WorldWideScience

Sample records for health crisis hampered

  1. US health care crisis.

    Science.gov (United States)

    Cirić, Ivan

    2013-01-01

    The United States health care is presently challenged by a significant economic crisis. The purpose of this report is to introduce the readers of Medicinski Pregled to the root causes of this crisis and to explain the steps undertaken to reform health care in order to solve the crisis. It is hoped that the information contained in this report will be of value, if only in small measure, to the shaping of health care in Serbia.

  2. The health crisis in Argentina.

    Science.gov (United States)

    Escudero, José Carlos

    2003-01-01

    The health crisis in Argentina is part of the larger crisis that has resulted from a collapse in the country's economic and political systems. After a brief review of the country's history over the last century, from international success story to economic failure, the author explains the health crisis in particular and the social crisis in general in terms of failed neoliberal policies imposed on Argentina by the United States and International Monetary Fund through the mediation of the country's political class.

  3. Enhancing crisis leadership in public health emergencies.

    Science.gov (United States)

    Deitchman, Scott

    2013-10-01

    Reviews of public health emergency responses have identified a need for crisis leadership skills in health leaders, but these skills are not routinely taught in public health curricula. To develop criteria for crisis leadership in public health, published sources were reviewed to identify attributes of successful crisis leadership in aviation, public safety, military operations, and mining. These sources were abstracted to identify crisis leadership attributes associated with those disciplines and compare those attributes with crisis leadership challenges in public health. Based on this review, the following attributes are proposed for crisis leadership in public health: competence in public health science; decisiveness with flexibility; ability to maintain situational awareness and provide situational assessment; ability to coordinate diverse participants across very different disciplines; communication skills; and the ability to inspire trust. Of these attributes, only competence in public health science is currently a goal of public health education. Strategies to teach the other proposed attributes of crisis leadership will better prepare public health leaders to meet the challenges of public health crises.

  4. Capitation-Based Financing Hampers the Provision of Preventive Services in Primary Health Care.

    Science.gov (United States)

    Sándor, János; Kósa, Karolina; Papp, Magor; Fürjes, Gergő; Kőrösi, László; Jakovljevic, Mihajlo; Ádány, Róza

    2016-01-01

    Mortality caused by non-communicable diseases has been extremely high in Hungary, which can largely be attributed to not performed preventive examinations (PEs) at the level of primary health care (PHC). Both structures and financial incentives are lacking, which could support the provision of legally defined PEs. A Model Programme was launched in Hungary in 2012 to adapt the recommendations for PHC of the World Health Organization. A baseline survey was carried out to describe the occurrence of not performed PEs. A sample of 4320 adults representative for Hungary by age and gender was surveyed. Twelve PEs to be performed in PHC as specified by a governmental decree were investigated and quantified. Not performed PEs per person per year with 95% confidence intervals were computed for age, gender, and education strata. The number of not performed PEs for the entire adult population of Hungary was estimated and converted into expenses according to the official reimbursement costs of the National Health Insurance Fund. The rate of service use varied between 16.7 and 70.2%. There was no correlation between the unit price of examinations and service use (r = 0.356; p = 0.267). The rate of not performed PEs was not related to gender, but older age and lower education proved to be risk factors. The total number of not performed PEs was over 17 million in the country. Of the 31 million euros saved by not paying for PEs, the largest share was not spent on those in the lowest educational category. New preventive services offered in the reoriented PHC model program include systematic and scheduled health examination health promotion programs at community settings, risk assessment followed by individual or group care, and/or referral and chronic care. The Model Programme has created a pressure for collaborative work, consultation, and engagement at each level, from the GPs and health mediators up to the decision-making level. It channeled the population into preventive

  5. The Economic Crisis and Public Health

    Directory of Open Access Journals (Sweden)

    Victor Sidel

    2009-06-01

    Full Text Available The current global economic crisis seriously threatens the health of the public. Challenges include increases in malnutrition; homelessness and inadequate housing; unemployment; substance abuse, depression, and other mental health problems; mortality; child health problems; violence; environmental and occupational health problems; and social injustice and violation of human rights; as well as decreased availability, accessibility, and affordability of quality medical and dental care. Health professionals can respond by promoting surveillance and documentation of human needs, reassessing public health priorities, educating the public and policymakers about health problems worsened by the economic crisis, advocating for sound policies and programs to address these problems, and directly providing necessary programs and services.

  6. Crisis management teams in health organisations.

    Science.gov (United States)

    Canyon, Deon V

    2012-01-01

    Crisis management teams (CMT) are necessary to ensure adequate and appropriate crisis management planning and response to unforeseen, adverse events. This study investigated the existence of CMTs, the membership of CMTs, and the degree of training received by CMTs in Australian health and allied health organisations. This cross-sectional study draws on data provided by executive decision makers in a broad selection of health and allied health organisations. Crisis management teams were found in 44.2 per cent of the health-related organisations surveyed, which is ten per cent lower than the figure for business organisations. Membership of these CMTs was not ideal and did not conform to standard CMT membership profiles. Similarly, the extent of crisis management training in health-related organisations is 20 per cent lower than the figure for business organisations. If organisations do not become pro-active in their crisis management practices, the onus is on government to improve the situation through regulation and the provision of more physical, monetary and skill resources to ensure that the health services of Australia are sufficiently prepared to respond to adverse events.

  7. Child Health and Economic Crisis in Peru

    OpenAIRE

    Paxson, Christina; Schady, Norbert

    2005-01-01

    The effect of macroeconomic crises on child health is a topic of great policy importance. This article analyzes the impact of a profound crisis in Peru on infant mortality. It finds an increase of about 2.5 percentage points in the infant mortality rate for children born during the crisis of the late 1980s, which implies that about 17,000 more children died than would have in the absence o...

  8. Crisis Management in the Health Sector: Qualities and characteristics of health crisis managers

    Directory of Open Access Journals (Sweden)

    Manwlidou Zacharoula

    2009-01-01

    Full Text Available The rapidly evolving nature of today’s health systems and the need to adapt to modern demands,require that these systems are staffed with skilled health crisis managers. Based on that scenario, crisis managerswith good knowledge and training, adequate experience, as well as virtues of excellent organizational skills,operational planning, mental power and social sensitivity, can play a key role in dealing successfully with crisesin the health sector.

  9. [Financial crisis and mental health in Greece].

    Science.gov (United States)

    Giotakos, O; Karabelas, D; Kafkas, A

    2011-01-01

    Several studies indicate an association between economic crises and psychological burden. To investigate the possible impact of the current economic crisis on mental health in Greece, the association between two economic indicators (unemployment and average income) and mental health variables (psychiatric clinic admittance, visits to outpatients' departments and emergency units, suicides, homicides, mortality rates and divorces) was studied. The data were gathered by the Greek Statistical Service and some others were provided by the following hospitals: Eginition Hospital, Psychiatric Hospital of Attica, Athens General Hospital and Evaggelismos Hospital. Simple and multiple regression analyses were performed on the data. There was no significant correlation between the level of unemployment, as well as the average income, and admittance to the psychiatric clinics. A significant correlation was isolated between unemployment and visits to outpatients' department (R2 = 0.40, p = 0.001) and emergency unit (R2 = 0.49, p = 0.0002) of Eginition Hospital. The unemployment rate during the period 1981-2008 was positively associated with the number of homicides (R2 = 0.16, beta = 0.000049, p = 0.03), as well as the number of divorces (R2 = 0.20, beta = 0.005, p = 0.02) during the same period. The average income showed positive association with the visits to both outpatients' department (R2 = 0.55, p positive correlation between the average income and divorce rates (R2 = 0.73, p impact of economic crisis on citizens' mental health.

  10. [The impact of the economic crisis on the health and healthcare of the immigrant population. SESPAS report 2014].

    Science.gov (United States)

    Vázquez, María Luisa; Vargas, Ingrid; Aller, Marta-Beatriz

    2014-06-01

    Despite the economic crisis, the immigrant population of Spain continues to be high, with 5.7 million persons (11.4%). This population, whose health needs are similar to those of the general population, is more vulnerable due to their exposure to worse social determinants (living and working conditions together with a higher risk of exclusion from social services). In this article, we analyze how the economic crisis affects or can affect the health of the immigrant population in Spain by examining distinct population-specific or institutional factors that influence the effects of the crisis and the available data. The available evidence is limited, but several effects can be identified: firstly, some social determinants, such as higher unemployment rates and worse working conditions, have deteriorated, which can be expected to lead to a worsening of health status. These consequences have already been described for mental health or have been estimated for infectious diseases. Secondly, political decisions have had a direct impact, excluding-with some exceptions-undocumented immigrants from the right to health care. Finally, the lower priority given to adapting health services to the specific characteristics of the immigrant population (most of whom are documented) together with the introduction of new barriers, has hampered or will hamper access to health care. As a result, the economic crisis can be expected to have a greater impact on the immigrant population. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  11. The ebola crisis : challenges for global health law

    NARCIS (Netherlands)

    Toebes, Brigit

    2015-01-01

    he recent Ebola crisis has caused approximately 20.000 deaths so far. Compared to other global health crises, including the deaths caused by armed conflicts and chronic diseases, this is still a small amount. Yet, from a global and domestic health law and governance perspective, this crisis raises a

  12. Public Health Crisis Preparedness and Response in Korea

    Science.gov (United States)

    Lee, Hye-Young; Oh, Mi-Na; Park, Yong-Shik; Chu, Chaeshin; Son, Tae-Jong

    2013-01-01

    Since the 2006 Pandemic Influenza Preparedness and Response Plan according to the World Health Organization’s recommendation, the Republic of Korea has prepared and periodically evaluated the plan to respond to various public health crises including pandemic influenza. Korea has stockpiled 13,000,000 doses of antiviral drugs covering 26% of the Korean population and runs 519 isolated beds in 16 medical institutions. The division of public health crisis response in Korea Centers for Disease Control and Prevention are in charge of responding to public health crises caused by emerging infectious diseases including severe acute respiratory syndrome, avian influenza human infection, and pandemic influenza. Its job description includes preparing for emerging infectious diseases, securing medical resources during a crisis, activating the emergency response during the crisis, and fortification of capabilities of public health personnel. It could evolve into a comprehensive national agency to deal with public health crisis based on the experience of previous national emerging infectious diseases. PMID:24298444

  13. Mental health and human rights: never waste a serious crisis

    OpenAIRE

    Minas, Harry

    2009-01-01

    Abstract A serious health and human rights crisis is unfolding in Indonesia. Media reports in the Jakarta press have highlighted the high death rates in shelters for people with mental illness that are run by the Jakarta Social Affairs Agency. This crisis represents an opportunity to bring about systematic and substantial changes in the Indonesian mental health system. In order to realise this opportunity the necessary elements of an approach are presented and briefly discussed.

  14. Combating Ukraine’s Health Crisis : Lessons from Europe

    OpenAIRE

    Rekha Menon

    2010-01-01

    This knowledge brief synthesizes the important findings of a recent study. It spotlights key issues and challenges facing Ukraine's health sector and suggests strategies for improvement. To combat the current health crisis, Ukraine could look at the lessons learned by other European countries that have faced similar health crises.

  15. Diabetic complications do not hamper improvement of health-related quality of life over the course of treatment of diabetic foot ulcers - the Eurodiale study.

    Science.gov (United States)

    Siersma, Volkert; Thorsen, Hanne; Holstein, Per E; Kars, Marleen; Apelqvist, Jan; Jude, Edward B; Piaggesi, Alberto; Bakker, Karel; Edmonds, Michael; Jirkovská, Alexandra; Mauricio, Didac; Reike, Heinrich; Spraul, Maximilian; Uccioli, Luigi; Urbancic, Vilma; van Acker, Kristien; van Baal, Jeff; Schaper, Nicolaas C

    2017-07-01

    Diabetic complications, and in particular diabetic foot ulcers (DFUs), are associated with low health-related quality of life (HRQoL). We evaluated whether the presence of diabetic complications also influenced the improvement of HRQoL during DFU treatment. 1088 patients presenting for DFU treatment at the centers participating in the Eurodiale study were followed prospectively up to one year. HRQoL was measured both at presentation and after healing or at end of follow up, using EQ-5D: a standardized instrument consisting of five domains and a summary index. The influence of diabetic comorbidity on the course of HRQoL was evaluated for each of the EQ-5D outcomes in multi-level linear regression analyses, adjusting for baseline characteristics. HRQoL improved in all EQ-5D outcomes over the course of treatment for those DFUs that healed. The few significant differences in the development of HRQoL between patients with and without comorbidity showed a more beneficial development for patients with comorbidity in DFUs that did not heal or healed slowly. Comorbidity does not hamper improvement of HRQoL in DFU treatment. On the contrary, HRQoL improved sometimes more in patients with certain comorbidity with hard-to-heal ulcers. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Role of the health center in health crisis management, especially in a radiation disaster

    International Nuclear Information System (INIS)

    Kurahashi, Toshiyuki

    2013-01-01

    In a disaster, in particular a radiation disaster, health centers should play an active role in taking advantage of its own expertise. There are various causes of a health crisis; the response to a health crisis is defined according to each cause. However, it should be adequately addressed by assuming the worst case for a health crisis of unknown cause. The role of health centers, in addition to the implementation of appropriate and timely treatment of any health crisis, is prevention of a future health crisis, advanced preparation, and damage recovery; activities during normal times are also important to maintain. Regarding the specific activities of the health center, judgment in the preference of measures to be performed is important. That the information is collected properly based on the idea of risk communication, coordination, and public relations transmission is required also for health centers. (author)

  17. The current crisis in human resources for health in Africa

    African Journals Online (AJOL)

    Overview. The current crisis in human resources for health in. Africa has reached a serious level in many countries. A complex set of reasons has contributed to this problem, some exogenous, such as the severe economic measures introduced by structural adjustment, which often result in cutbacks in the number of health ...

  18. [Economic crisis and mental health. SESPAS report 2014].

    Science.gov (United States)

    Gili, Margalida; García Campayo, Javier; Roca, Miquel

    2014-06-01

    Studies published before the financial crisis of 2008 suggest that economic difficulties contribute to poorer mental health. The IMPACT study conducted in primary health care centers in Spain found a significant increase in common mental disorders. Between 2006 and 2010, mood disorders increased by 19%, anxiety disorders by 8% and alcohol abuse disorders by 5%. There were also gender differences, with increased alcohol dependence in women during the crisis period. The most important risk factor for this increase was unemployment. In parallel, antidepressant consumption has increased in recent years, although there has not been a significant inrease in the number of suicides. Finally, the study offers some proposals to reduce the impact of the crisis on mental health: increased community services, employment activation measures, and active policies to reduce alcohol consumption and prevent suicidal behavior, particularly among young people. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  19. [Public health in major socio-economic crisis].

    Science.gov (United States)

    Cosmacini, G

    2014-01-01

    The term "crisis" in different cultures (such as ancient Greece or China) can have a positive meaning, since it indicates a time of growth, change and opportunity. Over the centuries there have been times of severe economic and social crisis that led to the implementation of major reforms and improved population health. Nowadays, despite the new economic crisis which has also affected health care for its rising costs, health economics does not hesitate to affirm the importance of key objectives such as prevention and medical assistance. Prevention is not prediction. Prevention means "going upstream" and fixing a problem at the source; the goal is to reduce diseases' effects, causes and risk factors, thereby reducing the prevalence of costly medical conditions.

  20. Public Health Leadership in a Crisis: Themes from the Literature

    Directory of Open Access Journals (Sweden)

    Zin M. Htway

    2015-11-01

    Full Text Available Recent catastrophic events and subsequent effects of leadership on afflicted populations demonstrates a need for improvement and increased managerial skill. The problem is catastrophic events create situations unfamiliar to many public health leaders. This manuscript was crafted from a review of 28 articles for the publication date range 1992-2012. Public health leadership in a crisis theorizes the application of four leadership skills: technical skills, interpersonal skills, conceptual skills, and emotional skills. A leader of a public health crisis will have to use these four skills for coordinating, managing, and direction of staff and resources. In addition to leading and managing public health resources, a leader in this role will also have to effectively communicate to the public and the media. This leadership theory connects lines of leadership skill to various stakeholders and collaborators. The importance of this leadership theory is for future public health crisis leaders to gain better understanding of the role of public health leadership in a crisis.

  1. Cervical cancer: A global health crisis.

    Science.gov (United States)

    Small, William; Bacon, Monica A; Bajaj, Amishi; Chuang, Linus T; Fisher, Brandon J; Harkenrider, Matthew M; Jhingran, Anuja; Kitchener, Henry C; Mileshkin, Linda R; Viswanathan, Akila N; Gaffney, David K

    2017-07-01

    Cervical cancer is the fourth most common malignancy diagnosed in women worldwide. Nearly all cases of cervical cancer result from infection with the human papillomavirus, and the prevention of cervical cancer includes screening and vaccination. Primary treatment options for patients with cervical cancer may include surgery or a concurrent chemoradiotherapy regimen consisting of cisplatin-based chemotherapy with external beam radiotherapy and brachytherapy. Cervical cancer causes more than one quarter of a million deaths per year as a result of grossly deficient treatments in many developing countries. This warrants a concerted global effort to counter the shocking loss of life and suffering that largely goes unreported. This article provides a review of the biology, prevention, and treatment of cervical cancer, and discusses the global cervical cancer crisis and efforts to improve the prevention and treatment of the disease in underdeveloped countries. Cancer 2017;123:2404-12. © 2017 American Cancer Society. © 2017 American Cancer Society.

  2. Global health disparities: crisis in the diaspora.

    Science.gov (United States)

    Cox, Raymond L.

    2004-01-01

    The United States spends more than the rest of the world on healthcare. In 2000, the U.S. health bill was 1.3 trillion dollars, 14.5% of its gross domestic product. Yet, according to the WHO World Health Report 2000, the United States ranked 37th of 191 member nations in overall health system performance. Racial/ethnic disparities in health outcomes are the most obvious examples of an unbalanced healthcare system. This presentation will examine health disparities in the United States and reveal how health disparities among and within countries affect the health and well-being of the African Diaspora. PMID:15101675

  3. The synergy of the refugee crisis and the financial crisis in Greece: Impact on mental health.

    Science.gov (United States)

    Anagnostopoulos, Dimitris C; Giannakopoulos, George; Christodoulou, Nikos G

    2017-06-01

    The current global financial crisis that started in 2008 resulted in a significant decline in global trade, slowing/reversing economic growth worldwide, and a dramatic increase in public sector debt. At the same time, the global migrant/refugee crisis has reached extreme rates, with millions of people being forced to abandon their homes and communities because of war, political violence or related threats. There is a broad consensus about the deleterious consequences of these crises on psychological well-being, depression, anxiety disorders, insomnia, alcohol abuse and suicidal behavior. Although the separate consequences of economic recession and immigration are extensively discussed in previous research, we know very little about the processes through which the intersection of economic crisis and migrant crisis contributes to the vulnerabilities of natives and migrants during these crises. Of particular concern is the status of children, adolescents and their families, who constitute one of the most vulnerable groups in society. To discuss the contexts that economic and migrant crises shape and suggest possible effects of this intersection on mental health risks, especially among children, adolescents and their families, through reflecting on the recent experience in Greece. Review of the literature and critical analysis of the effects of the confluent crises. The interactive effects of these two crises need further exploration. Novel and diverse models of psychological understanding need to be developed in order to manage the effects of the confluent crises. The role of mental health professionals is crucial in this respect, offering culturally flexible, accommodating and empathetic approaches, allowing healing and acceptance in the face of adversity.

  4. Protecting Pakistan's health during the global economic crisis.

    Science.gov (United States)

    Jooma, R; Khan, A; Khan, A A

    2012-03-01

    The world is facing an unprecedented global economic crisis, with many countries needing to reconsider their level of health care spending. This paper explores the many consequences of the global economic turndown on Pakistan's health, including reduced government and donor spending and increased poverty with the consequent diversion of funds away from health. Nevertheless, these challenges may provide opportunities not only to mitigate the adverse effects of the economic crisis but also to institute some much-needed reforms that may not receive political support during more affluent times. Our suggestions focus on setting priorities based on the national disease burden, prioritizing prevention interventions, demanding results, curbing corruption, experimenting with innovative funding mechanisms, advocating for increased funding by presenting health spending as an investment rather than an expense and by selected recourse to civil society interventions and philanthropy to bridge the gap between available and needed resources.

  5. "Psychological Boarding" and Community-Based Behavioral Health Crisis Stabilization.

    Science.gov (United States)

    Mukherjee, Dhrubodhi; Saxon, Verletta

    2018-01-27

    This exploratory paper presents a case study where a community based mental health organization forging a partnership with a local hospital system to establish a crisis stabilization unit (CSU) to address behavioral health emergency care. The study takes a mixed methods case study approach to address two research questions; (a) did this approach reduce the overall length of stay in the hospital emergency departments? (b) What challenges did the taskforce face in implementing this CSU model? The paper shares recommendation from the findings.

  6. Human Physiology The Urban Health Crisis: Strategies for Health for ...

    African Journals Online (AJOL)

    comes its English equivalent, Human Physiology. Though ... Summary of Human Physiology would have been a more appropriate ... This crisis has its origins in the interaction between .... The construction, layout and printing of the book are as.

  7. Health system resilience: Lebanon and the Syrian refugee crisis

    Science.gov (United States)

    Ammar, Walid; Kdouh, Ola; Hammoud, Rawan; Hamadeh, Randa; Harb, Hilda; Ammar, Zeina; Atun, Rifat; Christiani, David; Zalloua, Pierre A

    2016-01-01

    Background Between 2011 and 2013, the Lebanese population increased by 30% due to the influx of Syrian refugees. While a sudden increase of such magnitude represents a shock to the health system, threatening the continuity of service delivery and destabilizing governance, it also offers a unique opportunity to study resilience of a health system amidst ongoing crisis. Methods We conceptualized resilience as the capacity of a health system to absorb internal or external shocks (for example prevent or contain disease outbreaks and maintain functional health institutions) while sustaining achievements. We explored factors contributing to the resilience of the Lebanese health system, including networking with stakeholders, diversification of the health system, adequate infrastructure and health human resources, a comprehensive communicable disease response and the integration of the refugees within the health system. Results In studying the case of Lebanon we used input–process–output–outcome approach to assess the resilience of the Lebanese health system. This approach provided us with a holistic view of the health system, as it captured not only the sustained and improved outcomes, but also the inputs and processes leading to them. Conclusion Our study indicates that the Lebanese health system was resilient as its institutions sustained their performance during the crisis and even improved. PMID:28154758

  8. The health workforce crisis: the brain drain scourge.

    Science.gov (United States)

    Ike, Samuel O

    2007-01-01

    The magnitude of the health workforce crisis engendered by brain drain particularly in Africa, and nay more especially Nigeria, has been assuming increasingly alarming proportions in the past three decades. The challenge it poses in meeting the manpower needs in the healthcare sector as well as in the larger economy of the sending countries is enormous. This paper thus sets out to highlight the scope of this brain drain, its effects and the reasons sustaining it, as well as makes concrete suggestions to help stern the tide. A review of the literature on brain drain with particular emphasis on the health workforce sector was done, with focus on Africa, and specifically Nigeria. Literature search was done using mainly the Medline, as well as local journals. The historical perspectives, with the scope of external and internal brain drain are explored. The glaring effects of brain drain both in the global workforce terrain and specifically in the health sectors are portrayed. The countries affected most and the reasons for brain drain are outlined. Strategic steps to redress the brain drain crisis are proffered in this paper. The health workforce crisis resulting from brain drain must be brought to the front-burner of strategic policy decisions leading to paradigm shift in political, social and economic conditions that would serve as incentives to curb the scourge.

  9. Health Alert: Adrenal Crisis Causes Death in Some People Who Were Treated with hGH

    Science.gov (United States)

    ... Were Treated with hGH Health Alert: Adrenal Crisis Causes Death in Some People Who Were Treated with hGH ... Adrenal crisis is a serious condition that can cause death in people who lack the pituitary hormone ACTH. ...

  10. Public Health Intelligence: Learning From the Ebola Crisis

    Science.gov (United States)

    Weber, David Jay

    2015-01-01

    Today’s public health crises, as exemplified by the Ebola outbreak, lead to dramatic calls to action that typically include improved electronic monitoring systems to better prepare for, and respond to, similar occurrences in the future. Even a preliminary public health informatics evaluation of the current Ebola crisis exposes the need for enhanced coordination and sharing of trustworthy public health intelligence. We call for a consumer-centric model of public health intelligence and the formation of a national center to guide public health intelligence gathering and synthesis. Sharing accurate and actionable information with government agencies, health care practitioners, policymakers, and, critically, the general public, will mark a shift from doing public health surveillance on people to doing public health surveillance for people. PMID:26180978

  11. Changes between pre-crisis and crisis period in socioeconomic inequalities in health and stimulant use in Netherlands.

    Science.gov (United States)

    Bruggink, Jan-Willem; de Goeij, Moniek C M; Otten, Ferdy; Kunst, Anton E

    2016-10-01

    International research suggests an impact of economic crises on population health, with different effects among different socioeconomic groups. Since the end of 2008 the Netherlands experienced a period of economic crisis. Our study explores how inequalities in perceived general and mental health, and alcohol and tobacco use changed after the recession started. We used data from the Dutch Health Interview Surveys: 2006-2008 (pre-crisis period) and 2009-2013 (crisis period). Respondents aged 25-64 were divided into socioeconomic groups based on labour status, income level and income change. Inequalities in health and stimulant use among these socioeconomic groups were described by period and changes between the pre-crisis and crisis period were investigated using logistic regression models. Most inequalities did not change, with some exceptions. For perceived general health, inequalities between employed persons and persons not in the labour force were larger in the crisis period (unfavourable trends for those not in the labour force). For smoking, inequalities between unemployed and employed persons were larger in the crisis period (decreasing smoking rates only for those employed), as did inequalities between persons with low and high income levels (decreasing smoking rates for those with higher income levels). Excessive drinking decreased among employed persons and persons with a decrease in income, while it remained stable among persons not in the labour force and among persons with an increase in income. The widening of some socioeconomic inequalities in health and stimulant use might suggest an enhanced vulnerability of lower socioeconomic groups to the post-2008 crisis. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  12. Crisis in the health sector: Impact on nurses' working conditions.

    Science.gov (United States)

    Granero-Lázaro, Alberto; Blanch-Ribas, Josep M; Roldán-Merino, Juan Francisco; Torralbas-Ortega, Jordi; Escayola-Maranges, Ana María

    In a context of economic crisis and policies to reduce the public deficit, the budgets of the Catalan Health Institute (CHI) were cut by 15.33% between 2010 and 2014. To assess the perceived impact on nurses' work conditions of measures to contain health spending. The study design was descriptive and transversal. A sample of 1,760 nurses from the province of Barcelona answered a questionnaire on the perceived impact of health spending containment measures implemented in their workplace during the early years of the crisis. Among the main aspects of the perceived impact of these measures, 86.6% of the nurses identified a pay cut and an increase in the following relevant parameters of their working conditions: number of hours worked (66.7%), final ratio of treated patients (35.2%), task complexity and workload (75.3%), rotation through various departments (31.5%), work shifts (21.4%) or work areas (23.4%), job insecurity (58.4%) and loss of employment by dismissal (6.6%) or non-renewal of contract (9%). The perceived impact of the crisis showed a triple negative component: Pay cut, work overload and job insecurity. As a combined effect of this multiple trend, the nurses acknowledged a deterioration in their working conditions and quality of working life. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  13. Human resources for health: global crisis and international cooperation.

    Science.gov (United States)

    Portela, Gustavo Zoio; Fehn, Amanda Cavada; Ungerer, Regina Lucia Sarmento; Poz, Mario Roberto Dal

    2017-07-01

    From the 1990s onwards, national economies became connected and globalized. Changes in the demographic and epidemiological profile of the population highlighted the need for further discussions and strategies on Human Resources for Health (HRH). The health workforce crisis is a worldwide phenomenon. It includes: difficulties in attracting and retaining health professionals to work in rural and remote areas, poor distribution and high turnover of health staff particularly physicians, poor training of health workforces in new sanitation and demographic conditions and the production of scientific evidence to support HRH decision making, policy management, programs and interventions. In this scenario, technical cooperation activities may contribute to the development of the countries involved, strengthening relationships and expanding exchanges as well as contributing to the production, dissemination and use of technical scientific knowledge and evidence and the training of workers and institutional strengthening. This article aims to explore this context highlighting the participation of Brazil in the international cooperation arena on HRH and emphasizing the role of the World Health Organization in confronting this crisis that limits the ability of countries and their health systems to improve the health and lives of their populations.

  14. [Changes between pre-crisis and crisis period in socioeconomic inequalities in health and stimulant use in Netherlands].

    Science.gov (United States)

    Buggink, J W; de Goeij, M C M; Otten, F W J; Kunst, A

    2016-01-01

    International research suggests an impact of economic crises on population health, with different effects among different socioeconomic groups. Since the end of 2008 the Netherlands experienced a period of economic crisis. Our study explores how inequalities in perceived general and mental health, and alcohol and tobacco use changed after the recession started. Cross-sectional study using routinely collected data from surveys of the Dutch population. We used data from the Dutch Health Interview Surveys: 2006-2008 (pre-crisis period) and 2009-2013 (crisis period). Respondents aged 25-64 were divided into socioeconomic groups based on labour status, income level and income change. Inequalities in health and stimulant use among these socioeconomic groups were described by period and changes between the pre-crisis and crisis period were investigated using logistic regression models. Most inequalities did not change, with some exceptions. For perceived general health, inequalities between employed persons and persons not in the labour force were larger in the crisis-period (unfavourable trends for those not in the labour force). For smoking, inequalities between unemployed and employed persons were larger in the crisis period (decreasing smoking rates only for those employed), as did inequalities between persons with low and high income levels (decreasing smoking rates for those with higher income levels). Excessive drinking decreased among employed persons and persons with a decrease in income, while it remained stable among persons not in the labour force and among persons with an increase in income. The widening of some socioeconomic inequalities in health and stimulant use might suggest an enhanced vulnerability of lower socioeconomic groups to the post-2008 crisis.

  15. Financial Crisis, Health Outcomes, and Aging: Mexico in the 1980s and 1990s

    OpenAIRE

    Mendez, Oscar; Cutler, David; Knaul, Felicia; Lozano, Rafael; Zurita, Beatriz

    2002-01-01

    We study the impact of economic crisis on health in Mexico. There have been four wide-scale economic crises in Mexico in the past two decades, the most recent in 1995–96. We find that mortality rates for the very young and the elderly increase or decline less rapidly in crisis years as compared with non-crisis years. In the 1995–96 crisis, mortality rates were about 5 to 7 percent higher in the crisis years compared to the years just prior to the crisis. This translates into a 0.4 percent...

  16. Impact of financial crisis on selected health outcomes in Europe.

    Science.gov (United States)

    Baumbach, Anja; Gulis, Gabriel

    2014-06-01

    A number of health outcomes were affected by previous financial crises, e.g. suicides, homicides and transport accident mortality. Aim of this study was to analyse the effects of the current financial crisis on selected health outcomes at population level in Europe. A mixed approach of ecologic and time trend design was applied, including correlation analysis. For eight countries, data on the economic situation (unemployment rate and economic growth) and health indicators (overall mortality, suicide and transport accident mortality) was drawn from EUROSTAT database for 2000-10. Spearman's rank correlation was applied to analyse the influence of social protection on the association between exposure and outcome variables. The financial crisis had no visible effect on overall mortality in any of the eight countries until 2010. Transport accident mortality decreased in all eight countries, in the range of 18% in Portugal to 52% in Slovenia. In contrast, suicide mortality increased in Germany (+5.3%), Portugal (+5.2%), Czech Republic (+7.6%), Slovakia (+22.7%) and Poland (+19.3%). The effect of unemployment on suicide is higher in countries with lower social spending (Spearman's r = -0.83). Clear cause-effect relations could not be established owing to the ecological study design and issues concerning data availability. However, there are clear changes in suicide and transport accident mortality after onset of the crisis, and findings are consistent with previous work. As part of this work, a comprehensive framework was developed, which can be applied to analyse health effects of financial crises in more detail. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  17. When Culture Hampers European Integration

    DEFF Research Database (Denmark)

    Juul Petersen, Jeppe

    2016-01-01

    This article deals with Denmark’s skeptical attitude towards the EU cooperation. From a hermeneutical-institutional approach the aim of this article is to analyze why Denmark has been rejecting several initiatives from the EU. It illustrates how different democratic understandings hamper European...... integration. Based on Ronald Dworkin’s theoretical framework the article discusses two different perceptions on democracy: majoritarian democracy and constitutional democracy. It is shown when and why EU’s member states prefer to handle EU-related judicial disputes without involving supranational institutions....... In addition, the article provides tentative comparisons to Britain and the Nordic countries since they show similar attitudes to supranational institutions. The article concludes that Denmark’s majoritarian democracy provides political cultures incompatible with the EU’s constitutional democracy and this can...

  18. [Training of health-care employees in crisis resource management].

    Science.gov (United States)

    Spanager, Lene; Østergaard, Doris; Lippert, Anne; Nielsen, Kurt; Dieckmann, Peter

    2013-03-25

    Studies show that human errors contribute to up to 70% of mistakes and mishaps in health care. Crisis resource management, CRM, is a conceptual framework for analysing and training individual and team skills in order to prevent and manage errors. Different CRM training methods, e.g. simulation, are in use and the literature emphasises the need of training the full team or organisation for maximal effect. CRM training has an effect on skill improvement, but few studies have shown an effect on patient outcome. However, these studies show great variability of quality.

  19. Romanian Health Care Reform in the Context of Economic Crisis

    Directory of Open Access Journals (Sweden)

    Victoria Gheonea

    2010-12-01

    Full Text Available The effects of financial crisis are strongly felt in Romania, which already face with asignificant slowdown in economic growth or even economic recession. The current and internationalsituation remains still difficult, and requires high budget constraints. Under these conditions, thehealth system in Romania has become one of the most inefficient in Europe, mainly characterized bylack of transparency in the allocation of funds and inefficiency in resource use. The lack of clear andcoherent criteria to evaluate the performance of health institutions results in a difficultimplementation of efficient managerial systems to reward the efficient manager.

  20. Changes between pre-crisis and crisis period in socioeconomic inequalities in health and stimulant use in Netherlands

    NARCIS (Netherlands)

    Bruggink, Jan-Willem; de Goeij, Moniek C. M.; Otten, Ferdy; Kunst, Anton E.

    2016-01-01

    International research suggests an impact of economic crises on population health, with different effects among different socioeconomic groups. Since the end of 2008 the Netherlands experienced a period of economic crisis. Our study explores how inequalities in perceived general and mental health,

  1. A Novel Mental Health Crisis Service - Outcomes of Inpatient Data.

    Science.gov (United States)

    Morrow, R; McGlennon, D; McDonnell, C

    2016-01-01

    Northern Ireland has high mental health needs and a rising suicide rate. Our area has suffered a 32% reduction of inpatient beds consistent with the national drive towards community based treatment. Taking these factors into account, a new Mental Health Crisis Service was developed incorporating a high fidelity Crisis Response Home Treatment Team (CRHTT), Acute Day Care facility and two inpatient wards. The aim was to provide alternatives to inpatient admission. The new service would facilitate transition between inpatient and community care while decreasing bed occupancy and increasing treatment in the community. All services and processes were reviewed to assess deficiencies in current care. There was extensive consultation with internal and external stakeholders and process mapping using the COBRAs framework as a basis for the service improvement model. The project team set the service criteria and reviewed progress. In the original service model, the average inpatient occupancy rate was 106.6%, admission rate was 48 patients per month and total length of stay was 23.4 days. After introducing the inpatient consultant hospital model, the average occupancy rate decreased to 90%, admissions to 43 per month and total length of stay to 22 days. The results further decreased to 83% occupancy, 32 admissions per month and total length of stay 12 days after CRHTT initiation. The Crisis Service is still being evaluated but currently the model has provided safe alternatives to inpatient care. Involvement with patients, carers and all multidisciplinary teams is maximised to improve the quality and safety of care. Innovative ideas including structured weekly timetable and regular interface meetings have improved communication and allowed additional time for patient care.

  2. Assessing and Planning Health Actions During a Crisis

    Directory of Open Access Journals (Sweden)

    Selim SUNER

    2015-10-01

    Full Text Available SUMMARY: Initial stage of a disaster is managed with existing resources. The following stages of disaster response often involve assistance from outside of the disaster zone. This may consist of mutual aid from neighboring communities for small-scale incidents but in major disasters, the response is from federal or international agencies or often both. Rapid needs assessment after an incident is a collaborative effort between responding agencies and local emergency preparedness and health authorities. Ideally, a team from responding agencies with intimate knowledge and experience regarding the capabilities and assets of the responding entity along with local authorities, with decision making capacity, who have knowledge of the community, the limitations of the responding agencies and can obtain near real-time information about the incident and subject matter experts (engineering, medical, law enforcement, etc. comprise the needs assessment team. Keywords: Crisis, health action, disaster planning

  3. Making sense of the global health crisis: policy narratives, conflict, and global health governance.

    Science.gov (United States)

    Ney, Steven

    2012-04-01

    Health has become a policy issue of global concern. Worried that the unstructured, polycentric, and pluralist nature of global health governance is undermining the ability to serve emergent global public health interests, some commentators are calling for a more systematic institutional response to the "global health crisis." Yet global health is a complex and uncertain policy issue. This article uses narrative analysis to explore how actors deal with these complexities and how uncertainties affect global health governance. By comparing three narratives in terms of their basic assumptions, the way they define problems as well as the solutions they propose, the analysis shows how the unstructured pluralism of global health policy making creates a wide scope of policy conflict over the global health crisis. This wide scope of conflict enables effective policy-oriented learning about global health issues. The article also shows how exclusionary patterns of cooperation and competition are emerging in health policy making at the global level. These patterns threaten effective learning by risking both polarization of the policy debate and unanticipated consequences of health policy. Avoiding these pitfalls, the analysis suggests, means creating global health governance regimes that promote openness and responsiveness in deliberation about the global health crisis.

  4. Environmental Sanitation Crisis: More than just a health issue

    Directory of Open Access Journals (Sweden)

    Peter A. Harvey

    2008-01-01

    Full Text Available The global environmental sanitation crisis cannot be denied: well over a century after the sanitary revolution in 19th century Europe, 40% of the world’s population still lacks access to improved sanitation. Important lessons from the past must be applied today if the crisis is to be averted. Sanitation has suffered from a lack of prioritization for as long as it has remained the poor relation to water supply. The International Year of Sanitation 2008 provides an opportunity to separate the two and give sanitation the emphasis it requires. The economic argument for sanitation must be articulated and non-health incentives for improved sanitation exploited. Environmental sanitation results in a multitude of socio-economic benefits and can contribute positively to all the Millennium Development Goals. Community-led bottom-up approaches, rather than supply-led or technology-driven approaches, are most effective in increasing and sustaining access to sanitation but need to be implemented at scale. Targeted strategies for urban and school sanitation are also required. Evidence-based advocacy can help develop the political will that is now needed to ensure sufficient public sector investment, leadership, legislation and regulation to ensure that the fundamental human right of access to sanitation is realized.

  5. 5 CFR 550.409 - Evacuation payments during a pandemic health crisis.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Evacuation payments during a pandemic... during a pandemic health crisis. (a) An agency may order one or more employees to evacuate from their... the employee) during a pandemic health crisis without regard to whether the agency and the employee...

  6. Underdevelopment and the health care crisis in Nigeria.

    Science.gov (United States)

    Alubo, S O

    1985-01-01

    It has been said that in all societies but especially in the developing countries, health care is inextricably linked to a nation's political and economic system. Medical underdevelopment is a necessary feature of economic underdevelopment. Health care in Nigeria has traditionally been conceptualized as an autonomous, self-determining phenomenon without links to the wider society; and morbidity and mortality problems explained as internal factors, i.e., inadequate hospitals, clinics, equipment, and materials, and a lack of the necessary personnel. The structural underpinnings of these internal problems are assumed inconsequential and not addressed, and so is the international dimension. This essay goes beyond the modernization paradigm by locating Nigeria's health and sickness problems in the context of underdevelopment, demonstrating how health care is located in the context of Nigeria's political economy. 1st, Nigeria's position within the capitalist world economy is examined along with the structure of power and privileges. Against this background, prevalent morbidity and mortality patterns, and the policies to combat these, are discussed. The current health care crisis, it is argued, must be located within the framework of underdevelopment, and solutions are inseparable from overcoming present structural arrangements.

  7. Respiratory Health in Migrant Populations: A Crisis Overlooked

    Science.gov (United States)

    Holguin, Fernando; Moughrabieh, M. Anas; Ojeda, Victoria; Patel, Sanjay R.; Peyrani, Paula; Pinedo, Miguel; Celedón, Juan C.; Douglas, Ivor S.; Upson, Dona J.

    2017-01-01

    The crisis in the Middle East has raised awareness about the challenges encountered by migrant populations, in particular, health-care access and delivery. Similar challenges are encountered by migrant populations around the world, including those entering the United States as refugees and/or survivors of torture as well as Mexicans and other Latin Americans crossing the border. During the 2016 International American Thoracic Society Meeting held in San Francisco, California, a group of researchers and health-care providers discussed these challenges at a minisymposium devoted to the respiratory health of migrants. The discussion focused on the increased incidence of airway diseases among individuals migrating to more developed countries, the problems created by sleep disorders and their implications for cardiovascular and mental health, the challenges inherent in the control of infections in refugee populations, and the problems resulting from deportation. The group also discussed the potential impact of novel strategies made available by Internet-based technologies and how these strategies could be deployed to support worldwide efforts in assisting migrants and refugees, even in countries that find themselves in the direst circumstances. These presentations are summarized in this document, which is not meant to be exhaustive, but to improve awareness about the challenges confronted by migrants and their host nations regarding respiratory health-care access and delivery, and about the need for adequate investment of resources to better define these challenges through research and for the development of efficient strategies for intervention. PMID:28146384

  8. Specialized Police-Based Mental Health Crisis Response: The First 10 Years of Colorado's Crisis Intervention Team Implementation.

    Science.gov (United States)

    Khalsa, Hari-Mandir K; Denes, Attila C; M Pasini-Hill, Diane; Santelli, Jeffrey C; Baldessarini, Ross J

    2018-02-01

    This study examined the implementation of crisis intervention teams by law enforcement agencies in Colorado. Rates of Special Weapons and Tactics (SWAT) use, arrests, use of force, and injuries were assessed during 6,353 incidents involving individuals experiencing a mental health crisis. Relationships among original complaint, psychiatric illness, substance abuse, violence risk, and disposition of crisis calls were analyzed. Rates of SWAT use (<1%), injuries (<1%), arrests (<5%), and use of force (<5%) were low. The relative risk of transfer to treatment (versus no transfer) was significantly higher for incidents involving psychiatric illness, suicide threat or attempt, weapons, substance abuse, and violence potential. Use of force or SWAT, arrests, and injuries were infrequent. Suicide risk, psychiatric illness and substance abuse, even in the presence of a weapon or violence threat, increased the odds of transfer to treatment, whereas suicide risk lowered the odds of transfer to jail.

  9. Diabetic complications do not hamper improvement of health-related quality of life over the course of treatment of diabetic foot ulcers

    DEFF Research Database (Denmark)

    Siersma, Volkert; Thorsen, Hanne; Holstein, Per E.

    2017-01-01

    Aims: Diabetic complications, and in particular diabetic foot ulcers (DFUs), are associated with low health-related quality of life (HRQoL). We evaluated whether the presence of diabetic complications also influenced the improvement of HRQoL during DFU treatment. Methods: 1088 patients presenting...

  10. The crisis of capitalism and the marketisation of health care: the implications for public health professionals.

    Science.gov (United States)

    McKee, Martin; Stuckler, David

    2012-12-28

    The current economic crisis in Europe has challenged the basis of the economic model that currently prevails in much of the industrialised world. It has revealed a system that is managed not for the benefit of the people but rather for the corporations and the small elite who lead them, and which is clearly unsustainable in its present form. Yet, there is a hidden consequence of this system: an unfolding crisis in health care, driven by the greed of corporations whose profit-seeking model is also failing. Proponents of commodifying healthcare simultaneously argue that the cost of providing care for ageing populations is unaffordable while working to create demand for their health care products among those who are essentially healthy. Will healthcare be the next profit-fuelled investor bubble? In this paper, we call on health professionals to heed the warnings from the economic crisis and, rather than stand by while a crisis unfolds, act now to redirect increasingly market-oriented health systems to serve the common good.

  11. The crisis of capitalism and the marketization of health care: the implications for public health professionals

    Directory of Open Access Journals (Sweden)

    Martin McKee

    2012-12-01

    Full Text Available The current economic crisis in Europe has challenged the basis of the economic model that currently prevails in much of the industrialised world. It has revealed a system that is managed not for the benefit of the people but rather for corporations and the small elite who lead them and which is clearly unsustainable in its present form. Yet, there is a hidden consequence of this system: an unfolding crisis in health care, driven by the greed of corporations whose profit-seeking model is also failing. Proponents of commodifying healthcare simultaneously argue that the cost of providing care for ageing populations is unaffordable while working to create demand for their health care products among those who are essentially healthy. Will healthcare be the next profit-fuelled investor bubble? In this paper we call on health professionals to heed the warnings from the economic crisis and, rather than stand by while a crisis unfolds, act now to redirect increasingly market-oriented health systems to serve the common good.

  12. Gifts in Health Crisis: The Use of Health Coaching to Create Opportunity for a More Meaningful Life.

    Science.gov (United States)

    Nutt, Theresa

    2018-02-01

    The purpose of this article is to explore health coaching as an effective intervention in times of health crisis for patients, families, and health-care staff. The pause that a health crisis creates in the activities of normal life allows for deeper questions about a person's life to emerge. Health coaching provides a safe space for clients to engage with these life questions while facilitating a connection with their sense of personal empowerment and innate inner wisdom. The result is a more meaningful and resilient life despite the outcome of the health crisis.

  13. A family systems nursing intervention model for paediatric health crisis.

    Science.gov (United States)

    Tomlinson, Patricia Short; Peden-McAlpine, Cynthia; Sherman, Suzan

    2012-03-01

    This article discusses the development of a family systems nursing intervention for clinical use in health crisis. Although studies in paediatric critical care provide evidence that family stress is an important clinical phenomenon, studies have demonstrated that few nurses have the requisite family intervention skills to provide family members with adequate support during crisis. In addition, few intervention studies that focus on provider-family relationships with the goal of reducing stress have been reported. This article contributes to the literature by redressing this lack. Data sources.  The literature search supporting this project spanned from 1980 to 2009 and included searches from classic nursing theory, family theory and relevant nursing research specific to the design of the intervention reported. The goal of the intervention is to provide a theoretical and practical foundation for explicit action that enhances relationships with caregivers thereby supporting the integrity of the family and enhancing their coping abilities. The intervention, based on the Family Systems Model and the family's understandings of the situation, defines specific goals and desired outcomes to guide strategic actions. Discussion of the conceptual foundation, procedural development and an example of the protocol is provided. Implications for nursing.  The intervention is designed for nurses with limited knowledge in family theory to aid them to better help families dealing with stress. The proposed intervention can be used to increase nurses' skills in family centred nursing care. Although designed for use in paediatric critical care, it can, with modifications, be used in other nursing specialty areas. © 2011 Blackwell Publishing Ltd.

  14. National Suicide Prevention Lifeline: Enhancing Mental Health Care for Suicidal Individuals and Other People in Crisis

    Science.gov (United States)

    Gould, Madelyn S.; Munfakh, Jimmie L. H.; Kleinman, Marjorie; Lake, Alison M.

    2012-01-01

    Linking at-risk callers to ongoing mental health care is a key goal of crisis hotline interventions that has not often been addressed in evaluations of hotlines' effectiveness. We conducted telephone interviews with 376 suicidal and 278 nonsuicidal crisis callers to the National Suicide Prevention Lifeline (Lifeline) to assess rates of mental…

  15. Crisis, neoliberal health policy, and political processes in Mexico.

    Science.gov (United States)

    Laurell, A C

    1991-01-01

    The Mexican case represents an orthodox neoliberal health policy in the context of the structural adjustment adopted by the Mexican government in 1983. The social costs of this strategy are very high, including an increase in unemployment, wage depression, regressive redistribution of wealth, and profound changes in social policies. These transformations are reflected in the health sector, where the four main axes of neoliberal policy--expenditure restrictions, targeting, decentralization, and privatization--have been implemented. This represents a change in social policy from a model based on citizens' social rights and the state's obligation to guarantee them, to a model characterized by selective public charity. This strategy has been imposed on society as a result of the Mexican corporative political regime based on a state party system. Since 1985, however, there has been a growing process of independent organization of civil society. This led in the presidential elections of 1988 to the defeat of the candidate of the governing party by the candidate of a popular-democratic opposition front. Although the government party imposed its candidate through electoral fraud, social mobilization against neoliberal policies continues in the midst of an important political crisis that can only be resolved by profound democratization of Mexican society.

  16. Crisis averted: How consumers experienced a police and clinical early response (PACER) unit responding to a mental health crisis.

    Science.gov (United States)

    Evangelista, Eloisa; Lee, Stuart; Gallagher, Angela; Peterson, Violeta; James, Jo; Warren, Narelle; Henderson, Kathryn; Keppich-Arnold, Sandra; Cornelius, Luke; Deveny, Elizabeth

    2016-08-01

    When mental health crisis situations in the community are poorly handled, it can result in physical and emotional injuries. The purpose of this study was to ascertain the experiences and opinions of consumers about the way police and mental health services worked together, specifically via the Alfred Police and Clinical Early Response (A-PACER) model, to assist people experiencing a mental health crisis. Semi-structured in-depth interviews were conducted with 12 mental health consumers who had direct contact with the A-PACER team between June 2013 and March 2015. The study highlighted that people who encountered the A-PACER team generally valued and saw the benefit of a joint police-mental health clinician team response to a mental health crisis situation in the community. In understanding what worked well in how the A-PACER team operated, consumers perspectives can be summarized into five themes: communication and de-escalation, persistence of the A-PACER team, providing a quick response and working well under pressure, handover of information, and A-PACER helped consumers achieve a preferred outcome. All consumers acknowledged the complementary roles of the police officer and mental health clinician, and described the A-PACER team's supportive approach as critical in gaining their trust, engagement and in de-escalating the crises. Further education and training for police officers on how to respond to people with a mental illness, increased provision of follow-up support to promote rehabilitation and prevent future crises, and measures to reduce public scrutiny for the consumer when police responded, were proposed opportunities for improvement. © 2016 Australian College of Mental Health Nurses Inc.

  17. Politics and Public Health: The Flint Drinking Water Crisis.

    Science.gov (United States)

    Gostin, Lawrence O

    2016-07-01

    The Flint, Michigan, lead drinking water crisis is perhaps the most vivid current illustration of health inequalities in the United States. Since 2014, Flint citizens-among the poorest in America, mostly African American-had complained that their tap water was foul and discolored. But city, state, and federal officials took no heed. In March 2016, an independent task force found fault at every level of government and also highlighted what may amount to criminal negligence for workers who seemingly falsified water-quality results, allowing the people of Flint to continue to be exposed to water well above the federally allowed lead levels. It would have been possible to prevent lead seeping into the drinking water by treating the pipes with federally approved anticorrosives for around $100 per day. But today the cost of repairing the Flint water system is estimated at $1.5 billion, and fixing the ageing and lead-laden system across the United States would cost at least $1.3 trillion. How will Flint residents get justice and fair compensation for the wrongs caused by individual and systemic failures? And how will governments rebuild a water infrastructure that is causing and will continue to cause toxic conditions, particularly in economically marginalized cities and towns across America? © 2016 The Hastings Center.

  18. Deficient crisis-probing practices and taken-for-granted assumptions in health organisations

    Science.gov (United States)

    Canyon, Deon V.; Adhikari, Ashmita; Cordery, Thomas; Giguère-Simmonds, Philippe; Huang, Jessica; Nguyen, Helen; Watson, Michael; Yang, Daniel

    2011-01-01

    The practice of crisis-probing in proactive organisations involves meticulous and sustained investigation into operational processes and management structures for potential weaknesses and flaws before they become difficult to resolve. In health organisations, crisis probing is a necessary part of preparing to manage emerging health threats. This study examined the degree of pre-emptive probing in health organisations and the type of crisis training provided to determine whether or not they are prepared in this area. This evidence-based study draws on cross-sectional responses provided by executives from chiropractic, physiotherapy, and podiatry practices; dental and medical clinics; pharmacies; aged care facilities; and hospitals. The data show a marked lack of mandatory probing and a generalised failure to reward crisis reporting. Crisis prevention training is poor in all organisations except hospitals and aged care facilities where it occurs at an adequate frequency. However this training focuses primarily on natural disasters, fails to address most other crisis types, is mostly reactive and not designed to probe for and uncover key taken-for-granted assumptions. Crisis-probing in health organisations is inadequate, and improvements in this area may well translate into measurable improvements in preparedness and response outcomes. PMID:24149030

  19. Deficient crisis-probing practices and taken-for-granted assumptions in health organisations.

    Science.gov (United States)

    Canyon, Deon V; Adhikari, Ashmita; Cordery, Thomas; Giguère-Simmonds, Philippe; Huang, Jessica; Nguyen, Helen; Watson, Michael; Yang, Daniel

    2011-04-18

    The practice of crisis-probing in proactive organisations involves meticulous and sustained investigation into operational processes and management structures for potential weaknesses and flaws before they become difficult to resolve. In health organisations, crisis probing is a necessary part of preparing to manage emerging health threats. This study examined the degree of pre-emptive probing in health organisations and the type of crisis training provided to determine whether or not they are prepared in this area. This evidence-based study draws on cross-sectional responses provided by executives from chiropractic, physiotherapy, and podiatry practices; dental and medical clinics; pharmacies; aged care facilities; and hospitals. The data show a marked lack of mandatory probing and a generalised failure to reward crisis reporting. Crisis prevention training is poor in all organisations except hospitals and aged care facilities where it occurs at an adequate frequency. However this training focuses primarily on natural disasters, fails to address most other crisis types, is mostly reactive and not designed to probe for and uncover key taken-for-granted assumptions. Crisis-probing in health organisations is inadequate, and improvements in this area may well translate into measurable improvements in preparedness and response outcomes.

  20. Economic stress in the workplace: The impact of fear of the crisis on mental health.

    Science.gov (United States)

    Giorgi, Gabriele; Arcangeli, Giulio; Mucci, Nicola; Cupelli, Vincenzo

    2015-01-01

    Since 2008, a deep financial crisis, which started in the United States, has widely spread around the world. Scientists expressed their worry about this crisis by pointing out that potential negative health effects can be created by collective fear and panic. The main purpose of this cross-sectional study on the fear of the crisis has been to examine its impact on mental health through the use of structural equation modeling. In the trial a new model of economic stress we were also interested in identifying if fear of the crisis has an indirect relationship with employees' health (e.g. related to a poor social support or to work-related stress). Furthermore, this study aimed to examine whether a full or a partial mediation model best fits the data. Data collection took place between 2010 and 2011. During this period several private organizations that comprised of 1236 employees participated in the study. It was found that social support and job stress fully mediated the relationship between fear of the crisis and health, with all fit indices meeting their respective criteria, and with all path coefficients being significant. Implications for discussion of the crisis among employees were presented. In conclusion, fear of the crisis appeared to be an important innovative construct for organizational wellbeing.

  1. Police and mental health clinician partnership in response to mental health crisis: A qualitative study.

    Science.gov (United States)

    McKenna, Brian; Furness, Trentham; Oakes, Jane; Brown, Steve

    2015-10-01

    Police officers as first responders to acute mental health crisis in the community, commonly transport people in mental health crisis to a hospital emergency department. However, emergency departments are not the optimal environments to provide assessment and care to those experiencing mental health crises. In 2012, the Northern Police and Clinician Emergency Response (NPACER) team combining police and mental health clinicians was created to reduce behavioural escalation and provide better outcomes for people with mental health needs through diversion to appropriate mental health and community services. The aim of this study was to describe the perceptions of major stakeholders on the ability of the team to reduce behavioural escalation and improve the service utilization of people in mental health crisis. Responses of a purposive sample of 17 people (carer or consumer advisors, mental health or emergency department staff, and police or ambulance officers) who had knowledge of, or had interfaced with, the NPACER were thematically analyzed after one-to-one semistructured interviews. Themes emerged about the challenge created by a stand-alone police response, with the collaborative strengths of the NPACER (communication, information sharing, and knowledge/skill development) seen as the solution. Themes on improvements in service utilization were revealed at the point of community contact, in police stations, transition through the emergency department, and admission to acute inpatient units. The NPACER enabled emergency department diversion, direct access to inpatient mental health services, reduced police officer 'down-time', improved interagency collaboration and knowledge transfer, and improvements in service utilization and transition. © 2015 Australian College of Mental Health Nurses Inc.

  2. Public Health Crisis in War and Conflict - Health Security in Aggregate.

    Science.gov (United States)

    Quinn, John; Zelený, Tomáš; Subramaniam, Rammika; Bencko, Vladimír

    2017-03-01

    Public health status of populations is multifactorial and besides other factors it is linked to war and conflict. Public health crisis can erupt when states go to war or are invaded; health security may be reduced for affected populations. This study reviews in aggregate multiple indices of human security, human development and legitimacy of the state in order to describe a predictable global health portrait. Paradigm shift of large global powers to that non-state actors and proxies impact regional influence through scaled conflict and present major global health challenges for policy makers. Small scale conflict with large scale violence threatens health security for at-risk populations. The paper concludes that health security is directly proportional to state security. Copyright© by the National Institute of Public Health, Prague 2017

  3. Homelessness, Mental Health and Suicidality Among LGBTQ Youth Accessing Crisis Services.

    Science.gov (United States)

    Rhoades, Harmony; Rusow, Joshua A; Bond, David; Lanteigne, Amy; Fulginiti, Anthony; Goldbach, Jeremy T

    2018-01-10

    LGBTQ youth experience increased risks of homelessness, mental health disorder symptoms, and suicidality. Utilizing data from LGBTQ youth contacting a suicide crisis services organization, this study examined: (a) rates of homelessness among crisis services users, (b) the relationship between disclosure of LGBTQ identity to parents and parental rejection and homelessness, and (c) the relationship between homelessness and mental health disorder outcomes and suicidality. A nationwide sample of LGBTQ youth was recruited for a confidential online survey from an LGBTQ-focused crisis services hotline. Overall, nearly one-third of youth contacting the crisis services hotline had experienced lifetime homelessness, and those who had disclosed their LGBTQ identity to parents or experienced parental rejection because of LGBTQ status experienced higher rates of homelessness. Youth with homelessness experiences reported more symptoms of several mental health disorders and higher rates of suicidality. Suggestions for service providers are discussed.

  4. Psychological Health Before, During, and After an Economic Crisis: Results from Indonesia, 1993 – 2000

    Science.gov (United States)

    Friedman, Jed; Thomas, Duncan

    2015-01-01

    The 1997 Indonesian financial crisis resulted in severe economic dislocation and political upheaval, and the detrimental consequences for economic welfare, physical health, and child education have been established in several studies. The crisis also adversely impacted the psychological well-being of the Indonesian population. Comparing responses of the same individuals interviewed before and after the crisis, we document substantial increases in several different dimensions of psychological distress among male and female adults across the entire age distribution. In addition, the imprint of the crisis can be seen in the differential impacts of the crisis on low education groups, the rural landless, and residents in those provinces that were most affected by the crisis. Elevated levels of psychological distress persist even after indicators of economic well-being such as household consumption had returned to pre-crisis levels, suggesting the deleterious effects of the crisis on the psychological well-being of the Indonesian population may be longer lasting than the impacts on economic well-being. PMID:25892838

  5. Psychological Health Before, During, and After an Economic Crisis: Results from Indonesia, 1993 - 2000.

    Science.gov (United States)

    Friedman, Jed; Thomas, Duncan

    The 1997 Indonesian financial crisis resulted in severe economic dislocation and political upheaval, and the detrimental consequences for economic welfare, physical health, and child education have been established in several studies. The crisis also adversely impacted the psychological well-being of the Indonesian population. Comparing responses of the same individuals interviewed before and after the crisis, we document substantial increases in several different dimensions of psychological distress among male and female adults across the entire age distribution. In addition, the imprint of the crisis can be seen in the differential impacts of the crisis on low education groups, the rural landless, and residents in those provinces that were most affected by the crisis. Elevated levels of psychological distress persist even after indicators of economic well-being such as household consumption had returned to pre-crisis levels, suggesting the deleterious effects of the crisis on the psychological well-being of the Indonesian population may be longer lasting than the impacts on economic well-being.

