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.

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.

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

[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.

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

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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.

Crisis intervention for people with severe mental illnesses.

Science.gov (United States)

Murphy, Suzanne M; Irving, Claire B; Adams, Clive E; Waqar, Muhammad

2015-12-03

A particularly difficult challenge for community treatment of people with serious mental illnesses is the delivery of an acceptable level of care during the acute phases of severe mental illness. Crisis-intervention models of care were developed as a possible solution. To review the effects of crisis-intervention models for anyone with serious mental illness experiencing an acute episode compared to the standard care they would normally receive. If possible, to compare the effects of mobile crisis teams visiting patients' homes with crisis units based in home-like residential houses. We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials. There is no language, time, document type, or publication status limitations for inclusion of records in the register. This search was undertaken in 1998 and then updated 2003, 2006, 2010 and September 29, 2014. We included all randomised controlled trials of crisis-intervention models versus standard care for people with severe mental illnesses that met our inclusion criteria. We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assessed risk of bias for included studies and used GRADE to create a 'Summary of findings' table. The update search September 2014 found no further new studies for inclusion, the number of studies included in this review remains eight with a total of 1144 participants. Our main outcomes of interest are hospital use, global state, mental state, quality of life, participant satisfaction and family burden. With the exception of mental state, it was not possible to pool data for these outcomes.Crisis intervention may reduce repeat admissions to hospital (excluding index admissions) at six months (1 RCT, n = 369, RR 0.75 CI 0.50 to 1.13, high quality evidence), but does appear to reduce family burden (at six months: 1 RCT, n = 120, RR 0.34 CI 0.20 to 0.59, low quality evidence), improve

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

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.

[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.

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.

[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.

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...

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.

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.

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

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.

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.

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.

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.

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.

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.

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...

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.

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.

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.

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.

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.

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.

"It's overwhelming... everything seems to be too much:" A theory of crisis for individuals with severe persistent mental illness.

Science.gov (United States)

Ball, Jeffrey S; Links, Paul S; Strike, Carol; Boydell, Katherine M

2005-01-01

Crisis in individuals with severe persistent mental illness (SPMI) is a poorly understood phenomenon for which traditional crisis models do not apply. In this study we explored the crisis experience using in-depth interviews conducted with individuals with severe persistent mental illness from two community support programs. A grounded theory of the crisis experience was developed and the results illustrate that underlying vulnerability sets the stage for crisis occurrence which involves feeling overwhelmed and lacking control and manifests as agitation/anger/aggression, being low, feeling anxious, or euphoria. Immediate responses to crises involve getting help or managing alone and numerous factors contribute to crisis resolution and prevention.

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.

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

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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.

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.

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

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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.

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

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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.

ASSESSMENT OF THE SEVERITY OF THE CRISIS OF THE UKRAINIAN COMPANIES AND THE DEVELOPMENT OF MEASURES FOR ITS ELIMINATION

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Vladimir Nusinov

2016-11-01

Full Text Available The functioning of the market system everywhere is accompanied by the crisis phenomena. It is impossible to imagine the development of a modern economy without economic UPS and downs, which disrupted the economic stability and the economic entities enter into a certain imbalance. Not exception-eating is the development of the crisis and companies of Ukraine. The origin and course of the crisis in Ukrainian companies requires a deep scientific study of modern economic theory and practice, as it can be considered a certain phenomenon, with significant features in comparison with other countries in crises companies. The manifestation of the crisis can be expressed in the decline in production, the deterioration of economic indicators, the financial insolvency of the company, have other symptoms that characterize its presence, as well as evaluate the various degrees of severity. Despite the fact that the Ukrainian company has led to a crisis, as it was heavy, and what the symptoms manifested, the main aim of the company in a state of crisis of uncertainty is the "survival" of the market and the continuation of further functioning. The issue of assessing the severity of the crisis and to identify measures to eliminate it in Ukrainian companies is extremely important and yet insufficiently developed. This is because, firstly, in economic science remains poorly understood the essence of the crisis, its species and assessment methodology taking into account the realities of the modern Ukrainian. Secondly, the emergence of the crisis in Ukraine – a frequent phenomenon, their course is quite difficult and time-consuming, but also has its own characteristics, depending on the formation of the Ukrainian political and economic systems, historically developed social and economic development of the country, the impact of external macroeconomic factors. These points need to be considered in the development of evidence-based, effective system of anti-crisis

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

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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.

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

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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.

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

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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

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

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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.

Output Loss Severity across EU Countries. Evidence for the 2008 Financial Crisis

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Iustina Alina Boitan

2015-08-01

Full Text Available Financial crises are complex phenomena, in terms of the triggering factors, duration and severity, impact on both financial system and macroeconomic fundamentals and the full range of costs arising from its occurrence. The paper aims at providing an updated picture on the magnitude the 2008 financial crisis had, in terms of economic costs incurred by EU member states. It has been briefly reviewed crises’ main monetary and economic effects and costs. Then it has been employed International Monetary Fund’s approach for measuring crisis severity, expressed as an output loss indicator. To check the stability of the results, the basic methodology relying on a 3-year GDP trend has been complemented with a 7-year GDP trend. The output losses recorded by each EU country, under both trend assumptions, showed that Baltic states and Greece had been the most affected as they cumulated the highest losses. The lowest output losses have been registered in Western Europe countries (Austria, Belgium, France, Germany and Poland. Most EU economies’ growth still hasn’t entered on a robust ascending path, as they haven’t reached the level of GDP trend computed for the period preceding the onset of the financial crisis.

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

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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.

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,

Human resources for health: global crisis and international cooperation.

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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.

Health system resilience: Lebanon and the Syrian refugee crisis

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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

[Attempted suicide during the financial crisis in Athens].

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Stavrianakos, K; Kontaxakis, V; Moussas, G; Paplos, K; Papaslanis, T; Havaki-Kontaxaki, B; Papadimitriou, Gn

2014-01-01

Suicidal behavior is considered as the result of complex cognitive and emotional processes and it is a timeless, global and multifactorial phenomenon. Periods of financial crises in the past, such as the Great Depression in the USA in 1929 and the economic crises of Asia, Russia and Argentina in the late 1990s, have been associated with impairment of mental health of the economically affected. Unemployment, job insecurity, debts, poverty and social exclusion seems to lead to higher incidence of anxiety and depressive symptoms and increased suicidality. Alcohol and substance use and the reduction of the state budget for health services reinforce the negative effects of the economic recession on mental health. The financial crisis which currently affects many European countries began in 2008 and its impact on the mental health of European citizens is in progress. Greece is probably the most affected country by the European financial crisis. The aim of this study is to investigate the potential impact of the crisis' consequences on the attempted suicide rates in the Athens population and the differentiation of suicide attempters on social, demographic and clinical-psychopathological parameters during the crisis. A retrospective study was conducted. The semi-structured records of 165 attempters who were hospitalized in the Internal Medicine Clinics of the "Sotiria" General Hospital in Athens, after attempted suicide in the years 2007 and 2011, before and during the financial crisis respectively, were studied. Among suicide attempters 95(57.6%) were suffering from mental disorders. Most often diagnoses were these of mood disorders (n=60, 63.2%). Demographic data, current psychiatric disorder, previous suicide attempt and severity of psychopathology at the time of suicide attempt were recorded for each patient. Furthermore, the severity of each suicide attempt was estimated. Suicide attempts were 70 in 2007, before the financial crisis (mean age 36.9 years, 71% women

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

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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.

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...

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

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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.

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

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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.

Crisis interventions in online psychological counseling

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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.

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

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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.

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

[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.

Public Health Intelligence: Learning From the Ebola Crisis

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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

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.

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.

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.

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

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

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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.

Impact of financial crisis on selected health outcomes in Europe.

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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.

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

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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.

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

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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.

Hypertensive Crisis

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... 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 ...

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...

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

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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.

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

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... 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. ...

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

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

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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.

The true cost of the economic crisis on psychological well-being: a review

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Van Hal G

2015-01-01

Full Text Available Guido Van Hal Medical Sociology and Health Policy, University of Antwerp, Antwerp, Belgium Abstract: The recent economic crisis has led to many negative consequences, not the least having to do with the mental health and well-being of the populations involved. Although some researchers say it is still too early to speak about a relationship between the economic crisis and a rise in mental health problems resulting in suicides, there is solid evidence for the existence of such a relationship. However, several moderating or mediating mechanisms can also play a role. The main reactions of most policy makers to the economic crisis are (severe austerity measures. These measures seem to have, however, a detrimental effect on the mental health of the population: Just when people have the highest need for mental help, cost-cutting measures in the health care sector lead to a (substantial drop in the supply of services for the prevention, early detection, and cure of mental health problems. Policy makers should support moderating mechanisms such as financial and psychological coping and acculturation and the role of primary health care workers in the early detection of suicidal thoughts, suicide attempts, and suicide in times of economic recession. Several examples show that the countries best off regarding the mental health of their populations during the economic crisis are those countries with the strongest social safety net. Therefore, instead of cutting back on health care and social welfare measures, policy makers should in the future invest even more in social protection measures during economic crises. Keywords: economic recession, mental health, suicide, social protection, austerity, review

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

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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/.

Sickle Cell Crisis (For Teens)

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... 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 ...

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...

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

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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.

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

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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.

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

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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

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

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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

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 ...

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

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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

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

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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

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

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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.

Anesthetic management of hypertensive crisis in a three-year-old patient with undiagnosed severe renal artery stenosis: a case report.

Science.gov (United States)

Park, Sang-Hee; Lee, Yoon-Sook; Min, Too Jae; Kim, Woon Young; Kim, Jae Hwan; Park, Young Cheol

2014-10-01

Pediatric hypertensive crisis is a potentially life threatening medical emergency, usually secondary to an underlying disease. Hypertension commonly occurs during general anesthesia, and is usually promptly and appropriately treated by anesthesiologists. However in children with severe, unexplained, or refractory hypertension, it has the potential to cause morbidity and even mortality in susceptible patients. We report an anesthetic management of an unexpected hypertensive crisis that developed during general anesthesia in a three-year-old girl with undiagnosed severe left renal artery stenosis.

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

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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.

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.

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

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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.

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

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

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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.

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...

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.

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.

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

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.

Greek economic crisis and impaired perinatal parameters: experience from a public maternity hospital.

Science.gov (United States)

Sdona, E; Papamichail, D; Ragkou, E; Briana, D D; Malamitsi-Puchner, A; Panagiotopoulos, T

2017-07-04

Since 2008, Greece suffers a severe economic crisis. Adverse health outcomes have been reported, but studies on perinatal health are sparse. We aimed to examine the impact of economic crisis on perinatal parameters during early and established crisis periods. Birth records of 14 923 neonates, born in a public maternity hospital from 2005-2014, were reviewed for maternal (age, delivery mode) and neonatal (gender, birthweight, gestational age) variables. Univariable analysis tested the association of study variables with time-periods 2005-2007, 2009-2011 and 2012-2014. Multivariable logistic regression analysis identified factors independently associated with low birthweight (LBW) (period, independently of maternal age. In conclusion, impaired perinatal parameters, manifested by increasing maternal age, LBW, prematurity and CS rate, were observed during the years of economic decline, with possible adverse consequences for later health.

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.

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

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…

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.

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.

Akinetic Crisis in Parkinson's Disease Is Associated with a Severe Loss of Striatal Dopamine Transporter Function: A Report of Two Cases

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Valtteri Kaasinen

2014-11-01

Full Text Available Akinetic crisis or acute akinesia is a life-threatening complication of Parkinson's disease (PD with unknown pathophysiological mechanisms. Clinically, it resembles the neuroleptic malignant syndrome, and dopaminergic drugs are transiently ineffective in the acute phase of the condition. There are no published dopaminergic functional imaging studies on PD patients with akinetic crisis. Here we report 2 advanced PD patients with akinetic crisis who were scanned with SPECT using brain dopamine transporter ligand [123I]FP-CIT. The first patient was additionally scanned before the condition developed, and the second patient was scanned after recovery. Striatal dopamine transporter binding was lower during than before the crisis, and both patients showed a nearly complete loss of dopamine transporter binding during the crisis. Serial imaging showed that the uptake remained negligible despite an improvement in motor function after recovery. Akinetic crisis in PD appears to be associated with a particularly severe loss of presynaptic striatal dopamine function that does not improve after recovery. Apart from presynaptic dopaminergic function, other dopaminergic or nondopaminergic mechanisms are involved in the clinical improvement of motor functions after akinetic crisis in PD.

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.

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.

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.

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.

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.

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.

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

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.

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,

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

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.

[Human Metapneumovirus (hMPV) associated to severe bronchial asthmatic crisis].

Science.gov (United States)

López, M A; Kusznierz, G F; Imaz, M S; Cociglio, R; Tedeschi, F A; Zalazar, F E

2006-01-01

Human Metapneumovirus (hMPV) is a recently reported agent of acute infection in the respiratory tract. It has been found in children as well as in young adults and elders. The clinical manifestations produced by hMPV are indistinguishable from those by common respiratory virus, and can evolve from asymptomatic infection into severe pneumonia. On the other hand, some authors have described cases of bronchial asthma exacerbation associated with hMPV infection. In this work we report a case of a child who presented a severe bronchial asthmatic crisis with a suspected viral associated infection. Immunofluorescence tests yielded negative results for sincitial respiratory virus, adenovirus, a-b influenza virus and parainfluenza 1, 2, 3, virus. In an attempt to detect the presence of hMPV, a RT-PCR was carried out to amplify sequences from both N and F genes. Using this approach, a positive result for hMPV was obtained. To our knowledge, this is the first description of a case of asthma exacerbation associated to hMPV in our region. In addition, these results are similar to previous reports where it was hypothesized that, like RSV, hMPV can trigger a respiratory chronic disease as asthma.

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.

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.

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

Crisis strategies in BP's Deepwater Horizon response : An image repair and situational crisis communication study

OpenAIRE

Johansson, Mikael

2017-01-01

The BP Deepwater Horizon crisis in 2010 was one the largest catastrophes in the history of the oil industry. BP was sued over the disaster, and lost several billion dollars. This study examines the crisis response strategies and/or image repair strategies, which can be found in BP's press releases following the Deepwater Horizon crisis. In particular, the study looks closer at what established crisis communication strategies could be discerned in the material, and how they are used discursive...

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

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.

Metabolic crisis in severely head-injured patients: is ischemia just the tip of the iceberg?

Science.gov (United States)

Carre, Emilie; Ogier, Michael; Boret, Henry; Montcriol, Ambroise; Bourdon, Lionel; Jean-Jacques, Risso

2013-10-11

Ischemia and metabolic crisis are frequent post-traumatic secondary brain insults that negatively influence outcome. Clinicians commonly mix up these two types of insults, mainly because high lactate/pyruvate ratio (LPR) is the common marker for both ischemia and metabolic crisis. However, LPR elevations during ischemia and metabolic crisis reflect two different energetic imbalances: ischemia (Type 1 LPR elevations with low oxygenation) is characterized by a drastic deprivation of energetic substrates, whereas metabolic crisis (Type 2 LPR elevations with normal or high oxygenation) is associated with profound mitochondrial dysfunction but normal supply of energetic substrates. The discrimination between ischemia and metabolic crisis is crucial because conventional recommendations against ischemia may be detrimental for patients with metabolic crisis. Multimodal monitoring, including microdialysis and brain tissue oxygen monitoring, allows such discrimination, but these techniques are not easily accessible to all head-injured patients. Thus, a new "gold standard" and adapted medical education are required to optimize the management of patients with metabolic crisis.

Metabolic crisis in severely head-injured patients: is ischemia just the tip of the iceberg?

Directory of Open Access Journals (Sweden)

Emilie eCarre

2013-10-01

Full Text Available Ischemia and metabolic crisis are frequent post-traumatic secondary brain insults that negatively influence outcome. Clinicians commonly mix up these two types of insults, mainly because high lactate/pyruvate ratio (LPR is the common marker for both ischemia and metabolic crisis. However, LPR elevations during ischemia and metabolic crisis reflect two different energetic imbalances: ischemia (Type 1 LPR elevations with low oxygenation is characterized by a drastic deprivation of energetic substrates, whereas metabolic crisis (Type 2 LPR elevations with normal or high oxygenation is associated with profound mitochondrial dysfunction but normal supply of energetic substrates. The discrimination between ischemia and metabolic crisis is crucial because conventional recommendations against ischemia may be detrimental for patients with metabolic crisis. Multimodal monitoring, including microdialysis and brain tissue oxygen monitoring, allows such discrimination, but these techniques are not easily accessible to all head-injured patients. Thus, a new gold standard and adapted medical education are required to optimize the management of patients with metabolic crisis.

