community support, establish effective two-tier referring mechanism between hospital and
Full Text Available Through corporate governance is aimed the building of a structure enabling a wide degree of freedom, within the law, and includes several changes of principle in accordance with international standards of transparency. A good governance within an organization mitigate risk, increase performance, pave the way towards financial markets, brings competitive goods and services on market, improves management style, show transparency towards all stakeholders and social responsibility. The lack of some mandatory rules and structures can lead to chaos in business. The paper aims to present the role and the importance of the corporate governance for modern companies, as well as the principles on which this is based. In order to do that we also identified the main ways to quantificate the level of corporate governance, including also the non-financial performance criteria used by investors to assess companies listed on stock exchange.
Full Text Available Abstract Introduction Sustained cooperative action is required to improve the mental health of populations, particularly in low and middle-income countries where meagre mental health investment and insufficient human and other resources result in poorly performing mental health systems. The Observatory The International Observatory on Mental Health Systems is a mental health systems research, education and development network that will contribute to the development of high quality mental health systems in low and middle-income countries. The work of the Observatory will be done by mental health systems research, education and development groups that are located in and managed by collaborating organisations. These groups will be supported by the IOMHS Secretariat, the International IOMHS Steering Group and a Technical Reference Group. Summary The International Observatory on Mental Health Systems is: 1 the mental health systems research, education and development groups; 2 the IOMHS Steering Group; 3 the IOMHS Technical Reference Group; and 4 the IOMHS Secretariat. The work of the Observatory will depend on free and open collaboration, sharing of knowledge and skills, and governance arrangements that are inclusive and that put the needs and interests of people with mental illness and their families at the centre of decision-making. We welcome contact from individuals and institutions that wish to contribute to achieving the goals of the Observatory. Now is the time to make it happen where it matters, by turning scientific knowledge into effective action for people's health. (J.W. Lee, in his acceptance speech on his appointment as the Director-General of the World Health Organization 1.
Tempelaar, Wanda M; de Vos, Nelleke; Plevier, Carolien M; van Gastel, Willemijn A; Termorshuizen, Fabian; MacCabe, James H; Boks, Marco P M
Previous research suggests that cognitive functioning is associated with the risk of several adult psychiatric disorders. In this study we investigated whether adolescents who perform worse than expected at secondary school are at a higher risk for general mental health problems. In a cross-sectional survey comprising 10,866 Dutch adolescents aged 13 to 16 years, underachievement at secondary school was defined as the discrepancy between predicted school grade and actual grade 1 or 3 years later. Mental health problems were assessed using the Strengths and Difficulties Questionnaire. We investigated the association of underachievement with mental health problems using logistic regression, adjusting for potential confounders. Underachievement was associated with general psychopathology in pupils aged 13 to 14 years (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.47-2.37) and in pupils aged 15 to 16 years (OR, 2.05; 95% CI, 1.67-2.52) in a multivariate analysis including sociodemographic factors. The association between underachievement and mental health problems was attenuated when school factors such as teacher advice and interaction between underachievement and teacher advice were added, but underachievement remained significantly associated with mental health problems in adolescents in the higher educational tracks (pupils aged 13-14 years: OR, 2.22; 95% CI, 1.07-4.60 and OR, 2.41; 95% CI, 1.10-5.30, age 15-16 years: OR, 2.63; 95% CI, 1.38-5.03). In the multivariate analysis including the interaction between underachievement and teacher advice, a significant interaction effect occurs between underachievement and teacher advice in the higher tracks. Values of OR and CI are given for each significant interaction term. In the younger age group (pupils aged 13-14 years) this results in 2 sets of OR and CI. This association was most pronounced for the hyperactivity subscale of the Strengths and Difficulties Questionnaire. Underachievement at secondary school
Hoffman, Lily M
This article examines New York City's response to the 2009 H1N1 pandemic in the context of the post-9/11 US security regime. While the federal level 'all-hazards' approach made for greater depth of support, it also generated unrealistic assumptions at odds with an effective local response. The combination of structurally induced opportunity and actor specific strengths (size, expertise) made for effective local governance by the New York City Department of Health and Mental Hygiene. By underlining the importance of locality as a first line of defence and linking defence function to policy initiative in regard to health governance, this study illustrates the continuing relevance of Weber's insight into the institutional structure of the city. © 2012 The Author. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.
The open mode of thinking, acting and being has been associated with liberating, participatory and collaborative arrangements that have prompted us to redefine how research, science, innovation and citizenship are to be conceived. In an era where much is said about the ‘open society’ and open inn...... at the local governance level, with implications for both theory and practice....
Rugema, Lawrence; Krantz, Gunilla; Mogren, Ingrid; Ntaganira, Joseph; Persson, Margareta
In Rwanda, many people are still mentally affected by the consequences of the genocide and yet mental health care facilities are scarce. While available literature explains the prevalence and consequences of mental disorders, there is lack of knowledge from low-income countries on health care seeking behavior due to common mental disorders. Therefore, this study sought to explore health care professionals' acquired experiences of barriers and facilitators that people with common mental disorders face when seeking mental health care services in Rwanda. A qualitative approach was applied and data was collected from six focus group discussions (FGDs) conducted in October 2012, including a total of 43 health care professionals, men and women in different health professions. The FGDs were performed at health facilities at different care levels. Data was analyzed using manifest and latent content analysis. The emerging theme "A constant struggle to receive mental health care for mental disorders" embraced a number of barriers and few facilitators at individual, family, community and structural levels that people faced when seeking mental health care services. Identified barriers people needed to overcome were: Poverty and lack of family support, Fear of stigmatization, Poor community awareness of mental disorders, Societal beliefs in traditional healers and prayers, Scarce resources in mental health care and Gender imbalance in care seeking behavior. The few facilitators to receive mental health care were: Collaboration between authorities and organizations in mental health and having a Family with awareness of mental disorders and health insurance. From a public health perspective, this study revealed important findings of the numerous barriers and the few facilitating factors available to people seeking health for mental disorders. Having a supportive family with awareness of mental disorders who also were equipped with a health insurance was perceived as vital for
Karvalics, Laszlo Z.; Dalal, Nikunj
In current times, we are seeing the emergence of a new paradigm to describe, understand, and analyze the expanding "knowledge domain". This overarching framework - called knowledge governance - draws from and builds upon knowledge management and may be seen as a kind of meta-layer of knowledge management. The emerging knowledge governance approach deals with issues that lie at the intersection of organization and knowledge processes. Knowledge governance has two main interpretation levels in the literature: the company- (micro-) and the national (macro-) level. We propose a three-layer model instead of the previous two-layer version, adding a layer of "global" knowledge governance. Analyzing and separating the main issues in this way, we can re-formulate the focus of knowledge governance research and practice in all layers.
Schaap, Nina; van Arem, Bart; van der Horst, Richard; Brookhuis, Karel; Alkim, T.P.; Arentze, T.
Advanced Driver Assistance (ADA) Systems may provide a solution for safety-critical traffic situations. But these systems are new additions into the vehicle that might increase drivers’ mental workload. How do drivers behave in situations with high mental workload, and do they actively prioritize
Eaton, Julian; Agomoh, Ahamefula O
This grass-roots level mental health awareness programme considerably increased use of community-based mental health services in a part of Nigeria where knowledge about treatability of mental illness was limited. The benefits of the programme were sustained for a significant period after the initial awareness programme. In order for attitude changes to be reinforced, similar awareness programmes must be repeated at regular intervals.
Nap, A.W.; van Loon, A.; Peen, J.; van Schaik, D.J.F.; Beekman, A.T.F.; Dekker, J.J.M.
Background: The level of acculturation of migrants varies and is associated with variations in mental health. However, this association is complex and may differ among migrant groups. Aim: The aim of this study is to explore the association between acculturation, mental health and treatment effect.
Full Text Available Background: Posting and transfer (PT of health personnel - placing the right health workers in the right place at the right time - is a core function of any large-scale health service. In the context of government health services, this may be seen as a simple process of bureaucratic governance and implementation of the rule of law. However the literature from India and comparable low and middle-income country health systems suggests that in reality PT is a contested domain, driven by varied expressions of private and public interest throughout the chain of implementation. Objective: To investigate policymaking for PT in the government health sector and implementation of policies as experienced by different health system actors and stakeholders at primary health care level. Methodology: We undertook an empirical case study of a PT reform policy at primary health care level in Tamil Nadu State, to understand how different groups of health systems actors experience PT. In-depth qualitative methods were undertaken to study processes of implementation of PT policies enacted through ′counselling′ of health workers (individualized consultations to determine postings and transfers. Results: PT emerges as a complex phenomenon, shaped partially by the laws of the state and partially as a parallel system of norms and incentives requiring consideration and coordination of the interests of different groups. Micro-practices of governance represent homegrown coping mechanisms of health administrators that reconcile public and private interests and sustain basic health system functions. Beyond a functional perspective of PT, it also reflects justice and fairness as it plays out in the health system. It signifies how well a system treats its employees, and by inference, is an index of the overall health of the system. Conclusions: For a complex governance function such as PT, the roles of private actors and private interests are not easily separable from the
Hailemariam, Maji; Fekadu, Abebaw; Selamu, Medhin; Alem, Atalay; Medhin, Girmay; Giorgis, Tedla Wolde; DeSilva, Mary; Breuer, Erica
Scaling up mental healthcare through integration into primary care remains the main strategy to address the extensive unmet mental health need in low-income countries. For integrated care to achieve its goal, a clear understanding of the organisational processes that can promote and hinder the integration and delivery of mental health care is essential. Theory of Change (ToC), a method employed in the planning, implementation and evaluation of complex community initiatives, is an innovative approach that has the potential to assist in the development of a comprehensive mental health care plan (MHCP), which can inform the delivery of integrated care. We used the ToC approach to develop a MHCP in a rural district in Ethiopia. The work was part of a cross-country study, the Programme for Improving Mental Health Care (PRIME) which focuses on developing evidence on the integration of mental health in to primary care. An iterative ToC development process was undertaken involving multiple workshops with stakeholders from diverse backgrounds that included representatives from the community, faith and traditional healers, community associations, non-governmental organisations, Zonal, Regional and Federal level government offices, higher education institutions, social work and mental health specialists (psychiatrists and psychiatric nurses). The objective of this study is to report the process of implementing the ToC approach in developing mental health care plan. A total of 46 persons participated in four ToC workshops. Four critical path dimensions were identified: community, health facility, administrative and higher level care organisation. The ToC participants were actively engaged in the process and the ToC encouraged strong commitment among participants. Key opportunities and barriers to implementation and how to overcome these were suggested. During the workshops, a map incorporating the key agreed outcomes and outcome indicators was developed and finalized later
Bommel, van S.; Kuindersma, W.
This report assesses the integration of climate policy in Dutch public policy at the national, regional, local and area level. The national analysis focuses on the horizontal integration of climate policy in national government programmes, adaptation and mitigation strategies and specific policy
It is unclear how ethnic differences in HbA 1c levels are affected by individual variations in mental wellbeing. Thus, the aim of this study was to assess the extent to which HbA 1c disparities between Caucasian and South Asian adults are mediated by various aspects of positive psychological functioning. Data from the 2014 Health Survey for England was analysed using bootstrapping methods. A total of 3894 UK residents with HbA 1c data were eligible to participate. Mental wellbeing was assessed using the Warwick-Edinburgh Mental Well-being Scale. To reduce bias BMI, blood pressure, diabetes status, and other factors were treated as covariates. Ethnicity directly predicted blood sugar control (unadjusted coefficient -2.15; 95% CI -3.64, -0.67), with Caucasians generating lower average HbA 1c levels (37.68 mmol/mol (5.6%)) compared to South Asians (39.87 mmol/mol (5.8%)). This association was mediated by positive mental wellbeing, specifically concerning perceived vigour (unadjusted effect 0.30; 95% CI 0.13, 0.58): South Asians felt more energetic than Caucasians (unadjusted coefficient -0.32; 95% CI -0.49, -0.16), and greater perceived energy predicted lower HbA 1c levels (unadjusted coefficient -0.92; 95% CI -1.29, -0.55). This mediator effect accounted for just over 14% of the HbA 1c variance and was negated after adjusting for BMI. Caucasian experience better HbA 1c levels compared with their South Asian counterparts. However, this association is partly confounded by individual differences in perceived energy levels, which is implicated in better glycaemic control, and appears to serve a protective function in South Asians.
Full Text Available Abstract Background The Ugandan government recognizes mental health as a serious public health and development concern, and has of recent implemented a number of reforms aimed at strengthening the country's mental health system. The aim of this study was to provide a profile of the current mental health policy, legislation and services in Uganda. Methods A survey was conducted of public sector mental health policy and legislation, and service resources and utilisation in Uganda, in the year 2005, using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS Version 2.2. Results Uganda's draft mental health policy encompasses many positive reforms, including decentralization and integration of mental health services into Primary Health Care (PHC. The mental health legislation is however outdated and offensive. Services are still significantly underfunded (with only 1% of the health expenditure going to mental health, and skewed towards urban areas. Per 100,000 population, there were 1.83 beds in mental hospitals, 1.4 beds in community based psychiatric inpatient units, and 0.42 beds in forensic facilities. The total personnel working in mental health facilities were 310 (1.13 per 100,000 population. Only 0.8% of the medical doctors and 4% of the nurses had specialized in psychiatry. Conclusion Although there have been important developments in Uganda's mental health policy and services, there remains a number of shortcomings, especially in terms of resources and service delivery. There is an urgent need for more research on the current burden of mental disorders and the functioning of mental health programs and services in Uganda.
Full Text Available In order to recycle and dispose of all people’s expired drugs, the government should design a subsidy policy to stimulate users to return their expired drugs, and drug-stores should take the responsibility of recycling expired drugs, in other words, to be recycling stations. For this purpose it is necessary for the government to select the right recycling stations and treatment stations to optimize the expired drug recycling logistics network and minimize the total costs of recycling and disposal. This paper establishes a tri-level programming model to study how the government can optimize an expired drug recycling logistics network and the appropriate subsidy policies. Furthermore, a Hybrid Genetic Simulated Annealing Algorithm (HGSAA is proposed to search for the optimal solution of the model. An experiment is discussed to illustrate the good quality of the recycling logistics network and government subsides obtained by the HGSAA. The HGSAA is proven to have the ability to converge on the global optimal solution, and to act as an effective algorithm for solving the optimization problem of expired drug recycling logistics network and government subsidies.
Banks, D; Clifton, A V; Purdy, M J; Crawshaw, P
Mental health nurses frequently draw on self-disclosure practices within their working relationships. These 'confessional' acts can in turn be predicated on traditional assumptions of moral authority exercised by more senior colleagues. More broadly, attention has been drawn to the increasing significance of 'technologies of the self' inside neo-liberal regimes of governance. Through various forms of self-disclosure people are obliged 'to speak the truth about themselves'. By publically declaring themselves as 'fit for purpose' nurses are required to be reflexive, self-monitoring individuals, capable of constructing their own identities and biographies, and guided by expert knowledges. In this way, risk becomes a form of governance, as the individuals continually find themselves balancing risks and opportunities. Foucault's insights into the importance of 'care of the self' and 'surveillance of the self' to systems of social order and governance, such as mental health services, are significant in identifying nursing as a potential form of confessional practice. 'Reflective practice' and 'clinical supervision' are therefore 'technologies', functioning as 'modes of surveillance', and as 'confessional practices'. So 'clinical supervision' may be understood as part of a process of 'governance' that does not necessarily empower nurses, but can act to guide, correct and modify ways in which they conduct themselves. © 2012 John Wiley & Sons Ltd.