  6. A fuzzy set approach to economic crisis, austerity and public health. Part II: How are configurations of crisis and austerity related to changes in population health across Europe?

    Science.gov (United States)

    Saltkjel, Therese; Holm Ingelsrud, Mari; Dahl, Espen; Halvorsen, Knut

    2017-08-01

    Based on the ideal type classification of European countries done in Part I of this paper, Part II explores whether the real 'danger' to public health is the interplay between austerity and crisis, rather than recession itself. We constructed two fuzzy sets of changes in population health based on a pooled file of European Union Statistics on Income and Living Conditions (EU-SILC) data (2008 and 2013) including 29 European countries. The linear probability analyses of 'limiting long-standing illness' and 'less than good' health were restricted to the age group 20-64 years. We performed fuzzy set qualitative comparative analysis (fsQCA) and studied whether configurations of 'severe crisis' and 'austerity' were linked to changes in population health. Overall, the results of this fsQCA do not support the 'crisis-austerity' thesis. Results on 'less than good' health were highly inconsistent, while results on 'limiting long-standing illness', contrary to the thesis, showed a two-path model. Countries with either no severe crisis or no austerity were subsets of the set of countries that experienced deteriorated health. Results also show that several countries combined both paths. This fuzzy set analysis does not support Stuckler and Basu's 'crisis-austerity' thesis, as those European countries that experienced recession and austerity were not consistently the countries with deteriorating health. There may be multiple reasons for this result, including analytical approach and operationalization of key concepts, but also resilient forces such as family support. We suggest more research on the topic based on more recent data and possibly other, or more, dimensions of austerity.

  7. Uncharted Waters: Communicating Health Risks During the 2014 West Virginia Water Crisis.

    Science.gov (United States)

    Thomas, Tracey L; Friedman, Daniela B; Brandt, Heather M; Spencer, S Melinda; Tanner, Andrea

    2016-09-01

    This study is among the first to examine how health risks are communicated through traditional and social media during a public health crisis. Using an innovative research approach, the study combined a content analysis with in-depth interviews to examine and understand how stakeholders involved in crisis response perceived media coverage after a chemical spill contaminated the drinking water of 300,000 West Virginia residents. A content analysis of print, television, and online media stories and tweets revealed that health risk information was largely absent from crisis coverage. Although traditional media stories were significantly more likely to include health information compared to tweets, public health sources were underutilized in traditional media coverage. Instead, traditional media favored the use of government sources outside the public health field, which stakeholders suggested was problematic because of a public distrust of officials and official information during the crisis. Results also indicated that Twitter was not a common or reliable source for health information but was important in the spread of other types of information. Ultimately, the study highlights a need for more deliberate media coverage of health risks and provides insight into how Twitter is used to spread crisis information.

  8. Impact of the east Asian economic crisis on health and health care: Malaysia's response.

    Science.gov (United States)

    Suleiman, A B; Lye, M S; Yon, R; Teoh, S C; Alias, M

    1998-01-01

    In the wake of the east Asian economic crisis, the health budget for the public sector in Malaysia was cut by 12%. The Ministry of Health responded swiftly with a series of broad-based and specific strategies. There was a careful examination of the operating expenditure and where possible measures were taken to minimise the effects of the budget constraints at the service interface. The MOH reprioritised the development of health projects. Important projects such as rural health projects and training facilities, and committed projects, were continued. In public health, population-based preventive and promotive activities were expected to experience some form of curtailment. There is a need to refocus priorities, maximise the utilisation of resources, and increase productivity at all levels and in all sectors, both public and private, in order to minimise the impact of the economic downturn on health.

  9. [Sexual and reproductive health and the economic crisis in Spain. SESPAS report 2014].

    Science.gov (United States)

    Larrañaga, Isabel; Martín, Unai; Bacigalupe, Amaia

    2014-06-01

    Sexual and reproductive health (SRH) is protected by the public authorities to ensure that people enjoy a free, satisfying, and safe sexual life. Despite the approval of the National Sexual and Reproductive Health Strategy in 2011, the progress achieved may be jeopardized by recent proposals for legislative changes affecting this area (abortion Law and 16/2012 Law) and by the impact of the current economic crisis. This article aims to describe the current situation of sexual and reproductive health in the Spanish population and to identify the potential impact of the economic crisis. To this end, we used the following information sources: the National Sexual Health Survey, the DAPHNE surveys, births and fetal deaths statistics from the Spanish National Institute of Statistics, the Registry of Voluntary Pregnancy Interruptions, reports from the National Epidemiology Center, and the National AIDS Registry. Sexual health and the availability of information are rated as good by the Spanish population. Among young people, schools and health services have become less important as information sources and the internet has become more important. Since the beginning of the crisis, contraceptive use and fertility have declined and maternity has been delayed. The economic crisis seems to have affected some indicators of sexual and reproductive health. However, the potential effects on other indicators should continue to be monitored because insufficient time may have passed for accurate determination of the full effect of the crisis. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  10. Health trends in the wake of the financial crisis-increasing inequalities?

    Science.gov (United States)

    Nelson, Kenneth; Tøge, Anne Grete

    2017-08-01

    The financial crisis that hit Europe in 2007-2008 and the corresponding austerity policies have generated concern about increasing health inequalities, although impacts have been less salient than initially expected. One explanation could be that health inequalities emerged first a few years into the crisis. This study investigates health trends in the wake of the financial crisis and analyses health inequalities across a number of relevant population subgroups, including those defined by employment status, age, family type, gender, and educational attainment. This study uses individual-level panel data (EU-SILC, 2010-2013) to investigate trends in self-rated health. By applying individual fixed effects regression models, the study estimates the average yearly change in self-rated health for persons aged 15-64 years in 28 European countries. Health inequalities are investigated using stratified analyses. Unemployed respondents, particularly those who were unemployed in all years of observation, had a steeper decline in self-rated health than the employed. Respondents of prime working age (25-54 years) had a steeper decline than their younger (15-24) and older (55-64) counterparts, while single parents had a more favorable trend in self-rated health than dual parents. We did not observe any increasing health inequalities based on gender or educational attainment. Health inequalities increased in the wake of the financial crisis, especially those associated with employment status, age, and family type. We did not observe increasing health inequalities in terms of levels of educational attainment and gender.

  11. A crisis recovery model for adolescents with severe mental health problems.

    Science.gov (United States)

    Kaplan, Tony; Racussen, Lisa

    2013-04-01

    A model of intervention at the interface and for the in-patient phase for adolescents with severe mental health crises was developed to reduce length of stay while maintaining quality of service consonant with the 'recovery model'. The model is described, and discussed in the context of the limited literature on both crisis intervention with adolescents and families, and 'recovery' in this age-group. The model may be suitable also for use by community teams dealing with adolescents in crisis.

  12. Evaluating multidisciplinary health care teams: taking the crisis out of CRM.

    Science.gov (United States)

    Sutton, Gigi

    2009-08-01

    High-reliability organisations are those, such as within the aviation industry, which operate in complex, hazardous environments and yet despite this are able to balance safety and effectiveness. Crew resource management (CRM) training is used to improve the non-technical skills of aviation crews and other high-reliability teams. To date, CRM within the health sector has been restricted to use with "crisis teams" and "crisis events". The purpose of this discussion paper is to examine the application of CRM to acute, ward-based multidisciplinary health care teams and more broadly to argue for the repositioning of health-based CRM to address effective everyday function, of which "crisis events" form just one part. It is argued that CRM methodology could be applied to evaluate ward-based health care teams and design non-technical skills training to increase their efficacy, promote better patient outcomes, and facilitate a range of positive personal and organisational level outcomes.

  13. The financial crisis, health and health inequities in Europe: the need for regulations, redistribution and social protection.

    Science.gov (United States)

    De Vogli, Roberto

    2014-07-25

    In 2009, Europe was hit by one of the worst debt crises in history. Although the Eurozone crisis is often depicted as an effect of government mismanagement and corruption, it was a consequence of the 2008 U.S. banking crisis which was caused by more than three decades of neoliberal policies, financial deregulation and widening economic inequities.Evidence indicates that the Eurozone crisis disproportionately affected vulnerable populations in society and caused sharp increases of suicides and deaths due to mental and behavioral disorders especially among those who lost their jobs, houses and economic activities because of the crisis. Although little research has, so far, studied the effects of the crisis on health inequities, evidence showed that the 2009 economic downturn increased the number of people living in poverty and widened income inequality especially in European countries severely hit by the debt crisis. Data, however, also suggest favorable health trends and a reduction of traffic deaths fatalities in the general population during the economic recession. Moreover, egalitarian policies protecting the most disadvantaged populations with strong social protections proved to be effective in decoupling the link between job losses and suicides.Unfortunately, policy responses after the crisis in most European countries have mainly consisted in bank bailouts and austerity programs. These reforms have not only exacerbated the debt crisis and widened inequities in wealth but also failed to address the root causes of the crisis. In order to prevent a future financial downturn and promote a more equitable and sustainable society, European governments and international institutions need to adopt new regulations of banking and finance as well as policies of economic redistribution and investment in social protection. These policy changes, however, require the abandonment of the neoliberal ideology to craft a new global political economy where markets and gross

  14. Social Media Messages in an Emerging Health Crisis: Tweeting Bird Flu.

    Science.gov (United States)

    Vos, Sarah C; Buckner, Marjorie M

    2016-01-01

    Limited research has examined the messages produced about health-related crises on social media platforms and whether these messages contain content that would allow individuals to make sense of a crisis and respond effectively. This study uses the crisis and emergency risk communication (CERC) framework to evaluate the content of messages sent via Twitter during an emerging crisis. Using manual and computer-driven content analysis methods, the study analyzed 25,598 tweets about the H7N9 virus that were produced in April 2013. The study found that a large proportion of messages contained sensemaking information. However, few tweets contained efficacy information that would help individuals respond to the crisis appropriately. Implications and recommendations for practice and future study are discussed.

  15. Responding to the public health consequences of the Ukraine crisis: an opportunity for global health diplomacy.

    Science.gov (United States)

    Mackey, Tim K; Strathdee, Steffanie A

    2015-01-01

    Peace and stability in Eastern Europe is now at a crossroads with the rapidly deteriorating foreign policy crisis continuing to unfold in the Ukraine. However, largely overlooked in the context of other foreign policy and diplomatic priorities are the serious public health consequences for the region following the annexation of Crimea and the subsequent decision to ban opioid substitution therapy in the disputed territory. On 1 May 2014, the Republic of Crimea officially announced it would end access to opioid substitution therapy, an essential harm reduction tool recognized by international organizations and virtually all other European countries. The policy development marks a critical reversal in the region's fight against its growing HIV epidemic and also threatens years of public health gains aimed at providing evidence-based and integrated treatment approaches to combat drug dependence and HIV. Beyond these risks, the Ukrainian conflict could also negatively impact control of other infectious diseases that are converging with HIV and injection drug use, such as multidrug-resistant tuberculosis and hepatitis C virus. The continuing conflict is also likely to have a significant negative impact on Ukraine's fragile public health system leading to even worse population health outcomes than currently experienced by the country. In response to this crisis, the application of global health diplomacy principles represents a possible route of advocacy to ensure that HIV prevention, humane treatment of substance using populations, and improving public health outcomes in the region are pursued among concerned international stakeholders. In order to be effective, global health diplomacy efforts must be coordinated and advocated in all forms of diplomatic engagement, including at the core, multistakeholder and informal levels and through existing channels such as the different human rights bodies of the United Nations as well as amongst other actors. Hence, the Ukraine

  16. Educational inequalities in health expectancy during the financial crisis in Denmark

    DEFF Research Database (Denmark)

    Brønnum-Hansen, Henrik; Baadsgaard, Mikkel; Eriksen, Mette Lindholm

    2015-01-01

    in expected lifetime in self-rated good health increased by 1.3 years for men and 1.2 years for women. CONCLUSIONS: The social inequality in DFLE for men and expected lifetime in self-rated good health for both genders increased slightly during the short period. The financial crisis did not seem to indicate...

  17. Impact of the 2008 economic and financial crisis on child health: A systematic review

    NARCIS (Netherlands)

    L. Rajmil (Luis); M.-J.F. de Sanmamed (María-José Fernandez); I. Choonara (Imti); T. Faresjö (Tomas); A. Hjern (Anders); A. Kozyrskyj (Anita); P.J. Lucas (Patricia); H. Raat (Hein); L. Séguin (Louise); N. Spencer (Nick); D. Taylor-Robinson (David)

    2014-01-01

    textabstractThe aim of this study was to provide an overview of studies in which the impact of the 2008 economic crisis on child health was reported. Structured searches of PubMed, and ISI Web of Knowledge, were conducted. Quantitative and qualitative studies reporting health outcomes on children,

  18. The financial crisis and global health: the International Monetary Fund's (IMF) policy response.

    Science.gov (United States)

    Ruckert, Arne; Labonté, Ronald

    2013-09-01

    In this article, we interrogate the policy response of the International Monetary Fund (IMF) to the global financial crisis, and discuss the likely global health implications, especially in low-income countries. In doing so, we ask if the IMF has meaningfully loosened its fiscal deficit targets in light of the economic challenges posed by the financial crisis and adjusted its macro-economic policy advice to this new reality; or has the rhetoric of counter-cyclical spending failed to translate into additional fiscal space for IMF loan-recipient countries, with negative health consequences? To answer these questions, we assess several post-crisis IMF lending agreements with countries requiring financial assistance, and draw upon recent academic studies and civil society reports examining policy conditionalities still being prescribed by the IMF. We also reference recent studies examining the health impacts of these conditionalities. We demonstrate that while the IMF has been somewhat more flexible in its crisis response than in previous episodes of financial upheaval, there has been no meaningful rethinking in the application of dominant neoliberal macro-economic policies. After showing some flexibility in the initial crisis response, the IMF is pushing for excessive contraction in most low and middle-income countries. We conclude that there remains a wide gap between the rhetoric and the reality of the IMF's policy and programming advice, with negative implications for global health.

  19. The Impact of the 1997-1998 East Asian Economic Crisis on Health and Health Care in Indonesia

    NARCIS (Netherlands)

    Pradhan, M.P.; Waters, H.; Saadah, F.

    2003-01-01

    This article identifies the effects of the 1997-98 East Asian economic crisis on health care use and health status in Indonesia. The article places the findings in the context of a framework showing the complex cause and effect relationships underlying the effects of economic downturns on health and

  20. The health implications of financial crisis: a review of the evidence.

    Science.gov (United States)

    Stuckler, David; Basu, Sanjay; Suhrcke, Marc; McKee, Martin

    2009-09-01

    What will the current economic crisis mean for the health of the people of Northern Ireland? We review the experience of three major economic crises in the 20(th) century: the Great Depression (1929), the Post-communist Depression (early 1990 s) and the East Asian financial crisis (late 1990 s). Available evidence suggests that health is at risk in times of rapid economic change, in both booms and busts. However the impact on mortality is exacerbated where people have easy access to the means to harm themselves and is ameliorated by the presence of strong social cohesion and social protection systems. On this basis, Northern Ireland may escape relatively unscathed in the short term but as every crisis also provides an opportunity, this is an appropriate time for the Northern Ireland Executive to reflect on whether they are making a sufficient investment in the long term health of their population.

  1. The global financial crisis and health equity: early experiences from Canada.

    Science.gov (United States)

    Ruckert, Arne; Labonté, Ronald

    2014-01-06

    It is widely acknowledged that austerity measures in the wake of the global financial crisis are starting to undermine population health results. Yet, few research studies have focused on the ways in which the financial crisis and the ensuing 'Great Recession' have affected health equity, especially through their impact on social determinants of health; neither has much attention been given to the health consequences of the fiscal austerity regime that quickly followed a brief period of counter-cyclical government spending for bank bailouts and economic stimulus. Canada has not remained insulated from these developments, despite its relative success in maneuvering the global financial crisis. The study draws on three sources of evidence: A series of semi-structured interviews in Ottawa and Toronto, with key informants selected on the basis of their expertise (n = 12); an analysis of recent (2012) Canadian and Ontario budgetary impacts on social determinants of health; and documentation of trend data on key social health determinants pre- and post the financial crisis. The findings suggest that health equity is primarily impacted through two main pathways related to the global financial crisis: austerity budgets and associated program cutbacks in areas crucial to addressing the inequitable distribution of social determinants of health, including social assistance, housing, and education; and the qualitative transformation of labor markets, with precarious forms of employment expanding rapidly in the aftermath of the global financial crisis. Preliminary evidence suggests that these tendencies will lead to a further deepening of existing health inequities, unless counter-acted through a change in policy direction. This article documents some of the effects of financial crisis and severe economic decline on health equity in Canada. However, more research is necessary to study policy choices that could mitigate this effect. Since the policy response to a similar set of

  2. Is it a policy crisis or it is a health crisis? The Egyptian context ...

    African Journals Online (AJOL)

    The International health officials said the swine flu virus that has caused worldwide fear is not transmitted by pigs, and that pig slaughters do nothing to stop its spread. The WHO ... The extinction of the Egyptian pigs is an example of how a health issue can be used to persecute a minority within a country. Although the ...

  3. Framing in the Spanish press about the health crisis because of the E. coli bacterium

    Directory of Open Access Journals (Sweden)

    Paloma López Villafranca

    2013-12-01

    Full Text Available This research article analyses  the approach made by press media and other institutional advertising about the E. coli bacterium, most commonly known as cucumber crisis in Spain. While in the rest of Europe this crisis receives the same treatment as A Flu or mad cow disease in this country it is treated as a crisis that affects to the spanish economy and not to the health of the citizen. Economic interests prevail over public health and this is due to official information given. An analysis of contents of the most popular journals in Spain, according to OJD, is made to prove this hypothesis, El Pais, El Mundo and ABC, as well as a study of the main institutional advertising made about E. coli bacterium by official spanish organizations and the media.

  4. The fiscal crisis in the health sector: Patterns of cutback management across Europe.

    Science.gov (United States)

    Ongaro, Edoardo; Ferré, Francesca; Fattore, Giovanni

    2015-07-01

    The article investigates trends in health sector cutback management strategies occurred during the ongoing financial and fiscal crisis across Europe. A European-wide survey to top public healthcare managers was conducted in ten different countries to understand their perception about public sector policy reactions to the financial and economic crisis; answers from 760 respondents from the healthcare sector (30.7% response rate) were analyzed. A multinomial logistic regression was used to assess the characteristics of respondents, countries' institutional healthcare models and the trend in public health resources availability during the crisis associated to the decision to introduce unselective cuts, targeted cuts or efficiency savings measures. Differentiated responses to the fiscal crisis that buffeted public finances were reported both across and within countries. Organizational position of respondents is significant in explaining the perceived cutback management approach introduced, where decentralized positions detect a higher use of linear cuts compared to their colleagues working in central level organizations. Compared to Bismark-like systems Beveridge-like ones favour the introduction of targeted cuts. Postponing the implementation of new programmes and containing expenses through instruments like pay freezes are some of the most popular responses adopted, while outright staff layoffs or reduction of frontline services have been more selectively employed. To cope with the effects of the fiscal crisis healthcare systems are undergoing important changes, possibly also affecting the scope of universal coverage. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Austerity, economic crisis, and their persistent effects on mental health in Greece

    Directory of Open Access Journals (Sweden)

    Christodoulou Nikos

    2016-01-01

    Full Text Available Since its beginning in 2008, the on-going global economic crisis has left many countries struggling with a disaster. Greece is probably the worst affected country, having lost close to a third of its economic productivity, and being still under the imposition of harsh austerity measures. Individual mental health has suffered, as suicide, depression and anxiety, among others, substantially rose during the crisis. Despite efforts to protect mental health systems, they were severely and persistently affected, and evidence suggests that eventually they started failing to meet the health needs of the population. In this narrative review we sought to explore the reasons for this persistent detrimental effect. We identified several evidence based examples of resonating factors that could help explain why the effects of the crisis are so persistent. We suggest that mental health systems need additional support and investment to overcome the resonating effects of the crisis and to meet the population’s mental health needs We also suggest that such resonating effects should be taken into account for contingency planning and the prevention of future crises.

  6. [Indicators to monitor the evolution of the economic crisis and its effects on health and health inequalities. SESPAS report 2014].

    Science.gov (United States)

    Pérez, Glòria; Rodríguez-Sanz, Maica; Domínguez-Berjón, Felicitas; Cabeza, Elena; Borrell, Carme

    2014-06-01

    The economic crisis has adverse effects on determinants of health and health inequalities. The aim of this article was to present a set of indicators of health and its determinants to monitor the effects of the crisis in Spain. On the basis of the conceptual framework proposed by the Commission for the Reduction of Social Health Inequalities in Spain, we searched for indicators of social, economic, and political (structural and intermediate) determinants of health, as well as for health indicators, bearing in mind the axes of social inequality (gender, age, socioeconomic status, and country of origin). The indicators were mainly obtained from official data sources published on the internet. The selected indicators are periodically updated and are comparable over time and among territories (among autonomous communities and in some cases among European Union countries), and are available for age groups, gender, socio-economic status, and country of origin. However, many of these indicators are not sufficiently reactive to rapid change, which occurs in the economic crisis, and consequently require monitoring over time. Another limitation is the lack of availability of indicators for the various axes of social inequality. In conclusion, the proposed indicators allow for progress in monitoring the effects of the economic crisis on health and health inequalities in Spain. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  7. Defining and Acting on Global Health: The Case of Japan and the Refugee Crisis

    Directory of Open Access Journals (Sweden)

    Claire Leppold

    2016-08-01

    Full Text Available What counts as global health? There has been limited discourse to date on the ways in which country-level contexts may shape positioning in global health agendas. By reviewing Japan’s response to the refugee crisis, we demonstrate a clash between rhetoric and action on global responsibility, and suggest that cultural and historical factors may be related to the ways of perceiving and acting upon global health.

  8. Defining and Acting on Global Health: The Case of Japan and the Refugee Crisis.

    Science.gov (United States)

    Leppold, Claire; Ozaki, Akihiko; Shimada, Yuki; Morita, Tomohiro; Tanimoto, Tetsuya

    2016-05-31

    What counts as global health? There has been limited discourse to date on the ways in which country-level contexts may shape positioning in global health agendas. By reviewing Japan's response to the refugee crisis, we demonstrate a clash between rhetoric and action on global responsibility, and suggest that cultural and historical factors may be related to the ways of perceiving and acting upon global health. © 2016 by Kerman University of Medical Sciences.

  9. Financial Health of electricity producers. What strategies to the crisis?

    International Nuclear Information System (INIS)

    Aristide, Adrien; Gobert, Yann; Bailey, Christopher

    2017-02-01

    This publication reports an analysis of the financial situation of 15 European electric power producing companies which represent 55 per cent of the electricity production. In a crisis context (decrease of turnover and of EBITDA between 2013 and 2015), three strategies seem to emerge: a model based on renewable production, orientation towards renewable production, and focus on an operational efficiency of the energy mix. As the installed production capacity has increased, electric power consumption has decreased. Thus, the financial situation of power utilities is strongly affected by the economic context, and companies are trying to maintain their financial ratios (control of financial debt and preservation of asset profitability) while they are facing a loss of confidence from investors as revealed by their performance on the stock exchange market. In response, they diversify their activities and redefine their strategy as mentioned here above. These elements are first presented with commented graphs, and then more precisely discussed

  10. Stretching single fibrin fibers hampers their lysis.

    Science.gov (United States)

    Li, Wei; Lucioni, Tomas; Li, Rongzhong; Bonin, Keith; Cho, Samuel S; Guthold, Martin

    2017-09-15

    Blood clots, whose main structural component is a mesh of microscopic fibrin fibers, experience mechanical strain from blood flow, clot retraction and interactions with platelets and other cells. We developed a transparent, striated and highly stretchable substrate made from fugitive glue (a styrenic block copolymer) to investigate how mechanical strain affects lysis of single, suspended fibrin fibers. In this suspended fiber assay, lysis manifested itself by fiber elongation, thickening (disassembly), fraying and collapse. Stretching single fibrin fibers significantly hampered their lysis. This effect was seen in uncrosslinked and crosslinked fibers. Crosslinking (without stretching) also hampered single fiber lysis. Our data suggest that strain is a novel mechanosensitive factor that regulates blood clot dissolution (fibrinolysis) at the single fiber level. At the molecular level of single fibrin molecules, strain may distort, or hinder access to, plasmin cleavage sites and thereby hamper lysis. Fibrin fibers are the major structural component of a blood clot. We developed a highly stretchable substrate made from fugitive glue and a suspended fibrin fiber lysis assay to investigate the effect of stretching on single fibrin fibers lysis. The key findings from our experiments are: 1) Fibers thicken and elongate upon lysis; 2) stretching strongly reduces lysis; 3) this effect is more pronounced for uncrosslinked fibers; and 4) stretching fibers has a similar effect on reducing lysis as crosslinking fibers. At the molecular level, strain may distort plasmin cleavage sites, or restrict access to those sites. Our results suggest that strain may be a novel mechanobiological factor that regulates fibrinolysis. Copyright © 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  11. Global Warming and the Political Ecology of Health: Emerging Crisis and Systemic Solutions

    Directory of Open Access Journals (Sweden)

    Kate Smith

    2012-06-01

    Full Text Available Review of Global Warming and the Political Ecology of Health: Emerging Crisis and Systemic Solutions. Hans Baer and Merrill Singer. 2008. Left Coast Press, Inc., Walnut Creek, CA. Pp. 238. $32.95 (paperback. ISBN 978-1-59874-354-8.

  12. The Korean economic crisis and coping strategies in the health sector: pro-welfarism or neoliberalism?

    Science.gov (United States)

    Kim, Chang-Yup

    2005-01-01

    In South Korea, there have been debates on the welfare policies of the Kim Dae-jung government after the economic crisis beginning in late 1997, but it is unquestionable that health and health care policies have followed the trend of neoliberal economic and social polices. Public health measures and overall performance of the public sector have weakened, and the private health sector has further strengthened its dominance. These changes have adversely affected the population's health status and access to health care. However, the anti-neoliberal coalition is preventing the government's drive from achieving a full success.

  13. [Study protocol on the effect of the economic crisis on mortality and reproductive health and health inequalities in Spain].

    Science.gov (United States)

    Pérez, Glòria; Gotsens, Mercè; Palència, Laia; Marí-Dell'Olmo, Marc; Domínguez-Berjón, M Felicitas; Rodríguez-Sanz, Maica; Puig, Vanessa; Bartoll, Xavier; Gandarillas, Ana; Martín, Unai; Bacigalupe, Amaia; Díez, Elia; Ruiz, Miguel; Esnaola, Santiago; Calvo, Montserrat; Sánchez, Pablo; Luque Fernández, Miguel Ángel; Borrell, Carme

    The aim is to present the protocol of the two sub-studies on the effect of the economic crisis on mortality and reproductive health and health inequalities in Spain. Substudy 1: describe the evolution of mortality and reproductive health between 1990 and 2013 through a longitudinal ecological study in the Autonomous Communities. This study will identify changes caused by the economic crisis in trends or reproductive health and mortality indicators using panel data (17 Autonomous Communities per study year) and adjusting Poisson models with random effects variance. Substudy 2: analyse inequalities by socioeconomic deprivation in mortality and reproductive health in several areas of Spain. An ecological study analysing trends in the pre-crisis (1999-2003 and 2004-2008) and crisis (2009-2013) periods will be performed. Random effects models Besag York and Mollié will be adjusted to estimate mortality indicators softened in reproductive health and census tracts. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Intervention pattern in crisis: mental health as a nursing care approach at a general hospital

    OpenAIRE

    Oliveira, Elias Barbosa; Kestenberg, Célia Caldeira Fonseca; Silva, Alexandre Vicente

    2013-01-01

    Objective: Testing and validating the application of Intervention in Crisis theory as an approach in mental health on HIV/AIDS patients care who are interned at a general hospital. Method: Help Interview has been accomplished as an activity for Mental Health subject according to an applied guide by graduation in nursing students in order to identify this illness psycho-social repercussion and draft therapeutic plan for patients under their care. The outcomes were the reports results presented...

  15. Public Health Security in Crisis Situations. Basic Premises and Strategic Objectives

    OpenAIRE

    Konieczny, Jerzy

    2012-01-01

    In recent years the approach to public health has changed, making the adoption of a uniform definition difficult. This is forced by the growing number of extraordinary dangers: terrorist attacks, natural disasters, dangerous invading microbial and virus diseases, bioterrorist, chemical and radiation threats, transport accidents and disasters. These threats create crisis situations which are very complicated and define new challenges for the authorities and public health leaders as well as fo...

  16. Child Health and the 1988-92 Economic Crisis in Peru

    OpenAIRE

    Paxson, Christina; Schady, Norbert

    2004-01-01

    The effect of economic crises on child health is a topic of great policy importance. The authors use data from the Demographic and Health Surveys (DHS) to analyze the impact of the profound 1988-92 economic crisis in Peru on infant mortality and anthropometrics. They show that there was an increase in the infant mortality rate of about 2.5 percentage points for children born in late 1989 ...

  17. Policy Options for Addressing Health System and Human Resources for Health Crisis in Liberia Post-Ebola Epidemic

    Directory of Open Access Journals (Sweden)

    Fidel C.T. Budy, MPH

    2016-01-01

    Full Text Available Qualified healthcare workers within an effective health system are critical in promoting and achieving greater health outcomes such as those espoused in the Millennium Development Goals. Liberia is currently struggling with the effects of a brutal 14-year long civil war that devastated health infrastructures and caused most qualified health workers to flee and settle in foreign countries. The current output of locally trained health workers is not adequate for the tasks at hand. The recent Ebola Virus Disease (EVD exposed the failings of the Liberian healthcare system. There is limited evidence of policies that could be replicated in Liberia to encourage qualified diaspora Liberian health workers to return and contribute to managing the phenomenon. This paper reviews the historical context for the human resources for health crisis in Liberia; it critically examines two context-specific health policy options to address the crisis, and recommends reverse brain drain as a policy option to address the immediate and critical crisis facing the health care sector in Liberia.

  18. Policy Options for Addressing Health System and Human Resources for Health Crisis in Liberia Post-Ebola Epidemic

    Science.gov (United States)

    Budy, Fidel C.T.

    2015-01-01

    Qualified healthcare workers within an effective health system are critical in promoting and achieving greater health outcomes such as those espoused in the Millennium Development Goals. Liberia is currently struggling with the effects of a brutal 14-year long civil war that devastated health infrastructures and caused most qualified health workers to flee and settle in foreign countries. The current output of locally trained health workers is not adequate for the tasks at hand. The recent Ebola Virus Disease (EVD) exposed the failings of the Liberian healthcare system. There is limited evidence of policies that could be replicated in Liberia to encourage qualified diaspora Liberian health workers to return and contribute to managing the phenomenon. This paper reviews the historical context for the human resources for health crisis in Liberia; it critically examines two context-specific health policy options to address the crisis, and recommends reverse brain drain as a policy option to address the immediate and critical crisis facing the health care sector in Liberia. PMID:27622002

  19. The wealth, health and wellbeing of Ireland's older people before and during the economic crisis.

    Science.gov (United States)

    Barrett, A; O'Sullivan, V

    2014-07-03

    The economic crisis of 2008/9 was felt more acutely in Ireland relative to elsewhere and culminated in the international bailout in 2010. Given the economic collapse, Ireland provides an ideal case-study of the link between wealth collapses and movements in variables such as health and well-being. Using nationally-representative samples of older people collected before and during the crisis, we show that mean net assets fell by 45 percent between 2006/7 and 2012/13. In spite of this massive fall in wealth, measures of health and well-being remained broadly unchanged. However, expectations about future living standards became less optimistic. The results tend to support the findings of other recent studies that recessions do not have widespread negative effects on health and well-being.

  20. Impact of the 2008 Economic and Financial Crisis on Child Health: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Luis Rajmil

    2014-06-01

    Full Text Available The aim of this study was to provide an overview of studies in which the impact of the 2008 economic crisis on child health was reported. Structured searches of PubMed, and ISI Web of Knowledge, were conducted. Quantitative and qualitative studies reporting health outcomes on children, published since 2007 and related to the 2008 economic crisis were included. Two reviewers independently assessed studies for inclusion. Data were synthesised as a narrative review. Five hundred and six titles and abstracts were reviewed, from which 22 studies were included. The risk of bias for quantitative studies was mixed while qualitative studies showed low risk of bias. An excess of 28,000–50,000 infant deaths in 2009 was estimated in sub-Saharan African countries, and increased infant mortality in Greece was reported. Increased price of foods was related to worsening nutrition habits in disadvantaged families worldwide. An increase in violence against children was reported in the U.S., and inequalities in health-related quality of life appeared in some countries. Most studies suggest that the economic crisis has harmed children’s health, and disproportionately affected the most vulnerable groups. There is an urgent need for further studies to monitor the child health effects of the global recession and to inform appropriate public policy responses.

  1. The early NHS and the crisis of public health nursing.

    Science.gov (United States)

    Webster, C

    2000-01-01

    Establishment of the NHS in 1948 is rightly seen as a major turning point in health care in the United Kingdom. Notwithstanding conditions of severe austerity, the NHS succeeded remarkably well in its basic remit to make all essential medical care available to the entire population, free at point of delivery. The benefits of the new system extended across the entire front of its services. However, it is important to recognise that the reforms of 1948 were uniformly advantageous. It has for instance long been recognised that the NHS failed to bring about the expected transformation in standards of general medical practice. In this short paper the author argues that public health represented a further major sphere of underdevelopment. The fact that, with minor exceptions, public health is the least studied aspect of the early NHS is itself suggestive of its status as the Cinderella of the modern health services. The author also underlines the adverse implications of this inferior position for domiciliary midwifery, district nursing and health visiting. These constituted small but strategically important sectors of nursing, all of which fell under public health administration in the new health service. The author concentrates on the first phase of the NHS, the period between 1948 and 1974, now often regarded as its golden age. For the purposes of this discussion, most of the evidence relates to the formative phase of the new service, when many major policy questions relating to public health were first confronted. It is suggested that the early neglect of public health and its constituent nursing functions has left a legacy of problems that have still not entirely been resolved. For the purposes of this paper the term will be used to embrace the totality of health functions administered by departments of local government in the period from 1948 to 1974. Most of these services fell within the public health departments of local government, headed by the Medical Office

  2. Double deprivation: a phenomenological study into the experience of being a carer during a mental health crisis.

    Science.gov (United States)

    Albert, Rikke; Simpson, Alan

    2015-12-01

    To explore carers' experience of caring during a mental health crisis. Community mental health care including crisis care relies increasingly on carers. The relationship between carers and professionals is at times fraught due to issues of what constitutes a crisis, confidentiality and a perception of lack of empathy. The caring experience can lead carers to feel isolated and neglected. A qualitative study with a phenomenological approach. Eight carers participated and were interviewed individually using a semi-structured approach. Analysis used the Interpretive Phenomenological Analysis method including transcribing of interviews, initial noting, searching for connections and patterns across the transcripts and cases. The themes were checked with the participants for their views on the emerging themes. The data were collected from November 2011-May 2012. Carers experienced 'double deprivation' by not receiving support from professionals and protecting their social network from the trauma of the crisis. The caring in crisis invoked complex feelings of guilt and loyalty which made discussing aggression difficult. Caring was described as a terrifying experience not just because of the aggression but also because of the perception of abandonment by professionals. The experience was an overwhelmingly negative one with a wish for acknowledgement of the crisis and support from mental health services. For most of the participants the caring during crisis was traumatic which left the carer feeling isolated and unsupported. The study should be used to help educate professionals on the complexities of caring during a crisis. © 2015 John Wiley & Sons Ltd.

  3. National Institutes of Health Funding in Plastic Surgery: A Crisis?

    Science.gov (United States)

    Silvestre, Jason; Abbatematteo, Joseph M; Serletti, Joseph M; Chang, Benjamin

    2016-09-01

    Decreasing funding rates and increasing competition for National Institutes of Health research grants have prompted diverse interventions in various fields of biomedicine. Currently, the state of National Institutes of Health funding for plastic surgery research is poorly understood. The purpose of this study was to describe the portfolio of National Institutes of Health grants in academic plastic surgery. Plastic surgery faculty at integrated and independent programs were queried individually in the National Institutes of Health RePORTER database for grants awarded in 2014. Funding totals, mechanisms, and institutes were calculated. Abstracts were categorized by research type and field of interest. Characteristics of National Institutes of Health-funded principal investigators were elucidated. Eight hundred sixty-one academic plastic surgeons at 94 programs were queried, and only 18 investigators (2.1 percent) were funded at 12 programs (12.8 percent). National Institutes of Health-funded investigators were predominately male (72 percent), fellowship-trained (61 percent), and aged 49.3 ± 7.8 years. A total of 20 awards amounted to $6,916,886, with an average award of $345,844 ± $222,909. Costs were primarily awarded through the R01 mechanism (77.2 percent). The top three National Institutes of Health institutes awarded 72.9 percent of the entire portfolio. Funding supported clinical (41.1 percent), translational (36.9 percent), and basic science (22.0 percent) research. Craniofacial (20.5 percent), hand (18.7 percent), and breast (16.2 percent) had the greatest funding. Few programs and faculty drive the National Institutes of Health portfolio of plastic surgery research. These data suggest a tenuous funding situation that may be susceptible to future spending cuts. Future research is needed to identify barriers to National Institutes of Health funding procurement in academic plastic surgery.

  4. The mental health service crisis of neoliberalism -- an antipodean perspective.

    Science.gov (United States)

    Carney, Terry

    2008-01-01

    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.

  5. Children's moral experiences of crisis management in a child mental health setting.

    Science.gov (United States)

    Montreuil, Marjorie; Thibeault, Catherine; McHarg, Linda; Carnevale, Franco A

    2018-02-15

    The experiences of children related to conflict and crisis management in child mental health settings, especially those aged 12 and below, have been rarely studied. This study examined the moral experiences of children related to conflict and crisis management and the related use of restraint and seclusion in a child mental health setting. A 5-month focused ethnography using a participatory hermeneutic framework was conducted in a day hospital programme for children with severe disruptive disorders within a mental health institute. Children considered restraints and seclusion could help them feel safe in certain instances, for example if another child was being aggressive towards them or in exceptional cases to prevent self-injury. However, their own experiences of being restrained were predominantly negative, especially if not knowing the reason for their use, which they then found unfair. Some of the children emphasized the punitive nature of the use of restraints and seclusion, and most children disagreed with these practices when used as a punishment. Children's perspectives also highlighted the limits of the use of a uniform de-escalation approach by the staff to manage crises. Children considered discussing with the staff and developing a relationship with them as more helpful in case of a crisis then the use of a de-escalation approach or coercive strategies. © 2018 Australian College of Mental Health Nurses Inc.

  6. Police Mental Health Partnership project: Police Ambulance Crisis Emergency Response (PACER) model development.

    Science.gov (United States)

    Huppert, David; Griffiths, Matthew

    2015-10-01

    To review internationally recognized models of police interactions with people experiencing mental health crises that are sometimes complex and associated with adverse experience for the person in crisis, their family and emergency service personnel. To develop, implement and review a partnership model trial between mental health and emergency services that offers alternative response pathways with improved outcomes in care. Three unique models of police and mental health partnership in the USA were reviewed and used to develop the PACER (Police Ambulance Crisis Emergency Response) model. A three month trial of the model was implemented and evaluated. Significant improvements in response times, the interactions with and the outcomes for people in crisis were some of the benefits shown when compared with usual services. The pilot showed that a partnership involving mental health and police services in Melbourne, Australia could be replicated based on international models. Initial data supported improvements compared with usual care. Further data collection regarding usual care and this new model is required to confirm observed benefits. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  7. Crisis, Living Conditions and Health in Mexico: New Challenges for Social Policy

    Directory of Open Access Journals (Sweden)

    Oliva López Arellano

    2010-08-01

    Full Text Available In the last 30 years, Mexico has faced major crises in its political, economic, and social life. These crises have affected living conditions and health. With the implementation in the 1980's of structural adjustment and economic stabilization policies, Mexico saw a rapid growth of poverty accelerating trends toward social polarization and social division. The current crisis, fueled by deregulation of the global financial markets, only deepens the tendency towards economic stagnation. It has led to an increase in unemployment, worsening income inequalities, and generalized inflation. The increase in food prices, in particular, has made life more difficult for the Mexican population. The crisis has had a palpable and concrete impact on living conditions, health status, and food security for diverse social groups.

  8. The global financial crisis and health: scaling up our effort.

    Science.gov (United States)

    Labonté, Ronald

    2009-01-01

    Economic events of the past year are beginning to create hardships for tens of thousands of Canadians. There are likely to be health effects as well, to the extent that unemployment and poverty rates rise. Conditions, however, will be much worse for those living in poorer countries. High-income countries are committing trillions of dollars in countercyclical spending and banking bail-outs. Poorer countries need to do the same, but lack the resources to do so. Yet foreign aid and fairer trade are widely expected to be among the first high-income country victims of the recession fallout as nations turn inwards and protectionist. This is neither good for global health nor necessary given the scale of untaxed (or unfairly taxed) wealth that could be harnessed for a truly global rescue package. Policy choices confront us. The Canadian public health community must hold our political leadership accountable for making those choices that will improve health globally and not further imperil the well-being of much of the world's population in efforts to secure our own future economic revival.

  9. The contemporary refugee crisis: an overview of mental health challenges.

    Science.gov (United States)

    Silove, Derrick; Ventevogel, Peter; Rees, Susan

    2017-06-01

    There has been an unprecedented upsurge in the number of refugees worldwide, the majority being located in low-income countries with limited resources in mental health care. This paper considers contemporary issues in the refugee mental health field, including developments in research, conceptual models, social and psychological interventions, and policy. Prevalence data yielded by cross-sectional epidemiological studies do not allow a clear distinction to be made between situational forms of distress and frank mental disorder, a shortcoming that may be addressed by longitudinal studies. An evolving ecological model of research focuses on the dynamic inter-relationship of past traumatic experiences, ongoing daily stressors and the background disruptions of core psychosocial systems, the scope extending beyond the individual to the conjugal couple and the family. Although brief, structured psychotherapies administered by lay counsellors have been shown to be effective in the short term for a range of traumatic stress responses, questions remain whether these interventions can be sustained in low-resource settings and whether they meet the needs of complex cases. In the ideal circumstance, a comprehensive array of programs should be provided, including social and psychotherapeutic interventions, generic mental health services, rehabilitation, and special programs for vulnerable groups. Sustainability of services, ensuring best practice, evidence-based approaches, and promoting equity of access must remain the goals of future developments, a daunting challenge given that most refugees reside in settings where skills and resources in mental health care are in shortest supply. © 2017 World Psychiatric Association.

  10. Early Childhood Dental Caries: A Rising Dental Public Health Crisis

    Science.gov (United States)

    Gomez, Grace Felix

    2013-01-01

    The aim of this article is to examine the literature and review the risk factors and disparities contributing to early childhood caries (ECC), which is a major health problem among preschoolers in the United States of America. A search was conducted using MEDLINE, PubMed, Google Scholar, and the Cochrane Library databases and the key terms…

  11. Equity during an economic crisis: financing of the Argentine health system.

    Science.gov (United States)

    Cavagnero, Eleonora; Bilger, Marcel

    2010-07-01

    This article analyses the redistributive effect caused by health financing and the distribution of healthcare utilization in Argentina before and during the severe 2001/2002 economic crisis. Both dramatically changed during this period: the redistributive effect became much more positive and utilization shifted from pro-poor to pro-rich. This clearly demonstrates that when utilization is contingent on financing, changes can occur rapidly; and that an integrated approach is required when monitoring equity. From a policy perspective, the Argentine health system appears vulnerable to economic downturns mainly due to high reliance on out-of-pocket payments and the strong link between health insurance and employment.

  12. Lead poisoning in China: a health and human rights crisis.

    Science.gov (United States)

    Cohen, Jane E; Amon, Joseph J

    2012-12-15

    Acute and chronic lead poisoning is occurring throughout China and is a major cause of childhood morbidity. The Chinese government's emphasis on industrial development and poverty reduction has, over the past three decades, decreased by 500 million the number of people surviving on less than one dollar per day, but has caused significant environmental degradation that threatens public health. Drawing upon in-depth interviews conducted in 2009 and 2010 with families affected by lead poisoning, environmental activists, journalists, government and civil society organization officials in Shaanxi, Henan, Hunan, and Yunnan provinces, as well as a review of scientific and Chinese media, and health and environmental legal and policy analysis, we examine the intersection of civil, political, economic, and social rights related to access to information, screening, treatment, and remediation related to lead poisoning. In-depth interviews in each province uncovered: censorship and intimidation of journalists, environmental activists, and parents seeking information about sources and prevention of lead poisoning; denial of screening for lead poisoning, often based upon arbitrary eligibility criteria; and inadequate and inappropriate treatment being promoted and provided by health facilities. Over the past decade, the Chinese government has prioritized health care and invested billions of dollars towards universal health coverage, and strengthened environmental to address industrial pollution and guarantee access to information on the environment. Yet, despite these reforms, information remains constrained and citizens seeking information and redress are sometimes arrested, in violation of Chinese and international law. Local government officials and national environmental policies continue to prioritize economic development over environmental protection. To effectively address lead poisoning requires an emphasis on prevention, and to combat industrial pollution requires

  13. Understanding the impact of the economic crisis on child health: the case of Spain.

    Science.gov (United States)

    Rajmil, Luis; Siddiqi, Arjumand; Taylor-Robinson, David; Spencer, Nick

    2015-10-14

    The objectives of the study were to explore the effect of the economic crisis on child health using Spain as a case study, and to document and assess the policies implemented in response to the crisis in this context. Serial cross-sectional data from Eurostat, the Spanish Health Interview Survey, and the database of childhood hospitalisation were analysed to explore impacts on child health, and key determinants of child health. A content analysis of National data sources/government legislation, and Spanish literature was used to describe policies implemented following the crisis. Unemployment rates in the general population (8.7% in 2005 and 25.6% in 2013), and children living in unemployed families (5.6% and 13.8%) increased in the study period. The percentage of children living under the poverty line, and income inequalities increased 15-20% from 2005 to 2012. Severe material deprivation rate has worsened in families with Primary Education, while the number of families attending Non-Governmental Organisations has increased. An impact on children's health at the general population level has not currently been detected; however an impact on general health, mental health and use of healthcare services was found in vulnerable groups. Investment in social protection and public policy for children showed a reduction as part of austerity measures taken by the Spanish governments. Despite the impact on social determinants, a short-term impact on child health has been detected only in specific vulnerable groups. The findings suggest the need to urgently protect vulnerable groups of children from the impact of austerity.

  14. Pathogens, prejudice, and politics: the role of the global health community in the European refugee crisis.

    Science.gov (United States)

    Khan, Mishal S; Osei-Kofi, Anna; Omar, Abbas; Kirkbride, Hilary; Kessel, Anthony; Abbara, Aula; Heymann, David; Zumla, Alimuddin; Dar, Osman

    2016-08-01

    Involuntary migration is a crucially important global challenge from an economic, social, and public health perspective. The number of displaced people reached an unprecedented level in 2015, at a total of 60 million worldwide, with more than 1 million crossing into Europe in the past year alone. Migrants and refugees are often perceived to carry a higher load of infectious diseases, despite no systematic association. We propose three important contributions that the global health community can make to help address infectious disease risks and global health inequalities worldwide, with a particular focus on the refugee crisis in Europe. First, policy decisions should be based on a sound evidence base regarding health risks and burdens to health systems, rather than prejudice or unfounded fears. Second, for incoming refugees, we must focus on building inclusive, cost-effective health services to promote collective health security. Finally, alongside protracted conflicts, widening of health and socioeconomic inequalities between high-income and lower-income countries should be acknowledged as major drivers for the global refugee crisis, and fully considered in planning long-term solutions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. How to solve the cost crisis in health care.

    Science.gov (United States)

    Kaplan, Robert S; Porter, Michael E

    2011-09-01

    U.S. health care costs currently exceed 17% of GDP and continue to rise. One fundamental reason that providers are unable to reverse the trend is that they don't understand what it costs to deliver patient care or how those costs compare with outcomes. To put it bluntly, few health care providers measure the actual costs for treating a given patient with a given medical condition over a full cycle of care, or compare the costs they incur with the outcomes they achieve. What isn't measured cannot be managed or improved, and this is all too true in health care, where poor costing systems mean that effective and efficient providers go unrewarded, and inefficient ones have little incentive to improve. But all this can be remedied by exploring the concept of value in health care and carefully measuring costs. This article describes a new way to analyze costs that uses patients and their conditions--not organizational units or narrow diagnostic treatment groups--as the fundamental unit of analysis for measuring costs and outcomes. The new approach, called time-driven activity-cased costing, is currently being implemented in pilots at the Head and Neck Center at MD Anderson, the Cleft Lip and Palate Program at Children's Hospital in Boston, and units performing knee replacements at Schön Klinik in Germany and Brigham & Women's Hospital in Boston. As providers and payors better understand costs, they will be positioned to achieve a true "bending of the cost curve" from within the system, not in response to top-down mandates. Accurate costing also unlocks a whole cascade of opportunities, such as process improvement, better organization of care, and new reimbursement approaches that will accelerate the pace of innovation and value creation.

  16. A framework and methodology for navigating disaster and global health in crisis literature.

    Science.gov (United States)

    Chan, Jennifer L; Burkle, Frederick M

    2013-04-04

    Both 'disasters' and 'global health in crisis' research has dramatically grown due to the ever-increasing frequency and magnitude of crises around the world. Large volumes of peer-reviewed literature are not only a testament to the field's value and evolution, but also present an unprecedented outpouring of seemingly unmanageable information across a wide array of crises and disciplines. Disaster medicine, health and humanitarian assistance, global health and public health disaster literature all lie within the disaster and global health in crisis literature spectrum and are increasingly accepted as multidisciplinary and transdisciplinary disciplines. Researchers, policy makers, and practitioners now face a new challenge; that of accessing this expansive literature for decision-making and exploring new areas of research. Individuals are also reaching beyond the peer-reviewed environment to grey literature using search engines like Google Scholar to access policy documents, consensus reports and conference proceedings. What is needed is a method and mechanism with which to search and retrieve relevant articles from this expansive body of literature. This manuscript presents both a framework and workable process for a diverse group of users to navigate the growing peer-reviewed and grey disaster and global health in crises literature. Disaster terms from textbooks, peer-reviewed and grey literature were used to design a framework of thematic clusters and subject matter 'nodes'. A set of 84 terms, selected from 143 curated terms was organized within each node reflecting topics within the disaster and global health in crisis literature. Terms were crossed with one another and the term 'disaster'. The results were formatted into tables and matrices. This process created a roadmap of search terms that could be applied to the PubMed database. Each search in the matrix or table results in a listed number of articles. This process was applied to literature from PubMed from

  17. The crisis as catalyst for reframing health care policies in the European Union.

    Science.gov (United States)

    Helderman, Jan-Kees

    2015-01-01

    Seen from the perspective of health, the global financial crisis (GFC) may be conceived of as an exogenous factor that has undermined the fiscal sustainability of European welfare states and consequently, their (expanding) health systems as well. Being one of the core programs of European welfare states, health care has always belonged to the sovereignty of European Member States. However, in past two decades, European welfare states have in fact become semi-sovereign states and the European Union (EU) no longer is an exogenous actor in European health policy making. Today, the EU not only puts limits to unsustainable growth levels in health care spending, it also acts as an health policy agenda setter. Since the outbreak of the GFC, it does so in an increasingly coercive and persuasive way, claiming authority over health system reforms alongside the responsibilities of its Member States.

  18. Substandard drugs: a potential crisis for public health

    Science.gov (United States)

    Johnston, Atholl; Holt, David W

    2014-01-01

    Poor-quality medicines present a serious public health problem, particularly in emerging economies and developing countries, and may have a significant impact on the national clinical and economic burden. Attention has largely focused on the increasing availability of deliberately falsified drugs, but substandard medicines are also reaching patients because of poor manufacturing and quality-control practices in the production of genuine drugs (either branded or generic). Substandard medicines are widespread and represent a threat to health because they can inadvertently lead to healthcare failures, such as antibiotic resistance and the spread of disease within a community, as well as death or additional illness in individuals. This article reviews the different aspects of substandard drug formulation that can occur (for example, pharmacological variability between drug batches or between generic and originator drugs, incorrect drug quantity and presence of impurities). The possible means of addressing substandard manufacturing practices are also discussed. A concerted effort is required on the part of governments, drug manufacturers, charities and healthcare providers to ensure that only drugs of acceptable quality reach the patient. PMID:24286459

  19. Home health nursing care services in Greece during an economic crisis.

    Science.gov (United States)

    Adamakidou, T; Kalokerinou-Anagnostopoulou, A

    2017-03-01

    The purpose of this review was to describe public home healthcare nursing services in Greece. The effectiveness and the efficiency of home healthcare nursing are well documented in the international literature. In Greece, during the current financial crisis, the development of home healthcare nursing services is the focus and interest of policymakers and academics because of its contribution to the viability of the healthcare system. A review was conducted of the existing legislation, the printed and electronic bibliography related to the legal framework, the structures that provide home health care, the funding of the services, the human resources and the services provided. The review of the literature revealed the strengths and weaknesses of the existing system of home health care and its opportunities and threats, which are summarized in a SWOT analysis. There is no Greek nursing literature on this topic. The development of home health nursing care requires multidimensional concurrent and combined changes and adjustments that would support and strengthen healthcare professionals in their practices. Academic and nursing professionals should provide guidelines and regulations and develop special competencies for the best nursing practice in home health care. At present, in Greece, which is in an economic crisis and undergoing reforms in public administration, there is an undeniable effort being made to give primary health care the position it deserves within the health system. There is an urgent need at central and academic levels to develop home healthcare services to improve the quality and efficiency of the services provided. © 2016 International Council of Nurses.

  20. The Syrian public health and humanitarian crisis: A 'displacement' in global governance?

    Science.gov (United States)

    Akbarzada, Sumaira; Mackey, Tim K

    2018-07-01

    Ongoing failure by the international community to resolve the Syrian conflict has led to destruction of critical infrastructure. This includes the collapse of the Syrian health system, leaving millions of internally displaced persons (IDPs) in urgent need of healthcare services. As the conflict intensifies, IDP populations are suffering from infectious and non-communicable disease risks, poor maternal and child health outcomes, trauma, and mental health issues, while healthcare workers continually exit the country. Healthcare workers who remain face significant challenges, including systematic attacks on healthcare facilities and conditions that severely inhibit healthcare delivery and assistance. Within this conflict-driven public health crisis, the most susceptible population is arguably the IDP. Though the fundamental 'right to health' is a recognised international legal principle, its application is inadequate due to limited recognition by the UN Security Council and stymied global governance by the broader international community. These factors have also negatively impacted other vulnerable groups other than IDPs, such as refugees and ethnic minorities, who may or may not be displaced. Hence, this article reviews the current Syrian conflict, assesses challenges with local and global governance for IDPs, and explores potential governance solutions needed to address this health and humanitarian crisis.

  1. Effect of pregnancy during TMI crisis on mothers' mental health and their child's development

    International Nuclear Information System (INIS)

    Houts, P.S.; Tokuhata, G.K.; Bratz, J.; Bartholomew, M.J.; Sheffer, K.W.

    1991-01-01

    Five years after the Three Mile Island nuclear accident, the mental health of women who had been pregnant and living within 10 miles of Three Mile Island at the time of the accident was similar to that of women from the same area who became pregnant after the accident. Ratings of the development of the two groups of children when they were 5 years old were also similar. However, women who were pregnant during the crisis and had been extremely disturbed about their pregnancies rated their children's health as poorer than did the women who were pregnant later

  2. Improving outcomes for people in mental health crisis: a rapid synthesis of the evidence for available models of care.

    Science.gov (United States)

    Paton, Fiona; Wright, Kath; Ayre, Nigel; Dare, Ceri; Johnson, Sonia; Lloyd-Evans, Brynmor; Simpson, Alan; Webber, Martin; Meader, Nick

    2016-01-01

    Crisis Concordat was established to improve outcomes for people experiencing a mental health crisis. The Crisis Concordat sets out four stages of the crisis care pathway: (1) access to support before crisis point; (2) urgent and emergency access to crisis care; (3) quality treatment and care in crisis; and (4) promoting recovery. To evaluate the clinical effectiveness and cost-effectiveness of the models of care for improving outcomes at each stage of the care pathway. Electronic databases were searched for guidelines, reviews and, where necessary, primary studies. The searches were performed on 25 and 26 June 2014 for NHS Evidence, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, NHS Economic Evaluation Database, and the Health Technology Assessment (HTA) and PROSPERO databases, and on 11 November 2014 for MEDLINE, PsycINFO and the Criminal Justice Abstracts databases. Relevant reports and reference lists of retrieved articles were scanned to identify additional studies. When guidelines covered a topic comprehensively, further literature was not assessed; however, where there were gaps, systematic reviews and then primary studies were assessed in order of priority. Systematic reviews were critically appraised using the Risk Of Bias In Systematic reviews assessment tool, trials were assessed using the Cochrane risk-of-bias tool, studies without a control group were assessed using the National Institute for Health and Care Excellence (NICE) prognostic studies tool and qualitative studies were assessed using the Critical Appraisal Skills Programme quality assessment tool. A narrative synthesis was conducted for each stage of the care pathway structured according to the type of care model assessed. The type and range of evidence identified precluded the use of meta-analysis. One review of reviews, six systematic reviews, nine guidelines and 15 primary studies were included. There was very limited evidence for access to support

  3. The present global financial and economic crisis poses an additional risk factor for mental health problems on the employees.

    Science.gov (United States)

    Avčin, Bojana Avguštin; Kučina, Andrea Užmah; Sarotar, Brigita Novak; Radovanović, Mirjana; Plesničar, Blanka Kores

    2011-09-01

    The global financial and economic crisis starting in 2007 led to a deterioration of several socio-economic determinants of mental health. The aim of this cross-sectional study was to examine the impact of the present economic crisis on the depression and anxiety levels of the employed in the private and public sector in Slovenia. Altogether 1592 employees completed an internet based self-reported questionnaire. Data about perceived impact of the economic crisis, several socio-demographic, socioeconomic, and health parameters were collected. Depression symptoms were assessed by the Center for Epidemiological Studies-Depression Scale and anxiety symptoms by the Spielberger State-Inventory. Regression models were used 1) to explore the associations of the economic crisis with the level of depression and anxiety symptoms while controlling for some sociodemographic and work characteristic variables, and 2) to understand the relationship between some potentially important socioeconomic variables and the perception of the economic crisis. Depressive and anxiety scores were significantly increased among 590 (46.6%) employees being affected by the economic crisis. The level of depressive symptoms was significantly associated with perceived impact by the crisis, recent sick leave, reported injuries sustained at work, benzodiazepine and analgesic use, the lack of emotional support, and trust in crisis telephone lines. The level of anxiety symptoms yielded the robust association with the level of depression symptoms, reported injuries sustained on the way to work and education. The economic crisis poses an additional risk factor for mental health problems which clinicians should internalize and become more aware of them. Symptoms of depression and anxiety can be masked in high-utilizers of medical care with physical complaints or psychoactive drug use.

  4. [Crisis and the independence of public health policies. SESPAS report 2014].