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.

Dalla crisi finanziaria alla crisi reale

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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.

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

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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

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

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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.

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

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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.

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

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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.

Assessing and Planning Health Actions During a Crisis

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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

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

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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.

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

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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.

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

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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

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

Informed, advance refusals of treatment by people with severe mental illness in a randomised controlled trial of joint crisis plans: demand, content and correlates.

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Henderson, Claire; Farrelly, Simone; Flach, Clare; Borschmann, Rohan; Birchwood, Max; Thornicroft, Graham; Waheed, Waquas; Szmukler, George

2017-11-24

In the UK, crisis planning for mental health care should acknowledge the right to make an informed advance treatment refusal under the Mental Capacity Act 2005. Our aims were to estimate the demand for such treatment refusals within a sample of service users who had had a recent hospital admission for psychosis or bipolar disorder, and to examine the relationship between refusals, and service user characteristics. To identify refusals we conducted content analysis of Joint Crisis Plans, which are plans formulated by service users and their clinical team with involvement from an external facilitator, and routine care plans in sub-samples from a multi-centre randomised controlled trial of Joint Crisis Plans (plus routine mental health care) versus routine care alone (CRIMSON) in England. Factors hypothesised to be associated with refusals were identified using the trial data collected through baseline interviews of service users and clinicians and collection of routine clinical data. Ninety-nine of 221 (45%) of the Joint Crisis Plans contained a treatment refusal compared to 10 of 424 (2.4%) baseline routine care plans. No Joint Crisis Plans recorded disagreement with refusals on the part of clinicians. Among those with completed Joint Crisis Plans, adjusted analyses indicated a significant association between treatment refusals and perceived coercion at baseline (odds ratio = 1.21, 95% CI 1.02-1.43), but not with baseline working alliance or a past history of involuntary admission. We demonstrated significant demand for written treatment refusals in line with the Mental Capacity Act 2005, which had not previously been elicited by the process of treatment planning. Future treatment/crisis plans should incorporate the opportunity for service users to record a treatment refusal during the drafting of such plans. ISRCTN11501328 Registered 13th March 2008.

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

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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.

Deoxyribonucleoside kinases activate nucleoside antibiotics in severely pathogenic bacteria

DEFF Research Database (Denmark)

Sandrini, Michael; Shannon, O.; Clausen, A.R.

2007-01-01

Common bacterial pathogens are becoming progressively more resistant to traditional antibiotics, representing a major public-health crisis. Therefore, there is a need for a variety of antibiotics with alternative modes of action. In our study, several nucleoside analogs were tested against pathog...... alternative for combating pathogenic bacteria.......Common bacterial pathogens are becoming progressively more resistant to traditional antibiotics, representing a major public-health crisis. Therefore, there is a need for a variety of antibiotics with alternative modes of action. In our study, several nucleoside analogs were tested against...... pathogenic staphylococci and streptococci. We show that pyrimidine-based nucleoside analogs, like 3'-azido-3'-deoxythymidine (AZT) and 2',2'-difluoro-2'deoxycytidine (gemcitabine), are specifically activated by the endogenous bacterial deoxyribonucleoside kinases, leading to cell death. Deoxyribonucleoside...

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

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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.

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

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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.

Policing the Global Crisis

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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.

Crisis management to avoid damage for corporate reputation: the case of retail chain crisis in the Baltic countries

OpenAIRE

Šontaitė-Petkevičienė, Miglė

2014-01-01

This paper analyses crisis management in relation to its effect on corporate reputation. It provides theoretical analysis of crises management actions that contribute to avoid damage for corporate reputation. Empirical research of the paper provides case analysis of retail chain “Maxima” crisis management in the Baltic countries. Even though retail chain “Maxima” has made several mistakes during crisis, in general crisis was managed properly so this case provides valuable insights how prevent...

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.

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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

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

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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

[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.

Environmental Sanitation Crisis: More than just a health issue

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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.

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

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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.

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.

[Economic crisis, poverty and childhood. What are the expected short- and long-term effects for the "children of the crisis"? SESPAS report 2014].

Science.gov (United States)

Flores, Manuel; García-Gómez, Pilar; Zunzunegui, María-Victoria

2014-06-01

The way a person will develop over the lifespan is largely determined by the first few years of life. A substantial share of the inequalities in health and socioeconomic status observed in adult life originate during childhood (and even while in utero). In this paper, we first review the literature on the impact of childhood conditions throughout the life cycle. We next discuss some of the social and biological mechanisms behind the transmission of the effects of poverty during the prenatal period, childhood, and adulthood. We then analyze several international experiences aimed at reducing intergenerational transmission of poverty. The article ends with some critical thoughts and policy recommendations to avoid the possible long-term effects of the current crisis on the health and socioeconomic status of the "children of the crisis" in Spain. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Metabolic Crisis in Severely Head-Injured Patients: Is Ischemia Just the Tip of the Iceberg?

OpenAIRE

Carre, Emilie; Ogier, Michael; Boret, Henry; Montcriol, Ambroise; Bourdon, Lionel; Jean-Jacques, Risso

2013-01-01

Ischemia and metabolic crisis are frequent post-traumatic secondary brain insults that negatively influence outcome. Clinicians commonly mix up these two types of insults, mainly because high lactate/pyruvate ratio (LPR) is the common marker for both ischemia and metabolic crisis. However, LPR elevations during ischemia and metabolic crisis reflect two different energetic imbalances: ischemia (Type 1 LPR elevations with low oxygenation) is characterized by a drastic deprivation of energetic s...

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.

Veterans Crisis Line: Videos About Reaching out for Help

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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 ...

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

[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.

Veterans Crisis Line: Videos About Reaching out for Help

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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 ...

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.

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

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.

ECONOMIC CRISIS AND ECONOMIC DISPARITIES IN EUROPEAN UNION

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Rodica CRUDU

2015-09-01

Full Text Available The impact of the economic and financial crisis is still being felt. It started as an acute crisis of the banking system, but then quickly affected the real economy, causing a substantial slump in business investment, household demand and output. The current economic crisis has affected almost all European countries but the countries of the European south and the former eastern socialist republics have suffered the most. The objective in this paper is to quantify economic disparities as expressed by several growth indicators, such as GDP per capita, employment/unemployment rates, labour productivity rates and use them to compare the economic performances before and after the crisis. EU took several measures to recover from the economic crisis. Nevertheless, its ability to adjust to widely diverse national and local contexts that have been impacted differently by the effects of the crisis, and to support the different patterns of economic growth that will result from it, is yet to be seen.

The Asian financial crisis: identification, interdependence, and transmission

OpenAIRE

Lestano, M.

2006-01-01

The 1980s and 1990s witnessed several episodes of financial turmoil, including the sovereign debt crisis of Latin America in the 1980s, the near-breakdown of the European Exchange Rate Mechanism (ERM) in 1992-1993 and the severe crisis that swept through Asian economies in 1997-1998. Three generations of theoretical models have been proposed to describe and explain such financial crises. The so-called first-generation models ars focussed on the Latin America debt crisis, which is characterise...

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

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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.

Perception of spokespersons' performance and characteristics in crisis communication: experience of the 2003 severe acute respiratory syndrome outbreak in Taiwan.

Science.gov (United States)

Lyu, Shu-Yu; Chen, Ruey-Yu; Wang, Shih-fan Steve; Weng, Ya-Ling; Peng, Eugene Yu-Chang; Lee, Ming-Been

2013-10-01

To explore perception of spokespersons' performance and characteristics in response to the 2003 severe acute respiratory syndrome (SARS) outbreak. This study was conducted from March to July, 2005, using semi-structured in-depth interviews to collect data. All interviews were audio-recorded and transcribed verbatim. A qualitative content analysis was employed to analyze the transcribed data. Interviewees included media reporters, media supervisors, health and medical institution executives or spokespersons, and social observers. Altogether, 35 interviewees were recruited for in-depth interviews, and the duration of the interview ranged from 1 hour to 2 hours. Results revealed that the most important characteristics of health/medical institutions spokespersons are professional competence and good interaction with the media. In contrast, the most important behaviors they should avoid are concealing the truth and misreporting the truth. Three major flaws of spokespersons' performance were identified: they included poor understanding of media needs and landscape; blaming the media to cover up a mistake they made in an announcement; and lack of sufficient participation in decision-making or of authorization from the head of organization. Spokespersons of health and medical institutions play an important role in media relations during the crisis of a newly emerging infectious disease. Copyright © 2013. Published by Elsevier B.V.

SMEs capital structure determinants during severe economic crisis: The case of Greece

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D. Balios

2016-12-01

Full Text Available The objective of this paper was to explore whether and how the main capital structure determinants of SMEs affected capital structure determination in different ways during the years of economic crisis. We used panel data of 8,052 SMEs operating in Greece during 2009–2012. We found that the effect of capital structure determinants on leverage does not change in an environment of economic crisis; larger SMEs continued to show higher debt ratios, the relationship between profitability and tangibility of assets with leverage continued to be negative, and growth was positively related to leverage.

["Crisis"--oscillating between keyword and buzzword. On the discourse about a "crisis of medicine" in the Weimar Republic].

Science.gov (United States)

Geiger, Karin

2010-01-01

The buzzword "crisis" has not only become omnipresent since the recent financial crisis. The term that originated in Ancient Greece underwent several different usages--quantitatively as well as qualitatively; especially in the Weimar Republic, the time period that has long been considered as the crisis era par excellence. Using the discourse about the "crisis of medicine" in the 1920s and the early 1930s as an example, the article attempts to provide a critical reflection on the concept of "crisis". The focus of this article is on the idea's construction, the different semantic usages of "crisis" and the motives of the different authors for their respective rhetorical applications of this term. The analysis of the examined publications on the "crisis of medicine", how they influenced other periods and the reconstruction of their origin show that the semantics of the word "crisis" went far beyond a simply negative connotation, and with regard to its rhetorical usage have oscillated between keyword and a meaningless but catchy buzzword.

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.

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.

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.

The Asian financial crisis : identification, interdependence, and transmission

NARCIS (Netherlands)

Lestano, M.

2006-01-01

The 1980s and 1990s witnessed several episodes of financial turmoil, including the sovereign debt crisis of Latin America in the 1980s, the near-breakdown of the European Exchange Rate Mechanism (ERM) in 1992-1993 and the severe crisis that swept through Asian economies in 1997-1998. Three

Economic crisis, austerity and unmet healthcare needs: the case of Greece.

Science.gov (United States)

Zavras, Dimitris; Zavras, Athanasios I; Kyriopoulos, Ilias-Ioannis; Kyriopoulos, John

2016-07-27

The programme for fiscal consolidation in Greece has led to income decrease and several changes in health policy. In this context, this study aims to assess how economic crisis affected unmet healthcare needs in Greece. Time series analysis was performed for the years 2004 through 2011 using the EU-SILC database. The dependent variable was the percentage of people who had medical needs but did not use healthcare services. Median income, unemployment and time period were used as independent variables. We also compared self-reported unmet healthcare needs drawn from a national survey conducted in pre-crisis 2006 with a similar survey from 2011 (after the onset of the crisis). A common questionnaire was used in both years to assess unmet healthcare needs, including year of survey, gender, age, health status, chronic disease, educational level, income, employment, health insurance status, and prefecture. The outcome of interest was unmet healthcare needs due to financial reasons. Ordinary least squares, as well as logistic regression analysis were conducted to analyze the results. Unmet healthcare needs increased after the enactment of austerity measures, while the year of participation in the survey was significantly associated with unmet healthcare needs. Income, educational level, employment status, and having insurance, private or public, were also significant determinants of unmet healthcare needs due to financial reasons. The adverse economic environment has significantly affected unmet health needs. Therefore health policy actions and social policy measures are essential in order to mitigate the negative impact on access to healthcare services and health status.

L’Italia: una crisi nella crisi.(Italy: A Crisis within the Crisis

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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  

Crisis, What Crisis? The Media: Business and Journalism in Times of Crisis

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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.

The current international financial crisis: how much is new?

OpenAIRE

Steven B. Kamin

1999-01-01

The paper surveys a broad array of data to compare the scope and impact of three emerging-market financial crises: the debt crisis of the 1980s, the Mexican financial crisis of 1994-95, and the current international financial crisis. While certain conventional views regarding the three episodes are supported by the data examined in this paper, we find that in several respects, the current crisis is more similar to prior emerging-market crisis episodes than is commonly believed.

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.

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.

Further explication of mega-crisis concept and feasible responses

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Yen Victor Yew-Cho

2017-01-01

Full Text Available The contemporary world is in an era of mega-crises, caused by a host of physical, economic, political, social, and cultural factors. Through a step-by-step explication of the root concepts of problem, mess, and crisis, a mega-crisis is posited to be a set of interacting crises that are severe in impact, complex in nature, and global in fallout, with no seeming end in sight. Compared to a crisis, a mega-crisis is higher in severity and deeper in complexity. The paper argues for a stakeholder perspective in megacrisis response, as relying on the organizational standpoint is inadequate for reaching long-term resolutions.

[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.

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

The Integrated Crisis Management Model for the Hotel Industry: Lowering Crisis Susceptibility and Strengthening Stakeholder Relationship Management

Directory of Open Access Journals (Sweden)

Nicola ZECH

2016-03-01

Full Text Available This research paper focuses on crisis management processes within the hotel industry – an industry which still seems reluctant in implementing profound and structured crisis management concepts. Responses to crisis situations are mostly intuitive and ad-hoc. In times of high competition in almost all destinations, categories and conceptions no opportunity of convincing guests as well as all other stakeholders of a trustworthy management shall be missed in order to gain competitive advantage. Each corporate crisis affects several or all stakeholder groups of the organisation – to a varying extent. Stakeholders might either affect or be affected by the hotel organisation and the respective crisis management processes. Taking the manifold opportunities for co-operation of a hotel organisation and its respective stakeholder groups into consideration, an integrated crisis management model for the hotel industry is evolved based both on theoretical foundations and empirical findings from the analysis of expert interviews as well as stakeholder surveys. The model neutralizes the deficits and discrepancies revealed between general crisis management literature and status quo respectively specific prerequisites for the hotel industry.

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...

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.

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

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...

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.

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.

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.

Indonesian heath care and the economic crisis: is managed care the needed reform?

Science.gov (United States)

Hotchkiss, D R; Jacobalis, S

1999-03-01

The ramifications of the current economic crisis are being felt throughout Asia, but problems are particularly acute in Indonesia; in the midst of high inflation and unemployment the government is considering expanding managed care reform. In this paper, we discuss the impact of the recent economic crisis on the health sector in Indonesia, and analyze the potential for implementing effective reform following the managed care model. The health sector is discussed, highlighting pre-existing problems in the health care supply environment. The determinants of the economic crisis are summarized, and the broad impacts of the crisis to date on the health sector are assessed. Next the prospects for success of current managed-care reform proposals are examined in some detail: viability of expanded managed care reform measures are assessed in light of the continuing crisis and its likely impacts on the consumers and suppliers of health care. Analysis of the potential impact of the continuing crisis focuses on key participants in health care reform: households, the government, and private health care providers. In conclusion the potential viability of managed care appears poor, given the current economic, political, and institutional conditions and likely future impacts, and suggest some alternative reform measures.

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

Stress in crisis managers: evidence from self-report and psychophysiological assessments.

Science.gov (United States)

Janka, A; Adler, C; Fischer, L; Perakakis, P; Guerra, P; Duschek, S

2015-12-01

Directing disaster operations represents a major professional challenge. Despite its importance to health and professional performance, research on stress in crisis management remains scarce. The present study aimed to investigate self-reported stress and psychophysiological stress responses in crisis managers. For this purpose, 30 crisis managers were compared with 30 managers from other disciplines, in terms of self-reported stress, health status and psychophysiological reactivity to crisis-related and non-specific visual and acoustic aversive stimuli and cognitive challenge. Crisis managers reported lower stress levels, a more positive strain-recuperation-balance, greater social resources, reduced physical symptoms, as well as more physical exercise and less alcohol consumption. They exhibited diminished electrodermal and heart rate responses to crisis-related and non-specific stressors. The results indicate reduced stress and physical complaints, diminished psychophysiological stress reactivity, and a healthier life-style in crisis managers. Improved stress resistance may limit vulnerability to stress-related performance decline and facilitate preparedness for major incidents.