Covarrubias, Irene; Han, Meekyung
In this study, the attitudes toward and beliefs about serious mental illness (SMI) held by a group of graduate social work students in the northwestern United States were examined. Mental health stigma was examined with relation to the following factors: participants' level of social contact with SMI populations, adherence to stereotypes about SMI…
Full Text Available In the past two decades a new way of delivering public services has emerged, a method very similar to e-commerce and based on the increasing use of Internet; this new manner is called e-government and its benefits are enormous. This paper focuses on the e-government from the perspective of local institutions, covering all the cities which have municipality rank; it analyzes their websites in order to determine the level of development of e-government and the usability of the websites. The main purpose is to establish the level of e-government and to compare it to the United Nations model of development and to the European Commission maturity model. A second objective is to test if there is a relation between the level of e-government and the number of residents, the main political party at the local level and the usability of the websites. The conclusion is somehow surprising since e-government development is at a relatively medium level compared to the low level of broadband penetration rate and the percentage of people with no Internet skills.
Fountain, Jane E
Digital government is typically defined as the production and delivery of information and services inside government and between government and the public using a range of information and communication technologies. Two types of government relationships with other entities are government-to-citizen and government-to-government relationships. Both offer opportunities and challenges. Assessment of a public health agency's readiness for digital government includes examination of technical, managerial, and political capabilities. Public health agencies are especially challenged by a lack of funding for technical infrastructure and expertise, by privacy and security issues, and by lack of Internet access for low-income and marginalized populations. Public health agencies understand the difficulties of working across agencies and levels of government, but the development of new, integrated e-programs will require more than technical change - it will require a profound change in paradigm.
Globalisation in food production and consumption is fundamentally transforming a wide variety of social practices at different levels in society. Simply adding another level of governance will therefore not solve the problems related to food production and consumption in global modernity. Different
Aggarwal, Anuj K.; Thompson, Maxwell; Falik, Rebecca; Shaw, Amy; O'Sullivan, Patricia; Lowenstein, Daniel H.
Objectives: Medical students have been shown to have high levels of psychological distress, including self-stigmatization and unwillingness to seek care. The authors hypothesized that a student-led curriculum involving personal mental illness experience, given during the first-year neuroscience course, and titled "Mental Illness Among Us…
Full Text Available The article endeavors to trace the outset of governance concept, its dominant meanings and discourse, and its implication towards governability. The central role of government in the governing processes has predominantly been adopted. The concept of governance was emerged precisely in the context of the failure of government as key player in regulation, economic redistribution and political participation. Governance is therefore aimed to emphasize pattern of governing which are based both on democratic mechanism and sound development management. However, practices of such good governance concept –which are mainly adopted and promoted by donor states and agencies– tend to degrade state and/or government authority and legitimacy. Traditional function of the state as sole facilitator of equal societal, political and legal membership among citizens has been diminished. The logic of fair competition has been substituted almost completely by the logic of free competition in nearly all sectors of public life. The concept and practices of good governance have resulted in decayed state authority and failed state which in turn created a condition for "ungovernability". By promoting democratic and humane governance, the article accordingly encourages discourse to reinstall and bring the idea of accountable state back in.
Adult mental illness in the community including depression and anxiety has achieved greater public awareness and visibility in recent years and this has also resulted in increased recognition about the widespread impact on dependent children. During the past decade in Australia, policies and specific programs for infants, children and youth in terms of prevention, early intervention and promotion in relation to children of parents with a mental illness ('copmi') have been devised. However, these have generally been disconnected projects, essentially supported only by non-recurrent funding. In more recent years, systematic and interconnected responses involving a wider range of government, non-government and consumer and carer organisations to build sustainability have become the focus. However, little research about change processes affecting the organisational systems serving children of parents with mental illness and their families has been undertaken. This aim of the current study is to describe the enablers and barriers that contribute to change in systems and government and non-government organisations in relation to children of parents with a mental illness in Australia over the past decade, within the context of sustainability. The study involved interviews, focus groups and website and literature searches regarding systems change across Australian states and territories and nationally in relation to the enablers, barriers and future directions. Strategic and intentional processes within organisations, more evolutionary ongoing cross-agency processes and links to sustained changes are key systems change findings. Relevance for change in other health services is highlighted.
Malaysia is a developing Islamic state that faced budget deficit since 1998. But it is not accepted by all and hopes that state should be in a position of either balance budget or surplus budget. The optimum level of Government budget is the state where government expenditure is totally offset by source of government revenue and that can be achieved through increasing tax revenue or decreasing expenditure. The aim of this study to find out the theoretical relationship betwee...
This article analyses the governance process of offshore oil and gas activities in the Arctic with the concept of multilevelgovernance and legal pluralism to address both issues of management of the environment and public participation. The analysis goes beyond the single issue of fragmentation p...... and from regional government, indigenous shareholders and corporation perspectives, could be helpful in providing relevant actors with arguments to weigh the decision on seismic and drilling activities in relation to risk acceptance.......This article analyses the governance process of offshore oil and gas activities in the Arctic with the concept of multilevelgovernance and legal pluralism to address both issues of management of the environment and public participation. The analysis goes beyond the single issue of fragmentation...... pertaining to the international and supranational levels, to encompass national and regional levels and evaluate how the interactions between those levels structure the policy process and impact the efficiency of environmental management and public participation. Four paths of reflection arise from...
Gyaase, Patrick Ohemeng Kwadwo
This research was undertaken to study the diffusion of E-government as a tool for decentralization, using Ghana as a case study. E-governance has been credited with the potency of facilitating good governance in countries with appreciable level of E-government maturity. Much attention is being...... espoused by E-government. This research therefore assesses the diffusion of E-government as a tool for decentralization in Ghana. The research was carried out using mixed-methods and was approached from four theoretical perspectives namely Innovation Diffusion theory the TOE framework for technological....... Qualitative data was used to assess the factors affecting the diffusion of e-government as a tool for decentralization and the results pointed to vendor and donor led diffusion as affecting E-government implementation. There is also the absence of convergence between the E-government, the decentralization...
Kampen, Jarl K
We study the empirical consistency of survey based (micro level) indicators of social capital and local government performance on the one, and municipality based (aggregate level) measures of these two concepts on the other hand. Knowledge about the behavior of these indicators is helpful for evaluating the value of studies carried out in isolated contexts, that is, with access to data on either, but not both, levels. The method is by comparing data collected by Statistics Belgium on Flemish municipalities, to data collected at citizen level by means of a face-to-face survey. The available evidence supplies at best a meager basis for presupposing a shared component of the indicators under study.
Conclusion There is an increased pervasive attitude to children with mental retardation. Therefore, efforts aimed at changing parental and by extension societal attitudes toward these children are necessary for their care and survival. There is also need for government and charitable organizations to reach-out to parents of ...
Evans-Lacko, Sara; Knapp, Martin; McCrone, Paul; Thornicroft, Graham; Mojtabai, Ramin
A period of economic recession may be particularly difficult for people with mental health problems as they may be at higher risk of losing their jobs, and more competitive labour markets can also make it more difficult to find a new job. This study assesses unemployment rates among individuals with mental health problems before and during the current economic recession. Using individual and aggregate level data collected from 27 EU countries in the Eurobarometer surveys of 2006 and 2010, we examined changes in unemployment rates over this period among individuals with and without mental health problems. Following the onset of the recession, the gap in unemployment rates between individuals with and without mental health problems significantly widened (odds ratio: 1.12, 95% confidence interval: 1.03, 1.34). This disparity became even greater for males, and individuals with low levels of education. Individuals with mental health problems living in countries with higher levels of stigmatizing attitudes regarding dangerousness of people with mental illness were more vulnerable to unemployment in 2010, but not 2006. Greater agreement that people with mental health problems have themselves to blame, was associated with lower likelihood of unemployment for individuals with and without mental health problems. These findings study suggest that times of economic hardship may intensify social exclusion of people with mental health problems, especially males and individuals with lower education. Interventions to combat economic exclusion and to promote social participation of individuals with mental health problems are even more important during times of economic crisis, and these efforts should target support to the most vulnerable groups.
Malhotra, Savita; Shah, Ruchita
Gender is a critical determinant of mental health and mental illness. The patterns of psychological distress and psychiatric disorder among women are different from those seen among men. Women have a higher mean level of internalizing disorders while men show a higher mean level of externalizing disorders. Gender differences occur particularly in the rates of common mental disorders wherein women predominate. Differences between genders have been reported in the age of onset of symptoms, clin...
Jörg, Frederike; Visser, Ellen; Ormel, Johan; Reijneveld, Sijmen A; Hartman, Catharina A; Oldehinkel, Albertine J
The aim of the study was to estimate the proportion of adolescents with and without a psychiatric diagnosis receiving specialist mental health care and investigate their problem levels as well as utilization of other types of mental health care to detect possible over- and undertreatment. Care utilization data were linked to psychiatric diagnostic data of 2230 adolescents participating in the TRAILS cohort study, who were assessed biannually starting at age 11. Psychiatric diagnoses were established at the fourth wave by the Composite International Diagnostic Interview. Self-, parent- and teacher-reported emotional and behavioral problems and self-reported mental health care use were assessed at all four waves. Of all diagnosed adolescents, 35.3 % received specialist mental health care. This rate increased to 54.5 % when three or more disorders were diagnosed. Almost a third (28.5 %) of specialist care users had no psychiatric diagnosis; teachers gave them relatively high ratings on attention and impulsivity subscales. Diagnosed adolescents without specialist mental health care also reported low rates of other care use. We found no indication of overtreatment. Half of the adolescents with three or more disorders do not receive specialist mental health care nor any other type of care, which might indicate unmet needs.
Full Text Available Abstract Background Many Tibetan refugees flee Tibet in order to escape physical and mental hardships, and to access the freedoms to practice their culture and religion. We aimed to determine the prevalence of mental illnesses within the refugee population and determine the prevalence of previous torture reported within this population. Methods We performed a systematic literature search of 10 electronic databases from inception to May 2005. In addition, we searched the internet, contacted all authors of located studies, and contacted the Tibetan Government-in-exile, to locate unpublished studies. We included any study reporting on prevalence of mental illness within the Tibetan refugee populations. We determined study quality according to validation, translation, and interview administration. We calculated proportions with exact confidence intervals. Results Five studies that met our inclusion criteria (total n = 410. All studies were conducted in North India and 4 were specifically in adult populations. Four studies provided details on the prevalence of torture and previous imprisonment within the populations. The prevalence of post-traumatic stress disorder ranged from 11–23%, anxiety ranged from 25–77%, and major depression ranged from 11.5–57%. Conclusion Our review indicates that the prevalence of serious mental health disorders within this population is elevated. The reported incidence of torture and imprisonment is a possible contributor to the illnesses. Non-government organizations and international communities should be aware of the human rights abuses being levied upon this vulnerable population and the mental health outcomes that may be associated with it.
Forbes-Mewett, Helen; Sawyer, Anne-Maree
Since the early 2000s, reports of increased rates of mental ill health among young people worldwide have received much attention. Several studies indicate a greater incidence of mental health problems among tertiary students, compared with the general population, and higher levels of anxiety, in particular, among international students compared…
In the last half decade, a rising literature has focused on the idea that processes of economic, political and social globalization require analysis in terms of governance at the global level. It is argued in this article that emerging forms of global governance have produced significant challenges to conventional conceptions of international…
Full Text Available Patients with infertility are a high risk group in depression and anxiety. However, an existing theoretically and empirically validated model of stressors, stress, and mental symptoms specific for infertile patients is still a void. This study aimed to determine the related factors and their relational structures that affect the level of depressive and anxiety symptoms among infertile patients.A cross-sectional sample of 400 infertility outpatients seeking reproduction treatments in three teaching hospitals across Taiwan participated in the structured questionnaire survey in 2011. The hypothesized model comprising 10 latent variables was tested by Structural Equation Modeling using AMOS 17.Goodness-of-fit indexes, including χ2/DF = 1.871, PGFI = 0.746, PNFI = 0.764, and others, confirmed the modified model fit the data well. Marital stressor, importance of children, guilt-and-blame, and social stressor showed a direct effect on perceived stress. Instead of being a factor of stress, social support was directly and positively related to self-esteem. Perceived stress and self-esteem were the two major mediators for the relationships between stressors and mental symptoms. Increase in social support and self-esteem led to decrease in mental symptoms among the infertile patients.The relational structures were identified and named as the Stressors Stress Symptoms Model, clinically applied to predict anxiety and depression from various stressors. Assessing sources and level of infertility-related stress and implementing culturally-sensitive counseling with an emphasis on positive personal value may assist in preventing the severity of depression and anxiety.
Wang, Jong-Yi; Li, Yi-Shan; Chen, Jen-De; Liang, Wen-Miin; Yang, Tung-Chuan; Lee, Young-Chang; Wang, Chia-Woei
Patients with infertility are a high risk group in depression and anxiety. However, an existing theoretically and empirically validated model of stressors, stress, and mental symptoms specific for infertile patients is still a void. This study aimed to determine the related factors and their relational structures that affect the level of depressive and anxiety symptoms among infertile patients. A cross-sectional sample of 400 infertility outpatients seeking reproduction treatments in three teaching hospitals across Taiwan participated in the structured questionnaire survey in 2011. The hypothesized model comprising 10 latent variables was tested by Structural Equation Modeling using AMOS 17. Goodness-of-fit indexes, including χ2/DF = 1.871, PGFI = 0.746, PNFI = 0.764, and others, confirmed the modified model fit the data well. Marital stressor, importance of children, guilt-and-blame, and social stressor showed a direct effect on perceived stress. Instead of being a factor of stress, social support was directly and positively related to self-esteem. Perceived stress and self-esteem were the two major mediators for the relationships between stressors and mental symptoms. Increase in social support and self-esteem led to decrease in mental symptoms among the infertile patients. The relational structures were identified and named as the Stressors Stress Symptoms Model, clinically applied to predict anxiety and depression from various stressors. Assessing sources and level of infertility-related stress and implementing culturally-sensitive counseling with an emphasis on positive personal value may assist in preventing the severity of depression and anxiety.
Full Text Available This paper consists of three factors, namely: Good Governance, Business Climate and Corruption. How they affect the development product of Albania, not only as a concept, and a principle but mostly as a sensitive aspect in the integration process. There are some interpretations of this concept, but I intend to analyze the key factors and actors, their cooperation and concrete production in society. Improving governance is necessary to have an integrated long term strategy based upon a continuous cooperation between institutions and citizens. But in developing countries like Albania there are some important questions such as: How can we measure the improvement of Good Governance through policies? Has Good Governance indicated an effective way for the sustainable development? (Meisel, 2008, 6. These question give us the orientation to reflect about the process of development, social economic political behavior and how this multidimensional is transformed in product of good governance. The business cycle is strongly connected with many aspects of political-, social-, juridical aspects and good governance. Despite attempts to draft law regulations, the level of corruption and informality in Albania continues to be a major obstacle. The credibility level in the implementation of law is an indicator that affects democratization and institutional integration. At present, different reports of international institutions, define Albania as the country with the highest level of Corruption in the Balkans, which is a key factor influencing business. The ways with
Lee, Myung-Soo; Lim, Hee-Young; Kim, Youngki; Lee, Yong-Suk
One of the most typical and chronic problem in Korean mental health system is the prolonged length of hospital stay. In contrast to there are many components which leads to long length of stay of psychiatric patients in Korean situation such as low and fixed medical fee for psychiatric inpatient treatment, shortage of community resources, lack of care-givers' awareness and so on, there are just few mechanisms to handle this issue such as Mental Health Review Board (MHRB) which is based on Mental Health Act since 1995. However, the discharge order rate was very low and there community care system after discharge order is still very weak. The Korean government has revised the Mental Health Act in 2008 and changed the operating principals of the MHRB from a regional level to a local level to strengthen the function of MHRB. However, the discharge order rate versus the whole evaluation requests still remains at a very low level or less than 5%. And it is still very difficult to execute a discharge order against a patient whose symptoms and conditions become psychiatrically stabilized enough for discharge, due to a shortage of community care facilities and a lack of social support system. These results are exactly same with former studies. Any policies to promote psychiatric discharge including MHRB are needed to take the comprehensive factors into consideration, such as payment program, community infrastructure, increasing care-givers' acceptance and so on. Despite of the political trial of Korean government to reduce length of stay of chronic psychiatric patients, it was not successful. Still it had failed to propose a detailed policy measure in terms of the above-mentioned prerequisites. Therefore, new system and program developments including reform of payment system which reflect prior studies' recommendations are essential.