    Science.gov (United States)

    Hernández Aguado, Ildefonso; Lumbreras Lacarra, Blanca

    2014-06-01

    Independence in the formulation of public health policies can be affected by various agents with objectives contrary to population health, such as large corporations. This lack of independence may be exacerbated by the economic crisis due to lower funding for health regulatory bodies or other measures designed to protect health. Large corporations have influenced the formulation of certain policies with an impact on health, such as those related to the tobacco industry, the chemical industry, nutrition, alcohol, pharmaceuticals, and health technology. The main areas in which these companies can influence policies are science, education, politics, and society in general. In this scenario, public health associations should take an active role in ensuring the independence of political decisions via actions such as the following: supporting strategies that guarantee the independence of public health policies and apply criteria of impartiality and transparency; rejecting those public-private partnerships launched to prevent health problems partly caused by these corporations; establishing partnerships to achieve independent training of health professionals and an institution with scientific authority in order to improve public health communication and counteract the lack of sound public health information; promoting a critical analysis of the definition of health problems and their solutions, and establishing related agendas (scientific, political and media) and alliances, so that continuing training for health professionals is independent. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  5. The modern crisis in health services--professional concerns and the public interest.

    Science.gov (United States)

    Sheps, C G

    1981-01-01

    The modern crisis in the health service systems of developed nations is described. Six major issues are discussed. 1) The need for recognition of the wholeness of man and the implications of this for implementing the concept of essential unity in the development and organization of health services; 2) the creation of ample opportunity for health manpower to work effectively in team situations; 3) the need for community-wide epidemiologic intelligence that will allow for better identification of problems and solutions; 4) the need to move away from the entrepreneurial framework of health care and regionalize facilities; 5) the assessment of costs both in terms of actions and inactions; and 6) the need for the professionals and public to work together in order to improve health services.

  6. Health inequalities by socioeconomic characteristics in Spain: the economic crisis effect.

    Science.gov (United States)

    Barroso, Clara; Abásolo, Ignacio; Cáceres, José J

    2016-04-11

    An economic crisis can widen health inequalities between individuals. The aim of this paper is to explore differences in the effect of socioeconomic characteristics on Spaniards' self-assessed health status, depending on the Spanish economic situation. Data from the 2006-2007 and 2011-2012 National Health Surveys were used and binary logit and probit models were estimated to approximate the effects of socioeconomic characteristics on the likelihood to report good health. The difference between high and low education levels leads to differences in the likelihood to report good health of 16.00-16.25 and 18.15-18.22 percentage points in 2006-07 and 2011-12, respectively. In these two periods, the difference between employees and unemployed is 5.24-5.40 and 4.60-4.90 percentage points, respectively. Additionally, the difference between people who live in households with better socioeconomic conditions and those who are in worse situation reaches 5.37-5.46 and 3.63-3.74 percentage points for the same periods, respectively. The magnitude of the contribution of socioeconomic characteristics to health inequalities changes with the economic cycle; but this effect is different depending on the socioeconomic characteristics indicator that is being measured. In recessive periods, health inequalities due to education level increase, but those linked to individual professional status and household living conditions are attenuated. When the joint effects of individuals' characteristics are considered, the economic crisis brings about a slight increase in the inequalities in the probability of reporting good health between the two extreme profiles of individuals. The design of public policies aimed at preventing any worsening of health inequalities during recession periods should take into account these differential effects of socioeconomic characteristics indicators on health inequalities.

  7. A framework for assessing health system resilience in an economic crisis: Ireland as a test case.

    Science.gov (United States)

    Thomas, Steve; Keegan, Conor; Barry, Sarah; Layte, Richard; Jowett, Matt; Normand, Charles

    2013-10-30

    The financial crisis that hit the global economy in 2007 was unprecedented in the post war era. In general the crisis has created a difficult environment for health systems globally. The purpose of this paper is to develop a framework for assessing the resilience of health systems in terms of how they have adjusted to economic crisis. Resilience can be understood as the capacity of a system to absorb change but continue to retain essentially the same identity and function. The Irish health system is used as a case study to assess the usefulness of this framework. The authors identify three forms of resilience: financial, adaptive and transformatory. Indicators of performance are presented to allow for testing of the framework and measurement of system performance. Both quantitative and qualitative methods were used to yield data for the Irish case study. Quantitative data were collected from government documents and sources to understand the depth of the recession and the different dimensions of the response. Semi-structured interviews were conducted with key decision makers to understand the reasons for decisions made. In the Irish case there is mixed evidence on resilience. Health funding was initially protected but was then followed by deep cuts as the crisis deepened. There is strong evidence for adaptive resilience, with the health system showing efficiency gains from the recession. Nevertheless, easy efficiencies have been made and continued austerity will mean cuts in entitlements and services. The prospects for building and maintaining transformatory resilience are unsure. While the direction of reform is clear, and has been preserved to date, it is not certain whether it will remain manageable given continued austerity, some loss of sovereignty and capacity limitations. The three aspects of resilience proved a useful categorisation of performance measurement though there is overlap between them. Transformatory resilience may be more difficult to assess

  8. District health care between quality assurance and crisis management. Possibilities within the limits, Mporokoso and Kaputa District, Zambia

    NARCIS (Netherlands)

    van Bergen, J. E.

    1995-01-01

    A tension exists between objectives of health policy makers to achieve high quality standards of care on one hand, and district multi-crisis reality in sub-Saharan Africa on the other hand where sheer survival of the (public) health system is questioned. The collapsing health services as well as the

  9. Medical Supplies Shortages and Burnout among Greek Health Care Workers during Economic Crisis: a Pilot Study

    Science.gov (United States)

    Rachiotis, George; Kourousis, Christos; Kamilaraki, Maria; Symvoulakis, Emmanouil K.; Dounias, George; Hadjichristodoulou, Christos

    2014-01-01

    Greece has been seriously affected by the economic crisis. In 2011 there were reports of 40% reduction to public hospital budgets. Occasional shortages of medical supplies have been reported in mass media. We attempted to pivotally investigate the frequency of medical supplies shortages in two Greek hospital units of the National Health System and to also assess their possible impact on burnout risk of health care workers. We conducted a cross-sectional study (n=303) of health care workers in two Greek hospitals who were present at the workplace during a casually selected working day (morning shift work). The Maslach Burnout Inventory (MBI) was used as the measure of burnout. An additional questionnaire was used about demographics, and working conditions (duration of employment, cumulative night shifts, type of hospital including medical supplies shortages and their impact on quality of healthcare. The prevalence of emotional exhaustion, depersonalization and low personal accomplishment was 44.5%, 43.2% and 51.5%, respectively. Medical supply shortages were significantly associated with emotional exhaustion and depersonalization. This finding provides preliminary evidence that austerity has affected health care in Greece. Moreover, the medical supply shortages in Greek hospitals may reflect the unfolding humanitarian crisis of the country. PMID:24688306

  10. Beyond the Great Recession: Was the Foreclosure Crisis Harmful to the Health of Individuals With Diabetes?

    Science.gov (United States)

    Downing, Janelle; Laraia, Barbara; Rodriguez, Hector; Dow, William H; Adler, Nancy; Schillinger, Dean; Warton, E Margaret; Karter, Andrew J

    2017-03-15

    The housing foreclosure crisis was harmful to the financial well-being of many households. In the present study, we investigated the health effects of the housing foreclosure crisis on glycemic control within a population of patients with diabetes. We hypothesized that an increase in the neighborhood foreclosure rate could worsen glycemic control by activating stressors such as higher neighborhood crime, lower housing prices, and erosion of neighborhood social cohesion. To test this, we linked public foreclosure records at the census-block level with clinical records from 2006 to 2009 of patients with diabetes. We specified individual fixed-effects models and controlled for individual time-invariant confounders and area-level time-varying confounders, including housing prices and unemployment rate, to estimate the effect of the foreclosure rate per census-block group on glycated hemoglobin. We found no statistically significant relationship between changes in the neighborhood foreclosure rate per block group in the prior year and changes in glycated hemoglobin. There is no evidence that increased foreclosure rates worsened glycemic control in this continuously insured population with diabetes. More research is needed to inform our knowledge of the role of insurance and health-care delivery systems in protecting the health of diabetic patients during times of economic stress. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Educational inequalities in health expectancy during the financial crisis in Denmark.

    Science.gov (United States)

    Brønnum-Hansen, Henrik; Baadsgaard, Mikkel; Eriksen, Mette Lindholm; Andersen-Ranberg, Karen; Jeune, Bernard

    2015-12-01

    To investigate educational differentials in health expectancy among 50-year-old Danes before and during the financial crisis. Nationwide register data on mortality were combined with data from SHARE surveys in 2006/2007 and 2010/2011 to estimate disability-free life expectancy (DFLE) and expected lifetime in self-rated good health by educational level. The difference in life expectancy between 50-year-old men and women with high and low educational levels increased by 0.3 and 0.8 years, respectively. The overall educational differentials in DFLE did not change much for women, whereas for men the tendency was that DFLE increased for those with high educational level and decreased for those with less education ascending the difference by almost 2 years (from 5.9 to 7.8 years), although the difference was not statistically significant. The educational disparity in expected lifetime in self-rated good health increased by 1.3 years for men and 1.2 years for women. The social inequality in DFLE for men and expected lifetime in self-rated good health for both genders increased slightly during the short period. The financial crisis did not seem to indicate a change in the persistent trend of the widening social gap.

  12. The health insurance industry: perpetuating the opioid crisis through policies of cost-containment and profitability

    Directory of Open Access Journals (Sweden)

    Schatman ME

    2015-03-01

    Full Text Available Michael E Schatman1, Lynn R Webster21Foundation for Ethics in Pain Care, Bellevue, WA, USA; 2PRA Health Sciences, Salt Lake City, UT, USA"People don’t trust private health insurance companies for all the right reasons." – Senator Bernie Sanders.Throughout the world, industrialized nations look at the USA and are befuddled by its opioid crisis. Between 1999 and 2011, we witnessed the number of opioid deaths in the USA increase from 4,030 to 16,917,1 with these figures having seemingly stabilized over the past several years.2 Many agree regarding the root causes of the crisis, with an analysis by Webster et al3 identifying health comorbidities (most prominently substance use disorders, payer policies mandating methadone as a first-line treatment option, physician error due to a lack of knowledge, patient nonadherence, unanticipated medical and mental health issues, concomitant utilization of other central nervous system depressants such as benzodiazepines, and sleep-disordered breathing as contributory.

  13. Health Disparities by Income in Spain Before and After the Economic Crisis.

    Science.gov (United States)

    Coveney, Max; García-Gómez, Pilar; Van Doorslaer, Eddy; Van Ourti, Tom

    2016-11-01

    Little is known about how health disparities by income change during times of economic crisis. We apply a decomposition method to unravel the contributions of income growth, income inequality and differential income mobility across socio-demographic groups to changes in health disparities by income in Spain using longitudinal data from the Survey of Income and Living Conditions for the period 2004-2012. We find a modest rise in health inequality by income in Spain in the 5 years of economic growth prior to the start of the crisis in 2008, but a sharp fall after 2008. The drop mainly derives from the fact that loss of employment and earnings has disproportionately affected the incomes of the younger and healthier groups rather than the (mainly stable pension) incomes of the groups over 65 years. This suggests that unequal distribution of income protection by age may reduce health inequality in the short run after an economic recession. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  14. Long-term effects of youth unemployment on mental health: does an economic crisis make a difference?

    Science.gov (United States)

    Thern, Emelie; de Munter, Jeroen; Hemmingsson, Tomas; Rasmussen, Finn

    2017-04-01

    Ill health is a risk factor and a consequence of unemployment, which might vary depending on the national rate of unemployment. We investigated the long-term effect of youth unemployment on mental health and explored the possible interaction during periods of high (economic crisis) and low (non-crisis) unemployment rates. A register-linked population-based cohort study was conducted including individuals aged 17-24 years. The crisis cohort (n=6410) took part in the Labour Force Survey during the economic crisis (1991-1994) in Sweden and the non-crisis cohort (n=8162) took part in the same survey before the crisis (1983-1986). Follow-up was 19 years. Adjusted HRs and 95% CIs for an inpatient care discharge mental diagnosis with employed people as the reference group were calculated by Cox regressions models. In fully adjusted models, 6 months (2.70; 1.71 to 4.28) of unemployment were associated with increased risks of getting a mental diagnosis in the crisis cohort. In the non-crisis cohort the risks were: 1.92; 1.40 to 2.63, 2.60; 1.72 to 3.94 and 3.33; 2.00 to 5.57, respectively. No interactions between labour force status and level of unemployment were found. Youth unemployment is related to mental health problems, independent of the overall national rate of unemployment, which is important as the youth unemployment rates are currently at stable high level. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Can Health Surveillance be emancipatory? An alternative way of thinking about alternatives in times of crisis.

    Science.gov (United States)

    Porto, Marcelo Firpo de Souza

    2017-10-01

    This article in essay form is an invitation to reflect upon the emancipatory character of health surveillance, a debate that was interrupted in the 1990s. In these times of grave political and institutional crisis in Brazil and in the year of the first National Conference on Health Surveillance (1ª CNVS, acronym in Portuguese), it is particularly appropriate to revive the critical theoretical and epistemological discussions that have grounded the trajectory of Latin American social medicine and public health over the last 40 years. To this end, I draw on aspects of critical thinking on modernity devised by the Portuguese sociologist Boaventura de Sousa Santos, who postulates three pillars of domination: capitalism, colonialism (or coloniality), and patriarchy. In the current context of a crisis of civilization, rethinking emancipation requires us to refresh our understanding of the meaning of social struggles in terms of their relationship with the knowledges and epistemologies undermined by modern civilization and still present in the Global South, whether in spaces occupied by indigenous peoples and poor farmers or in urban peripheries.

  16. Improvement of Emergency Management Mechanism of Public Health Crisis in Rural China: A Review Article.

    Science.gov (United States)

    Hu, Jiaxiang; Chen, Chao; Kuai, Tingting

    2018-02-01

    With the rapid development of social economy in China, various public health emergencies frequently occur. Such emergencies cause a serious threat to human health and public safety, especially in rural China. Owing to flaws in emergency management mechanism and policy, the government is not capable to effectively deal with public health emergencies. Therefore, this study aimed to discuss the path to improve the emergency management mechanism for public health emergency in rural China. This study was conducted in 2017 to detect the emergency management mechanism of public health crisis (EMMPHC) in Rural China. Data were collected using the following keywords: Rural China, public health emergency, emergency management mechanism, organization mechanism, operation mechanism in the databases of PubMed, Scopus, Web of Science, and CNKI. EMMPHC in rural China can be enhanced from the following three aspects. First, a permanent institution for rural emergency management with public health management function is established. Second, the entire process of emergency management mechanism, including the stages of pre-disaster, disaster, and post-disaster, is improved. Finally, investment in rural public health is increased, and an adequate reserve system for emergency resources is formed. The new path of EMMPHC in rural China can effectively help the local government accomplish the dispatch capability in public health emergency, and it has important research significance for the protection of public health and social stability of residents in rural China.

  17. Public procurement of health technologies in Greece in an era of economic crisis.

    Science.gov (United States)

    Kastanioti, Catherine; Kontodimopoulos, Nick; Stasinopoulos, Dionysis; Kapetaneas, Nikolaos; Polyzos, Nikolaos

    2013-01-01

    Public procurement is generally an important sector of the economy and, in most countries, is controlled by the introduction of regulatory and policy mechanisms. In the Greek healthcare sector, recent legislation redefined centralized procurement through the reestablishment of a state Health Procurement Committee (EPY), with an aim to formulate a plan to reduce procurement costs of medical devices and pharmaceuticals, improve payment time, make uniform medical requests, transfer redundant materials from one hospital to another and improve management of expired products. The efforts described in this paper began in early 2010, under the co-ordination of the Ministry of Health (MoH) and with the collaboration of senior staff from the International Monetary Fund (IMF), the European Commission (EC) and the European Central Bank (ECB). The procurement practices and policies set forth by EPY and the first measurable outcomes, in terms of cost savings, resulting from these policies are presented. The importance of these measures is discussed in light of the worst economic crisis faced by Greece since the restoration of democracy in 1974, as a result of both the world financial crisis and uncontrolled government spending. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  18. Unemployment in Scandinavia during an economic crisis: cross-national differences in health selection.

    Science.gov (United States)

    Heggebø, Kristian

    2015-04-01

    Are people with ill health more prone to unemployment during the ongoing economic crisis? Is this health selection more visible among people with low education, women, or the young? The current paper investigates these questions in the Scandinavian context using the longitudinal part of the EU-SILC data material. Generalized least squares analysis indicates that people with ill health are laid off to a higher degree than their healthy counterparts in Denmark, but not in Norway and Sweden. Additionally, young individuals (Norway and Sweden, but not in Denmark. Neither women with ill health, nor individuals with low educational qualifications and ill health, are more likely to lose their jobs in Scandinavia. Individual level (and calendar year) fixed effects analysis confirms the existence of health selection out of employment in Denmark, whereas there is no suggestion of health selection in Sweden and Norway, except among young individuals. This finding could be related to the differing labor market demand the three Scandinavian countries have experienced during and preceding the study period (2007-2010). Another possible explanation for the cross-national differences is connected to the Danish "flexicurity" model, where the employment protection is rather weak. People with ill health, and hence more unstable labor market attachment, could be more vulnerable in such an arrangement. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Nutritional quality and price of university food bank hampers.

    Science.gov (United States)

    Willows, Noreen D; Au, Vivian

    2006-01-01

    Food insecurity appears to be a growing problem for post-secondary students, but little study has been made of the 51 campus-based food banks that exist. In 2003-04, the University of Alberta Campus Food Bank (CFB) distributed hampers intended to supply four days of food to 630 unique clients, of whom 207 (32.8%) were children. The nutritional adequacy of food hampers and cost saving to students were evaluated in the current study. Hampers prepared for one adult, and for one adult with one child, were nutritionally evaluated and scored for number of servings according to Canada's Food Guide to Healthy Eating. Two types of hampers were evaluated: those containing only non-perishable items, and those containing non-perishable and perishable items. Hamper contents were priced to establish the cost saving to students. The study revealed that a student with one child would receive up to 58.02 Canadian dollars worth of food in a hamper that contained perishable items. All hampers met the recommended minimum servings for each food group, but were very low in fat and protein from animal sources. Because students can obtain hampers only twice each month, the CFB is not the solution to food insecurity on campus. Awareness of the issue of post-secondary student food insecurity needs to be raised.

  20. The other crisis: the economics and financing of maternal, newborn and child health in Asia.

    Science.gov (United States)

    Anderson, Ian; Axelson, Henrik; Tan, B-K

    2011-07-01

    The Global Financial Crisis (GFC) of 2008/2009 was the largest economic slowdown since the Great Depression. It undermined the growth and development prospects of developing countries. Several recent studies estimate the impact of economic shocks on the poor and vulnerable, especially women and children. Infant and child mortality rates are still likely to continue to decline, but at lower rates than would have been the case in the absence of the GFC. Asia faces special challenges. Despite having been the fastest growing region in the world for decades, and even before the current crisis, this region accounted for nearly 34% of global deaths of children under 5, more than 40% of maternal deaths and 60% of newborn deaths. Global development goals cannot be achieved without much faster and deeper progress in Asia. Current health financing systems in much of Asia are not well placed to respond to the needs of women and their children, or the recent global financial and economic slowdown. Public expenditure is often already too low, and high levels of out-of-pocket health expenditure are an independent cause of inequity and impoverishment for women and their children. The GFC highlights the need for reforms that will improve health outcomes for the poor, protect the vulnerable from financial distress, improve public expenditure patterns and resource allocation decisions, and so strengthen health systems. This paper aims to highlight the most recent assessments of how economic shocks, including the GFC, affect the poor in developing countries, especially vulnerable women and children in Asia. It concludes that conditional cash transfers, increasing taxation on tobacco and increasing the level, and quality, of public expenditure through well-designed investment programmes are particularly relevant in the context of an economic shock. That is because these initiatives simultaneously improve health outcomes for the poor and vulnerable, protect them from further financial

  1. The refugee crisis in Africa and implications for health and disease: a political ecology approach.

    Science.gov (United States)

    Kalipeni, E; Oppong, J

    1998-06-01

    Political violence in civil war and ethnic conflicts has generated millions of refugees across the African continent with unbelievable pictures of suffering and unnecessary death. Using a political ecology framework, this paper examines the geographies of exile and refugee movements and the associated implications for re-emerging and newly emerging infectious diseases in great detail. It examines how the political ecologic circumstances underlying the refugee crisis influences health services delivery and the problems of disease and health in refugee camps. It has four main themes, namely, an examination of the geography of the refugee crisis: the disruption of health services due to political ecologic forces that produce refugees; the breeding of disease in refugee camps due to the prevailing desperation and destitution; and the creation of an optimal environment for emergence and spread of disease due to the chaotic nature of war and violence that produces refugees. We argue in this paper that there is great potential of something more virulent than cholera and Ebola emerging and taking a big toll before being identified and controlled. We conclude by noting that once such a disease is out in the public rapid diffusion despite political boundaries is likely, a fact that has a direct bearing on global health. The extensive evidence presented in this paper of the overriding role of political factors in the refugee health problem calls for political reform and peace accords, engagement and empowerment of Pan-African organizations, foreign policy changes by Western governments and greater vigilance of non-governmental organizations (NGOs) in the allocation and distribution of relief aid.

  2. The health, mental health, and well-being benefits of rape crisis counseling.

    Science.gov (United States)

    Westmarland, Nicole; Alderson, Sue

    2013-11-01

    There is very little research on interventions to alleviate the distress experienced following rape. This action research project developed and piloted the "Taking Back Control" tool that measured the impact of rape crisis counseling over time. Five rape crisis centers in the North of England agreed to pilot the tool, which was administered by the client's counselor, either on Week 1 or 2, and then repeated every 6 weeks until the end of counseling. Eighty-seven clients completed at least two questionnaires. This allowed us to measure change from their first compared with their last data collection point. The most change was made in relation to the statement "I feel empowered and in control of my life," where 61% strongly/disagreed at the first data collection point compared with 31% at the last data collection point. Large shifts were also seen in relation to "I have 'flashbacks' about what happened" and "I have panic attacks." Overall, some degree of positive change was seen for all measures. This research, despite some limitations, begins to develop an evidence base for rape crisis centers to demonstrate their benefits and to assess and develop their own practice.

  3. Turnaround in an aged persons' mental health service in crisis: a case study of organisational renewal.

    Science.gov (United States)

    Stafrace, Simon; Lilly, Alan

    2008-08-01

    This case study demonstrates how leadership was harnessed to turn around a decline in the performance of an aged persons' mental health service - the Namarra Nursing Home at Caulfield General Medical Centre in Melbourne, Australia. In 2000 the nursing home faced a crisis of public confidence due to failings in the management of quality, clinical risk and human resources within the service. These problems reflected structural and operational shortcomings in the clinical directorate and wider organisation. In this article, we detail the process of turnaround from the perspective of senior executive managers with professional and operational responsibility for the service. This turnaround required attention to local clinical accountability and transformation of the mental health program from a collocated but operationally isolated service to one integrated within the governance structures of the auspicing organisation.

  4. [Problems of work world and its impact on health. Current financial crisis].

    Science.gov (United States)

    Tomasina, Fernando

    2012-06-01

    Health and work are complex processes. Besides, they are multiple considering the forms they take. These two processes are linked to each other and they are influenced by each other. According to this, it is possible to establish that work world is extremely complex and heterogeneous. In this world, "old" or traditional risks coexist with "modern risks", derived from the new models of work organization and the incorporation of new technologies. Unemployment, work relationships precariousness and work risks outsourcing are results of neoliberal strategies. Some negative results of health-sickness process derived from transformation in work world and current global economic crisis have been noticed in current work conditions. Finally, the need for reconstructing policies focusing on this situation derived from work world is suggested.

  5. Beyond police crisis intervention: moving "upstream" to manage cases and places of behavioral health vulnerability.

    Science.gov (United States)

    Wood, Jennifer D; Beierschmitt, Laura

    2014-01-01

    Law enforcement officers continue to serve on the front lines as mental health interventionists, and as such have been subject to a wave of "first generation" reform designed to enhance their crisis response capabilities. Yet, this focus on crisis intervention has not answered recent calls to move "upstream" and bolster early intervention in the name of long-term recovery. This paper reports on findings from an action research project in Philadelphia aimed at exploring opportunities for enhanced upstream engagement. Study methods include spatial analyses of police mental health transportations from an eight year period (2004-2011) and qualitative data from twenty-three "framing conversations" with partners and other stakeholders, seven focus groups with police and outreach workers, five key informant interviews as well as document reviews of the service delivery system in Philadelphia. Recommendations include the need to move beyond a focus on what police can do to a wider conception of city agencies and business stakeholders who can influence vulnerable people and vulnerable spaces of the city. We argue for the need to develop shared principles and rules of engagement that clarify roles and stipulate how best to enlist city resources in a range of circumstances. Since issues of mental health, substance use and disorder are so tightly coupled, we stress the importance of establishing a data-driven approach to crime and disorder reduction in areas of the city we term "hotspots of vulnerability". In line with a recovery philosophy, such an approach should reduce opportunities for anti-social behavior among the "dually labeled" in ways consistent with "procedural justice". Furthermore, crime and disorder data flowing from police and security to behavioral health analysts could contribute to a more focused case management of "repeat utilizers" across the two systems. Our central argument is that a twin emphasis on "case management" and "place management" may provide

  6. A Coordinated Mental Health Crisis Response: Lessons Learned from Three Colorado School Shootings

    Science.gov (United States)

    Crepeau-Hobson, Franci; Sievering, Kathryn S.; Armstrong, Charlotte; Stonis, Julie

    2012-01-01

    This article describes a crisis response framework based on the authors' first-hand experience following three Colorado school shootings. During each crisis response, one or more of the authors joined school and/or district crisis teams, providing direct assistance and leadership. The authors' experiences helped guide subsequent responses and…

  7. Government Crisis Assessment and Reputation Management. A Case Study of the Vietnam Health Minister's Crises in 2013-2014

    Directory of Open Access Journals (Sweden)

    Tuong-Minh Ly-Le

    2015-06-01

    Full Text Available In Vietnam, many government announcements have gathered negative receptions from the public. Among them, Ms. Nguyen Thi Kim Tien, Vietnam Minister of Health, has received more of it. Through the case study of Ms. Kim Tien’s many scandals during the 2013-2014 period, this study is interested to see if the health scandals eventually elevated into a government crisis, how they affected the minister’s reputation, and what she could have done to better respond to the public. This study examined news articles on such health scandals to confirm whether the health scandals indeed escalated to be a government crisis. It also identified the advantages and disadvantages of Ms. Kim Tien’s responses in restoring her reputation to the public to understand what factors contributed to public dissatisfaction toward the minister. This study concluded that poorly-managed health scandals eventually elevated into a government crisis and greatly affected the minister’s reputation. It is suggested that PR is what the government needs to deal with such situations. The research also leaves room for a quantitative approach to the case to increase the result’s validity and representativeness. Until now, as the health issues and the resignation appeals are still needed, the crisis management effort should get more attention from the government, and such study is needed to better understand the situation.

  8. A COMPARATIVE STUDY of HEALTH UNITS of the 6TH GREEK HEALTH REGION DURING an ECONOMIC CRISIS PERIOD through DATA ENVELOPMENT ANALYSIS METHOD

    Directory of Open Access Journals (Sweden)

    Georgios I. Farantos

    2016-12-01

    Full Text Available The aim of the present study is to investigate the change in relative efficiency through a comparative study on the efficiency of health units within a Greek health region during an economic crisis environment, with the aid of a new application. The study is designed to collect data from the 6th Greek health region and to process that data with the use of Data Envelopment Analysis software. The study methodology extends to the application of the study of efficiency of organisations and the integration of the analysis in an interpretation framework within the economic crisis. The study refers to similar hospital clinics (pathological within one of the largest Greek health regions in order for the results to be comparable. We estimate and calculate the DEA sizes based on the CRS, VRS and SE models of the Health Units of a Greek health region, with the use of a new application which calculates the change of overall relative Efficiency during the crisis. The study of the change in the efficiency of health units leads to useful conclusions on the negative changes in the observed efficiency of the units and the integration of the studies on the change of efficiency in the Integrated crisis management. The study ranks the efficient and inefficient units and suggests ways of improvement. This study allows for further case studies in the future and the completion of the integrated crisis management model through comparative studies on the efficiency of systems.

  9. The health migration crisis: the role of four Organisation for Economic Cooperation and Development countries.

    Science.gov (United States)

    Pond, Bob; McPake, Barbara

    2006-04-29

    The crisis of human resources for health that is affecting low-income countries and especially sub-Saharan Africa has been attributed, at least in part, to increasing rates of migration of qualified health staff to high-income countries. We describe the conditions in four Organisation for Economic Cooperation and Development (OECD) health labour markets that have led to increasing rates of immigration. Popular explanations of these trends include ageing populations, growing incomes, and feminisation of the health workforce. Although these explanations form part of the larger picture, analysis of the forces operating in the four countries suggests that specific policy measures largely unrelated to these factors have driven growing demand for health staff. On this basis we argue that specific policy measures are equally capable of reversing these trends and avoiding the exploitation of low-income countries' scarce resources. These policies should seek to ensure local stability in health labour markets so that shortages of staff are not solved via the international brain drain.

  10. Sickle Cell Crisis (For Teens)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Sickle Cell Crisis (Pain Crisis) KidsHealth / For Teens / Sickle Cell ... drepanocíticas (Crisis de dolor) What Is a Sickle Cell Crisis? Sickle cell disease changes the shape of ...

  11. The effect of unemployment on self-reported health and mental health in Greece from 2008 to 2013: a longitudinal study before and during the financial crisis.

    Science.gov (United States)

    Drydakis, Nick

    2015-03-01

    The current study uses six annual waves of the Longitudinal Labor Market Study (LLMS) covering the 2008-2013 period to obtain longitudinal estimations suggesting statistically significant negative effects from unemployment on self-reported health and mental health in Greece. The specifications suggest that unemployment results in lower health and the deterioration of mental health during the 2008-2009 period compared with the 2010-2013 period, i.e., a period in which the country's unemployment doubled as a consequence of the financial crisis. Unemployment seems to be more detrimental to health/mental health in periods of high unemployment, suggesting that the unemployment crisis in Greece is more devastating as it concerns more people. Importantly, in all specifications, comparable qualitative patterns are found by controlling for unemployment due to firm closure, which allows us to minimize potential bias due to unemployment-health related reverse causality. Moreover, in all cases, women are more negatively affected by unemployment in relation to their health and mental health statuses than are men. Greece has been more deeply affected by the financial crisis than any other EU country, and this study contributes by offering estimates for before and during the financial crisis and considering causality issues. Because health and mental health indicators increase more rapidly in a context of higher surrounding unemployment, policy action must place greater emphasis on unemployment reduction and supporting women's employment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. How do people with long-term mental health problems negotiate relationships with network members at times of crisis?

    Science.gov (United States)

    Walker, Sandra; Kennedy, Anne; Vassilev, Ivaylo; Rogers, Anne

    2018-02-01

    Social network processes impact on the genesis and management of mental health problems. There is currently less understanding of the way people negotiate networked relationships in times of crisis compared to how they manage at other times. This paper explores the patterns and nature of personal network involvement at times of crises and how these may differ from day-to-day networks of recovery and maintenance. Semi-structured interviews with 25 participants with a diagnosis of long-term mental health (MH) problems drawn from recovery settings in the south of England. Interviews centred on personal network mapping of members and resources providing support. The mapping interviews explored the work of network members and changes in times of crisis. Interviews were recorded, transcribed and analysed using a framework analysis. Three key themes were identified: the fluidity of network relationality between crisis and recovery; isolation as a means of crises management; leaning towards peer support. Personal network input retreated at times of crisis often as result of "ejection" from the network by participants who used self-isolation as a personal management strategy in an attempt to deal with crises. Peer support is considered useful during a crisis, whilst the role of services was viewed with some ambiguity. Social networks membership, and type and depth of involvement, is subject to change between times of crisis and everyday support. This has implications for managing mental health in terms of engaging with network support differently in times of crises versus recovery and everyday living. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  13. Effects of the Global Financial Crisis on Health in High-Income Oecd Countries: A Narrative Review.

    Science.gov (United States)

    Karanikolos, Marina; Heino, Pia; McKee, Martin; Stuckler, David; Legido-Quigley, Helena

    2016-01-01

    A growing body of evidence documents how economic crises impact aspects of health across countries and over time. We performed a systematic narrative review of the health effects of the latest economic crisis based on studies of high-income countries. Papers published between January 2009 and July 2015 were selected based on review of titles and abstracts, followed by a full text review conducted by two independent reviewers. Ultimately, 122 studies were selected and their findings summarized. The review finds that the 2008 financial crisis had negative effects on mental health, including suicide, and to a varying extent on some non-communicable and communicable diseases and access to care. Although unhealthy behaviors such as hazardous drinking and tobacco use appeared to decline during the crisis, there have been increases in some groups, typically those already at greatest risk. The health impact was greatest in countries that suffered the largest economic impact of the crisis or prolonged austerity. The Great Recessions in high-income countries have had mixed impacts on health. They tend to be worse when economic impacts are more severe, prolonged austerity measures are implemented, and there are pre-existing problems of substance use among vulnerable groups. © The Author(s) 2016.

  14. From universal health insurance to universal healthcare? The shifting health policy landscape in Ireland since the economic crisis.

    Science.gov (United States)

    Burke, Sara Ann; Normand, Charles; Barry, Sarah; Thomas, Steve

    2016-03-01

    Ireland experienced one of the most severe economic crises of any OECD country. In 2011, a new government came to power amidst unprecedented health budget cuts. Despite a retrenchment in the ability of health resources to meet growing need, the government promised a universal, single-tiered health system, with access based solely on medical need. Key to this was introducing universal free GP care by 2015 and Universal Health Insurance from 2016 onwards. Delays in delivering universal access and a new health minister in 2014 resulted in a shift in language from 'universal health insurance' to 'universal healthcare'. During 2014 and 2015, there was an absence of clarity on what government meant by universal healthcare and divergence in policy measures from their initial intent of universalism. Despite the rhetoric of universal healthcare, years of austerity resulted in poorer access to essential healthcare and little extension of population coverage. The Irish health system is at a critical juncture in 2015, veering between a potential path to universal healthcare and a system, overwhelmed by years of austerity, which maintains the status quo. This papers assesses the gap between policy intent and practice and the difficulties in implementing major health system reform especially while emerging from an economic crisis. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  15. Epidemics in the news: Health and hygiene in the press in periods of crisis.

    Science.gov (United States)

    de Almeida, Maria Antónia Pires

    2013-10-01

    How did scientific knowledge reach the public? Using the press and keeping in mind the population's limited access to written material, this paper establishes how the latest scientific news was divulged to unspecialised audiences. In times of sanitary crisis in Oporto, such as the cholera morbus epidemic of 1854-1856, the bubonic plague in 1899 and the 1918 influenza pandemic, newspapers were important sources to access the information and advice given to the public. A database of 6700 articles, medical reports and advertisements published in daily newspapers reveals the state of the art of medical science. It also reveals the importance given by health authorities and journalists to the publication of recent discoveries and adequate hygiene procedures to prevent the spread of the epidemics. This is a subject that contributes to the debates on the dissemination of science and on the place that Portugal occupied in the international scientific community.

  16. [Social crisis and occupational fatigue among health professionals: warnings and resources].

    Science.gov (United States)

    Wolfberg, Elsa

    Due to the crisis of the welfare state, the smashing of the state budget and the labour flexibility, the "helping professions" (health service, education, etc.) are the main assistance for the poor, the elderly people and the victims of violence. This result in the emergence of occupational pathologies, mainly in the health workers, such as burnout, secondary traumatic stress or empaty caused fatigue, mobbing or moral harassment -all of them affecting not only the quality of life of professionals but also the body health. The corporal disorders may begin with mild malfunctions, considered as "natural" facts of life, then becoming severe illness. The professional may attempt to meliorate the situation with the use of alcohol, tobacco, ansiolitics, etc. thus worsening the whole health. At the moment there are not legal regulations for this emergent pathologies. We have to pay attention to the signals in order to be able to overcome the dysfunctional defense mechanisms and to activate the preventive and protective resources, such as reflexion groups at workplaces.

  17. Managing preventive occupational health and safety activities in Danish enterprises during a period of financial crisis

    DEFF Research Database (Denmark)

    Andersen, Hans H. K.; Bach, Elsa

    2017-01-01

    The onset of the financial crisis in 2008 has put pressure on enterprises that in turn have downsized and reorganized. Research has shown that economic recession has an effect on psychological and behavioral health that is attributed to working environment problems. The objective of this study is...... focus on the management of preventive workplace health and safety activities in enterprises during a period of economic recession....... is to unravel whether the onset of a general economic recession has had an impact on companies’ and public institutions’ preventive occupational health and safety activities. Hypotheses of the role of pro-cyclical and countercyclical effects are presented. This study is based on a survey of enterprise...... preventive occupational health safety activities. The baseline for the survey was established, in 2006 before the onset of the recession, with a follow up in 2011. Findings are discussed that support both the pro-cyclical and the countercyclical hypotheses. It is concluded that there is a need for a special...

  18. Emergency response in a global health crisis: epidemiology, ethics, and Ebola application.

    Science.gov (United States)

    Salerno, Jennifer; Hlaing, WayWay M; Weiser, Thomas; Striley, Catherine; Schwartz, Lisa; Angulo, Frederick J; Neslund, Verla S

    2016-04-01

    The link between ethics and epidemiology can go unnoticed in contemporary gatherings of professional epidemiologists or trainees at conferences and workshops, as well as in teaching. Our goal is to provide readers with information about the activities of the College and to provide a broad perspective on a recent major issue in epidemiology. The Ethics Committee of the American College of Epidemiology (ACE) presented a plenary session at the 2015 Annual Meeting in Atlanta, GA, on the complexities of ethics and epidemiology in the context of the 2014-2015 Ebola virus disease outbreak and response in West Africa. This article presents a summary and further discussion of that plenary session. Three main topic areas were presented: clinical trials and ethics in public health emergencies, public health practice, and collaborative work. A number of key ethical concepts were highlighted and discussed in relation to Ebola and the ACE Ethics Guidelines. The Ebola virus disease outbreak is an example of a public health humanitarian crisis from which we hope to better understand the role of professional epidemiologists in public health practice and research and recognize ethical challenges epidemiologists faced. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Effects of global financial crisis on funding for health development in nineteen countries of the WHO African Region.

    Science.gov (United States)

    Kirigia, Joses M; Nganda, Benjamin M; Mwikisa, Chris N; Cardoso, Bernardino

    2011-04-13

    There is ample evidence in Asia and Latin America showing that past economic crises resulted in cuts in expenditures on health, lower utilization of health services, and deterioration of child and maternal nutrition and health outcomes. Evidence on the impact of past economic crises on health sector in Africa is lacking. The objectives of this article are to present the findings of a quick survey conducted among countries of the WHO African Region to monitor the effects of global financial crisis on funding for health development; and to discuss the way forward. This is a descriptive study. A questionnaire was prepared and sent by email to all the 46 Member States in the WHO African Region through the WHO Country Office for facilitation and follow up. The questionnaires were completed by directors of policy and planning in ministries of health. The data were entered and analyzed in Excel spreadsheet. The main limitations of this study were that authors did not ask whether other relevant sectors were consulted in the process of completing the survey questionnaire; and that the overall response rate was low. The main findings were as follows: the response rate was 41.3% (19/46 countries); 36.8% (7/19) indicated they had been notified by the Ministry of Finance that the budget for health would be cut; 15.8% (3/19) had been notified by partners of their intention to cut health funding; 61.1% (11/18) indicated that the prices of medicines had increased recently; 83.3% (15/18) indicated that the prices of basic food stuffs had increased recently; 38.8% (7/18) indicated that their local currency had been devalued against the US dollar; 47.1% (8/17) affirmed that the levels of unemployment had increased since the onset of global financial crisis; and 64.7% (11/17) indicated that the ministry of health had taken some measures already, either in reaction to the global financing crisis, or in anticipation. A rapid assessment, like the one reported in this article, of the

  20. Addressing the human resources crisis: a case study of the Namibian health service

    Directory of Open Access Journals (Sweden)

    Awases Magda

    2007-01-01

    Full Text Available Abstract Background This paper addresses an important practical challenge to staff management. In 2000 the United Nations committed themselves to the ambitious targets embodied in the Millennium Development Goals (MDGs. Only five years later, it was clear that poor countries were not on track to achieve them. It was also clear that achieving the three out of the eight MDGs that concern health would only be possible if the appropriate human resources (HR were in place. Methods We use a case study based on semi-structured interview data to explore the steps that Namibia, a country facing severe health problems that include an alarmingly high AIDS infection rate, has taken to manage its health workers. Results In the fifteen years since independence, Namibia has patiently built up a relatively good strategic framework for health policy in the context of government policy as a whole, including strong training arrangements at every level of health staffing, and it has brought HIV/AIDS under the strategic umbrella through its National Strategic Plan for HIV/AIDS. Its major weakness is that it has not kept pace with the rise in HIV/AIDS and TB infection: the community counselling service, still at the pilot stage at the time of this study, was the only specific response. That has created a tension between building long-term capacity in a strategic context and responding to the short-term demands of the AIDS and TB crisis, which in turn affects the ability of HR to contribute to improving health outcomes. Conclusion It is suggested that countries like Namibia need a new paradigm for staffing their health services. Building on the existing strategic framework, it should target the training of 'mid-level cadres'. Higher-level cadres should take on the role of supporting and monitoring the mid-level cadres. To do that, they will need management training and a performance management framework for staff support and monitoring.

  1. [Health promotion and prevention in the economic crisis: the role of the health sector. SESPAS report 2014].

    Science.gov (United States)

    Márquez-Calderón, Soledad; Villegas-Portero, Román; Gosalbes Soler, Victoria; Martínez-Pecino, Flora

    2014-06-01

    This article reviews trends in lifestyle factors and identifies priorities in the fields of prevention and health promotion in the current economic recession. Several information sources were used, including a survey of 30 public health and primary care experts. Between 2006 and 2012, no significant changes in lifestyle factors were detected except for a decrease in habitual alcohol drinking. There was a slight decrease in the use of illegal drugs and a significant increase in the use of psychoactive drugs. Most experts believe that decision-making about new mass screening programs and changes in vaccination schedules needs to be improved by including opportunity cost analysis and increasing the transparency and independence of the professionals involved. Preventive health services are contributing to medicalization, but experts' opinions are divided on the need for some preventive activities. Priorities in preventive services are mental health and HIV infection in vulnerable populations. Most experts trust in the potential of health promotion to mitigate the health effects of the economic crisis. Priority groups are children, unemployed people and other vulnerable groups. Priority interventions are community health activities (working in partnership with local governments and other sectors), advocacy, and mental health promotion. Effective tools for health promotion that are currently underused are legislation and mass media. There is a need to clarify the role of the healthcare sector in intersectorial activities, as well as to acknowledge that social determinants of health depend on other sectors. Experts also warn of the consequences of austerity and of policies that negatively impact on living conditions. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  2. The interactions of Canadian ethics consultants with health care managers and governing boards during times of crisis.

    Science.gov (United States)

    Kaposy, Chris; Maddalena, Victor; Brunger, Fern; Pullman, Daryl; Singleton, Richard

    2017-01-01

    Health care organizations can be very complex, and are often the setting for crisis situations. In recent years, Canadian health care organizations have faced large-scale systemic medical errors, a nation-wide generic injectable drug shortage, iatrogenic infectious disease outbreaks, and myriad other crises. These situations often have an ethical component that ethics consultants may be able to address. Organizational leaders such as health care managers and governing boards have responsibilities to oversee and direct the response to crisis situations. This study investigates the nature and degree of involvement of Canadian ethics consultants in such situations. This qualitative study used semi-structured interviews with Canadian ethics consultants to investigate the nature of their interactions with upper-level managers and governing board members in health care organizations, particularly in times of organizational crisis. We used a purposive sampling technique to identify and recruit ethics consultants throughout Canada. We found variability in the interactions between ethics consultants and upper-level managers and governing boards. Some ethics consultants we interviewed did not participate in managing organizational crisis situations. Most ethics consultants reported that they had assisted in the management of some crises and that their participation was usually initiated by managers. Some ethics consultants reported the ability to bring issues to the attention of upper-level managers and indirectly to their governing boards. The interactions between managers and ethics consultants were characterized by varying degrees of collegiality. Ethics consultants reported participating in or chairing working groups, participating in incident management teams, and developing decision-making frameworks. Canadian ethics consultants tend to believe that they have valuable skills to offer in the management of organizational crisis situations. Most of the ethics consultants

  3. Building a Public Health Response to the Flint Water Crisis: Implications for Policy and Decision-Making

    Science.gov (United States)

    Furr-Holden, D.

    2017-12-01

    Flint, MI has experienced a recent, man-made public health crisis. The Flint Water Crisis, caused by a switch in the municipal water supply and subsequent violation of engineering and regulatory standards to ensure water quality lead to a large portion of the city being exposed to excess metals (including lead), bacteria and other water-borne pathogens. The data used to initially rebut the existence of the crisis were ecologically flawed as they included large numbers of people who were not on the Flint water supply. Policy-makers, municipal officials, the medical community, and public health professionals were at odds over the existence of a problem and the lack of data only fueled the debate. Pediatricians, lead by Dr. Mona Hannah-Attisha, began testing children in the Hurley Children's Medical Center for blood-lead levels and observed a 2-fold increase in elevated blood lead levels in Flint children compared to children in the area not on the Flint municipal water supply, where no increases in elevated lead were observed. Subsequent geospatial analyses revealed spatial clustering of cases based on where children live, go to school and play. These data represented the first step in data driven decision making leading to the subsequent switch of the municipal water supply and launch of subsequent advocacy efforts to remediate the effect of the Water Crisis. Since that time, a multi-disciplinary team of scientists including engineers, bench scientists, physicians and public health researchers have mounted evidence to promote complete replacement of the city's aging water infrastructure, developed a data registry to track cases and coordinate care and services for affected residents, and implemented a community engagement model that puts residents and community stakeholders at the heart of the planning and implementation efforts. The presentation will include data used at various stages to mount a public health response to the Flint Water Crisis and establish the

  4. Impact of economic crisis on the social representation of mental health: Analysis of a decade of newspaper coverage.

    Science.gov (United States)

    Dias Neto, David; Figueiras, Maria João; Campos, Sónia; Tavares, Patrícia

    2017-12-01

    Mass media plays a fundamental role in how communities understand mental health and its treatment. However, the effect of major events such as economic crises on the depiction of mental health is still unclear. This study aimed at analyzing representations of mental health and its treatment and the impact of the 2008 economic crisis. In total, 1,000 articles were randomly selected from two newspapers from a period before and after the economic crisis. These articles were analyzed with a closed coding system that classified the news as good or bad news according to the presence of themes associated with positive or stigmatizing representations. The results show a positive representation of mental health and a negative representation of treatment. Furthermore, the economic crisis had a negative impact on the representation of mental health, but not on treatment. These findings suggest that the representation of mental health is multifaceted and may be affected differently in its dimensions. There is a need for stigma-reducing interventions that both account for this complexity and are sensitive to context and period.

  5. [Economic Crisis and Portuguese National Health Service Physicians: Findings from a Descriptive Study of Their Perceptions and Reactions from Health Care Units in the Greater Lisbon Area].

    Science.gov (United States)

    Rego, Inês; Russo, Giuliano; Gonçalves, Luzia; Perelman, Julian; Pita Barros, Pedro

    2017-04-28

    In Europe, scant scientific evidence exists on the impact of economic crisis on physicians. This study aims at understanding the adjustments made by public sector physicians to the changing conditions, and their perceptions on the market for medical services in the Lisbon metropolitan area. A random sample of 484 physicians from São José Hospital and health center groups in Cascais and Amadora, to explore their perceptions of the economic crisis, and the changes brought to their workload. This paper provides a descriptive statistical analysis of physicians' responses. In connection to the crisis, our surveyed physicians perceived an increase in demand but a decrease of supply of public health services, as well as an increase in the supply of health services by the private sector. Damaging government policies for the public sector, and the rise of private services and insurance providers were identified as game changers for the sector. Physicians reported a decrease in public remuneration (- 30.5%) and a small increase of public sector hours. A general reduction in living standard was identified as the main adaptation strategy to the crisis. Passion for the profession, its independence and flexibility, were the most frequently mentioned compensating factors. A percentage of 15% of physicians declared considering migration as a possibility for the near future. The crisis has brought non-negligible changes to physicians' working conditions and to the wider market for medical services in Portugal. The physicians' intrinsic motivation for the professions helped counterbalance salary cuts and deteriorating working conditions.

  6. Crisis and Crisis Scenarios

    DEFF Research Database (Denmark)

    Larsen, Øjvind

    2016-01-01

    This special issue of Nordicum-Mediterraneum contains select proceedings from the third meeting of the Nordic Summer University research circle called “Crisis and Crisis Scenarios: Normativity, Possibilities and Dilemmas”, held April 9th — 12th, 2015 at the Lysebu Conference Centre in Oslo, Norway....... The circle’s research program runs from 2014 to 2016 and is aimed at examining the concept of crisis as it is used today in academia and public discussion. In this collection of papers from the symposium we present some of the different ways in which the topic of the study group was addressed....

  7. Gun Violence: Two Medical Students' Hometown Connection to This Public Health Crisis.

    Science.gov (United States)

    Kuhl, Nicholas O; Lieberman, Monica P

    2018-05-02

    The school shooting in Parkland, Florida in February 2018 left 17 people dead and countless other children and teachers with physical and psychological trauma that will require decades of healing. As Marjory Stoneman Douglas High School alumni and current medical students, the authors of this Invited Commentary contend that they are in a unique position to advocate on behalf of their neighbors, classmates, and future patients. Since the authors began medical school in 2015, there have been 19 mass shootings in the United States resulting in 253 deaths. During this same time period, there have been nearly 100,000 gun-related deaths in the United States. While 60.7% of those gun deaths were suicides, the public must not, and should not, attribute all gun violence to the spectrum of psychiatric diagnoses. Several studies have shown that increased access to firearms directly increases the rate of one of the United States' most pressing public health issues--gun violence. Despite this fact, and as the result of misguided health policies like the Dickey Amendment, the funding for research on gun violence pales in comparison to that for other leading causes of death. Consequently, the health care community has long been without adequate data to engage in evidence-based gun violence prevention and education efforts. As two students on the cusp of beginning their medical careers, the authors argue that they and other health care providers can no longer sit idly on the sidelines as this public health crisis continues to impact the United States.

  8. The impact of the financial crisis on human resources for health policies in three southern-Europe countries.

    Science.gov (United States)

    Correia, Tiago; Dussault, Gilles; Pontes, Carla

    2015-12-01

    The public health sector has been the target of austerity measures since the global financial crisis started in 2008, while health workforce costs have been a source of rapid savings in most European Union countries. This article aims to explore how health workforce policies have evolved in three southern European countries under external constraints imposed by emergency financial programmes agreed with the International Monetary Fund, Central European Bank and European Commission. The selected countries, Greece, Portugal and Cyprus, show similarities with regard to corporatist systems of social protection and comprehensive welfare mechanisms only recently institutionalized. Based on document analysis of the Memoranda of Understanding agreed with the Troika, our results reveal broadly similar policy responses to the crisis but also important differences. In Cyprus, General Practitioners have a key position in reducing public expenditure through gatekeeping and control of users' access, while Portugal and Greece seeks to achieve cost containment by constraining the decision-making powers of professionals. All three countries lack innovation as well as monitoring and assessment of the effects of the financial crisis in relation to the health workforce. Consequently, there is a need for health policy development to use human resources more efficiently in healthcare. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. The snakebite problem and antivenom crisis from a health-economic perspective.

    Science.gov (United States)

    Habib, Abdulrazaq G; Brown, Nicholas I

    2018-05-19

    The scourge of snakebite has been well documented but largely ignored by the global health community for several decades, especially the role that economics has played in causing and exacerbating this crisis. Every year millions of people in low and middle-income countries face death, disability and disadvantage from snakebite envenoming (SBE) without access to appropriate treatment. Health-economic factors pervade every aspect of this neglected problem. A multitude of financial and commercial factors helped to cause, and now perpetuate, shortages of high quality, affordable and region-appropriate antivenom in areas where they are most needed. Alongside the death, physical disability and psychological anguish from SBE is a debilitating financial toll, which includes both direct costs of treatment and indirect costs from lost income. SBE is a problem that disproportionately affects poor, rural and agrarian communities, with most victims being young and industrious subsistence workers. The burden of envenoming is often felt by families and communities that can least afford it, and negatively impacts local and national productivity. The lack of long-term investment in health systems to properly manage SBE has led to insufficient funding for antivenom development, procurement, quality control and distribution, despite highly favourable cost effectiveness of some antivenoms. This has contributed to market failures that have seen antivenom output fall and become inaccessible to most victims. Solutions to these problems exist and are achievable, however the challenge for advocates is to appreciate the importance of health-economics and ensure that strategies to redress the economic causes and consequences of SBE are themselves cost-effective and financially sustainable. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Governance and human resources for health

    NARCIS (Netherlands)

    Dieleman, Marjolein; Hilhorst, Thea

    2011-01-01

    Despite an increase in efforts to address shortage and performance of Human Resources for Health (HRH), HRH problems continue to hamper quality service delivery. We believe that the influence of governance is undervalued in addressing the HRH crisis, both globally and at country level. This thematic

  11. A fuzzy set approach to economic crisis, austerity and public health. Part I. European countries' conformity to ideal types during the economic downturn.

    Science.gov (United States)

    Saltkjel, Therese; Ingelsrud, Mari Holm; Dahl, Espen; Halvorsen, Knut

    2017-08-01

    This is the first part of a two-part paper that takes an explorative approach to assess crisis and austerity in European countries during the Great Recession. The ultimate aim of this two-part paper is to explore the "crisis-austerity" thesis by Stuckler and Basu and assess whether it is the interplay between austerity and crisis, rather than the current economic crisis per se, that can led to deterioration in population health. In Part I of this paper we offer one way of operationalizing crisis severity and austerity. We examine countries as specific configurations of crisis and policy responses and classify European countries into "ideal types." Cases included were 29 countries participating in the European Union Statistics on Income and Living Conditions (EU-SILC) surveys. Based on fuzzy set methodology, we constructed two fuzzy sets, "austerity" and "severe crisis." Austerity was measured by changes in welfare generosity; severe crisis was measured by changes in gross domestic product (GDP) per capita growth. In the initial phase of the Great Recession, most countries faced severe crisis combined with no austerity. From 2010-2011 onward, there was a divide between countries. Some countries consistently showed signs of austerity policies (with or without severe crisis); others consistently did not. The fuzzy set ideal-type analysis shows that the European countries position themselves, by and large, in configurations of crisis and austerity in meaningful ways that allow us to explore the "crisis-austerity" thesis by Stuckler and Basu. This exploration is the undertaking of Part II of this paper.

  12. The leadership crisis of medical profession in India: ongoing impact on the health system

    Directory of Open Access Journals (Sweden)

    Raman Kumar

    2015-01-01

    Full Text Available By 2030 India will have one million additional MBBS doctors; currently being produced @50,000 per year. Contrary to perception of scarcity of medical doctors, a large section of newly qualified physicians are spending considerable years in dysfunctional status due to mismanagement in human resource in health in India. There are very few employment opportunities for qualified doctors in public sector; at the same time the average salary of MBBS doctors in urban private hospitals is very low. Paradoxically, in a country of 1.3 billion populations there is no actual demand for medical professionals. While the popular perception is that young doctors are not willing for community service, a reality check is required on the count of intent and capacity of public sector as well as industry towards engagement of medical doctors in the process of service delivery. The visible leaders of medical profession are unable to reflect the ground reality. There is a leadership crisis among medical doctors in India.

  13. Development of a measure of model fidelity for mental health Crisis Resolution Teams.

    Science.gov (United States)

    Lloyd-Evans, Brynmor; Bond, Gary R; Ruud, Torleif; Ivanecka, Ada; Gray, Richard; Osborn, David; Nolan, Fiona; Henderson, Claire; Mason, Oliver; Goater, Nicky; Kelly, Kathleen; Ambler, Gareth; Morant, Nicola; Onyett, Steve; Lamb, Danielle; Fahmy, Sarah; Brown, Ellie; Paterson, Beth; Sweeney, Angela; Hindle, David; Fullarton, Kate; Frerichs, Johanna; Johnson, Sonia

    2016-12-01

    Crisis Resolution Teams (CRTs) provide short-term intensive home treatment to people experiencing mental health crisis. Trial evidence suggests CRTs can be effective at reducing hospital admissions and increasing satisfaction with acute care. When scaled up to national level however, CRT implementation and outcomes have been variable. We aimed to develop and test a fidelity scale to assess adherence to a model of best practice for CRTs, based on best available evidence. A concept mapping process was used to develop a CRT fidelity scale. Participants (n = 68) from a range of stakeholder groups prioritised and grouped statements (n = 72) about important components of the CRT model, generated from a literature review, national survey and qualitative interviews. These data were analysed using Ariadne software and the resultant cluster solution informed item selection for a CRT fidelity scale. Operational criteria and scoring anchor points were developed for each item. The CORE CRT fidelity scale was then piloted in 75 CRTs in the UK to assess the range of scores achieved and feasibility for use in a 1-day fidelity review process. Trained reviewers (n = 16) rated CRT service fidelity in a vignette exercise to test the scale's inter-rater reliability. There were high levels of agreement within and between stakeholder groups regarding the most important components of the CRT model. A 39-item measure of CRT model fidelity was developed. Piloting indicated that the scale was feasible for use to assess CRT model fidelity and had good face validity. The wide range of item scores and total scores across CRT services in the pilot demonstrate the measure can distinguish lower and higher fidelity services. Moderately good inter-rater reliability was found, with an estimated correlation between individual ratings of 0.65 (95% CI: 0.54 to 0.76). The CORE CRT Fidelity Scale has been developed through a rigorous and systematic process. Promising initial testing indicates

  14. Economic Crisis and Portuguese National Health Service Physicians: Findings from a Descriptive Study of Their Perceptions and Reactions from Health Care Units in the Greater Lisbon Area

    OpenAIRE

    Inês Rego; Giuliano Russo; Luzia Gonçalves; Julian Perelman; Pedro Pita Barros

    2017-01-01

    Introduction: In Europe, scant scientific evidence exists on the impact of economic crisis on physicians. This study aims at understanding the adjustments made by public sector physicians to the changing conditions, and their perceptions on the market for medical services in the Lisbon metropolitan area. Material and Methods: A random sample of 484 physicians from São José Hospital and health center groups in Cascais and Amadora, to explore their perceptions of the economic crisis, and the...

  15. Guns, Culture or Mental Health? Framing Mass Shootings as a Public Health Crisis.

    Science.gov (United States)

    DeFoster, Ruth; Swalve, Natashia

    2017-08-25

    In recent years, public health scholars and policymakers have been calling for increased research on the public health implications of gun violence. However, scientific research on this issue has been stifled by a 1996 budget rider that eliminated Centers for Disease Control and Prevention's (CDC) funding for gun research. In this study, we examined newspaper coverage of three mass shootings that took place over a 20-year period before and after the passage of this budget rider. We found that sources and frames provided by news media to contextualize gun violence shifted markedly over time, progressing from episodic and individual-level frames to broader thematic societal-level concerns, with increased discussion of mental health but limited discourse explicitly related to public health.

  16. The global financial crisis has led to a slowdown in growth of funding to improve health in many developing countries.