A scoping review of crisis teams managing dementia in older people

Directory of Open Access Journals (Sweden)

Streater A

2017-10-01

Full Text Available Amy Streater,1,2 Donna Maria Coleston-Shields,2 Jennifer Yates,2 Miriam Stanyon,2 Martin Orrell2 1Research and Development, North East London NHS Foundation Trust, Ilford, 2Institute of Mental Health, University of Nottingham, Nottingham, UK Background: Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1 conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2 conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice.Methods: For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis.Results: The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8% of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors.Conclusion: Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required

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

Evaluation of the 113Online Suicide Prevention Crisis Chat Service: Outcomes, Helper Behaviors and Comparison to Telephone Hotlines.

Science.gov (United States)

Mokkenstorm, Jan K; Eikelenboom, Merijn; Huisman, Annemiek; Wiebenga, Jasper; Gilissen, Renske; Kerkhof, Ad J F M; Smit, Johannes H

2017-06-01

Recognizing the importance of digital communication, major suicide prevention helplines have started offering crisis intervention by chat. To date there is little evidence supporting the effectiveness of crisis chat services. To evaluate the reach and outcomes of the 113Online volunteer-operated crisis chat service, 526 crisis chat logs were studied, replicating the use of measures that were developed to study telephone crisis calls. Reaching a relatively young population of predominantly females with severe suicidality and (mental) health problems, chat outcomes for this group were found to be comparable to those found for crisis calls to U.S. Lifeline Centers in 2003-2004, with similar but not identical associations with specific helpers' styles and attitudes. Our findings support a positive effect of the 113Online chat service, to be enhanced by practice standards addressing an apparent lack of focus on the central issue of suicidality during chats, as well as by the development of best practices specific for online crisis intervention. © 2016 The American Association of Suicidology.

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…

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.

Specialists without spirit: crisis in the nursing profession.

Science.gov (United States)

Hewa, S; Hetherington, R W

1990-01-01

This paper examines the crisis in the nursing profession in Western industrial societies in the light of Max Weber's theory of rationalisation. The domination of instrumental rational action in modern industrial societies in evident in the field of modern medicine. The burgeoning mechanistic approach to the human body and health makes modern health care services increasingly devoid of human values. Although the nursing profession has been influenced by various changes that took place in health care during the last few decades (for example greater reliance on technology), the underlying values of the nursing profession still emphasise a broad definition of the well-being of patients. Hence, in recent years the irrational consequences of growing technological medicine in North America has resulted in a serious crisis in the nursing profession. To resolve this crisis the authors propose a reorganisation of modern health care services on the basis of a new paradigm which is compatible with both the health care needs of the people and the main emphasis in education and training of the nursing profession. PMID:2287012

The Ethical Judgment and Moral Reaction to the Product-Harm Crisis: Theoretical Model and Empirical Research

Directory of Open Access Journals (Sweden)

Dong Lu

2016-07-01

Full Text Available Based on the dual-process theory of ethical judgment, a research model is proposed for examining consumers’ moral reactions to a product-harm crisis. A national-wide survey was conducted with 801 respondents in China. The results of this study indicate that consumers will react to a product-harm crisis through controlled cognitive processing and emotional intuition. The results of the study also show that consumers view a product-harm crisis as an ethical issue, and they will make an ethical judgment according to the perceived severity and perceived relevance of the crisis. The ethical judgment in the perceived crisis severity and perceived crisis relevance will affect consumers’ condemning emotions in terms of contempt and anger. Through controlled cognitive processing, a personal consumption-related reaction (purchasing intention is influenced by the perceived crisis severity. Furthermore, a social and interpersonal reaction (negative word of mouth is influenced by the perceived crisis relevance through the controlled cognitive processing. This social and interpersonal reaction is also influenced by the perceived crisis severity and perceived crisis relevance through the intuition of other-condemning emotion. Moreover, this study finds that the product knowledge negatively moderates the impact of the perceived crisis severity on the condemning emotions. Therefore, when a consumer has a high level of product knowledge, the effect of perceived crisis severity on the condemning emotions will be attenuated, and vice versa. This study provides scholars and managers with means of understanding and handling of consumers’ reactions to a product-harm crisis.

[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.

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.

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.

Chaos in power: Pakistan's electricity crisis

International Nuclear Information System (INIS)

Kessides, Ioannis N.

2013-01-01

Pakistan is facing a severe electricity crisis due to a persistent and widening gap between demand and available system generating capacity. The worsening of power shortages has become a major political issue, reflecting the hardships for individuals and businesses. It threatens to undermine the credibility and legitimacy of government and to further stress the social fabric of the country. The power crisis did not emerge suddenly. It is the direct result of imprudent and reckless energy policies over the last three decades. These policies have impeded the development of cheap and abundant domestic energy sources. They have also resulted in very inefficient fuel-mix choices, compromising energy and economic security. Pakistan's energy bankruptcy is ultimately due to massive institutional and governance failure. This paper analyzes the problems confronting Pakistan's electricity sector and identifies the key elements of a potential policy response to address the country's severe power crisis. - Highlights: ► We analyze the structure, conduct, and performance of Pakistan's electricity sector. ► The causes and economic impacts of Pakistan's electricity shortages are analyzed. ► We identify the potential policy response to the power crisis

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

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.

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...

Urbanization eases water crisis in China

Science.gov (United States)

Wu, Yiping; Liu, Shu-Guang; Ji, Chen

2012-01-01

Socioeconomic development in China has resulted in rapid urbanization, which includes a large amount of people making the transition from rural areas to cities. Many have speculated that this mass migration may have worsened the water crisis in many parts of the country. However, this study shows that the water crisis would be more severe if the rural-to-urban migration did not occur.

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.

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...

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.

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.

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.

[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.

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.

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…

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....

Logistics and logistics support in crisis management and citizen protection

OpenAIRE

HOLEJŠOVSKÝ, Jan

2010-01-01

ABSTRAKT LOGISTICS AND LOGISTICS SUPPORT IN CRISIS MANAGEMENT AND CITIZEN PROTECTION The graduation thesis on topic "Logistics and logistics support in crisis management and citizen protection" is divided into several chapters, which in summary are a material presenting information about logistics and logistics support in crisis management and citizen protection. This was one of the aims at this work. Chapters I., II., III., IV. describe logistics and logistics support, crisis management, cit...

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…

Exploring Crisis Management in U.S. Small Businesses

Science.gov (United States)

Williams, Jon

As a critical infrastructure, the US electricity grid supplies electricity to 340 million people within eight separate regions. The power infrastructure is vulnerable to many types of disasters capable of severing supplies of electricity. The impact on the employees and communities when small- and medium-size enterprises are shut down due to disasters can be severe. The purpose of the quantitative comparative study was to explore small- and medium-size enterprises crisis management strategies in the case of power infrastructure vulnerabilities. Perceptions of small business leaders were probed about crisis management planning relevant to three secondary factors: prior experience of crises, threat perceptions, and planning self-efficacy. Participants completed an adapted questionnaire instrument based on a five-point Likert scale for six sub-factors including resilience through planning, financial impact, operational crisis management, the perfect storm, the aftermath of survival, and atrophy. The instrument also measured three additional factors to include, prior experience of crises, threat perceptions, and planning self-efficacy, across seven types of crises. The results of this study indicated that of the 276 respondents, 104 had no crisis plans, but 172 did have crisis plans. Of those who had implemented crisis plans, 19% had specific provisions to address power outages or attacks on the electrical grid. Of the respondents who had not planned for power outages nor experienced significant losses of power, a statistically significant number acknowledged an external threat to their business. The majority of respondents indicated that long-term planning was related to resilience; however, the migration of crisis understanding into the planning process or implementation was not implemented. This heightened awareness of potential crises without the corresponding development and implementation of mitigation crisis plans requires additional research to understand

Feedback Models for Collaboration and Trust in Crisis Response Networks

National Research Council Canada - National Science Library

Hudgens, Bryan J; Bordetsky, Alex

2008-01-01

.... Coordination within disaster response networks is difficult for several reasons, including the chaotic nature of the crisis, a need for the various organizations to balance shared goals (crisis amelioration...

IMPACT OF ECONOMIC CRISIS ON FDI

Directory of Open Access Journals (Sweden)

Elena V. CHIRILA DONCIU

2014-04-01

Full Text Available The economic crisis has had a severe impact on the economy worldwide. The investment activity has strongly felt the crisis and caused dramatic changes in the hierarchy of large investors. The financial system did not have availability for credits and funding from companies' own resources was extremely limited in terms of reducing profits. The purpose of the paper is the analysis of global foreign direct investment under the effect of the largest financial and economic crisis. The research results show a dramatic decline in foreign direct investments flows perceived and generated in 2009, and the fact that since 2010 there has been an easy comeback.

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...

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.

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.

ROMANIAN ECONOMY IN THE EUROPEAN CRISIS

Directory of Open Access Journals (Sweden)

Aurel Mihuţ

2012-01-01

Full Text Available European economy still faces today, one of the worst economic and financial crisis since the Second World War. Economic and financial crisis has spread worldwide with maximum speed, the economies of all Member States of the European Union encountering serious difficulties, both in the banking system and real economy. Romanian economic crisis started in 2008 and the uncertain deadline, is a matter of concern for many people. It is true that today we are witnessing the worst crisis in 80 years. We have an official explanation of the crisis, provided by public institutions, that the problem stems from inappropriate behavior of economic agents: selfishness, greed, speculation and market unable to function smoothly, ensuring proper allocation of resources: information asymmetry, liquidity trap , deflation, etc.On the other hand, most researchers, members of the academic, and private sector analysts argue that state intervention just planted seeds of financial turmoil that cross the present. The recipe prescribed by the authorities can result in mitigation of economic difficulties but, in contrary to their aggravation. The economic crisis is the result of several factors, which mainly include monetary policy errors, distorted economic incentives and pathology of the banking and financial regulatory policy.This paper is to highlight what triggered today's crisis in the Romanian economy, hoping to find a remedy to the problems of the economic, social and political that we face.

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.

My Goodness, My Heritage! Constructing Good Heritage in the Irish Economic Crisis

Directory of Open Access Journals (Sweden)

Maja Lagerqvist

2015-06-01

Full Text Available In 2008, the Republic of Ireland entered a severe financial crisis partly as a part of the global economic crisis. Since then, it has seen large raises in income taxes and cuts in state spending on health, welfare, education and on heritage, which has suffered relatively large cuts. This implies a need for rethinking choices and prioritisations to cope with the changing circumstances. Across Europe, the effects of the crisis on heritage, or the whole cultural sector, have yet mostly been highlighted in general or supposed terms rather than empirically analysed. But what actually happens to how heritage is conceptualised in times of crisis? Inspired by Critical Discourse Analysis, this paper explores representation of and argumentation for heritage in Irish state heritage policies pre and post the recession 2008. Much concerns regarding heritage management are discursively shaped. Policies, stating the authorised viewpoint, are thus key in the construction of heritage and its values in society. Recently, research has highlighted a shift towards more instrumentality in cultural policy due to wider societal changes. A crisis could influence such development. The analysis departs from an often-stated notion of heritage as a part of the Irish national recovery, but what does that imply? Focus is therefore put on how different representations of heritage and its values are present, argued for and compete in a situation with increasing competition regarding relevance and support. The paper shows how heritage matters are refocused, streamlined and packaged as productive, good-for-all, unproblematic and decomplexified in order to be perceived and valued as part of the national recovery. This includes privileging certain instrumental values, foremost economic, by means of specificity, space and quantification, while heritage's contribution to social life, education or health, although often mentioned, are downplayed by being expressed in much more vague

Hyperphosphatemia during spontaneous tumor lysis syndrome culminate in severe hyphosphatemia at the time of blast crisis of Phneg CML to acute myelomoncytic leukemia

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Salomon Ophira

2012-08-01

Full Text Available Abstract Extreme swing of phosphor from severe hyperphosphatemia to severe hypophosphatemia in a patient with blast crisis of myeloid origin was the result of imbalance between massive apoptosis of leukemic cells in the context of spontaneous tumor lysis syndrome and massive production of leukemic cells with only 1% of blast in peripheral blood. The mutated p53 protein suggested acting as oncogene in the presented case and possibly affecting phosphor status.

The Impact of Demographics, Resources, and Training on the Quality of School Crisis Plans

Science.gov (United States)

Gurdineer, Erin E.

2013-01-01

As our nation has become more aware of severe, yet usually rare, crisis events in schools, the need for crisis planning is more evident. Although the severity of crises can differ greatly (e.g., school shooting versus physical assaults), crisis preparedness is an essential component of schools' responsibilities in order to effectively respond…

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.

Crisis communication in the area of risk management: the CriCoRM project

Directory of Open Access Journals (Sweden)

Carmelo Scarcella

2013-09-01

Full Text Available Background. During the last H1N1 pandemic has emerged the importance of crisis communication as an essential part of health crisis management. The Project aims specifically to improve the understanding of crisis communication dynamics and effective tools and to allow public health institutions to communicate better with the public during health emergencies.Design and Methods. The Project will perform different activities: i state of the art review; ii identification of key stakeholders; iii communicational analysis performed using data collected on stakeholder communication activities and their outcomes considering the lessons learnt from the analysis of the reasons for differing public reactions during pandemics; iv improvement of the existing guidelines; v development of Web 2.0 tools as web-platform and feed service and implementation of impact assessment algorithms; vi organization of exercises and training on this issues.Expected impact of the study for public health. In the context of health security policies at an EU level, the project aims to find a common and innovative approach to health crisis communication that was displayed by differing reactions to the H1N1 pandemic policies. The focus on new social media tools aims to enhance the role of e-health, and the project aims to use these tools in the specific field of health institutions and citizens. The development of Web 2.0 tools for health crisis communication will allow an effective two-way exchange of information between public health institutions and citizens. An effective communication strategy will increase population compliance with public health recommendations.

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.

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.

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

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.

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

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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.

CRISIS-DIAGNOSTICS IN ANTI-CRISIS MANAGEMENT

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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.

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.

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

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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.

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.

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...

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 ...

Fixing Health Systems

International Development Research Centre (IDRC) Digital Library (Canada)

In Africa, health care has been in a state of crisis for several decades. ..... Instead, think about them as representations of real people — people with families that ...... blood screening; patient care, counseling, and social support; palliative care.

Horn of Africa food crisis

CERN Multimedia

Staff Association

2011-01-01

YOU ARE WONDERFUL, THANK YOU! As we have indicated previously, the Horn of Africa is experiencing an extremely severe food crisis as a result of one of the toughest droughts since the early 1950s. A total of over 12 million people in Djibouti, Ethiopia, Somalia, Kenya and Uganda are severely affected by this devastating crisis and the UN has officially declared famine in these regions. In addition, children are the most vulnerable victims, with more than half a million children at risk of imminent death from severe malnutrition and an estimated 2.3 million children already malnourished. At the beginning of August we opened an account to receive your donations. We are pleased to announce that the funds received are 30’500 CHF, the total sum of which will be transferred to UNICEF. We would like to thank all those who have contributed to this important cause. Rolf Heuer Director-General Michel Goossens President of the Staff Association

Horn of Africa food crisis

CERN Multimedia

Association du personnel

2011-01-01

Dear colleagues, As many of you are already aware, the Horn of Africa is experiencing an extremely severe food crisis as a result of one of the toughest droughts since the early 1950s. A total of over 12 million people in Djibouti, Ethiopia, Somalia, Kenya and Uganda are severely affected by this devastating crisis and the UN has officially declared famine in these regions. In addition, children are the most vulnerable victims, with more than a half million children at risk of imminent death from severe malnutrition and an estimated 2.3 million children already malnourished. An immediate, determined mobilization is required in order to avert an imminent humanitarian catastrophe and to prevent millions of people from being robbed of a future through the scourge of hunger and malnutrition. CERN has decided to join this international mobilization by specifically opening an account for those who want to make a donation to help the drought- and famine-affected populations in the region. Children being the first...