Ismail, Nur'Ain; Ali, Siti Noor Asmiza Md; Othman, Nor A'aini; Jaffar, Nooraidawati
The satisfaction level of occupants toward the maintenance is very important to know the occupants comfortable with maintenance that was provided at the government quarters. The objective of the research is to determine the level of occupants satisfaction perceived of the maintenance in government quarter and also the level of quality of the maintenance of the government quarters. Data have been collected by using questionnaire in order to achieve the objective of the research. The questionnaires distributed among the occupants government quarters at Hospital Kota Bharu Kelantan. In the end of the research, the result are expected that to show the results on this satisfaction level of the occupants toward the maintenance at government quarters can be solve and the occupants can live more comfortable and get the good quality for maintenance and facilities in their houses.
Organizing by covenant : the organization of transitional labor markets : paper IREC Conference 2004 'Governance issues in shifting industrial and employment relations' Utrecht, The Netherlands, August 26-28, 2004 : session potential and limits of national level socio-economic governance
Korver, T.; Oeij, P.R.A.
From 26-28 August 2004 in Utrecht the Industrial Relations in Europe Conference (IREC) was held on governance issues in shifting industrial and employment relations. As part of the session 'potential and limits of national level socio-economic governance' this paper about the organization of
Full Text Available The onset of the independence process in Central and Eastern European (CEE countries during the 1990s was marked by tremendous optimism and a declared wish for stronger fiscal decentralisation and the transfer of powers, responsibilities and resources to the units of local and regional self-government that were supposed to be closest to citizens in resolving their daily problems. However, this has not happened in these countries, at least not according to the basic financial decentralisation indicators, and this is the main thesis of this work. Despite numerous adjustments made in the local self-government organisation in the observed countries, an optimum level of local and regional self-government organisation has still not been achieved. The units of local and regional self-government are still heavily dependent on, or rather restricted by, the strong central governments, which reduces their autonomy and their influence on the local social and economic development.
Kibriya, Shahriar; Xu, Zhicheng P.; Zhang, Yu
By using a geo-coded disaggregated dataset in sub-Saharan Africa over the period 1997–2013, we exploit year-to-year rainfall variation as an instrumental variable to estimate the causal effect of economic shocks on civil conflict conditional on governance quality. We confirm earlier findings that adverse rainfall shocks increase the likelihood of conflict in sub-Saharan Africa. We also investigate the role of governance quality on conflict in sub-Saharan Africa. The results underscore that im...
Full Text Available Abstract Background Substance users being admitted to inpatient treatment experience a high level of mental distress. In this study we explored changes in mental distress during treatment. Methods Mental distress, as measured by the HSCL-10, was registered at admission and at discharge among 164 substance users in inpatient treatment in Northern Norway. Predictors of reduction in mental distress were examined utilizing hierarchical regression analysis. Results We found a significant reduction in mental distress in the sample, but the number of patients scoring above cut-off on the HSCL-10 at discharge was still much higher than in the general population. A more severe use of substances as measured by the AUDIT and the DUDIT, and being female, predicted a higher level of mental distress at admission to treatment as well as greater reduction in mental distress during treatment. Holding no education beyond 10 year compulsory school only predicted a reduction in mental distress. Conclusions The toxic and withdrawal effects of substances, level of education as well as gender, contributed to the differences in change in mental distress during treatment. Regression to the mean may in part explain some of the findings.
Intertwined trends of massification, internationalisation and marketisation constitute and drive change in higher education at all levels. Consequences at the institutional level include: increased competition, adoption of corporate management forms, accrual of power to executive management, and greater emphasis on strategy. As Government policy…
Fries, Gabriel R; Gassen, Nils C; Schmidt, Ulrike; Rein, Theo
The immunophilin FK506 binding protein 51 (FKBP51) has emerged as one of the most intensely investigated proteins in stress-related mental disorders. It was originally characterized as Hsp90 cochaperone and part of the receptor-chaperone heterocomplex that governs the activity of steroid receptors. It turned out that the presence of FKBP51 in this heterocomplex leads to diminished activity of the corticosteroid receptors. In particular, based on its inhibitory action on the glucocorticoid receptor (GR), FKBP51 was included in a candidate gene approach to discover gene polymorphisms that might be relevant for the development and treatment of major depression. The discovery that polymorphisms in the gene coding for FKBP51 were linked to the treatment response of depressed patients intensified the research on the role of FKBP51 in stress-related diseases worldwide. It has become evident that FKBP51 is not only a regulator of GR action, but also a GR target. The function of this ultrashort intracellular feedback loop is critically important for cellular and physiological stress regulation as it does not only calibrate the function of GR, but also the levels of FKBP51. Given the pleiotropic functions of FKBP51, its levels might be equally important for mental disorders as GR function and hence for the development of potential FKBP51 drug targets.
Major transformations in forms of governance of the liberal state have been wrought over the course of the last century, including the rise of neoliberalism and 'new public management.' Mental health too has witnessed change, with pharmacological treatment displacing residential care, a shift to community-based services, mainstreaming with general health care, and greater reliance on civil society institutions such as the family or markets. This article considers whether mental health law, and its court/tribunal 'gatekeepers' have kept pace with those changes. It argues that the focus of the liberal project needs to shift to measures which will better guarantee access to mental health services, and keep a more watchful eye on both 'hidden' coercion of people on community treatment orders, and passive neglect of human need.
de Bruin, EA; Beersma, DGM; Daan, S; Bruin, Eveline A. de
Mental activity is a neglected factor in sleep research. The few investigations on sleep that manipulate prior mental activity are inconclusive with respect to the possible effects of mental activity on recovery. In the present study, the effects of two levels of mental activity on subsequent sleep
Hamdani, Yani; Ary, Ayelet; Lunsky, Yona
Introduction: Stigma is widely identified as an issue affecting the health and well-being of people with intellectual and developmental disabilities (IDD), and those with mental illnesses. To address this issue, a population mental health strategy, which includes a focus on reducing stigma and discrimination, was developed by the government of…
Burgess, Diana; Tran, Alisia; Lee, Richard; van Ryn, Michelle
Previous research has found that lesbian, gay, bisexual and transgender (LGBT) individuals are at risk for a variety of mental health disorders. We examined the extent to which a recent experience of a major discriminatory event may contribute to poor mental health among LGBT persons. Data were derived from a cross-sectional strata-cluster survey of adults in Hennepin County, Minnesota, who identified as LGBT (n=472) or heterosexual (n=7,412). Compared to heterosexuals, LGBT individuals had poorer mental health (higher levels of psychological distress, greater likelihood of having a diagnosis of depression or anxiety, greater perceived mental health needs, and greater use of mental health services), more substance use (higher levels of binge drinking, greater likelihood of being a smoker and greater number of cigarettes smoked per day), and were more likely to report unmet mental healthcare needs. LGBT individuals were also more likely to report having experienced a major incident of discrimination over the past year than heterosexual individuals. Although perceived discrimination was associated with almost all of the indicators of mental health and utilization of mental health care that we examined, adjusting for discrimination did not significantly reduce mental health disparities between heterosexual and LGBT persons. LGBT individuals experienced more major discrimination and reported worse mental health than heterosexuals, but discrimination did not account for this disparity. Future research should explore additional forms of discrimination and additional stressors associated with minority sexual orientation that may account for these disparities.
Blood copper, zinc, magnesium and lead levels were determined by atomic absorption spectroscopy for 15 males and 16 female suffering from depression, 6 males and 1 female with mental retardation and 3 males and 4 females with seizure disorders. They were all under no medication and belong to low income groups. No difference in copper levels was found between the sexes in any of the groups. The levels in all the groups were significantly higher than in the normals. In depressives, males had significantly higher zinc levels than females and only female depressives had lower levels from normals. In both depressives and normals, males had higher magnesium levels than females but no group of patients had significantly different levels from normals. Lead levels were significantly higher in female depressives and for those with seizure disorders than for controls. At least one metal abnormality was found in 21 (67.7%) depressive, 5 (71.4%) of those with mental retardation and 6 (85.7%) with seizure disorders. (author)
Full Text Available The intensity of ICT usage continues to increase. This should be accompanied by the increase of the government's performance, and one of the important components is governance of the ICT system planning. The ICT system planning with a good management will provide significant benefits to the organization. One cause of insignificant benefits ICT to the organizational goals is there is no ICT governance applied. It can be caused by many things, one of them is the lack of knowledge and awareness about the ICT governance, so there are still many government agencies which have not yet implemented properly the ICT governance. By using quantitative approaches, questionnaire instrument was adapted from the General Guide of the National ICT Governance. Framework COBIT and data analysis techniques adopted from the COBIT Maturity level. This study aims to explore the guidelines as an evaluation tool for the governance of the ICT system planning in Department of Communications and Information Technology in Bitung City. The results of this study found that the institution is still at low level, level 1 with 0,63 maturity level in governance planning of ICT system.
Vander Elst, Simon; De Rynck, Filip
Both the Belgian federal and Flemish regional government have framed the development of a series of authentic information sources as a key solution to reduce administrative burden for companies and citizens as these crossroads banks allow the sharing of information between different government agencies at different levels of government. The ultimate goal is to realize a more integrated, efficient and effective government service delivery towards citizens and companies. In our paper, we will c...
van den Berg, Maya Marieke
The local government level is considered to be crucial in preparing society for climate change impact. Yet little is known about why local authorities do or do not take action to adapt their community for climate change impacts. In order to implement effective adaptation policy, the motivations for
This article outlines a plan for a change project to improve the quality of physical health care on mental health wards. The plan was designed to improve the monitoring and recording of respiratory rates on mental health wards, through the implementation of a training programme for staff. A root cause analysis was used to explore the reasons for the low incidence of respiratory rate measurement on mental health wards, and the results of this establish the basis of the proposed change project and its aims and objectives. The article describes how the project could be implemented using a change management model, as well as how its effects could be measured and evaluated. Potential barriers to the planned change project are discussed, including the human dimensions of change. The article suggests methods to overcome such barriers, discusses the value of leadership as an important factor, and examines the principles of clinical governance in the context of the planned change project.
Full Text Available To complement this Special Feature on global water governance, we focused on a generic challenge at the global level, namely, the degree to which water issues need to be dealt with in a centralized, concentrated, and hierarchical manner. We examined water ecosystem services and their impact on human well-being, the role of policies, indirect and direct drivers in influencing these services, and the administrative level(s at which the provision of services and potential trade-offs can be dealt with. We applied a politics of scale perspective to understand motivations for defining a problem at the global or local level and show that the multilevel approach to water governance is evolving and inevitable. We argue that a centralized overarching governance system for water is unlikely and possibly undesirable; however, there is a need for a high-level think tank and leadership to develop a cosmopolitan perspective to promote sustainable water development.
Tzouvara, V; Papadopoulos, C
Mental illness stigma negatively affects the lives of individuals with mental health disorders. Studies have indicated that the type and degree of stigma significantly varies across cultures. This study aimed to add to this body of knowledge by examining the prevalence and the type of mental illness stigma among individuals who identified themselves as Greek. It also examined the influence of a range of potential within-culture stigma moderating factors, including levels of previous experience with mental illness and mental illness knowledge. A cross-sectional quantitative design was employed, and 111 participants living in England and Greece were sampled through the snowball sampling technique. Stigma prevalence was measured using the 'Community Attitudes to Mental Illness' questionnaire. The findings revealed that participants showed a high degree of sympathy for people with mental illness but also considered them to be inferior and of a lower social class, and needing strict societal control. Higher stigma was significantly associated with being educated in England (instead of Greece), higher religiosity, lower knowledge levels and lower levels personal experience of mental illness. Targeted antistigma campaigns specifically tailored for the Greek culture are required in order to help reduce stigmatizing attitudes. © 2014 John Wiley & Sons Ltd.
AI-Sebie, Madi M
This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University, 17/10/2005. A review of normative literature, in the field of e-government, indicates that the transactional stage of e-government is one of the most important to the implementation of an e-government system as it represents the highest level of interaction within organisations and between customers and government organisations. Due to the importance of the transactional stage of the e-govern...
Shen, Gordon C; Snowden, Lonnie R
Policies generate accountability in that they offer a standard against which government performance can be assessed. A central question of this study is whether ideological imprint left by policy is realized in the time following its adoption. National mental health policy expressly promotes the notion of deinstitutionalization, which mandates that individuals be cared for in the community rather than in institutional environments. We investigate whether mental health policy adoption induced a transformation in the structure of mental health systems, namely psychiatric beds, using panel data on 193 countries between 2001 and 2011. Our striking regression results demonstrate that late-adopters of mental health policy are more likely to reduce psychiatric beds in mental hospitals and other biomedical settings than innovators, whereas they are less likely than non-adopters to reduce psychiatric beds in general hospitals. It can be inferred late adopters are motivated to implement deinstitutionalization for technical efficiency rather than social legitimacy reasons.
Rasmussen, Rasmus Kjærgaard; Merkelsen, Henrik
This article combines the securitization approach with theory of risk and narratological methodology in the analysis of the Danish-Greenlandic government debates about potential uranium exploitation. The authors conclude that the securitization controversy visible at the surface level of policy...... documents reflects an identity struggle at the deeper narrative level closely related to the understanding of national identity politics. These underlying stakes are brought to the fore when securitization is used as a governance technique....
Full Text Available A period of economic recession may be particularly difficult for people with mental health problems as they may be at higher risk of losing their jobs, and more competitive labour markets can also make it more difficult to find a new job. This study assesses unemployment rates among individuals with mental health problems before and during the current economic recession.Using individual and aggregate level data collected from 27 EU countries in the Eurobarometer surveys of 2006 and 2010, we examined changes in unemployment rates over this period among individuals with and without mental health problems.Following the onset of the recession, the gap in unemployment rates between individuals with and without mental health problems significantly widened (odds ratio: 1.12, 95% confidence interval: 1.03, 1.34. This disparity became even greater for males, and individuals with low levels of education. Individuals with mental health problems living in countries with higher levels of stigmatizing attitudes regarding dangerousness of people with mental illness were more vulnerable to unemployment in 2010, but not 2006. Greater agreement that people with mental health problems have themselves to blame, was associated with lower likelihood of unemployment for individuals with and without mental health problems.These findings study suggest that times of economic hardship may intensify social exclusion of people with mental health problems, especially males and individuals with lower education. Interventions to combat economic exclusion and to promote social participation of individuals with mental health problems are even more important during times of economic crisis, and these efforts should target support to the most vulnerable groups.