    Science.gov (United States)

    Leach-Kemon, Katherine; Chou, David P; Schneider, Matthew T; Tardif, Annette; Dieleman, Joseph L; Brooks, Benjamin P C; Hanlon, Michael; Murray, Christopher J L

    2012-01-01

    How has funding to developing countries for health improvement changed in the wake of the global financial crisis? The question is vital for policy making, planning, and advocacy purposes in donor and recipient countries alike. We measured the total amount of financial and in-kind assistance that flowed from both public and private channels to improve health in developing countries during the period 1990-2011. The data for the years 1990-2009 reflect disbursements, while the numbers for 2010 and 2011 are preliminary estimates. Development assistance for health continued to grow in 2011, but the rate of growth was low. We estimate that assistance for health grew by 4 percent each year from 2009 to 2011, reaching a total of $27.73 billion. This growth was largely driven by the World Bank's International Bank for Reconstruction and Development and appeared to be a deliberate strategy in response to the global economic crisis. Assistance for health from bilateral agencies grew by only 4 percent, or $444.08 million, largely because the United States slowed its development assistance for health. Health funding through UN agencies stagnated, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria announced that it would make no new grants for the next two years because of declines in funding. Given the international community's focus on meeting the Millennium Development Goals by 2015 and persistent economic hardship in donor countries, continued measurement of development assistance for health is essential for policy making.

  17. The variation in the health status of immigrants and Italians during the global crisis and the role of socioeconomic factors.

    Science.gov (United States)

    Petrelli, Alessio; Di Napoli, Anteo; Rossi, Alessandra; Costanzo, Gianfranco; Mirisola, Concetta; Gargiulo, Lidia

    2017-06-12

    The effects of the recent global economic and financial crisis especially affected the most vulnerable social groups. Objective of the study was to investigate variation of self-perceived health status in Italians and immigrants during the economic global crisis, focusing on demographic and socioeconomic factors. Through a cross-sectional design we analyzed the national sample of multipurpose surveys "Health conditions and use of health services" (2005 and 2013) conducted by the Italian National Institute of Statistics (ISTAT). Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, derived from SF-12 questionnaire, were assumed as study outcome, dichotomizing variables distribution at 1 st quartile. Prevalence rate ratios (PRR) were estimated through log-binomial regression models, stratified by citizenship and gender, evaluating the association between PCS and MCS with surveys' year, adjusting for age, educational level, employment status, self-perceived economic resources, smoking habits, body mass index. From 2005 to 2013 the proportion of people not employed or reporting scarce/insufficient economic resources increased, especially among men, in particular immigrants. Compared with 2005 we observed in 2013 among Italians a significant lower probability of worse PCS (PRR = 0.96 both for males and females), while no differences were observed among immigrants; a higher probability of worse MCS was observed, particularly among men (Italians: PRR = 1.26;95%CI:1.22-1.29; immigrants: PRR = 1.19;95%CI:1.03-1.38). Self-perceived scarce/insufficient economic resources were strongly and significantly associated with worse PCS and MCS for all subgroups. Lower educational level was strongly associated with worse PCS in Italians and slightly associated with worse MCS for all subgroups. Being not employed was associated with worse health status, especially mental health among men. Our findings support the hypothesis that economic global crisis

  18. The Carter Center Mental Health Program: addressing the public health crisis in the field of mental health through policy change and stigma reduction.

    Science.gov (United States)

    Palpant, Rebecca G; Steimnitz, Rachael; Bornemann, Thomas H; Hawkins, Katie

    2006-04-01

    Some of the most pervasive and debilitating illnesses are mental illnesses, according to World Health Organization's The World Health Report 2001--Mental Health: New Understanding, New Hope. Neuropsychiatric conditions account for four of the top five leading causes of years of life lived with disability in people aged 15 to 44 in the Western world. Many barriers prevent people with mental illnesses from seeking care, such as prohibitive costs, lack of insurance, and the stigma and discrimination associated with mental illnesses. The Carter Center Mental Health Program, established in 1991, focuses on mental health policy issues within the United States and internationally. This article examines the public health crisis in the field of mental health and focuses on The Carter Center Mental Health Program's initiatives, which work to increase public knowledge of and decrease the stigma associated with mental illnesses through their four strategic goals: reducing stigma and discrimination against people with mental illnesses; achieving equity of mental health care comparable with other health services; advancing early promotion, prevention, and early intervention services for children and their families; and increasing public awareness about mental illnesses and mental health issues.

  19. Impact of the economic crisis on the health of older persons in Spain: research clues based on an analysis of mortality. SESPAS report 2014.

    Science.gov (United States)

    Benmarhnia, Tarik; Zunzunegui, Maria-Victoria; Llácer, Alicia; Béland, Francois

    2014-06-01

    Older adults are seldom considered in studies on the health impact of economic recessions or crises. However, they constitute a population group that is highly vulnerable to decreases in investment in health and social services and social security. Our aim is to examine the relationship between the economic crisis starting in 2008 and the health status of older adults in Spain. More specifically, we analyze changes in trends of mortality in relation to the crisis, the specific impact of winter on mortality and gender differences in the crisis' impact on mortality. Using data from the National Institute of Statistics of Spain on people over 60 years of age, the number of monthly deaths by age and sex from January 2005 to December 2012 was analyzed. Interrupted time series analyses and the "difference in differences" method were used. During the crisis, for adults 60 years and older: 1) the observed mortality seems to be decreasing at a slower rate than what would have been expected in the absence of the crisis; 2) there has been an increase in winter mortality; 3) the impact of the crisis has been greater for female than for male mortality. These results suggest sizable effects of the economic crisis on the mortality of older adults and argue for research done using more detailed analyses integrating economic indicators. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  20. Mental health and psychosocial support in crisis and conflict: report of the Mental Health Working Group.

    Science.gov (United States)

    Allden, K; Jones, L; Weissbecker, I; Wessells, M; Bolton, P; Betancourt, T S; Hijazi, Z; Galappatti, A; Yamout, R; Patel, P; Sumathipala, A

    2009-01-01

    The Working Group on Mental Health and Psychosocial Support was convened as part of the 2009 Harvard Humanitarian Action Summit. The Working Group chose to focus on ethical issues in mental health and psychosocial research and programming in humanitarian settings. The Working Group built on previous work and recommendations, such as the Inter-Agency Standing Committee's Guidelines on Mental Health and Psychosocial Support in Emergency Settings. The objective of this working group was to address one of the factors contributing to the deficiency of research and the need to develop the evidence base on mental health and psychosocial support interventions during complex emergencies by proposing ethical research guidelines. Outcomes research is vital for effective program development in emergency settings, but to date, no comprehensive ethical guidelines exist for guiding such research efforts. Working Group members conducted literature reviews which included peer-reviewed publications, agency reports, and relevant guidelines on the following topics: general ethical principles in research, cross-cultural issues, research in resource-poor countries, and specific populations such as trauma and torture survivors, refugees, minorities, children and youth, and the mentally ill. Working Group members also shared key points regarding ethical issues encountered in their own research and fieldwork. The group adapted a broad definition of the term "research", which encompasses needs assessments and data gathering, as well as monitoring and evaluation. The guidelines are conceptualized as applying to formal and informal processes of assessment and evaluation in which researchers as well as most service providers engage. The group reached consensus that it would be unethical not to conduct research and evaluate outcomes of mental health and psychosocial interventions in emergency settings, given that there currently is very little good evidence base for such interventions

  1. Health policy making under information constraints: an evaluation of the policy responses to the economic crisis in Greece.

    Science.gov (United States)

    Goranitis, Ilias; Siskou, Olga; Liaropoulos, Lycourgos

    2014-09-01

    Cost consolidation in the highly fragmented and inefficient Greek health care system was necessary. However, policies introduced were partly formed in a context of insufficient information. Expenditure data from a consumption point of view were lacking and the depth of the political and structural problems was of unknown magnitude to the supervisory authorities. Drawing upon relevant literature and evidence from the newly implemented OECD System of Health Accounts, the paper evaluates the health policy responses to the economic crisis in Greece. The discussion and recommendations are also of interest to other countries where data sources are not reliable or decisions are based on preliminary data and projections. Between 2009 and 2012, across-the-board cuts have resulted in a decline in public health expenditure for inpatient care by 8.6%, for pharmaceuticals by 42.3% and for outpatient care by 34.6%. Further cuts are expected from the ongoing reforms but more structural changes are needed. Cost-containment was not well targeted and expenditure cuts were not always addressed to the real reasons of the pre-crisis cost explosion. Policy responses were restricted to quick and easy fiscal adjustment, ignoring the need for substantial structural reforms or individuals' right to access health care irrespective of their financial capacity. Developing appropriate information infrastructure, restructuring and consolidating the hospital sector and moving toward a tax-based national health insurance could offer valuable benefits to the system. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Informal payments in the Greek health sector amid the financial crisis: old habits die last...

    Science.gov (United States)

    Souliotis, Kyriakos; Golna, Christina; Tountas, Yannis; Siskou, Olga; Kaitelidou, Daphne; Liaropoulos, Lycourgos

    2016-03-01

    Under-the-table informal payments are commonplace as reimbursements for health care services in Greece. As the country faces a severe financial crisis, the need to investigate the extent of such payments, their incidence and their impact on household income is pressing. A survey of 2,741 persons from across the country was conducted between December 2011 and February 2012. The sample was defined via a multistage selection process using a quota for municipality of residence, sex and age. The maximum error margin was 2.41% with a confidence interval of 95%. The survey reports under-the-table payments for approximately 32.4% of public hospital admissions. Private clinics, which display the bulk of out-of-pocket payments, naturally display the lowest under-the-table payments. The highest percentage of under-the-table payments in the private sector appears at visits to private practitioners and dentists (36%). Informal payments are most frequently made upon request, prior to service provision, to facilitate access to care and to reduce waiting times, and at a much lower percentage, to post-service provision, and out of gratitude. This survey reveals that, due to severe financial pressure, there is a growing unwillingness of citizens to pay informally and an increasing demand for these payments as a prerequisite for access to services or to redeem services provided. This "hidden" financial burden of at least 27% impacts negatively on the living conditions of households and is not reported as purchasing ability or cost of living.

  3. Crisis Reliability Indicators Supporting Emergency Services (CRISES): A Framework for Developing Performance Measures for Behavioral Health Crisis and Psychiatric Emergency Programs.

    Science.gov (United States)

    Balfour, Margaret E; Tanner, Kathleen; Jurica, Paul J; Rhoads, Richard; Carson, Chris A

    2016-01-01

    Crisis and emergency psychiatric services are an integral part of the healthcare system, yet there are no standardized measures for programs providing these services. We developed the Crisis Reliability Indicators Supporting Emergency Services (CRISES) framework to create measures that inform internal performance improvement initiatives and allow comparison across programs. The framework consists of two components-the CRISES domains (timely, safe, accessible, least-restrictive, effective, consumer/family centered, and partnership) and the measures supporting each domain. The CRISES framework provides a foundation for development of standardized measures for the crisis field. This will become increasingly important as pay-for-performance initiatives expand with healthcare reform.

  4. Framing in the Spanish press about the health crisis because of the E. coli bacterium

    OpenAIRE

    López Villafranca, Paloma

    2013-01-01

    En este artículo de investigación se realiza un análisis del reflejo en los medios de comunicación y en las campañas institucionales de  la crisis sanitaria de la bacteria E. coli, más conocida en España como crisis del pepino. Mientras que en el resto de Europa tuvo un tratamiento similar al de la gripe A o al mal de las vacas locas, en España se reflejó como una crisis que afectó a la economía y no a la salud de los ciudadanos españoles.  Los intereses económicos prevalecen sobre la salud p...

  5. The global financial crisis and psychological health in a sample of Australian older adults: a longitudinal study.

    Science.gov (United States)

    Sargent-Cox, Kerry; Butterworth, Peter; Anstey, Kaarin J

    2011-10-01

    Economic stress and uncertainty is argued to increase older adults' vulnerability to physical health decline and mental distress. Nevertheless, there is a paucity of research that examines the relationship between a large historical economic event, such as the recent global financial crisis (GFC), and health outcomes for older adults. This study provides a unique opportunity to compare self-reported health status and psychological functioning (number of depression and anxiety symptoms) in 1973 older Australian adults (mean age of 66.58 years (SD = 1.5)) prior to the GFC (2005-2006), with their status four years later during the GFC period (2009-2010). Latent difference score models revealed a significant difference in depression and anxiety symptoms over the two measurement occasions, indicating poorer psychological functioning for those who reported an impact as a result of the economic slowdown. These effects were not explained by demographic or socio-economic factors. Interaction effects showed that those participants who were surveyed within the acute salience period of the GFC (April to September 2009) were significantly less likely to report poorer psychological health over time compared to those who were surveyed after September 2009. This interesting timing effect is discussed in terms of potential time-lags in the negative effects of economic stress on health outcomes, as well as the possible protective effects of social norms that may be created by a large scale economic crisis. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. An examination of contemporary financing practices and the global financial crisis on nonprofit multi-hospital health systems.

    Science.gov (United States)

    Stewart, Louis J; Smith, Pamela C

    2011-01-01

    This study examines the impact of the 2008 global financial crisis on large US nonprofit health systems. We proceed from an analysis of the contemporary capital financing practices of 25 of the nation's largest nonprofit hospitals and health systems. We find that these institutions relied on operating cash flows, public issues of insured variable rate debt, and accumulated investment to meet their capital financing needs. The combined use of these three financial instruments provided these organizations with $22.4 billion of long-term capital at favorable terms and the lowest interest rates. Our analysis further indicates that the extensive utilization of bond insurance, auction rate debt, and interest rate derivatives created significant risk exposures for these health systems. These risks were realized by the broader global financial crisis of 2008. Findings indicate these health systems incurred large losses from the early retirement of their variable rate debt. In addition, many organizations were forced to post nearly $1 billion of liquid collateral due to the falling values of their interest rate derivatives. Finally, the investment portfolios of these large nonprofit health systems suffered millions of dollars of unrealized capital losses, which may minimize their ability to finance future capital investment requirements.

  7. Development of a peer-supported, self-management intervention for people following mental health crisis.

    Science.gov (United States)

    Milton, Alyssa; Lloyd-Evans, Brynmor; Fullarton, Kate; Morant, Nicola; Paterson, Bethan; Hindle, David; Kelly, Kathleen; Mason, Oliver; Lambert, Marissa; Johnson, Sonia

    2017-11-09

    A documented gap in support exists for service users following discharge from acute mental health services, and structured interventions to reduce relapse are rarely provided. Peer-facilitated self-management interventions have potential to meet this need, but evidence for their effectiveness is limited. This paper describes the development of a peer-provided self-management intervention for mental health service users following discharge from crisis resolution teams (CRTs). A five-stage iterative mixed-methods approach of sequential data collection and intervention development was adopted, following the development and piloting stages of the MRC framework for developing and evaluating complex interventions. Evidence review (stage 1) included systematic reviews of both peer support and self-management literature. Interviews with CRT service users (n = 41) regarding needs and priorities for support following CRT discharge were conducted (stage 2). Focus group consultations (n = 12) were held with CRT service-users, staff and carers to assess the acceptability and feasibility of a proposed intervention, and to refine intervention organisation and content (stage 3). Qualitative evaluation of a refined, peer-provided, self-management intervention involved qualitative interviews with CRT service user participants (n = 9; n = 18) in feasibility testing (stage 4) and a pilot trial (stage 5), and a focus group at each stage with the peer worker providers (n = 4). Existing evidence suggests self-management interventions can reduce relapse and improve recovery. Initial interviews and focus groups indicated support for the overall purpose and planned content of a recovery-focused self-management intervention for people leaving CRT care adapted from an existing resource: The personal recovery plan (developed by Repper and Perkins), and for peer support workers (PSWs) as providers. Participant feedback after feasibility testing was positive regarding facilitation of

  8. Impact of the 2008 global financial crisis on the health of Canadians: repeated cross-sectional analysis of the Canadian Community Health Survey, 2007-2013.

    Science.gov (United States)

    Nour, Sabrina; Labonté, Ronald; Bancej, Christina

    2017-04-01

    Despite a clear impact on the Canadian economy, little is known about the subsequent health impacts of the 2008 global financial crisis (GFC) in this country. This study fills this gap in knowledge by conducting a repeated cross-sectional analysis of the Canadian Community Health Survey (CCHS). Data from 7 cycles (2007-2013) of the CCHS were combined to form a large data set representative of the Canadian working-age population (15-64 years) residing in 1 of 10 provinces. A logistic regression model was used to determine whether exposure to various periods of the GFC resulted in increased odds of reporting poor mental health. Exposure was categorised into 4 periods based on political and economic indicators, as follows: precrisis period (baseline), initial crisis period, stimulus period and austerity period. Other outcomes investigated included: anxiety disorders (AD), mood disorders (MD), poor physical health and health-related behaviours (heavy alcohol drinking (HAD) and decreased fruit/vegetable consumption (FVC)). A significant increased odds of reporting poor mental health was observed during the austerity period compared with the precrisis period (OR=1.26 (1.16 to 1.32)); findings remain significant when adjusted for sex, marital status and education. Exposure to the austerity period was also significantly associated with increased odds of reporting AD, MD, HAD and decreased odds of FVC. No significant associations were observed for the poor self-perceived physical health variable. Statistically significant associations were observed between several negative health outcomes and the austerity period when compared with the precrisis period. Austerity has been linked to worsening health in other studies and represents an example of how the policy response can have greater detrimental impact on health than the financial crisis itself. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  9. The Ariadne's thread in co-payment, primary health care usage and financial crisis: findings from Cyprus public health care sector.

    Science.gov (United States)

    Petrou, P

    2015-11-01

    Cyprus entered a prolonged financial recession in 2011 and by early 2013 it applied for an international bail-out agreement. This presupposed massive reforms in public governance. Health sector was considerably reformed and one of the measures was the introduction of co-payment for outpatient visits to public health care sector. The scope of this study is to assess the impact of financial crisis and co-payment to public outpatient visits in Nicosia urban and greater Nicosia region. An Interrupted time-series analysis. All outpatient visits to public health care family doctor/general practitioners in Nicosia urban and greater Nicosia region from January 2011 until May of 2014 were registered and analysed. Financial crisis did not alter outpatient visits. Introduction of co-payment led to a statistically significant decrease from the second month after its introduction (p = 0.048) (R(2) = 0.329, Q = 23.75, p = 0.137). This decrease was consistent until the end of the observational period and it did not level off. Financial crisis did not affect outpatient visits while co-payment can be considered as a potent cost containment measure during financial recession, by normalising utilisation of healthcare resources. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  10. The use of a surveillance system to measure changes in mental health in Australian adults during the global financial crisis.

    Science.gov (United States)

    Shi, Zumin; Taylor, Anne W; Goldney, Robert; Winefield, Helen; Gill, Tiffany K; Tuckerman, Jane; Wittert, Gary

    2011-08-01

    This study aimed to describe trends in a range of mental health indicators in South Australia where a surveillance system has been in operation since July 2002 and assess the impact of the global financial crisis (GFC). Data were collected using a risk factor surveillance system. Participants, aged 16 years and above, were asked about doctor-diagnosed anxiety, stress or depression, suicidal ideation, psychological distress (PD), demographic and socioeconomic factors using Computer-Assisted Telephone Interviewing (CATI). Overall, there was a decreasing trend in the prevalence of PD between 2002 and 2009. Stress has decreased since 2004 although anxiety has increased. Comparing 2008 or 2009 (the economic crisis period) with 2005 or 2007, there was significant increase in anxiety for part-time workers but a decrease for full-time workers. There were significant differences for stress by various demographic variables. The overall prevalence of mental health conditions has not increased during the GFC. Some subgroups in the population have been disproportionately impacted by changes in mental health status. The use of a surveillance system enables rapid and specifically targeted public health and policy responses to socioeconomic and environmental stressors, and the evaluation of outcomes.

  11. An assessment of the effects of the 2002 food crisis on children's health in Malawi

    NARCIS (Netherlands)

    R. Hartwig (Renate); M. Grimm (Michael)

    2012-01-01

    textabstractThe food crisis encountered in 2002 in Malawi was arguably one of the worst in the recent history of the country. The World Food Programme estimated that between 2.1 and 3.2 million people were threatened by starvation. Despite this assumed severity, not much research on the actual

  12. Hypertensive Crisis

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Hypertensive Crisis: When You Should Call 9-1-1 for ... Nov 13,2017 A hypertensive ( high blood pressure ) crisis is when blood pressure rises quickly and severely ...

  13. Hemolytic crisis

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003270.htm Hemolytic crisis To use the sharing features on this page, please enable JavaScript. Hemolytic crisis occurs when large numbers of red blood cells ...

  14. Impact of the economic crisis on the health of older persons in Spain: research clues based on an analysis of mortality. SESPAS report 2014

    Directory of Open Access Journals (Sweden)

    Tarik Benmarhnia

    2014-06-01

    Full Text Available Older adults are seldom considered in studies on the health impact of economic recessions or crises. However, they constitute a population group that is highly vulnerable to decreases in investment in health and social services and social security. Our aim is to examine the relationship between the economic crisis starting in 2008 and the health status of older adults in Spain. More specifically, we analyze changes in trends of mortality in relation to the crisis, the specific impact of winter on mortality and gender differences in the crisis’ impact on mortality. Using data from the National Institute of Statistics of Spain on people over 60 years of age, the number of monthly deaths by age and sex from January 2005 to December 2012 was analyzed. Interrupted time series analyses and the “difference in differences” method were used. During the crisis, for adults 60 years and older: 1 the observed mortality seems to be decreasing at a slower rate than what would have been expected in the absence of the crisis; 2 there has been an increase in winter mortality; 3 the impact of the crisis has been greater for female than for male mortality. These results suggest sizable effects of the economic crisis on the mortality of older adults and argue for research done using more detailed analyses integrating economic indicators.

  15. Crisis Thought

    OpenAIRE

    Morris, Edwin Kent

    2016-01-01

    Crisis thought is an idea that gives a name to and accounts for some of the problematics of the sign crisis in political, social, cultural, and economic discourse. Specifically, crisis thought is a discursive formation, a concept used loosely here to refer to an assemblage of signs such as anxiety or fear that evoke or invoke similar, but inaccurate connotations as crisis in political and everyday usage. The general question this study grapples with is why political, social, cultural, and eco...

  16. Has the quality of health care for the immigrant population changed during the economic crisis in Catalonia (Spain)? Opinions of health professionals and immigrant users.

    Science.gov (United States)

    Porthé, Victoria; Vargas, Ingrid; Ronda, Elena; Malmusi, Davide; Bosch, Lola; Vázquez, M Luisa

    2017-06-02

    To analyse changes in health professionals' and immigrant users' perceptions of the quality of care provided to the immigrant population during the crisis. A qualitative descriptive-interpretative and exploratory study was conducted in two areas of Catalonia. Semi-structured individual interviews were used with a theoretical sample of medical (n=24) and administrative (n=10) professionals in primary care (PC) and secondary care (SC), and immigrant users (n=20). Thematic analysis was conducted and the results were triangulated. Problems related to technical and interpersonal quality emerged from the discourse of both professionals and immigrants. These problems were attributed to cutbacks during the economic crisis. Regarding technical quality, respondents reported an increase in erroneous or non-specific diagnoses, inappropriate use of diagnostic tests and non-specific treatments, due to reduction in consultation times as a result of cuts in human resources. With regard to interpersonal quality, professionals reported less empathy, and users also reported worse communication, due to changes in professionals' working conditions and users' attitudes. Finally, a reduction in the resolution capacity of the health services emerged: professionals described unnecessary repeated PC visits and limited responses in SC, while young immigrants reported an insufficient response to their health problems. The results indicate a deterioration in perceived technical and interpersonal quality during the economic crisis, due to cutbacks mainly in human resources. These changes affect the whole population, but especially immigrants. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Effect of the economic crisis on the use of health and home care services among Spanish COPD patients.

    Science.gov (United States)

    de Miguel-Diez, Javier; Lopez-de-Andres, Ana; Herandez-Barrera, Valentin; Jimenez-Trujillo, Isabel; Puente-Maestu, Luis; Cerezo-Lajas, Alicia; Jimenez-Garcia, Rodrigo

    2018-01-01

    Chronic obstructive pulmonary disease (COPD) is a major cause of disability and death worldwide. Consequently, COPD patients are frequent users of health and social resources. Therefore, they are highly vulnerable to decreases in investment in healthcare services. We aimed to describe the utilization of health and home care services among Spanish COPD patients during the economic crisis to identify factors independently associated with changes in the utilization of these services and to study the time trends from 2009 to 2014. We used data from the European Health Interview Surveys for Spain (EHSS) conducted between 2009/2010 (n=22,188) and 2014 (n=22,842). We included responses from adults with COPD aged 40 years or over. Dependent variables included self-reported hospitalizations during the previous year, general practitioner (GP) visits during the last 4 weeks, other health care services used during the previous year (nursing, rehabilitation, and psychological services), and home care services use during the previous year. Independent variables included demographic and socioeconomic characteristics, health status variables, and lifestyles. We identified 1,328 and 1,008 COPD patients from EHSS 2009 and EHSS 2014, respectively. We observed a significant increase in non-GP services use (30.6% in 2009 vs 39.11% in 2014; p home care services use over time. Multivariable models showed that associated factors with a higher use included any chronic comorbidity and worse self-rated health. Physical activity was a strong predictor of fewer hospitalizations and less home care service use. Female sex was associated with significantly fewer hospitalizations (OR 0.72; 95% CI 0.58-0.89). We found an increase in the use of non-GP services (nursing, rehabilitation, and psychological) but not in other health and home care services. The only differences in hospitalizations were observed according to sex. Therefore, the effect of the economic crisis, if any, seems to have been of

  18. How are the employed and unemployed affected by the economic crisis in Spain? Educational inequalities, life conditions and mental health in a context of high unemployment.

    Science.gov (United States)

    Córdoba-Doña, Juan Antonio; Escolar-Pujolar, Antonio; San Sebastián, Miguel; Gustafsson, Per E

    2016-03-15

    Despite an increasing number of studies on the factors mediating the impact of the economic recession on mental health, research beyond the individual employment status is scarce. Our objectives were to investigate in which ways the mental health of employed and unemployed populations is differently affected by the current economic recession along the educational scale and to examine whether financial strain and social support explain these effects of the crisis. A repeated cross-sectional study, using two waves of the Andalusian Health Survey in 2007 (pre-crisis) and 2011-2012 (crisis). A population aged between 19 and 64 years was selected. The dependent variable was the Mental Component Summary of the SF-12 questionnaire. We performed Poisson regression models stratified by working status, with period, educational level, financial strain and social support as independent variables. We examined interactions between period and educational level. Age, sex, main earner, cohabitation and partner's working status were considered as covariates. The study included 3210 individuals (1185 women) in 2007 and 3633 individuals (1486 women) in 2011-2012. In working individuals the prevalence of poor mental health increased for secondary and complete primary studies groups during crisis compared to the pre-crisis period, while it decreased significantly in the university study group (PR = 0.76, 95% CI: 0.58-0.99). However, in unemployed individuals prevalence ratios for poor mental health increased significantly only in the secondary studies group (PR = 1.73, 95% CI: 1.06-2.83). Financial strain and social support yielded consistent associations with mental health in all subgroups. Only financial strain could partly explain the crisis effect on mental health among the unemployed. Our study supports the finding that current economic recession is associated with poorer mental health differentially according to labour market status and educational level. Those with secondary

  19. Forced Migration and Global Responsibility for Health Comment on "Defining and Acting on Global Health: The Case of Japan and the Refugee Crisis".

    Science.gov (United States)

    Bozorgmehr, Kayvan; Razum, Oliver

    2016-11-05

    Forced migration has become a world-wide phenomenon in the past century, affecting increasing numbers of countries and people. It entails important challenges from a global health perspective. Leppold et al have critically discussed the Japanese interpretation of global responsibility for health in the context of forced migration. This commentary complements their analysis by outlining three priority areas of global health responsibility for European Union (EU) countries. We highlight important stages of the migration phases related to forced migration and propose three arguments. First, the chronic neglect of the large number of internally displaced persons (IDPs) in the discourses on the "refugee crisis" needs to be corrected in order to develop sustainable solutions with a framework of the Sustainable Development Goals (SDGs). Second, protection gaps in the global system of protection need to be effectively closed to resolve conflicts with border management and normative global health frameworks. Third, effective policies need to be developed and implemented to meet the health and humanitarian needs of forced migrants; at the same time, the solidarity crisis within the EU needs to be overcome. These stakes are high. EU countries, being committed to global health, should urgently address these areas. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  20. The Relationship between Therapeutic Alliance and Service User Satisfaction in Mental Health Inpatient Wards and Crisis House Alternatives: A Cross-Sectional Study

    Science.gov (United States)

    Sweeney, Angela; Fahmy, Sarah; Nolan, Fiona; Morant, Nicola; Fox, Zoe; Lloyd-Evans, Brynmor; Osborn, David; Burgess, Emma; Gilburt, Helen; McCabe, Rosemarie; Slade, Mike; Johnson, Sonia

    2014-01-01

    Background Poor service user experiences are often reported on mental health inpatient wards. Crisis houses are an alternative, but evidence is limited. This paper investigates therapeutic alliances in acute wards and crisis houses, exploring how far stronger therapeutic alliance may underlie greater client satisfaction in crisis houses. Methods and Findings Mixed methods were used. In the quantitative component, 108 crisis house and 247 acute ward service users responded to measures of satisfaction, therapeutic relationships, informal peer support, recovery and negative events experienced during the admission. Linear regressions were conducted to estimate the association between service setting and measures, and to model the factors associated with satisfaction. Qualitative interviews exploring therapeutic alliances were conducted with service users and staff in each setting and analysed thematically. Results We found that therapeutic alliances, service user satisfaction and informal peer support were greater in crisis houses than on acute wards, whilst self-rated recovery and numbers of negative events were lower. Adjusted multivariable analyses suggest that therapeutic relationships, informal peer support and negative experiences related to staff may be important factors in accounting for greater satisfaction in crisis houses. Qualitative results suggest factors that influence therapeutic alliances include service user perceptions of basic human qualities such as kindness and empathy in staff and, at service level, the extent of loss of liberty and autonomy. Conclusions and Implications We found that service users experience better therapeutic relationships and higher satisfaction in crisis houses compared to acute wards, although we cannot exclude the possibility that differences in service user characteristics contribute to this. This finding provides some support for the expansion of crisis house provision. Further research is needed to investigate why acute

  1. Assessment of health-care waste management in a humanitarian crisis: A case study of the Gaza Strip.

    Science.gov (United States)

    Caniato, Marco; Tudor, Terry Louis; Vaccari, Mentore

    2016-12-01

    Health-care waste management requires technical, financial and human resources, and it is a challenge for low- and middle income countries, while it is often neglected in protracted crisis or emergency situations. Indeed, when health, safety, security or wellbeing of a community is threatened, solid waste management usually receives limited attention. Using the Gaza Strip as the case study region, this manuscript reports on health-care waste management within the context of a humanitarian crisis. The study employed a range of methods including content analyses of policies and legislation, audits of waste arisings, field visits, stakeholder interviews and evaluation of treatment systems. The study estimated a production from clinics and hospitals of 683kg/day of hazardous waste in the Gaza Strip, while the total health-care waste production was 3357 kg/day. A number of challenges was identified including lack of clear definitions and regulations, limited accurate data on which to base decisions and strategies and poor coordination amongst key stakeholders. Hazardous and non-hazardous waste was partially segregated and treatment facilities hardly used, and 75% of the hazardous waste was left untreated. Recommendations for mitigating these challenges posed to patients, staff and the community in general are suggested. The outputs are particularly useful to support decision makers, and re-organize the system according to reliable data and sound assumptions. The methodology can be replicated in other humanitarian settings, also to other waste flows, and other sectors of environmental sanitation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Effect of the economic crisis on the use of health and home care services among elderly Spanish diabetes patients.

    Science.gov (United States)

    Lopez-de-Andres, Ana; de Miguel-Diez, Javier; Hernandez-Barrera, Valentin; Jiménez-Trujillo, Isabel; Martinez-Huedo, Maria-Angeles; Del Barrio, José Luis; Jimenez-Garcia, Rodrigo

    2018-03-27

    To describe the utilization of health and home care services among older people (≥65 years) with diabetes during the economic crisis; to identify the factors associated with changes in the utilization of these services; and to study the time trends (2009-2014). We used the European Health Interview Surveys for Spain (EEHSS) for 2009/10 and 2014. The dependent variables included self-reported hospitalizations; general practitioner (GP) visits; 'other healthcare services' (OHS) used; and home care services (HCS) used. We identified 6026 and 6020 diabetic patients (EEHSS2009 and EEHSS2014, respectively). A significant decrease in the number of GP visits (OR 0.94; 95% CI 0.91-0.98) and the use of HCS (OR 0.95; 95% CI 0.91-0.99) was found; however, we found an increase in the use of OHS (OR 1.06; 95% CI 1.02-1.10). Multivariate models showed that factors associated with an increased use included chronic conditions, worse self-rated health, pain and mental disorders. Physical activity was a strong predictor of lower hospitalizations and HCS use. Female gender was associated with significantly lower hospitalizations and a higher use of OHC and HCS. We found a decrease in the number of GP visits and the use of HCS among elderly diabetic adults; however, we also observed an increase in the use of OHS, which may partly explain this decrease in the figures. Significant differences in the use of health services were found according to gender. The effect of the economic crisis, if any, seems to have had a small magnitude. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Managing crisis

    OpenAIRE

    Bakacsi, Gyula

    2010-01-01

    The traditional approach to crisis management suggest autocratic leadership, that has risks anyway (leader is the bottle-neck of problem solving, single-loop learning, crisis management is a matter of efficiency). However, managing nowadays crisis is rather effectiveness issue, and requires double-loop learning (second-order change) and leadership role in the sense of Kotter’s theory. Paper discusses the top-management’s leadership responsibilities, and their special tasks in the problem solv...

  4. Veterans Crisis Line: Videos About Reaching out for Help

    Science.gov (United States)

    Veterans Crisis Line Skip to Main Content SuicidePreventionLifeline.org Get Help Materials Get Involved Crisis Centers About Be There ... see more videos from Veterans Health Administration Veterans Crisis Line -- After the Call see more videos from ...

  5. Health inequality between immigrants and natives in Spain: the loss of the healthy immigrant effect in times of economic crisis.

    Science.gov (United States)

    Gotsens, Mercè; Malmusi, Davide; Villarroel, Nazmy; Vives-Cases, Carmen; Garcia-Subirats, Irene; Hernando, Cristina; Borrell, Carme

    2015-12-01

    The immigrant population living in Spain grew exponentially in the early 2000s but has been particularly affected by the economic crisis. This study aims to analyse health inequalities between immigrants born in middle- or low-income countries and natives in Spain, in 2006 and 2012, taking into account gender, year of arrival and socioeconomic exposures. Study of trends using two cross-sections, the 2006 and 2012 editions of the Spanish National Health Survey, including residents in Spain aged 15-64 years (20 810 natives and 2950 immigrants in 2006, 14 291 natives and 2448 immigrants in 2012). Fair/poor self-rated health, poor mental health (GHQ-12 > 2), chronic activity limitation and use of psychotropic drugs were compared between natives and immigrants who arrived in Spain before 2006, adjusting robust Poisson regression models for age and socioeconomic variables to obtain prevalence ratios (PR) and 95% confidence interval (CI). Inequalities in poor self-rated health between immigrants and natives tend to increase among women (age-adjusted PR2006 = 1.39; 95% CI: 1.24-1.56, PR2012 = 1.56; 95% CI: 1.33-1.82). Among men, there is a new onset of inequalities in poor mental health (PR2006 = 1.10; 95% CI: 0.86-1.40, PR2012 = 1.34; 95% CI: 1.06-1.69) and an equalization of the previously lower use of psychotropic drugs (PR2006 = 0.22; 95% CI: 0.11-0.43, PR2012 = 1.20; 95% CI: 0.73-2.01). Between 2006 and 2012, immigrants who arrived in Spain before 2006 appeared to worsen their health status when compared with natives. The loss of the healthy immigrant effect in the context of a worse impact of the economic crisis on immigrants appears as potential explanation. Employment, social protection and re-universalization of healthcare would prevent further deterioration of immigrants' health status. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  6. Inpatient Profile of Patients with Major Depression in Portuguese National Health System Hospitals, in 2008 and 2013: Variation in a Time of Economic Crisis.

    Science.gov (United States)

    Rodrigues, Daniel Francisco Santos; Nunes, Carla

    2018-02-01

    The economic crisis has placed Portugal in a situation of budgetary constraints with repercussions on mental health, since 2009. This study analyses the association between economic crisis and the inpatient profile of major depression in the working-age population in Portuguese National Health System hospitals. This was an observational, descriptive and cross-sectional study. An individual analysis of hospitalisation and an ecological analysis at district level, were performed before 2008 and during the crisis (2013). Data on the hospitalisation episodes, working-age population and psychiatric inpatient beds were analysed. An increase in hospitalisation rates for major depression were observed, and across country, high spatial variations were perceived: districts with lower rates of urbanisation and population density had higher hospitalisation rates for major depression. Hospitalisation rates were positively influenced by the available inpatient beds. The results for 2013 were more critical (higher hospitalisation rates, less beds). Further research is needed to understand all patterns, considering other individual and contextual information.

  7. Are economic evaluations and health technology assessments increasingly demanded in times of rationing health services? The case of the Argentine financial crisis.

    Science.gov (United States)

    Rubinstein, Adolfo; Belizán, María; Discacciati, Vilda

    2007-01-01

    After 4 years of deepening recession, Argentina's economy plummeted after default in 2002. This crisis critically affected health expenditures and triggered acute rationing. Our objective was to explore health decision-makers' knowledge and attitudes about economic evaluations (EE) and whether health technology assessment (HTA) were increasingly used for decision making. A qualitative design based on semistructured interviews and focus groups was used to explore how decision makers belonging to different health sectors implement resource allocation decisions. Informants were mostly unaware of EE. The most important criteria mentioned to adopt a treatment were evidence of effectiveness, social/stakeholder demand, or resource availability. Despite general positive attitudes about EE, knowledge was rather limited. Although cost considerations were widely accepted by purchasers and managers, clinicians argued about these issues as interfering with the doctor-patient relationship. Other important perceived barriers to HTA use were lack of confidence in the transferability of studies conducted in developed countries and institutional fragmentation of the Argentine healthcare system. The new macroeconomic context was cited as a justification of implicit rationing measures. Although explicit priority setting was implemented by many purchasers and managers, HTA was not used to improve technical and/or allocative efficiency. The crisis seems to be a strong incentive to extend the use of HTA in Argentina, provided decision makers are aware as well as involved in the generation of local studies.

  8. Implications of the global financial crisis for the response to diseases of poverty within overall health sector development: the case of tuberculosis.

    Science.gov (United States)

    Maher, Dermot

    2010-01-01

    The global financial crisis poses a threat to global health, and may exacerbate diseases of poverty, e.g. HIV, malaria and tuberculosis. Exploring the implications of the global financial crisis for the health sector response to tuberculosis is useful to illustrate the practical problems and propose possible solutions. The response to tuberculosis is considered in the context of health sector development. Problems and solutions are considered in five key areas: financing, prioritization, government regulation, integration and decentralization. Securing health gains in global tuberculosis control depends on protecting expenditure by governments of countries badly affected by tuberculosis and by donors, taking measures to increase efficiencies, prioritizing health expenditures and strengthening government regulation. Lessons learned will be valuable for stakeholders involved in the health sector response to tuberculosis and other diseases of poverty.

  9. Hampered Vitamin B12 Metabolism in Gaucher Disease?

    Directory of Open Access Journals (Sweden)

    Luciana Hannibal PhD

    2017-02-01

    Full Text Available Untreated vitamin B 12 deficiency manifests clinically with hematological abnormalities and combined degeneration of the spinal cord and polyneuropathy and biochemically with elevated homocysteine (Hcy and methylmalonic acid (MMA. Vitamin B 12 metabolism involves various cellular compartments including the lysosome, and a disruption in the lysosomal and endocytic pathways induces functional deficiency of this micronutrient. Gaucher disease (GD is characterized by dysfunctional lysosomal metabolism brought about by mutations in the enzyme beta-glucocerebrosidase (Online Mendelian Inheritance in Man (OMIM: 606463; Enzyme Commission (EC 3.2.1.45, gene: GBA1 . In this study, we collected and examined available literature on the associations between GD, the second most prevalent lysosomal storage disorder in humans, and hampered vitamin B 12 metabolism. Results from independent cohorts of patients show elevated circulating holotranscobalamin without changes in vitamin B 12 levels in serum. Gaucher disease patients under enzyme replacement therapy present normal levels of Hcy and MMA. Although within the normal range, a significant increase in Hcy and MMA with normal serum vitamin B 12 was documented in treated GD patients with polyneuropathy versus treated GD patients without polyneuropathy. Thus, a functional deficiency of vitamin B 12 caused by disrupted lysosomal metabolism in GD is a plausible mechanism, contributing to the neurological form of the disorder but this awaits confirmation. Observational studies suggest that an assessment of vitamin B 12 status prior to the initiation of enzyme replacement therapy may shed light on the role of vitamin B 12 in the pathogenesis and progression of GD.

  10. Crisis Communication

    OpenAIRE

    Anca Jarmila Guţă

    2006-01-01

    The paper presents the manner in which the crisis of different types can disturb the normal activity of an organization and also the modalities by which the communication in this situation can solve or attenuate the negative effects of a crisis.

  11. [Impact of the crisis on the relationship between housing and health. Policies for good practice to reduce inequalities in health related to housing conditions].

    Science.gov (United States)

    Novoa, Ana M; Bosch, Jordi; Díaz, Fernando; Malmusi, Davide; Darnell, Mercè; Trilla, Carme

    2014-06-01

    Housing conditions can impact on physical and mental health through 4 interrelated dimensions: 1) the home (the emotional housing conditions), 2) the physical housing conditions, and 3) the physical environment, and 4) the social (community) environment of the neighborhood where the house is located. In Spain, the use of the construction market as an engine for economic growth and the promotion of private property as the main type of housing tenure has led to the use of housing as a speculative good instead of its being considered a first-necessity good. While Spain is the Organisation for Economic Co-operation and Development (OECD) country with the largest housing stock per inhabitant, this stock is highly underutilized, thus excluding the most deprived sector of the population from access to housing. The impact of the current economic crisis on housing has mainly been due to a reduction in household income, which has increased the number of families or persons struggling to cover their housing costs or being evicted. Evidence indicates that this type of problem has a negative impact on health, especially on mental health, but financial problems also make it difficult to meet other basic needs such as eating. There are several instruments to reduce the impact of the economic crisis, such as debt financing or deed of assignment in payment. In the long-term, the creation of a social housing stock should be promoted, as well as rental assistance mechanisms. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  12. A Closer Look at the Junior Doctor Crisis in the United Kingdom's National Health Services: Is Emigration Justifiable?

    Science.gov (United States)

    Teo, Wendy Zi Wei

    2018-07-01

    This article attempts to tackle the ethically and morally troubling issue of emigration of physicians from the United Kingdom, and whether it can be justified. Unlike most research that has already been undertaken in this field, which looks at migration from developing countries to developed countries, this article takes an in-depth look at the migration of physicians between developed countries, in particular from the United Kingdom (UK) to other developed countries such as Canada, Australia, New Zealand, and the United States (US). This examination was written in response to a current and critical crisis in the National Health Service (NHS), where impending contract changes may bring about a potential exodus of junior doctors.

  13. The effectiveness of crisis resolution/home treatment teams for older people with mental health problems: a systematic review and scoping exercise.

    Science.gov (United States)

    Toot, Sandeep; Devine, Mike; Orrell, Martin

    2011-12-01

    To assess the effectiveness of crisis resolution/home treatment services for older people with mental health problems. A systematic review was conducted to report on the effectiveness of crisis resolution/home treatment teams (CRHTTs) for older people with mental health problems. As part of the review, we also carried out a scoping exercise to assess the typologies of older people's CRHTTs in practice, and to review these in the context of policy and research findings. The literature contains Grade C evidence, according to the Oxford Centre of Evidence Based Medicine (CEBM) guidelines, that CRHTTs are effective in reducing numbers of admissions to hospitals. Outcomes such as length of hospital stay and maintenance of community residence were reviewed but evidence was inadequate for drawing conclusions. The scoping exercise defined three types of home treatment service model: generic home treatment teams; specialist older adults home treatment teams; and intermediate care services. These home treatment teams seemed to be effectively managing crises and reducing admissions. This review has shown a lack of evidence for the efficacy of crisis resolution/home treatment teams in supporting older people with mental health problems to remain at home. There is clearly a need for a randomised controlled trial to establish the efficacy of crisis resolution/home treatment services for older people with mental health problems, as well as a more focussed assessment of the different home treatment service models which have developed in the UK. Copyright © 2011 John Wiley & Sons, Ltd.

  14. The mental health risks of economic crisis in Spain: evidence from primary care centres, 2006 and 2010.

    Science.gov (United States)

    Gili, Margalida; Roca, Miquel; Basu, Sanjay; McKee, Martin; Stuckler, David

    2013-02-01

    Nearly all European countries have been affected by the economic crisis that began in 2007, but the consequences have been among the worst in Spain. We investigated the associations of the recession on the frequency of mood, anxiety, somatoform, alcohol-related and eating disorders among those visiting Spanish primary care settings. Primary care physicians selected randomized samples of patients attending primary care centres representing Spain's consulting populations. A total of 7940 patients in 2006-07 and 5876 in 2010-11 were administered the Primary Care Evaluation of Mental Disorders (PRIME-MD) instrument to diagnose mental disorders. Multivariate logistic regression models were used to quantify overall changes in the frequency of mental disorders, adjusting for potential socio-demographic differences in consulting populations unrelated to economic factors. Compared with the pre-crisis period of 2006, the 2010 survey revealed substantial and significant increases in the proportion of patients with mood (19.4% in major depression), anxiety (8.4% in generalized anxiety disorder), somatoform (7.3%) and alcohol-related disorders (4.6% in alcohol dependence), all significant at P < 0.001, but not in eating disorders (0.15%, P = 0.172). Independent of observed risks of unemployment [odds ratio (OR) = 1.72, P < 0.001], we observed a significantly elevated risk of major depression associated with mortgage repayment difficulties (OR = 2.12, P < 0.001) and evictions (OR = 2.95, P < 0.001). About one-third of the overall risk in the consulting population's attendance with mental health disorders could be attributed to the combined risks of household unemployment and mortgage payment difficulties. Recession has significantly increased the frequency of mental health disorders and alcohol abuse among primary care attendees in Spain, particularly among families experiencing unemployment and mortgage payment difficulties.

  15. Cancer screening and health system resilience: keys to protecting and bolstering preventive services during a financial crisis.

    Science.gov (United States)

    Martin-Moreno, Jose M; Anttila, Ahti; von Karsa, Lawrence; Alfonso-Sanchez, Jose L; Gorgojo, Lydia

    2012-09-01

    The aim of this paper is to elucidate the rationale for sustaining and expanding cost-effective, population-based screening services for breast, cervical and colorectal cancers in the context of the current financial crisis. Our objective is not only to promote optimal delivery of high-quality secondary cancer prevention services, but also to underline the importance of strengthening comprehensive cancer control, and with it, health system response to the complex care challenges posed by all chronic diseases. We focus primarily on issues surrounding planning, organisation, implementation and resources, arguing that given the growing cancer burden, policymakers have ample justification for establishing and expanding population-based programmes that are well-organised, well-resourced and well-executed. In a broader economic context of rescue packages, deficits and cutbacks to government entitlements, health professionals must intensify their advocacy for the protection of vital preventive health services by fighting for quality services with clear benefits for population health outcomes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Determinants of dropout in a community-based mental health crisis centre.

    Science.gov (United States)

    Henzen, Alexandre; Moeglin, Clotilde; Giannakopoulos, Panteleimon; Sentissi, Othman

    2016-04-19

    Dropping out during the course of medical follow up is defined as an early therapy withdrawal without the agreement of the therapist. In a psychiatric crisis unit in Geneva, we empirically observed that almost 50% of the patients were not showing up to their first appointments, which were scheduled for 3 to 7 days post discharge. The aim of this naturalistic descriptive cohort study is to identify the demographic, patient and care-related predictive factors of dropout in a community-based psychiatric crisis centre. We included 245 consecutive outpatients followed-up for 4 to 6 weeks of intensive outpatient psychiatric treatment. Logistic regression models were built to examine the association between dropout and demographic, care and patient-related variables. Among the 245 outpatients, dropout occurred in 37.5% of cases, and it most frequently occurred (81.8%) in the first 2 days of follow-up. Among care-related variables, referral by hospital units or private psychiatrists led to significantly lower levels of dropout compared to patients referred by the psychiatric emergency unit (respectively: OR = .32; p = .04; 95% CI [.10, .93]; OR = .36; p = .04; 95% CI [.13, .96]; OR = .22; p = .002; 95% CI [.08, .58]). Among patient-related variables, younger age increased the risk of dropout (OR = .96; 95%; p = .002; 95% CI [.94, .99]). Anxiety and personality but not mood disorders were also related to higher rates of dropout (respectively: OR = 2.40; p = .02; 95% CI [1.14, 4.99]; and OR = 1.98; p = .02; 95% CI [1.09, 3.59]). Unipolar depression (72.2%; OR = 1.47; p = .48; 95% CI [.34, 1.21]) was the most frequent primary diagnosis in this sample. This study makes clear the need for increased efforts to improve care adherence in young patients with anxious or personality disorders seen in emergency rooms because they are prone to early discontinuation of treatments. Future studies in this field are warranted to gain

  17. Changes in Access to Health Services of the Immigrant and Native-Born Population in Spain in the Context of Economic Crisis

    Science.gov (United States)

    Garcia-Subirats, Irene; Vargas, Ingrid; Sanz-Barbero, Belén; Malmusi, Davide; Ronda, Elena; Ballesta, Mónica; Vázquez, María Luisa

    2014-01-01

    Aim: To analyze changes in access to health care and its determinants in the immigrant and native-born populations in Spain, before and during the economic crisis. Methods: Comparative analysis of two iterations of the Spanish National Health Survey (2006 and 2012). Outcome variables were: unmet need and use of different healthcare levels; explanatory variables: need, predisposing and enabling factors. Multivariate models were performed (1) to compare outcome variables in each group between years, (2) to compare outcome variables between both groups within each year, and (3) to determine the factors associated with health service use for each group and year. Results: unmet healthcare needs decreased in 2012 compared to 2006; the use of health services remained constant, with some changes worth highlighting, such as the decline in general practitioner visits among autochthons and a narrowed gap in specialist visits between the two populations. The factors associated with health service use in 2006 remained constant in 2012. Conclusion: Access to healthcare did not worsen, possibly due to the fact that, until 2012, the national health system may have cushioned the deterioration of social determinants as a consequence of the financial crisis. Further studies are necessary to evaluate the effects of health policy responses to the crisis after 2012. PMID:25272078

  18. Changes in Access to Health Services of the Immigrant and Native-Born Population in Spain in the Context of Economic Crisis

    Directory of Open Access Journals (Sweden)

    Irene Garcia-Subirats

    2014-09-01

    Full Text Available Aim: To analyze changes in access to health care and its determinants in the immigrant and native-born populations in Spain, before and during the economic crisis. Methods: Comparative analysis of two iterations of the Spanish National Health Survey (2006 and 2012. Outcome variables were: unmet need and use of different healthcare levels; explanatory variables: need, predisposing and enabling factors. Multivariate models were performed (1 to compare outcome variables in each group between years, (2 to compare outcome variables between both groups within each year, and (3 to determine the factors associated with health service use for each group and year. Results: unmet healthcare needs decreased in 2012 compared to 2006; the use of health services remained constant, with some changes worth highlighting, such as the decline in general practitioner visits among autochthons and a narrowed gap in specialist visits between the two populations. The factors associated with health service use in 2006 remained constant in 2012. Conclusion: Access to healthcare did not worsen, possibly due to the fact that, until 2012, the national health system may have cushioned the deterioration of social determinants as a consequence of the financial crisis. Further studies are necessary to evaluate the effects of health policy responses to the crisis after 2012.

  19. Crisis? What Crisis? The Normality of the Current Food Crisis

    OpenAIRE

    Lang, T.

    2010-01-01

    The 2005–8 food crisis was a shock to political elites, but in some respects the situation was normal. Food policies are failing to respond adequately to the squeeze on land, people, health and environment. Strong evidence of systems failure and stress, termed here New Fundamentals, ought to reframe twenty-first century food politics and effort. Yet so far, international discourse is too often narrow and technical. The paper suggests that 2005–8 reinforced how the dominant twentieth century p...

  20. The CORE Service Improvement Programme for mental health crisis resolution teams: study protocol for a cluster-randomised controlled trial.

    Science.gov (United States)

    Lloyd-Evans, Brynmor; Fullarton, Kate; Lamb, Danielle; Johnston, Elaine; Onyett, Steve; Osborn, David; Ambler, Gareth; Marston, Louise; Hunter, Rachael; Mason, Oliver; Henderson, Claire; Goater, Nicky; Sullivan, Sarah A; Kelly, Kathleen; Gray, Richard; Nolan, Fiona; Pilling, Stephen; Bond, Gary; Johnson, Sonia

    2016-03-22

    As an alternative to hospital admission, crisis resolution teams (CRTs) provide intensive home treatment to people experiencing mental health crises. Trial evidence supports the effectiveness of the CRT model, but research suggests that the anticipated reductions in inpatient admissions and increased user satisfaction with acute care have been less than hoped for following the scaling up of CRTs nationally in England, as mandated by the National Health Service (NHS) Plan in 2000. The organisation and service delivery of the CRTs vary substantially. This may reflect the lack of a fully specified CRT model and the resources to enhance team model fidelity and to improve service quality. We will evaluate the impact of a CRT service improvement programme over a 1-year period on the service users' experiences of care, service use, staff well-being, and team model fidelity. Twenty-five CRTs from eight NHS Trusts across England will be recruited to this cluster-randomised trial: 15 CRTs will be randomised to receive the service improvement programme over a 1-year period, and ten CRTs will not receive the programme. Data will be collected from 15 service users and all clinical staff from each participating CRT at baseline and at the end of the intervention. Service use data will be collected from the services' electronic records systems for two 6-month periods: the period preceding and the period during months 7-12 of the intervention. The study's primary outcome is service user satisfaction with CRT care, measured using a client satisfaction questionnaire. Secondary outcomes include the following: perceived continuity of care, hospital admission rates and bed use, rates of readmission to acute care following CRT support, staff morale, job satisfaction, and general health. The adherence of the services to a model of best practice will be assessed at baseline and follow-up. Outcomes will be compared between the intervention and control teams, adjusting for baseline

  1. The end of the era of generosity? Global health amid economic crisis

    Directory of Open Access Journals (Sweden)

    Garrett Laurie

    2009-01-01

    Full Text Available Abstract In the past decade donor commitments to health have increased by 200 percent. Correspondingly, there has been a swell of new players in the global health landscape. The unprecedented, global response to a single disease, HIV/AIDS, has been responsible for a substantial portion of this boon. Numerous health success have followed this windfall of funding and attention, yet the food, fuel, and economic crises of 2008 have shown the vulnerabilities of health and development initiatives focused on short term wins and reliant on a constant flow of foreign funding. For too long, the international community has responded to global health and development challenges with emergency solutions that often reflect the donor's priorities, values, and political leanings, rather than funding durable health systems that can withstand crises. Progress towards achieving the Millennium Development Goals has stalled in many countries. Disease specific initiatives have weakened health systems and limited efforts to improve maternal and child health. As we enter this era of scarce resources, there is a need to return to the foundations of the Alma Ata Declaration signed thirty years ago with the goal of providing universal access to primary healthcare. The global health community must now objectively evaluate how we can most effectively respond to the crises of 2008 and take advantage of this moment of extraordinary attention for global health and translate it into long term, sustainable health improvements for all.

  2. The International Monetary Fund's effects on global health: before and after the 2008 financial crisis.

    Science.gov (United States)

    Stuckler, David; Basu, Sanjay

    2009-01-01

    In April 2009, the G20 countries committed US $750 billion to the International Monetary Fund (IMF), which has assumed a central role in global economic management. The IMF provides loans to financially ailing countries, but with strict conditions, typically involving a mix of privatization, liberalization, and fiscal austerity programs. These loan conditions have been extremely controversial. In principle, they are designed to help countries balance their books. In practice, they often translate into reductions in social spending, including spending on public health and health care delivery. As more countries are being exposed to IMF policies, there is a need to establish what we know and do not know about the IMF's effects on global health. This article introduces a series in which contributors review the evidence on the relationship between the IMF and public health and discuss potential ways to improve the Fund's effects on health. While more evidence is needed for some regions, there is sufficient evidence to indicate that IMF programs have been significantly associated with weakened health care systems, reduced effectiveness of health-focused development aid, and impeded efforts to control tobacco, infectious diseases, and child and maternal mortality. Reforms are urgently needed to prevent the current wave of IMF programs from further undermining public health in financially ailing countries and limiting progress toward the health Millennium Development Goals.

  3. Nutritional quality and price of food hampers distributed by a campus food bank: a Canadian experience.

    Science.gov (United States)

    Jessri, Mahsa; Abedi, Arvin; Wong, Alexander; Eslamian, Ghazaleh

    2014-06-01

    Food insecurity is a mounting concern among Canadian post-secondary students. This study was conducted to evaluate the content of food hampers distributed by University of Alberta Campus Food Bank (CFB) and to assess the cost savings to students, using these hampers. Contents of hampers distributed among 1,857 students and their dependants since 2006 were evaluated against Canada's Food Guide (CFG) recommendations and Dietary Reference Intakes (DRI). Hampers were aimed at serving university students and one to five members of their households located in Edmonton, Western Canada. One thousand eight hundred fifty-seven clients in Alberta, Canada, were included in the study. Although all hampers provided adequate energy, their fat and animal protein contents were low. Compared to the CFG recommendations, the requirements of milk and alternatives and meat and alternatives were not sufficiently met for clients using > or = 3-person hampers. None of food hampers (i.e. one- to five-person hampers) met the DRI recommendations for vitamin A and zinc. Clients of CFB received Canadian dollar (CN$) 14.88 to 64.3 worth of non-perishable food items in one- to five-person hampers respectively. Hampers provided from the CFB need improvement. Nutrients missing from the food hampers could be provided from fresh fruits, vegetables, dairy, and meat products; however, these foods are more expensive than processed food items. The CFB provides a significant amount of savings to its clients even without considering the additional perishable donations that are provided to clients. Interpretation of our data required the assumption that all clients were consuming all of their hampers, which may not always be the case. Clients that do not fully consume their hampers may benefit less from the food bank.

  4. The intersection of climate/environment, food, nutrition and health: crisis and opportunity.

    Science.gov (United States)

    Raiten, Daniel J; Aimone, Ashley M

    2017-04-01

    Climate/environmental change (C-E-C) is affecting human health and quality of life. Significant attention has been given to the impact of C-E-C on food supply, and food as a vehicle for exposure. However, C-E-C has been superimposed on prevalent malnutrition, infectious and non-communicable diseases. We discuss why nutrition is not synonymous with food and must be viewed as a biological variable that affects and is affected by both C-E-C as well as the current global health challenges. The nexus of C-E-C, food, nutrition and health must be considered in the development of safe and efficacious interventions. A case is presented for how the convergence of C-E-C, food/nutrition and health, presents an opportunity for more integrated approaches to achieve global health goals. Published by Elsevier Ltd.

  5. Cooking crisis: What crisis?

    OpenAIRE

    Caraher, M.

    2014-01-01

    Cooking has long been a topic of discussion and concern among those arguing for a healthy diet. Chadwick, the great public health reformer, in 1842 called for cooking education.\\ud \\ud The Obama administration has heartedly endorsed cooking, mainly through the First Lady and a program called Cooking Matters, to address the obesity problem in the United States (http://cookingmatters.org/). \\ud \\ud Changing practices in cooking and food preparation and the way we eat some argue are driven by a ...

  6. Global payment for health services as a solution in the financial crisis in Europe.

    Science.gov (United States)

    Schrijvers, Guus

    2012-10-01

    In these financial difficult years many European governments used global ceilings to control costs of health services. Two scenarios are thinkable. The first is that all individual providers get a budget for their own costs: general practitioners, specialists, hospitals, nursing homes and mental health institutes. The second scenario is to work with global budgets for health care providers servicing a total population. Scientists and policy makers in Europe, North America and Asia need time to design new payment systems based on the idea of global budgeting, bundled payment and shared savings.