How many infants likely died in Africa as a result of the 2008-2009 global financial crisis?

Science.gov (United States)

Friedman, Jed; Schady, Norbert

2013-05-01

The human consequences of the recent global financial crisis for the developing world are presumed to be severe, but few studies have quantified them. This letter estimates the human cost of the 2008-2009 global financial crisis in one critical dimension-infant mortality-for countries in sub-Saharan Africa. The analysis pools birth-level data, as reported in female adult retrospective birth histories from all Demographic and Health Surveys collected in sub-Saharan Africa. This results in a data set of 639,000 births to 264,000 women in 30 countries. We use regression models with flexible controls for temporal trends to assess an infant's likelihood of death as a function of fluctuations in national income. We then calculate the expected number of excess deaths by combining these estimates with growth shortfalls as a result of the crisis. The results suggest 28,000-50,000 excess infant deaths in sub-Saharan Africa in the crisis-affected year of 2009. Notably, most of these additional deaths were concentrated among girls. Policies that protect the income of poor households and that maintain critical health services during times of economic contraction may reduce the expected increase in mortality. Interventions targeted at female infants and young girls can be particularly beneficial. Copyright © 2012 John Wiley & Sons, Ltd.

Crisis Communication in the Area of Risk Management: The CriCoRM Project.

Science.gov (United States)

Scarcella, Carmelo; Antonelli, Laura; Orizio, Grazia; Rossmann, Costanze; Ziegler, Lena; Meyer, Lisa; Garcia-Jimenez, Leonarda; Losada, Jose Carlos; Correia, Joao; Soares, Joana; Covolo, Loredana; Lirangi, Enrico; Gelatti, Umberto

2013-09-02

During the last H1N1 pandemic has emerged the importance of crisis communication as an essential part of health crisis management. The Project aims specifically to improve the understanding of crisis communication dynamics and effective tools and to allow public health institutions to communicate better with the public during health emergencies. THE PROJECT WILL PERFORM DIFFERENT ACTIVITIES: i) state of the art review; ii) identification of key stakeholders; iii) communicational analysis performed using data collected on stakeholder communication activities and their outcomes considering the lessons learnt from the analysis of the reasons for differing public reactions during pandemics; iv) improvement of the existing guidelines; v) development of Web 2.0 tools as web-platform and feed service and implementation of impact assessment algorithms; vi) organization of exercises and training on this issues. In the context of health security policies at an EU level, the project aims to find a common and innovative approach to health crisis communication that was displayed by differing reactions to the H1N1 pandemic policies. The focus on new social media tools aims to enhance the role of e-health, and the project aims to use these tools in the specific field of health institutions and citizens. The development of Web 2.0 tools for health crisis communication will allow an effective two-way exchange of information between public health institutions and citizens. An effective communication strategy will increase population compliance with public health recommendations. Significance for public healthThe specific aim of the project is to develop a European strategy approach on how to communicate with the population and with different stakeholders groups involved in the crisis management process, based on an analysis of the communication process during the H1N1 pandemic (content analysis of press releases, press coverage and forum discussions) and on interviews with key

Afghanistan's population: planning to avoid a crisis.

Science.gov (United States)

Rosenthal, J E

1973-07-09

Though the population of Afghanistan is exploding (AID estimates net growth rate at 2.5%), private, governmental, and foreign efforts should avert a crisis. The family-planning situation in this developing nation is discussed. The Afghan Family Guidance Association (AFGA), formed in July 1968, is a private organization but has semi-official status. AFGA runs 6 clinics in Kabul and 13 in the provinces. AFGA family Guides talk of mothers about their health and their children's health and about the desirability and methods of spacing children. In a pilot project several male Family Guides approach husbands with information about family planning. The Afghan government's family-planning program, scheduled to begin this year, has had its way paved by the work of the AFGA. The government plans to establish 280 basic health centers within 5 years. AID gives $1 million annually for family-planning projects, supplies, and services in Afghanistan. AID also is providing $1.7 million to finance the first demographic study of the nation.

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…

A neoclassical analysis of the 2001 crisis in Turkey

OpenAIRE

Türe, Elif Hatice; Ture, Elif Hatice

2008-01-01

In early 2001, Turkey experienced a severe economic crisis and many researchers attempted to qualitatively explain this downturn through analyzing the facts that caused the crisis and the effects it had on the economy. The focus of this paper is to complement these studies by quantitatively analyzing the economic fluctuations during the 2001 crisis in the light of the neoclassical growth theory. In this paper, it is shown that a standard dynamic stochastic small open economy model with exogen...

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.

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.

Socioeconomic crisis and aggressive behaviour of Greek adolescents.

Science.gov (United States)

Lazaratou, Helen; Kalogerakis, Zacharias; Economou, Marina; Xenitidis, Kiriakos

2017-09-01

Aggressive behaviours are common during adolescence. In Greece, adolescents and their families experience a severe and enduring recession with potentially adverse impact on mental health. This study aimed to examine the correlation between adolescents' aggressive behaviour and economic factors. The Buss-Perry Aggression Questionnaire (AQ) was used to measure aggression. Reduction in pocket money and three items of the Household Food Insecurity Access Scale were used to measure material deprivation as a result of the economic crisis. The questionnaires were administrated to a sample of 2,159 adolescent students of the Greater Athens Metropolitan Area. Students who during the previous 4 weeks had experienced household food insecurity (anxiety/uncertainty about food, insufficient food quality or insufficient food intake) or had their pocket money decreased within the last 6 months scored on average significantly higher in the AQ compared to their counterparts who did not. The shortage in basic goods due to the actual Greek economic crisis seems to be related to aggressive behaviours during adolescence and we should take this into account in clinical practice.

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.

WORLD ECONOMIC CRISIS, EXPRESSION OF THE GENERAL CRISIS CAPITALISM AND THE SITUATION WORKERS IN THE CLASS STRUGGLE AGAINST THE CAPITAL

Directory of Open Access Journals (Sweden)

Vicente E. Escandell-Sosa

2016-01-01

Full Text Available This work, based on the method dialectical materialist of Marx, argues with scientific approaches, that the world economic crisis, for very sharp and severe she is, is not a crisis without exit of the capitalism neither it will cause the collapse of the capitalism, although she constitutes part of the general crisis of the capitalism and increase the same one, since no crisis of the capitalism will take it to its end in absence of a fight of classes, because the social force that must generate the revolutionary changes is very limited. «Without the products of the fight of classes, the economic crises, «per se» won’t be a threat for the capital. The essential question is if the proletariat will live the crisis like object or like decisive fellow». The immaturity of the proletariat and its subordination to the laws of the capital indicate that the specific nature of the capital remains hidden.» 

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.

Danish Cartoon Crisis/Controversy

DEFF Research Database (Denmark)

Hervik, Peter

2017-01-01

The Danish Cartoon Crisis Controversy is one of several terms that refer to the turmoil that associates with the Danish newspaper Morgenavisen Jyllands-Posten’s publication of 12 cartoons on 30 September 2005. “The Muhammad Cartoon Crisis” is an alternative heading used for the violent global rea...

Health anxiety by proxy in women with severe health anxiety

DEFF Research Database (Denmark)

Thorgaard, Mette Viller; Frostholm, Lisbeth; Walker, Lynn

2017-01-01

Health anxiety (HA) refers to excessive worries and anxiety about harbouring serious illness based on misinterpretation of bodily sensations or changes as signs of serious illness. Severe HA is associated with disability and high health care costs. However, the impact of parental HA on excessive...... concern with their children's health (health anxiety by proxy) is scantly investigated. The aim of this study is to investigate HA by proxy in mothers with severe HA. Fifty mothers with severe HA and two control groups were included, i.e. mothers with rheumatoid arthritis (N = 49) and healthy mothers (N...

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...

The effects of dictatorship on health: the case of Turkmenistan.

Science.gov (United States)

Rechel, Bernd; McKee, Martin

2007-07-30

There is a health crisis in Turkmenistan similar to, but more severe than, in other Central Asian countries. This paper asks whether the health crisis in Turkmenistan is attributable to the consequences of the dictatorship under president Niyazov, who died in 2006. The basis for this paper was a series of semi-structured in-depth interviews with key informants complemented by an iterative search of internet sites, initially published as a report in April 2005, and subsequently updated with feedback on the report as well as a comprehensive search of secondary information sources and databases. This paper describes in depth three areas in which the dictatorship in Turkmenistan had a negative impact on population health: the regime's policy of secrecy and denial, which sees the "solution" to health care problems in concealment rather than prevention; its complicity in the trafficking of drugs from Afghanistan; and the neglect of its health care system. The paper concludes that dictatorship has contributed to the health crisis facing Turkmenistan. One of the first tests of the new regime will be whether it can address this crisis.

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 ...

Effects of the Financial Crisis on Psychotropic Drug Consumption in a Cohort from a Semi-Urban Region in Catalonia, Spain

Science.gov (United States)

Barceló, Maria A.; Coll-Negre, Montserrat; Coll-de-Tuero, Gabriel; Saez, Marc

2016-01-01

Purpose Evidence of whether the recent economic crisis has or has not had an effect on psychotropic drug consumption is very scarce. Our objective was to determine if there had in fact been an increase in psychotropic drug use as a result of the financial crisis. Methods In our study a retrospective cohort (between January 1, 2005, and December 31, 2012) was made up of individuals from the general population in a region in the northeast of Catalonia, Spain. We specified a generalized linear mixed model along with combined ‘selection on observables’ as (propensity scoring) matching and ‘selection on unobservables’ as (random coefficient) the panel data model methods, and performed inferences using a Bayesian framework. Results In the period following the economic crisis (post 2009), there was an increase in the consumption of psychotropic drugs which was significantly higher among those who had already been consuming psychotropic drugs prior to 2009 and those most likely to be unemployed. The increase was of greater significance when consumption was measured by the number of drugs being taken, rather than by the defined daily dose (DDD), with the greatest increase occurring in 2011; the very year in which Spain was most affected by the crisis. Conclusions Once the financial crisis had ended, there was an increase in the severity, rather than the intensity, of mental health disorders in individuals who had already had disorders before the crisis. This increase occurred in those most likely to be unemployed, and the severity was accentuated in the toughest year of the economic crisis. PMID:26872210

Effects of the Financial Crisis on Psychotropic Drug Consumption in a Cohort from a Semi-Urban Region in Catalonia, Spain.

Directory of Open Access Journals (Sweden)

Maria A Barceló

Full Text Available Evidence of whether the recent economic crisis has or has not had an effect on psychotropic drug consumption is very scarce. Our objective was to determine if there had in fact been an increase in psychotropic drug use as a result of the financial crisis.In our study a retrospective cohort (between January 1, 2005, and December 31, 2012 was made up of individuals from the general population in a region in the northeast of Catalonia, Spain. We specified a generalized linear mixed model along with combined 'selection on observables' as (propensity scoring matching and 'selection on unobservables' as (random coefficient the panel data model methods, and performed inferences using a Bayesian framework.In the period following the economic crisis (post 2009, there was an increase in the consumption of psychotropic drugs which was significantly higher among those who had already been consuming psychotropic drugs prior to 2009 and those most likely to be unemployed. The increase was of greater significance when consumption was measured by the number of drugs being taken, rather than by the defined daily dose (DDD, with the greatest increase occurring in 2011; the very year in which Spain was most affected by the crisis.Once the financial crisis had ended, there was an increase in the severity, rather than the intensity, of mental health disorders in individuals who had already had disorders before the crisis. This increase occurred in those most likely to be unemployed, and the severity was accentuated in the toughest year of the economic crisis.

Unemployment and health selection in diverging economic conditions: Compositional changes? Evidence from 28 European countries.

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Heggebø, Kristian; Dahl, Espen

2015-11-04

Unemployment and health selection in diverging economic conditions: Compositional changes? Evidence from 28 european countries. People with ill health tend to be overrepresented among the unemployment population. The relationship between health and unemployment might, however, be sensitive to the overall economic condition. Specifically, the health composition of the unemployment population could change dramatically when the economy takes a turn for the worse. Using EU-SILC cross sectional data from 2007 (pre-crisis) and 2011 (during crisis) and linear regression models, this paper investigates the relationship between health and unemployment probabilities under differing economic conditions in 28 European countries. The countries are classified according to (i) the level of and (ii) increase in unemployment rate (i.e. >10 percent and doubling of unemployment rate = crisis country). Firstly, the unemployment likelihood for people with ill health is remarkably stable over time in Europe: the coefficients are very similar in pre-crisis and crisis years. Secondly, people with ill health have experienced unemployment to a lesser extent than those with good health status in the crisis year (when we pool the data and compare 2007 and 2011), but only in the countries with a high and rising unemployment rate. The health composition of the unemployment population changes significantly for the better, but only in those European countries that have been severely hit by the current economic crisis.

The financial crisis in Europe: Impact on satisfaction with life.

Science.gov (United States)

Clench-Aas, Jocelyne; Holte, Arne

2017-08-01

The 2008 financial crisis in Europe came abruptly and surprisingly. Many countries also suffered a second recession during the period 2010-2012. We examined the impact of the crisis on life satisfaction (LS) by country and individual socioeconomic level. We used a representative sample from the European Social Survey (2002-2014) with data from 26 countries ( N = 294,407). LS was measured with a single question with 11 response alternatives. Time from start of crisis (either 2008 or 2010-2012) was determined separately for each interview. Data were analyzed by multilevel analysis Results: There was a sharp decrease in LS in the beginning of the crisis in 2008, and another, but not so severe, decline in 2011, each of them of short duration. However, there was also a slight and progressive yearly decrease in LS that continued one to at least 3 years after either financial crisis that was independent of the effect of being unemployed. Associations varied considerably between countries. A negative decline after the financial crisis was especially evident among those in the most educated groups, and in those in the higher occupational levels. The 2008 financial crisis had a double effect on LS: (1) a sharp short-term decrease consistent with the Easterlin paradox; (2) a slighter long-term progressive decrease that was over and above the strong negative relationship with unemployment that lasted several years. The long-term decline in LS after the start of the financial crisis tended to occur especially in the higher socioeconomic groups.

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

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.

Reforms in the Greek pharmaceutical market during the financial crisis.

Science.gov (United States)

Vandoros, Sotiris; Stargardt, Tom

2013-01-01

Following the financial crisis of 2008, Greece has been facing severe fiscal problems associated with high public debt and deficit. Given their significant contribution to public sector expenditure, part of the effort to reduce public expenditure has involved a focus on pharmaceutical markets. Our aim is to provide an overview of recent policy changes in the Greek pharmaceutical market as a response to the crisis. We also discuss other potential measures that can be implemented. The recommendations are relevant to European countries facing debt crises, but also to any other country, as improving efficiency makes funds available to be used on other interventions. In 2010 and 2011, following the debt crisis and the agreement with the IMF, EU and ECB, the Greek government introduced several policy measures aimed at cost-containment. These changes included (a) price cuts, (b) the re-introduction of a positive list, (c) changes in the profit margins of pharmacies and wholesalers, and (d) tenders for hospital drugs. As a result, public drug expenditure decreased from €5.09 billion in 2009 to €4.25 billion in 2010 and €4.10 billion in 2011. As the need to cut expenditure becomes more urgent, seeking efficiency is possibly the only option for countries that do not wish to compromise quality of healthcare and public health. However, efficiency and cost containment are not only about introducing new policies, but also about the enforcement of existing laws and fighting corruption. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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.

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...

False alarms, real challenges--one university's communication response to the 2001 anthrax crisis.

Science.gov (United States)

Clarke, Christopher E; Chess, Caron

2006-01-01

Considerable research exists on how government agencies at the federal, state, and local levels communicated during the fall 2001 anthrax attacks. However, there is little research on how other institutions handled this crisis, in terms of their response to potential anthrax contamination (aka "white powder scares") and their approach to disseminating important health and safety information. In this article, we investigate a major university's communication response to the anthrax crisis. First, we describe its communication experiences relating to a large white powder scare that occurred in October 2001. Second, we describe the university's broader communication efforts in terms of several important elements of risk communication research, including influence of source attributes, key messages, preferred channels, responses to information requests, and organizational influences. This study underlines that an institution does not have to be directly affected by a crisis to find itself on the communication "front lines." Moreover, other institutions may find it useful to learn from the experiences of this university, so that they may communicate more effectively during future crises.

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

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...