Evans-Lacko, Sara; Knapp, Martin; McCrone, Paul
Objectives A period of economic recession may be particularly difficult for people with mental health problems as they may be at higher risk of losing their jobs, and more competitive labour markets can also make it more difficult to find a new job. This study assesses unemployment rates among individuals with mental health problems before and during the current economic recession. Methods Using individual and aggregate level data collected from 27 EU countries in the Eurobarometer surveys of 2006 and 2010, we examined changes in unemployment rates over this period among individuals with and without mental health problems. Results Following the onset of the recession, the gap in unemployment rates between individuals with and without mental health problems significantly widened (odds ratio: 1.12, 95% confidence interval: 1.03, 1.34). This disparity became even greater for males, and individuals with low levels of education. Individuals with mental health problems living in countries with higher levels of stigmatizing attitudes regarding dangerousness of people with mental illness were more vulnerable to unemployment in 2010, but not 2006. Greater agreement that people with mental health problems have themselves to blame, was associated with lower likelihood of unemployment for individuals with and without mental health problems. Conclusion These findings study suggest that times of economic hardship may intensify social exclusion of people with mental health problems, especially males and individuals with lower education. Interventions to combat economic exclusion and to promote social participation of individuals with mental health problems are even more important during times of economic crisis, and these efforts should target support to the most vulnerable groups. PMID:23922801
Full Text Available The article makes the theoretical analysis of the features of professional performance of civil servants and officials of local self-government bodies. The significant level of staff turnover among civil servants and the significant level of registered unemployed among the persons who had previously worked in these structures was revealed. The article carries out the theoretical analysis of psychological researches, which testify to the existence of direct correlation between the level of achievement motivation and success in an entrepreneurial activity. The purpose has been set to study the peculiar properties of achievement motivation of civil servants and officials of local self-government bodies. The researches have shown that the level of motivation for the achievement has a straightforward connection with the success of entrepreneurship. The purpose is to study the peculiarities of the motivation of achievement of civil servants and officials of local self-government bodies. There is the possibility for engagement of fired civil servants to entrepreneurial activities. The empirical study of achievement motivation peculiarities of female employees has been conducted. A statistically significant inverse correlation between the level of achievement motivation and the length of civil service has been established. The paper substantiates the need in further research aimed at uncovering the factors responsible for the inverse correlation between the level of achievement motivation and the term of service in the civil service.
Vladimir V. Redko
Full Text Available The article is devoted to the issues of the activities of the local government of Japan. Particular attention is drawn to the legal framework and the material basis for the functioning of local self-government bodies. The system of local self-government is considered as a special form of self-government with a specific functional and meaning; system of municipal management and delegation of authority, as well as features of interaction between civil and imperious levels. The allocation of the city with a special status, as well as the financial structure of the local government of Japan, is considered in detail.
Friche, Nanna; Normann Andersen, Vibeke
unintended consequences. Theoretically, we draw on different management and governance theories, e.g. performance management. Empirically, the study is based on surveys to teachers and students at all Danish vocational colleges and interviews with school leaders, teachers and students at six colleges (cases...... and well-being of students enrolled in the VETs must be strengthened. We focus on target 1, 2 and 4. The reform is being implemented in a field of VET that can be characterized by four logics of governance. Firstly, a governance logic characterized by institutional independence of vocational colleges......For the last fifteen years completion rates in Danish vocational education and training (VET) has stayed on a rather low level. In 2014, only half of the students enrolled in a vocational program on upper secondary level, graduated from the program (Flarup et al 2016). In Denmark, like in other...
Prüfer, J.; Diamond, S.; Wainwright, N.
This paper applies economic governance theory to the cloud computing industry. We analyze which governance institution may be best suited to solve the problems stemming from asymmetric information about the true level of data protection, security, and accountability offered by cloud service
Rudolf Bauer; Jana Knezova; Andrej Steiner
Dynamism of development and competiveness of regions, as spatially and administratively defined units, depend not only on their natural, economic, social, and territorial potential but also on quality of regional development governance. At the time of creation of the regional level of territorial management in Slovakia there was expected that by introducing this new governance level the regional governments would become strong players in the field of regional development policy and provide su...
Patel, Vikram; Kleinman, Arthur
A review of English-language journals published since 1990 and three global mental health reports identified 11 community studies on the association between poverty and common mental disorders in six low- and middle-income countries. Most studies showed an association between indicators of poverty and the risk of mental disorders, the most consistent association being with low levels of education. A review of articles exploring the mechanism of the relationship suggested weak evidence to support a specific association with income levels. Factors such as the experience of insecurity and hopelessness, rapid social change and the risks of violence and physical ill-health may explain the greater vulnerability of the poor to common mental disorders. The direct and indirect costs of mental ill-health worsen the economic condition, setting up a vicious cycle of poverty and mental disorder. Common mental disorders need to be placed alongside other diseases associated with poverty by policy-makers and donors. Programmes such as investment in education and provision of microcredit may have unanticipated benefits in reducing the risk of mental disorders. Secondary prevention must focus on strengthening the ability of primary care services to provide effective treatment.
Idstad, Mariann; Torvik, Fartein Ask; Borren, Ingrid; Rognmo, Kamilla; Røysamb, Espen; Tambs, Kristian
The association between mental distress and divorce is well established in the literature. Explanations are commonly classified within two different frameworks; social selection (mentally distressed people are selected out of marriage) and social causation (divorce causes mental distress). Despite a relatively large body of literature on this subject, selection effects are somewhat less studied, and research based on data from both spouses is scarce. The purpose of the present study is to investigate selection effects both at the individual level and the couple level. The current study is based on couple-level data from a Norwegian representative sample including 20,233 couples. Long-term selection effects were tested for by means of Cox proportional hazard models, using mental distress in both partners at baseline as predictors of divorce the next 16 years. Three identical sets of analyses were run. The first included the total sample, whereas the second and third excluded couples who divorced within the first 4 or 8 years after baseline, respectively. An interaction term between mental distress in husband and in wife was specified and tested. Hazard of divorce was significantly higher in couples with one mentally distressed partner than in couples with no mental distress in all analyses. There was also a significant interaction effect showing that the hazard of divorce for couples with two mentally distressed partners was higher than for couples with one mentally distressed partner, but lower than what could be expected from the combined main effects of two mentally distressed partners. Our results suggest that mentally distressed individuals are selected out of marriage. We also found support for a couple-level effect in which spouse similarity in mental distress to a certain degree seems to protect against divorce.
Lund, Crick; Myer, Landon; Stein, Dan J; Williams, David R; Flisher, Alan J
Little is known regarding the links between mental disorder and lost income in low- and middle-income countries. The purpose of this study was to investigate the association between mental disorder and lost income in the first nationally representative psychiatric epidemiology survey in South Africa. A probability sample of South African adults was administered the World Health Organization Composite International Diagnostic Interview schedule to assess the presence of mental disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders, version IV. The presence of severe depression or anxiety disorders was associated with a significant reduction in earnings in the previous 12 months among both employed and unemployed South African adults (p = 0.0043). In simulations of costs to individuals, the mean estimated lost income associated with severe depression and anxiety disorders was $4,798 per adult per year, after adjustment for age, gender, substance abuse, education, marital status, and household size. Projections of total annual cost to South Africans living with these disorders in lost earnings, extrapolated from the sample, were $3.6 billion. These data indicate either that mental illness has a major economic impact, through the effect of disability and stigma on earnings, or that people in lower income groups are at increased risk of mental illness. The indirect costs of severe depression and anxiety disorders stand in stark contrast with the direct costs of treatment in South Africa, as illustrated by annual government spending on mental health services, amounting to an estimated $59 million for adults. The findings of this study support the economic argument for investing in mental health care as a means of mitigating indirect costs of mental illness.
This article presents a theoretical overview of personal and institutional governance capacities (experience, leadership and knowledge on the individual level, and organizational capital available on the institutional level) and their relationship to politics and policies in the Latin American context. Using the theoretical production of Carlos Matus regarding the act of governing, diverse dimensions of this problem are put into discussion in relation to other authors and experiences in different historical moments. Theories, methods and techniques of government are explored and the need for state reform with an internal logic is analyzed. It is concluded that there is a need to build a theory for the practice of governing/managing public organizations, and this construction requires creative actions that use theory as a toolbox.
Devi, S K; Chansauria, J P; Udupa, K N
In cases of mental depression, the plasma serotonin, melatonin and glutamate levels are increased along with the lowering of urinary - 5 - hydroxyindole acetic acid, plasma monoamine oxidase and cortisol levels following three and six months Practice of Kundalini Yoga. The pulse rate and blood pressure in these patients are also lowered after Kundalini Yoga practice. Thus, the practice of Kundalini Yoga helps to maintain a perfect homeostasis by bringing an equilibrium between the sympathetic and parasympathetic activities and it can be used as a non - medical measure in treating patients with mental depression.
Cane, Fiona Eloise; Oland, Louise
Government guidance in 2008 endorsed the "Targeting Mental Health in Schools" (TaMHS) agenda, which sets out to promote mental health in schools through the delivery of universal and targeted interventions. This paper initially defines mental health and outlines the TaMHS initiative. It then offers empirical findings from four focus…
Full Text Available In this paper we have evaluated the influence of the modification of public investment level and unemployment rate on the general government deficit at the European Union level. We have created a regression model that shows that a sustained and increased investment policy and the reduction of unemployment rate have a favorable effect on the objective of minimizing the budget deficit. In the last years European Union’s countries had to face a difficult problem concerning fiscal policy. They had to make public investments to stimulate economic growth and, in the same time, they had to meet the convergence criteria’s of public deficit. On the other hand, EU has to deal with a higher rate of unemployment. Through our model we try to see how European Union countries should implement their political strategies on unemployment and investment with the main objective of reducing the general government deficit.
Voluntaristic siting procedures for deep geological repositories are becoming increasingly common; they reconfigure the relationship of repositories and society in ways that have implications for the long-term governance of these facilities. This paper identifies three challenges emerging in relation to this question: principles of monitoring, repository content, and facility closure. This paper discusses them in a comparison with similar challenges being addressed in Belgian partnerships founded to facilitate the siting and design of a low- and intermediate level short lived waste repository. The empirical exploration confirms the importance of securing stakeholder engagement throughout the repository lifecycle, for which there is a need to develop knowledge about how to encourage long-term democratic governance systems.
Hendrik Marius Wessels
Full Text Available For any business to operate effectively, a governance framework that operates at the relevant maturity level is required. An organisational governance maturity framework is a tool that leadership can use to determine governance maturity. This study aims to determine whether the organisational governance maturity framework (developed by Wilkinson can be applied to the selected retail industry organisation to assess the maturity of the organisation’s governance, limited to the ‘leadership’ attribute. Firstly, a high-level literature review on ethical leadership, ethical decision-making, ethical foundation and culture (‘tone at the top’, and organisational governance and maturity was conducted. Secondly, a Johannesburg Stock Exchange (JSE listed South African-based company was selected for the empirical part of the study using a single case study research design. The empirical results confirmed that the organisational governance maturity framework can be used to determine the maturity level of organisational governance for the selected attribute of ‘leadership’
Hadley, Trevor R.; Goldman, Howard H.
to the seriously mentally ill. This is the expressed priority of government, advocates and providers, alike.These new entities could be created at either the purchaser or provider level or, as exists in a number of jurisdictions in the US, at both levels, where a single purchaser may be responsible for multiple consolidated providers. This combination is now the emerging model for innovative services in the US. In the UK, the development of a local mental health authority at the purchaser and/or provider level might be relatively simple. Although the creation of a statutory authority would require primary legislation and is therefore probably not a short-term solution, there appears to be a variety of administrative options that would have the same effect. IMPLICATIONS FOR HEALTH POLICY FORMULATION: The creation of a local mental health authority may be a necessary first step towards the development of a coordinated and comprehensive system of care. It seems likely that there is currently more "political" support for the development of a purchaser model but the development of a sophisticated purchsaer is also likely to take considerable time and effort. Although all the structural and policy problems of the mental health system in the UK will not all be solved by local mental health authorities, they may be beneficial if responsibility for mental illness care is to be centralized and fragmentation is to be reduced. Without making structural changes, the best efforts by clinicians, policymakers and managers are most likely to be in vain. Without a clear point of ultimate purchasing and service responsibility, the fragmentation and inefficiency of the current system will remain (Hadley et al., 1996).
Moradi Sheykhjan, Tohid
We all have mental health. Mental health relates to how we think, feel, behave and interact with other people. At its simplest, good mental health is the absence of a mental disorder or mental health problem. Adults, children and young people with good mental health are likely to have high levels of mental wellbeing. The World Health Organisation…
Chatfield , Akemi ,; Brajawidagda , Uuf
Part 2: Open Government Data and Transparency; International audience; Government transparency is critical to cut government bureaucracy and corruption, which diminish political accountability and legitimacy, erode trust in government, and hinder citizen engagement and government performance. Previously, Jakarta’s local governments lacked government transparency, holding high-level meetings under a close-door policy, sustaining a critical and fundamental flaw in policy-making and fueling gove...
Read, Ursula M; Adiibokah, Edward; Nyame, Solomon
The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mental illness and their families. This research forms part of a longitudinal anthropological study of people with severe mental illness in rural Ghana. Visits were made to over 40 households with a family member with mental illness, as well as churches, shrines, hospitals and clinics. Ethnographic methods included observation, conversation, semi-structured interviews and focus group discussions with people with mental illness, carers, healers, health workers and community members. Chaining and beating of the mentally ill was found to be commonplace in homes and treatment centres in the communities studied, as well as with-holding of food ('fasting'). However responses to mental illness were embedded within spiritual and moral perspectives and such treatment provoked little sanction at the local level. Families struggled to provide care for severely mentally ill relatives with very little support from formal health services. Psychiatric services were difficult to access, particularly in rural communities, and also seen to have limitations in their effectiveness. Traditional and faith healers remained highly popular despite the routine maltreatment of the mentally ill in their facilities. Efforts to promote the human rights of those with mental illness must engage with the experiences of mental illness within communities affected in order to grasp how these may underpin the use of practices such as mechanical
Elena S. Zinovieva
Full Text Available The article studies the processes of Internet governance at the international level in the context of the position and interests of Russia in this area. The theory of global governance was used as a theoretical and methodological framework of the study. Initially, Internet governance was carried out on the state level, with coordination carried out in the interests of the United States created the Internet. At the present stage states and other actors in world politics has to be integrated into the existing system of Internet governance, resulting in development of multi-level or multi-directional diplomacy, formation of the so-called "hybrid" organizations and new models of cooperation. There are new formats of regulation of international relations formed under the influence of scientific and technological progress. Russia's position on Internet governance is based on the goal to ensure equal consideration of interests of all states in the governance of the Internet.
Sørensen, Eva; Torfing, Jacob
This paper aims to take stock of the European debate on governance networks in order to assess whether or not it has succeeded to develop a new a viable paradigm based on clear concepts, sound theories and methods and an expansive research agenda. The political and institutional conditions...... for the emergence of the Europe governance debate are analyzed and the notions of ‘governance’ and ‘governance networks’ are critically examined and defined. A brief assessment of the empirical significance of governance networks at different levels of governing is followed by a presentation and comparison...... development, the European debate on governance networks provides a new and important paradigm for understanding the emerging forms of multilateral action and pluricentric governance....