  7. Jobs without benefits: the health insurance crisis faced by small businesses and their workers.

    Science.gov (United States)

    Robertson, Ruth; Stremikis, Kristof; Collins, Sara R; Doty, Michelle M; Davis, Karen

    2012-11-01

    The share of U.S. workers in small firms who were offered, eligible for, and covered by health insurance through their jobs has declined over the past decade. Less than half of workers in companies with fewer than 50 employees were both offered and eligible for health insurance through their jobs in 2010, down from 58 percent in 2003. In contrast, about 90 percent of workers in companies with 100 or more employees were offered and eligible for their employer's health plans in both 2003 and 2010. Workers in the smallest firms--and those with the lowest wages--continue to be less likely to get coverage from their employers and more likely to be uninsured than workers in larger firms or with higher wages. The Affordable Care Act includes new subsidies that will lower the cost of health insurance for small businesses and workers who must purchase coverage on their own.

  8. The Ongoing U.S. Health Care Crisis: A Data Update.

    Science.gov (United States)

    Himmelstein, David U; Woolhandler, Steffie; Almberg, Mark; Fauke, Clare

    2018-04-01

    While efforts to repeal the Affordable Care Act were narrowly defeated, grave problems in health care persist. Twenty-eight million remain uninsured, a number that is likely to increase. Millions more who have coverage cannot afford care because of high cost-sharing requirements. Meanwhile, the corporate takeover of medical care in the United States is at a gallop. This article provides a brief précis of recent data on U.S. health policy.

  9. [Hospital governance: between crisis management and implementation of public health policy].

    Science.gov (United States)

    Bréchat, Pierre-Henri; Antoine, Leenhardt; Mathieu-Grenouilleau, Marie-Christine; Rymer, Roland; Matisse, François; Baraille, Denis; Beaufils, Philippe

    2010-01-01

    The implementation of the recent act to amend the law on hospitals, patient health and territories (HPST Law) completes the reform of the organization and governance of health facilities, which was announced in 2002 by the "Hospital 2007" plan. What kind of assessments and perspectives can be considered and envisaged for these Hospital Activity Poles? We compared our experience with a review of the professional and scientific literature in order to stimulate answers to these questions for advocacy purposes prior to the Act's implementation. The hospital's cluster of activities should reinforce--not call into question the core activities and the financial stability of the facility, while respecting the contract on agreed objectives and the necessary means and resources to meet the health needs of the catchment population as well as national priorities. Although significant, but limited, successes exist, five obstacles to hospital reorganization can be identified. These include, for example: lack of delegation of management and centralization of decisions, the heterogeneity of numerous Hospital Activity Poles or problems related to timing. These obstacles may cause strain, or put the Hospital Activity Poles and the health facilities in a difficult situation with respect to their dynamics. This may show that the State and social health insurance should steer and direct public health policy and that the delegation of management roles and responsibilities to the Hospital Activity Poles should be addressed.

  10. Structural Factors of the Middle East Respiratory Syndrome Coronavirus Outbreak as a Public Health Crisis in Korea and Future Response Strategies

    Directory of Open Access Journals (Sweden)

    Dong-Hyun Kim

    2015-11-01

    Full Text Available The recent Middle East respiratory syndrome coronavirus (MERS-CoV outbreak has originated from a failure in the national quarantine system in the Republic of Korea as most basic role of protecting the safety and lives of its citizens. Furthermore, a number of the Korean healthcare system’s weaknesses seem to have been completely exposed. The MERS-CoV outbreak can be considered a typical public health crisis in that the public was not only greatly terrorized by the actual fear of the disease, but also experienced a great impact to their daily lives, all in a short period of time. Preparedness for and an appropriate response to a public health crisis require comprehensive systematic public healthcare measures to address risks comprehensively with an all-hazards approach. Consequently, discussion regarding establishment of post-MERS-CoV improvement measures must focus on the total reform of the national quarantine system and strengthening of the public health infrastructure. In addition, the Korea Centers for Disease Control and Prevention must implement specific strategies of action including taking on the role of “control tower” in a public health emergency, training of Field Epidemic Intelligence Service officers, establishment of collaborative governance between central and local governments for infection prevention and control, strengthening the roles and capabilities of community-based public hospitals, and development of nationwide crisis communication methods.

  11. Global health and national borders: the ethics of foreign aid in a time of financial crisis.

    Science.gov (United States)

    Johri, Mira; Chung, Ryoa; Dawson, Angus; Schrecker, Ted

    2012-06-28

    The governments and citizens of the developed nations are increasingly called upon to contribute financially to health initiatives outside their borders. Although international development assistance for health has grown rapidly over the last two decades, austerity measures related to the 2008 and 2011 global financial crises may impact negatively on aid expenditures. The competition between national priorities and foreign aid commitments raises important ethical questions for donor nations. This paper aims to foster individual reflection and public debate on donor responsibilities for global health. We undertook a critical review of contemporary accounts of justice. We selected theories that: (i) articulate important and widely held moral intuitions; (ii) have had extensive impact on debates about global justice; (iii) represent diverse approaches to moral reasoning; and (iv) present distinct stances on the normative importance of national borders. Due to space limitations we limit the discussion to four frameworks. Consequentialist, relational, human rights, and social contract approaches were considered. Responsibilities to provide international assistance were seen as significant by all four theories and place limits on the scope of acceptable national autonomy. Among the range of potential aid foci, interventions for health enjoyed consistent prominence. The four theories concur that there are important ethical responsibilities to support initiatives to improve the health of the worst off worldwide, but offer different rationales for intervention and suggest different implicit limits on responsibilities. Despite significant theoretical disagreements, four influential accounts of justice offer important reasons to support many current initiatives to promote global health. Ethical argumentation can complement pragmatic reasons to support global health interventions and provide an important foundation to strengthen collective action.

  12. Global health and national borders: the ethics of foreign aid in a time of financial crisis

    Directory of Open Access Journals (Sweden)

    Johri Mira

    2012-06-01

    Full Text Available Abstract Background The governments and citizens of the developed nations are increasingly called upon to contribute financially to health initiatives outside their borders. Although international development assistance for health has grown rapidly over the last two decades, austerity measures related to the 2008 and 2011 global financial crises may impact negatively on aid expenditures. The competition between national priorities and foreign aid commitments raises important ethical questions for donor nations. This paper aims to foster individual reflection and public debate on donor responsibilities for global health. Methods We undertook a critical review of contemporary accounts of justice. We selected theories that: (i articulate important and widely held moral intuitions; (ii have had extensive impact on debates about global justice; (iii represent diverse approaches to moral reasoning; and (iv present distinct stances on the normative importance of national borders. Due to space limitations we limit the discussion to four frameworks. Results Consequentialist, relational, human rights, and social contract approaches were considered. Responsibilities to provide international assistance were seen as significant by all four theories and place limits on the scope of acceptable national autonomy. Among the range of potential aid foci, interventions for health enjoyed consistent prominence. The four theories concur that there are important ethical responsibilities to support initiatives to improve the health of the worst off worldwide, but offer different rationales for intervention and suggest different implicit limits on responsibilities. Conclusions Despite significant theoretical disagreements, four influential accounts of justice offer important reasons to support many current initiatives to promote global health. Ethical argumentation can complement pragmatic reasons to support global health interventions and provide an important

  13. Using Lean to Rapidly and Sustainably Transform a Behavioral Health Crisis Program: Impact on Throughput and Safety.

    Science.gov (United States)

    Balfour, Margaret E; Tanner, Kathleen; Jurica, Paul J; Llewellyn, Dawn; Williamson, Robert G; Carson, Chris A

    2017-06-01

    Lean has been increasingly applied in health care to reduce waste and improve quality, particularly in fast-paced and high-acuity clinical settings such as emergency departments. In addition, Lean's focus on engagement of frontline staff in problem solving can be a catalyst for organizational change. In this study, ConnectionsAZ demonstrates how they applied Lean principles to rapidly and sustainably transform clinical operations in a behavioral health crisis facility. A multidisciplinary team of management and frontline staff defined values-based outcome measures, mapped the current and ideal processes, and developed new processes to achieve the ideal. Phase I was implemented within three months of assuming management of the facility and involved a redesign of flow, space utilization, and clinical protocols. Phase II was implemented three months later and improved the provider staffing model. Organizational changes such as the development of shift leads and daily huddles were implemented to sustain change and create an environment supportive of future improvements. Post-Phase I, there were significant decreases (pre vs. post and one-year post) in median door-to-door dwell time (343 min vs. 118 and 99), calls to security for behavioral emergencies (13.5 per month vs. 4.3 and 4.8), and staff injuries (3.3 per month vs. 1.2 and 1.2). Post-Phase II, there were decreases in median door-to-doctor time (8.2 hours vs. 1.6 and 1.4) and hours on diversion (90% vs. 17% and 34%). Lean methods can positively affect safety and throughput and are complementary to patient-centered clinical goals in a behavioral health setting. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  14. Human rights and political crisis in Brazil: Public health impacts and challenges.

    Science.gov (United States)

    Malta, Monica

    2018-01-25

    In 31 August 2016, Brazilian president Dilma Rousseff was impeached and replaced by her vice president Michel Temer. Herein, we examine how the conservative agenda of Mr Temer and his supporters is influencing key decisions in the human rights and public health arena in Brazil. The government's austerity agenda includes severe cuts in critical areas such as health, education and science, jeopardising well-known strategies such as the Brazilian Public Health System (SUS) and nationwide cash transfer program, 'Bolsa Familia' - both benefited millions and were the largest of their kind in the world. Mr Temer's decisions show not only severe cuts in critical areas but also a political agenda that clearly demonstrates a broad shift away from the progressivism and social agenda presented and supported by its predecessors. Most vulnerable groups such as the LGBTQ community, women, people who use drugs and disenfranchised communities have been severely affected. Mr Temer's administration is putting Brazil far from its once nationwide goal to foster free and universal health care access and social equity for all its citizens. The near future for Brazil is unknown, but both national and international communities anticipate severe problems within the national human rights arena, if nothing changes. CCT: Conditional Cash Transfer; LGBTQ: Lesbian, Gay, Bisexual, Transgender and Queer (and/or Questioning); SUS: Brazilian Public Health System.

  15. Enhancing behavioral health treatment and crisis management through mobile ecological momentary assessment and SMS messaging.

    Science.gov (United States)

    Smith, Brad; Harms, William D; Burres, Stephanie; Korda, Holly; Rosen, Howard; Davis, Jamie

    2012-12-01

    Many veterans returning from service in Afghanistan or Iraq suffer from post-traumatic stress disorder or mild traumatic brain injury. Treating these conditions can be challenging because of high rates of relapse and associated memory impairments. We report on a pilot study that assessed the utility of mobile health (mHealth) technologies, including personal digital assistant-based ecological momentary assessment and two-way interactive text (SMS) messaging, for providing treatment feedback to clinicians, encouraging and motivating veterans throughout treatment, and monitoring participants for relapse after treatment discharge. The results of the pilot suggest that mHealth technologies are feasible adjuncts to traditional mental treatment in the veteran population. Additional work is needed to establish the degree of clinical and economic value.

  16. Effectiveness of a Brief Health Education Intervention for Breast Cancer Prevention in Greece Under Economic Crisis

    Directory of Open Access Journals (Sweden)

    Kyriakoula Merakou

    2013-01-01

    Full Text Available Background: Prevalence rates in breast cancer have now reached epidemic levels. One of the main reasons behind onset of breast cancer is poor preventive beliefs and behavior of women towards cancer prevention. We examined the effectiveness of health education intervention in two communities of South Greece.Objective: The study investigates the effectiveness of a brief health education intervention on women’s beliefs and behaviour changes concerning breast cancer prevention.Methodology: A 90-minute, one-off encounter, health education study was designed for 300 women from Peloponissos, South Greece. A Health Belief Model questionnaire, was used before the intervention, immediately after and 6-months after the intervention.Results: Despite certain perception-related barriers (embarrassment, anxiety, ect women’s overall beliefs towards breast cancer prevention (perceived susceptibility, perceived benefits and perceived barriers changed positively after the health education intervention and this change was sustained at 6-month follow up. However, specific barriers (embarrassment, fear of pain, anxiety when anticipating tests’ results were not maintained at the same level of post-intervention during the same follow up. During the follow up period, women performed breast self-examination every month (73% and 55.10% had breast examination by a clinician and underwent a mammography.Conclusions: Short, low cost, health education interventions for breast cancer prevention to women can be effective in changing beliefs and behaviour. Tailored interventions are necessary to overcome relapsing of specific barriers. Emphasis should be given on the importance of doctor/nurse role in breast screening.

  17. Health system's response for physician workforce shortages and the upcoming crisis in Ethiopia: a grounded theory research.

    Science.gov (United States)

    Assefa, Tsion; Haile Mariam, Damen; Mekonnen, Wubegzier; Derbew, Miliard

    2017-12-28

    , medical teachers, library…". In the future, it was anticipated to end in surplus in physician workforce, unemployment, inefficiency, and pressure on the system: "…flooding may seem a good strategy superficially but it is a dangerous strategy. It may put the country into crisis, even if good physicians are being produced; they may not get a place where to go…". Massive physician workforce production which is not closely aligned with the training capacity of the medical schools and the absorption of graduates in to the health system will end up in unanticipated adverse consequences.

  18. Dedicated pediatric behavioral health unit: serving the unique and individual needs of children in behavioral health crisis.

    Science.gov (United States)

    Grover, Purva; Lee, Timothy

    2013-02-01

    Pediatric mental health emergencies are an increasing part of emergency medical practice because emergency departments have become the safety net for a fragmented mental health infrastructure that is experiencing critical shortages in services in all sectors. The emergency services for behavioral health unit at Akron Children's Hospital is an innovative model for delivering care to pediatric patients with mental health emergencies. A multidisciplinary team using the expertise of emergency services, psychiatry, social work, parent advisory counsel, security services, and engineering/architecture developed the emergency services for behavioral health unit blueprint, process, and staffing model.

  19. The Human Resource crisis in the Zambian Health Sector – a ...

    African Journals Online (AJOL)

    USER

    Zambian organizations and the international community as the ... of one doctor to 5,000 and a nurse to a population ... Across the country, AIDS patients are often left unattended for .... recruitment of health cadres does not go far as politics.

  20. Confusion, Crisis, and Opportunity: Professional School Counselors' Role in Responding to Student Mental Health Issues

    Science.gov (United States)

    Walley, Cynthia; Grothaus, Tim; Craigen, Laurie

    2009-01-01

    With the array of challenges facing today's youth, school counselors are in a unique position to recognize and respond to the diverse mental health needs of students. After a brief examination of the challenges and some promising responses, this article will consider the use of advocacy, collaboration, and professional development to aid school…

  1. Treating the Healthcare Workforce Crisis: A Prescription for a Health Informatics Curriculum

    Science.gov (United States)

    Campbell, S. Matt; Pardue, J. Harold; Longenecker, Herbert E., Jr.; Barnett, H. Les; Landry, Jeffrey P.

    2012-01-01

    A serious need exists for information systems workers who have an understanding of the healthcare environment. Traditional information systems degree programs do not adequately prepare students to enter the healthcare environment. In this paper, we propose a curriculum for a baccalaureate health informatics degree that combines the technical and…

  2. Policies and practices of countries experiencing a crisis in Human Resources for Health : A tracking survey

    NARCIS (Netherlands)

    van den Broek, Ankie; Gedik, Gulin; dal Poz, Mario; Dieleman, M.A.

    2010-01-01

    In order to understand and monitor the progress in developing and implementing HRH policies in the 57 countries experiencing a critical deficit in the health workforce, this tracking survey provides an overview of the current situation in terms of HRH policies, plans, capacities and processes. The

  3. The mental health consequences of the economic crisis in Europe among the employed, the unemployed, and the non-employed.

    Science.gov (United States)

    Buffel, Veerle; Van de Velde, Sarah; Bracke, Piet

    2015-11-01

    Applying a multi-level framework to the data from the European Social Survey's Round 3 (2006) and Round 6 (2012), we assessed the crisis by increases in rates of unemployment, while also controlling for countries' pre-crisis economic conditions. We found a positive relationship between depression and an increase in national unemployment rates. This relationship can be only partly ascribed to an increase in the number of unemployed and those employed in nonstandard job conditions-with the exception of the self-employed and women working part-time. The crisis effect is more pronounced among men and those between 35 and 49years of age. Moreover, in strongly effected countries, the crisis has changed the relationship between part-time work and depression, between depression and certain subcategories of the unemployed (looking for a job or not looking), and between depression and the non-employed. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Cholera in Zimbabwe: Developing an Educational Response to a Health Crisis

    Science.gov (United States)

    Mandikonza, Caleb; Musindo, Beatrice; Taylor, Jim

    2011-01-01

    In February 2009, the World Health Organization (WHO) reported that the cholera epidemic in Zimbabwe had claimed 3,300 lives and infected 66,000 people--greater than the toll of that disease in the whole of Africa in most years. How is it possible that a disease such as cholera can have such a devastating effect in modern times? How should one…

  5. High food prices and the global financial crisis have reduced access to nutritious food and worsened nutritional status and health.

    Science.gov (United States)

    Brinkman, Henk-Jan; de Pee, Saskia; Sanogo, Issa; Subran, Ludovic; Bloem, Martin W

    2010-01-01

    A global economic and financial crisis is engulfing the developing world, coming on top of high food and fuel prices. This paper assesses the impact of the crises on food consumption, nutrition, and health. Several methods were applied, including risk analysis using the cost of the food basket, assessment surveys, simulations, regression analysis using a food consumption score (FCS), reflecting diet frequency and diversity, and a review of the impact of such dietary changes on nutritional status and health. The cost of the food basket increased in several countries, forcing households to reduce quality and quantity of food consumed. The FCS, which is a measure of diet diversity, is negatively correlated with food prices. Simulations show that energy consumption declined during 2006-2010 in nearly all developing regions, resulting potentially in an additional 457 million people (of 4.5 billion) at risk of being hungry and many more unable to afford the dietary quality required to perform, develop, and grow well. As a result of the crises, large numbers of vulnerable households have reduced the quality and quantity of foods they consume and are at risk of increased malnutrition. Population groups most affected are those with the highest requirements, including young children, pregnant and lactating women, and the chronically ill (particularly people with HIV/AIDS and tuberculosis). Because undernutrition during the first 2 y of life has life-long consequences, even short-term price rises will have long-term effects. Thus, measures to mitigate the impact of the crises are urgently required.

  6. Changing planet, changing health: how the climate crisis threatens our health and what we can do about it

    National Research Council Canada - National Science Library

    Epstein, Paul R; Ferber, Dan

    2011-01-01

    .... Brilliantly connecting stories of real people with cutting-edge scientific and medical information, Changing Planet, Changing Health brings us to places like Mozambique, Honduras, and the United...

  7. Crisis Management

    Science.gov (United States)

    Brock, Stephen E., Ed.

    2011-01-01

    This paper presents summaries of four articles relevant to school crisis response. The first article, "Peritraumatic Dissociation Predicts Posttraumatic Stress in Youth Following Accidents" summarized by Jim Matthews, suggests that peritraumatic dissociation is a powerful predictor of PTSD symptoms among youth who have been in a car…

  8. Crisis meeting

    CERN Multimedia

    Staff Association

    2014-01-01

      To all CERN staff: your rights are at risk ! We invite you to come to a crisis meeting on Wednesday 2nd April at 10:30 a.m., Auditorium, Main Building, Meyrin site. Your presence is crucial, we are ALL concerned !

  9. Crisis meeting

    CERN Multimedia

    Staff Association

    2015-01-01

    To all CERN staff: your rights are at risk! We invite you to come to a crisis meeting on Thursday 7th May 2015 at 9 a.m., Auditorium, Main Building, Meyrin site. Your presence is crucial, we are ALL concerned!

  10. Health Care Systems and National Policy: Role of Leadership in the Obesity Crisis.

    Science.gov (United States)

    Jones, Jessica Lynn; Sundwall, David

    2016-03-01

    Obesity, defined as a body mass index (BMI) of 30 or higher in adults and BMI in the 95th percentile or higher for children, is epidemic in the United States. The predominant culture of caloric excess and sedentary behaviors contributes to this problem. Obesity increases the risk of many chronic diseases and premature death. The broad response to this costly disease includes efforts from medical providers, local and federal governments, and nongovernmental agencies. Although obesity can be addressed on an individual basis, it is largely recognized as a public health issue. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Health educators in the workplace: helping companies respond to the AIDS crisis.

    Science.gov (United States)

    Bauman, L J; Aberth, J

    1986-01-01

    As the number of cases of AIDS increases, more and more companies will have to decide how to handle employees with AIDS and those at high risk. AIDS creates medical, legal, and ethical issues in the workplace, all of which are emotional and complex; managers need expert assistance to guide their decision-making and policy development. This article identifies various dimensions of the AIDS-related issues emerging in corporations nationwide, including: confidentiality, the right of patients to work, benefits and insurance, HTLV-III screening, fears of contagion among workers, needs of companies to avoid financial and legal exposure, and effects on worker productivity. Health educators are in a unique position to contribute to the satisfactory resolution of AIDS-related problems in the workplace through their training and experience in education, policy development and the relevant legal and ethical issues in the health care field. However, they will have to initiate discussions with corporation executives themselves in order to reach this most important audience.

  12. Today's threat is tomorrow's crisis: advocating for dental education, dental and biomedical research, and oral health.

    Science.gov (United States)

    Bresch, Jack E; Luke, Gina G; McKinnon, Monette D; Moss, Myla J; Pritchard, Daryl; Valachovic, Richard W

    2006-06-01

    The current political environment in the nation's capital threatens federal support for programs vital to the academic dental community. To develop a strong cadre of advocates who can deliver an effective and unified message to members of Congress on behalf of dental education and dental research, the American Dental Education Association (ADEA) and the American Association for Dental Research (AADR) created a new organizational structure: the National Oral Health Advocacy Committee (NOHAC) and the National Advocacy Network (NAN). The basic skills and knowledge required to function as an effective advocate include an understanding of the political environment, a working knowledge of the legislative processes and the political players, and the ability to build and work with grassroots networks and coalitions. NOHAC and NAN are designed to provide leadership in these areas to support effective advocacy for dental education and dental research.

  13. Changing planet, changing health: how the climate crisis threatens our health and what we can do about it

    National Research Council Canada - National Science Library

    Epstein, Paul R; Ferber, Dan

    2011-01-01

    .... Written by a physician and world expert on climate and health and an award-winning science journalist, the book reveals the surprising links between global warming and cholera, malaria, lyme disease...

  14. [Integration of new psychosocial facilities into the health care system: considerations on a social ecological evaluation concept exemplified by ambulatory crisis care].

    Science.gov (United States)

    Leferink, K; Bergold, J B

    1996-11-01

    With respect to the methodological problems concerning the outcome evaluation of crisis intervention centers the outlines of a social-ecological research approach are developed. It is suggested that this approach is more suitable to take into account the role of the network of mental health services. The data come from a research project which was designed to explain the historical and social aspects of the process of integration of a crisis intervention service. The results indicate that on the one hand the practice of the service strongly depends on what other services do and on the other hand influences them. The social integration of an institution into the network of other services is discussed as an alternative criterion of evaluation.

  15. The urgent need for health impact assessment: proposing a transdisciplinary approach to the e-waste crisis in sub-Saharan Africa.

    Science.gov (United States)

    Tetteh, Dinah; Lengel, Lara

    2017-06-01

    Electronic waste (e-waste) is a growing health and environmental concern in developing countries. In the sub-Saharan African region e-waste is considered a crisis with no end in sight yet; there is lack of structures and regulations to manage the problem. In this article, we discuss the potential of Health Impact Assessment (HIA) in addressing the health, environmental, and social impacts of e-waste in sub-Saharan Africa. We draw from environmental policy, environmental communication, global health policy, and health communication to argue that managing e-waste could be framed as ongoing HIA where all the steps of HIA are performed on a rolling basis with input from local communities. Further, we suggest that HIA should be infused into recycling legislation to help streamline the practice in order to make it safe for health and the environment and to maximize the economic benefits.

  16. Affective language during the H1N1 influenza health crisis

    Directory of Open Access Journals (Sweden)

    Morant Marco, Ricard

    2010-12-01

    Full Text Available In this article we analyze the effects that, as seen through the written press, the arrival of H1N1 had on certain affective behaviors in society. After the spread of H1N1, health authorities recommended maintaining physical distance in social settings and, among other measures, advised against kissing. At first, this show of affection became a victim of the pandemic, especially in certain activities and rituals. However, once the media impact of swine flu had subsided, kissing recovered its habitual place and frequency, demonstrating that customs which are socially and culturally entrenched are resistant to change.

    El presente artículo analiza los efectos que según la prensa escrita tuvo la llegada de la gripe A en ciertos comportamientos afectivos de la población. Las autoridades sanitarias, tras la expansión del virus H1N1, recomendaron aumentar la distancia social y aconsejaron, entre otras medidas, evitar los besos. Esta manifestación afectiva, en un primer momento, notó los efectos de la pandemia, sobre todo en ciertas actividades y rituales. Sin embargo, una vez pasado el impacto mediático de la gripe A, recuperó su uso y frecuencia habitual, demostrando que las costumbres fuertemente enraizadas se resisten a cambiar.

  17. Information Crisis

    CERN Document Server

    Losavio, Michael

    2012-01-01

    Information Crisis discusses the scope and types of information available online and teaches readers how to critically assess it and analyze potentially dangerous information, especially when teachers, editors, or other information gatekeepers are not available to assess the information for them. Chapters and topics include:. The Internet as an information tool. Critical analysis. Legal issues, traps, and tricks. Protecting personal safety and identity. Types of online information.

  18. The role of crisis in family crisis intervention: do crisis experience and crisis change matter?

    NARCIS (Netherlands)

    Al, C.M.W.; Stams, G.J.J.M.; van der Laan, P.H.; Asscher, J.J.

    2011-01-01

    Evaluation studies of crisis intervention have focused on prevention of out-of-home placement of children or family functioning, but largely neglected the aspect of crisis. The present study examined crisis in 183 families receiving Family Crisis Intervention (FCI), addressing crisis characteristics

  19. Chinese Crisis Management

    National Research Council Canada - National Science Library

    Gudgel, Andy

    2004-01-01

    .... China's crisis management strategy is geared towards obtaining the maximum political advantage for China, as opposed to resolving the crisis. China tries to define the crisis on its terms in order to shape the resolution favorably.

  20. Crisis Communication Online

    DEFF Research Database (Denmark)

    Utz, Sonja; Schultz, Friederike; Glocka, Sandra

    2013-01-01

    Social media play in today's societies a fundamental role for the negotiation and dynamics of crises. However, classical crisis communication theories neglect the role of the medium and focus mainly on the interplay between crisis type and crisis communication strategy. Building on the recently...... developed “networked crisis communication model” we contrast effects of medium (Facebook vs. Twitter vs. online newspaper) and crisis type (intentional vs. victim) in an online experiment. Using the Fukushima Daiichi nuclear disaster as crisis scenario, we show that medium effects are stronger than...... the effects of crisis type. Crisis communication via social media resulted in a higher reputation and less secondary crisis reactions such as boycotting the company than crisis communication in the newspaper. However, secondary crisis communication, e.g. talking about the crisis communication, was higher...

  1. KANT CRISIS

    OpenAIRE

    William H Carter

    2011-01-01

    • ISSUE 2-1, 2011 • 68 KANT CRISIS This study approaches the last days of Immanuel Kant through the lens of his contemporary biographers and other correspondents. Among the latter, Kant’s brother and, subsequently, his brother’s family provide a symptomatic reflection upon Kant’s management of his genealogy and his legacy. Yet behind this body of work is another corpus, one which embodies maternal and paternal legacies that are not readily subsumed by Oedipus or Kant’s philosophy. This work (...

  2. The Impact of the Financial Crisis on Lifestyle Health Determinants Among Older Adults Living in the Mediterranean Region: The Multinational MEDIS Study (2005-2015

    Directory of Open Access Journals (Sweden)

    Alexandra Foscolou

    2017-01-01

    Full Text Available Objectives By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands. Methods From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6, that is, smoking habits, diet quality (MedDietScore, depression status (Geriatric Depression Scale and physical activity. Results Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05, irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001. Conclusions A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.

  3. Presentation of the CEA's crisis national organization: coordination centre in case of crisis, crisis technical teams, intervention means, and so on

    International Nuclear Information System (INIS)

    Pectorin, X.

    2010-01-01

    After having briefly recalled the existence of a legal framework for crisis management organisation, this report briefly describes how the CEA plans the crisis management. This management is based on the definition of critical scenarios, on the building up of a crisis management team, and on the elaboration of crisis management operational documents. It evokes the alert organisation and the triggering of crisis management. Then, it describes the CEA's national crisis organisation with its main crisis management structures, the role and the operation of the Crisis Coordination Centre (CCC, the decision body), the role and operation of the Central Crisis Technical Teams (ETC-C, Equipes Techniques de Crise Centrales), the role of field interveners (various rescue, protection, health care and technical teams) and of other additional intervention actors. It evokes the objectives of the various exercises which are organised every year at the internal, national or international level

  4. Overpopulation crisis.

    Science.gov (United States)

    Russell, C; Russell Wms

    1984-01-01

    This article reviews field research on the violent response on the part of animals to conditions of crowding. Monkey species in zoos have consistently been noted to be more quarrelsome and violent than their counterparts in the wild. Up to a certain critical population density various animal species form cooperative social units; however, a surplus population upsets this balance. In addition, under conditions of intense crowding, mammal's care and protection of the young is transformed into indifference, neglect, competition, domination, and ultimately murder. The reversal of social behavior under crowded conditions can be understood as a means of response to a population crisis, in which population is in danger of outrunning resources. In the absence of confinement, tensions among monkeys lead to war between bands. A community weakened by crowding also is more likely to succumb to certain stress diseases and to have less resilience against parasites. Under various special conditions, tolerance may evolve to permit temporary compression without violence; on the other hand, when a violent response is suppressed, the response tends to be explosive when it does occur. If population reduction is delayed too long, the result may be violence, famine, and permanent damage to the environment from overgrazing. In human society there has generally been a lag in the full development of the violent response to crowding. Given the power of modern military technology, it is imperative that human populations avert a population crisis response by substituting voluntary fertility control for involuntary mortality control.

  5. Adapting the Crisis Intervention Team (CIT) Model of Police–Mental Health Collaboration in a Low-Income, Post-Conflict Country: Curriculum Development in Liberia, West Africa

    Science.gov (United States)

    Blasingame, Elise; Compton, Michael T.; Dakana, Samuel F.; Dossen, Benedict; Lang, Frank; Strode, Patricia; Cooper, Janice

    2015-01-01

    Objectives. We sought to develop a curriculum and collaboration model for law enforcement and mental health services in Liberia, West Africa. Methods. In 2013 we conducted key informant interviews with law enforcement officers, mental health clinicians, and mental health service users in Liberia, and facilitated a 3-day curriculum workshop. Results. Mental health service users reported prior violent interactions with officers. Officers and clinicians identified incarceration and lack of treatment of mental health service users as key problems, and they jointly drafted a curriculum based upon the Crisis Intervention Team (CIT) model adapted for Liberia. Officers’ mental health knowledge improved from 64% to 82% on workshop assessments (t = 5.52; P < .01). Clinicians’ attitudes improved (t = 2.42; P = .03). Six months after the workshop, 69% of clinicians reported improved engagement with law enforcement. Since the Ebola outbreak, law enforcement and clinicians have collaboratively addressed diverse public health needs. Conclusions. Collaborations between law enforcement and mental health clinicians can benefit multiple areas of public health, as demonstrated by partnerships to improve responses during the Ebola epidemic. Future research should evaluate training implementation and outcomes including stigma reduction, referrals, and use of force. PMID:25602903

  6. Adapting the Crisis Intervention Team (CIT) model of police-mental health collaboration in a low-income, post-conflict country: curriculum development in Liberia, West Africa.

    Science.gov (United States)

    Kohrt, Brandon A; Blasingame, Elise; Compton, Michael T; Dakana, Samuel F; Dossen, Benedict; Lang, Frank; Strode, Patricia; Cooper, Janice

    2015-03-01

    We sought to develop a curriculum and collaboration model for law enforcement and mental health services in Liberia, West Africa. In 2013 we conducted key informant interviews with law enforcement officers, mental health clinicians, and mental health service users in Liberia, and facilitated a 3-day curriculum workshop. Mental health service users reported prior violent interactions with officers. Officers and clinicians identified incarceration and lack of treatment of mental health service users as key problems, and they jointly drafted a curriculum based upon the Crisis Intervention Team (CIT) model adapted for Liberia. Officers' mental health knowledge improved from 64% to 82% on workshop assessments (t=5.52; P<.01). Clinicians' attitudes improved (t=2.42; P=.03). Six months after the workshop, 69% of clinicians reported improved engagement with law enforcement. Since the Ebola outbreak, law enforcement and clinicians have collaboratively addressed diverse public health needs. Collaborations between law enforcement and mental health clinicians can benefit multiple areas of public health, as demonstrated by partnerships to improve responses during the Ebola epidemic. Future research should evaluate training implementation and outcomes including stigma reduction, referrals, and use of force.

  7. Ethnic variations in pathways to acute care and compulsory detention for women experiencing a mental health crisis.

    Science.gov (United States)

    Lawlor, Caroline; Johnson, Sonia; Cole, Laura; Howard, Louise M

    2012-01-01

    Much recent debate on excess rates of compulsory detention and coercive routes to care has focused on young black men; evidence is less clear regarding ethnic variations among women and factors that may mediate these. To explore ethnic variations in compulsory detentions of women, and to explore the potential role of immediate pathways to admission and clinician-rated reasons for admission as mediators of these differences. All women admitted to an acute psychiatric inpatient ward or a women's crisis house in four London boroughs during a 12-week period were included. Data were collected regarding their pathways to care, clinician-rated reasons for admission, hospital stays, and social and clinical characteristics. Two hundred and eighty seven (287) women from white British, white other, black Caribbean, black African and black other groups were included. Adjusting for social and clinical characteristics, all groups of black patients and white other patients were significantly more likely to have been compulsorily admitted than white British patients; white British patients were more likely than other groups to be admitted to a crisis house and more likely than all the black groups to be admitted because of perceived suicide risk. Immediate pathways to care differed: white other, black African and black other groups were less likely to have referred themselves in a crisis and more likely to have been in contact with the police. When adjustment was made for differences in pathways to care, the ethnic differences in compulsory admission were considerably reduced. There are marked ethnic inequities not only between white British and black women, but also between white British and white other women in experiences of acute admission. Differences between groups in help-seeking behaviours in a crisis may contribute to explaining differences in rates of compulsory admission.

  8. Crisis management and crisis prevention

    International Nuclear Information System (INIS)

    Wallensteen, P.

    1988-01-01

    This paper reports that many proposals have come forth to ease the tension between East and West. Some focus on arms developments, others take up diplomatic issues. In addition, some have raised the question of crisis management and crisis prevention. Can crises be prevented even before they have taken place? The Palme Commission on Disarmament and Security suggested, in its 1982 report, ways of restraining superpower involvement in Third World conflicts. Such conflicts, it was argued, could escalate and ultimately result in nuclear confrontation between the United States and the Soviet Union. Certainly, the commission also paid attention to conflicts over issues in Europe and to problems in Eastern or in Western Europe. However, the commission raised a question that lately has received increasing attention: the dangers of superpower confrontation over Third World issues. In his statement to the United Nations on 24 October 1985, President Regan pointed to the need for settling regional conflicts as they play a large role in building suspicions and tensions. Regan's initiative explicitly concerned Afghanistan, Cambodia, Ethiopia, Angola and Nicaragua. It included negotiations with the Soviet Union over Afghanistan, and, at a later stage, also over other issues. The goal, he the, was not to force a settlement on the parties. The initiative concerned issues that have for the American public, justified armaments and reduced Soviet credibility

  9. Crisis Communication

    International Nuclear Information System (INIS)

    Dunkle, M.K.

    1989-01-01

    The author discusses how one of the strongest examples of how destructive poor crisis communications can be the Three Mile Island accident of March 1979. This was an event that was minimal in its physical effects on the public and environment beyond the walls of that nuclear power plant. However, the emotional trauma on the local public, the economic impact on area businesses and property owners, and the long term impact on the entire nuclear utility industry were great. Approximately 80,000 people as far as 15 miles from the plant evacuated over a weekend. There have been no new orders for nuclear plants and many cancellations since the event 10 years ago. This paper presents an analysis of the accident at Three Mile Island

  10. Can we halt health workforce deterioration in failed states? Insights from Guinea-Bissau on the nature, persistence and evolution of its HRH crisis.

    Science.gov (United States)

    Russo, Giuliano; Pavignani, Enrico; Guerreiro, Catia Sá; Neves, Clotilde

    2017-02-07

    Guinea-Bissau is one of the world's poorest and least developed countries. Amid poverty, political turmoil and state withdrawal, its health workforce (HW) has been swamped for the last four decades in a deepening crisis of under-resourcing, poor performance and laissez-faire. The present study aimed at analysing the human resources for health (HRH) situation in Guinea-Bissau in light of the recent literature on distressed health systems, with the objective of contributing to understanding the ways health workers react to protracted turmoil, the resulting distortions and the counter-measures that might be considered. Through document analysis, focus group discussions, 14 semi-structured and 5 in-depth interviews, we explored patterns as they became visible on the ground. Since independence, Guinea-Bissau experienced political events that have reflected on the healthcare arena and on the evolution of its health workforce, such as different coup attempts, waves of diaspora and shifting external assistance. The chronic scarcity of funds and a 'stable political instability' have lead to the commercialisation of public health services and to flawed mechanisms for training and deploying health personnel. In absence of any form of governance, health workers have come to own and run the health system. We show that the HRH crisis in Guinea-Bissau can only be understood by looking at its historical evolution and at the wider socio-economic context. There are no quick fixes for the deterioration of HRH in undergoverned states; however, the recognition of the ingrained distortions and an understanding of the forces determining the behaviour of key actors are essential premises for the identification of solutions. Guinea-Bissau's case study suggests that any policy that does not factor in the limited clout of health authorities over a effectively privatised healthcare arena is doomed from the start. Improving health system governance and quality of training should take

  11. Counting indirect crisis-related deaths in the context of a low-resilience health system: the case of maternal and neonatal health during the Ebola epidemic in Sierra Leone.

    Science.gov (United States)

    Sochas, Laura; Channon, Andrew Amos; Nam, Sara

    2017-11-01

    Although the number of direct Ebola-related deaths from the 2013 to 2016 West African Ebola outbreak has been quantified, the number of indirect deaths, resulting from decreased utilization of routine health services, remains unknown. Such information is a key ingredient of health system resilience, essential for adequate allocation of resources to both 'crisis response activities' and 'core functions'. Taking stock of indirect deaths may also help the concept of health system resilience achieve political traction over the traditional approach of disease-specific surveillance. This study responds to these imperatives by quantifying the extent of the drop in utilization of essential reproductive, maternal and neonatal health services in Sierra Leone during the Ebola outbreak by using interrupted time-series regression to analyse Health Management Information System (HMIS) data. Using the Lives Saved Tool, we then model the implication of this decrease in utilization in terms of excess maternal and neonatal deaths, as well as stillbirths. We find that antenatal care coverage suffered from the largest decrease in coverage as a result of the Ebola epidemic, with an estimated 22 percentage point (p.p.) decrease in population coverage compared with the most conservative counterfactual scenario. Use of family planning, facility delivery and post-natal care services also decreased but to a lesser extent (-6, -8 and -13 p.p. respectively). This decrease in utilization of life-saving health services translates to 3600 additional maternal, neonatal and stillbirth deaths in the year 2014-15 under the most conservative scenario. In other words, we estimate that the indirect mortality effects of a crisis in the context of a health system lacking resilience may be as important as the direct mortality effects of the crisis itself. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved

  12. Ethical, Political and Societal Implications of the Open Access Journal Movement in the Era of Economic Crisis, with Emphasis on Public Health Pharmacogenomics.

    Science.gov (United States)

    Bragazzi, Nicola Luigi

    2013-12-01

    Publication of the research outputs is a vital step of the research processes and a gateway between the laboratory and the global society. Open Access is revolutionizing the dissemination of scientific ideas, particularly in the field of public health pharmacogenomics that examines the ways in which pharmacogenomics impacts health systems and services at a societal level, rather than a narrow bench to bedside model of translation science. This manuscript argues that despite some limitations and drawbacks, open access has profound ethical, political and societal implications especially on underdeveloped and developing countries, and that it provides opportunities for science to grow in these resource-limited countries, particularly in the era of a severe economic and financial crisis that is imposing cuts and restrictions to research.

  13. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available Veterans Crisis Line Skip to Main Content SuicidePreventionLifeline.org Get Help Materials Get Involved Crisis Centers About Be There ... see more videos from Veterans Health Administration Veterans Crisis Line -- After the Call see more videos from ...

  14. Kant Crisis

    Directory of Open Access Journals (Sweden)

    William H Carter

    2011-10-01

    Full Text Available • ISSUE 2-1, 2011 • 68 KANT CRISIS This study approaches the last days of Immanuel Kant through the lens of his contemporary biographers and other correspondents. Among the latter, Kant’s brother and, subsequently, his brother’s family provide a symptomatic reflection upon Kant’s management of his genealogy and his legacy. Yet behind this body of work is another corpus, one which embodies maternal and paternal legacies that are not readily subsumed by Oedipus or Kant’s philosophy. This work (of art is Kant’s own body or corpus, which he painstakingly maintained and which provided a case study for his refelctions on preventive medicine in The Conflict of the Faculties. William H. Carter studied at the University of Virginia, the University of Heidelberg, and earned his Ph.D. at the University of California, Santa Barbara. He taught German for three years at Tulane University and recently returned to the Department of World Languages and Cultures at Iowa State University, where he began his teaching career. His current book project is titled “Devilish Details: Goethe’s Public Service and Political Economy.” Julian Fickler attends the Academy of Fine Arts Karlsruhe, class of Helmut Dorner. He is the recipient of a prestigious fellowship award bestowed by the Künstlerförderung des Cusanuswerks Bonn. He has exhibited solo locally and in group at venues in Berlin and Hamburg.

  15. Beyond the crisis: building back better mental health care in 10 emergency-affected areas using a longer-term perspective.

    Science.gov (United States)

    Epping-Jordan, JoAnne E; van Ommeren, Mark; Ashour, Hazem Nayef; Maramis, Albert; Marini, Anita; Mohanraj, Andrew; Noori, Aqila; Rizwan, Humayun; Saeed, Khalid; Silove, Derrick; Suveendran, T; Urbina, Liliana; Ventevogel, Peter; Saxena, Shekhar

    2015-01-01

    Major gaps remain - especially in low- and middle-income countries - in the realization of comprehensive, community-based mental health care. One potentially important yet overlooked opportunity for accelerating mental health reform lies within emergency situations, such as armed conflicts or natural disasters. Despite their adverse impacts on affected populations' mental health and well being, emergencies also draw attention and resources to these issues and provide openings for mental health service development. Cases were considered if they represented a low- or middle-income country or territory affected by an emergency, were initiated between 2000 and 2010, succeeded in making changes to the mental health system, and were able to be documented by an expert involved directly with the case. Based on these criteria, 10 case examples from diverse emergency-affected settings were included: Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, occupied Palestinian territory, Somalia, Sri Lanka, and Timor-Leste. These cases demonstrate generally that emergency contexts can be tapped to make substantial and sustainable improvements in mental health systems. From these experiences, 10 common lessons learnt were identified on how to make this happen. These lessons include the importance of adopting a longer-term perspective for mental health reform from the outset, and focusing on system-wide reform that addresses both new-onset and pre-existing mental disorders. Global progress in mental health care would happen more quickly if, in every crisis, strategic efforts were made to convert short-term interest in mental health problems into momentum for mental health reform.

  16. The Quest to Extend Health Services to Vulnerable Substance Users in Rio de Janeiro, Brazil in the Context of an Unfolding Economic Crisis.

    Science.gov (United States)

    Krawczyk, Noa; Kerrigan, Deanna; Bastos, Francisco Inácio

    2017-07-01

    Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation's most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens. In consequence of such prospects, this commentary aims to discuss barriers marginalized substance users face in accessing health services that are at risk of worsening with government cutbacks. Using Rio de Janeiro as an example, we explore two primary issues: the resource-strained, under-staffed and decentralized nature of the Brazilian Unified Health System and the pervading stigma that bars vulnerable citizens from official structures and services. Abandoning initiated government efforts to increase access to health services would risk maintaining vulnerable citizens at the margins of public structures, inhibiting the opportunity to offer this population humane and urgently needed treatment and care.

  17. [Health services supply and the economic crisis: either we fund goods and services according to their value or we become bankrupt. SESPAS report 2014].

    Science.gov (United States)

    Bernal-Delgado, Enrique; Campillo-Artero, Carlos; García-Armesto, Sandra

    2014-06-01

    Health policy has reacted to the financial crisis by overemphasising measures targeted at reducing unit costs, increasing barriers to access (waiting lists) or closing premises. It is too soon for scientific assessment of the impact of this reshaping of supply on equity, quality and safety, and on individual and population health. Nevertheless, the emergency measures taken to achieve fiscal stabilization have shifted the focus to resolving budget problems at the expenses of sounder and deeper initiatives aimed at deciding what must be funded and how. This article advocates a policy based on selective funding of services and benefits on the basis of their value. Other countries' experiences can serve as a useful guide, including robust methods to identify technologies (or their uses) of questionable value, prioritization criteria, and careful consideration of limitations associated with the elimination of a certain benefit, especially if it affects the founding values of the system. The necessary tools are available to the Spanish health system: the regulatory framework and technical bodies able to identify lower value care, support for decision-making, and timely evaluation of such decisions. Despite the numerous hurdles, maintaining the status quo is too expensive a choice, given the opportunity costs of effectiveness and safety losses, measured in terms of equity and the economic efficiency of the Spanish health system, which may ultimately translate into worsening of the population's health status. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  18. The Carter Center Mental Health Program: Addressing the Public Health Crisis in the Field of Mental Health Through Policy Change and Stigma Reduction

    OpenAIRE

    Rebecca G. Palpant, MS; Rachael Steimnitz; Thomas H. Bornemann, EdD; Katie Hawkins

    2006-01-01

    Some of the most pervasive and debilitating illnesses are mental illnesses, according to World Health Organization’s The World Health Report 2001 — Mental Health: New Understanding, New Hope. Neuropsychiatric conditions account for four of the top five leading causes of years of life lived with disability in people aged 15 to 44 in the Western world. Many barriers prevent people with mental illnesses from seeking care, such as prohibitive costs, lack of insurance, and the stigma and discrimin...

  19. Thinking ahead about reproductive health: contingency planning and emergency preparedness in crisis situations (Iraq and West Africa).

    Science.gov (United States)

    DeLargy, Pamela; Alakbarov, Ramiz

    2004-09-01

    The United Nations Population Fund (UNFPA) coordinated efforts to integrate RH into contingency planning for the 2003 Iraq crisis and the 2003 regional response for displaced populations in West Africa. Using UNFPA's network of country offices in the Middle East, staff developed logistics plans, conducted workshops and pre-positioned RH supplies. Though refugee movements did not occur, the contingency planning enhanced the response capacity of UNFPA offices and made it possible to rapidly provide assistance inside Iraq. In West Africa, multi-country workshops and follow-up resulted in country-level and regional action plans useful during the renewed crises of 2003; scarce funding, however, limited their full implementation. UNFPA's experiences show that contingency planning requires committing resources for crises, some of which will not occur; new staff skills; and follow-up. Moreover, RH is considered by some to be additional to the core elements of contingency planning. RH's political sensitivity, particularly with certain donors, further complicated integrated planning.

  20. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... videos from Veterans Health Administration Veterans Crisis Line -- After the Call see more videos from Veterans Health ... videos from Veterans Health Administration Talking About It Matters see more videos from Veterans Health Administration Stand ...

  1. Indicators of health system coverage and activity in Ireland during the economic crisis 2008-2014 - from 'more with less' to 'less with less'.

    LENUS (Irish Health Repository)

    Burke, Sara

    2014-09-01

    A new Irish government came to power in March 2011 with the most radical proposals for health system reform in the history of the state, including improving access to healthcare, free GP care for all by 2015 and the introduction of Universal Health Insurance after 2016. All this was to be achieved amidst the most severe economic crisis experienced by Ireland since the 1930s. The authors assess how well the system coped with a downsizing of resources by an analysis of coverage and health system activity indicators. These show a health system that managed \\'to do more with less\\' from 2008 to 2012. They also demonstrate a system that was \\'doing more with less\\' by transferring the cost of care onto people and by significant resource cuts. From 2013, the indicators show a system that has no choice but \\'to do less with less\\' with diminishing returns from crude cuts. This is evident in declining numbers with free care, of hospital cases and home care hours, alongside increased wait-times and expensive agency staffing. The results suggest a limited window of benefit from austerity beyond which cuts and rationing prevail which is costly, in both human and financial terms.

  2. Delayed and differential effects of the economic crisis in Sweden in the 1990s on health-related exclusion from the labour market: A health equity assessment

    OpenAIRE

    Burstrom, Bo; Nylen, Lotta; Barr, Ben; Clayton, Stephen; Holland, Paula; Whitehead, Margaret

    2012-01-01

    Abstract\\ud \\ud Many OECD countries are currently experiencing economic crisis and introducing counter-measures with unknown effects. To learn from previous experience, we explored whether there were delayed or differential effects of the Swedish recession in the 1990s and the government's response to it for people with limiting longstanding illness or disability (LLSI) from different socioeconomic groups (SEGs), by policy analysis and secondary data analysis of the Swedish Survey of Living C...

  3. Superoxide radical dismutation as protective mechanism to hamper the progression of Parkinson's disease

    OpenAIRE

    Filograna, Roberta

    2015-01-01

    Abstract Parkinson's disease (PD) is a degenerative neurological syndrome characterized by the preferential loss of dopaminergic (DAergic) neurons in the Substantia Nigra pars compacta. PD is still incurable and conventional therapies treat only symptoms to improve the quality of life. Therefore, there is a impelling need to find out new therapeutic strategies that not only provide symptomatic relief but also halt or reverse the neuronal damage hampering PD progression. Even though the pat...

  4. Psychosocial crisis management: the unexplored intersection of crisis leadership and psychosocial support.

    NARCIS (Netherlands)

    Dückers, M.L.A.; Yzermans, C.J.; Jong, W.; Boin, A.

    2017-01-01

    Epidemiological research has documented the serious health issues that can affect the victims of disasters and major crises. Yet, the psychosocial dimension of crisis has received little attention in crisis management literature. This paper integrates psychosocial principles with a model of

  5. Crisis Management: Research Summaries

    Science.gov (United States)

    Brock, Stephen E., Ed.; Dorman, Sally; Anderson, Luke; McNair, Daniel

    2013-01-01

    This article presents summaries of three studies relevant to school crisis response. The first report, "A Framework for International Crisis Intervention" (Sally Dorman), is a review of how existing crisis intervention models (including the NASP PREPaRE model) have been adapted for international use. The second article, "Responding…

  6. RESPONSE OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES IN PROTECTING CIVILIAN AMERICANS IN JAPAN DURING THE FUKUSHIMA NUCLEAR CRISIS.

    Science.gov (United States)

    Simon, Steven L; Coleman, C Norman; Noska, Michael A; Bowman, Thomas

    2012-05-01

    Following the earthquake and tsunami in northern Japan on 11 March 2011, and the ensuing damage to the Fukushima Daiichi nuclear power plant complex, a request by the U.S. Ambassador to Japan to the U.S. Department of Health and Human Services (DHHS) Assistant Secretary for Preparedness and Response (ASPR) resulted in deployment of a five-person team of subject matter experts to the U.S. Embassy. The primary purpose of the deployment was to provide the U.S. Embassy in Tokyo with guidance on health and medical issues related to potential radiation exposure of U.S. citizens in Japan, including employees of the U.S. Department of State at consulates in Japan and American citizens living in or visiting Japan. At the request of the Government of Japan, the deployed health team also assisted Japanese experts in their public health response to the radiation incident. Over a three-week period in Japan and continuing for weeks after their return to the U.S., the team provided expertise in the areas of medical and radiation oncology, health physics, assessment of radiation dose and cancer risk, particularly to U.S. citizens living in Tokyo and the surrounding areas, food and water contamination and the acceptable limits, countermeasures to exposure such as potassium iodide (KI), the use of KI and an offered donation from the United States, evacuation and re-entry issues, and health/emergency-related communication strategies. This paper describes the various strategies used and observations made by the DHHS team during the first two months after the Fukushima crisis began.

  7. Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis

    OpenAIRE

    Cohen, Odeya; Feder-Bubis, Paula; Bar-Dayan, Yaron; Adini, Bruria

    2015-01-01

    Background: Public health legal preparedness (PHLP) for emergencies is a core component of the health system response. However, the implementation of health legal preparedness differs between low- and middle-income countries (LMIC) and developed countries.Objective: This paper examines recent trends regarding public health legal preparedness for emergencies and discusses its role in the recent Ebola outbreak.Design: A rigorous literature review was conducted using eight electronic databases a...

  8. Suicide and crisis management

    Directory of Open Access Journals (Sweden)

    B S Chavan

    2015-01-01

    Full Text Available Suicide among the general population is a major public health problem and thus is a cause of concern for India. Since suicide is the outcome of multiple factors including socioeconomic, cultural, religious, and political; intervention and prevention strategies will vary from region to region. The legal framework and guidelines in a country can influence the suicide rate by eliminating barriers to mental health services, by adopting and strictly implementing policies on access to firearms for persons with risk of suicide, providing services for treatment of substance abuse patients, and by training of school personnel so that they can identify and assist vulnerable youth in accessing help. Mental Healthcare Bill (MHCB, 2013, will soon become the guiding law for the treatment and rehabilitation of persons suffering from mental health issues. Although MHCB has been criticized on many fronts, it still has laudable provisions that attempt to address reducing treatment gap through the proposal of availability of minimum mental health facilities at primary health center, proposing comprehensive treatment facilities including rehabilitation and the proposal to remove attempted suicide from Section 309 of IPS, etc., which might contribute in suicide prevention and other mental health crisis situations.

  9. Atención primaria de salud, vía para enfrentar los efectos de la crisis económica en salud Primary health care a procedure to confront the effects of health recession

    Directory of Open Access Journals (Sweden)

    Néstor Marimón Torres

    2010-09-01

    Full Text Available El presente estudio analiza la actual crisis económica y financiera global y sus efectos negativos para los sistemas de salud. Profundiza en las afectaciones para Cuba y en la preparación del sistema nacional de salud, a partir de su concepción, sus principios, así como la preparación que tiene el país ante crisis anteriores, como lo constituyó el Período Especial. Se evidencia que la forma viable de mantener los niveles de salud de la población y mejorar sus indicadores de morbimortalidad, a pesar de las carencias económicas actuales y las futuras, en caso de empeorar la situación mundial, es la Atención Primaria de Salud, base del sistema cubano, el cual alcanza un importante desarrollo luego de 50 años de transformaciones y perfeccionamiento. Se exponen los principales resultados alcanzados y las medidas trazadas, enfocadas a su sostenibilidad en este nuevo escenario mundial, con la intención de que esta experiencia pueda servir de referencia a otros países, reforzar las capacidades nacionales y contribuir al perfeccionamiento de los sistemas de salud, como propuesta de enfrentamiento a esta grave situación mundial y lograr la salud de las poblaciones.Present paper analyzes the current global recession and financial crisis and its negative effects on the health system studying in depth the Cuban affectations and the preparation of health national system from its conception, its principles, as well as the preparation of our country in face of previous crises, by example, the Special Period. It is evidenced that the viable way to maintain the health levels of population and to improve its indicators of morbidity and mortality, despite the current and the future economic lacks if the world situation get worse, is the Primary Health Care which is the foundation of Cuban system achieving a significant development after 50 years of transformation and improvement. Authors expose the major results achieved and the outlines measures

  10. Problems in producing nuclear reactor for medical isotopes and the Global Crisis of molybdenum supply

    International Nuclear Information System (INIS)

    Zubiarrain, A.

    2011-01-01

    Nuclear medicine uses drugs that incorporate a radioactive isotope radiopharmaceuticals. Every year are performed, worldwide, 35 million nuclear medicine procedures, of which 80% are done with radiopharmaceuticals containing the isotope, molybdenum-99, produced in nuclear reactors. In recent years, there have been several supply crisis of molybdenum-99, which have hampered diagnostic procedure with technitium-99m. (Author)

  11. The health effects of the global financial crisis: can we reconcile the differing views? A network analysis of literature across disciplines.

    Science.gov (United States)

    Stuckler, David; Reeves, Aaron; Karanikolos, Marina; McKee, Martin

    2015-01-01

    Why are researchers studying the health effects of economic change reaching markedly varying conclusions? To understand these differences, we first systematically searched Web of Science for the literature on recessions and health yielding 461 articles and 14,401 cited documents. We then undertook a network analysis of co-citation pattern by disciplines, journals and backgrounds of the authors, followed by a chronological review of the literature, to trace the evolution of ideas. We then examined the extent to which earlier literature predicted what has happened in the 2007-2012 crisis. Our analysis finds the literature is dominated by disciplinary silos, with economics studies predominantly citing each other and relative isolation of psychiatry and substance abuse journals. Different philosophical approaches to assessing causality appear to contribute to varying interpretations, a tendency that is unlikely to be resolved without a shift in research norms. We conclude by calling for more inter-disciplinary research that combines empirical findings with a search for plausible mechanisms. This approach would evaluate not only the effects of economic shocks but also the mechanisms that offer protection against them.

  12. Ideologies of Black churches in New York City and the public health crisis of HIV among Black men who have sex with men.

    Science.gov (United States)

    Wilson, Patrick A; Wittlin, Natalie M; Muñoz-Laboy, Miguel; Parker, Richard

    2011-01-01

    Black men who have sex with men (MSM) are disproportionately affected by HIV and AIDS in New York City (NYC). Black churches in NYC have a history of engaging in community mobilisation; however, research suggests that churches play a role in promoting stigma against Black MSM, which impedes prevention efforts. The goal of this study was to explore church ideologies surrounding sexuality and health, and the relationship of these ideologies to church mobilisation in response to HIV/AIDS among Black MSM. We conducted interviews and focus groups with pastors and parishioners at Black churches in NYC. Three prominent themes were identified: (1) 'Love the sinner, hate the sin'--distinguishing behaviour and identity; (2) 'Don't ask, don't tell'--keeping same-sex behaviour private; and (3) 'Your body is a temple'--connecting physical and spiritual health. We discuss the implications of these ideologies for church mobilisation and HIV prevention efforts. In doing so, we pay close attention to how ideologies may both impede and facilitate church dialogue around sexuality and heightened responses to the HIV crisis affecting Black MSM.

  13. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... videos from Veterans Health Administration Talking About It Matters see more videos from Veterans Health Administration Stand ... Health Administration I am A Veteran Family/Friend Active Duty/Reserve and Guard Signs of Crisis Identifying ...

  14. Is it a policy crisis or it is a health crisis? The Egyptian context--analysis of the Egyptian health policy for the H1N1 flu pandemic control.

    Science.gov (United States)

    Seef, Sameh; Jeppsson, Anders

    2013-01-01

    A new influenza virus that was first detected in people in April 2009, was initially referred to colloquially as "swine flu", since it contained genes from swine, avian and human influenza viruses. It can, however, not be transmitted by eating pork or dealing with pigs. In Egypt, several hundred thousand pigs were killed in May, in spite of advice from global health authorities that such an action was unnecessary. Pigs are raised and consumed mainly by the Christian minority, which constitute some 10% of the population. Health Ministry estimated there were between 300,000-350,000 pigs in Egypt. This paper will analyze the Egyptian health policy for controlling the pandemic H1N1 flu, exploring its context, content, process, and actors. The analysis is based on the Leichter Context, which refers to systemic factors-political, economic and social, both national and international-that may have an effect on health policy, and is based on data collected from literature review and policy documents. The International health officials said the swine flu virus that has caused worldwide fear is not transmitted by pigs, and that pig slaughters do nothing to stop its spread. The WHO stopped using the term "swine flu" to avoid confusion. In Egypt, even the editor of a pro-government newspaper criticized the order to slaughter: "Killing (pigs) is not a solution, otherwise, we should kill the people, because the virus spreads through them," wrote Abdullah Kamal of the daily Rose El-Youssef. The World Health organization also criticized the decision. The extinction of the Egyptian pigs is an example of how a health issue can be used to persecute a minority within a country. Although the current influenza has nothing whatsoever to do with pigs, the previous name of the epidemic was used as an argument to violate the rights of the Christian minority in Egypt.