A rare cause of fever and icterus: Thyroid crisis

Directory of Open Access Journals (Sweden)

Emine Parlak

2013-03-01

Full Text Available Thyroid crisis is the severe form of hyperthyroidism. The predisposing factors are mostly surgeries and additional diseases.Although the case is rare, the mortality rate is high. Here, we present a thyroid crisis case which implies infectiousdiseases. A 36-year-old female patient admitted to the hospital with high fever, abdominal pain, and unstable mentalstate. Physical examination revealed icterus, tachycardia, and hepatosplenomegaly. Serum free triiodothyronine (FT3,and free thyroxine (FT4 levels were elevated and thyroid-stimulating hormone (TSH was highly suppressed. An infectiousetiology was suspected on admission, but further investigation revealed thyroid crisis. Patients with high fevershould be considered in differential diagnosis of non-infectious causes such as thyroid crisis. In these cases, early andcorrect diagnosis is important for prognosis. . J Microbiol Infect Dis 2013; 3(1: 36-38Key words: Thyroid crisis, fever, icterus, hyperthyroidism

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.

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.

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

Building Responsive and Responsible Financial Regulators in the Aftermath of the Global Financial Crisis

NARCIS (Netherlands)

Iglesias Rodriguez, P.

2015-01-01

The global financial crisis that started in 2007 sparked several academic debates about the role that financial sector regulators played in the crisis and prompted policy reforms in the financial supervision architectures of several countries. This book focuses on the question of what

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

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

Lifecycle effects of a recession on health behaviors: Boom, bust, and recovery in Iceland.

Science.gov (United States)

Ásgeirsdóttir, Tinna Laufey; Corman, Hope; Noonan, Kelly; Reichman, Nancy E

2016-03-01

This study uses individual-level longitudinal data from Iceland, a country that experienced a severe economic crisis in 2008 and substantial recovery by 2012, to investigate the extent to which the effects of a recession on health behaviors are lingering or short-lived and to explore trajectories in health behaviors from pre-crisis boom, to crisis, to recovery. Health-compromising behaviors (smoking, heavy drinking, sugared soft drinks, sweets, fast food, and tanning) declined during the crisis, and all but sweets continued to decline during the recovery. Health-promoting behaviors (consumption of fruit, fish oil, and vitamins/minerals and getting recommended sleep) followed more idiosyncratic paths. Overall, most behaviors reverted back to their pre-crisis levels or trends during the recovery, and these short-term deviations in trajectories were probably too short-lived in this recession to have major impacts on health or mortality. A notable exception is for binge drinking, which declined by 10% during the 2 crisis years, continued to fall (at a slower rate of 8%) during the 3 recovery years, and did not revert back to the upward pre-crisis trend during our observation period. These lingering effects, which directionally run counter to the pre-crisis upward trend in consumption and do not reflect price increases during the recovery period, suggest that alcohol is a potential pathway by which recessions improve health and/or reduce mortality. Copyright © 2015 Elsevier B.V. All rights reserved.

An implementation study of the crisis resolution team model in Norway: Are the crisis resolution teams fulfilling their role?

Directory of Open Access Journals (Sweden)

Johnson Sonia

2011-05-01

Full Text Available Abstract Background The establishment of crisis resolution teams (CRTs is part of the national mental health policy in several Western countries. The purpose of the present study is to describe characteristics of CRTs and their patients, explore the differences between CRTs, and examine whether the CRTs in Norway are organized according to the international CRT model. Methods The study was a naturalistic study of eight CRTs and 680 patients referred to these teams in Norway. Mental health problems were assessed using the Health of the Nation Outcome Scales (HoNOS, Global Assessment of Functioning Scales (GAF and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10. Results None of the CRTs operated 24 hours a day, seven days a week (24/7 availability or had gate-keeping functions for acute wards. The CRTs also treated patients who were not considered for hospital admission. Forty per cent of patients waited more than 24 hours for treatment. Fourteen per cent had psychotic symptoms, and 69% had affective symptoms. There were significant variations between teams in patients' total severity of symptoms and social problems, but no variations between teams with respect to patients' aggressive behaviour, non-accidental self-injury, substance abuse or psychotic symptoms. There was a tendency for teams operating extended hours to treat patients with more severe mental illnesses. Conclusions The CRT model has been implemented in Norway without a rapid response, gate-keeping function and 24/7 availability. These findings indicate that the CRTs do not completely fulfil their intended role in the mental health system.

The effects of dictatorship on health: the case of Turkmenistan

OpenAIRE

Rechel, Bernd; McKee, Martin

2007-01-01

Abstract Background There is a health crisis in Turkmenistan similar to, but more severe than, in other Central Asian countries. This paper asks whether the health crisis in Turkmenistan is attributable to the consequences of the dictatorship under president Niyazov, who died in 2006. Methods The basis for this paper was a series of semi-structured in-depth interviews with key informants complemented by an iterative search of internet sites, initially published as a report in April 2005, and ...

Abortion misinformation from crisis pregnancy centers in North Carolina.

Science.gov (United States)

Bryant, Amy G; Levi, Erika E

2012-12-01

This study assessed the accuracy of medical information provided by crisis pregnancy centers in North Carolina. We performed a secondary data analysis of a "secret shopper survey" performed by a nonprofit organization. Reports from phone calls and visits to crisis pregnancy centers were analyzed for quality and content of medical information provided. Web sites of crisis pregnancy centers in the state were also reviewed. Thirty-two crisis pregnancy centers were contacted. Nineteen of these were visited. Fourteen centers (44%) offered that they "provide counseling on abortion and its risks." Inaccurate information provided included a link between abortion and breast cancer (16%), infertility (26%) and mental health problems (26%). Of the 36 Web sites identified, 31 (86%) provided false or misleading information, including 26 sites (72%) linking abortion to "post-abortion stress." Many crisis pregnancy centers give inaccurate medical information regarding the risks of abortion. Overstating risks stigmatizes abortion, seeks to intimidate women and is unethical. Copyright © 2012 Elsevier Inc. All rights reserved.

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,…

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...

Diagnosis of Financial Crisis in Asia : From Miracle to Debacle

NARCIS (Netherlands)

van de Gevel, A.J.W.

1998-01-01

This paper discusses the causes, cures and consequences of the Asian financial crisis.Since mid-1997 a number of Southeast Asian economies have been in the grip of a severe financial crisis that has thrown the region into a deep recession.On the basis of expected diminishing returns this has raised

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…

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.

Costs of treating patients with schizophrenia who have illness-related crisis events

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Peng Xiaomei

2008-08-01

Full Text Available Abstract Background Relatively little is known about the relationship between psychosocial crises and treatment costs for persons with schizophrenia. This naturalistic prospective study assessed the association of recent crises with mental health treatment costs among persons receiving treatment for schizophrenia. Methods Data were drawn from a large multi-site, non-interventional study of schizophrenia patients in the United States, conducted between 1997 and 2003. Participants were treated at mental health treatment systems, including the Department of Veterans Affairs (VA hospitals, community mental health centers, community and state hospitals, and university health care service systems. Total costs over a 1-year period for mental health services and component costs (psychiatric hospitalizations, antipsychotic medications, other psychotropic medications, day treatment, emergency psychiatric services, psychosocial/rehabilitation group therapy, individual therapy, medication management, and case management were calculated for 1557 patients with complete medical information. Direct mental health treatment costs for patients who had experienced 1 or more of 5 recent crisis events were compared to propensity-matched samples of persons who had not experienced a crisis event. The 5 non-mutually exclusive crisis event subgroups were: suicide attempt in the past 4 weeks (n = 18, psychiatric hospitalization in the past 6 months (n = 240, arrest in the past 6 months (n = 56, violent behaviors in the past 4 weeks (n = 62, and diagnosis of a co-occurring substance use disorder (n = 413. Results Across all 5 categories of crisis events, patients who had a recent crisis had higher average annual mental health treatment costs than patients in propensity-score matched comparison samples. Average annual mental health treatment costs were significantly higher for persons who attempted suicide ($46,024, followed by persons with psychiatric hospitalization in

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.

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...

The effects of dictatorship on health: the case of Turkmenistan

Directory of Open Access Journals (Sweden)

McKee Martin

2007-07-01

Full Text Available Abstract Background There is a health crisis in Turkmenistan similar to, but more severe than, in other Central Asian countries. This paper asks whether the health crisis in Turkmenistan is attributable to the consequences of the dictatorship under president Niyazov, who died in 2006. Methods The basis for this paper was a series of semi-structured in-depth interviews with key informants complemented by an iterative search of internet sites, initially published as a report in April 2005, and subsequently updated with feedback on the report as well as a comprehensive search of secondary information sources and databases. Results This paper describes in depth three areas in which the dictatorship in Turkmenistan had a negative impact on population health: the regime's policy of secrecy and denial, which sees the "solution" to health care problems in concealment rather than prevention; its complicity in the trafficking of drugs from Afghanistan; and the neglect of its health care system. Conclusion The paper concludes that dictatorship has contributed to the health crisis facing Turkmenistan. One of the first tests of the new regime will be whether it can address this crisis.

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.

A comparison of currency crisis dating methods : East Asia 1970-2002

NARCIS (Netherlands)

Lestano, [No Value; Jacobs, Jan P.A.M.

2004-01-01

Generally, a currency crisis is defined to occur if an index of currency pressure exceeds a threshold. This paper compares several currency crisis dating methods adopting different definitions of currency pressure indexes and ad-hoc and extreme value based thresholds. We illustrate the methods with

Framing the Refugee Crisis in Online Media: A Romanian Perspective

OpenAIRE

Nicoleta Corbu; Raluca Buturoiu; Flavia Durach

2017-01-01

The European Union (EU) is under severe pressure, due to the multiple crises it has to manage. Among them, the refugee crisis is remarkable, since it is shaking both the individual member states and the EU as a whole. The media coverage of the refugee crisis is important because the media still are the main source of information concerning distant issues (the refugee crisis included), and as such it facilitates people’s access to social reality. Using the perspective of agenda-setting and the...

FINANCIAL CRISIS FROM THE MACROECONOMIC LEVEL TO THE MICROECONOMIC LEVEL

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SANDA GHEORGHE GABRIEL

2014-08-01

Full Text Available The current economic and financial crisis, beyond the problems it generates both at micro and macro level, should determine an adaptation of the mechanisms, institutions and monetary / financial policies to the real economy we are facing. The issue of financial crises is extremely complex, including a series of quantitative and qualitative factors, financial, economic, social, ethical, technological and human, which can intervene and influence the financial operations in a country or several countries simultaneously. We believe that it is difficult to appreciate that a traditional model might explain a financial crisis, given that every context of occurrence, conditions of development and crisis settlement programs are unique and unrepeatable. Every crisis has in its structure certain issues that may be capitalized and can lead to success. Perhaps more obvious are the ways that can lead to total failure of the organization. Finding and capitalizing the potential success is the essence of the crisis management. The essence of the mismanagement of the crisis is to worse situation. The successful management of a crisis involves admitting that you are facing a crisis, taking reasonable measures to remedy the situation, to be seen taking them and heard saying the right words. The issue at this stage of crisis management is that perception becomes true reality. Crisis management is a set of factors designed to combat the crisis and reduce the damage caused by the crisis. In other words, crisis management attempts to prevent or reduce the negative effects of the crisis and protect the organization, the public involved and the specific field by the possible damages. The effective management of the crisis includes crisis communication. This is an essential component through which the organization faced with the difficult situation can rehabilitate it’s publicly image or even to improve it. The crisis communication occurs between the organization and

The BIS and the Latin American debt crisis of the 1980s

OpenAIRE

Piet Clement; Ivo Maes

2013-01-01

The Latin American debt crisis, which broke out in August 1982, was the first global financial crisis in the postwar period. While the crisis started in the "periphery", it constituted a threat to the "core" of the world economy, as the banking system was under severe pressure. Alongside the IMF, the BIS played an important role in coordinating the international response to the crisis. Moreover, a lot of work at the BIS in the second half of the 1970s had aimed at restraining the debt build-u...

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.

Residential consumer behavior during and after an energy crisis

Energy Technology Data Exchange (ETDEWEB)

Aragao Neto, Raymundo [International Institute for Energy Conservation, Rio de Janeiro, RJ (Brazil)]. E-mail: raragao@iiec.org; Javaroni, Mario Cesar [ECOLUZ Consultores Associados, Rio de Janeiro, RJ (Brazil)]. E-mail: javaroni@ecoluz.com.br

2004-07-01

Brazil faced a severe energy crisis during 2001 and 2002 that reflected in all sectors including residential, and obliged to reduce in 20 per cent consumption, considering 2000 basis. New products were largely used, and domestic customs changed. This paper evaluates how residential behaviour has changed during the crisis period, and one year later what initiatives (habits, appliances) remained, considering a survey with 240 consumers. (author)

A Complex Interplay: Cognitive Behavioural Therapy for Severe Health Anxiety in Addison's Disease to Reduce Emergency Department Admissions.

Science.gov (United States)

Daniels, Jo; Sheils, Elizabeth

2017-07-01

Addison's disease (AD) is a rare chronic illness caused by adrenocortical insufficiency. Due to the pivotal role of the regulating hormone cortisol in AD, there is a common symptom overlap between the presentation of anxiety and adrenal crisis. Previous literature has identified the prevalence of anxiety in endocrinological disorders, however there is a paucity of research examining the complex interplay between AD and anxiety. This paper describes a single case study of a patient with severe health anxiety and co-morbid AD. The aims of the study were to establish if standard cognitive behavioural therapy for health anxiety in AD can lead to a reduction in psychological distress, and whether this approach is an effective intervention for the reduction of Emergency Department admissions. A single case design was used, with pre- and post-measures of health anxiety, general anxiety and depression. Data on Emergency Department admissions prior to and following treatment were used to assess change in this domain. Reliable and clinically significant reductions were seen across all measures, from severe to sub-clinical levels. There was a complete amelioration of Emergency Department admissions in the 12 months following completion of treatment. This preliminary study provides a sound rationale for further research into AD complicated by anxiety. Findings support the clinical utility of the cognitive behavioural therapy model for complex presentations of AD, offering a potential treatment option where anxiety is elevated and interfering with self-management and leading to high levels of health service use.

Global Financial Crisis and Philanthropy: Malaysian Case

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Janice Lay Hui Nga

2015-08-01

Full Text Available This paper investigates the issue of the global financial crisis and its impacts on philanthropy and civil society organisations (CSOs in Malaysia. CSOs are popularly known as non-governmental organisations (NGOs in Malaysia. Financial crisis has caused NGOs in many countries to receive less funding. This situation may threaten and discourage voluntary works. Undoubtedly, these beneficial contributions from the NGOs are needful services to the society. This paper examines the impact of financial crisis through the lens of NGOs and philanthropy activities in Malaysia. It utilises primary and secondary data, employs a mixed method approach, and uses quantitative and qualitative data. While there are many influencing factors in this development, this paper presents several significant aspects in the Malaysian context, including the style and nature of giving, culture, religion, and political pressure. This study attempts to seek potential solutions, pathways and possible approaches beneficial to NGOs and philanthropy activities for their sustainability in facing the financial crisis and its consequences. Experiences and lessons learnt in Malaysia may well be useful and applicable to some extent in other countries.

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.

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

The financial crisis in Italy: implications for the healthcare sector.

Science.gov (United States)

de Belvis, Antonio Giulio; Ferrè, Francesca; Specchia, Maria Lucia; Valerio, Luca; Fattore, Giovanni; Ricciardi, Walter

2012-06-01

The global economic and financial crisis is having and impact on the Italian healthcare system which is undergoing a devolution process from the central government to regions and where about one third of the regional governments (mainly in the central and southern part of the country) are facing large financial deficits. The paper briefly describes the current macro scenario and the main responses taken to face the crisis and highlights the downside risks of introducing "linear" cuts in the allocation of resources. While justified by the risk of a national debt default, present fiscal policies might increase inequalities in access to care, deteriorate overall health indicators and population wellbeing, and sharpen existing difference in the quality of care between regions. Preliminary evidence shows that the crisis is affecting the quality of nutrition and the incidence of psychiatric disorders. During this difficult financial situation Italy is also facing the risk of a major reduction in investments for preventive medicine, Evidence Based Medicine infrastructures, health information systems and physical capital renewal. This cost-cutting strategy may have negative long term consequences Also, important achievement in terms of limiting waiting lists, improving continuity of care and patients' centeredness, and promoting integration between social and health care may be negatively affected by unprecedented resources' cuts. It is essential that in such a period of public funding constraints health authorities monitor incidence of diseases and access to care of the most vulnerable groups and specifically target interventions to those who may be disproportionally hit by the crisis. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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...