Wellander, Lisa; Wells, Michael B; Feldman, Inna
In Sweden, the local government is responsible for funding schools in their district. One funding initiative is for schools to provide students with mental health problems with additional support via extra teachers, personal assistants, and special education classes. There are evidence-based preventive interventions delivered in schools, which have been shown to decrease the levels of students' mental health problems. However, little is known about how much the local government currently spends on students' mental health support and if evidence-based interventions could be financially beneficial. The aim of this study was to estimate the costs of providing additional support for students' mental health problems and the potential cost-offsets, defined as reduced school-based additional support, if two evidence-based school interventions targeting children's mental health problems were implemented in routine practice. This study uses data on the additional support students with mental health problems received in schools. Data was collected from one school district for students aged 6 to 16 years. We modeled two Swedish school interventions, Comet for Teachers and Social and Emotional Training (SET), which both had evidence of reducing mental health problems. We used a cost-offset analysis framework, assuming both interventions were fully implemented throughout the whole school district. Based on the published studies, the expected effects and the costs of the interventions were calculated. We defined the cost-offsets as the amount of predicted averted additional support for students with ongoing mental health problems who might no longer require receiving services such as one-on-one time with an extra teacher, a personal assistant, or to be placed in a special education classroom. A cost-offset analysis, from a payer's perspective (the local government responsible for school financing), was conducted comparing the costs of both interventions with the potential cost
The present study was conducted to find the relation of Mental Health of Adolescents with their Emotional Maturity and Parent Child Relationship. The sample comprised of 200 9th class adolescents (100 boys and 100 girls) from Government Secondary Schools of Moga district The data was obtained by using Emotional Maturity Scale (2011) by Singh and Bhargava, Parent Child Relationship Scale (2011) by Rao and Mental Health Battery (2012) by Singh and Gupta. The results of the study showed positive...
Joshi, Nayan Krishna
This paper examines the impact of local (county-level) house prices on individual self-reported mental health using individual level data from the United States Behavioral Risk Factor Surveillance System between 2005 and 2011. Exploiting a fixed-effects model that relies on within-county variations, relative to the corresponding changes in other counties, I find that while individuals are likely to experience worse self-reported mental health when local house prices decline, this association is most pronounced for individuals who are least likely to be homeowners. This finding is not consistent with a prediction from a pure wealth mechanism but rather with the hypothesis that house prices act as an economic barometer. I also demonstrate that the association between self-reported mental health and local house prices is not driven by unemployment or foreclosure. The primary result-that lower local house prices have adverse impact on self-reported mental health of homeowners and renters-is consistent with studies using data from the United Kingdom.
Jaradat, Y M; Nielsen, M B; Kristensen, P; Bast-Pettersen, R
Associations between shift work (SW) schedules, mental distress and job satisfaction have never been completely described. To examine gender-specific associations of SW with mental distress and job satisfaction in nurses in Hebron District, Palestine, in 2012. Detailed information on work schedules (day versus shift), socio-demographic status, mental distress (General Health Questionnaire, GHQ-30) and job satisfaction (Generic Job Satisfaction Scale) in nurses employed in Hebron District, Palestine, was obtained through a questionnaire survey. Associations of SW and outcomes were examined by linear regression analysis. Of 372 nurses eligible for the study, 309 and 338 completed surveys regarding mental distress and job satisfaction, respectively. The sample comprised 62% women and 38% men. After adjusting for covariates, women working shifts reported significantly higher levels of mean mental distress [β coefficient 3.6; 95% confidence interval (CI) 0.3-7.0] compared with women working regular day shifts. Men working shifts reported significantly lower levels of job satisfaction (-3.3; 95% CI -6.2 to -0.5) than men working regular day shifts. Women reported higher levels of mental distress than men, but this was unrelated to work schedule. In this study, nurses working shifts reported higher levels of mental distress and lower levels of job satisfaction, although these associations were weaker when adjusted for potential covariates. There was no evidence of a gender differential in the association between SW and mental distress and job satisfaction. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine.
Full Text Available Backround: The presence, upbringing and looking after of a mentally retarded child in the family, can become a threat to the mental health of its parents and is the main predisposing factor of stress for the parents.Aim: The purpose of this systematic review is (a to document the contemporary research bibliography related to the stress of parents with mentally retarded children, (b to aggregate the factors and secondary parameters based on the contemporary research related to the influence of the (child’s mental retardation on the parents and (c to show an intercultural aspect regarding the presence of stress to parents with mentally retarded children.Methods: Systematic review of research articles published in scientific journals included in the international academic databases HEAL-LING, SAGE, ELSEVIER, WILSON, SCIENCEDIRECT, MEDLINE, PUBMED, PsycINFO, Cochrane, EMBASE, SCIRUS and CINAHL having as search criteria and key words the terms («parental stress and mental retardation» [MeSH], «parenting stress and persons with special needs» [MeSH], «mental retardation and family problems» [MeSH], «stress and parents» [MeSH], «parenting and stress» [MeSH], «mental delay and parents» [MeSH], «developmental disabilities and family stress» [MeSH], «intellectual handicap and parenting» [MeSH], «maternal stress and child with disabilities» [MeSH].Discussion: The review has proven that all forms of mental retardation have an important -from a statistic point of viewimpacton the parents’ mental health. Anxiety, stress and depression are common symptoms mentioned by the parents.Additionally, there are individual variables such as the husband-wife relationship, the parents’ approach to their child’s disability, the parental strategies used in order to cope with the daily life of the child’s disability and the behavioural problems of their child, all of which contribute to the increase of the level of parental stress
Groundwater governance provisions and arrangements in South Africa were studied at national level and at local level for a highly productive aquifer, the Botleng Dolomite Aquifer. Technical, legal, institutional and operational governance provisions were found to be reasonable at the national level but weak with regards to ...
Blegen, Nina Elisabeth; Severinsson, Elisabeth
Mental health nurses are agents of change, and their leadership, management role and characteristics exist at many levels in health care. Previous research presents a picture of mental health nurses as subordinate and passive recipients of the leader's influence and regard leadership and management as distinct from the nurses' practical work. The aim was to provide a synthesis of the studies conducted and to discuss the relationship between nursing leadership and nursing management in the context of mental health nursing. A literature search was conducted using EBSCO-host, Academic Search Premier, Science Direct, CINAHL and PubMed for the period January 1995-July 2010. Leadership and management in the context of mental health nursing are human activities that imply entering into mutual relationships. Mental health nurses' leadership, management and transformational leadership are positively related in terms of effectiveness and nurses' skills. It is important to consider mental health nurses' management as a form of leadership similar to or as a natural consequence of transformational leadership (TL) and that ethical concerns must be constantly prioritized throughout every level of the organization. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.
Zhang, Xindi; Warren, Jim; Corter, Arden; Goodyear-Smith, Felicity
This paper describes development of a prototype data analytics portal for analysis of accumulated screening results from eCHAT (electronic Case-finding and Help Assessment Tool). eCHAT allows individuals to conduct a self-administered lifestyle and mental health screening assessment, with usage to date chiefly in the context of primary care waiting rooms. The intention is for wide roll-out to primary care clinics, including secondary school based clinics, resulting in the accumulation of population-level data. Data from a field trial of eCHAT with sexual health questions tailored to youth were used to support design of a data analytics portal for population-level data. The design process included user personas and scenarios, screen prototyping and a simulator for generating large-scale data sets. The prototype demonstrates the promise of wide-scale self-administered screening data to support a range of users including practice managers, clinical directors and health policy analysts.
Mahoney, John W; Gucciardi, Daniel F; Ntoumanis, Nikos; Mallett, Cliff J; Mallet, Cliff J
We argue that basic psychological needs theory (BPNT) offers impetus to the value of mental toughness as a mechanism for optimizing human functioning. We hypothesized that psychological needs satisfaction (thwarting) would be associated with higher (lower) levels of mental toughness, positive affect, and performance and lower (higher) levels of negative affect. We also expected that mental toughness would be associated with higher levels of positive affect and performance and lower levels of negative affect. Further, we predicted that coaching environments would be related to mental toughness indirectly through psychological needs and that psychological needs would indirectly relate with performance and affect through mental toughness. Adolescent cross-country runners (136 male and 85 female, M(age) = 14.36) completed questionnaires pertaining to BPNT variables, mental toughness, and affect. Race times were also collected. Our findings supported our hypotheses. We concluded that BPNT is generative in understanding some of the antecedents and consequences of mental toughness and is a novel framework useful for understanding mental toughness.
Laura Helena Andrade
Full Text Available BACKGROUND: World population growth is projected to be concentrated in megacities, with increases in social inequality and urbanization-associated stress. São Paulo Metropolitan Area (SPMA provides a forewarning of the burden of mental disorders in urban settings in developing world. The aim of this study is to estimate prevalence, severity, and treatment of recently active DSM-IV mental disorders. We examined socio-demographic correlates, aspects of urban living such as internal migration, exposure to violence, and neighborhood-level social deprivation with 12-month mental disorders. METHODS AND RESULTS: A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face using the WHO Composite International Diagnostic Interview (CIDI, to generate diagnoses of DSM-IV mental disorders within 12 months of interview, disorder severity, and treatment. Administrative data on neighborhood social deprivation were gathered. Multiple logistic regression was used to evaluate individual and contextual correlates of disorders, severity, and treatment. Around thirty percent of respondents reported a 12-month disorder, with an even distribution across severity levels. Anxiety disorders were the most common disorders (affecting 19.9%, followed by mood (11%, impulse-control (4.3%, and substance use (3.6% disorders. Exposure to crime was associated with all four types of disorder. Migrants had low prevalence of all four types compared to stable residents. High urbanicity was associated with impulse-control disorders and high social deprivation with substance use disorders. Vulnerable subgroups were observed: women and migrant men living in most deprived areas. Only one-third of serious cases had received treatment in the previous year. DISCUSSION: Adults living in São Paulo megacity had prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world. Integration of mental health promotion
This study was designed to determine the extent to which poverty, gender stereotype, socio-cultural belief and lack of awareness influence low level of women participation in literacy programme in Maiha Local Government Area of Adamawa State. Survey designed was adopted for the study and a sample consisting of three hundred (300) women who were…
Zuo, Li-Jun; Yu, Shu-Yang; Hu, Yang; Wang, Fang; Piao, Ying-Shan; Lian, Teng-Hong; Yu, Qiu-Jin; Wang, Rui-Dan; Li, Li-Xia; Guo, Peng; Du, Yang; Zhu, Rong-Yan; Jin, Zhao; Wang, Ya-Jie; Wang, Xiao-Min; Chan, Piu; Chen, Sheng-Di; Wang, Yong-Jun; Zhang, Wei
Fatigue is a very common non-motor symptom in Parkinson disease (PD) patients. It included physical fatigue and mental fatigue. The potential mechanisms of mental fatigue involving serotonergic dysfunction and abnormal iron metabolism are still unknown. Therefore, we evaluated the fatigue symptoms, classified PD patients into fatigue group and non-fatigue group, and detected the levels of serotonin, iron and related proteins in CSF and serum. In CSF, 5-HT level is significantly decreased and the levels of iron and transferrin are dramatically increased in fatigue group. In fatigue group, mental fatigue score is negatively correlated with 5-HT level in CSF, and positively correlated with the scores of depression and excessive daytime sleepiness, and disease duration, also, mental fatigue is positively correlated with the levels of iron and transferrin in CSF. Transferrin level is negatively correlated with 5-HT level in CSF. In serum, the levels of 5-HT and transferrin are markedly decreased in fatigue group; mental fatigue score exhibits a negative correlation with 5-HT level. Thus serotonin dysfunction in both central and peripheral systems may be correlated with mental fatigue through abnormal iron metabolism. Depression, excessive daytime sleepiness and disease duration were the risk factors for mental fatigue of PD.
Teismann, Tobias; Brailovskaia, Julia; Siegmann, Paula; Nyhuis, Peter; Wolter, Marcus; Willutzki, Ulrike
Positive and negative mental health are independent but correlated concepts. Yet, it is unknown whether positive mental health does co-occur with suicide ideation. The present study aimed to determine the proportion of patients who have positive mental health as well as suicide ideation. Inpatients (N=100) and outpatients (N=182) completed self-report measures of positive mental health, suicide ideation and lifetime suicide attempts. Eleven outpatients (6%) and ten inpatients (10%) with suicide ideation reported moderate to high levels of positive mental health. Lifetime suicide attempts were less likely in inpatients who suffered from suicide ideation in the presence of positive mental health. Positive mental health does co-occur with suicide ideation and should be considered as a protective factor in suicide risk assessments. Copyright © 2017 Elsevier B.V. All rights reserved.
Aghukwa Nkereuwem Chikaodiri
Full Text Available A few months from the time of this survey, the nearly completed inpatient psychiatric facility within the Aminu Kano Teaching Hospital’s complex would be ready for admissions. Understanding the health workers’ level of experience of mental illness and their likely behavioural responses towards people with psychiatric illness, therefore, should be a good baseline to understanding their likely reactions towards admitting such patients within a general hospital setting. The study, which used a pre-tested and adapted attribution questionnaire, was prospective and cross-sectional. Randomly selected health workers in Aminu Kano Teaching Hospital had their level of familiarity and attributions towards psychiatric patients assessed. The respondents showed a high level of experience with mental illness, with more than 3 in 5 of them having watched movies on mental illness before. More than half of them held positive (favorable attributions towards persons with mental illness on nine of the ten assessed attribution factors. Almost all held negative (unfavourable opinion towards intimate relationships with such persons. Attribution factors, “Responsibility, “Anger”, “Dangerousness”, “Fear” and “Segregation” were significantly related to the respondents’ level of education (P less than 0.05. Marital status of the respondents related significantly to “Pity” and “Avoidance” factors (P less than 0.05. Having watched movies on mental illness significantly related to “Responsibility” and “Fear” factors (P less than 0.05. Programs designed to improve the health workers mental health literacy, and increased positive professional contacts with mentally ill persons on treatment, would further enhance their perceived positive attributions towards them.
Full Text Available The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981–97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986–96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994–98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998–2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000–2003, in
The current study aimed to measure the stress levels of family caregivers of individuals with mental illness and compare their stress levels according to the diagnosis and other sociodemographic characteristics. The sample comprised 310 family caregivers of individuals with mental illness in Jordan. Family caregivers completed a demographic checklist and the Arabic version of the Perceived Stress Scale 10-Item (PSS-10) questionnaire. A significant difference was found in PSS-10 levels among family caregivers according to gender, diagnosis of their family member, and time since diagnosis. Female caregivers reported significantly higher stress levels than male caregivers. Family members of individuals with schizophrenia reported the highest stress levels (p family caregivers and time since diagnosis. Investigating stress levels in family members of individuals with mental illness may be helpful when designing interventions to reduce such stress. [Journal of Psychosocial Nursing and Mental Health Services, 55(6), 30-35.]. Copyright 2017, SLACK Incorporated.
was delegated at the local level. The local authorities have been transferred some resources to implement it. So the system of local budgets was build. The most successful period of the local govern-ment activity accounts for 1920s. The city and district are considered as the territorial foundation of local government. Scientific field formed that studies the feature of local govern-ment in the Soviet conditions.In the 1930s, there is centralization of government. The development of the city is subject to problems of industrialization and development of the rural areas is subject to problems of collectivization. The state policy does not consider the interests of local communities.The liberalization of the political regime in the late 1950s has led to a revival of the idea of decentralization. But decentralization of government is considered solely as an economic rather than a social and political problem. This understanding persisted until the end of the Soviet period.The lack of stable historical tradition of local government negatively affects the municipal development of the Russian Federation.