  15. Knowledge gaps that hamper prevention and control of Mycobacterium avium subspecies paratuberculosis infection

    DEFF Research Database (Denmark)

    Barkema, H W; Orsel, K; Nielsen, S S

    2018-01-01

    In the last decades, many regional and country-wide control programmes for Johne's disease (JD) were developed due to associated economic losses, or because of a possible association with Crohn's disease. These control programmes were often not successful, partly because management protocols were...... programmes are typically evaluated in a limited number of herds and the duration of the study is less than 5 year, making it difficult to adequately assess the efficacy of control programmes. In this manuscript, we identify the most important gaps in knowledge hampering JD prevention and control programmes......, including vaccination and diagnostics. Secondly, we discuss directions that research should take to address those knowledge gaps....

  16. 'HTA for Crisis': sharing experiences during the 7th EBHC Symposium.

    Science.gov (United States)

    Wladysiuk, Magdalena; Tabor, Anna; Godman, Brian

    2013-02-01

    The Central and Eastern European Society of Technology Assessment in Health Care was founded in Krakow, Poland in 2003. On October 8th and 9th, the 7th symposium took place titled 'HTA for Crisis'. This meeting was attended by over 250 decision makers, evidence-based specialists, healthcare managers, commercial company personnel and experts. The symposium was principally divided into four main themes: insurance in times of crisis; importance of pricing of health services in times of crisis; managing welfare benefits in times of crisis and Health Technology Assessment in crisis-laden countries. The symposium finished by debating potential ways forward for healthcare systems in times of crisis.

  17. Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis.

    Science.gov (United States)

    Cohen, Odeya; Feder-Bubis, Paula; Bar-Dayan, Yaron; Adini, Bruria

    2015-01-01

    Public health legal preparedness (PHLP) for emergencies is a core component of the health system response. However, the implementation of health legal preparedness differs between low- and middle-income countries (LMIC) and developed countries. This paper examines recent trends regarding public health legal preparedness for emergencies and discusses its role in the recent Ebola outbreak. A rigorous literature review was conducted using eight electronic databases as well as Google Scholar. The results encompassed peer-reviewed English articles, reports, theses, and position papers dating from 2011 to 2014. Earlier articles concerning regulatory actions were also examined. The importance of PHLP has grown during the past decade and focuses mainly on infection-disease scenarios. Amid LMICs, it mostly refers to application of international regulations, whereas in developed states, it focuses on independent legislation and creation of conditions optimal to promoting an effective emergency management. Among developed countries, the United States' utilisation of health legal preparedness is the most advanced, including the creation of a model comprising four elements: law, competencies, information, and coordination. Only limited research has been conducted in this field to date. Nevertheless, in both developed and developing states, studies that focused on regulations and laws activated in health systems during emergencies, identified inconsistency and incoherence. The Ebola outbreak plaguing West Africa since 2014 has global implications, challenges and paralleling results, that were identified in this review. The review has shown the need to broaden international regulations, to deepen reciprocity between countries, and to consider LMICs health capacities, in order to strengthen the national health security. Adopting elements of the health legal preparedness model is recommended.

  18. Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis

    Directory of Open Access Journals (Sweden)

    Odeya Cohen

    2015-10-01

    Full Text Available Background: Public health legal preparedness (PHLP for emergencies is a core component of the health system response. However, the implementation of health legal preparedness differs between low- and middle-income countries (LMIC and developed countries. Objective: This paper examines recent trends regarding public health legal preparedness for emergencies and discusses its role in the recent Ebola outbreak. Design: A rigorous literature review was conducted using eight electronic databases as well as Google Scholar. The results encompassed peer-reviewed English articles, reports, theses, and position papers dating from 2011 to 2014. Earlier articles concerning regulatory actions were also examined. Results: The importance of PHLP has grown during the past decade and focuses mainly on infection–disease scenarios. Amid LMICs, it mostly refers to application of international regulations, whereas in developed states, it focuses on independent legislation and creation of conditions optimal to promoting an effective emergency management. Among developed countries, the United States’ utilisation of health legal preparedness is the most advanced, including the creation of a model comprising four elements: law, competencies, information, and coordination. Only limited research has been conducted in this field to date. Nevertheless, in both developed and developing states, studies that focused on regulations and laws activated in health systems during emergencies, identified inconsistency and incoherence. The Ebola outbreak plaguing West Africa since 2014 has global implications, challenges and paralleling results, that were identified in this review. Conclusions: The review has shown the need to broaden international regulations, to deepen reciprocity between countries, and to consider LMICs health capacities, in order to strengthen the national health security. Adopting elements of the health legal preparedness model is recommended.

  19. Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis

    Science.gov (United States)

    Cohen, Odeya; Feder-Bubis, Paula; Bar-Dayan, Yaron; Adini, Bruria

    2015-01-01

    Background Public health legal preparedness (PHLP) for emergencies is a core component of the health system response. However, the implementation of health legal preparedness differs between low- and middle-income countries (LMIC) and developed countries. Objective This paper examines recent trends regarding public health legal preparedness for emergencies and discusses its role in the recent Ebola outbreak. Design A rigorous literature review was conducted using eight electronic databases as well as Google Scholar. The results encompassed peer-reviewed English articles, reports, theses, and position papers dating from 2011 to 2014. Earlier articles concerning regulatory actions were also examined. Results The importance of PHLP has grown during the past decade and focuses mainly on infection–disease scenarios. Amid LMICs, it mostly refers to application of international regulations, whereas in developed states, it focuses on independent legislation and creation of conditions optimal to promoting an effective emergency management. Among developed countries, the United States’ utilisation of health legal preparedness is the most advanced, including the creation of a model comprising four elements: law, competencies, information, and coordination. Only limited research has been conducted in this field to date. Nevertheless, in both developed and developing states, studies that focused on regulations and laws activated in health systems during emergencies, identified inconsistency and incoherence. The Ebola outbreak plaguing West Africa since 2014 has global implications, challenges and paralleling results, that were identified in this review. Conclusions The review has shown the need to broaden international regulations, to deepen reciprocity between countries, and to consider LMICs health capacities, in order to strengthen the national health security. Adopting elements of the health legal preparedness model is recommended. PMID:26449204

  20. Economic crisis: prelude to an energetic crisis?

    International Nuclear Information System (INIS)

    Chevallier, B.

    2009-01-01

    Recession due to the financial crisis of 2008 has stopped the world economic development and the hydrocarbons sector too. Collapse of prices, cancellation of investments, reach of a 'peak demand', the four speeches which are given here, describe these impacts and their consequences; but in scrutinizing the incentives of the crisis, they show the new role of petroleum: pretext value against the weakness of dollar and the inflation risks, speculative value for the investment funds. (O.M.)

  1. Learning Crisis Unit through Post-Crisis: Characteristics and Mechanisms

    Science.gov (United States)

    Chebbi, Hela; Pündrich, Aline Pereira

    2015-01-01

    Purpose: This paper aims to identify the characteristics that a crisis unit should have to achieve effective learning after crisis. Literature has identified many relations between learning organizations and crisis; yet, there is a dearth of research on specific studies about crisis units and their post-crisis learning features. Thus, this paper…

  2. Economic crisis and nursing in Spain.

    Science.gov (United States)

    Zabalegui, Adelaida; Cabrera, Esther

    2010-07-01

    The purpose of the present study is to describe the economic context in Spain and its impact on the health care sector and in nursing schools. The global economic crisis is affecting nursing in Spain. This study analyses and compares indicators related to health care and nursing schools among European countries. Some new strategies to cope with the challenges arising from the health care crisis are suggested. Health care costs are increasing as a result of the ageing of the Spanish population, immigration, chronicity of health problems and new medical technology. Nursing education has changed in 2010 from a 3-year diploma programme to a 4-year University degree in Nursing. This change requires new resources involving staff, facilities and equipment, all of which are lacking because of the economic crisis in Spain. The worldwide economic crisis has affected Spain more than it has other European Union (EU) countries. This global crisis has an impact on the health care sector as well on nursing schools. It is essential for nursing management to develop creative approaches to maintain cost effective patient care. New programmes and technology must be carefully evaluated in terms of cost effectiveness before being implemented. All health care professionals should be well informed and have a solid understanding of this situation.

  3. The anti snake venom crisis in Africa: a suggested manufacturers product guide.

    Science.gov (United States)

    Simpson, Ian D; Blaylock, Roger S M

    2009-01-01

    Considerable attention has been given to the shortage of anti snake venom in Africa. The current supply is reported to rest at crisis levels, and considerable attention has been given to reporting the crisis. What has been absent is a recommended list of anti snake venoms that suppliers can produce in order to alleviate the problem. Suppliers who may want to enter the market and provide new anti snake venoms are hampered by a lack of knowledge of which to provide, where to source the venoms necessary for production, and the likely volume levels required. Snakebite epidemiology is recognized as being poor, particularly in estimating the number of envenomations. Snakebite authorities and organizations such as the World Health Organisation have provided lists of medically significant species, but these are inadequate as a guide to production. This paper proposes a list of anti snake venoms that could be produced by suppliers and crucially lists relevant species by geographical area, venom sources for the target species, and likely production volumes to enable suppliers to develop a confident forecast of demand to ensure sustainability.

  4. L’Italia: una crisi nella crisi

    Directory of Open Access Journals (Sweden)

    Alessandro Roncaglia

    2011-01-01

    Full Text Available The article synthesises the large and extending literature on the financial and economic crisis from a Post-Keynesian point of view. The authors take on the position that the international and internal real imbalances are serious and worrying, but yet they are not the cause of the crisis or of its tremendous dimension. The flawed and insufficient regulation of finance is the prime cause of the crisis, as well as it is one of the main hindrances to expansionary macroeconomic policies that may less painfully drive developed countries out of the crisis. It then examines the most recent developments in the euro-area, claiming that we are not facing a sovereign debt crisis but rather a speculative attack on the euro. Finally, the article considers specifically the situation of Italy, currently at the hearth of such an attack, and suggests that the country was already facing critical developments before the 2007/2008 crisis. Thus, the policy measures so far suggested to exit the current stressful situation, in so far as they ignore this fact, seriously run the risk of proving insufficient or altogether noxious.

  5. Comparative effectiveness research as choice architecture: the behavioral law and economics solution to the health care cost crisis.

    Science.gov (United States)

    Korobkin, Russell

    2014-02-01

    With the Patient Protection and Affordable Care Act ("ACA") set to dramatically increase access to medical care, the problem of rising costs will move center stage in health law and policy discussions. "Consumer directed health care" proposals, which provide patients with financial incentives to equate marginal costs and benefits of care at the point of treatment, demand more decisionmaking ability from consumers than is plausible due to bounded rationality. Proposals that seek to change the incentives of health care providers threaten to create conflicts of interest between doctors and patients. New approaches are desperately needed. This Article proposes a government-facilitated but market-based approach to improving efficiency in the private market for medical care that I call "relative value health insurance." This approach focuses on the "choice architecture" necessary to enable even boundedly rational patients to contract for an efficient level of health care services through their health insurance purchase decisions. It uses comparative effectiveness research, which the ACA funds at a significant level for the first time, to rate medical treatments on a scale of one to ten based on their relative value, taking into account expected costs and benefits. These relative value ratings would enable consumers to contract with insurers for different levels of medical care at different prices, reflecting different cost-quality trade-offs. The Article describes both the benefits of relative value health insurance and the impediments to its implementation. It concludes with a brief discussion of how relative value ratings could also help to rationalize expenditures on public health insurance programs.

  6. Consumer experience of formal crisis-response services and preferred methods of crisis intervention.

    Science.gov (United States)

    Boscarato, Kara; Lee, Stuart; Kroschel, Jon; Hollander, Yitzchak; Brennan, Alice; Warren, Narelle

    2014-08-01

    The manner in which people with mental illness are supported in a crisis is crucial to their recovery. The current study explored mental health consumers' experiences with formal crisis services (i.e. police and crisis assessment and treatment (CAT) teams), preferred crisis supports, and opinions of four collaborative interagency response models. Eleven consumers completed one-on-one, semistructured interviews. The results revealed that the perceived quality of previous formal crisis interventions varied greatly. Most participants preferred family members or friends to intervene. However, where a formal response was required, general practitioners and mental health case managers were preferred; no participant wanted a police response, and only one indicated a preference for CAT team assistance. Most participants welcomed collaborative crisis interventions. Of four collaborative interagency response models currently being trialled internationally, participants most strongly supported the Ride-Along Model, which enables a police officer and a mental health clinician to jointly respond to distressed consumers in the community. The findings highlight the potential for an interagency response model to deliver a crisis response aligned with consumers' preferences. © 2014 Australian College of Mental Health Nurses Inc.

  7. Algeria's Role in the Sahelian Security Crisis

    Directory of Open Access Journals (Sweden)

    Laurence Aida Ammour

    2013-06-01

    Full Text Available While Mali is confronting a deep political crisis with a still serious risk of territorial split and Libya is descending into increasing instability, Algeria appears reluctant to assume the responsibilities of a hegemonic power. Algeria’s refusal to consider any joint strategy with its neighbors and other international actors towards the Malian crisis shows it has once again succumbed to the fear of encirclement that characterized its policies in the 1970s. Behind this refusal, there lies a desire to maintain its position as a pivotal actor in regional security matters while conducting a wait-and-see diplomacy, an approach which many observers and regional leaders have deemed incomprehensible. Internal power struggles at the highest levels of government have also without a doubt permeated Algeria’s policy vis-à-vis the regional crisis, hampering Algiers’ ability to act regionally and weakening its position as a regional leader. The initial lack of commitment could in fact be the result of conflicting positions and divergent interests within the regime and of the lack of transparency in decision-making. These factors are crippling its diplomatic power. Today, three revealing events are symptomatic of Algeria’s loss of hegemony within the region.

  8. Crise dos serviços de saúde no cotidiano da mídia impressa The news about the health service crisis in the newspaper

    Directory of Open Access Journals (Sweden)

    Vera Sonia Mincoff Menegon

    2008-01-01

    Full Text Available Apoiando-nos na perspectiva da Psicologia Social, acatamos o pressuposto de que a mídia é um importante espaço de difusão de informações, atuando como co-produtora de sentidos e de subjetividades no cotidiano das pessoas. Assim, a partir da análise de notícias, publicadas em jornais de Campo Grande, MS, tendo como tema serviços de saúde e, mais especificamente, notícias sobre um período de crise nesses serviços, problematizamos o posicionamento do hospital como lócus privilegiado no cuidado com a saúde e as formas verticais de negociação. A ruptura com essa associação e a abertura ao diálogo é um grande desafio para que o Sistema Único de Saúde (SUS se constitua em um sistema público, pautado pelos eixos da integralidade e da humanização na atenção à saúde que, no debate atual, formatam propostas defendidas pela Saúde Coletiva e outras áreas que atuam na saúde, entre eles a Psicologia.From the perspective of Social Psychology, we agree on the assumption that news media is an important space to propagate information, acting as a co-producer of meanings and of subjectivities in people's everyday lives. Therefore, based on the analysis of newspaper news, published in local newspapers of Campo Grande , MS, and having as their subject health service, more specifically news about the crisis in this kind of service, we critically consider the positioning of hospitals as the privileged locus for health care as well as the vertical forms of negotiation. The rupture with this association and the opening for dialogue conveys a great challenge for the Sistema Única de Sáude - SUS (Brazil's public health care system so that it can be constituted as a public system, based on universal health care and humanization of health care attention which, under current debate, forms the proposals defended by Collective Health and other fields of knowledge involved in health care, including Psychology.

  9. Chemical activation of bituminous coal for hampering oligomerization of organic contaminants.

    Science.gov (United States)

    Yan, Liang; Sorial, George A

    2011-12-15

    Activated carbons prepared by KOH activation of bituminous coal were studied for hampering oligomerization of phenolic compounds on its surface. A total of 24 activated carbons with different microporosity and BET surface area were created. The effect of the different variables of the activation process (KOH/bituminous coal ratio, heating temperature, activation time, and flow rate of nitrogen gas) on critical carbon parameters was analyzed. The impact of activated carbon on oligomerization was examined by conducting isotherm experiments at a neutral pH on Carbon(exp) produced with optimal characteristics and granular activated carbon (GAC) F400 for phenol, 2-methylphenol and 2-ethylphenol. These isotherms were collected under anoxic (absence of molecular oxygen) and oxic (presence of molecular oxygen) conditions. The single solute adsorption of phenol, 2-methylphenol and 2-ethylphenol on Carbon(exp) showed no obvious differences between oxic and anoxic environment, which indicated that the Carbon(exp) sample is very effective in hampering the oligomerization of phenolic compounds under oxic conditions. On the other hand, F400, which have lower micropore percentage and BET surface area, significant increases in the adsorptive capacity had been observed when molecular oxygen was present. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. Crisis of Legitimacy in Palestine

    Directory of Open Access Journals (Sweden)

    Hani Albasoos

    2016-04-01

    Full Text Available Abstract: Palestinian society is geographically separated and politically fragmented. This is attributed to partisan affiliation and alignment, absence of conceptual and professional framework of civil society, unethical approach of Palestinian political leaders, and unconstitutional political institutions. Such polarization and division have created political antagonism within elites and between factions. The broad objective of this research is to investigate the legitimacy crisis in Palestine, the current political dilemma in the Palestinian Authority, and the public response to the situation. The research introduces direct and thorough understanding of the developing political context surrounding these issues; taking into consideration that growing deficit in legitimacy could create potentially dire consequences, particularly if present trends on the ground continue. The research promotes an analytical perspective based on legitimacy theory and exploring recent public opinion polls. This study formulates a constructive analysis of the failure of the Palestinian political institutions at the leadership level to meet the basic expectations of the Palestinian people and the unproductive methodology of hampering the implementation of the Basic Law concerning the Palestinian political system. It reviews the empirical dilemmas of the Palestinian Authority and eliminates several assumptions of Fatah and Hamas’s - main parties - political and domestic priorities. The possibility of a new Palestinian political phenomena emerging is in the context of a new popular mobilisation lessened by the fact that both movements (Fatah and Hamas are firmly enmeshed in the very fabric of Palestinian society through patronage networks.

  11. Economic stability and health status: evidence from East Asia before and after the 1990s economic crisis.

    Science.gov (United States)

    Hopkins, Sandra

    2006-02-01

    The East Asian economies of Indonesia, Malaysia and Thailand suffered declines in their economic growth rates in 1997. The Indonesian and Thai government followed the World Bank prescription for adjustment, which included a cut-back in government spending at a time when there were significant job losses. Malaysia chose its own path to adjustment. Evidence presented in this paper shows that although the declines were short-lived that there was an impact on the health status measured by mortality rates for the populations of Indonesia and Thailand. There was little apparent impact on the health status of Malaysians. The lessons for other developing economies include the importance of social safety nets and the maintenance of government expenditure in minimising the impact of economic shocks on health.

  12. Defining Crisis in Families of Individuals with Autism Spectrum Disorders

    Science.gov (United States)

    Weiss, Jonathan A.; Wingsiong, Aranda; Lunsky, Yona

    2014-01-01

    Parents of children diagnosed with autism spectrum disorder often report higher levels of depression, anxiety, and mental health-related issues. The combination of stressors and family adjustment difficulties can cause distress which may develop into a crisis. Understanding crisis in the family is important to mental health practice since it can…

  13. How the Spectre of Societal Homogeneity Undermines Equitable Healthcare for Refugees Comment on "Defining and Acting on Global Health: The Case of Japan and the Refugee Crisis".

    Science.gov (United States)

    Razum, Oliver; Wenner, Judith; Bozorgmehr, Kayvan

    2016-10-17

    Recourse to a purported ideal of societal homogeneity has become common in the context of the refugee reception crisis - not only in Japan, as Leppold et al report, but also throughout Europe. Calls for societal homogeneity in Europe originate from populist movements as well as from some governments. Often, they go along with reduced social support for refugees and asylum seekers, for example in healthcare provision. The fundamental right to health is then reduced to a citizens' right, granted fully only to nationals. Germany, in spite of welcoming many refugees in 2015, is a case in point: entitlement and access to healthcare for asylum seekers are restricted during the first 15 months of their stay. We show that arguments brought forward to defend such restrictions do not hold, particularly not those which relate to maintaining societal homogeneity. European societies are not homogeneous, irrespective of migration. But as migration will continue, societies need to invest in what we call "globalization within." Removing entitlement restrictions and access barriers to healthcare for refugees and asylum seekers is one important element thereof. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  14. Crowds and Crisis

    DEFF Research Database (Denmark)

    Borch, Christian

    The November Revolution in 1918 made manifest and further unleashed a political crisis in Germany, the consequences of which have been thoroughly examined. What has attracted less attention is how the Revolution also triggered a semantic crisis within sociology, namely with regard to conceptions...... selected aspects of classical crowd semantics – in particular notions of imitation and suggestibility – and for placing them centrally in the understanding of the social, in times of crisis and not....

  15. Integrated crisis management exercises

    International Nuclear Information System (INIS)

    Callen, R.B.; DeHart, R.E.

    1994-01-01

    This paper describes some of the steps that Mobil has taken to enhance their crisis management capability and to improve their readiness. The approach stretches from the individual plant level to Mobil's Corporate offices in Fairfax, Virginia. Some of the lessons learned from several integrated crisis management exercises are outlined and some areas where additional industry co-operation in crisis management could pay dividends are suggested

  16. Long working hours and health in Europe: Gender and welfare state differences in a context of economic crisis.

    Science.gov (United States)

    Artazcoz, Lucía; Cortès, Imma; Benavides, Fernando G; Escribà-Agüir, Vicenta; Bartoll, Xavier; Vargas, Hernán; Borrell, Carme

    2016-07-01

    This article examines the relationship between moderately long working hours and health status in Europe. A cross-sectional study based on data from the 2010 European Working Conditions Survey (13,518 men and 9381 women) was performed. Working moderately long hours was consistently associated with poor health status and poor psychological wellbeing in countries with traditional family models, in both sexes in Liberal countries and primarily among women in Continental and Southern European countries. A combination of economic vulnerability, increasing labour market deregulation and work overload related to the combination of job and domestic work could explain these findings. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Officials Warn of a Crisis in Student Health Insurance as Medical Costs Soar and Companies Revise Policies.

    Science.gov (United States)

    Collison, Michele N-K

    1989-01-01

    As costs rise and companies discontinue coverage of college students under parents' policies, students are choosing to forego insurance rather than pay for it themselves, so suggest speakers at the American College Health Association's annual meeting. Colleges offering group-insurance policies to students are also having problems renewing them.…

  18. Did the crisis really hurt? Effects of the 1980-82 economic recession on satisfaction, mental health and mortality

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    1989-01-01

    textabstractThis book is about the social costs of macro-economic fluctuations. It considers the effects of the 1980/1982 economic recession on individual well-being in the OECD countries. Timeseries data are presented on income evaluation, life-satisfaction, health complaints, psychosomatic

  19. [The crisis of medicine or the antimedicine crisis].

    Science.gov (United States)

    Foucault, M

    1976-01-01

    In this lecture, Professor Michel Foucault makes an in-depth study of the problems currently afflicting medical institutions and the medical practice. He deals with the thesis set forth by Ivan Illich in his book Medical Nemesis--The expropriation of Health, as well as the 1942 Beveridge Plan, but goes even further back in history to discover the origin of the medical crisis common throughout the world--back to the XVIII century roots of the social practice of medicine. He also describes the phases through which medical activity has passed from then until now and deals with what he calls the political economy of medicine. Finally, he reaches the conclusion that what matters is not so much the present crisis of medicine, which he considers to be a false concept, but the discipline's historical model dating from the XVIII century and serving to determine to what extent it can be modified.

  20. Location, Allocation and Routing of Temporary Health Centers in Rural Areas in Crisis, Solved by Improved Harmony Search Algorithm

    Directory of Open Access Journals (Sweden)

    Mahdi Alinaghian

    2017-01-01

    Full Text Available In this paper, an uncertain integrated model for simultaneously locating temporary health centers in the affected areas, allocating affected areas to these centers, and routing to transport their required good is considered. Health centers can be settled in one of the affected areas or in a place out of them; therefore, the proposed model offers the best relief operation policy when it is possible to supply the goods of affected areas (which are customers of goods directly or under coverage. Due to that the problem is NP-Hard, to solve the problem in large-scale, a meta-heuristic algorithm based on harmony search algorithm is presented and its performance has been compared with basic harmony search algorithm and neighborhood search algorithm in small and large scale test problems. The results show that the proposed harmony search algorithm has a suitable efficiency.

  1. Crowdsourcing, citizen sensing and Sensor Web technologies for public and environmental health surveillance and crisis management: trends, OGC standards and application examples

    LENUS (Irish Health Repository)

    Kamel Boulos, Maged N

    2011-12-21

    Abstract \\'Wikification of GIS by the masses\\' is a phrase-term first coined by Kamel Boulos in 2005, two years earlier than Goodchild\\'s term \\'Volunteered Geographic Information\\'. Six years later (2005-2011), OpenStreetMap and Google Earth (GE) are now full-fledged, crowdsourced \\'Wikipedias of the Earth\\' par excellence, with millions of users contributing their own layers to GE, attaching photos, videos, notes and even 3-D (three dimensional) models to locations in GE. From using Twitter in participatory sensing and bicycle-mounted sensors in pervasive environmental sensing, to creating a 100,000-sensor geo-mashup using Semantic Web technology, to the 3-D visualisation of indoor and outdoor surveillance data in real-time and the development of next-generation, collaborative natural user interfaces that will power the spatially-enabled public health and emergency situation rooms of the future, where sensor data and citizen reports can be triaged and acted upon in real-time by distributed teams of professionals, this paper offers a comprehensive state-of-the-art review of the overlapping domains of the Sensor Web, citizen sensing and \\'human-in-the-loop sensing\\' in the era of the Mobile and Social Web, and the roles these domains can play in environmental and public health surveillance and crisis\\/disaster informatics. We provide an in-depth review of the key issues and trends in these areas, the challenges faced when reasoning and making decisions with real-time crowdsourced data (such as issues of information overload, "noise", misinformation, bias and trust), the core technologies and Open Geospatial Consortium (OGC) standards involved (Sensor Web Enablement and Open GeoSMS), as well as a few outstanding project implementation examples from around the world.

  2. Crowdsourcing, citizen sensing and sensor web technologies for public and environmental health surveillance and crisis management: trends, OGC standards and application examples

    Science.gov (United States)

    2011-01-01

    'Wikification of GIS by the masses' is a phrase-term first coined by Kamel Boulos in 2005, two years earlier than Goodchild's term 'Volunteered Geographic Information'. Six years later (2005-2011), OpenStreetMap and Google Earth (GE) are now full-fledged, crowdsourced 'Wikipedias of the Earth' par excellence, with millions of users contributing their own layers to GE, attaching photos, videos, notes and even 3-D (three dimensional) models to locations in GE. From using Twitter in participatory sensing and bicycle-mounted sensors in pervasive environmental sensing, to creating a 100,000-sensor geo-mashup using Semantic Web technology, to the 3-D visualisation of indoor and outdoor surveillance data in real-time and the development of next-generation, collaborative natural user interfaces that will power the spatially-enabled public health and emergency situation rooms of the future, where sensor data and citizen reports can be triaged and acted upon in real-time by distributed teams of professionals, this paper offers a comprehensive state-of-the-art review of the overlapping domains of the Sensor Web, citizen sensing and 'human-in-the-loop sensing' in the era of the Mobile and Social Web, and the roles these domains can play in environmental and public health surveillance and crisis/disaster informatics. We provide an in-depth review of the key issues and trends in these areas, the challenges faced when reasoning and making decisions with real-time crowdsourced data (such as issues of information overload, "noise", misinformation, bias and trust), the core technologies and Open Geospatial Consortium (OGC) standards involved (Sensor Web Enablement and Open GeoSMS), as well as a few outstanding project implementation examples from around the world. PMID:22188675

  3. Crowdsourcing, citizen sensing and sensor web technologies for public and environmental health surveillance and crisis management: trends, OGC standards and application examples

    Directory of Open Access Journals (Sweden)

    Kamel Boulos Maged N

    2011-12-01

    Full Text Available Abstract 'Wikification of GIS by the masses' is a phrase-term first coined by Kamel Boulos in 2005, two years earlier than Goodchild's term 'Volunteered Geographic Information'. Six years later (2005-2011, OpenStreetMap and Google Earth (GE are now full-fledged, crowdsourced 'Wikipedias of the Earth' par excellence, with millions of users contributing their own layers to GE, attaching photos, videos, notes and even 3-D (three dimensional models to locations in GE. From using Twitter in participatory sensing and bicycle-mounted sensors in pervasive environmental sensing, to creating a 100,000-sensor geo-mashup using Semantic Web technology, to the 3-D visualisation of indoor and outdoor surveillance data in real-time and the development of next-generation, collaborative natural user interfaces that will power the spatially-enabled public health and emergency situation rooms of the future, where sensor data and citizen reports can be triaged and acted upon in real-time by distributed teams of professionals, this paper offers a comprehensive state-of-the-art review of the overlapping domains of the Sensor Web, citizen sensing and 'human-in-the-loop sensing' in the era of the Mobile and Social Web, and the roles these domains can play in environmental and public health surveillance and crisis/disaster informatics. We provide an in-depth review of the key issues and trends in these areas, the challenges faced when reasoning and making decisions with real-time crowdsourced data (such as issues of information overload, "noise", misinformation, bias and trust, the core technologies and Open Geospatial Consortium (OGC standards involved (Sensor Web Enablement and Open GeoSMS, as well as a few outstanding project implementation examples from around the world.

  4. Crowdsourcing, citizen sensing and sensor web technologies for public and environmental health surveillance and crisis management: trends, OGC standards and application examples.

    Science.gov (United States)

    Kamel Boulos, Maged N; Resch, Bernd; Crowley, David N; Breslin, John G; Sohn, Gunho; Burtner, Russ; Pike, William A; Jezierski, Eduardo; Chuang, Kuo-Yu Slayer

    2011-12-21

    'Wikification of GIS by the masses' is a phrase-term first coined by Kamel Boulos in 2005, two years earlier than Goodchild's term 'Volunteered Geographic Information'. Six years later (2005-2011), OpenStreetMap and Google Earth (GE) are now full-fledged, crowdsourced 'Wikipedias of the Earth' par excellence, with millions of users contributing their own layers to GE, attaching photos, videos, notes and even 3-D (three dimensional) models to locations in GE. From using Twitter in participatory sensing and bicycle-mounted sensors in pervasive environmental sensing, to creating a 100,000-sensor geo-mashup using Semantic Web technology, to the 3-D visualisation of indoor and outdoor surveillance data in real-time and the development of next-generation, collaborative natural user interfaces that will power the spatially-enabled public health and emergency situation rooms of the future, where sensor data and citizen reports can be triaged and acted upon in real-time by distributed teams of professionals, this paper offers a comprehensive state-of-the-art review of the overlapping domains of the Sensor Web, citizen sensing and 'human-in-the-loop sensing' in the era of the Mobile and Social Web, and the roles these domains can play in environmental and public health surveillance and crisis/disaster informatics. We provide an in-depth review of the key issues and trends in these areas, the challenges faced when reasoning and making decisions with real-time crowdsourced data (such as issues of information overload, "noise", misinformation, bias and trust), the core technologies and Open Geospatial Consortium (OGC) standards involved (Sensor Web Enablement and Open GeoSMS), as well as a few outstanding project implementation examples from around the world.

  5. Non-conventional humanitarian interventions on Ebola outbreak crisis in West Africa: health, ethics and legal implications.

    Science.gov (United States)

    Tambo, Ernest

    2014-01-01

    Due to the lack of Ebola outbreak early warning alert, preparedness, surveillance and response systems, the most deadly, complex and largest ever seen Ebola war has been devastating West African communities. The unparalleled Ebola tsunami has prompted interrogations into, and uncertainties about, the effectiveness and efficiency of national, regional and international community's illed- responses using conventional humanitarian control and containment approaches and methods. The late humanitarian and local non-government organisations emergency responses and challenges to curb transmission dynamics and stop the ongoing spread in the Ebola outbreak in West Africa have led to an unprecedented toll of 14,413 reported Ebola cases in eight countries since the outbreak began, with 5,177 reported deaths including 571 health-care workers and 325 died as 14 November 2014. These indications the need of further evaluation of monitoring as substantial proportion of infections outside the context of Ebola epicentres, Ebola health centres treatment and care, infection prevention and control quality assurance checks in these countries. At the same time, exhaustive efforts should target ensuring an sufficient supply of optimal personal protective equipment (PPE) to all Ebola treatment facilities, along with the provision of training and relevant guidelines to limit to the minimum possible level of risk. The continent hosts a big proportion of the world's wealth, yet its people live in abject poverty, with governments unable to feed and govern them effectively, and who are condemned to endure even darker moments with the Ebola outbreak in West Africa. Institutionalisation of practical and operational non-conventional emergency response models efficient health systems, and tailored programmes can clearly support to prevent, control and eventually stamp out Ebola geo-distribution in addition to population mental health services that are requisite to address the massive range of the

  6. 76 FR 69729 - Pesticide Emergency Exemptions; Agency Decisions and State and Federal Agency Crisis Declarations

    Science.gov (United States)

    2011-11-09

    ...; Agency Decisions and State and Federal Agency Crisis Declarations AGENCY: Environmental Protection Agency... following form: Crisis, public health, quarantine, or specific. EPA has also listed denied emergency... or public health purposes. These are rarely requested. 3. A ``crisis exemption'' is initiated by a...

  7. Crisis homes for adult psychiatric patients

    DEFF Research Database (Denmark)

    Aagaard, Jørgen; Freiesleben, Michael; Foldager, Leslie

    2008-01-01

    INTRODUCTION: Inspired by the Crisis Home programme in Madison, we have adapted and evaluated the programme at the Community Mental Health (CMH) Centre in Tønder, Denmark. MATERIAL AND METHODS: Procedures and schedules from the Crisis Home programme were applied in this open trial. Questionnaire...... data concerning satisfaction with the stay and registration data concerning the admissions and bed days two years before and two years after the first stay were obtained. RESULTS: During four years, 52 different patients had a total of 187 stays in a crisis home. Twenty (38.5%) of the patients were...... attached to the ACT team. The average duration of the stays was 4.0 days. The number of readmissions and bed days after the first stay showed a significant downward tendency for the subgroup of patients with a more severe mental disorder, but not for the whole group. The patients, the crisis homes families...

  8. Corruption in the commons: why bribery hampers enforcement of environmental regulations in South African fisheries

    Directory of Open Access Journals (Sweden)

    Aksel Sundström

    2013-08-01

    Full Text Available Few studies have explored on the micro-level why corruption hampers environmental regulations. The relationship between corruption and regulatory compliance is here investigated through confidential in-depth interviews with South African small-scale fishermen. Respondents describe how the expected behavior of inspectors and other resource users to ask for or accept bribes are vital in their compliance decisions. The interviews also shed some light on the puzzling role of trust and trustworthiness of public officials. While resource users often knows inspectors personally – and uphold discretion necessary for bribery to continue – they depict them as dishonest and describe how corrupt acts decrease their trustworthiness. The findings from the South African case illustrate the importance of curbing both grand and petty corruption to increase the effectiveness of regulations in natural resource management.

  9. Crisis interventions in online psychological counseling

    Directory of Open Access Journals (Sweden)

    Juliana Amaral Medeiros da Silva

    2015-12-01

    Full Text Available Introduction: The world's population is often assailed by crises of various orders. Disasters caused by nature and by humans themselves also impact on people's mental health. Psychological crises, such as suicide attempts, represent a growing problem in mental health. When faced with such scenarios, specific strategies of crisis intervention are both appropriate and necessary. Objective: To conduct a systematic review of the literature dealing with online psychological crisis intervention, describing and discussing their operational design, specific characteristics and applications. Method: A systematic review of literature indexed on the PubMed, PsycINFO, and SciELO databases identified by searches conducted from January to June of 2014. Results: The searches identified 17 empirical studies about online crisis interventions which were reviewed. Three crisis contexts emerged: 1 disasters, 2 risk/prevention of suicide, and 3 trauma. Eleven different intervention programs were described and the predominant treatment approach was cognitive behavioral therapy. The results showed that research into online psychological crisis intervention has been conducted in several different countries, especially the Netherlands and Australia, and that the users of these tools benefit from them. Conclusion: Online crisis interventions have been developed and researched in many countries around the world. In Brazil, there is still a lack of investment and research in this area.

  10. Dalla crisi finanziaria alla crisi reale

    Directory of Open Access Journals (Sweden)

    CARLO D’ADDA

    2010-01-01

    Full Text Available The financial crisis of 2008 is put in relation with two bubbles, financial and housing. Easy credit is at the origin of both bubbles. Risky bonds were issued to mobilize mortgages originated in the housing market, and bad bonds entered a fantastic number of institutional and private portfolios all over the world without any perception of the their risk. Unfortunately, bank credit to speculators was abundant and fed the final growth of the bubbles. When fears started to spread, the fall was immediate and expectations impaired very rapidly. The main aggregate demand components were severely curtailed and production fell as well. This is the crisis of the real economy. Fortunately, as opposed to what happened in 1929, the interventions of central banks and governments have been of an unprecedented size. The bail out of insolvent banks in particular has been providential. The exit from the current crisis, however, will surely be slow.

  11. Crisis Management Research Summaries

    Science.gov (United States)

    Brock, Stephen E., Ed.

    2009-01-01

    In this column, Crisis Management in the Schools Interest Group members summarize recent crisis management publications. The first article summarized was a meta-analysis of the risk factors associated with Posttraumatic Stress Disorder (PTSD) among adults. The second study looked at the presence of life stressors among students who were expelled…

  12. Energy and crisis

    International Nuclear Information System (INIS)

    Rosa, L.P.

    1984-01-01

    Several aspects of the Brazilian energy policy are dealt with, regarding petroleum, electric energy and the nuclear question. Regional and international aspects relating to the energy crisis are discussed, and some alternatives for this crisis are suggested. (I. de C.R.) [pt

  13. Crisis control - the background

    International Nuclear Information System (INIS)

    Young, R.E.

    1983-01-01

    The problems of destructive accidents and the need for a crisis management system to deal with every kind of emergency is discussed. Crisis control with regard to the ''Problem'' and the ''Outlook'' were covered, as well as the ''Development of an Incident''. (U.K.)

  14. Muslim Americans' safety and well-being in the wake of Trump: A public health and social justice crisis.

    Science.gov (United States)

    Abu-Ras, Wahiba; Suárez, Zulema E; Abu-Bader, Soleman

    2018-04-09

    This study examined the perceived impact of religious discrimination and Islamophobia on Muslim Americans' well-being during the 2016 United States presidential election campaign. Data were collected from a national sample of 1,130 Muslim Americans. Perceived religious discrimination (PRD) was measured using the Perceived Religious Discrimination Scale. Results of canonical correlation analysis showed that perceived Islamophobia was associated with safety (β = .45, p < .001), level of stress (β = -.25, p < .001), level of religiosity (β = -.11, p < .05), and employment (β = .11, p < .05). PRD was associated with preexposure to religious-based discrimination; β = -.12, p < .05), safety (.47, p < .001), level of stress (β = -.33, p < .001), religiosity (β = -.15, p < .010), and years in the United States (β = .16, p < .010). Results also suggest that some Muslim subgroups, such as women and older people, may face "double jeopardy" based on multiple stigmatized identities. When addressing mental health concerns in marginalized groups, it is necessary to link health with social justice and examine how social injustices may affect people's well-being. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  15. Defining crisis in families of individuals with autism spectrum disorders

    OpenAIRE

    Weiss, Jonathan A; Wingsiong, Aranda; Lunsky, Yona

    2014-01-01

    Parents of children diagnosed with autism spectrum disorder often report higher levels of depression, anxiety, and mental health–related issues. The combination of stressors and family adjustment difficulties can cause distress which may develop into a crisis. Understanding crisis in the family is important to mental health practice since it can serve as a guide in delivering service to at-risk families. This study investigated the subjective experience of crisis in 155 mothers of children di...

  16. Enhancing Organizational Survivability in a Crisis: Perceived Organizational Crisis Responsibility, Stance, and Strategy

    Directory of Open Access Journals (Sweden)

    JiYeon Jeong

    2015-08-01

    Full Text Available For the purpose of enhancing organizational sustainability during a crisis, an organization takes a position in decision-making, how to respond toward its public, and that is supposed to determine which stance or tactic to employ. This study aims to examine whether publics’ perceptions of organizational crisis responsibility affect their expectations that an organization should choose certain stances and strategies toward the public in a crisis. To address these concerns, an experiment was conducted. As the specific public of this research, health journalists were selected, since they affect public perceptions significantly and public opinion can ultimately put pressure on an organization. Results from an analysis of the experimental data with health journalists confirm that they expect a more accommodative stance/strategy when they perceive that the organization is highly responsible for a health-related crisis. Conversely, when the journalists perceive that an organization has a low level of responsibility for a crisis, they expect a more advocative stance/strategy. By taking into account the health journalists’ expectations along with the needs of the organization, public relations practitioners are better able to make optimal decisions regarding their client organizations’ adopted stance and strategy, and finally, enhance organizational sustainability in a crisis.

  17. White plan and crisis management. Help guide for the elaboration of extended white plans and of white plans for health establishments. Issue 2006, appendix to circular nr DHOS/CGR/2006/401 of 2006 September 14

    International Nuclear Information System (INIS)

    2006-01-01

    White plans are specific emergency plans to be implemented in public and private health establishments. While introducing necessary modifications and taking public health policy effects into account, this document first defines crises and their management (levels of intervention from the local to the national level, typology of emergency plans, emergency medical chain, extended white plans). The second part proposes a set of sheets which aim to be a support in the elaboration of the extended white plan and of the white plan. The third part, based on professional contributions and lessons learned, addresses two important issues: firstly, the crisis management exercise, and secondly the hospital under tension and white plan triggering thresholds

  18. Survivors' perceptions of public health messages during an Ebola crisis in Liberia and Sierra Leone: An exploratory study.

    Science.gov (United States)

    Schwerdtle, Patricia; De Clerck, Veronique; Plummer, Virginia

    2017-12-01

    The outbreak of Ebola virus disease in Guinea, Liberia, and Sierra Leone was the largest epidemic of Ebola ever recorded. The healthcare workforce was diminished and exhausted as the region emerged from civil war. Few qualitative, descriptive studies have been conducted to date that concentrate on the voices of Ebola survivors and their perceptions of health messages. In this study, we employed an interpretive, qualitative design to explore participant experiences. Twenty five survivors who had recovered from Ebola were recruited from three villages in Liberia and Sierra Leone in August 2015. Data were collected using semistructured interviews. Data analysis revealed four themes: (i) degrees of mistrust; (ii) messages conflicting with life and culture; (iii) seeing is believing; and (iv) recovery inspires hope. The findings were explored in the context of the relevant literature. The themes highlight the need to develop culturally-appropriate messages, underpinned by a sound understanding of the community and a willingness to work with the culture and trusted leaders. © 2017 John Wiley & Sons Australia, Ltd.

  19. Crisis Communication and Management: Surviving a Public Relations Crisis

    Science.gov (United States)

    Eramo, Eric M.

    2009-01-01

    Crisis management, or crisis communication, is never a good thing for a business to experience. It is, however, a public relations' professional moment to shine and put their honed skills to good use. A good crisis management plan is not only action during the crisis but preparation and reflection. Hiring a PR firm that deals with crisis…

  20. From oil crisis to climate crisis

    International Nuclear Information System (INIS)

    Langseth, Bjarne

    2000-01-01

    The oil crisis in the 1970s led to the shift from oil to hydro- and nuclear power. An almost similar shift might soon come as a ''climate crisis''. A climate crisis may imply a renaissance for hydropower and nuclear power and natural gas will be used on a large scale. In Europe, natural gas is currently considered environmentally friendly. Although there is at present growing opposition to nuclear power in Sweden and Germany, this attitude may change as the result of increased focus on the costs of the alternatives. A forced phase-out of nuclear power in Europe simultaneously with a climate crisis with reduced energy production from fossil fuels is likely to entail significantly increased prices of electricity. In Norway, 98% of the country's electric power production is based on hydro power, which means that much more heating can be based on electricity than in countries in which electricity is produced by combustion of fossil fuels. Much research is in progress to find technologies that will make it possible to shift from fossil fuel energy to energy from renewable sources like solar, water, wind, biomass and geothermal energy

  1. Husserl's Crisis as a crisis of psychology.

    Science.gov (United States)

    Feest, Uljana

    2012-06-01

    This paper places Husserl's mature work, The Crisis of the European Sciences, in the context of his engagement with--and critique of--experimental psychology at the time. I begin by showing (a) that Husserl accorded psychology a crucial role in his philosophy, i.e., that of providing a scientific analysis of subjectivity, and (b) that he viewed contemporary psychology--due to its naturalism--as having failed to pursue this goal in the appropriate manner. I then provide an analysis of Husserl's views about naturalism and scientific philosophy. Some central themes of the Crisis are traced back to Husserl's earlier work and to his relationship with his teacher, Franz Brentano, with whom he disagreed about the status of "inner perception" as the proper scientific method for a phenomenological analysis. The paper then shows that Husserl was well aware of at least one publication about the crisis of psychology (Bühler's 1927 book), and it teases out some aspects of the complicated relationship between Husserl and members of the Würzburg School of thought psychology: The latter had drawn on Husserl's writings, but Husserl felt that they had misunderstood his central thesis. I conclude by placing Husserl's work in the wider context of scientific, cultural, and political crisis-discourses at the time. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Narratives of crisis: identity crisis or crisis of meaning?!

    Directory of Open Access Journals (Sweden)

    Roseli Araújo Barros Costa

    2006-06-01

    Full Text Available This article is about a review of a broader research on the understanding of the professional development of Mathematics teachers, especially the results of the analysis of one of the selected categories, the projectors and the crisis narratives. This analysis was theoretically supported by Larrosa (2002. To carry out the research, we adopted the qualitative research, with a narrative focus, based on semi-structured interviews about the life history of a teacher who teaches mathematics in Basic Education. Based on a concept of professional development taken from a continuous perspective, idealized in a broader context of teaching work, permeating crises and conflicts, the analysis shows that the teacher's crisis reports are related to factors such as: low salaries, conflicts in her current institution Lack of social prestige and insecurity. His reports reveal that initial training did nothing to address the "new" changes in education. It shows that their lack of enthusiasm is associated with the emptying of the useful meaning of their formation, which results from the overvaluation of their exchange value. However, a crisis narrative can construct the present as a critical moment in the double sense of the word as a decisive moment and, at the same time, as a moment in which the subject critically recovers his own history, appropriates himself critically To find out where it is and to decide its own movement (LARRROSA, 2002. The individual, by critically restoring his history, can rethink the past, think the present, and (reconstruct his own future. The teacher, in her crisis narratives, shows that, by critically recovering her story, by putting out all her "revolt", she opens a "door" that will possibly show a new path to be taken. This seeks new challenges for their professional development

  3. Dalla crisi finanziaria alla crisi reale. ( Financial and real crisis

    Directory of Open Access Journals (Sweden)

    Carlo D'Adda

    2010-03-01

    Full Text Available  The financial crisis of 2008 is put in relation with two bubbles, financial and housing. Easy credit is at the origin of both bubbles. Risky bonds were issued to mobilize mortgages originated in the housing market, and bad bonds entered a fantastic number of institutional and private portfolios all over the world without any perception of the their risk. Unfortunately, bank credit to speculators was abundant and fed the final growth of the bubbles. When fears started to spread, the fall was immediate and expectations impaired very rapidly. The main aggregate demand components were severely curtailed and production fell as well. This is the crisis of the real economy. Fortunately, as opposed to what happened in 1929, the interventions of central banks and governments have been of an unprecedented size. The bail out of insolvent banks in particular has been providential. The exit from the current crisis, however, will surely be slow.  JEL: E44, G01, G10

  4. The public health crisis of child sexual abuse in low and middle income countries: an integrative review of the literature.

    Science.gov (United States)

    Veenema, Tener Goodwin; Thornton, Clifton P; Corley, Andrew

    2015-04-01

    social or family strain are exacerbating factors to CSA. There is inadequate representation of CSA research in LMICs, and an increasing awareness that sexual abuse of children is an endemic threat to the health and safety of children worldwide. This review lays the foundation for an array of further areas of analysis to explore the expanse of unanswered questions that remain regarding the phenomena of CSA in low and middle-income countries. Healthcare workers hold a unique position and responsibility for identifying and responding to CSA. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Health Systems Sustainability and Rare Diseases.

    Science.gov (United States)

    Ferrelli, Rita Maria; De Santis, Marta; Egle Gentile, Amalia; Taruscio, Domenica

    2017-01-01

    The paper is addressing aspects of health system sustainability for rare diseases in relation to the current economic crisis and equity concerns. It takes into account the results of the narrative review carried out in the framework of the Joint Action for Rare Diseases (Joint RD-Action) "Promoting Implementation of Recommendations on Policy, Information and Data for Rare Diseases", that identified networks as key factors for health systems sustainability for rare diseases. The legal framework of European Reference Networks and their added value is also presented. Networks play a relevant role for health systems sustainability, since they are based upon, pay special attention to and can intervene on health systems knowledge development, partnership, organizational structure, resources, leadership and governance. Moreover, sustainability of health systems can not be separated from the analysis of the context and the action on it, including fiscal equity. As a result of the financial crisis of 2008, cuts of public health-care budgets jeopardized health equity, since the least wealthy suffered from the greatest health effects. Moreover, austerity policies affected economic growth much more adversely than previously believed. Therefore, reducing public health expenditure not only is going to jeopardise citizens' health, but also to hamper fair and sustainable development.

  6. Institutional and relational determinants in high- and medium-extent food product crises: the inner perspective of a public health crisis.

    Science.gov (United States)

    Charlebois, Sylvain; Horan, Hilary

    2010-08-01

    In 2008, Canada enacted its biggest-ever food recall in response to a Listeria crisis, stemming from a Maple Leaf Foods plant, that killed 22 Canadians. Afterwards, Maple Leaf's market share quickly returned to pre-crisis levels, but the long-term repercussions of the scare still reverberate in Maple Leaf's brand. In this case study, which offers an organizational perspective on the food recall, data was collected, through in-depth interviews of persons involved in the crisis response, and analyzed. The aim of this paper is to make transparent the ways in which Maple Leaf Foods organized their resources to manage the 2008 food recall. Results reveal that institutional and relational determinants are the most important factors in high- and medium-extent food product crises, whereas external and internal effects primarily influence an organization's capacity to cope with severe crises. Based on these findings, a conceptual framework is presented and managerial implications are discussed.

  7. Problems in producing nuclear reactor for medical isotopes and the Global Crisis of molybdenum supply; Problemas en la produccion en reactores nucleares de isotopos con fines medicos y la crisis mundial de suministro de molibdeno ({sup 9}9Mo)

    Energy Technology Data Exchange (ETDEWEB)

    Zubiarrain, A.

    2011-07-01

    Nuclear medicine uses drugs that incorporate a radioactive isotope radiopharmaceuticals. Every year are performed, worldwide, 35 million nuclear medicine procedures, of which 80% are done with radiopharmaceuticals containing the isotope, molybdenum-99, produced in nuclear reactors. In recent years, there have been several supply crisis of molybdenum-99, which have hampered diagnostic procedure with technitium-99m. (Author)

  8. Trust vs. Crisis

    DEFF Research Database (Denmark)

    Mogensen, Kirsten

    2014-01-01

    The three social phenomena -- norms, trust, and crisis -- are in this paper combined into one model that illustrates their function and relationship. Crisis is seen as a reaction to serious violations of expectations that leave people disoriented, insecure about situational norms, and unable...... to judge whom to trust. One logical solution to a crisis is to rebuild a shared understanding of the norms involved in any given context. Banking is used as a case. Central concepts are borrowed from Niklas Luhmann Trust (1968), Alf Ross Directives and Norms (1967), and Arthur G. Neal National Trauma...

  9. Trust vs. Crisis

    Directory of Open Access Journals (Sweden)

    Kirsten Mogensen

    2014-06-01

    Full Text Available The three social phenomena -- norms, trust, and crisis -- are in this paper combined into one model that illustrates their function and relationship. Crisis is seen as a reaction to serious violations of expectations that leave people disoriented, insecure about situational norms, and unable to judge whom to trust. One logical solution to a crisis is to rebuild a shared understanding of the norms involved in any given context. Banking is used as a case. Central concepts are borrowed from Niklas Luhmann Trust (1968, Alf Ross Directives and Norms (1967, and Arthur G. Neal National Trauma & Collective Memory (1998.

  10. Crisis response to schools.

    Science.gov (United States)

    Johnson, K

    2000-01-01

    While community based crisis response teams offer needed resources to schools impacted by crisis, they are often not asked to help. Reports from crisis team leaders at the school shooting incidents at James W. Parker Middle School, Edinboro, Pennsylvania and Columbine High School, Littleton, Colorado are contrasted regarding utilization of community resources. Factors limiting the usefulness of community based teams include unfamiliarity with school organization, culture, and procedures. Key differences in school vs. community team precepts, decision-making, and strategic paradigms render team coordination difficult. Successful cross training presents opportunities for school-community partnership and utilization of community teams for school duty.

  11. Diversification of an organisational field: how Europe promotes and hampers domestic change

    Energy Technology Data Exchange (ETDEWEB)

    Boasson, Elin Lerum

    2008-11-15

    Better understanding of Europeanization requires research on national, societal change. This paper presents a theoretical framework that enables assessment of Europeanised change processes within national industries. Empirically it explores how European Union (EU) state aid regulations and European renewable energy trends in conjunction led to diversification among Norwegian stationary energy producers. Key theoretical implications are as follows: (1) The pattern of interaction between change impulses from the European environment, governmental hierarchical steering and institutional logics within the national organisational field was crucial to the output of the change process. (2) Misfit between institutional logics at the European level and the organisational field hampers change, rather than promoting it. (3) The carriers / the actors that bring the European impulses into the organisational field / matter because they translate change impulses in line with their institutional logic. (4) National politicians are unable to control the process of translating these impulses, and that reduces their political clout. (5) Europeanization brings greater challenges to national democratic governance of liberalised industries. (author). refs., tabs

  12. Crowdsourcing, citizen sensing and Sensor Web technologies for public and environmental health surveillance and crisis management: trends, OGC standards and application examples

    Energy Technology Data Exchange (ETDEWEB)

    Kamel Boulos, Maged; Resch, Bernd; Crowley, David N.; Breslin, John G.; Sohn, Gunho; Burtner, Edwin R.; Pike, William A.; Jeziersk, Eduardo; Slayer Chuang, Kuo Yu

    2011-12-21

    The PIE Activity Awareness Environment is designed to be an adaptive data triage and decision support tool that allows role and activity based situation awareness through a dynamic, trainable filtering system. This paper discusses the process and methodology involved in the application as well as some of its capabilities. 'Wikification of GIS by the masses' is a phrase-term first coined by Kamel Boulos in 2005, two years earlier than Goodchild's term 'Volunteered Geographic Information'. Six years later (2005-2011), OpenStreetMap and Google Earth (GE) are now full-fledged, crowdsourced 'Wikipedias of the Earth' par excellence, with millions of users contributing their own layers to GE, attaching photos, videos, notes and even 3-D (three dimensional) models to locations in GE. From using Twitter in participatory sensing and bicycle-mounted sensors in pervasive environmental sensing, to creating a 100,000-sensor geo-mashup using Semantic Web technology, to the 3-D visualisation of indoor and outdoor surveillance data in real-time and the development of next-generation, collaborative natural user interfaces that will power the spatially-enabled public health and emergency situation rooms of the future, where sensor data and citizen reports can be triaged and acted upon in real-time by distributed teams of professionals, this paper offers a comprehensive state-of-the-art review of the overlapping domains of the Sensor Web, citizen sensing and 'human-in-the-loop sensing' in the era of the Mobile and Social Web, and the roles these domains can play in environmental and public health surveillance and crisis/disaster informatics. We provide an in-depth review of the key issues and trends in these areas, the challenges faced when reasoning and making decisions with real-time crowdsourced data (such as issues of information overload, 'noise', misinformation, bias and trust), the core technologies and Open Geospatial

  13. The crisis in human resources for health care and the potential of a 'retired' workforce: case study of the independent midwifery sector in Tanzania.

    Science.gov (United States)

    Rolfe, Ben; Leshabari, Sebalda; Rutta, Fredrik; Murray, Susan F

    2008-03-01

    The human resource crisis in health care is an important obstacle to attainment of the health-related targets for the Millennium Development Goals. One suggested strategy to alleviate the strain upon government services is to encourage new forms of non-government provision. Detail on implementation and consequences is often lacking, however. This article examines one new element of non-government provision in Tanzania: small-scale independent midwifery practices. A multiple case study analysis over nine districts explored their characteristics, and the drivers and inhibitors acting upon their development since permitted by legislative change. Private midwifery practices were found concentrated in a 'new' workforce of 'later life entrepreneurs': retired, or approaching retirement, government-employed nursing officers. Provision was entirely facility-based due to regulatory requirements, with approximately 60 'maternity homes' located mainly in rural or peri-urban areas. Motivational drivers included fear of poverty, desire to maintain professional status, and an ethos of community service. However, inhibitors to success were multiple. Start-up loans were scarce, business training lacking and registration processes bureaucratic. Cost of set-up and maintenance were prohibitively high, registration required levels of construction and equipping similar to government sector dispensaries. Communities were reluctant to pay for services that they expected from government. Thus, despite offering a quality of basic maternity care comparable to that in government facilities, often in poorly-served areas, most private maternity homes were under-utilized and struggling for sustainability. Because of their location and emphasis on personalized care, small-scale independent practices run by retired midwives could potentially increase rates of skilled attendance at delivery at peripheral level. The model also extends the working life of members of a professional group at a time of

  14. Qualitative Investigation of the Wellness Recovery Action Plan in a UK NHS Crisis Care Setting.

    Science.gov (United States)

    Ashman, Michael; Halliday, Vanessa; Cunnane, Joseph G

    2017-07-01

    Crisis theory suggests that in addition to presenting a threat to mental well-being, crises are also opportunities where successful interventions can lead to successful outcomes. UK mental health crisis teams aim to reduce hospital admission by treating people at home and by building resilience and supporting learning from crisis, yet data on repeat crisis episodes suggest this could be improved. This qualitative study sought to explore the Wellness Recovery Action Plan (WRAP) as a means of supporting resilience-building and maximising the opportunity potential of crisis. The following themes emerged: The meaning of crisis; Engaging with the WRAP process; WRAP and self-management; and Changes and transformations. This research suggests that WRAP has potential in supporting recovery from crisis, revealing insights into the nature of crisis which can inform the further development of crisis services.

  15. Crisis communication: an inequalities perspective on the 2010 Boston water crisis.

    Science.gov (United States)

    Galarce, Ezequiel M; Viswanath, K

    2012-12-01

    Although the field of crisis risk communication has generated substantial research, the interaction between social determinants, communication processes, and behavioral compliance has been less well studied. With the goal of better understanding these interactions, this report examines how social determinants influenced communications and behavioral compliance during the 2010 Boston, Massachusetts, water crisis. An online survey was conducted to assess Boston residents' knowledge, beliefs, attitudes, mass and interpersonal communication, and preventive behaviors on emergency preparedness topics dealing with the water crisis. Of a total sample of 726 respondents, approximately one-third (n = 267) reported having been affected by the water crisis. Only data from affected participants were analyzed. Following an order to boil water, 87.5% of respondents refrained from drinking unboiled tap water. These behaviors and other cognitive and attitudinal factors, however, were not uniform across population subgroups. All communication and behavioral compliance variables varied across sociodemographic factors. Crisis communication, in conjunction with other public health preparedness fields, is central to reducing the negative impact of sudden hazards. Emergency scenarios such as the Boston water crisis serve as unique opportunities to understand how effectively crisis messages are conveyed to and received by different segments of the population.