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

Crisis Response Strategy and Crisis Types Suitability: A Preliminary Study on MH370

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Mohamad Ashari Noratikah

2017-01-01

Full Text Available In time of crisis, the organisation’s tactic in responding to the crisis according to its type/s may significantly affect the organisation’s effort to survive its reputational damages. The study of crisis response strategy (CRS requires further exploration within the Malaysian context, moreso with the greater and apparent use of social media as a platform for the organisation in crisis to reach out to its stakeholders. This preliminary paper studies the MH370 crisis in light of Coombs [1] Situational Crisis Communication Theory (SCCT. It aims to discuss the suitability of the CRS applied by Malaysia Airlines System (MAS with the crisis type/s that was/were experienced by the organisation. Hence, the need for this paper to investigate the crisis type/s of MH370 and examines the CRS applied by MAS by content analysing media statements that were disseminated directly to the organisation’s stakeholders on Facebook during the first day of the crisis. Results ultimately show an interesting analysis to the crisis type of MH370, and the suitability of the CRS applied by MAS for that matter.

Relación entre la severidad de las manifestaciones de asma bronquial y el cumplimiento del tratamiento intercrisis Relation between the severity of bronchial asthma manifestations and the fulfilment of the inter-crisis treatment

Directory of Open Access Journals (Sweden)

Tatiana de la Vega Pazitková

2011-09-01

Full Text Available INTRODUCCIÓN: En la última década han aumentado la morbilidad y la mortalidad por asma bronquial. Se estima que esta enfermedad la padecen actualmente 300 millones de personas en el mundo. En Cuba, el asma bronquial constituye también un importante problema de salud. OBJETIVO: Establecer la relación entre el cumplimiento del tratamiento en periodos intercrisis y la severidad de las manifestaciones clínicas de la enfermedad. MÉTODOS: Se estudiaron 119 pacientes con diagnóstico de asma bronquial pertenecientes al policlínico "Ana Betancourt". Para la recolección de datos se aplicaron cuestionarios de forma individual a los pacientes o a los familiares que están directamente al cuidado de estos. Los pacientes fueron agrupados según la Guía española para el manejo del asma de 2009. RESULTADOS: Se detectaron 23 pacientes asmáticos intermitentes, 42 persistentes leves, 36 persistentes moderados y 18 persistentes graves. El 95 % de los pacientes estudiados desencadenaba la crisis con inhalantes respiratorios. En el 79 % de los hogares se detectó la presencia de fumadores. Solo el 41 % de los pacientes cumplía el tratamiento correctamente en los periodos intercrisis. CONCLUSIONES: Existe una relación directa entre la severidad de las manifestaciones clínicas del asma bronquial y el no cumplimiento del tratamiento intercrisis, lo que puede condicionar la exacerbación de la enfermedad.INTRODUCTION: In past decade the morbidity and mortality from bronchial asthma have increased. This is a diseased suffered nowadays by 300 millions of persons in the world. In Cuba, the bronchial asthma is also an important health problem. OBJECTIVE: To establish the relation between the fulfilment of treatment in inter-crisis period and the severity of the clinical manifestations of this entity. METHODS: A total of 119 patients diagnosed with bronchial asthma from the "Ana Betancourt" Polyclinic were studied. In data collection authors applied individual

Facing the Global Economic Crisis: the Case of Swedish Heavy Vehicle Subcontractors

OpenAIRE

Helmersson, Andreas; Radway, Robert

2010-01-01

In this paper, we investigate organisational responses to an economic crisis within a group of seven subcontractors in the Swedish heavy vehicle industry. Although the participating firms had similar exposures to an abrupt and severe shift in demand, their performances during the crisis varied extensively. One year after the crisis began, some firms were still encountering financial problems threatening their survival, yet others had orchestrated a recovery that was generating healthy cash fl...

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...

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.

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 ...

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.

the dutch crisis and recovery act: economic recovery and legal crisis

African Journals Online (AJOL)

Jonathan

THE DUTCH CRISIS AND RECOVERY ACT: ECONOMIC RECOVERY AND. LEGAL CRISIS? J Verschuuren. 1 Introduction. Throughout the world, governments are responding to the financial and economic crisis. Such responses vary from supporting the banking system to adopting economic stimulus packages. The latter ...

Distress and burnout in young medical researchers before and during the Greek austerity measures: forerunner of a greater crisis?

Science.gov (United States)

Sifaki-Pistolla, Dimitra; Chatzea, Vasiliki-Eirini; Melidoniotis, Evangelos; Mechili, Enkeleint-Aggelos

2018-07-01

Distress and burnout are strongly correlated with austerity and financial recessions. Aim of this study was to assess distress and burnout among young medical researchers (YMR) in Greece before and during the financial crisis. In total 2050 YMR affiliated in all the nursing and medical departments of Greece were enrolled (1025 in Period A: 2008 and 1025 in Period B: 2017). Distress and burnout were measured via DASS-21 and Maslach Burnout Inventory (MBI) questionnaires. Before the crisis, prevalence of distress and burnout among young medical researchers was 24 and 20%, respectively. During the financial crisis distress prevalence increased significantly (56%), while there has also been a tremendous increase in burnout occurrence (60%). Specific sociodemographic characteristics presented significantly increased rate of change (females, singles and divorced/widowers, living with family members, volunteers, smokers and heavy alcohol consumers). Distress and burnout scales were positively correlated (Spearman's r = 0.81; p = 0.01). Depression scores shifted from normal to moderate (rate of change = 13.1%), anxiety levels increased from normal to severe (rate of change = 14.3%) and tension/stress scores elevated from normal to severe (rate of change = 20.2%). It is evident that the current financial crisis and working conditions have a strong impact on health status of young medical researchers in Greece. The observed increased trends and the identified predictors could guide targeted and comprehensive interventions towards tackling distress among the medical researchers not only in Greece but also in other countries suffering from financial crisis.

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 ...

Crisis discussions in psychology--New historical and philosophical perspectives.

Science.gov (United States)

Sturm, Thomas; Mülberger, Annette

2012-06-01

In this introductory article, we provide a historical and philosophical framework for studying crisis discussions in psychology. We first trace the various meanings of crisis talk outside and inside of the sciences. We then turn to Kuhn's concept of crisis, which is mainly an analyst's category referring to severe clashes between theory and data. His view has also dominated many discussions on the status of psychology: Can it be considered a "mature" science, or are we dealing here with a pre- or multi-paradigmatic discipline? Against these Kuhnian perspectives, we point out that especially, but not only in psychology distinctive crisis declarations and debates have taken place since at least the late 19th century. In these, quite different usages of crisis talk have emerged, which can be determined by looking at (a) the content and (b) the dimensions of the declarations, as well as (c) the functions these declarations had for their authors. Thus, in psychology at least, 'crisis' has been a vigorous actor's category, occasionally having actual effects on the future course of research. While such crisis declarations need not be taken at face value, they nevertheless help to break the spell of Kuhnian analyses of psychology's history. They should inform ways in which the history and philosophy of psychology is studied further. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Lessons from abroad. Current and previous crisis in other countries. SESPAS report 2014].

Science.gov (United States)

Rivadeneyra-Sicilia, Ana; Minué Lorenzo, Sergio; Artundo Purroy, Carlos; Márquez Calderón, Soledad

2014-06-01

The evidence available on the impact of previous crises on health reveals different patterns attributable to study designs, the characteristics of each crisis, and other factors related to the socioeconomic and political context. There is greater consensus on the mediating role of government policy responses to financial crises. These responses may magnify or mitigate the adverse effects of crises on population health. Some studies have shown a significant deterioration in some health indicators in the context of the current crisis, mainly in relation to mental health and communicable diseases. Alcohol and tobacco use have also declined in some European countries. In addition, this crisis is being used by some governments to push reforms aimed at privatizing health services, thereby restricting the right to health and healthcare. Specifically, action is being taken on the three axes that determine health system financing: the population covered, the scope of services, and the share of the costs covered. These measures are often arbitrarily implemented based on ideological decisions rather than on the available evidence and therefore adverse consequences are to be expected in terms of financial protection, efficiency, and equity. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Advance statements for borderline personality disorder: a qualitative study of future crisis treatment preferences.

Science.gov (United States)

Borschmann, Rohan; Trevillion, Kylee; Henderson, R Claire; Rose, Diana; Szmukler, George; Moran, Paul

2014-06-01

Little is known about the crisis treatment preferences of people with borderline personality disorder. Clinicians may also question service users' ability to make considered decisions about their treatment when in crisis. Therefore, this qualitative study aimed to investigate crisis treatment preferences of a sample of community-dwelling adults with borderline personality disorder. Participants were 41 adults with borderline personality disorder who had created joint crisis plans during a randomized controlled trial. Data from all 41 joint crisis plans were analyzed iteratively via a thematic analysis framework. Participants gave clear statements in their crisis plans relating to the desire to recover from the crisis and to improve their social functioning. Key themes included the desire to be treated with dignity and respect and to receive emotional and practical support from clinicians. Many participants spoke of the importance of connecting with others during periods of crisis, but several reported a clear desire to be left alone during a future crisis. Other themes concerned preferences for specific treatment refusals during crises, including particular types of psychotropic medication and involuntary treatment. The variation of participants' preferences underscores the importance of developing individually tailored crisis plans for people with borderline personality disorder. The need to be treated with dignity and respect and to be given autonomy in decision making--also identified in global surveys of people with severe mental illness--is important to people with borderline personality disorder. Key messages for clinicians, service users, and policy makers, in addition to staff training issues, are discussed.

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...

Talking about a Crisis - Italian Bloggers' Perceptions of Alitalia's Crisis Responses

DEFF Research Database (Denmark)

Valentini, Chiara; Romenti, Stefania

In this study we intend to examine the way in which bloggers and blog readers framed a company performance during a crisis, but looking at the most discussed crisis's themes, at the sources of their statements and at their evaluations. To facilitate that, we focused on a specific crisis case......, the Alitalia's one, as this case shows some specificities that have influenced the contents of the communicative discourses among bloggers and blog readers on the organization's response to its crisis....

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.

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.

Catalan family companies with high growth during the crisis period

Directory of Open Access Journals (Sweden)

Nuria Arimany-Serrat

2016-11-01

Full Text Available Purpose: This study aims to analyze the financial and economic health of the Catalan family companies with high growth during the crisis period (2008-2013, as an engine of job creation and economic development of the territory, identifying the economic and financial characteristics. Design/methodology/approach: The data used comes from the financial statements of the high growth Catalan companies during the crisis period of 2008-2013, in particular it collects a sample of the 140 high growth Catalan companies where a 70% of them are family businesses, there is a financial and economic analysis using descriptive statistics of these family businesses with a regression model to achieve results and conclusions. Findings: During the 2008-2013 crisis, Catalan family companies with high growth that are mostly small businesses have a good economic and financial health, with moderate innovation and a great potential for survival. Research limitations/implications: It would be convenient to make the same study in similar territories where most of the companies are family businesses, in order to compare the financial and economic analysis, valuing the impact of these companies in the business. Practical implications: It allows valuing the projection of these kinds of family companies, mostly in Catalonia, in a financial and economic level, identifying if they have a proper financial strategy. Social implications: The results show that these companies have great financial and economic health and have a better response during a crisis period. Originality / value: The study shows that family businesses have moderate indebtedness and acceptable rendibility in the crisis period, although, since they are small businesses the lack of innovation and patents can lead to future problems.

Something in the Water: Hospital Responds to Water Crisis.

Science.gov (United States)

Redfern, Roberta; Micham, Jennifer; Daniels, Rebecca; Childers, Sue

2018-02-05

Early on August 2, 2014, in the city of Toledo, Ohio, a media alert informed the public that traces of microcystin, a hazardous toxin, had been detected in the drinking water. The warning stated that residents should not drink, boil, or even touch the contaminated water. A water crisis of this magnitude was recognized to pose a potentially serious and significant impact on patient care and safety in health care environments. ProMedica Toledo Hospital's Emergency Operation Plan addressed 3 critical issues: safe water availability, alternate cleaning solutions, and preparations for a prolonged crisis. This report details some of the lessons learned throughout the response to the crisis: particularly, because the impact was county-wide which affected other hospitals who used the same vendors, alternate water sources should have been secured in advance; the courier service was vital to delivery of supplies and moving equipment to alternate areas for sterilization processes; and finally, communication with staff and patients was jeopardized by external media outlets. Changes to the emergency plan considering these unanticipated aspects proved useful in a later incident and should be considered by all health care facilities as water emergency policies and procedures are created and reviewed. (Disaster Med Public Health Preparedness. 2018;page 1 of 3).

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.

[Celiac crisis with quadriplegia due to potassium depletion as presenting feature of celiac disease].

Science.gov (United States)

Atikou, A; Rabhi, M; Hidani, H; El Alaoui Faris, M; Toloune, F

2009-06-01

Adult coeliac disease revealed by coeliac crisis and quadriplegia due to potassium depletion is an extremely rare situation. A 26-year-old woman presented with a suddenly developed weakness of all four limbs and a severe diarrhea. Authors emphasize coeliac crisis, which is a presenting feature of coeliac disease, characterized by acute diarrhea with life-threatening acid base and electrolyte abnormalities. The patient improved with correction of hypokalemia and gluten-free diet. A severe acute diarrhea with metabolic and systemic complications, the so-called coeliac crisis, is a possible presenting clinical feature of a previously undiagnosed adult celiac disease.

Perception of economic crisis among Spanish nursing students: Its relation to burnout and engagement.

Science.gov (United States)

Manzano-García, Guadalupe; Montañés, Pilar; Megías, Jesús L

2017-05-01

The high levels of indebtedness and deficit of Spain's autonomous communities as a consequence of the national and European economic crisis have caused radical changes in the Spanish National Health Service. At the present time, the economic crisis is seriously affecting nurses in several European countries, and especially in Spain. The aim of this study was to analyse whether nursing students' perceptions of economic crisis influence their levels of burnout and engagement in relation to their studies. We have also tried to clarify the relationship of sociodemographic variables (age and gender) and personal control factors (self-efficacy, locus of control and success) with these factors. This was a transversal study based on descriptive and inferential statistical analysis. Analysis of the quantitative data was performed using Statistical Package for Social Sciences, IBM 19.0 (SPSS, 2010). 166 nursing students participated in the study, comprising 142 women and 24 men studying in Schools of Nursing in the North of Spain. They completed various questionnaires to gather information on sociodemographic variables and measure burnout, engagement, locus of control, expectations of success and perceptions of threat due to the economic crisis. Higher perception of economic crisis by the students is related to higher scores for burnout and lower scores for engagement. The scores for burnout were also positively predicted by external locus of control and negatively predicted by perception of self-efficacy. The age of participants is related to lower levels of burnout and higher levels of engagement. Finally, expectation of success also positively predicted the level of engagement. The results demonstrate the importance of the perceptions of the economic crisis on the development of burnout and engagement among nursing students. Copyright © 2017 Elsevier Ltd. All rights reserved.

Nursing workforce policy and the economic crisis: a global overview.

Science.gov (United States)

Buchan, James; O'May, Fiona; Dussault, Gilles

2013-09-01

To assess the impact of the global financial crisis on the nursing workforce and identify appropriate policy responses. This article draws from international data sources (Organisation for Economic Co-operation and Development [OECD] and World Health Organization), from national data sources (nursing regulatory authorities), and the literature to provide a context in which to examine trends in labor market and health spending indicators, nurse employment, and nurse migration patterns. A variable impact of the crisis at the country level was shown by different changes in unemployment rates and funding of the health sector. Some evidence was obtained of reductions in nurse staffing in a small number of countries. A significant and variable change in the patterns of nurse migration also was observed. The crisis has had a variable impact; nursing shortages are likely to reappear in some OECD countries. Policy responses will have to take account of the changed economic reality in many countries. This article highlights key trends and issues for the global nursing workforce; it then identifies policy interventions appropriate to the new economic realities in many OECD countries. © 2013 Sigma Theta Tau International.