Forsman, Anna K; Fredén, Lars; Lindqvist, Rafael; Wahlbeck, Kristian
The field of public mental health has been defined by an expert group convened by the Nordic School of Public Health (NHV) as encompassing the experience, occurrence, distribution and trajectories of positive mental health and mental health problems and their determinants; mental health promotion and prevention of mental disorders; as well as mental health system policies, governance and organization. The mental health priorities of the Nordic Council of Ministers in 2010 signalled a mutual Nordic exchange of knowledge in the following thematic areas: child and adolescent mental health; working life and mental health; mental health in older people; strengthening the role of primary care in mental health service provision; stronger involvement of users and carers; and reduction of use of coercion in psychiatric care. Efforts to realize these priorities included commissioning the Nordic Research Academy for Mental Health, an NHV-based network of research institutions with a common interest in mental health research across the Nordic countries, to develop, organize and follow-up projects on public mental health. The research initiatives included mental health policy analysis, register-based research and research focused on the users' perspective in a Nordic context, as well as EU-level research policy analysis. The public mental health research conducted at the NHV highlighted the complexity of mental health and emphasized that the broad determinants of mental health need to be increasingly addressed in both public health research and practice. For example, health promotion actions, improved access to health care, a healthy alcohol policy and prevention of suicides and violence are all needed to reduce the life expectancy gap - a red flag indicator of public health inequalities. By exchanging knowledge and best practice, the collaboration between the Nordic countries contributes to the welfare of the region. The expertise and traditions developed at the NHV are of
Knieling, Joerg [HafenCity Univ. Hamburg (Germany). Urban Planning and Regional Development; Leal Filho, Walter (eds.) [HAW Hamburg (Germany). Research and Transfer Centre Applications of Life Science
Climate change is a cause for concern both globally and locally. In order for it to be tackled holistically, its governance is an important topic needing scientific and practical consideration. Climate change governance is an emerging area, and one which is closely related to state and public administrative systems and the behaviour of private actors, including the business sector, as well as the civil society and non-governmental organisations. Questions of climate change governance deal both with mitigation and adaptation whilst at the same time trying to devise effective ways of managing the consequences of these measures across the different sectors. Many books have been produced on general matters related to climate change, such as climate modelling, temperature variations, sea level rise, but, to date, very few publications have addressed the political, economic and social elements of climate change and their links with governance. This book will address this gap. Furthermore, a particular feature of this book is that it not only presents different perspectives on climate change governance, but it also introduces theoretical approaches and brings these together with practical examples which show how main principles may be implemented in practice.
Nishida, Atsushi; Richards, Marcus; Stafford, Mai
Mental health problems in adolescence are predictive of future mental distress and psychopathology; however, few studies investigated adolescent mental health problems in relation to future mental wellbeing and none with follow-up to older age. To test prospective associations between adolescent mental health problems and mental wellbeing and life satisfaction in early old age. A total of 1561 men and women were drawn from the Medical Research Council National Survey of Health and Development (the British 1946 birth cohort). Teachers had previously completed rating scales to assess emotional adjustment and behaviours, which allowed us to extract factors of mental health problems measuring self-organisation, behavioural problems, and emotional problems during adolescence. Between the ages of 60-64 years, mental wellbeing was assessed using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and life satisfaction was self-reported using the Satisfaction with Life Scale (SWLS). After controlling for gender, social class of origin, childhood cognitive ability, and educational attainment, adolescent emotional problems were independently inversely associated with mental wellbeing and with life satisfaction. Symptoms of anxiety/depression at 60-64 years explained the association with life satisfaction but not with mental wellbeing. Associations between adolescent self-organisation and conduct problems and mental wellbeing and life satisfaction were of negligible magnitude, but higher childhood cognitive ability significantly predicted poor life satisfaction in early old age. Adolescent self-organisation and conduct problems may not be predictive of future mental wellbeing and life satisfaction. Adolescent emotional problems may be inversely associated with future wellbeing, and may be associated with lower levels of future life satisfaction through symptoms of anxiety/depression in early old age. Initiatives to prevent and treat emotional problems in adolescence may
Buffel, Veerle; van de Straat, Vera; Bracke, Piet
Framed within the recent economic crisis, in this study we investigate the medical mental health care use of the unemployed compared with that of the employed in Europe, and whether the relationship between employment status and mental health care use varies across macro-economic conditions. We examine whether the macro-economic context and changes therein are related to mental health care use, via their impact on mental health, or more directly, irrespective of mental health. We use data from three waves of the Eurobarometer (2002, 2005/2006, and 2010), which has a repeated cross-sectional and cross-national design. Linear and logistic multilevel regression analyses are performed with mental health, contacting a general practitioner, and contacting a psychiatrist for mental health problems as dependent variables. The multilevel design has three levels (the individual, the period-country, and the country), which allows us to estimate both longitudinal and cross-sectional macro-effects. The macro-economic context and changes therein are assessed using national unemployment rates and growth rates in Gross Domestic Product (GDP). The mean unemployment rate is negatively related to mental health, although for women, this effect only applies to the employed. Among women, no relationship is found between changes in the macro-economic context and mental health. The unemployment rate, and changes in both the unemployment rate and the real GDP growth rate, are associated with men's care use, regardless of their mental health, whereas this does not hold for women. In countries with an increase in the unemployment rate, both unemployed and employed men tend to medicalize their problems more by contacting a general practitioner, irrespective of their mental health, while the likelihood of contacting a psychiatrist is lower among employed men. Our findings stress the importance of taking the macro-economic context and changes therein into account when studying the mental health
Toyama, Mauricio; Castillo, Humberto; Galea, Jerome T.; Brandt, Lena R.; Mendoza, María; Herrera, Vanessa; Mitrani, Martha; Cutipé, Yuri; Cavero, Victoria; Diez-Canseco, Francisco; Miranda, J. Jaime
Background: Mental, neurological, and substance (MNS) use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods: Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results: Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion: Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru has achieved a
Full Text Available Background Mental, neurological, and substance (MNS use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru
Sakai, Christina; Mackie, Thomas I; Shetgiri, Rashmi; Franzen, Sara; Partap, Anu; Flores, Glenn; Leslie, Laurel K
To examine the perspectives of youth on factors that influence mental health service use after aging out of foster care. Focus groups were conducted with youth with a history of mental health needs and previous service use who had aged out of foster care. Questions were informed by the Health Belief Model and addressed 4 domains: youth perceptions of the "threat of mental health problems," treatment benefits versus barriers to accessing mental health services, self-efficacy, and "cues to action." Data were analyzed using a modified grounded-theory approach. Youth (N = 28) reported ongoing mental health problems affecting their functioning; however, they articulated variable levels of reliance on formal mental health treatment versus their own ability to resolve these problems without treatment. Past mental health service experiences influenced whether youth viewed treatment options as beneficial. Youth identified limited self-efficacy and insufficient psychosocial supports "cueing action" during their transition out of foster care. Barriers to accessing mental health services included difficulties obtaining health insurance, finding a mental health provider, scheduling appointments, and transportation. Youths' perceptions of their mental health needs, self-efficacy, psychosocial supports during transition, and access barriers influence mental health service use after aging out of foster care. Results suggest that strategies are needed to 1) help youth and clinicians negotiate shared understanding of mental health treatment needs and options, 2) incorporate mental health into transition planning, and 3) address insurance and other systemic barriers to accessing mental health services after aging out of foster care. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Full Text Available This article examines common barriers to achieving adequate levels of forest resource governance in countries of Latin America. It looks at the deficiencies of the policy and regulatory frameworks affecting forests, the common failure to impose the rule of law, the main factors that constrain the effectiveness of government actions in the forest sector and at the political barriers to introducing reforms for change in governance structures. The elimination of these barriers acquires new importance in the implementation of successful REDD+ programs in the countries of the region.
Pyone, Thidar; Smith, Helen; van den Broek, Nynke
Governance of the health system is a relatively new concept and there are gaps in understanding what health system governance is and how it could be assessed. We conducted a systematic review of the literature to describe the concept of governance and the theories underpinning as applied to health systems; and to identify which frameworks are available and have been applied to assess health systems governance. Frameworks were reviewed to understand how the principles of governance might be operationalized at different levels of a health system. Electronic databases and web portals of international institutions concerned with governance were searched for publications in English for the period January 1994 to February 2016. Sixteen frameworks developed to assess governance in the health system were identified and are described. Of these, six frameworks were developed based on theories from new institutional economics; three are primarily informed by political science and public management disciplines; three arise from the development literature and four use multidisciplinary approaches. Only five of the identified frameworks have been applied. These used the principal-agent theory, theory of common pool resources, North's institutional analysis and the cybernetics theory. Governance is a practice, dependent on arrangements set at political or national level, but which needs to be operationalized by individuals at lower levels in the health system; multi-level frameworks acknowledge this. Three frameworks were used to assess governance at all levels of the health system. Health system governance is complex and difficult to assess; the concept of governance originates from different disciplines and is multidimensional. There is a need to validate and apply existing frameworks and share lessons learnt regarding which frameworks work well in which settings. A comprehensive assessment of governance could enable policy makers to prioritize solutions for problems identified
Full Text Available Abstract Background The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mental illness and their families. Methods This research forms part of a longitudinal anthropological study of people with severe mental illness in rural Ghana. Visits were made to over 40 households with a family member with mental illness, as well as churches, shrines, hospitals and clinics. Ethnographic methods included observation, conversation, semi-structured interviews and focus group discussions with people with mental illness, carers, healers, health workers and community members. Results Chaining and beating of the mentally ill was found to be commonplace in homes and treatment centres in the communities studied, as well as with-holding of food ('fasting'. However responses to mental illness were embedded within spiritual and moral perspectives and such treatment provoked little sanction at the local level. Families struggled to provide care for severely mentally ill relatives with very little support from formal health services. Psychiatric services were difficult to access, particularly in rural communities, and also seen to have limitations in their effectiveness. Traditional and faith healers remained highly popular despite the routine maltreatment of the mentally ill in their facilities. Conclusion Efforts to promote the human rights of those with mental illness must engage with the experiences of mental illness within communities affected in order to
Maycraft Kall, Wendy
This article analyzed the apparent paradox of disability rights in Sweden. Despite strong welfare state traditions and stated Government ambitions to create generous statutory entitlements for all disabled people using a single, comprehensive Disability Act, psychiatric disabilities were principally excluded from the Disability Act's rights and provisions. The study focused on Sweden's Mental Health Reform and Disability Reform using governance perspectives that traced and analyzed the policy-processes of both reforms. Theoretically guided analytical frameworks were developed to help understand the divergent reform outcomes. The first focused on legislative arguments of regulatory specificity and legal enforcement mechanisms to consider whether the Disability Act was formulated in a manner that was easier to apply to certain disabilities. The second analyzed ideological arguments and the influence of Government political beliefs that signaled specific reform 'visions' to implementers and thereby influenced policy implementation. The main findings are that both perspectives matter as the dual influences of legislative and ideological differences tended to exclude mental health service users from the Act's generous disability rights. The overall conclusion was that while legislation was an important regulatory mechanism, the Government's underlying ideological reform vision was also an essential governance instrument that signaled Government intentions to implementing agencies and thus influenced the creation of enduring disability rights. Copyright © 2014 Elsevier Ltd. All rights reserved.
Full Text Available Background. There is a lack of studies assessing the profile and outcome of psychiatric patients at entry-level public hospitals that are prescribed by the Mental Health Care Act to provide a decentralised model of psychiatric care. Objective. To assess the demographic and clinical profile as well as length of stay and outcomes of mental healthcare users admitted to a district-level public hospital in the Western Cape. Method. Demographic data, clinical diagnosis, length of stay, referral profile and outcomes of patients (N=487 admitted to Helderberg Hospital during the period 1 January 2011 - 31 December 2011 were collected. Results. Psychotic disorders were the most prevalent (n=287, 59% diagnoses, while 228 (47% of admission episodes had comorbid/secondary diagnoses. Substance use disorders were present in 184 (38% of admission episodes, 37 (57% of readmissions and 19 (61% of abscondments. Most admission episodes (n=372, 76% were discharged without referral to specialist/tertiary care. Conclusion. Methamphetamine use places a significant burden on the provision of mental healthcare services at entry-level care. Recommendations for improving service delivery at this district-level public hospital are provided.
Spagnolo, Jessica; Champagne, François; Leduc, Nicole; Piat, Myra; Melki, Wahid; Charfi, Fatma; Laporta, Marc
In low- and middle-income countries (LMICs), addressing the high prevalence of mental disorders is a challenge given the limited number and unequal distribution of specialists, as well as scarce resources allocated to mental health. The Mental Health Gap Action Programme (mhGAP) and its accompanying Intervention Guide (IG), developed by the World Health Organization (WHO), aim to address this challenge by training non-specialists such as general practitioners (GPs) in mental health care. This trial aims to implement and evaluate an adapted version of the mhGAP-IG (version 1.0) offered to GPs in 2 governorates of Tunisia (i.e., Tunis and Sousse), in order to uncover important information regarding implementation process and study design before country-wide implementation and evaluation. First, a systematic review will be conducted to explore types and effectiveness of mental health training programs offered to GPs around the world, with a specific focus on programs implemented and evaluated in LMICs. Second, a cluster randomized controlled trial (RCT) will be conducted to evaluate the effectiveness of the implemented training based on the mhGAP-IG (version 1.0). Third, multiple case study design will be used to explore how contextual factors impact the successful implementation of the training and desired outcomes. In Tunisia, an important need exists to further develop proximity health services and to address the growing mental health treatment gap. One solution is to train GPs in the detection, treatment, and management of mental health problems, given their strategic role in the healthcare system. This trial thus aims to implement and evaluate an adapted version of a training based on the mhGAP-IG (version 1.0) in Tunis and Sousse before country-wide implementation and evaluation. Several contributions are envisioned: adding to the growing evidence on the mhGAP and its accompanying guide, especially in French-speaking nations; building research capacity in
Sergey Sergeevich Shirin
Full Text Available The article is devoted to the research of Russian initiatives concerning its participation in international system of Internet governance. In the research, conceptual and theoretic basis for participation of state governments in Internet governance is given, academic discourse of this issue is assessed, the review of main Russian initiatives made from 2005 (since the second stage of the World Summit on Information Society till the present day is carried out. The conclusion is made that the most successful Internet governance initiative of Russia is the implementation of cyrillic top level domains. Much less successful are Russian attempts to reconstruct existing organizational structure of Internet governance. Russian policy is assessed as a policy of preferring loud statements and PR rather than real influence on development of Internet technologies. Russia consideres Internet as political resource and tries to increase its influence on decision making process on a political, not operational level of Internet governance. The author states that federal government of the United States of America has fully lost the control on the domain name systems. These functions are going to be given to the private sector, while ICANN, which was established according to the Memorandum of Understanding/Joint Project Agreement with U.S. Department of Commerce, is becoming a truly independent international organization. Considering this, the author comes to the conclusion that political transformations for the sake of Russia are already made. He also forecast that next initiatives of Russia will be directed to the segmentation of the Internet.