  16. Companies’ management during economic crisis

    OpenAIRE

    Kumpikaitė, Vilmantė; Grybauskas, Andrius; Juodelis, Mantas; Strumyla, Dovydas

    2011-01-01

    Lots of companies faced recent economic crisis. It was generated by global markets deregulation and it triggered relevant situation to emerge other types of crisis. Many scientists all over the world analyses how crisis affected global economy and changed companies’ management actions. Scientists exclude these types of crisis: economic, informational, physical, human resource, reputational, psychopathic acts production and financial. This paper examines economic crisis generated negative effe...

  17. Veterans Crisis Line

    Data.gov (United States)

    Department of Veterans Affairs — The caring responders at the Veterans Crisis Line are specially trained and experienced in helping Veterans of all ages and circumstances. Some of the responders are...

  18. Emotional crisis communication

    NARCIS (Netherlands)

    van der Meer, T.G.L.A.; Verhoeven, J.W.M.

    2014-01-01

    Organizational crises are usually highly emotional experiences for both organizations and stakeholders. Hence, crisis situations often result in emotionally charged communication between the two parties. Despite the attention of organizations and scholars to the emotions of stakeholders during

  19. Policing the Global Crisis

    Directory of Open Access Journals (Sweden)

    William I. Robinson

    2015-08-01

    Full Text Available As part of my research for a book manuscript on the crisis of global capitalism I recently finished writing (Robinson forthcoming, I decided to re-read the classic 1978 study conducted by the noted socialist and cultural theorist Stuart Hall and several of his colleagues, Policing the Crisis. The authors show in that book how the restructuring of capitalism as a response to the crisis of the 1970s - which was the last major crisis of world capitalism until the current one hit in 2008 -led in the United Kingdom and elsewhere to an "exceptional state," by which they meant a situation in which there was an ongoing breakdown of consensual mechanisms of social control and a growing authoritarianism.

  20. 2030 the ecological crisis

    International Nuclear Information System (INIS)

    Ferone, G.

    2008-01-01

    The ecological crisis will happen on 2030. A combination of climatic change, energy problems, increase in population, will mix up. The author debates about true questions on the economy: how to get quickly towards renewable energies use, how much will it cost, must we generalize the carbon tax, what about economic giant as India and China, what about the technology development to solve the crisis? (A.L.B.)

  1. International Trade Crisis

    OpenAIRE

    Popa Diana

    2011-01-01

    This article captures a brief history of the negotiations of the Doha Development Agenda (DDA), analyzes its deadlock and offers some suggestions for a successful Doha deal. First, this study shows that the nearly decade-long negotiation stalemate is caused by the opposite perceptions between industrialized countries and developing ones on agriculture, as well as by the influences of economic crisis on the world trade. Subsequently, some proposals are presented to solve the current crisis fro...

  2. The World Financial Crisis

    OpenAIRE

    F. Gerard Adams

    2009-01-01

    The world financial crisis of 2008 is a consequence of new financial technologies, new accounting methods and new international linkages. These developments have come at a time when governments have returned to an old-fashioned freemarket philosophy. This paper links the systemic financial/economic crisis of 2008 to the new economy developments, globalisation and policy philosophy perspectives of recent decades. It raises the question of how to re-establish confidence once traditional thinkin...

  3. Crisis decision making

    International Nuclear Information System (INIS)

    Holsti, O.R.

    1989-01-01

    This article presents evidence that the potential loss of control of events by officials who must operate under conditions that generate substantial stress is one of the central problems of crisis decision making. Examples of U.S. crises management and alliance management are reviewed, and possible tools for improving crisis management decisions are discussed. This article particularly focuses on crises which may lead to nuclear war

  4. L’Italia: una crisi nella crisi.(Italy: A Crisis within the Crisis

    Directory of Open Access Journals (Sweden)

    Carlo D'ippoliti

    2011-10-01

    Full Text Available The article synthesises the large and extending literature on the financial and economic crisis from a Post-Keynesian point of view. The authors take on the position that the international and internal real imbalances are serious and worrying, but yet they are not the cause of the crisis or of its tremendous dimension. The flawed and insufficient regulation of finance is the prime cause of the crisis, as well as it is one of the main hindrances to expansionary macroeconomic policies that may less painfully drive developed countries out of the crisis. It then examines the most recent developments in the euro-area, claiming that we are not facing a sovereign debt crisis but rather a speculative attack on the euro. Finally, the article considers specifically the situation of Italy, currently at the hearth of such an attack, and suggests that the country was already facing critical developments before the 2007/2008 crisis. Thus, the policy measures so far suggested to exit the current stressful situation, in so far as they ignore this fact, seriously run the risk of proving insufficient or altogether noxious.JEL: B50; E12; G01  

  5. Commentary: Advancing an implementation science agenda on mental health and psychosocial responses in war-affected settings: comment on trials of a psychosocial intervention for youth affected by the Syrian crisis - by Panter-Brick et al. (2018).

    Science.gov (United States)

    Betancourt, Theresa S; Fazel, Mina

    2018-05-01

    Syria's civil conflict has created the largest humanitarian disaster of our time, causing massive population displacement, tremendous exposure to trauma, and loss. Advancing the mental health and psychosocial responses of war-affected populations both during acute humanitarian emergencies and in post-conflict transition is imperative in forging a constructive implementation agenda. This study makes an important contribution in building evidence toward effective interventions to advance the mental health and well-being of those affected by the Syrian crisis. Using an innovative approach, this work demonstrates that a thoughtful, ethical, and scientifically valid trial can be carried out in the midst of mass displacement. Further research is urgently needed on the effectiveness of interventions for vulnerable populations, with a growing need to embed studies of evidence-based mental health interventions within humanitarian responses. © 2018 Association for Child and Adolescent Mental Health.

  6. Limited by the host: Host age hampers establishment of holoparasite Cuscuta epithymum

    Science.gov (United States)

    Meulebrouck, Klaar; Verheyen, Kris; Brys, Rein; Hermy, Martin

    2009-07-01

    A good understanding of the relationship between plant establishment and the ecosystem of which they are part of is needed to conserve rare plant species. Introduction experiments offer a direct test of recruitment limitation, but generally only the seed germination and seedling phases are monitored. Thus the relative importance of different establishment stages in the process of recruitment is not considered. This is particularly true for parasitic plants where empirical data are generally missing. During two consecutive growing seasons we examined the effect of heathland management applications, degree of heathland succession (pioneer, building and mature phase) and seed-density on the recruitment and establishment of the endangered holoparasite Cuscuta epithymum. In general, recruitment after two growing seasons was low with 4.79% of the sown seeds that successfully emerged to the seedling stage and a final establishment of 89 flowering adults (i.e. <1.5% of the sown seeds). Although a higher seed-density resulted in a higher number of seedlings, seed-density did not significantly affected relative germination percentages. The management type and subsequent heath succession had no significant effect on seedling emergence; whereas, seedling attachment to the host, establishment and growth to full-grown size were hampered in older heath vegetation (i.e. high, dense, and mature canopy). Establishment was most successful in turf-cut pioneer heathland, characterised by a relatively open and low vegetation of young Calluna vulgaris. The age of C. vulgaris, C. epithymum's main host, proved to be the most limiting factor. These results emphasise the importance of site quality (i.e. successional phase of its host) on recruitment success of C. epithymum, which is directly affected by the management applied to the vegetation. Lack of any heathland management will thus seriously restrict establishment of the endangered parasite.

  7. Boundary Crossing during Pre-service Teacher Training: empowering or hampering professional growth?

    Science.gov (United States)

    Harrison, Christine

    2017-10-01

    Yuli Rahmawati's paper presents an auto-ethnographic inquiry into her lived experiences as a science teacher in different countries. Through her reflections and analysis of events, Yuli captures and builds a model of her identity and explores the influence of inter- and intra-cultural perspectives in shaping how she recognizes herself and brings meaning to her professional life. Yuli's insights and explanations of teaching within different cultural contexts highlight the importance of personally relevant and meaningful knowledge, where expectations and accepted norms, that might fit well within one community, may be seen quite differently in another. While for Yuli, this led to professional growth as she inquired and made sense of her new context, my concern is that the social and cultural change could, in some instances, lead to disengagement rather than professional growth. My concern is that the conflict that arises from boundary crossing may be experienced even stronger by inexperienced professionals, such as pre-service teachers. The learning trajectory of pre-service teachers is steep; they need to gain stronger knowledge of curriculum and pedagogy and an awareness of how their students learn. They also need to build confidence in their professional self and what they can do to support and trigger student learning. For this to happen, in the tight time frames available on teacher education courses, pre-service teachers need to understand and engage with the new community that they are placed in very quickly, to make sense of both their role and that of others within the community. This paper suggests that pre-service providers should carefully consider the learning opportunities offered by school contexts, that may vary dramatically from the social and cultural contexts experienced by their teachers as part of their own education, to prevent disengagement or misunderstanding hampering professional growth.

  8. 77 FR 8860 - Pesticide Emergency Exemptions; Agency Decisions and State and Federal Agency Crisis Declarations

    Science.gov (United States)

    2012-02-15

    ...; Agency Decisions and State and Federal Agency Crisis Declarations AGENCY: Environmental Protection Agency... agencies. The emergency exemptions may take the following form: Crisis, public health, quarantine, or.... These are rarely requested. 3. A ``crisis exemption'' is initiated by a State or Federal agency (and is...

  9. Integrating Public Relations and Legal Responses during a Crisis: The Case of Odwalla, Inc.

    Science.gov (United States)

    Martinelli, Kathleen A.; Briggs, William

    1998-01-01

    Examines the crisis-communication strategies employed by Odwalla, Inc. during its juice contamination crisis, a crisis whose impact on public health and safety gave it the potential for developing into an issue that required public policy relief. Finds that public-relations response strategies dominated legal response strategies, followed by mixed…

  10. Financial crisis and crisis management in Sweden: Lessons for today

    OpenAIRE

    Jonung, Lars

    2009-01-01

    This paper gives an account of the Swedish financial crisis covering the period 1985-2000, dealing with financial deregulation and the boom in the late 1980s, the bust and the financial crisis in the early 1990s, the recovery from the crisis and the bank resolution policy adopted during the crisis. The paper focuses on three issues: the causes and consequences of the financial crisis, the policy response concerning bank resolution, and the applicability of the Swedish model of bank crisis man...

  11. RESTRUCTURING COMPANIES UNDER CRISIS

    Directory of Open Access Journals (Sweden)

    Hezi Aviram SHAYB

    2016-12-01

    Full Text Available Nobody is planning to fail, but many companies are failing because of lack of planning. Real business experience showed during the years that crisis can be prevented, avoided or limited. If detected in time, the risks associated with the crisis can be mitigated and the effects can be diminished, with the condition that the actions required are done fast, in a sharp and accurate manner. When it comes, a crisis brings an intense level of pressure and under these conditions there is no time or room for mistakes. Delays, losing focus and lack of planning will bring a company one step away from failure. The right way to deal with crisis, if required measures are not done in time, is to minimize the losses and reposition in the best way possible. Analysing the success stories of some of the biggest and strongest companies in the world, led to an important conclusion: the majority of these companies were in the situation to face huge crises which threatened their ability to survive in certain moments, on their way to success. With the right planning and by setting a proper organisational structure, the negative aspects of the crisis can be turned into benefits and opportunities for the company. The most critical challenge for management is to assess the level of exposure to risk of the company and identify the key points to focus on in order to overcome the crisis and create value. In order to set up a strong plan in dealing with crisis, a business organisation needs reliable, efficient and effective tools and this is what this article is all about.

  12. Characteristics of Kentucky local health departments that influence public health communication during times of crisis: information dissemination associated with H1N1 novel influenza.

    Science.gov (United States)

    Howard, Alex F; Bush, Heather M; Shapiro, Robert M; Dearinger, Angela

    2012-01-01

    The purpose of this study was to investigate the association of selected characteristics of local health departments (LHDs) in Kentucky with the receipt of information by external stakeholders, specifically physicians and pharmacists, during the initial H1N1 outbreak of 2009. This study utilized a cross-sectional survey to gather characteristic information from local health departments. In addition, cross sectional surveys of physicians and pharmacists were used to determine information receipt. All 54 LHDs in Kentucky were surveyed; however, only those physicians belonging to the Kentucky Family Physician Association or the Kentucky Ambulatory Network were surveyed. Also, pharmacists included in this survey were members of the Kentucky Pharmacist Association. Descriptive data analyses, including chi-square test of independence, were conducted, and generalized estimating equations were used to calculate odds ratios to depict associations related to information exchange in this study. Response rates for the study were as follows: LHDs 65% (35/54), physicians 18.5% (96/518), and pharmacists 21.1% (211/1000). Of the 35 participating LHDs the most common characteristic identified was the presence of a public information officer (PIO) and a pandemic influenza plan, 76% and 64%, respectively. Despite these factors, 72% of external stakeholders did not receive any information regarding H1N1 from the LHD. Generalized estimating equations also indicated that stakeholders in jurisdictions lacking a PIO had 6 (95% confidence interval, 1.3-26.95) greater odds of not receiving information from the LHD. External stakeholders in jurisdictions without a pandemic influenza plan had 3.38 (95% confidence interval, 0.80-1.17) increased odds of not receiving information but this association was not statistically significant. Observations from this study indicate a need to improve information exchange between LHDs and their external stakeholders, specifically physicians and pharmacists

  13. Abordando la crisis de los Recursos Humanos para la Salud: ¿Hasta dónde hemos llegado? ¿Qué podemos esperar lograr al 2015? Addressing the Human Resources for Health crisis in countries: How far have we gone? What can we expect to achieve by 2015?

    Directory of Open Access Journals (Sweden)

    Manuel M. Dayrit

    2011-06-01

    Full Text Available El reporte mundial de la Salud del 2006 (World Health Report 2006 ha identificado 57 países en los que la densidad de trabajadores de salud con respecto a la población general se encuentra por debajo del umbral crítico de 2,3 por 1000 habitantes. Esto significa que por debajo de este umbral crítico, un país no sería capaz de brindar los servicios básicos para su población, definidos como el 80% de coberturas de inmunización y 80% de atención calificada del parto. De los 57 países, 36 pertenecen al África. Este artículo revisa el progreso realizado por los países para afrontar su crisis de recursos humanos en salud. Cita tres de los estudios mundiales más recientes y los indicadores utilizados para medir el progreso. Asimismo, se presenta la experiencia de ocho países: Malawi, Perú, Etiopía, Brasil, Tailandia, Zambia y Mali. Ello brinda un panorama diverso de esfuerzos, retos y éxitos en cada uno de estos países. El artículo lanza la interrogante sobre si la meta de una reducción del 25% en el número de países en crisis puede lograrse para el año 2015, objetivo definido por la Asamblea Mundial de la Salud en el 2008. El optimismo que los autores quisieran mantener sobre los esfuerzos orientados a esta meta, debe ir sin embargo a la par con un adecuado nivel de inversión de los países en recursos humanos en salud. Los siguientes cuatro años nos mostrarán cuánto en realidad puede ser logrado.The World Health Report 2006 identified 57 countries world-wide whose health worker to population density fell below a critical threshold of 2.3 per 1,000 population. This meant that below this critical threshold, a country could not provide the basic health services to its population, defined here as 80% immunization coverage and 80% skilled birth attendance at delivery. Of the 57 countries, 36 are located in Africa. This article reviews the progress countries have made in addressing their health workforce crisis. It cites 3 of

  14. Crisis exercises at AREVA

    International Nuclear Information System (INIS)

    Chanson, D.

    2016-01-01

    AREVA being an operator of nuclear facilities has to organize crisis exercises regularly. About 100 crisis exercises are performed each year in AREVA installations. These exercises allow the training of the staff, the assessing of material and humane means and the checking of the quality of the interfaces between all the participants (other AREVA teams or Nuclear Safety Authority or...). The management of nuclear crisis is based on anticipation and relies on 3 pillars: a referential gathering all the useful documents (emergency plans, procedures,...), the training and practice of AREVA staff in specific domains to cope with emergency situations, and various crisis exercises to keep fit all the teams. The basis emergency exercise lasts 2 hours and is organized into modules. First module: detecting abnormal conditions, alerting, rescuing and limiting the consequences; second module: launching the emergency plan; third module: understanding the situation and limiting the consequences; fourth module: communicating with other actors that intervene in a nuclear crisis (nuclear safety authority, state or local officials, the media...); and fifth module: anticipating the end of the emergency phase to prepare post-accidental management. (A.C.)

  15. Unpacking the Global Crisis

    DEFF Research Database (Denmark)

    Juego, Bonn; Schmidt, Johannes Dragsbæk

    The paper hopes to contribute to a reading of the political economy of the current global crisis with a focus on four interrelated themes. First, we discuss the constitutive role and functional character of crises in the evolution of neo-liberalism in particular and in capitalist reproduction...... opposing crisis responses—from multilaterals to regional organisations to global civil society—and realise that responses from either pro-neoliberal or anti-neoliberal forces are fundamentally the same through the years, simply re-articulating analyses and programmes that they have respectively...... pursued and advocated long before the global crisis. And fourth, in the context of East and Southeast Asia, we examine the tendencies of the global crisis vis-à-vis the strengthening and even acceleration of emergent authoritarian liberalism in the region despite and because of the global crisis....

  16. Public Health Surveillance via Template Management in Electronic Health Records: Tri-Service Workflow's Rapid Response to an Infectious Disease Crisis.

    Science.gov (United States)

    Berkley, Holly; Barnes, Matthew; Carnahan, David; Hayhurst, Janet; Bockhorst, Archie; Neville, James

    2017-03-01

    To describe the use of template-based screening for risk of infectious disease exposure of patients presenting to primary care medical facilities during the 2014 West African Ebola virus outbreak. The Military Health System implemented an Ebola risk-screening tool in primary care settings in order to create early notifications and early responses to potentially infected persons. Three time-sensitive, evidence-based screening questions were developed and posted to Tri-Service Workflow (TSWF) AHLTA templates in conjunction with appropriate training. Data were collected in January 2015, to assess the adoption of the TSWF-based Ebola risk-screening tool. Among encounters documented using TSWF templates, 41% of all encounters showed use of the TSWF-based Ebola risk-screening questions by the fourth day. The screening rate increased over the next 3 weeks, and reached a plateau at approximately 50%. This report demonstrates the MHS capability to deploy a standardized, globally applicable decision support aid that could be seen the same day by all primary care clinics across the military health direct care system, potentially improving rapid compliance with screening directives. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  17. Paying to see a bug on my food: how regulations and information can hamper radical innovations in the European Union

    NARCIS (Netherlands)

    Magistris, de T.; Pascucci, S.; Mitsopoulos, D.

    2015-01-01

    Purpose – The purpose of this paper is to examine the role of the European Novel Food Regulation (ENFR) on consumers’ acceptance of and willingness to pay (WTP) for radical food innovations. The research question is focussed on determining whether the ENFR is hampering the market potential of

  18. Dealing with emotions when the ability to cry is hampered: emotion processing and regulation in patients with primary Sjogren's syndrome

    NARCIS (Netherlands)

    Leeuwen, N. van; Bossema, E.R.; Middendorp, H. van; Kruize, A.A.; Bootsma, H.; Bijlsma, J.W.J.; Geenen, R.

    2012-01-01

    OBJECTIVES: The hampered ability to cry in patients with Sjogren's syndrome may affect their ways of dealing with emotions. The aim of this study was to examine differences in emotion processing and regulation between people with and without Sjogren's syndrome and correlations of emotion processing

  19. Crisis and emergency risk communication as an integrative model.

    Science.gov (United States)

    Reynolds, Barbara; W Seeger, Matthew

    2005-01-01

    This article describes a model of communication known as crisis and emergency risk communication (CERC). The model is outlined as a merger of many traditional notions of health and risk communication with work in crisis and disaster communication. The specific kinds of communication activities that should be called for at various stages of disaster or crisis development are outlined. Although crises are by definition uncertain, equivocal, and often chaotic situations, the CERC model is presented as a tool health communicators can use to help manage these complex events.

  20. Re-Envisioning Crisis

    DEFF Research Database (Denmark)

    Snaith, Holly; Rosamond, Ben

    2015-01-01

    of EU integration – namely the 1970s oil shocks and the more recent global financial crisis – in order to determine the extent to which these events have been contemporarily defined as providing opportunities to act, or simply challenges to the existing order. The paper provides an analysis of the way...... in which EU actors have mobilised the idea of ‘crisis’ in order to (a) exert control over endogenous and exogenous destabilising forces, (b) (re)define the EU as an object of both political engagement and academic study, and finally (c) make the case for further expansion and integration (particularly....... The comparative nature of the findings helps to contextualise current discourses around the global financial crisis, in order to evaluate the EU’s previous efforts at global repositioning, and the significance of crisis discourse to these efforts....

  1. Crisis and Regional Integration

    DEFF Research Database (Denmark)

    Dosenrode, Søren

    , Tunisia, Egypt …. ), where the crisis referred to could be humanitarian, environmental, economic, political … Europe, too, has also according to mass media, been a victim of a crisis, the financial one. Could ‘crisis’ be a beginning of enhanced regional integration? This paper will try to look...... at the processes of regional integration in relation to ‘crisis’ in Africa and Europe. First, this paper will look at the concept of ‘crisis’, before it moves on to discuss ‘regional integration’ and the correlation between the two, emphasizing the approaches of neo-functionalism and federal theory....... This is the basis for two short case studies of African and European regional integration. The paper tentative answers to the question: will the crisis in Africa and Europe respectively further or block regional integration? With a ‘that depends’. But the use of Federalism theory and neo-functionalism is seen...

  2. Was the 2007 crisis really a global banking crisis?

    NARCIS (Netherlands)

    Shehzad, Choudhry Tanveer; De Haan, Jakob

    We argue that the 2007 crisis was not a global banking crisis. Stock prices of banks in emerging countries faced a temporary shock but quickly recovered, while stock prices of banks located in industrial countries remained much lower than before the 2007 crisis. Our results also suggest that stock

  3. The Euro crisis. Causes and Symptoms

    Directory of Open Access Journals (Sweden)

    Christoph S. Weber

    2015-06-01

    Full Text Available The Euro crisis is mainly a consequence of the international financial crisis of 2008. Thereby, the term Euro crisis is misleading as there is no currency crisis. First, the article shows some of the birth defects of the Euro. Second, it shows that the increase in public debt was caused by rescue measures for banks and anti-cyclical fiscal policy. Third, we argue that the Euro crisis is not just one crisis (a sovereign debt crisis but it is a combination of several macroeconomic crises including a growth crisis, a labour market crisis, a public debt crisis, and a current account crisis.

  4. Communication in the state of crisis

    OpenAIRE

    Senić Vladimir; Senić Radoslav

    2015-01-01

    Due to diversity of research related to crisis it is rather important to present definitions of various key terms related to crisis, crisis management and crisis communication, in order to establish tangible boundaries among them. Those three are mutually intertwined and should be considered starting from the first symptoms of crisis to crisis management and finally crisis communication. In the state of crisis, conventional management practice is often not adequate, while types of reaction ar...

  5. Crisis of Transient Chaos

    Institute of Scientific and Technical Information of China (English)

    王文秀; 陆云清; 陈贺胜; 马明全; 竹有章; 何大韧

    2002-01-01

    A new kind of crisis, which is marked by a sudden change of a strange repeller, is observed in an electronicrelaxation oscillator. Firstly, by its simplified piecewise linear model, we show analytically that a strange repellerappears after a hole-induced crisis, and that the fractal dimension of the strange repeller and the average lifetimeof the iterations in the region occupied by the original attractor suddenly change at the critical parameter valuewhen the repeller disappears. Our numerical investigation convinces us that the corresponding phenomenon canbe found in the original electronic relaxation oscillator.

  6. Crisis, What Crisis? The Media: Business and Journalism in Times of Crisis

    Directory of Open Access Journals (Sweden)

    Rosario de Mateo

    2010-08-01

    Full Text Available The global financial and economic crisis is often used to justify a crisis of media and journalism: lower advertising, collapses in the share price, falls in consumption, more unemployment. But is this just a business crisis, or is it also a crisis in journalism and its role in democratic societies? In this case, is the journalism crisis attributable to the economic crisis or, rather, was it forged during the years of high profitability and high salaries in the mass media? These two sides of the crisis, in media industry and in journalism, are addressed in this article, which explores the evolution of mainly Spanish media in the years before the crisis. However, in order to understand how they reached the current situation, political and economic transformations in what has been called the Information Society and neoliberal globalization must be addressed.

  7. The Phony Funding Crisis

    Science.gov (United States)

    Guthrie, James W.; Peng, Arthur

    2010-01-01

    If one relies on newspaper headlines for education funding information, one might conclude that America's schools suffer from a perpetual fiscal crisis, every year perched precariously on the brink of financial ruin, never knowing whether there will be sufficient funding to continue operating. Budgetary shortfalls, school district bankruptcies,…

  8. Refugee Crisis in Hungary

    DEFF Research Database (Denmark)

    Stoklosa, Katarzyna

    2018-01-01

    Hungary faced a barrage of criticism from various quarters for its lack of support during the 2015/16 refugee crisis. People wondered what had happened to the liberal country that was the first among the Eastern Bloc countries to open its borders to the West, and which had actively assisted GDR...

  9. Managing a Crisis

    Science.gov (United States)

    Pierce, Dennis

    2016-01-01

    Planning ahead, practicing your response for various scenarios, being open and honest, showing empathy and respect for other peoples' perspectives and assuring stakeholders that you have the situation covered are the foundations of communicating successfully during a crisis, experts say. This article provides strategies for Community College…

  10. Crisis Counseling: An Overview

    Science.gov (United States)

    Sandoval, Jonathan; Scott, Amy Nicole; Padilla, Irene

    2009-01-01

    Psychologists working in schools are often the first contacts for children experiencing a potentially traumatizing event or change in status. This article reviews basic concepts in crisis counseling and describes the components of psychological first aid. This form of counseling must be developmentally and culturally appropriate as well as…

  11. Democracy in Crisis?

    Science.gov (United States)

    O'Neill, Brenda

    2006-01-01

    This article discusses the state of Canadian democracy. Although calling Canadian democracy as something to be in a crisis is still debatable, the author expresses worry over the declining turnout levels in recent elections. Canada--along with a number of other liberal democracies--has experienced a significant and consistent decline in election…

  12. Fighting the Financial Crisis

    DEFF Research Database (Denmark)

    Hull Kristensen, Peer

    2015-01-01

    This paper is concerned to show how the Danish political elite interpreted and responded to the consequences of the 2008 financial crisis for the Danish economy. In particular, the paper describes how this interpretive construction focused primarily on three features of the Danish context to the ...

  13. Illiquidity and financial crisis

    NARCIS (Netherlands)

    A.M. Pacces (Alessio)

    2013-01-01

    textabstractThis article analyzes the determinants of liquidity crises based on the dynamics of banking and finance under Knightian uncertainty. In this perspective, the facts of the global financial crisis seem to confirm Minsky's hypothesis of endogenous financial instability derived from Keynes's

  14. Crisis and Environmental Philosophy

    Directory of Open Access Journals (Sweden)

    Peter Wolsing

    2014-06-01

    Full Text Available Environmental ethics began in the 1960s with a growing awareness of coming environmental problems such as pollution and the projected shortage of resources caused by an acceleration in human’s technically based exploitation of nature. In addition to becoming an issue in public debate and in politics since the 1970s, the environmental crisis, which can be laid at the door of industrialization, calls for a more basic consideration of man’s attitude to nature. In this paper I give a short presentation of the concept of crisis in a selection of the principal classical critical philosophies of history and suggest that they all connect crisis to the oppression of man’s inner nature. I go on to sketch the idea of environmental crisis as an oppression of outer nature (the natural environment suggesting that a new, more nuanced organic concept of nature is needed as a condition for ascribing value to life on earth as a whole, which is what most non-anthropocentric ethical theories to some extent do.

  15. China's water crisis

    International Nuclear Information System (INIS)

    Van Dijk, B.

    2008-01-01

    After the devastating natural disasters that have hit China recently, another crisis is looming, Drought, pollution and heavy usage in the fast-developing megacities have resulted in a shortage of water. A huge construction effort is underway to divert water from the south to the north. But experts warn that it will not solve China's structural water problems

  16. Las crisis familiares

    Directory of Open Access Journals (Sweden)

    Idarmis González Benítez

    2000-06-01

    Full Text Available Con este trabajo nos propusimos actualizar el tema de las crisis familiares. Se pone de manifiesto que tanto los eventos propios del desarrollo, como los accidentales, dan lugar a la aparición de crisis en la familia. Queda esclarecido, que no necesariamente han de tener implicaciones negativas para la familia. Se hace énfasis en la valoración del evento por la familia y su significación. Se destaca el papel de los recursos familiares como protectores y moduladores de las crisis. Por último se señalan algunos pasos a seguir en la intervención familiarWith this paper we intend to update the topic of the family crises. It is shown that the own events of development as well as the accidental ones bring about the appearance of crises in the family. It is made clear that they not always have negative implications for the family. Emphasis is made on the assessment of the event for the family and its significance. The role played by the family resources as protective and modulators of the crisis is stressed. Finally, some of the steps to be taken in family intervention are mentioned

  17. Utilization of medical care following the Three Mile Island crisis.

    Science.gov (United States)

    Houts, P S; Hu, T W; Henderson, R A; Cleary, P D; Tokuhata, G

    1984-02-01

    Four studies are reported on how utilization of primary health care was affected by the Three Mile Island (TMI) crisis and subsequent distress experienced by persons living in the vicinity of the plant. The studies concerned: 1) Blue Cross-Blue Shield records of claims by primary care physicians in the vicinity of TMI; 2) utilization rates in a family practice located near the facility; 3) interviews with persons living within five miles of TMI following the crisis; and 4) responses to a questionnaire by primary care physicians practicing within 25 miles of TMI. All four studies indicated only slight increases in utilization rates during the year following the crisis. One study found that persons who were upset during the crisis tended to be high practice utilizers both before and after the crisis. These results suggest that, while patterns of physician utilization prior to the TMI crisis predicted emotional response during the crisis, the impact of the TMI crisis on subsequent physician utilization was small.

  18. Utilization of medical care following the Three Mile Island crisis

    International Nuclear Information System (INIS)

    Houts, P.S.; Hu, T.W.; Henderson, R.A.; Cleary, P.D.; Tokuhata, G.

    1984-01-01

    Four studies are reported on how utilization of primary health care was affected by the Three Mile Island (TMI) crisis and subsequent distress experienced by persons living in the vicinity of the plant. The studies concerned: 1) Blue Cross-Blue Shield records of claims by primary care physicians in the vicinity of TMI; 2) utilization rates in a family practice located near the facility; 3) interviews with persons living within five miles of TMI following the crisis; and 4) responses to a questionnaire by primary care physicians practicing within 25 miles of TMI. All four studies indicated only slight increases in utilization rates during the year following the crisis. One study found that persons who were upset during the crisis tended to be high practice utilizers both before and after the crisis. These results suggest that, while patterns of physician utilization prior to the TMI crisis predicted emotional response during the crisis, the impact of the TMI crisis on subsequent physician utilization was small

  19. Insights into the Ukrainian Crisis

    Directory of Open Access Journals (Sweden)

    Costel Daniel Arfire

    2014-05-01

    Full Text Available Political crises are increasingly frequent and devastating not only for the population of a state, but also for the international diplomacy. Such an example is the ongoing Ukrainian crisis. Starting from S. Fink‘s life cycle of a crisis and T.W. Coombs‘s crisis response strategies, I will analyse the evolution of the Ukrainian crisis and the crisis response strategies of three major international actors: Vladimir Putin, Barack Obama and Angela Merkel. The findings of my study will prove that the denial strategy prevails in Putin‘s statement, whereas Obama uses the diminish strategy and Merkel focuses on the bolstering strategy.

  20. Crisis on campus: Eating disorder intervention from a developmental-ecological perspective.

    Science.gov (United States)

    Taylor, Julia V; Gibson, Donna M

    2016-01-01

    The purpose of this article is to review a crisis intervention using the developmental-ecological protocol (Collins and Collins, 2005) with a college student presenting with symptomatology of an active eating disorder. Participants included University Wellness Center employees responding to the crisis. Methods include an informal review of the crisis intervention response and application of the ABCDE developmental-ecological crisis model. Results reported include insight into crisis intervention when university counseling and health center is not available as resources. ABCDE Developmental-ecological model recommendations for university faculty and staff are included.

  1. Application of the cognitive therapy model to initial crisis assessment.

    Science.gov (United States)

    Calvert, Patricia; Palmer, Christine

    2003-03-01

    This article provides a background to the development of cognitive therapy and cognitive therapeutic skills with a specific focus on the treatment of a depressive episode. It discusses the utility of cognitive therapeutic strategies to the model of crisis theory and initial crisis assessment currently used by the Community Assessment & Treatment Team of Waitemata District Health Board on the North Shore of Auckland, New Zealand. A brief background to cognitive therapy is provided, followed by a comprehensive example of the use of the Socratic questioning method in guiding collaborative assessment and treatment of suicidality by nurses during the initial crisis assessment.

  2. Presentation of the CEA's crisis national organization: coordination centre in case of crisis, crisis technical teams, intervention means, and so on; Presentation de l'organisation nationale de crise du CEA: centre de coordination en cas de crise, equipes techniques de crise, moyens d'intervention...

    Energy Technology Data Exchange (ETDEWEB)

    Pectorin, X. [CEA Fontenay-aux-Roses, MR/DCS/DIR, 92 (France)

    2010-07-01

    After having briefly recalled the existence of a legal framework for crisis management organisation, this report briefly describes how the CEA plans the crisis management. This management is based on the definition of critical scenarios, on the building up of a crisis management team, and on the elaboration of crisis management operational documents. It evokes the alert organisation and the triggering of crisis management. Then, it describes the CEA's national crisis organisation with its main crisis management structures, the role and the operation of the Crisis Coordination Centre (CCC, the decision body), the role and operation of the Central Crisis Technical Teams (ETC-C, Equipes Techniques de Crise Centrales), the role of field interveners (various rescue, protection, health care and technical teams) and of other additional intervention actors. It evokes the objectives of the various exercises which are organised every year at the internal, national or international level

  3. The correlation between stress and economic crisis: a systematic review

    Directory of Open Access Journals (Sweden)

    Mucci N

    2016-04-01

    Full Text Available Nicola Mucci,1 Gabriele Giorgi,2 Mattia Roncaioli,3 Javier Fiz Perez,2 Giulio Arcangeli11Department of Experimental and Clinical Medicine, University of Florence, Florence, 2Department of Psychology, European University of Rome, Rome, 3Department of Biomedical Sciences for Health, University of Milan, Milan, ItalyAbstract: In 2008 a deep economic crisis started in the US and rapidly spread around the world. The crisis severely affected the labor market and employees’ well-being. Hence, the aim of this work is to implement a systematic review of the principal studies that analyze the impact of the economic crisis on the health of workers. We conducted our search on the PubMed database, and a total of 19 articles were selected for review. All studies showed that the economic crisis was an important stressor that had a negative impact on workers’ mental health. Most of the studies documented that a rise in unemployment, increased workload, staff reduction, and wages reduction were linked to an increased rate of mood disorders, anxiety, depression, dysthymia, and suicide. Some studies showed that problems related to the crisis may have also affected the general health of workers by increasing the risk of such health problems as cardiovascular and respiratory diseases. Finally, some studies looked at the impact of the crisis on health care services. These studies demonstrated that the reduction in public expenditure on health care services, and the reduction of public hospital budgets due to the recession, led to organizational problems (eg, medical supply shortages.Keywords: economic crisis, recession, work-related stress, mental health, risks assessment, occupational medicine

  4. Consequences of the crisis: New concepts

    OpenAIRE

    Andrei Marga

    2010-01-01

    The crisis that started in 2008 began with the malfunctioning of the financial mechanisms, i.e. as a financial crisis; it quickly became an economic crisis and is now threatening to become an energetic crisis and, lately, a crisis of agricultural products, announcing at the same time the crisis of a development model and an ontological crisis. It engages the questioning of certain conceptualizations and orientations. If one wonders about the new concepts employed by the foreseen “ontological ...

  5. Crisis Communication and Social

    DEFF Research Database (Denmark)

    Tække, Jesper

    2017-01-01

    The academic field of crisis communication is more relevant than ever due to the digital media revolution, setting new standards for how to manage criticism and crises. This paper presents a systems theoretical approach to crisis communication in the age of digital media with a special regard...... to social media. The paper shows that the recent changes in the media environment require that organizations be more observant, reflected and responsive to the public opinion. Correspondingly, organizations need to engage in strategic impression management with the aim to be, or to be observed to be, more...... consistent with their communicated values and strategies, thus managing to appear as trustworthy in a hyper-dynamic social surrounding world. Copyright © 2017 John Wiley & Sons, Ltd....

  6. Disaster in Crisis

    DEFF Research Database (Denmark)

    Illner, Peer

    initiatives and bottom-up organising as the preferred method to combat disaster. Once construed as strictly a responsibility of the state, the mitigation and management of disasters has shifted since the 1970s into a matter for civil society: a shift which has been heralded as progressive, democratic...... the banner of disaster. Focussing on the modifications to disaster management in the United States between 1970 and 2012, I show how the inclusion of civil society in the provision of aid services was accompanied by a structural withdrawal of the state from disaster relief and other welfare services. I...... contextualise this withdrawal in the US government’s general turn to austerity in response to the economic crisis of the 1970s. My account couples the notion of disaster with that of economic crisis on the one hand and structural violence on the other to examine disasters as a specific problem for social...

  7. Spirituality, Crisis, and Illusions

    Directory of Open Access Journals (Sweden)

    LOSONCZ, Alpar

    2016-03-01

    Full Text Available This article deals with the structural interpretations of the ongoing crisis. The author considers the approaches of Joseph Alois Schumpeter and Tibor Scitovsky that thematize the long-run destiny of capitalism. The viewpoint is constituted as the relation between the structural socio-economic tendencies and existential constellations. What is addressed by the crisis is capitalism as a dependent system. The author emphasizes that capitalism cannot survive without the outside sphere, reciprocal interactions, economics of community, eco-system and complex eco-social moments. This can be applied to the frequently mentioned embeddedness which is related to Polanyi and other researchers who are influenced by Polanyi’s concepts. Embeddedness can be analyzed through the holon, from the inside perspective. Only comprehensive perspective enables to see the entire horizon, since capitalism cannot summarize the eco-system, not even with the most sophisticated techniques that recognize monetary expressions.

  8. Racism, crisis, Brexit

    OpenAIRE

    Virdee, S.; McGeever, Brendan Francis

    2017-01-01

    This article offers a conjunctural analysis of the financial and political crisis within which Brexit occurred with a specific attentiveness to race and racism. Brexit and its aftermath have been overdetermined by racism, including racist violence. We suggest that the Leave campaign secured its victory by bringing together two contradictory but inter-locking visions. The first comprises an imperial longing to restore Britain’s place in the world as primus inter pares that occludes any coming ...

  9. The US Financial Crisis

    DEFF Research Database (Denmark)

    Campbell, John L.

    2011-01-01

    Many comparative political economists hold that market performance depends on the presence of institutional complementarities. Some argue that when institutions reinforce similar incentives markets work best. Others disagree and argue that for markets to function well institutions must compensate...... for each other's shortcomings rather than reinforce each other's incentives. This paper uses evidence from the US financial crisis of 2008 to adjudicate this debate. It argues that different types of institutional complementarities are necessary in combination to ensure market stability and successful...

  10. Nuclear crisis management

    International Nuclear Information System (INIS)

    Hamburg, D.A.; George, A.L.

    1984-01-01

    Renewed interest in crisis management is caused by a growing recognition that a failure of communication between the superpowers in the face of a crisis provoked by some third party could issue in a nuclear war, other causes of this renewed interest are the fear of miscalculation and runaway escalation if the US and Soviet Union are drawn into a regional war in which each had vital interests and a concern that a missile might be fired on either side by accident or without proper authorization despite precautions. The authors, stating that crisis prevention should be viewed as an objective, not as a strategy, support the establishment of a joint US-Soviet nuclear risk control center designed to carry out four functions: (1) to facilitate communications between the two countries, (2) to avert nuclear confrontations during periods of accelerating tension, (3) to serve as an exchange of confidence building information during normal periods, and (4) to serve as a joint management center to plan for responses to terrorist or other third party group

  11. Leadership in Crisis Situations

    Directory of Open Access Journals (Sweden)

    Cameron R. Hume

    1997-12-01

    Full Text Available ¿Qué hay que hacer para prevenir el estallido o la continuación de un conflicto interno que tenga consecuencias internacionales? ¿Qué circunstancias podrían generar una acción unilateral por parte de los Estados Unidos, Francia o el Reino Unido para crear coalicionesque dieran una respuesta internacional a estas situaciones de crisis? Para acercarse a las respuestas de estas preguntas, Hume examina la actual y sobrecargada agenda del Consejo de Seguridad de las Naciones Unidas y las actitudes ante situaciones de crisis. El autor revisa tres de las fuentes de liderazgo nacional –voluntad, capacidad y visión– y las relaciona con la problemática internacional y las experiencias de las Naciones Unidas en Somalia y Rwanda y de UNPROFOR en Bosnia. A partir de su análisis, Hume argumenta que, a la hora de afrontar situaciones de crisis, la autoridad para usar la fuerza no debiera divorciarse de los intereses nacionales de los Estados participantes en una misión de las Naciones Unidas, aunque, en una fase posterior, otros actores debieran participar para identificar vías de diálogo, preservar las normas internacionales y hallar soluciones a los conflictos internos.

  12. Iran, the crisis situation

    International Nuclear Information System (INIS)

    Gere, Francois

    2010-01-01

    This book is an updated edition of a previous book by the same author: 'Iran and the nuclear: the Persian torments'. The author addresses the Iranian nuclear crisis within an historic perspective, and states that this crisis has its roots in the recent Iranian history, but has deeper origins before the Islamic Revolution of 1979. In a first part, he draws a portrait of Iran by opposing current myths and realities like Persia and an actual ethnic diversity, an oil-based wealth in a context of under-development, tyranny and an actual political complexity. He also analyses the Iranian geo-strategy and its recent evolutions, the relationships and attitudes towards the three Satans (USA, France and Israel), and describes the main evolutions of the Iranian defence, notably after 9/11. The second part describes the long evolution of the Iranian nuclear programme, from its beginning at the time of the Shah, until now (projects, programmes and realities of the Iranian electronuclear industry), and recalls the different steps of the nuclear crisis between 2002 and 2006. The third part is a prospective one. The author discusses several aspects of the conflict (power balance, rumours and threats, sanctions and military scenarios, Iranian retaliation capacities) and discusses what a nuclear Iran would be (its capacities, its objectives, geo-strategic consequences of a nuclear Iran, and remaining opportunities for negotiations)

  13. Global financial crisis

    Directory of Open Access Journals (Sweden)

    MSc. Jusuf Qarkaxhija

    2011-03-01

    Full Text Available The most recent developments in economy are a clear indicator of many changes, which are a result of this high rate pacing, which also demonstrates as such. Market economy processes occur as a result of intertwining of many potential technological and human factors, thereby creating a system of numerous diver-gences and turbulences. Economics, a social science, is characteri-sed with movements from a system to another system, and is har-monized with elements or components which have impacted the development and application of economic policies as a result. This example can be illustrated with the passing from a commanded system (centralized to a self-governing (decentrali-zed system, while the movement from a system to another is known as transi-tion. Such transition in its own nature bears a number of problems of almost any kind (political, economic, social, etc., and is charac-terised with differences from a country to another. Financial crisis is a phenomenon consisting of a perception of economic policies and creation of an economic and financial stabi-lity in regional and global structures. From this, one may assume that each system has its own changes in its nature, and as a result of these changes, we have the crisis of such a system. Even in the economic field, if we look closely, we have such a problem, where development trends both in human and technological fields have created a large gap between older times and today, thereby crea-ting dynamics with a high intensity of action. If we dwell on the problem, and enter into the financial world, we can see that the so-called industrialized countries have made giant leaps in deve-lopment, while countries in transition have stalled in many fields, as a result of a high rate of corruption and unemployment in these countries, and obviously these indicators are directly connected, thereby stroking the financial system in these countries. Corruption is an element, which directly and indirectly

  14. Chapter 7: The media and crisis management

    International Nuclear Information System (INIS)

    Otway, H.

    1991-01-01

    Upon becoming aware that an accident such as in Chernobyl had occurred, governments were confronted with the necessity of managing an emergency whose dimensions were yet unknown, and of meeting public demands for information about it. In seven European countries it was investigated how the media communicated information dealing with nuclear technology and with the effects of radiation on public health. Common problems were identified and ways were suggested in which communications and crisis management might be improved. (DG)

  15. Is endemic political corruption hampering provision of ART and PMTCT in developing countries?

    Science.gov (United States)

    Young Nicola Man, Wing; Worth, Heather; Kelly, Angela; Wilson, David P; Siba, Peter

    2014-01-01

    Leadership is a key factor in the success of HIV prevention and treatment. Positive HIV-related outcomes are also affected by funding levels for HIV, health sector resources, disease burden and the socio-economic environment. Leadership on HIV as well as these other factors are affected by the quality of political governance of the country, which may be an overarching factor that influences the making of effective responses to the HIV epidemic. The aim of the study was to investigate the association between quality of political governance, on one hand, and coverage of antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT), on the other, in low- to middle-income countries. This investigation was carried out through a global review, online data sourcing and statistical analyses. We collected data on health burden and resources, the socio-economic environment, HIV prevalence, ART and PMTCT coverage and indicators of political governance. Outcome variables were coverage of ART (from 2004) and PMTCT (from 2007) to 2009 as a percentage of persons needing it. Potential predictors of treatment coverage were fitted with a baseline multilevel model for univariable and multivariable analyses. Countries with higher levels of political voice and accountability, more political stability and better control of corruption have higher levels of ART coverage but not PMTCT coverage. Control of corruption (in standard deviation units) had a strong association with ART (AOR=1.82, p=0.002) and PMTCT (AOR=1.97, p=0.01) coverage. Indicators of economic development were not significant when control of corruption was included in the multivariable regression model. Many countries in all income groups had high ART but not PMTCT coverage (e.g. Mexico, Brazil and Romania in the upper-middle-income group; Papua New Guinea and Philippines in the lower-middle-income group; and Cambodia, Laos and Comoros in the low-income group). Very few low-income countries (notably

  16. Is endemic political corruption hampering provision of ART and PMTCT in developing countries?

    Science.gov (United States)

    Man, Wing Young Nicola; Worth, Heather; Kelly, Angela; Wilson, David P; Siba, Peter

    2014-01-01

    Introduction Leadership is a key factor in the success of HIV prevention and treatment. Positive HIV-related outcomes are also affected by funding levels for HIV, health sector resources, disease burden and the socio-economic environment. Leadership on HIV as well as these other factors are affected by the quality of political governance of the country, which may be an overarching factor that influences the making of effective responses to the HIV epidemic. Aim The aim of the study was to investigate the association between quality of political governance, on one hand, and coverage of antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT), on the other, in low- to middle-income countries. Methods This investigation was carried out through a global review, online data sourcing and statistical analyses. We collected data on health burden and resources, the socio-economic environment, HIV prevalence, ART and PMTCT coverage and indicators of political governance. Outcome variables were coverage of ART (from 2004) and PMTCT (from 2007) to 2009 as a percentage of persons needing it. Potential predictors of treatment coverage were fitted with a baseline multilevel model for univariable and multivariable analyses. Results Countries with higher levels of political voice and accountability, more political stability and better control of corruption have higher levels of ART coverage but not PMTCT coverage. Control of corruption (in standard deviation units) had a strong association with ART (AOR=1.82, p=0.002) and PMTCT (AOR=1.97, p=0.01) coverage. Indicators of economic development were not significant when control of corruption was included in the multivariable regression model. Many countries in all income groups had high ART but not PMTCT coverage (e.g. Mexico, Brazil and Romania in the upper-middle-income group; Papua New Guinea and Philippines in the lower-middle-income group; and Cambodia, Laos and Comoros in the low-income group). Very few

  17. Ebola Crisis in the United States

    Directory of Open Access Journals (Sweden)

    Avinash Raghunath Patwardhan M.D.

    2014-12-01

    Full Text Available This article is about readiness of the U.S. health care system to deal with crises. Using the Ebola crisis as a reference, first it examines the response to the current challenge. However, that is the smaller objective of the article. Lately, we are also being challenged to deal with other kinds of epidemics like obesity, mental health diseases, and violence. These crises are not dramatic like the Ebola crisis. However, these are no less insidious than Ebola. If we are not ready for them, then these crises have the potential to undermine the long-term health and prosperity of our society. In this context, and therefore mainly, this article is about two major long-standing systemic problems in the U.S. health care system that the unfolding of the Ebola crisis has bared. One is about how the inherent problem in the design of American federalist system regarding state autonomy on health matters is creating a dysfunctional health care system. The other is about the inertia of the research industry in the health care system in clinging to an archaic outdated inefficient mind-set and methodology that fails to generate the right information required for an appropriate decision making in matters of health care delivery, including crises. These problems are not small, nor their solutions easy. However, no matter how uncomfortable and tedious, facing them is necessary and inevitable. The discussions and arguments in this article are to outline their nature broadly and to make a call to further a dialogue.

  18. Central Banking after the Crisis

    OpenAIRE

    Frederick S. Mishkin

    2013-01-01

    This paper explores where central banking is heading after the recent financial crisis. First it discusses the central bank consensus before the crisis and then outlines the key facts learned from the crisis that require changes in the way central banks conduct their business. Finally, it discusses four main areas in which central banks are altering their policy frameworks: 1) the interaction between monetary and financial stability policies, 2) nonconventional monetary policy, 3) risk manage...

  19. Marketing in current financial crisis

    OpenAIRE

    Mariánek, Lukáš

    2009-01-01

    The paper is describing the effects of recessions and current financial crisis on companies and their marketing. The topic covers the history of marketing throughout the world biggest recessions and describes the current marketing efforts of Czech companies under the current financial crisis. A strategical analysis with the impacts of crisis on long-term strategy planning is provided at the end of the paper.

  20. Trust During an Energy Crisis

    OpenAIRE

    Smith, Eric R.A.N.; Carlisle, Juliet; Michaud, Kristy

    2003-01-01

    In every energy crisis the U.S. has faced—beginning with the first crisis in 1973—we have seen a common sequence of events, which has been labelled the “energy crisis cycle” (Smith 2002). The steps in the cycle are: (1) When the demand for energy exceeded the supply, energy prices rose sharply — starting the energy crisis cycle. (2) Along with increases in energy prices came large increases in the profits of energy producers. (3) Politicians and interest group advocates criticized the energy...

  1. Crisis, routine, consolidation: the politics of the Mediterranean migration crisis

    NARCIS (Netherlands)

    Jeandesboz, J.; Pallister-Wilkins, P.

    2016-01-01

    The current ‘migration crisis’ is framed as a moment of reckoning in the EU’s dealings with its Mediterranean neighbourhood. Yet to what extent is crisis the most useful tool to account for migration and European border control practices in the current context? An exclusive focus on crisis, we

  2. Complex traffic flow that allows as well as hampers lane-changing intrinsically contains social-dilemma structures

    Science.gov (United States)

    Iwamura, Yoshiro; Tanimoto, Jun

    2018-02-01

    To investigate an interesting question as to whether or not social dilemma structures can be found in a realistic traffic flow reproduced by a model, we built a new microscopic model in which an intentional driver may try lane-changing to go in front of other vehicles and may hamper others’ lane-changes. Our model consists of twofold parts; cellular automaton emulating a real traffic flow and evolutionary game theory to implement a driver’s decision making-process. Numerical results reveal that a social dilemma like the multi-player chicken game or prisoner’s dilemma game emerges depending on the traffic phase. This finding implies that a social dilemma, which has been investigated by applied mathematics so far, hides behind a traffic flow, which has been explored by fluid dynamics. Highlight - Complex system of traffic flow with consideration of driver’s decision making process is concerned. - A new model dovetailing cellular automaton with game theory is established. - Statistical result from numerical simulations reveals a social dilemma structure underlying traffic flow. - The social dilemma is triggered by a driver’s egocentric actions of lane-changing and hampering other’s lane-change.

  3. Framing the Newspaper Crisis

    DEFF Research Database (Denmark)

    Bruggemann, Michael; Humprecht, Edda; Kleis, Rasmus

    2016-01-01

    as well as a qualitative analysis of policy documents and relevant media coverage. The study demonstrates that debates on the newspaper crisis are only partly influenced by (1) economic realities and (2) media policy traditions in the six countries but also reflect (3) the strategic motives of powerful...... the problem mainly by developing innovative content and business strategies. This liberal market paradigm displays one blind spot however: it does not seriously consider a scenario where the market is failing to provide sustainable journalistic quality....

  4. Flexicurity, the Crisis & Young

    DEFF Research Database (Denmark)

    Smith, Mark; Leschke, Janine; Villa, Paola

    ‘Flexicurity’ is a controversial concept but at the core is the delicate balancing act between matching labourmarket security and flexibility. Labour market flexibility is usually captured by contractual flexibility but canalso relate to internal flexibility through adaptation of working time. On...... of “flexicurity” policies on young people’s objective andsubjective insecurity and their well-being. Finally, we explored developments in employment policy makingbefore, during and after the crisis with a particular focus on ‘flexicurity’ and youth....

  5. Crisis Management for Biobanks.

    Science.gov (United States)

    Parry-Jones, Alison; Hansen, Jarle; Simeon-Dubach, Daniel; Bjugn, Roger

    2017-06-01

    All organizations are subject to risk and uncertainty. Adverse events may disrupt normal organizational activity and may even cause complete failure of business operations. Biorepositories are also at risk and there have been instances where multiple samples or entire collections have been destroyed. Biobank guidelines accordingly recommend the establishment of contingency plans to reduce risk to an acceptable level. In this review article, we will use general theory on risk management and illustrate how such principles can be used to establish a practical crisis management plan for any biobank organization.

  6. Bargaining in the crisis

    DEFF Research Database (Denmark)

    Ibsen, Christian Lyhne; Andersen, Søren Kaj; Due, Jesper Jørgen

    2011-01-01

    differences in bargaining structures, processes and output. On the whole, the crisis seems to have had little effect on the Danish bargaining system due to a strong centralization on the employer side through the Confederation of Danish Industries, union moderation and the coordination of bargaining areas...... by Denmark’s mediation institution. Conversely, the bargaining round in Sweden puts a question-mark over the viability of the whole Swedish bargaining system. Union coordination was shattered when the white-collar unions broke ranks and concluded agreements before the LO unions. But more importantly...

  7. Challenge - oil crisis

    International Nuclear Information System (INIS)

    Vogler, O.

    1981-01-01

    After a short survey on recent developments of energy supply the risks of future energy supply and its effects are discussed. The parameters of dependence on oil-producing countries are studied and an evaluation is given on the measures which have to be taken by the Western industrialized countries in response to the dependence on oil. Further subjects are: mechanism of oil distribution in case of crisis, long-term cooperation of producer countries, measures on international level in the USA and Japan, and the energy-importing countries in the conflict area between OPEC- and industrialized countries. (UA) [de

  8. [Crisis in medical ethics].

    Science.gov (United States)

    Stellamor, K

    1996-01-01

    There is a disproportion between diagnostic and therapeutic medical achievements and the doctor/patient relationship. Are we allowed to do everything we are able to do in medicine? People are concerned and worried (genetic technology, invasive medicine, embryos in test tubes etc.). The crisis of ethics in medicine is evident. The analysis of the situation shows one of the causes in the shift of the paradigma-modern times to postmodern following scientific positivism-but also a loss of ethics in medicine due to an extreme secularism and to modern philosophical trends (Hans Jonas and the responsibility for the future and on the other hand modern utilitarism).

  9. Culture and crisis communication transboundary cases from nonwestern perspectives

    CERN Document Server

    George, Amiso M

    2017-01-01

    Culture and Crisis Communication presents an examination of how politics, culture, religion, and other social issues affect crisis communication and management in nonwestern countries. From intense human tragedy to the follies of the rich, the chapters examine how companies, organizations, news outlets, health organizations, technical experts, politicians, and local communities communicate in crisis situations. Taking a wider view than a single country’s perspective, the text contains a cross-cultural and cross-country approach. In addition, the case studies offer valuable lessons that organizations that wish to operate or are operating in those cultures can adopt in preparing and managing crises. The book highlights recent crisis events such as Syria’s civil war, missing Malaysia Flight MH370, andJapan’s Fukushima Daiichi nuclear power plant disaster. Each of the case studies examines how culture impacts communication and responses to crises. Authoritative, insightful, and instructive, this importan...

  10. Legal strategies to protect sexual and reproductive health and rights in the context of the refugee crisis in Europe: a complaint before the European Ombudsperson.

    Science.gov (United States)

    Laporta Hernández, Elena

    2017-11-01

    In the context of the refugee crisis in Europe, the measures taken by the institutions and bodies of the European Union as they relate to respecting, protecting, and ensuring human rights have proven to be woefully inadequate. The development of a restrictive, defensive, security-based immigration policy has led to failure by European countries and the European Union to fulfil their human rights obligations. Specifically, the Agreement struck between the European Union and Turkey on 18 March 2016, in addition to externalising borders, placed economic and political considerations centre stage, leading to serious violations of the human rights of refugees and migrants, including their sexual and reproductive rights. In an effort to identify the failures and the institutions responsible for promoting the necessary measures to mitigate the negative impacts these policies have had, the international human rights organisation Women's Link Worldwide lodged a complaint with the European Ombudsperson. In its complaint, Women's Link alleges maladministration by the European Commission for its failure to carry out a human rights impact assessment of the 18 March 2016 EU-Turkey Agreement and the reports on its implementation. Such an assessment should include a gender perspective and a children's rights approach, and its omission is not only a failure to comply with international human rights standards, but also directly and negatively affects women's and children's rights.

  11. Chronicity, crisis, and the 'end of AIDS'.

    Science.gov (United States)

    Sangaramoorthy, Thurka

    2018-01-11

    In biomedical, public health, and popular discourses, the 'end of AIDS' has emerged as a predominant way to understand the future of HIV research and prevention. This approach is predicated on structuring and responding to HIV in ways that underscore its presumed lifelong nature. In this article, I examine the phenomenon of HIV chronicity that undergirds the 'end of AIDS' discourse. In particular, I explore how the logic of HIV chronicity, induced by technological advances in treatment and global financial and political investments, intensifies long-term uncertainty and prolonged crisis. Focusing on over 10 years of anthropological and public health research in the United States, I argue that HIV chronicity, and subsequently, the 'end of AIDS' discourse, obscure the on-going HIV crisis in particular global communities, especially among marginalised and ageing populations who live in under-resourced areas. By tracing the 'end of AIDS' discourse in my field sites and in other global locations, I describe how HIV chronicity signals a continuing global crisis and persistent social precarity rather than a 'break' with a hopeless past or a promising future free from AIDS.

  12. The crisis of health in a crisis ridden region.

    Science.gov (United States)

    Maziak, Wasim

    2009-01-01

    The overall picture of the Arab world today is dire; no Arab country is free from political strife, foreign intervention, or the threat of terrorism. Continuing instability and the failure of national governments to uphold the rule of law and deliver on development are tearing apart the fabric of Arab societies. Internally, Arab regimes' agendas are shaped by security and their makeup by kinship and loyalty, pushing people to seek refuge within their primordial loyalties. From the outside, foreign meddling in the name of "democracy" is deepening the Arab world's instability, therefore providing justification for opponents of change to discredit the values of human rights and power sharing. In such an environment, the voiceless majority becomes the main victims, with detrimental effects on their physical and mental wellbeing. A domino-like breakdown of the Arab region, with serious consequences for world's stability, is becoming an increasingly likely scenario.