Population-based Post-crisis Psychological Distress: An Example From the SARS Outbreak in Taiwan

Science.gov (United States)

Peng, Eugene Yu-Chang; Lee, Ming-Been; Tsai, Shang-Ta; Yang, Chih-Chien; Morisky, Donald Edward; Tsai, Liang-Ting; Weng, Ya-Ling; Lyu, Shu-Yu

2011-01-01

Background/Purpose As a result of the severe acute respiratory syndrome (SARS) pandemic, the World Health Organization placed Taiwan on the travel alert list from May 21 to July 5, 2003. The aim of this study was to explore the post-crisis psychological distress among residents in Taiwan after the SARS epidemic. Methods The target population consisted of a nationwide representative sample of residents aged ≥ 18 years. Data were collected using computer assisted telephone interview systems by stratified random sampling according to geographic area. The survey (n = 1278) was conducted in November 2003, about 4 months after resolution of the SARS crisis in Taiwan. The maximum deviation of sampling error at the 95% confidence level was ± 2.74%. Psychological distress was measured by a question related to subject’s changes in perception of life, plus the five-item Brief Symptom Rating Scale. Multivariate logistic regression was used to examine the correlation of psychological distress. Results About 9.2% of the participants reported that their perceptions of life became more pessimistic following the SARS crisis. The prevalence of psychiatric morbidity was 11.7%. Major predictors of higher levels of pessimism after the SARS epidemic included demographic factors, perception of SARS and pre-paredness, knowing people or having personal experiences of SARS-related discrimination, and individual worries and psychiatric morbidity. The correlates of symptomatic cases, as indicated by the five-item Brief Symptom Rating Scale, included age ≥ 50 years, senior high school graduate, and worries about recurrence of SARS. Conclusion Psychological distress was significantly correlated with demographic factors and perception regarding the SARS epidemic. It is suggested that marketing of mental health education should be segmented according to age and education level, which should enhance crisis communication for newly emerging infectious diseases among community populations

Crisis Response Strategy and Crisis Types Suitability: A Preliminary Study on MH370

OpenAIRE

Mohamad Ashari Noratikah; Abang Ahmad Dayang Aizza Maisha; Samani Mus Chairil

2017-01-01

In time of crisis, the organisation’s tactic in responding to the crisis according to its type/s may significantly affect the organisation’s effort to survive its reputational damages. The study of crisis response strategy (CRS) requires further exploration within the Malaysian context, moreso with the greater and apparent use of social media as a platform for the organisation in crisis to reach out to its stakeholders. This preliminary paper studies the MH370 crisis in light of Coombs [1] Si...

Crisis management aspects of bam catastrophic earthquake: review article.

Science.gov (United States)

Sadeghi-Bazargani, Homayoun; Azami-Aghdash, Saber; Kazemi, Abdolhassan; Ziapour, Behrad

2015-01-01

Bam earthquake was the most catastrophic natural disasters in recent years. The aim of this study was to review different aspects of crisis management during and after the catastrophic earthquake in Bam City, Iran. Data needed for this systematic review were collected through searching PubMed, EMBASE and SID databases, for the period from 2003 to 2011. Keywords included earthquake, Iran and Bam earthquake. The data were summarized and were analyzed using Content Analysis. Out of 422 articles, 25 articles were included in the study. Crisis Management aspects and existing pitfalls were classified into seven categories including planning and organization, human resource management, management of logistics, international humanitarian aids, field performance of the military and security forces, health and medical service provision, and information management. Positive aspects and major pitfalls of crisis management have been introduced in all the mentioned categories. The available evidence indicated poor crisis management during Bam earthquake that resulted in aggravating the losses as well as diminishing the effect of interventions. Thus, concerning the importance of different aspects of the crisis management and the high prevalence of disasters in Iran, the observed vulnerability in disaster management process should be addressed.

The impact of crisis response strategy, crisis type, and corporate social responsibility on post-crisis consumer trust and purchase intention

NARCIS (Netherlands)

Hegner, Sabrina M.; Beldad, Ardion D.; Kraesgenberg, Anne Lotte

2016-01-01

Organisational crises can have deleterious consequences for organisational reputation and sales. Hence, one exigent question pertains to the effects of a company's action prior to the crisis and its crisis response on customers' post-crisis attitude and behavioural intention. To address that

THE CURRENCY CRISIS TRIGGER OF THE ROMANIAN FINANCIAL CRISIS OF 2008

Directory of Open Access Journals (Sweden)

Radu SOVIANI

2014-07-01

Full Text Available This paper analyses the ways the financial crisis started to manifest into the Romanian Financial System, through the exchange rate channel. The focus of this Paper is on how the Romanian decision makers contributed in triggering the financial crisis (that would have been triggered anyway. The paper will determine the trigger (the first obvious event for the Romanian Financial Crisis (the debut and it will prove that the consequences of this trigger could have been anticipated - it is in line with similar triggers for the debut in other currency crises. Therefore, one of the main conclusions of this paper is that while a global crisis starts to manifest the local economy should limit the exuberance of the decision makers in order to smooth the effects of the crisis.

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.

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

Celiac crisis presenting with status epilepticus and encephalopathy.

Science.gov (United States)

Hijaz, Nadia M; Bracken, Julia M; Chandratre, Sonal R

2014-12-01

Celiac crisis is a life-threatening presentation of celiac disease which is described in the context of classic gastrointestinal (GI) symptoms of diarrhea, leading to dehydration and electrolyte imbalance. Neurologic manifestations are atypical symptoms of celiac crisis. To the best of our knowledge, there is no published report on seizure or encephalopathy as the presenting manifestation of celiac crisis. We describe a 2-year-old boy presenting with acute status epilepticus and lethargy. Prior to presentation, he had mild abdominal distention and intermittent diarrhea. Laboratory analysis revealed hyponatremia, anemia, hypocalcemia, transaminitis, and hyperglycemia. Electroencephalography revealed severe diffuse encephalopathy, and complete infectious work-up was negative. Initial brain magnetic resonance imaging was normal; however, repeat imaging showed osmotic demyelination syndrome. Given the history of GI symptoms and hyperglycemia, celiac serology was obtained revealing elevated tissue transglutaminase, and a diagnosis was confirmed by Marsh 3c lesions in the duodenum. He significantly improved with steroid therapy in addition to adequate nutrition, fluids, and initiation of a gluten-free diet. We report herein on the first case of celiac crisis presenting with status epilepticus and encephalopathy in the absence of profound GI symptoms. Our case suggests that celiac crisis should be considered in the differential of seizures and encephalopathy in children.

How Severe Was the Impact of the Financial Crisis on Individual Investor Perceptions and Behavior?

NARCIS (Netherlands)

Hoffmann, A.; Post, T.; Pennings, J.M.E.

2011-01-01

Abstract: Based on a unique combination of monthly survey data and matching trading records, we examine how individual investor perceptions change and drive trading and risk-taking behavior during the 2007–2009 financial crisis. Investor perceptions fluctuate significantly, with risk tolerance and

Improving Therapeutic Relationships: Joint Crisis Planning for Individuals With Psychotic Disorders.

Science.gov (United States)

Farrelly, Simone; Lester, Helen; Rose, Diana; Birchwood, Max; Marshall, Max; Waheed, Waquas; Henderson, R Claire; Szmukler, George; Thornicroft, Graham

2015-12-01

Outcomes for individuals with psychosis remain far from acceptable. Recently, prominent psychiatrists have called for an improved understanding of the impact of social contexts, and how social contexts might influence the development and maintenance of mental health problems. A key social context for individuals with psychosis is the therapeutic relationship. As part of a trial of joint crisis planning in England, this qualitative study aimed to determine the mechanism through which joint crisis planning might affect the therapeutic relationship. Results suggest that routine processes in mental health care are affected by policy and organizational requirements for risk mitigation-aspects that undermine person-centered approaches. In contrast, strong therapeutic relationships are characterized by individualized care and reliable and respectful treatment. The Joint Crisis Plan intervention partially succeeded in reducing contextual influences on routine role enactments, facilitating the demonstration of respect and improving the therapeutic relationship. © The Author(s) 2015.

Supranational institutions as central stakeholders during eurozone debt crisis in 2008-2012

Directory of Open Access Journals (Sweden)

Viljar Veebel

2013-12-01

Full Text Available The financial crisis in the Eurozone is combining several new interdisciplinary debates. Has the financial crisis been caused by the decisions of the political actors or rather by complicated economic dilemmas? In what way have the different social stakeholders acted during the years of the crisis and which of the groups have had biggest influence in different stages of the crisis? Why and how national political elites have lost their dominant position in crisis management and which were the cornerstones of this power transition process and what role have the supranational institutions like the European Commission and the European Central Bank played during the crisis? Accordingly, the main goal of the article is to define crucial events and stakeholders in Eurozone crisis solution process by using empirical process tracking and narrative analysis as research methods. This article will also look on the possible interests and future actions of the Eurozone stakeholders based on the last four years´ experience. It will also be inquired into how and why national political elites and citizens delegated their democratic competences and powers to non-electable institutions during Eurozone crisis.

Possibilities and tools of business crisis management during the natural crisis

OpenAIRE

Bosáková, Renáta

2009-01-01

This work analyses disposable tools of business crisis management to manage crisis which are induced by natural threats and it considers possibilities of these methods using. On basis of performed analysis then in the practical part it uses the acceptable methods and tools to look for threats and risks of the firm and suggests optimal structure of crisis plan.

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.

Impact of the financial crisis on COPD burden: Greece as a case study

Directory of Open Access Journals (Sweden)

Ourania S. Kotsiou

2018-01-01

Full Text Available Poverty and low socioeconomic status have been associated with chronic obstructive pulmonary disease (COPD. The current financial crisis has forced millions back into poverty. Greece is one of the countries hit the hardest, and is in the middle of a deep ongoing collapse. There have been early reports stating the apparent effects of the Greek downturn on respiratory health. This review summarises the overall impact of the financial crisis on COPD burden throughout the period of economic downturn by analysing the case study of Greece. In all levels of the healthcare system, current economic restrictions have reduced the capacity to prevent, diagnose and treat COPD in parallel with current higher detection rates of COPD. Remarkably, expenditure on healthcare has been reduced by >25%, resulting in major healthcare equipment shortages. Lower wages (by up to 20% and higher co-payments of up to 25% of a drug's purchase price have led to patients struggling to afford inhaled medications. Treatment nonadherence has been reported, resulting in 11.5% more exacerbations and 14.1% more hospitalisations annually, while the mean cost per severe COPD exacerbation has been approximated as €2600. Greece is a noteworthy example illustrating how COPD burden, quality of care and patients' outcome can be affected by economic crisis.

Effects of global financial crisis on network structure in a local stock market

Science.gov (United States)

Nobi, Ashadun; Maeng, Seong Eun; Ha, Gyeong Gyun; Lee, Jae Woo

2014-08-01

This study considers the effects of the 2008 global financial crisis on threshold networks of a local Korean financial market around the time of the crisis. Prices of individual stocks belonging to KOSPI 200 (Korea Composite Stock Price Index 200) are considered for three time periods, namely before, during, and after the crisis. Threshold networks are constructed from fully connected cross-correlation networks, and thresholds of cross-correlation coefficients are assigned to obtain threshold networks. At the high threshold, only one large cluster consisting of firms in the financial sector, heavy industry, and construction is observed during the crisis. However, before and after the crisis, there are several fragmented clusters belonging to various sectors. The power law of the degree distribution in threshold networks is observed within the limited range of thresholds. Threshold networks are fatter during the crisis than before or after the crisis. The clustering coefficient of the threshold network follows the power law in the scaling range.

The Impact of the 2008 Economic Crisis on Substance Use Patterns in the Countries of the European Union.

Science.gov (United States)

Dom, Geert; Samochowiec, Jerzy; Evans-Lacko, Sara; Wahlbeck, Kristian; Van Hal, Guido; McDaid, David

2016-01-13

From 2008 on, a severe economic crisis (EC) has characterized the European Union (E.U.). However, changes in substance use behavioral patterns as a result of the economic crisis in Europe, have been poorly reflected upon, and underlying mechanisms remain to be identified; In this review we explore and systematize the available data on the effect of the 2008 economic crisis on patterns of substance use and related disorders, within the E.U. countries; The results show that effects of the recession need to be differentiated. A number of studies point to reductions in population's overall substance use. In contrast, an increase in harmful use and negative effects is found within specific subgroups within the society. Risk factors include job-loss and long-term unemployment, and pre-existing vulnerabilities. Finally, our findings point to differences between types of substances in their response on economic crisis periods; the effects of the 2008 economic crisis on substance use patterns within countries of the European Union are two-sided. Next to a reduction in a population's overall substance use, a number of vulnerable subgroups experience serious negative effects. These groups are in need of specific attention and support, given that there is a real risk that they will continue to suffer negative health effects long after the economic downfall has formally been ended.

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.

Analyzing the financial crisis using the entropy density function

Science.gov (United States)

Oh, Gabjin; Kim, Ho-yong; Ahn, Seok-Won; Kwak, Wooseop

2015-02-01

The risk that is created by nonlinear interactions among subjects in economic systems is assumed to increase during an abnormal state of a financial market. Nevertheless, investigating the systemic risk in financial markets following the global financial crisis is not sufficient. In this paper, we analyze the entropy density function in the return time series for several financial markets, such as the S&P500, KOSPI, and DAX indices, from October 2002 to December 2011 and analyze the variability in the entropy value over time. We find that the entropy density function of the S&P500 index during the subprime crisis exhibits a significant decrease compared to that in other periods, whereas the other markets, such as those in Germany and Korea, exhibit no significant decrease during the market crisis. These findings demonstrate that the S&P500 index generated a regular pattern in the return time series during the financial crisis.

Why practitioners do (not) apply crisis communication theory in practice

OpenAIRE

Claeys, An-Sofie; Opgenhaffen, Michaël

2016-01-01

Twenty-five in-depth interviews with Belgian crisis communication practitioners were conducted to examine the gap between theory and practice. Crisis communication has become an important research area within public relations. Several studies have resulted in theories and guidelines regarding the effective use of communication during organizational crises. Unfortunately, these findings are not always put into practice. This study examines to what extent public relations practitioners apply th...

SARS: Key factors in crisis management.

Science.gov (United States)

Tseng, Hsin-Chao; Chen, Thai-Form; Chou, Shieu-Ming

2005-03-01

This study was conducted at a single hospital selected in Taipei during the SARS (Severe Acute Respiratory Syndrome) outbreak from March to July, 2003 in Taiwan. During this period of time, 104 SARS patients were admitted to the hospital. There were no negative reports related to the selected hospital despite its being located right in the center of an area struck by the epidemic. The purpose of this study was to identify the key factors enabling the hospital to survive SARS unscathed. Data were collected from in-depth interviews with the nursing directors and nursing managers of the SARS units, along with a review of relevant hospital documents. The five key elements identified as survival factors during this SARS crisis are as follows: 1. good control of timing for crisis management, 2. careful decision-making, 3. thorough implementation, 4. effective communication, and 5. trust between management and employees. The results of this study reconfirmed the selected hospital as a model for good crisis management during the SARS epidemic.

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...

Conflict devastates health service delivery in South Sudan

African Journals Online (AJOL)

The return to conflict in December 2013 has set the country back and reversed the many gains ... environment for the worst humanitarian and health crisis in the country [2]. ... medical supplies looted and several health workers have lost their lives ... The trauma of war can also have devastating consequences on the mental.

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)

THE ROLE AND IMPORTANCE OF COMPANY CRISIS DIAGNOSIS IN ANTI-CRISIS MANAGEMENT

OpenAIRE

Klodane, Alona

2016-01-01

Nowadays, under a free market, crises at companies are a frequent phenomenon; however, anti-crisis management and related aspects are currently a little researched problem in Latvia. The research aim is to examine the nature of company crisis diagnosis and its role and importance in the anti-crisis management system. The research general tasks are: to describe the nature of company crisis diagnosis and review the scope, purpose and tasks of performing a diagnosis; to examine the role and impo...