Doré, Isabelle; Caron, Jean
Objectives This article aims to situate the concept of mental health in a historical perspective. This article presents the most commonly used measurement tools in Canada and elsewhere in the world to assess specific and multiple dimensions of mental health; when available, psychometric properties are discussed. Finally, research findings on quality of life and mental health determinants are presented.Methods A literature review of concepts, measurement and determinants of mental health is presented in this paper. The selection of measurement scales presented is based on the findings of the research reports conducted by the second author, an expert on mental health measures, for Health Canada and Statistics Canada.Results Mental health is more than the absence of mental illness; rather it is a state of complete well-being, which refers to our ability to enjoy life and deal with the challenges we face. Accordingly, mental health and mental illness are not extremes of the same continuum, but distinct yet correlated concepts. The traditional conceptualization suggesting that mental health represents simply the absence of mental illness has been replaced, in the last few decades, by a more holistic characterization, which directly concerns public health. The components of mental health include emotional well-being/quality of life (QOL) and psychological and social well-being. Mental health influences the personal and social functioning of individuals, justifying the importance of intervening upstream to promote mental health. Specific scales are relevant for obtaining a detailed measure of one aspect of well-being in particular (emotional/quality of life, psychological or social well-being); however, to account for the global mental health status, measurement tools that integrate all three forms of well-being (emotional, psychological and social) should be privileged. A diversity of determinants at the individual, social and neighbourhood levels influence quality of
Padt, F.; Opdam, P.F.M.; Polman, N.B.P.; Termeer, C.J.A.M.
Sensitivity to scales is one of the key challenges in environmental governance. Climate change, food production, energy supply, and natural resource management are examples of environmental challenges that stretch across scales and require action at multiple levels. Governance systems are typically
Full Text Available Social governance of the grassroots is the foundation for maintaining social stability and building a harmonious society. The obvious problems of weakened power, abnormal petitioning, hidden danger of social security, weakness of virtual social control, and vacancy in management of the special group in the vast grassroots area did exist. Faced with the problems, the rapid development of urbanization and the relative lack of public service, the public’s strengthened consciousness of rights safeguarding and not sound interests safeguard mechanism, heavy tasks on social governance of the grassroots and not enough resources, and the imbalance between the public’s improved expectation and the ability of the cadres in grass-root level, the level of grass-roots social governance needs to be improved by employing the “five-in-one” thinking mode of governance by law.
Kotera, Yasuhiro; Adhikari, Prateek; Van Gordon, William
The primary purposes of this study were to (i) assess levels of different types of work motivation in a sample of UK hospitality workers and make a cross-cultural comparison with Chinese counterparts and (ii) identify how work motivation and shame-based attitudes towards mental health explain the variance in mental health problems in UK hospitality workers. One hundred three UK hospitality workers completed self-report measures, and correlation and multiple regression analyses were conducted to identify significant relationships. Findings demonstrate that internal and external motivation levels were higher in UK versus Chinese hospitality workers. Furthermore, external motivation was more significantly associated with shame and mental health problems compared to internal motivation. Motivation accounted for 34-50% of mental health problems. This is the first study to explore the relationship between motivation, shame, and mental health in UK hospitality workers. Findings suggest that augmenting internal motivation may be a novel means of addressing mental health problems in this worker population.
Ott, J. C.
There are substantial differences in happiness in nations. Average happiness on scale 0-10 ranges in 2006 from 3.24 in Togo to 8.00 in Denmark and the inequality of happiness, as measured by the standard deviation, ranges from 0.85 in Laos to 3.02 in the Dominican Republic. Much of these differences are due to quality of governance and in…
Andrade, Laura Helena; Wang, Yuan-Pang; Andreoni, Solange; Silveira, Camila Magalhães; Alexandrino-Silva, Clovis; Siu, Erica Rosanna; Nishimura, Raphael; Anthony, James C.; Gattaz, Wagner Farid; Kessler, Ronald C.; Viana, Maria Carmen
Background World population growth is projected to be concentrated in megacities, with increases in social inequality and urbanization-associated stress. São Paulo Metropolitan Area (SPMA) provides a forewarning of the burden of mental disorders in urban settings in developing world. The aim of this study is to estimate prevalence, severity, and treatment of recently active DSM-IV mental disorders. We examined socio-demographic correlates, aspects of urban living such as internal migration, exposure to violence, and neighborhood-level social deprivation with 12-month mental disorders. Methods and Results A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face using the WHO Composite International Diagnostic Interview (CIDI), to generate diagnoses of DSM-IV mental disorders within 12 months of interview, disorder severity, and treatment. Administrative data on neighborhood social deprivation were gathered. Multiple logistic regression was used to evaluate individual and contextual correlates of disorders, severity, and treatment. Around thirty percent of respondents reported a 12-month disorder, with an even distribution across severity levels. Anxiety disorders were the most common disorders (affecting 19.9%), followed by mood (11%), impulse-control (4.3%), and substance use (3.6%) disorders. Exposure to crime was associated with all four types of disorder. Migrants had low prevalence of all four types compared to stable residents. High urbanicity was associated with impulse-control disorders and high social deprivation with substance use disorders. Vulnerable subgroups were observed: women and migrant men living in most deprived areas. Only one-third of serious cases had received treatment in the previous year. Discussion Adults living in São Paulo megacity had prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world. Integration of mental health promotion and care into the
Full Text Available The continuous development of the new IT technologies was followed up by a rapid integration of them at the organization level. The management of the organizations face a new challenge: structural redefinition of the IT component in order to create plus value and to minimize IT risks through an efficient management of all IT resources of the organization. These changes have had a great impact on the governance of the IT component. The paper proposes an audit methodology of the IT Governance at the organization level. From this point of view the developed audit strategy is a strategy based on risks to enable IT auditor to study from the best angle efficiency and effectiveness of the IT Governance structure. The evaluation of the risks associated with IT Governance is a key process in planning the audit mission which will allow the identification of the segments with increased risks. With now ambition for completeness, the proposed methodology provides the auditor a useful tool in the accomplishment of his mission.
Herzog, Thomas R.; Hayes, Lauren J.; Applin, Rebecca C.; Weatherly, Anna M.
A straightforward prediction from attention restoration theory is that the level of incompatibility in a person's life should be positively correlated with that person's level of mental (or directed attention) fatigue. The authors tested this prediction by developing a new self-report measure of incompatibility in which they attempted to isolate…
Adesoji A. ONI
Full Text Available The study investigated the views and perception of school leavers about the democratic government in Nigeria. A self-designed questionnaire was used for collection of their views. The participants of the study comprised 500 school leavers selected across different working places in the six states of Southwest Nigeria. Results clearly revealed that majority of the respondents are not satisfied with the current performance of the present democratic Government in Nigeria. Most of the respondents suggested participation of everyone in the act of governance that favor rule of law, equality, and freedom and that this should be adopted by the government. The researcher therefore recommended a democratic system of government that will incorporate all the basic principles of democracy into the system of government, while marginalization and neglect of the poor, women, youth, and rural dwellers should be avoided.
Daniel J. Erchick
Full Text Available Background Routine immunization coverage in Nigeria has remained low, and studies have identified a lack of accountability as a barrier to high performance in the immunization system. Accountability lies at the heart of various health systems strengthening efforts recently launched in Nigeria, including those related to immunization. Our aim was to understand the views of health officials on the accountability challenges hindering immunization service delivery at various levels of government. Methods A semi-structured questionnaire was used to interview immunization and primary healthcare (PHC officials from national, state, local, and health facility levels in Niger State in north central Nigeria. Individuals were selected to represent a range of roles and responsibilities in the immunization system. The questionnaire explored concepts related to internal accountability using a framework that organizes accountability into three axes based upon how they drive change in the health system. Results Respondents highlighted accountability challenges across multiple components of the immunization system, including vaccine availability, financing, logistics, human resources, and data management. A major focus was the lack of clear roles and responsibilities both within institutions and between levels of government. Delays in funding, especially at lower levels of government, disrupted service delivery. Supervision occurred less frequently than necessary, and the limited decision space of managers prevented problems from being resolved. Motivation was affected by the inability of officials to fulfill their responsibilities. Officials posited numerous suggestions to improve accountability, including clarifying roles and responsibilities, ensuring timely release of funding, and formalizing processes for supervision, problem solving, and data reporting. Conclusion Weak accountability presents a significant barrier to performance of the routine immunization
Although underdeveloped in mental health care, the sub-Saharan country of Ghana is advanced in telecommunications. In this context, innovative mobile health (mHealth) approaches may help to overcome limited infrastructure (lack of clinics, trained professionals, and landlines) and to address significant unmet public mental health needs. The Technology in Mental Health editor reports on travels to Ghana to assess the viability of mHealth for mental health initiatives in the region. He found that stakeholders from all sectors (patients, providers, government officials, and traditional and faith healers) were open to exploring whether mHealth approaches could promote more humane care, reduce human rights violations, and improve the clinical outcomes of those in need. mHealth strategies that use audio and video content to overcome barriers associated with limited literacy may be most suitable. To succeed, any mHealth model must be culturally and contextually adapted to fit the needs, beliefs, and capacities of Ghanaian users.
Harnish, Autumn; Corrigan, Patrick; Byrne, Thomas; Pinals, Debra A; Rodrigues, Stephanie; Smelson, David
This pilot study examined whether substance use or mental illness was more stigmatizing among individuals with co-occurring mental health and substance abuse problems. This study included 48 individuals with co-occurring substance use and mental health problems enrolled in a Substance Abuse and Mental Health Services funded treatment program. Subjects received a baseline assessment that included addiction, mental health, and stigma measures. The sample consisted primarily of White males with an average age of 38 years. Substance abuse was found to be more stigmatizing than mental illness, F(1, 47) = 14.213, p stigma varied across four different levels of stigma (Aware, Agree, Apply, and Harm), F(2.099, 98.675) = 117.883, p stigma was also significant, F(2.41, 113.284) = 20.250, p stigma between types varied across levels of stigma. Post hoc tests found a significant difference between all levels of stigma except for the comparison between Apply and Harm. Reported stigma was significantly higher for substance abuse than mental illness at the Aware and Agree levels. In addition, pairwise comparisons found significant differences between all levels of stigma with the exception of the comparison between Apply and Harm, indicating a pattern whereby reported stigma generally decreased from the first level (Aware stage) to subsequent levels. These results have important implications for treatment, suggesting the need to incorporate anti-stigma interventions for individuals with co-occurring disorders with a greater focus on substance abuse.
The Heritage Foundation and the Fraser Institute measure economic freedom in nations using indices with ten and five indicators respectively. Eight of the Heritage indicators and four of the Fraser-indicators are about specific types of institutional quality, like rule of law, the protection of property, and the provision of sound money. More of these is considered to denote more economic freedom. Both indices also involve indicators of 'big government', or levels of government activities. More of that is seen to denote less economic freedom. Yet, levels of government spending, consumption, and transfers and subsidies appear to correlate positively with the other indicators related to institutional quality, while this correlation is close to zero for the level of taxation as a percentage of GDP. Using government spending, consumption transfers and subsidies as positive indicators is no alternative, because these levels stand for very different government activities, liberal or less liberal. This means that levels of government activities can better be left out as negative or positive indicators. Thus shortened variants of the indices create a better convergent validity in the measurement of economic freedom, and create higher correlations between economic freedom and alternative types of freedom, and between economic freedom and happiness. The higher correlations indicate a better predictive validity, since they are predictable in view of the findings of previous research and theoretical considerations about the relations between types of freedom, and between freedom and happiness.
Ponte, Stefano; Sturgeon, Timothy
In this article, we review the evolution and current status of global value chain (GVC) governance theory and take some initial steps toward a broader theory of governance through an exercise in ‘modular theory-building’. We focus on two GVC governance theories to which we previously contributed...... additional theories, to connect theories together better or in different modular configurations, and to incorporate elements at the macro level that reflect the changing constellation of key actors in GVC governance – the increasing influence of, for example, NGOs, taste and standard makers, and social...
James, David V
The form that diversion mechanisms take in a given jurisdiction will be influenced both by mental health law and sentencing policies, and by the structure of criminal justice and health care systems. In England and Wales, treatment in hospital in lieu of any other sentence is available as a disposal option following a finding of guilt. In addition, there is a National Health Service, free at the point of delivery, the existence of which creates the potential for a co-ordinated nationwide response to mental disorder within the criminal justice system. In recent years, the National Health Service has taken over the delivery of health care in prisons, including psychiatric services, with the principle being one of equivalence between the quality of health provision provided in the community and that provided in prisons. However, problems within the system dictate that an important place remains for add-on diversion initiatives at courts and police stations, which aim to circumvent some of the delays in dealing with mentally disordered people or to prevent them entering the criminal justice system in the first place. It has been demonstrated that such mechanisms can be highly effective, and a government-sponsored review in 1992 recommended their general adoption. A lack of central co-ordination determined that progress was very slow. A new government-commissioned report in 2009 set out detailed recommendations for reform throughout the system. It laid emphasis on a co-ordinated response at all levels and between all agencies, and placed importance on linking initiatives with community services and with preventative measures, including attention to the effects of social exclusion. Some grounds for optimism exist, although there are particular problems in implementing change at a time of financial austerity. Copyright 2010 Elsevier Ltd. All rights reserved.
Reay, Jonathon L; Kennedy, David O; Scholey, Andrew B
Single doses of the traditional herbal treatment Panax ginseng have recently been shown to elicit cognitive improvements in healthy young volunteers. The mechanisms by which ginseng improves cognitive performance are not known. However, they may be related to the glycaemic properties of some Panax species. Using a double-blind, placebo-controlled, balanced crossover design, 30 healthy young adults completed a 10 min test battery at baseline, and then six times in immediate succession commencing 60 min after the day's treatment (placebo, 200mg G115 or 400mg G115). The 10 min battery comprised a Serial Threes subtraction task (2 min); a Serial Sevens task (2 min); a Rapid Visual Information Processing task (5 min); then a 'mental fatigue' visual analogue scale. Blood glucose was measured prior to each day's treatment, and before, during and after the post-dose completions of the battery. Both the 200mg and 400mg treatments led to significant reductions in blood glucose levels at all three post-treatment measurements (p 0.005 in all cases). The most notable behavioural effects were associated with 200mg of ginseng and included significantly improved Serial Sevens subtraction task performance and significantly reduced subjective mental fatigue throughout all (with the exception of one time point in each case) of the post-dose completions of the 10 min battery (p 0.05). Overall these data suggest that Panax ginseng can improve performance and subjective feelings of mental fatigue during sustained mental activity. This effect may be related to the acute gluco-regulatory properties of the extract.
Contreras, C; Aguilar, M; Eappen, B; Guzmán, C; Carrasco, P; Millones, A K; Galea, J T
Mental health is an important factor in responding to natural disasters. Observations of unmet mental health needs motivated the subsequent development of a community-based mental health intervention following one such disaster affecting Peru in 2017. Two informal human settlements on the outskirts of Lima were selected for a mental health intervention that included: (1) screening for depression and domestic violence, (2) children's activities to strengthen social and emotional skills and diminish stress, (3) participatory theater activities to support conflict resolution and community resilience, and (4) community health worker (CHW) accompaniment to government health services. A total of 129 people were screened across both conditions, of whom 12/116 (10%) presented with depression and 21/58 (36%) reported domestic violence. 27 unique individuals were identified with at least one problem. Thirteen people (48%) initially accepted CHW accompaniment to government-provided services. This intervention provides a model for a small-scale response to disasters that can effectively and acceptably identify individuals in need of mental health services and link them to a health system that may otherwise remain inaccessible.
Astawa, I. P. M.; Dewi, K. C.