  13. Collection for Refugee and Migration Crisis

    CERN Multimedia

    Rolf Heuer, Director-General,

    2015-01-01

    Dear Colleagues, In response to the current refugee and migration crisis, we are starting a collection today and we are calling on your generosity. The funds will be forwarded to the International Federation of Red Cross and Red Crescent Societies to respond to the humanitarian needs of the refugees and migrants, providing immediate and longer-term relief, including emergency medical care and basic health services, psychological support, temporary shelter, distribution of food & water and other urgently needed items. We hope that your contributions to the above-mentioned appeal will not prevent you from sparing a thought for them and doing whatever you can to help them. Bank account details for donations: Bank account holder: Association du personnel CERN - 1211 GENEVE 23 Account number: 279-HU106832.1 IBAN: CH85 0027 9279 HU10 6832 1 BIC:  UBSWCHZH80A Please mention: Refugee and Migration Crisis

  14. Organizational Learning and Crisis Management

    Science.gov (United States)

    Wang, Jia

    2007-01-01

    The impact of crises on organizations has been stronger than ever. This article explores the role of organizational learning in crisis management, an area that has received little attention from HRD community. Recognizing the dynamics and interconnectedness of crisis management, organizational learning, and organizational change, the article…

  15. Education and Our Ecological Crisis

    Science.gov (United States)

    Klimas, John

    1970-01-01

    Discusses causes of our ecological crisis and suggests that in order to overcome the crisis we have to sprinkle our teaching with a sense of wonder, impress upon the youth that there is nothing difficult or mysterious about the ecological viewpoint, give youth an awareness of the diversity of things in our environment, stress interrelationships…

  16. Varieties of capitalism in crisis?

    DEFF Research Database (Denmark)

    Bruff, Ian; Horn, Laura

    2012-01-01

    In this introduction to the special issue, we provide a brief overview of the two distinct but connected meanings of the phrase ‘varieties of capitalism in crisis’: (1) the crisis of empirical political economies under conditions of capitalist diversity; and (2) the crisis of the institutionalist...

  17. Regulating Finance After the Crisis

    DEFF Research Database (Denmark)

    Moschella, Manuela; Tsingou, Eleni

    2013-01-01

    It is now widely recognized that regulatory failures contributed to the onset of the global financial crisis. Redressing such failures has, thus, been a key policy priority in the post-crisis reform agenda at both the domestic and international levels. This special issue investigates the process ...

  18. The Little-Known Crisis

    Science.gov (United States)

    Eckholm, Erik P.

    1975-01-01

    For one-third of the world's people, the energy crisis means the daily scramble to find the wood they need to cook. The accelerating destruction of forests throughout Africa, Asia and Latin America and the utilization of manure as a firewood substitute may produce the most profound ecological crisis of this century. (BT)

  19. CRISIS, SOCIAL SECTOR AND INCOME DISTRIBUTION IN SOME SOUTHEAST ASIAN COUNTRIES

    OpenAIRE

    Mukhopadhaya, Pundarik

    2002-01-01

    This paper examines the social impact of the recent Asian Economic crisis, drawing on the results of studies in two countries: Singapore and Thailand. The economic crisis had interrupted three decades of steady growth that had been accompanied by remarkable progress in poverty reduction and a betterment of social indicators like health and education. In particular, this crisis is feared to have a large negative effect on household welfare. It is found that absolute poverty became more acute i...

  20. Infectious disease health services for refugees and asylum seekers during a time of crisis: A scoping study of six European Union countries.

    Science.gov (United States)

    Bozorgmehr, Kayvan; Samuilova, Mariya; Petrova-Benedict, Roumyana; Girardi, Enrico; Piselli, Pierluca; Kentikelenis, Alexander

    2018-04-11

    Systematic information on infectious disease services provided to refugees and asylum seekers in the European Union (EU) is sparse. We conducted a scoping study of experts in six EU countries in order to map health system responses related to infectious disease prevention and control among refugees and asylum seekers. We conducted 27 semi-structured in-depth interviews with first-line staff and health officials to collect information about existing guidelines and practices at each stage of reception in first-entry (Greece/Italy), transit (Croatia/Slovenia), and destination countries (Austria/Sweden). Thematic coding was used to perform a content analysis of interview material. Guidance on infectious disease screening and health assessments lack standardisation across and-partly-within countries. Data collection on notifiable infectious diseases is mainly reported to be performed by national public health institutions, but is not stratified by migrant status. Health-related information is not transferred in a standardized way between facilities within a single country. International exchange of medical information between countries along the migration route is irregular. Services were reported to be fragmented, and respondents mentioned no specific coordination bodies beyond health authorities at different levels. Infectious disease health services provided to refugees and asylum seekers lack standardisation in health assessments, data collection, transfer of health-related information and (partly) coordination. This may negatively affect health system performance including public health emergency preparedness. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Access to Credit of SMEs in the Czech Republic During the Financial Crisis and in the Post-crisis Period

    Directory of Open Access Journals (Sweden)

    Petr Koráb

    2015-01-01

    Full Text Available We investigate the impact of the financial crisis on the access of small and medium-sized enterprises in the Czech Republic to external financing. We apply the non-parametric kernel density estimation on a firm-level measure of financing constraints and evaluate its distribution on a balanced panel of SMEs. We focus on financing constraints related to financial health of companies since they determine the commercial banks’ lending behaviour. Our results reveal that firms were more constrained during the crisis and their financing constraints did not largely improve after the end of financial crisis. We argue that enterprises were financially constrained during the crisis because of reduced cash-flow and cash holdings.

  2. International institutions, global health initiatives and the challenge of sustainability: lessons from the Brazilian AIDS programme.

    Science.gov (United States)

    Le Loup, G; Fleury, S; Camargo, K; Larouzé, B

    2010-01-01

    The sustainability of successful public health programmes remains a challenge in low and middle income settings. These programmes are often subjected to mobilization-demobilization cycle. Indeed, political and organizational factors are of major importance to ensure this sustainability. The cooperation between the World Bank and the Brazilian AIDS programme highlights the role of international institutions and global health initiatives (GHI), not only to scale up programmes but also to guarantee their stability and sustainability, at a time when advocacy is diminishing and vertical programmes are integrated within health systems. This role is critical at the local level, particularly when economic crisis may hamper the future of public health programmes. Political and organizational evolution should be monitored and warnings should trigger interventions of GHI before the decline of these programmes.

  3. Thyrotoxic crisis presenting with jaundice.

    Science.gov (United States)

    Wickramasinghe, R D S S; Luke, W A N V; Sebastiampillai, B S; Gunathilake, M P M L; Premaratna, R

    2016-06-23

    Thyrotoxic crisis is a medical emergency requiring early diagnosis and urgent management, which can be challenging due to its diverse clinical presentations. While common presentations include fever, sweating, palpitations, tremors and confusion, presence of jaundice is rare. We report a 35-year-old male who presented with jaundice due to cholestasis along with other features of thyrotoxic crisis due to Graves' disease. He had a good clinical recovery with resolution of cholestasis following treatment for thyrotoxic crisis. Jaundice can be a rare manifestation of thyrotoxic crisis, and should be considered in the differential diagnosis when other clinical features of thyrotoxic crisis are present. However secondary causes of jaundice should be looked into and excluded.

  4. Credibility and Crisis Stress Testing

    Directory of Open Access Journals (Sweden)

    Li Lian Ong

    2014-02-01

    Full Text Available Credibility is the bedrock of any crisis stress test. The use of stress tests to manage systemic risk was introduced by the U.S. authorities in 2009 in the form of the Supervisory Capital Assessment Program. Since then, supervisory authorities in other jurisdictions have also conducted similar exercises. In some of those cases, the design and implementation of certain elements of the framework have been criticized for their lack of credibility. This paper proposes a set of guidelines for constructing an effective crisis stress test. It combines financial markets impact studies of previous exercises with relevant case study information gleaned from those experiences to identify the key elements and to formulate their appropriate design. Pertinent concepts, issues and nuances particular to crisis stress testing are also discussed. The findings may be useful for country authorities seeking to include stress tests in their crisis management arsenal, as well as for the design of crisis programs.

  5. Impact of Global Financial Crisis on Nigerian Stock Market | Onuoha ...

    African Journals Online (AJOL)

    Impact of Global Financial Crisis on Nigerian Stock Market. ... that the global financial crisis measured by currency crisis, credit crisis, liquidity crisis, ... relevant regulatory authorities should use the financial stress index (FSI) as proposed by ...

  6. Crisis Communication in Public Health Emergencies: The Limits of 'Legal Control' and the Risks for Harmful Outcomes in a Digital Age.

    Science.gov (United States)

    Quinn, Paul

    2018-02-06

    Communication by public authorities during a crisis situation is an essential and indispensable part of any response to a situation that may threaten both life and property. In the online connected world possibilities for such communication have grown further, in particular with the opportunity that social media presents. As a consequence, communication strategies have become a key plank of responses to crises ranging from epidemics to terrorism to natural disaster. Such strategies involve a range of innovative practices on social media. Whilst being able to bring about positive effects, they can also bring about a range of harmful unintended side effects. This include economic harms produced by incorrect information and a range of social harms that can be fuelled by myths and rumours, worsening negative phenomena such as stigmatisation and discrimination. Given the potential for such harms, one might expect that affected or potentially affected individuals would be able to challenge such measures before courts or administrative tribunals. As this paper demonstrates however this is not the case. More often than not seemingly applicable legal approaches are unlikely to be able to engage such methods. This is often because such measures represent activities that are purely expressive in nature and therefore not capable of imposing any binding legal or corporeal changes on individuals. Whilst some forms of soft law may pose requirements for public officials involved in such activities (e.g. codes of conduct or of professional ethics), they are not likely to offer potentially harmed individuals the chance to to challenge particular communication strategies before courts or legal tribunals. The result is that public authorities largely have a free reign to communicate how they wish and do not have to have to comply with a range of requirements (e.g. relating to form and substantive) content) that would in general apply to most forms of official administrative act.

  7. Current Studies on Crisis Response Communication:Focus on Crisis Communication Theories in the United States

    OpenAIRE

    平澤 敦

    2017-01-01

    Researchers have shown an increased interest in crisis communication as well as crisis management. Crisis communication became an established corporate discipline in the last 20 years. Because of the recent rash of corporate (organizational) scandals, natural disasters and so on, importance of crisis communication (management) attracts much more attention than the past.Crisis communication is used to help governments and companies organizations to respond to and recover from a crisis. Crisis ...

  8. Crisis? What crisis? How European professionals handle crises and crisis communication

    NARCIS (Netherlands)

    Verhoeven, P.; Tench, R.; Zerfass, A.; Moreno, A.; Verčič, D.

    2014-01-01

    A broad study in 43 European countries shows that 70% of communication professionals encounter at least one crisis a year, mostly institutional, related to the performance of the organization or a crisis in management or leadership. Organizational response and image restoration approaches are mainly

  9. Energy crisis? The likelihood of a global energy crisis

    International Nuclear Information System (INIS)

    Franssen, H.

    2001-01-01

    This paper assess global energy problems and compares the energy crises of the 1970s with current US energy problems. The reaction of the OECD countries to the oil crises of 1973/4 and 1979/80, the perception of future oil supplies, and the difficulties faced by ordinary consumers in accepting that there is an energy crisis are discussed along with the Californian electricity crisis, the falling US natural gas supplies, and the low return on investment in the US refining industry. The prospect of another oil crisis, and the need for consumers to learn to live with price volatility are considered

  10. Food Safety Crisis Management-A Comparison between Germany and the Netherlands.

    Science.gov (United States)

    van Asselt, E D; van der Fels-Klerx, H J; Breuer, O; Helsloot, I

    2017-02-01

    In order to prevent food safety incidents from becoming a crisis, a good crisis management structure is essential. The aim of the current study was to compare and evaluate the national food incident response plans of 2 neighboring EU Member States: Germany and the Netherlands. This revealed that the structure of these plans is comparable, starting with initial alerting, assessment of the problem, upscaling, an execution phase and finally an evaluation of the crisis management. However, the German communication structure is more complex than the Dutch one and cross-border communication between both countries is currently limited. In general, the presence of national response plans does not guarantee a good and swift response to a food safety incident as this is often hampered by difficulties in tracing the source of the problem as well as difficulties in communication between organizations involved in crisis management. A timely detection can be improved through the development of fast screening and detecting systems and through combining various data sources using computer software systems. Mutual cooperation and communication can be improved through joint exercises or projects. This will help to streamline communication toward consumers and trade partners. Such communication should be transparent relaying not only the facts but also the uncertainties in a crisis in order to gain consumer trust and safeguard international trade. © 2017 Institute of Food Technologists®.

  11. Structural Сharacteristics of Mental States in Women Experiencing Difficulties Coping with Midlife Crisis

    Directory of Open Access Journals (Sweden)

    Skripacheva E.H.,

    2015-10-01

    Full Text Available The development of a midlife crisis in women is accompanied by forming mental states that affect the quality of life and determine the possibilities of transformation of midlife crisis into a new stage of self-development. Study sample were 168 women, aged 30 to 44 years. We used projective techniques, questionnaires, content analysis as study methods. The deviation indicator from autogenous norm of M. Lusher test in women with the crisis symptoms has a rather strong positive correlation with the «negative conditions» index (r=0,4; p<0,001. We have identified the parameters of mental states (antipathy, anxiety, tension, asintonia, fatigue that may contribute to the formation of negative mental states in general, hampering personal and social changes in the midlife crisis. The article defines the dominant motivations meaningful for development and transformation of midlife crisis in women. The results complement the scientific understanding of mental states and age characteristics from a gender perspective

  12. “There’s a housing crisis going on in Sydney for Aboriginal people”: focus group accounts of housing and perceived associations with health

    Directory of Open Access Journals (Sweden)

    Melanie J. Andersen

    2016-05-01

    Full Text Available Abstract Background Poor housing is widely cited as an important determinant of the poor health status of Aboriginal Australians, as for indigenous peoples in other wealthy nations with histories of colonisation such as Canada, the United States of America and New Zealand. While the majority of Aboriginal Australians live in urban areas, most research into housing and its relationship with health has been conducted with those living in remote communities. This study explores the views of Aboriginal people living in Western Sydney about their housing circumstances and what relationships, if any, they perceive between housing and health. Methods Four focus groups were conducted with clients and staff of an Aboriginal community-controlled health service in Western Sydney (n = 38. Inductive, thematic analysis was conducted using framework data management methods in NVivo10. Results Five high-level themes were derived: the battle to access housing; secondary homelessness; overcrowding; poor dwelling conditions; and housing as a key determinant of health. Participants associated their challenging housing experiences with poor physical health and poor social and emotional wellbeing. Housing issues were said to affect people differently across the life course; participants expressed particular concern that poor housing was harming the health and developmental trajectories of many urban Aboriginal children. Conclusions Housing was perceived as a pivotal determinant of health and wellbeing that either facilitates or hinders prospects for full and healthy lives. Many of the specific health concerns participants attributed to poor housing echo existing epidemiological research findings. These findings suggest that housing may be a key intervention point for improving the health of urban Aboriginal Australians.

  13. "There's a housing crisis going on in Sydney for Aboriginal people": focus group accounts of housing and perceived associations with health.

    Science.gov (United States)

    Andersen, Melanie J; Williamson, Anna B; Fernando, Peter; Redman, Sally; Vincent, Frank

    2016-05-24

    Poor housing is widely cited as an important determinant of the poor health status of Aboriginal Australians, as for indigenous peoples in other wealthy nations with histories of colonisation such as Canada, the United States of America and New Zealand. While the majority of Aboriginal Australians live in urban areas, most research into housing and its relationship with health has been conducted with those living in remote communities. This study explores the views of Aboriginal people living in Western Sydney about their housing circumstances and what relationships, if any, they perceive between housing and health. Four focus groups were conducted with clients and staff of an Aboriginal community-controlled health service in Western Sydney (n = 38). Inductive, thematic analysis was conducted using framework data management methods in NVivo10. Five high-level themes were derived: the battle to access housing; secondary homelessness; overcrowding; poor dwelling conditions; and housing as a key determinant of health. Participants associated their challenging housing experiences with poor physical health and poor social and emotional wellbeing. Housing issues were said to affect people differently across the life course; participants expressed particular concern that poor housing was harming the health and developmental trajectories of many urban Aboriginal children. Housing was perceived as a pivotal determinant of health and wellbeing that either facilitates or hinders prospects for full and healthy lives. Many of the specific health concerns participants attributed to poor housing echo existing epidemiological research findings. These findings suggest that housing may be a key intervention point for improving the health of urban Aboriginal Australians.

  14. Gas crisis in Europe

    International Nuclear Information System (INIS)

    2002-01-01

    The gas crisis in Europe is getting more evident. Basing his discussion on BP's annual statistical review of world energy, 2002, the author concludes that an increasing number of the major European consumers of natural gas may acquire a supply- and safety problem and become more dependent on imported gas for operating power stations. This is going to be most dramatic for France, Germany and Italy. Great Britain have gas reserves that will last for about seven years. Spain is an interesting ''phenomenon'' in the European gas market; they have trebled their gas consumption during the last decade. Europe's dependence on a high production rate on the Norwegian Shelf has become stronger from year to year

  15. The Iranian nuclear crisis

    International Nuclear Information System (INIS)

    Le Guelte, Georges

    2006-01-01

    This article proposes an overview of the Iranian nuclear issue. The author first recalls that Iran has launched a nuclear program during the 1970's with the objective of building several nuclear power stations for electricity production. He evokes contracts signed by the Shah and the consequences of the Islamic revolution after which Iranian governments thought it was absurd to leave these constructions unfinished. The author outlines the several mistakes made by Western countries in their relationship with Iran, and those made by Iran (development of hidden nuclear program for example), which altogether leaded to the present crisis. The author discusses some legal aspects, notably the fact that Iran signed very early the NPT (non proliferation Treaty) as other countries who posses nuclear weapons, did not. He outlines the political challenges at different scales, regional as well as international, and finally discusses the uncertain perspectives

  16. Euro crisis in perspective

    Directory of Open Access Journals (Sweden)

    Francesco Bogliacino

    2017-05-01

    Full Text Available In this article we analyze the process of monetary integration in Europe, identifying the structural determinants and the dysfunctional elements in the institutions of the European Union. Secondly, we explain two prevailing discourses that fail in interpreting the events: on the one hand, a purely ideological position that see integration as a process of convergence that should not be interfered with; on the other hand, a purely idealist perspective, according to which the ideal of integration will prevail over any contradiction engendered by the institutional system. The combination of these two perspectives helped justify post crisis interventions (fiscal consolidation and the institutional design that followed, which eventually aggravated the macroeconomic instability in the area.

  17. Crisis cambiaria en Argentina

    OpenAIRE

    Féliz, Mariano

    2009-01-01

    El análisis de la articulación entre el proceso de valorización exitosa de capital y la tendencia a la desvalorización de las mercancías se aplica a una de las manifestaciones de la crisis argentina: la devaluación del peso. Se estudia la relación entre la determinación del tipo de cambio y la valorización del capital. Se discuten las tendencias concretas de la economía argentina en la década de 1990 y se muestra cómo la devaluación de 2001-2002 fue producto necesario del propio proceso de va...

  18. La hospitalidad en crisis

    Directory of Open Access Journals (Sweden)

    Axel Ramiro Mancioli

    2015-12-01

    Full Text Available La pregunta por la hospitalidad en la crisis Argentina de 2001 surge de la principal consigna que en esos días se escuchaba en las calles, “Que se vayan todos” es una consigna no hospitalaria, es negar una hospitalidad. Pero también es el reconocimiento de un “hasta acá”, el señalamiento de una situación de hospitalidad que se termina. Hubo hospitalidad pero ya no hay. Es decir, solo se puede expulsar a alguien en tanto se es el anfitrión, entonces solo se puede decir “Que se vayan todos” en esa condición. Pero ¿quién es el anfitrión el 19 y 20 en Argentina?, ¿el poder del Estado y el “todos” encarnado en la “clase política”?, ¿o es el pueblo?, ¿o la sociedad civil?, ¿o los piquetes o las cacerolas? ¿Y quién es el extranjero? Estos interrogantes que surgen ponen en primer plano el problema de la democracia representativa, la relación entre representantes y representados ¿puede ser pensada en términos de hospitalidad?, ¿se puede pensar esa relación en términos políticos?. A partir de los planteos de Derrida respecto de la hospitalidad, y de Badiou respecto de la crisis de la política, este ensayo recorre esas y otras preguntas.

  19. Managing stress in a crisis.

    Science.gov (United States)

    Wright-Reid, Alison

    2018-01-01

    Crisis situations are inherently uncertain and threatening. Although the primal stress reactions they provoke deliver some advantages, they so severely restrict intellect and behaviour that consultants observe crisis teams making the same mistakes over and again. Stress risks can be managed before, during and after a crisis. Crisis planning can select the right people, control the crisis team environment, and mitigate fatigue risks and memory demands. Because stress reactions are primitive, stress can be manipulated at a remarkably primitive level and teams can increase their resilience through such basics as sleep and breathing skills. Teams can learn to manipulate perceptions of danger, to tolerate uncertainty and to become comfortable making decisions which were reasonable at the time. Crisis leaders can frame the crisis as a challenge and options as gains, and can ensure the team avoids groupthink and challenges the paradigm. Where individuals are trained to apply critical thinking processes, intuitive decision-making is not only fast, but also accurate, and helps to challenge assumptions, predictions and groupthink. Crises are more easily recognised and managed where training has covered critical decision methods.

  20. Crisis prevention and management during SARS outbreak, Singapore.

    Science.gov (United States)

    Quah, Stella R; Hin-Peng, Lee

    2004-02-01

    We discuss crisis prevention and management during the first 3 months of the severe acute respiratory syndrome (SARS) outbreak in Singapore. Four public health issues were considered: prevention measures, self-health evaluation, SARS knowledge, and appraisal of crisis management. We conducted telephone interviews with a representative sample of 1,201 adults, > or = 21 years of age. We found that sex, age, and attitude (anxiety and perception of open communication with authorities) were associated with practicing preventive measures. Analysis of Singapore's outbreak improves our understanding of the social dimensions of infectious disease outbreaks.

  1. Alcohol and the economic crisis in Argentina: recent findings.

    Science.gov (United States)

    Munné, Myriam I

    2005-12-01

    In 2002 Argentina participated in the GENACIS project (Gender, Alcohol, and Culture: An International Study) as one of the countries funded by the World Health Organization. Four questions about the current economic crisis in Argentina were added to the original GENACIS questionnaire in order to find out the opinions of the general population in relation to alcohol and the economic crisis. Gender differences in the answers to these questions were examined. Logistic regression was used to identify demographic, drinking pattern and drinking problems variables related significantly to responses to the economic crisis questions. During the economic crisis people stopped or reduced going to bars and instead drank at home or at friends' homes. A large number of respondents also reported that people had changed to cheaper or lower-quality alcoholic drinks. Women were more likely to agree with statements that the economic crisis had increased 'escape' drinking and required reductions in money spent on alcohol; men were more likely to agree that the crisis had led to less drinking in bars and to the purchase of cheaper or lower-quality alcoholic beverages. Respondents who reported having significant others with drinking-related problems were more likely to endorse all four statements about effects of the economic crisis on drinking behaviour. A qualitative approach was used to discuss themes in the general comments that were recorded by the interviewers while collecting data. A strongly moralistic attitude towards alcohol was present in these comments, especially among women. The findings suggest that the economic crisis in Argentina led to major changes in patterns of drinking that differed according to gender roles and other demographic variables. The long-term effects of these changes remain to be determined as economic circumstances improve.

  2. Treating Chronic Crisis Bearers and Their Families

    Science.gov (United States)

    Doyle, Averil Marie; Dorlac, Charles

    1978-01-01

    This article presents a method for family crisis intervention. The goal is extended from restoring the crisis bearing unit to its pre-crisis level of coping to a basic restructuring of maladaptive pre-crisis behaviors. It is aimed at general behavior change as well as resolution of the immediate situation. (Author)

  3. Understanding the Role of Medical Experts during a Public Health Crisis Digital Tools and Library Resources for Research on the 1918 Spanish Influenza.

    Science.gov (United States)

    Ewing, E Thomas; Gad, Samah; Ramakrishnan, Naren; Reznick, Jeffrey S

    2014-10-01

    Humanities scholars, particularly historians of health and disease, can benefit from digitized library collections and tools such as topic modeling. Using a case study from the 1918 Spanish Flu epidemic, this paper explores the application of a big humanities approach to understanding the impact of a public health official on the course of the disease and the response of the public, as documented through digitized newspapers and medical periodicals.

  4. The Roman Empire - The Third Century Crisis and Crisis Management

    Science.gov (United States)

    2012-04-04

    December 2010. Hekster, Olivier, Gerda De Kleijn, and Danielle Slootjes. "Introduction." Impact of Empire. 7, (2006, June 1): 3-10. Koselleck...Crisis of the Third Century. Edited by Olivier Hekster, Gerda De Kleijn, and Danielle Slootjes. Vol. 7, Impact of EMpire. Boston: Brill Academic, 2012...1. Protagoras and John Nicols, Mapping the Crisis of the Third Century, ed. Olivier Hekster, Gerda De Kleijn, and Danielle Slootjes

  5. School Crisis Management: A Model of Dynamic Responsiveness to Crisis Life Cycle

    Science.gov (United States)

    Liou, Yi-Hwa

    2015-01-01

    Purpose: This study aims to analyze a school's crisis management and explore emerging aspects of its response to a school crisis. Traditional linear modes of analysis often fail to address complex crisis situations. The present study applied a dynamic crisis life cycle model that draws on chaos and complexity theory to a crisis management case,…

  6. An Investigation of Southwestern Area Principals and the Enactment of Crisis Plans in High Schools

    Science.gov (United States)

    Parker, Kerry L.

    2012-01-01

    The purpose of this study was to identify what southwestern area high school principals reported as the enactment of school crisis plans as described in the Center for Mental Health in Schools at UCLA (CMHS, 2008), "Resource Aid: Responding to a Crisis at School." The conceptual framework guiding the study was an adaptation of the Crisis…

  7. Research on Sichuan Cuisine Enterprises Crisis

    Directory of Open Access Journals (Sweden)

    Jianfei Nan

    2014-04-01

    Full Text Available It is impossible to avoid crisis for Sichuan cuisine enterprises. On the basis of emphasizing the importance of the research of Sichuan cuisine enterprises crisis, the paper mainly analyzed the issue of Sichuan cuisine enterprises crisis from three aspects including formation mechanism of Sichuan cuisine enterprises crisis, the impact mechanism of Sichuan cuisine enterprises crisis and its response measures(such as principles, methods and strategiesin order to provide an important reference so that Sichuan cuisine enterprises have a correct understanding of the crisis, effectively response to the crisis, and strengthen crisis management so as to achieve their scientific development themselves. To some extent, the paper is helpful to cope with the crisis and promote the safety operation of the enterprises which are facing the crisis.

  8. Diffusion of new technology, health services and information after a crisis: a focus group study of the Sichuan "5.12" Earthquake.

    Science.gov (United States)

    Zhou, Hong; Shi, Lu; Mao, Yuping; Tang, Juan; Zeng, Yu

    2014-01-01

    The Sichuan "5.12" Earthquake in 2008 occurred in a relatively underdeveloped area in China. The rainy weather, the mountainous environment and the local languages all posed major challenges to the dissemination of information and services after the disaster. By adopting a communication perspective, this study applies the diffusion of innovations theory to investigate how healthcare professionals diffused health technologies, health information and services during the rescue and relief operation. The authors conducted three focus group sessions with the health professionals who had attended to the rescue and relief work of the Sichuan "5.12" Earthquake in 2008. A range of questions regarding the diffusion of innovations were asked during these sessions. The health professionals used their cell phones to communicate with other healthcare providers, disseminated knowledge of health risks and injuries to affected residents with pamphlets and posters and attended daily meetings at the local government offices. They reported on the shortage of maritime satellite cell phones and large-size tents for medical use, and the absence of fully equipped ambulances. Volunteers, local health professionals and local officials provided health information and services in different ways. However, the diffusion of health information and services was less likely to reach those living next to transportation centers, in remote areas and in disaster areas neglected by the media. New communication devices such as cell phones and the mobile Internet enabled medical professionals to coordinate the rescue and relief work after this major natural disaster, at a time when the country's emergency response system still had plenty of room for improvement. In future, the mobile Internet should be used as a means of collecting bottom-up disaster reports so that the media will not neglect any disaster areas as they did during the Sichuan Earthquake. Rescue relief work would have been substantially

  9. Structural violence and marginalisation. The sexual and reproductive health experiences of separated young people on the move. A rapid review with relevance to the European humanitarian crisis.

    Science.gov (United States)

    Mason-Jones, A J; Nicholson, P

    2018-05-01

    To explore the main sexual and reproductive health (SRH) issues for separated young migrants. We conducted a rapid review. The search for articles published between 2000 and June 2017 including peer-reviewed and 'grey' published literature from a range of databases including MEDLINE, AMED, Embase, ASSIA, Scopus, Web of Science and websites of international organisations (Missing Children Alliance, United Nations Population Fund (UNFPA), World Health Organization (WHO), United Nations Human Rights Council (UNHRC), Human Rights Watch, United Nations Children's Fund (UNICEF) and FBX Centre for Health and Human Rights) took place over 4 months. Themes emerging from the included studies and articles were synthesised. We found 44 articles from a range of countries of which 64% were peer-reviewed and 36% were from 'grey' literature. Structural violence and marginalisation were the key analytical themes that emerged and included young people's vulnerability to violence, unmet knowledge and service needs, barriers and stigma and poor SRH outcomes. This is the first known review to summarise the key SRH issues for separated young migrants. As Europe hosts the greatest number of separated young people in recent history, their unique SRH concerns risk being overlooked. Public health practitioners and policy makers are encouraged to challenge the gaps that exist in their services. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  10. Factors predicting crisis counselor referrals to other crisis counseling, disaster relief, and psychological services: a cross-site analysis of post-Katrina programs.

    Science.gov (United States)

    Rosen, Craig S; Matthieu, Monica M; Norris, Fran H

    2009-05-01

    An important aspect of crisis counseling is linking survivors with services for their unmet needs. We examined determinants of referrals for disaster relief, additional crisis counseling, and psychological services in 703,000 crisis counseling encounters 3-18 months after Hurricane Katrina. Referrals for disaster relief were predicted by clients' losses, age (adults rather than children), and urbanicity. Referrals for additional counseling and psychological services were predicted by urbanicity, losses and trauma exposure, prior trauma, and preexisting mental health problems. Counseling and psychological referrals declined over time despite continuing mental health needs. Results confirm large urban-rural disparities in access to services.

  11. Sudan: The Crisis in Darfur

    National Research Council Canada - National Science Library

    Dagne, Ted

    2004-01-01

    The ongoing crisis in Darfur Province in western Sudan has raised serious concerns about a major humanitarian disaster, with an estimated 1 million people displaced and more than 140,000 people forced...

  12. Public relations in crisis management

    Directory of Open Access Journals (Sweden)

    Anna Dziadkiewicz

    2012-12-01

    Full Text Available The company crisis decreases its value. Undoubtedly, it ruins the company’s image, the stakeholders’ opinion and puts the company at a disadvantage on the market. It strikes very unexpectedly and destroys the company financially. Moreover, the company loses its credibility and limits its relations with the environment. It does effect the emotional sphere of the top management and employees, which is crucial for the company. This report presents the heart of crisis management. It defines such terms as issue and crisis management, as well as shows the most effective way to create the communications channel in case of crisis and its reduction. Apart from the academic aspect, there are also practical references concerning insurance agreement as a means of risk elimination.

  13. The psychology behind the crisis

    Directory of Open Access Journals (Sweden)

    Amalia PANDELICA

    2010-05-01

    Full Text Available This paper is an extensive analysis of bought international business press andacademic literature in the field about crisis management and related fields. The paperis grounded on the premise that the psychology of the crisis is an important componentof the present international context and psychological factors play an important part inthe alteration of consumer’s behavior. The question that generated our researchapproach in such conditions was at what extent peoples’ behavior is determined byindividual rational choices. The central message of this paper is that in the presenteconomic crisis conditions the factors that are playing an important role in shapingpeople’s behaviour are: risk perception and risk attitude. We consider that at presentmanagers should understand how their clients react in crisis conditions and how theirbehavior changes in order to handle successfully the present situation.

  14. Crisis?: What crisis?: currency vs. banking in the financial crisis of 1931

    OpenAIRE

    Albrecht Ritschl; Samad Salferaz

    2010-01-01

    This paper examines the role of currency and banking in the German financial crisis of 1931 for both Germany and the U.S. We specify a structural dynamic factor model to identify financial and monetary factors separately for each of the two economies. We find that monetary transmission through the Gold Standard played only a minor role in causing and propagating the crisis, while financial distress was important. We also find evidence of crisis propagation from Germany to the U.S. via the ban...

  15. Leading in crisis: lessons for safety leaders.

    Science.gov (United States)

    George, William W; Denham, Charles R; Burgess, L Hayley; Angood, Peter B; Keohane, Carol

    2010-03-01

    The National Quality Forum (NQF) Safe Practices are a group of 34 evidence-based Safe Practices that should be universally used to reduce the risk of harm to patients. Four of these practices specifically address leadership. A recently published book, 7 Lessons for Leading in Crisis, offers practical advice on how to lead in crisis. An analysis of how concepts from the 7 lessons could be applied to the Safe Practices was presented nationally by webinar to assess the audience's reaction to the information. The objective of this article was to present the information and the audience's reaction to it. Recommendations for direct actions that health care leaders can take to accelerate adoption of NQF Safe Practices were presented to health care leaders, followed by an immediate direct survey that used Reichheld's "Net Promoter Score" to assess whether the concepts presented were considered applicable and valuable to the audience. In a separate presentation, the challenges and crises facing nursing leaders were addressed by nursing leaders. Six hundred seventy-four hospitals, with an average of 4.5 participants per hospital, participated in the webinar. A total of 272 safety leaders responded to a survey immediately after the webinar. A Net Promoter Score assessment revealed that 58% of those surveyed rated the value of the information at 10, and 91% scored the value of the webinar to be between 8 and 10, where 10 is considered a strong recommendation that those voting would recommend this program to others. The overwhelmingly high score indicated that the principles presented were important and valuable to this national audience of health care leadership. The 2010 environment of uncertainty and shrinking financial resources poses significant risk to patients and new challenges for leaders at all levels. A values-grounded focus on personal accountability for leading in crisis situations strongly resonates with those interested in or leading patient safety initiatives.

  16. Chapter 2: The Financial Crisis

    OpenAIRE

    Hans-Werner Sinn; John Hassler; Gilles Saint-Paul; Giancarlo Corsetti; Michael P. Devereux; Tim Jenkinson; Jan-Egbert Sturm; Xavier Vives

    2009-01-01

    The financial turmoil that originated in 2007 and developed into an unprecedented crisis battering financial and real markets is the latest manifestation, on a grand scale and with new attributes, of a welldefined pathology in the process of market liberalization and integration in the post-Bretton Woods era. At the root of the crisis lies a fundamental inconsistency between financial globalisation – the process of liberalization and deregulation driving the impressive growth of world finan...

  17. Thailand: Post-Crisis Rebalancing

    OpenAIRE

    Chalongphob Sussangkarn; Deunden Nikomborirak

    2012-01-01

    Since the Asian financial crisis in 1997, Thailand has become highly dependent on exports as the main engine of economic growth. In 2008, the ratio of export to GDP was about 76.5 percent. The global economic crisis triggered by the sub-prime loans debacle in the United States has prompted Thailand to rethink its high dependence on export. This paper examines the options for external and internal economic rebalancing strategies for Thailand. External rebalancing will require Thailand to rely ...

  18. BENEFITS OF LINKED DATA FOR INTEROPERABILITY DURING CRISIS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    R. Roller

    2015-08-01

    Full Text Available Floodings represent a permanent risk to the Netherlands in general and to her power supply in particular. Data sharing is essential within this crisis scenario as a power cut affects a great variety of interdependant sectors. Currently used data sharing systems have been shown to hamper interoperability between stakeholders since they lack flexibility and there is no consensus in term definitions and interpretations. The study presented in this paper addresses these challenges by proposing a new data sharing solution based on Linked Data, a method of interlinking data points in a structured way on the web. A conceptual model for two data sharing parties in a flood-caused power cut crisis management scenario was developed to which relevant data were linked. The analysis revealed that the presented data sharing solution burderns its user with extra costs in the short run, but saves resources in the long run by overcoming interoperability problems of the legacy systems. The more stakeholders adopt Linked Data the stronger its benefits for data sharing will become.

  19. Cross-sectional study on factors hampering implementation of measles pre- and postexposure measures in Dutch hospitals during the 2013-2014 measles outbreak.

    Science.gov (United States)

    Fievez, L C R; Wong, A; Ruijs, W L M; Meerstadt-Rombach, F S; Timen, A

    2017-07-01

    This study examined adherence to national recommendations on measles pre- and postexposure measures, including immunization of health care workers (HCWs) in Dutch hospitals, during a national outbreak of measles in The Netherlands. This study also investigated which hospital characteristics and organizational issues hamper implementation. This was a cross-sectional survey among all general and academic hospitals in The Netherlands. An online structured questionnaire (48 questions) was administered. Analysis was performed using descriptive statistics and logistic regression. Of 88 hospitals, 70 (79.5%) were included. Of 68 hospitals, 48 (70.6%) assessed susceptibility to measles in HCWs. Of 70 hospitals, 61 (87.1%) offered vaccination to susceptible HCWs. Of 63 hospitals, 42 (66.7%) had postexposure policies consistent with national recommendations. Of 62 hospitals, 30 (48.4%) implemented all these measures, which is the minimum set of measures considered necessary to adequately prevent measles in HCWs. Logistic regression suggests that hospitals with several locations, hospitals with more employees, and hospitals where infectious disease experts designed infection prevention policies while occupational health experts implemented the policy less often implemented this minimum set of measures (P measles outbreak, most hospitals took measures to prevent measles in HCWs, but less than half implemented the minimum set of measures required. Implementation strategies in hospitals need to be improved, especially in large-sized hospitals and hospitals with several locations, and with respect to the assignment of responsibilities for infection prevention policies. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  20. Leadership in a (permanent) crisis.

    Science.gov (United States)

    Heifetz, Ronald; Grashow, Alexander; Linsky, Marty

    2009-01-01

    The current economic crisis is not just another rough spell. Today's mix of urgency, high stakes, and uncertainty will continue even after the recession ends. The immediate crisis--which we will get through with policy makers' expert technical adjustments--sets the stage for a sustained, or even permanent, crisis, a relentless series of challenges no one has encountered before. Instead of hunkering down and relying on their familiar expertise to deal with the sustained crisis, people in positions of authority--whether they are CEOs or managers heading up a company initiative--must practice what the authors call adaptive leadership. They must, of course, tackle the underlying causes of the crisis, but they must also simultaneously make the changes that will allow their organizations to thrive in turbulent environments. Adaptive leadership is an improvisational and experimental art, requiring some new practices. Like Julie Gilbert, who overcame internal resistance to reorient Best Buy toward female purchasers, adaptive leaders get things done to meet today's challenges and then modify those things to thrive in tomorrow's world. They also embrace disequilibrium, using turbulence as an opportunity to build crucial new capacities, as Paul Levy did to rescue Beth Israel Deaconess Medical Center from a profound financial crisis. Finally, adaptive leaders, such as Egon Zehnder, the founder of an executive search firm, draw out the leadership skills that reside deep in the organization, recognizing the interdependence of all employees and mobilizing everyone to generate solutions.

  1. An alternative perspective on how laboratory medicine can contribute to solve the health care crisis: a model to save costs by acquiring excellence in diagnostic systems.

    Science.gov (United States)

    Mussap, Michele

    2014-01-01

    The rapid escalation in health care costs has led to the idea to deliver better care at lower costs, reshaping the responsibilities of the health care system to achieve the goal of creating value for the patient. The pressure for fiscal containment and the progressive reduction in available health care resources originated very short term strategies consisting of abrupt reductions in expenditure, specifically in the provision of clinical pathology laboratory medicine services. However, the impact of laboratory test results on diagnostic and therapeutic interventions has increased enormously in the past decade, due to advances in personalized medicine and to the strictly correlated requirement to use new biomarkers with increasing sensitivity and specificity in clinical practice. In order to create savings by delivering better care there is the need to invest financial resources in purchasing high technology and new sophisticated tests and to promote the expertise of clinical pathologists and laboratory medicine professionals. This approach to creating value in patient health care is more productive and sustainable ethically, morally and economically as a long-term strategy. It can be successfully achieved by applying defined rules that make public-private cooperation clearer, skipping incompatible solutions such as transforming clinical laboratories to 'industrially productive premises', outsourcing laboratory medicine services and using central acquisition of diagnostic systems. © 2013.

  2. Evaluation of a School-Based Transition Program Designed to Facilitate School Reentry Following a Mental Health Crisis or Psychiatric Hospitalization

    Science.gov (United States)

    White, Henry; LaFleur, Jennifer; Houle, Katherine; Hyry-Dermith, Paul; Blake, Susan M.

    2017-01-01

    In recent decades, increasing attention has been paid to the number of adolescents experiencing extended absences from school due to mental health crises. Upon returning to school, these students often face difficulties in functioning, risk of relapse, and vulnerability to academic failure and social isolation. This paper presents results of a…

  3. Mobile crisis management teams as part of an effective crisis management system for rural communities.

    Science.gov (United States)

    Trantham, Doug; Sherry, Anne

    2012-01-01

    Mobile crisis management teams provide crisis prevention and intervention services in community settings. The Appalachian Community Services crisis management program shows how such teams can be used to effectively serve rural communities.

  4. CRISIS-DIAGNOSTICS IN ANTI-CRISIS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Gavrylenko Valentina

    2018-01-01

    Full Text Available Introduction. In today’s conditions of a changing market environment, uncertainty and risk, one of the main tasks of management is the timely detection of crisis symptoms and the development of measures aimed at preventing their negative impact on the activities of the enterprise. The purpose of this article is to determine the accounting and analytical information for the development of the model KRIZІS-diagnostics and ensure the effectiveness of its functioning in anti-crisis management. Results. The analysis of definition of the concept «KRIZІS-diagnostics» in the scientific literature is carried out. Multi-factor models for assessing the financial status and the diagnostics of enterprises bankruptcy for different countries are presented. The specified classification of management KRIZІS-diagnostics is specified. The stages and tasks of KRIZІS-diagnostics are determined. The sources of information, which are determinants of the early symptoms of the crisis and necessary for KRIZІS-diagnostics are indicated and the characteristic is also given. Qualitative and quantitative indicators that characterize the business processes of the enterprise and can be used to analyze the state of the enterprise in a changing environment for preventing the crisis are determined. Conclusions. This approach of identifying crisis symptoms in business processes is the basis for managing an enterprise to make strategic management decisions in order to prevent a crisis at its early stages. The development of KRIZІS-diagnostics as an information provision for anti-crisis management is the direction of further research.

  5. CAPITALIST CRISIS: BRIEF REMARKS

    Directory of Open Access Journals (Sweden)

    José Claudinei Lombardi

    2010-01-01

    Full Text Available Based on the joint context of the theory of crises and the resultant theory of revolutions of Marx and Engels for the analysis of the genesis, development and death of Capitalism, a summary of the historical confronts from which relations of capital have been hegemonic in the XX and XXI centuries is presented. Within this same context, a synthesis of the debates on the structural crisis of Capitalism in the past years is made with an emphasis on its relevance and seriousness in history. It is emphasized that communism is not an idea to be implemented but a reality to be constructed by real men in struggles, conquests and defeats. The revolution of a way of production is not made by itself or by decree, but it is in fact the product of organized men. It is claimed that the maturing of a struggle may lead to the formation of a wide front to articulate anti-capitalist and revolutionary forces. It is observed the need for a tactic and strategic organization to overcome the logics of the Capital and the role each educationalist must play to expand and deepen the debate.

  6. Crisis - Weisskopf's view

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1993-10-15

    'We are facing a crisis, not only in particle physics but in the whole of fundamental science', said Victor Weisskopf, doyen of quantum physics, during his traditional summer CERN stopover. 'Basic science - science for its own sake - and especially high energy physics, is really in danger.' As well as explaining how this has come about, the former CERN Director General (1961-5) proposed action to reverse the trend. Rather than dividing science into the conventional 'big' and 'small' camps, he slices across another axis. On one hand there is obviously applicable 'terrestrial science' - biology, medicine, solid state, much of the nuclear sector, nonlinear behaviour, chaos,....all directly connected with processes that happen on Earth. On the other there is 'cosmic science' - astronomy, astrophysics, particle physics and some of the nuclear sector - addressing deeper issues, not attainable naturally on this planet at all, and where applications are less immediately obvious. (This classification is not completely watertight - even cosmic science can, and does, foster immediate spinoff, Weisskopf points out, citing Georges Charpak's detector work.) Tracing the evolution of science in this century, Weisskopf sees the rapid evolution of American influence in the 1930s as a turning point. Before then, the United States had not been in the front line, and it had been important for US researchers to spend some time in Europe.

  7. The immature electrophysiological phenotype of iPSC-CMs still hampers in vitro drug screening: Special focus on IK1.

    Science.gov (United States)

    Goversen, Birgit; van der Heyden, Marcel A G; van Veen, Toon A B; de Boer, Teun P

    2018-03-01

    Preclinical drug screens are not based on human physiology, possibly complicating predictions on cardiotoxicity. Drug screening can be humanised with in vitro assays using human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs). However, in contrast to adult ventricular cardiomyocytes, iPSC-CMs beat spontaneously due to presence of the pacemaking current I f and reduced densities of the hyperpolarising current I K1 . In adult cardiomyocytes, I K1 finalises repolarisation by stabilising the resting membrane potential while also maintaining excitability. The reduced I K1 density contributes to proarrhythmic traits in iPSC-CMs, which leads to an electrophysiological phenotype that might bias drug responses. The proarrhythmic traits can be suppressed by increasing I K1 in a balanced manner. We systematically evaluated all studies that report strategies to mature iPSC-CMs and found that only few studies report I K1 current densities. Furthermore, these studies did not succeed in establishing sufficient I K1 levels as they either added too little or too much I K1 . We conclude that reduced densities of I K1 remain a major flaw in iPSC-CMs, which hampers their use for in vitro drug screening. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  8. Mycobacterium tuberculosis co-operonic PE32/PPE65 proteins alter host immune responses by hampering Th1 response

    Directory of Open Access Journals (Sweden)

    Mohd eKhubaib

    2016-05-01

    Full Text Available PE/PPE genes, present in cluster with ESAT-6 like genes, are suspected to have a role in antigenic variation and virulence of Mycobacterium tuberculosis. Their roles in immune evasion and immune modulation of host are also well documented. We present evidence that PE32/PPE65 present within the RD8 region are co-operonic, co-transcribed and co-translated, and play role in modulating host immune responses. Experiments with macrophage cell lines revealed that this protein complex suppresses pro-inflammatory cytokines such as TNF-α and IL-6 whereas also inducing high expression of anti-inflammatory IL-10. Immunization of mice with these recombinant proteins dampens an effective Th1 response as evident from reduced frequency of IFN-g and IL-2 producing CD4+ and CD8+ T cells. IgG sub-typing from serum of immunized mice revealed high levels of IgG1 when compared with IgG2a and IgG2b. Further IgG1/IgG2a ratio clearly demonstrated that the protein complex manipulates the host immune response favourable to the pathogen. Our results demonstrate that the co-transcribed and co-translated PE32 and PPE65 antigens are involved specifically in modulating anti-mycobacterial host immune response by hampering Th1 response.

  9. Hampered long-term depression and thin spine loss in the nucleus accumbens of ethanol-dependent rats.

    Science.gov (United States)

    Spiga, Saturnino; Talani, Giuseppe; Mulas, Giovanna; Licheri, Valentina; Fois, Giulia R; Muggironi, Giulia; Masala, Nicola; Cannizzaro, Carla; Biggio, Giovanni; Sanna, Enrico; Diana, Marco

    2014-09-02

    Alcoholism involves long-term cognitive deficits, including memory impairment, resulting in substantial cost to society. Neuronal refinement and stabilization are hypothesized to confer resilience to poor decision making and addictive-like behaviors, such as excessive ethanol drinking and dependence. Accordingly, structural abnormalities are likely to contribute to synaptic dysfunctions that occur from suddenly ceasing the use of alcohol after chronic ingestion. Here we show that ethanol-dependent rats display a loss of dendritic spines in medium spiny neurons of the nucleus accumbens (Nacc) shell, accompanied by a reduction of tyrosine hydroxylase immunostaining and postsynaptic density 95-positive elements. Further analysis indicates that "long thin" but not "mushroom" spines are selectively affected. In addition, patch-clamp experiments from Nacc slices reveal that long-term depression (LTD) formation is hampered, with parallel changes in field potential recordings and reductions in NMDA-mediated synaptic currents. These changes are restricted to the withdrawal phase of ethanol dependence, suggesting their relevance in the genesis of signs and/or symptoms affecting ethanol withdrawal and thus the whole addictive cycle. Overall, these results highlight the key role of dynamic alterations in dendritic spines and their presynaptic afferents in the evolution of alcohol dependence. Furthermore, they suggest that the selective loss of long thin spines together with a reduced NMDA receptor function may affect learning. Disruption of this LTD could contribute to the rigid emotional and motivational state observed in alcohol dependence.

  10. The Ebola crisis

    African Journals Online (AJOL)

    problems of natural disasters, political instability, wars, poor political governance, inadequate health financing, inattention to the social determinants of health, and weak health systems. The six building blocks for ... Leadership, governance and management. All six need strengthening in African countries.[4] It is therefore not.

  11. Health technology assessment (HTA): a brief introduction of history and the current status in the field of cardiology under the economic crisis.

    Science.gov (United States)

    Fanourgiakis, John; Kanoupakis, Emmanuel

    2015-08-01

    In a time of economic recession health technology assessment is an established aid in decision making in many countries in order to identify cost-containment policy options. Moreover, as the volume, complexity, and cost of new medical technology increases, the need for evaluating benefits, risks and costs becomes increasingly important. In recent years there has been a proliferation of health technology assessment initiatives internationally, aimed in introducing rationality in the decision-making process, informing reimbursement, providing clinical guidance on the use of medical technologies across the world in an evidence-based decision-making environment and in pricing decisions. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

  12. The Great Recession and inequalities in access to health care: a study of unemployment and unmet medical need in Europe in the economic crisis.

    Science.gov (United States)

    Madureira-Lima, Joana; Reeves, Aaron; Clair, Amy; Stuckler, David

    2018-02-01

    Unmet medical need (UMN) had been declining steadily across Europe until the 2008 Recession, a period characterized by rising unemployment. We examined whether becoming unemployed increased the risk of UMN during the Great Recession and whether the extent of out-of-pocket payments (OOP) for health care and income replacement for the unemployed (IRU) moderated this relationship. We used the European Survey on Income and Living Conditions (EU-SILC) to construct a pseudo-panel (n = 135 529) across 25 countries to estimate the relationship between unemployment and UMN. We estimated linear probability models, using a baseline of employed people with no UMN, to test whether this relationship is mediated by financial hardship and moderated by levels of OOP and IRU. Job loss increased the risk of UMN [β = 0.027, 95% confidence interval (CI) 0.022-0.033] and financial hardship exacerbated this effect. Fewer people experiencing job loss lost access to health care in countries where OOPs were low or in countries where IRU is high. The results are robust to different model specifications. Unemployment does not necessarily compromise access to health care. Rather, access is jeopardized by diminishing financial resources that accompany job loss. Lower OOPs or higher IRU protect against loss of access, but they cannot guarantee it. Policy solutions should secure financial protection for the unemployed so that resources do not have to be diverted from health. © The Author 2017. Published by Oxford University Press on behalf of the International Epidemiological Association

  13. Measuring the impact of intangible asset investment toward companies financial health and agency problem : empirical reasearch from Indonesian companies during world financial crisis period 2006-2011

    OpenAIRE

    Widiantoro, Dimas Mukhlas

    2012-01-01

    Masteroppgave i økonomi og administrasjon - Universitetet i Agder 2012 The thesis examines the impact of intangible investment toward company‟s health and company agency problem. The research chooses Intangible asset because of its special characteristic. Intangible asset as the asset of production has equipped the employee with better skills and knowledge on productions. On the other hand, an intangible asset that does not have physical evidence also triggered the liquidity problem of the...

  14. Health workforce planning and service expansion during an economic crisis: A case study of the national breast screening programme in Ireland.

    Science.gov (United States)

    McHugh, S M; Tyrrell, E; Johnson, B; Healy, O; Perry, I J; Normand, C

    2015-12-01

    This article aims to estimate the workforce and resource implications of the proposed age extension of the national breast screening programme, under the economic constraints of reduced health budgets and staffing levels in the Irish health system. Using a mixed method design, a purposive sample of 20 participants were interviewed and data were analysed thematically (June-September 2012). Quantitative data (programme-level activity data, screening activity, staffing levels and screening plans) were used to model potential workload and resource requirements. The analysis indicates that over 90% operational efficiency was achieved throughout the first six months of 2012. Accounting for maternity leave (10%) and sick leave (3.5%), 16.1 additional radiographers (whole time equivalent) would be required for the workload created by the age extension of the screening programme, at 90% operational efficiency. The results suggest that service expansion is possible with relatively minimal additional radiography resources if the efficiency of the skill mix and the use of equipment are improved. Investing in the appropriate skill mix should not be limited to clinical groups but should also include administrative staff to manage and support the service. Workload modelling may contribute to improved health workforce planning and service efficiency. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Monitoring the aftermath of Flint drinking water contamination crisis: Another case of sampling bias?

    Science.gov (United States)

    Goovaerts, Pierre

    2017-07-15

    The delay in reporting high levels of lead in Flint drinking water, following the city's switch to the Flint River as its water supply, was partially caused by the biased selection of sampling sites away from the lead pipe network. Since Flint returned to its pre-crisis source of drinking water, the State has been monitoring water lead levels (WLL) at selected "sentinel" sites. In a first phase that lasted two months, 739 residences were sampled, most of them bi-weekly, to determine the general health of the distribution system and to track temporal changes in lead levels. During the same period, water samples were also collected through a voluntary program whereby concerned citizens received free testing kits and conducted sampling on their own. State officials relied on the former data to demonstrate the steady improvement in water quality. A recent analysis of data collected by voluntary sampling revealed, however, an opposite trend with lead levels increasing over time. This paper looks at potential sampling bias to explain such differences. Although houses with higher WLL were more likely to be sampled repeatedly, voluntary sampling turned out to reproduce fairly well the main characteristics (i.e. presence of lead service lines (LSL), construction year) of Flint housing stock. State-controlled sampling was less representative; e.g., sentinel sites with LSL were mostly built between 1935 and 1950 in lower poverty areas, which might hamper our ability to disentangle the effects of LSL and premise plumbing (lead fixtures and pipes present within old houses) on WLL. Also, there was no sentinel site with LSL in two of the most impoverished wards, including where the percentage of children with elevated blood lead levels tripled following the switch in water supply. Correcting for sampling bias narrowed the gap between sampling programs, yet overall temporal trends are still opposite. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Modified crisis intervention for personality disorder.

    Science.gov (United States)

    Rudnick, A

    1998-01-01

    This study proposes that the goal of crisis intervention for persons with personality disorders should be to return them to their pre-crisis level of functioning, even though this is maladaptive. This is contrasted with standard crisis intervention, which aims to return normal or neurotic persons to their pre-crisis normal or neurotic functioning, usually by means of few and short-term therapeutic encounters. The modification proposed costs more time and resources in persons with personality disorders in crisis and fits the intervention to the personality type. This is illustrated by the case of Eve, a patient in crisis, whose pre-crisis functioning was maladaptive because of a dependent personality disorder. The goal of (modified) crisis intervention in this case was to return the patient to her dependent lifestyle, by means of pharmacotherapy combined with intensive supportive psychotherapy during 3-4 months of partial (day) hospitalization. The special nature of crisis in personality disorders is discussed.

  17. Simulation-based crisis resource management training for pediatric critical care medicine: a review for instructors.

    Science.gov (United States)

    Cheng, Adam; Donoghue, Aaron; Gilfoyle, Elaine; Eppich, Walter

    2012-03-01

    To review the essential elements of crisis resource management and provide a resource for instructors by describing how to use simulation-based training to teach crisis resource management principles in pediatric acute care contexts. A MEDLINE-based literature source. OUTLINE OF REVIEW: This review is divided into three main sections: Background, Principles of Crisis Resource Management, and Tools and Resources. The background section provides the brief history and definition of crisis resource management. The next section describes all the essential elements of crisis resource management, including leadership and followership, communication, teamwork, resource use, and situational awareness. This is followed by a review of evidence supporting the use of simulation-based crisis resource management training in health care. The last section provides the resources necessary to develop crisis resource management training using a simulation-based approach. This includes a description of how to design pediatric simulation scenarios, how to effectively debrief, and a list of potential assessment tools that instructors can use to evaluate crisis resource management performance during simulation-based training. Crisis resource management principles form the foundation for efficient team functioning and subsequent error reduction in high-stakes environments such as acute care pediatrics. Effective instructor training is required for those programs wishing to teach these principles using simulation-based learning. Dissemination and integration of these principles into pediatric critical care practice has the potential for a tremendous impact on patient safety and outcomes.

  18. Adverse effect of the financial crisis in Greece on perinatal factors.

    Science.gov (United States)

    Zografaki, Irini; Papamichail, Dimitris; Panagiotopoulos, Takis

    2018-05-16

    Starting in 2008 recession affected many European countries and especially Greece. Previous studies have reported increases in low birth weight, preterm birth and stillbirth rates in Greece during early crisis. In our study we used data on births from 1980 to 2014 that allowed us to distinguish recent changes, which could possibly be attributed to the financial crisis, from long term trends, and controlled for maternal age and country of origin as potential confounders. Our study covered a longer period (up to 2014) than what has been studied before and looked separately at the effect of early and established crisis. We used national vital statistics data from 1980 to 2014. We performed age standardization and calculated age standardized rates and standardized rate ratios (SRRs) for perinatal factors for three time periods (pre-crisis, early crisis and established crisis) for Greek and non-Greek women. We found an increase in low birth weight deliveries independent of maternal age and origin and an increased stillbirth rate in Greek women younger than 25 in early (RR = 1.42 95%CI: 1.12-1.80) and established crisis periods (RR = 1.36 95%CI: 1.07-1.72) compared with pre-crisis. Non-Greek women have also been affected, with their advantage regarding birth outcomes becoming less profound in the established crisis period (low birth weight: established crisis SRR = 0.84 95%CI: 0.82-0.87, pre-crisis SRR = 0.79 95% CI: 0.76- 0.81). The financial crisis has possibly adversely affected perinatal factors in Greece. Our results highlight the need of appropriate public health interventions and family support policies, especially for younger people, unemployed and immigrants.

  19. Response to Agencywide Crisis: A Model for Administrative Action.

    Science.gov (United States)

    Alwon, Floyd J.

    1980-01-01

    Guidelines are suggested whereby mental health agency administrators can promote organizational growth and avoid dangers during an agency crisis. Emphasis is placed on the administrator's comprehension of leadership styles and task organization. Typical staff reactions to agency crises are described. (Author/DB)

  20. Ethical challenges in conducting research in humanitarian crisis ...

    African Journals Online (AJOL)

    ... culturally sensitive to the needs of the victims of the humanitarian crisis. In emergency situations, the roles of Institutional Review Boards (IRBs) may have to be modified without compromising the ethical standards that health researchers have globally attempted to achieve. Malawi Medical Journal Vol. 20 (2) 2008: pp.