E-Government in higher education can be utilized in order to provide public services to stakeholders both internal and external. The research objectives is to analyze the e-government facilities for public services in higher education. The research began by reviewing the concept of public services and e-government, then continued by analysing e-government facilities based on the E-Government Maturity Level developed by Wirtz and Piehler. The research subject was the e-government website of three universities that ranked the top three of webometrics version (Indonesia country rank), while the research object was e-government facilities for public services. Data collection was done by observing e-government sites via online browsing. The research’s results indicated that all three e-government sites have met four e-government business model and provided e-government services in line with the fourth stage on the e-government development stage. It can concluded that the three universities have achieved e-government maturity at the fourth level.
van Rensburg, André Janse; Fourie, Pieter
, information and resource management. Normative integration (a common frame of reference) included collective attitude, sense of urgency, and linking cultures, though aspects such as conflict management, quality features of the informal collaboration, and trust were largely lacking. Most countries stressed the importance of integrating mental health on primary healthcare level, though an absence of supporting strategies could prove to bar implementation. Inter-service collaboration emerged as a significant goal, though a lack of (especially) normative integration dimensions could prove to be a key omission. Despite the usefulness of the Rainbow Model, it failed to adequately frame regional governance aspects of integration, as the SADC Secretariat could play an important role in coordinating and supporting the development and strengthening of better mental health systems.
Farmers' suicide in India is a cause of concern and government figures, though conservative, predict an impending epidemic. Various measures to curb this calamity are being made in a piecemeal manner. Considering it as an issue of social and mental health concern, this article attempts to evaluate the situation based on the tenet that health and illness are the result of a complex interplay between biological, psychological, social, environmental, economic and political factors. Thus in India the agrarian crisis, among other causes, has been largely debated as the major reason for the current state of farmers. It is important that (psychiatric) epidemiology and public mental health try to evolve mechanisms to understand and implement measures, and take this into consideration when attempting health promotion and prevention.
Full Text Available The purpose of this study was to investigate the relationship between community-level exposure to changes in economic conditions and the incidence and prevalence of mental disorders and cardiovascular disease in 29 resource-based communities (with a focus on mining communities in British Columbia (BC during a period of time marked by an economic downturn (1991–2002 The investigation relied on Labour Force Survey (LFS and Statistics Canada Census data, and health records from the British Columbia Ministry of Health (MoH. Age and sex adjusted prevalence and incidence rates were calculated for each community from 1991 to 2002 and the development of an economic change indicator defined using Census data and industry/government documents allowed for yearly assessment of community-level exposure to economic conditions. The relationship between exposure to economic change and rates of acute and chronic cardiovascular disease and mental disorders across the 29 study communities was investigated using a generalized linear model (stratified by type of community, and adjusted for the effect of the community. Findings indicate an impact on the prevalence rates for acute cardiovascular disease (CVD during periods of economic decline (rate increased by 13.1 cases per 1,000 population, p < 0.0001 as compared with stable periods and bust conditions (rate increased by 30.1 cases per 1,000 population, p < 0.0001 as compared with stable conditions and mental disorders (rate increased by 13.2 cases per 1,000 population, p = 0.0001 in mining communities during declining economic conditions as compared to steady periods of mining employment. This is not observed in other resource-based communities. The paper concludes by highlighting implications for the mining industry to consider as they begin to recognize and commit to mining community health.
Whiteford, Harvey; Buckingham, Bill; Harris, Meredith; Diminic, Sandra; Stockings, Emily; Degenhardt, Louisa
A population health approach to mental health service planning requires estimates that align interventions with the needs of people with mental illness. The primary objective was to estimate the number of people in Australia living with severe and persistent mental illness who have complex, multi-agency needs. The secondary objective was to describe the possible service needs of individuals with severe mental illness. We disaggregated the estimated 12-month prevalence of adults with severe mental illness into needs-based sub-groups, using multiple data sources. Possible service needs of 1825 adults with psychotic disorders and 334 adults with severe past-year affective and/or anxiety disorders were described using data from the 2010 Survey of High Impact Psychosis and 2007 National Survey of Mental Health and Wellbeing, respectively. Using best available data, we estimated that 3.3% of adults experience a severe mental illness each year, of whom one-third (1.1% of adults) experience a persistent mental illness that requires ongoing services to address residual disability. Among those with severe and persistent mental illness, one-third of adults (0.4% or 59,000 adults in 2015) have complex needs requiring multi-agency support to maximise their health, housing, social participation and personal functioning. Survey of High Impact Psychosis data indicated that among adults with psychotic disorders, use of accommodation (40%), non-government (30%) services and receipt of income support (85%) services were common, as were possible needs for support with socialising, personal care and employment. National Survey of Mental Health and Wellbeing data indicated that among individuals with severe affective and anxiety disorders, receipt of income support (37%) was common (information on accommodation and non-government support services was not available), as were possible needs for financial management and employment support. Agreed indicators of complex, multi-agency needs
Tam, C L; Foo, Y C; Lee, T H
To examine gender differences in mental health and perceived social support, relationship between parents' income and mental health, and differences in mental health across education levels. A total of 303 students aged 16 to 26 years were recruited from Selangor, Malaysia. The Multidimensional Scale of Perceived Social Support and General Health Questionnaire were used to measure the level of perceived social support and the mental health status. Demographic data, including education level and parents' income, were also obtained. Females perceived significantly higher levels of overall social support than males (t = -2.7; p mental health status between males and females (t = -1.8; p > 0.05), as well as mental health status among different parental income groups (chi2 = 5.0; p > 0.05) and the education levels of the subjects (chi2 = 0.7; p > 0.05). A more favourable mental health status of the subjects was associated with higher parental incomes (r = -0.1; p mental health status in older adolescents and young adults. There was also a relationship between parental income and an individual's mental health status, but mental health was not related to their education level.
The severely constrained resources for mental health service in less-developed regions like sub-Saharan Africa underscore the need for good public mental health literacy as a potential additional mental health resource. Several studies examining the level of public knowledge about the nature and dynamics of mental illness in sub-Saharan Africa in the last decade had concluded that such knowledge was poor and had called for further public enlightenment. What was thought to be mental health 'ignorance' has also been blamed for poor mainstream service utilization. These views however assume that non-alignment of the views of community dwellers in sub-Saharan Africa with the biomedical understanding of mental illness connotes 'ignorance', and that correcting such 'ignorance' will translate to improvements in service utilization. Within the framework of contemporary thinking in mental health literacy, this paper argues that such assumptions are not culturally nuanced and may have overrated the usefulness of de-contextualized public engagement in enhancing mental health service utilization in the region. The paper concludes with a discourse on how to contextualize public mental health enlightenment in the region and the wider policy initiatives that can improve mental health service utilization. © The Author(s) 2015.
Taylor, L; Jones, S
Clinical governance has been acknowledged as the driving force behind National Health Service (NHS) reform since the government white paper outlined a new style of NHS in the UK in 1997. The framework of clinical governance ensures that NHS organizations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will develop. A major component of a clinical governance framework requires utilizing audit procedures, which assess the effectiveness of current systems and ultimately direct continual quality improvement. This paper describes the audit component of a local clinical governance framework designed for a unit based within an NHS trust, which has utilized a multidisciplinary approach to assess the effectiveness of a newly commissioned service and its impact on the residents and staff. The unit is a 12-bedded, low-secure-intensive rehabilitation unit for clients with severe and enduring mental illness. Using recognized and standardized psychometric outcome measures, information was collected on clinical symptoms, social functioning, social behaviour, quality of life, relationship quality with named nurses and medication side-effects. Additionally, confidential staff measures were included to assess levels of burnout, identify expressed emotion and assess staff perception of models of illness. The paper includes a comprehensive account of how managerial commitment, teaching processes and application of technology ensured prompt data collection and maintained the momentum through the audit timescale. Data analysis and presentation of data in both clinical reviews and in senior management meetings within the unit are discussed. Findings highlight the full integration of the audit system into the processes of the unit. Clinically, the paper highlights the enhancement of the knowledge base of the client group and the influence on clinical decision
Background: Success in the treatment of the mentally-ill is suggested by patient's level of functioning. This study is to determine the highest overall level of functioning among the mentally-ill patients on follow-up at the University of Benin Teaching Hospital. Methods: Patients were picked consecutively as they presented at ...
Kakuma, R; Kleintjes, S; Lund, C; Drew, N; Green, A; Flisher, A J
Stigma plays a major role in the persistent suffering, disability and economic loss associated with mental illnesses. There is an urgent need to find effective strategies to increase awareness about mental illnesses and reduce stigma and discrimination. This study surveys the existing anti-stigma programmes in South Africa. The World Health Organization's Assessment Instrument for Mental Health Systems Version 2.2 and semi-structured interviews were used to collect data on mental health education programmes in South Africa. Numerous anti-stigma campaigns are in place in both government and non-government organizations across the country. All nine provinces have had public campaigns between 2000 and 2005, targeting various groups such as the general public, youth, different ethnic groups, health care professionals, teachers and politicians. Some schools are setting up education and prevention programmes and various forms of media and art are being utilized to educate and discourage stigma and discrimination. Mental health care users are increasingly getting involved through media and talks in a wide range of settings. Yet very few of such activities are systematically evaluated for the effectiveness and very few are being published in peer-review journals or in reports where experiences and lessons can be shared and potentially applied elsewhere. A pool of evidence for anti-stigma and awareness-raising strategies currently exists that could potentially make a scientific contribution and inform policy in South Africa as well as in other countries.
This paper aims to share the experience carried on in the Social Enterprises which are part of the Mental Health System of the state of Chubut (Argentina) since 2009. First, the context of the founding of the social enterprises inside a program which involves the government and the civil society in line with the state policies is presented, taking labour as a paradigm of psychosocial rehabilitation of people with mental suffering in effective interaction with other people from the community. Then, testimonies of entrepreneurs, as well as their definition of the enterprise and their personal experiences when participating in it are presented. Finally, the future challenges of this type of practice is summarised.
Gina Livioara GOGA
Full Text Available Considering the EU adhesion, good governance has been analyzed from different perspectives, in the judicial literature being an analytic model or a normative concept. Some authors have wondered if this concept is a fashion, comprising some older ideas and principles, while other authors have asserted that the reasons why different methods of governance appear in the EU are based on “the complexity and the uncertainty of the problems on the agenda, an irreducible, the new approaches on public administration and law, hidden competencies, legitimacy and subsidiarity”. At a normative level, the White Paper of European Governance consecrated five principles on which good governance is based upon: openness, participation, responsibility, efficiency and coherence.
Dua, Tarun; Barbui, Corrado; Clark, Nicolas; Fleischmann, Alexandra; Poznyak, Vladimir; Van Ommeren, Mark H.; Yasamy, Mohammad Taghi; Ayuso Mateos, José Luis; Birbeck, Gretchen Lano; Drummond, Colin; Freeman, Melvyn; Giannakopoulos, Pantéléimon; Levav, Itzhak; Obot, Isidore S.; Omigbodun, Olayinka
Funding for the mhGAP Programme, under which the work reported in this manuscript was done, was provided by the following: American Psychiatric Foundation, USA; Association of Aichi Psychiatric Hospitals, Japan; Autism Speaks, USA; CBM; Government of Italy; Government of Japan; Government of The Netherlands; International Bureau for Epilepsy; International League Against Epilepsy; Medical Research Council, UK; National Institute of Mental Health, USA; Public Health Agency of Canad...
Marcio M. Vasconcelos
Full Text Available OBJETIVO: Esta revisão aborda as recentes descobertas da neurobiologia do retardo mental, enfatizando os novos recursos da citogenética, das técnicas moleculares e da neurorradiologia para esclarecer o diagnóstico. FONTES DE DADOS: O autor pesquisou o banco de dados MEDLINE da National Library of Medicine utilizando as palavras-chave "mental retardation", "developmental disability", "child" e "adolescent" em diferentes combinações, abrangendo o período de janeiro de 2000 a outubro de 2003. Também foram utilizados os bancos de dados das revistas científicas Pediatrics e New England Journal of Medicine através da palavra-chave "mental retardation". No total, o autor consultou cerca de 1.500 títulos de artigos e 500 resumos, e teve acesso direto a 150 artigos completos pertinentes. Quando oportuno, algumas referências dos artigos consultados também foram consideradas. O site Online Mendelian Inheritance in Man foi utilizado como fonte de informações em genética clínica. SÍNTESE DOS DADOS: Em outubro de 2003, o total de síndromes genéticas associadas a retardo mental chegou a 1.149. Considerando-se o conjunto das causas genéticas ou ambientais e congênitas ou adquiridas de retardo mental, a avaliação diagnóstica atual é capaz de esclarecer a etiologia em 50 a 70% dos casos. CONCLUSÕES: O autor sugere uma avaliação diagnóstica do retardo mental em etapas lógicas, visando ao uso racional dos dispendiosos recursos da citogenética, biologia molecular e neuroimagem.OBJECTIVE: This paper describes recent advances in the neurobiology of mental retardation, emphasizing new diagnostic resources provided by cytogenetics, molecular testing, and neuroimaging. SOURCES OF DATA: MEDLINE (January 2000 through October 2003, using the following key words: mental retardation, developmental disability, child, and adolescent. Search of the Pediatrics and New England Journal of Medicine websites using the key word mental retardation. The
Full Text Available One of the realities brought forward by the financial crisis is that the corporate Governance, based until now mainly on self-regulation, has not been as effective as possible. A better management of organizations is important not only in order to reduce the possibility of occurrence of a new crisis in the future, but also for organizations to be more competitive. Currently we do not have a definition of corporate governance that is unanimously accepted. At global level, there are a variety of definitions for this term, depending on national, cultural or legislative characteristics. In this article we present the concept of corporate governance as being a complex process occurring at the level of the management of the organization, which integrates control, risk management and internal audit in a formula that is meant to determine the level of performance for the organizational achievements.
Kar, Nilamadhab; Khanna, Rakesh; Kar, Gopal Chandra
Most of the autistic disorder patients are also mentally retarded and many mentally retarded persons exhibit autistic symptoms. By using a standard instrument (Ritvo-Freeman Real Life Rating Scale) the autistic features of the mentally retarded children were studied. The study also examined the influence of age, sex and level of mental retardation on the occurrence of autistic symptoms. Children who came for consultation to child psychiatric unit were compared with those at a school for children with mental retardation receiving stimulation. Male children from child psychiatric unit had significantly higher scores than those from the school. Social and language impairment could be reliably identified and grouped. It was possible to diagnose the syndrome of autism in children with mental retardation in a significant number (9.6%)as compared to that was possible only clinically (1.9%). More number of children with severe/ profound mental retardation could be diagnosed as autistic. The autistic syndrome in children with mental retardation can be picked up more effectively by the use of structured instrument. PMID:21584097
Paul, Mohd Altaf; Khan, Waheeda
Prevalence of mental disorders among children is affected by armed conflict and same is true in protracted conflict of Kashmir, where the ongoing conflict has affected mental health of children badly. In order to understand mental health condition of school going children, the present study was designed to study the nature and prevalence of mental disorders among school children in Kashmir valley. The present study employed multi-stage sampling and multi-informant reporting of mental health problems in children. A sample of 1000 school children was taken from 12 schools of Shopian district through systematic random sampling method. Data was collected at different levels of screening by using Strength and Difficulties Questionnaire (SDQ) (Teacher form) and Mini International Neuropsychiatric Inventory (MINI-Kid). Socio-demographic data sheet was included to gather relevant information. The prevalence rates of mental disorders among school children were presented at different levels of sc