Efficiency of mutual funds in Croatia: a DEA-based approach applied in the pre-crisis, crisis and post crisis period

Directory of Open Access Journals (Sweden)

Margareta Gardijan

2017-01-01

Full Text Available The aim of this paper is to estimate the overall performance of mutual funds in Croatia in terms of their relative efficiency based on several performance indicators using data envelopment analysis (DEA. DEA is a non-parametric method that can provide an overall relative efficiency score of a certain fund given a number of risk, cost or reward or profitability measures. Since traditional mutual fund performance indicators are mostly based on the CAPM paradigm that demands using rigid assumptions and questionable benchmarks, we endeavor to overcome the limitations of such an approach by considering more appropriate risk and reward measures, such as Expected Shortfall, stochastic dominance and higher order moments. In this way, we developed an adjusted DEA-based mutual fund performance index. The efficiency scores obtained from the DEA model help in identifying efficient funds and ranking the funds based on certain criteria. DEA also identifies mutual fund(s that can be benchmarks for other mutual funds that have similar investment strategies. These results were compared to various traditional indicators of absolute and relative risk-adjusted performance of mutual funds. The analysis was divided into three periods: the pre-crisis period, crisis period and post-crisis period with different conclusions for mutual fund performances in Croatia. The analysis includes altogether 60 UCITS funds in Croatia, in the period from the beginning of 2005 until the end of 2015, and was conducted on daily data of share prices, available from the Bloomberg terminal.

Financing Africa : Through the crisis and beyond

NARCIS (Netherlands)

Beck, T.H.L.; Munzele Maimbo, S.; Faye, I.; Triki, T.

2011-01-01

The environment in which African financial systems operate has changed dramatically over the past years. The global financial system has undergone a major transformation after the recent financial crisis, with the center of economic and financial power shifting from developed to several emerging

Crisis Diagnosis in Anti-Crisis Management Process in a Company

OpenAIRE

Ruta Meiste; Sandra Jakstiene

2015-01-01

Crisis concept links up to its appearance area. Some different kinds and levels of crises have been found: we face with global, mainly nature cataclysm crises, state economic crises, corporate crises and individual or psychological crises. The research area of this paper is micro level, i.e. corporate crises or crisis in a company. However, it is emphasized that company is a sociotechnical system, performing in a complex environment, therefore crisis in a company is closely related to global ...

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

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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

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.

Political pragmatism and principles in times of crisis : the role of pragmatist political crisis management during the U.S. financial crisis

NARCIS (Netherlands)

Bartenberger, M.

2017-01-01

Based on philosophical pragmatism, this study builds a model of pragmatist crisis management at the political-strategic level and contrasts it with a principle-guided approach towards political crisis management. It identifies four cornerstons of pragmatist political crisis management and builds a

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...

Incidence and Characteristics of Adrenal Crisis in Children Younger than 7 Years with 21-Hydroxylase Deficiency: A Nationwide Survey in Japan.

Science.gov (United States)

Ishii, Tomohiro; Adachi, Masanori; Takasawa, Kei; Okada, Satoshi; Kamasaki, Hotaka; Kubota, Takuo; Kobayashi, Hironori; Sawada, Hirotake; Nagasaki, Keisuke; Numakura, Chikahiko; Harada, Shohei; Minamitani, Kanshi; Sugihara, Shigetaka; Tajima, Toshihiro

2018-01-01

We aimed to evaluate the incidence and characteristics of adrenal crisis in Japanese children with 21-hydroxylase deficiency (21-OHD). We conducted a retrospective nationwide survey for the councilors of the Japanese Society for Pediatric Endocrinology (JSPE) regarding adrenal crisis in children under 7 years with 21-OHD, admitted to hospitals from 2011 through 2016. We defined adrenal crisis as the acute impairment of general health due to glucocorticoid deficiency with at least two of symptoms, signs, or biochemical abnormalities. The councilors of the JSPE in 83 institutions responded to this survey (response rate, 60.1%). Data analyses of 378 patients with 1,101.4 person-years (PYs) revealed that 67 patients (17.7%) experienced at least 1 episode of hospital admission for adrenal crisis at the median age of 2 years. The incidence of adrenal crisis was calculated as 10.9 per 100 PYs (95% confidence interval [CI] 9.6-12.2). Infections were the most common precipitating factors, while no factor was observed in 12.5%. Hypoglycemia occurred concomitantly in 27.4%. One patient died from severe hypoglycemia, resulting in a mortality rate of 0.09 per 100 PYs (95% CI 0.0-0.2). Adrenal crisis is not rare and can be accompanied by disastrous hypoglycemia in children with 21-OHD. © 2018 S. Karger AG, Basel.

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.

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

Waiting for a Crisis: Case Studies of Crisis Leaders in Higher Education

Science.gov (United States)

Muffet-Willett, Stacy L.

2010-01-01

This study examines the system of crisis leadership in higher education. Using case study methods, five crisis leadership participants were interviewed to develop a deep understanding of how they perceive their university crisis leadership system. Two participants were from a private institution, and three were from a public institution. Higher…

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.

Conceptual Framework of Crisis Negotiation Competency Development in Managers of Internal Affairs Bodies

Directory of Open Access Journals (Sweden)

Vakhnina V.V.

2017-11-01

Full Text Available In this article the authors examine the psychological features of the development of an integral psychological concept of crisis negotiation activities from the perspective of system-situational and reflexive approaches.This research forms the basis of a new scientific direction in legal psychology, the psychology of crisis negotiation activities of employees of internal affairs bodies, as a system of coping with and preventing crisis in negotiations.The data was collected and analysed in several stages from 1995 to 2014 and included a survey of managers of internal affairs bodies as well as a systematic analysis of the data pool of 1705 crisis situations.Basing on the analysis the authors propose a matrix of negotiations which identifies priority strategies and possible crisis zones at various stages of the negotiation process depending on the characteristics of the situation, thus helping to carry out crisis negotiations effectively.

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.

The impact of the financial crisis on the currency and the monetary system

Directory of Open Access Journals (Sweden)

Petre DEACONU

2010-09-01

Full Text Available The present-day economic and financial crisis (depression appears unprecedented in the last half century. The international financial crisis has been extended to the Romanian economy. However, in terms of direct impact, the Romanian banking system was less affected by not being exposed to toxic assets, and because of prudential and administrative measures taken by the NBR. Indirectly, however, the international financial crisis and especially its obvious consequence – the recession in developed countries - has expanded to the Romanian economy, on several channels. The shopping channel slowed export growth and even reduced them. The financial channel has limited the access to external financing, and thus restricted the lending volume, generating private external debt service difficulties. On the exchange rate channel, the reduction in external financing reflected in national currency depreciation. On the confidence channel, there was a withdrawal of investors from Eastern Europe countries. Among the measures adopted by the central bank, the most notable were targeting inflation and currency interventions. By adopting inflation targeting, the central bank opted to make more room in establishing foreign exchange market, and after the onset of the current international financial crisis, including the 2009-2010, adopted a controlled floating exchange rate. This does not mean intervention in the forex market on a discretionary basis. NBR policy on foreign exchange intervention has been guided by the philosophy that high exchange rate volatility is harmful for both the inflation target and the financial health of the real and financial sector.

PERFORMANCE PREMISES FOR HUMAN RESOURCES FROM PUBLIC HEALTH ORGANIZATIONS IN ROMANIA

Directory of Open Access Journals (Sweden)

Amalia-Luisa PUPĂZĂ

2011-03-01

Full Text Available Improving the performance of health sector human resources is a goal pursued by all developed or developing countries. However, the lack of human resources planning and lack of clear and transparent human resources policies may lead to a crisis in this area. Human resource planning should be a priority in terms of health policies. In Romania, the lack of a planning concept and the lack of a policy on human resources has led to the actual context, with a human resources crisis of public health organizations. The role that human resources play in the health care system is indisputable. Essential to achieve quality performance in health care is human resources management. To overcome the human resources crisis that public health organizations in Romania is facing , specialists in the field have made several key recommendations: development of a coherent policy formation, development and allocation of human resources in health, increasing the number of medical staff and opportunities of professional career development in the medical field. Health system reform involves changing some aspects of employment, working conditions, degree of decentralization of management, skills, salary system and staff motivation.

Framing the Refugee Crisis in Online Media: A Romanian Perspective

Directory of Open Access Journals (Sweden)

Nicoleta Corbu

2017-07-01

Full Text Available The European Union (EU is under severe pressure, due to the multiple crises it has to manage. Among them, the refugee crisis is remarkable, since it is shaking both the individual member states and the EU as a whole. The media coverage of the refugee crisis is important because the media still are the main source of information concerning distant issues (the refugee crisis included, and as such it facilitates people’s access to social reality. Using the perspective of agenda-setting and the conceptual background of framing theory, we aim to (1 identify the most prominent frames online media employ with reference to the refugee crisis, and (2 reveal the tone of voice online media use when portraying issues related to this crisis. To achieve these two goals, we content analyzed 1493 online news articles, published between April 15, 2015 and February 29, 2016. Main findings show that online media outlets mainly refer to the refugee crisis in terms of responsibility and conflict, in this order of prominence. At the same time, online media portals prefer using a reasonably balanced viewpoint when portraying the refugees, and a slightly negative one in terms of attitudes towards the European Union.

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 ...

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.)

[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.

Impact of the 2013 French Pill Crisis on Women's Behaviour Regarding Contraception.

Science.gov (United States)

Lemaitre, Magali; Lastennet, Glenn; Syr, David; Emmerich, Joseph; Zureik, Mahmoud

2015-03-01

In the last decade, several epidemiological studies have shown the increased risk of venous thromboembolism associated with third- and fourth-generation oral contraceptives (C3Gs and C4Gs) versus older combined first- and second-generation oral contraceptives (C1Gs and C2Gs). In France, in December 2012, a lawsuit filed against the National Agency for the Safety of Medicines and Health Products (ANSM) by a patient who had experienced a stroke, possibly due to the use of a C3G, triggered a national 'pill crisis'. Consequently, a 'crisis cell' was set up and pre-existing health recommendations were reinforced. The main aim of this study was to evaluate, in real time, the impact of the French health authorities' recommendations and communications on French women's behaviour regarding contraception. Real-time monthly sales data reported during 2013 were compared with monthly sales data reported in 2012. Analyses were stratified according to the type of contraceptive and age. An index corresponding to the number of months of contraception sold was developed to facilitate comparison of the different contraceptives despite their distinct features and to assess the overall trend of contraception. After a 2-year analysis (2013 versus 2012), a significant 45 % decrease (p sales was observed, compared with a significant increase of 30 % (p sales. The sharp increase in C1G-2G sales focused specifically on C2Gs with an oestrogen concentration below 20 µg. Moreover, a large (47 %) increase was reported in sales of intrauterine devices (p sales into account, a slight decrease (1 %) in overall sales was identified. Thanks to an effective national communication plan, real-time monitoring of drug sales and favourable reactions from physicians and patients, French women changed their behaviour regarding contraception. However, this study was conducted over a short period following the crisis. A longitudinal analysis is required in order to assess any real long-term changes.

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.

Currency Crisis Revisited: A Literature Review

Directory of Open Access Journals (Sweden)

Teuta Ismaili Muharremi

2015-12-01

Full Text Available This paper elaborates on currency crisis, focusing on the main factors causing the currency crisis. After a brief overview of the main factors driving currency crisis, the paper provides a literature review highlighting that the history of the global economy experienced a number of currency crisis whereas as relates to the triggers of the currency crisis there are three generations of models that have been used to explain currency crisis during the last four decades. Underscoring the role of the government in financial market, in particular the evolution of this role as a result of the recent global financial crisis and highlighting other factors that trigger such crisis, the paper concludes that the potential financial crisis can be addressed using early warning system, which consists of indicators proven to be beneficial in anticipation of the currency crisis, and using the advanced empirical models of currency crisis. In this context the paper reveals that currency crisis are associated with all factors impacting them such as inflation, real exchange rate, import growth, US interest rates, public debt/GDP, and current account/GDP – all with a slightly different time lag.

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....

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.

Nuclear management during crisis: a study through representations of crisis managers

International Nuclear Information System (INIS)

Suchet, Romain

2015-01-01

This thesis is the result of almost 4 years of research carried out within the IRSN, one of the actors among the different actors in charge of nuclear crisis response. We started with the following question: how France gets prepared to manage a nuclear accident situation and what are the results of this preparation in a real accident case even if it is a minor accident or if it happens abroad? Thanks to a very fruitful documentary and in field research work, we are able to show in this thesis that the unilateral management of a 'crisis' situation by the different actors organized under the leadership of high level engineers from the 'Corps de mines', results in a very technical definition of the 'crisis' focused on the technical aspects while disregarding the general public. As a consequence, emergency drills that are defined and carried out do not prepare intervention teams to manage social reactions that may be caused by a nuclear accident. To the opposite and paradoxically, such a vision that neglects the reaction of the population may generate by itself a crisis situation even when an accident is deemed to be 'technically' of a minor importance. However the management system of nuclear crisis is evolving. Organizational changes in this area that progressively take into account the social factor, really result from the in field experience of dealing with the general public reactions during a real nuclear crisis. Crisis training and drills have a lesser impact on this evolution. (author)

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…

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.

Globalization Crisis and National Security: A Reflection on Nigeria ...

African Journals Online (AJOL)

Globalization Crisis and National Security: A Reflection on Nigeria Textile Industry. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... Thus, while globalization has several palpable positive effects on the countrys industrial growth, it also ...

A pilot investigation in constructing crisis communications: what leads to best practice?

Science.gov (United States)

Firestone, Rachel M; Everly, George S

2013-01-01

Crisis communications can play an important role in mitigating, or exacerbating, the psychological and behavioral reactions to critical incidents and disasters. Effective crisis communications can serve to mitigate anxiogenesis and direct rapid and focused rescue, recovery, and rehabilitative operations. Ambiguous and/or deceptive communications can serve to worsen mental health reactions and delay operational response and recovery (Everly, Strouse, & Everly, 2010). It seems, therefore, that inquiry into the content of acute crisis communications would be warranted Said more simply, given limited time, cryptic messaging in social media, and the "sound bite" mentality that seems to govern news dissemination, it is important to identify the most important content to convey in the wake of critical incidents and disasters. This paper reports on a pilot investigation into "best practices" for the construction of acute crisis communications.

On-scene crisis intervention: psychological guidelines and communication strategies for first responders.

Science.gov (United States)

Miller, Laurence

2010-01-01

Effective emergency mental health intervention for victims of crime, natural disaster or terrorism begins the moment the first responders arrive. This article describes a range of on-scene crisis intervention options, including verbal communication, body language, behavioral strategies, and interpersonal style. The correct intervention in the first few moments and hours of a crisis can profoundly influence the recovery course of victims and survivors of catastrophic events.

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.

Dutch guideline for the management of hypertensive crisis -- 2010 revision.

Science.gov (United States)

van den Born, B J H; Beutler, J J; Gaillard, C A J M; de Gooijer, A; van den Meiracker, A H; Kroon, A A

2011-05-01

Hypertensive crises are divided into hypertensive urgencies and emergencies. Together they form a heterogeneous group of acute hypertensive disorders depending on the presence or type of target organs involved. Despite better treatment options for hypertension, hypertensive crisis and its associated complications remain relatively common. In the Netherlands the number of patients starting renal replacement therapy because of 'malignant hypertension' has increased in the past two decades. In 2003, the first Dutch guideline on hypertensive crisis was released to allow a standardised evidence-based approach for patients presenting with a hypertensive crisis. In this paper we give an overview of the current management of hypertensive crisis and discuss several important changes incorporated in the 2010 revision. These changes include a modification in terminology replacing 'malignant hypertension' with 'hypertensive crisis with retinopathy and reclassification of hypertensive crisis with retinopathy under hypertensive emergencies instead of urgencies. With regard to the treatment of hypertensive emergencies, nicardipine instead of nitroprusside or labetalol is favoured for the management of perioperative hypertension, whereas labetalol has become the drug of choice for the treatment of hypertension associated with pre-eclampsia. For the treatment of hypertensive urgencies, oral administration of nifedipine retard instead of captopril is recommended as first-line therapy. In addition, a section on the management of hypertensive emergencies according to the type of target organ involved has been added. Efforts to increase the awareness and treatment of hypertension in the population at large may lower the incidence of hypertensive crisis and its complications.

Power-law behavior in complex organizational communication networks during crisis

Science.gov (United States)

Uddin, Shahadat; Murshed, Shahriar Tanvir Hasan; Hossain, Liaquat

2011-08-01

Communication networks can be described as patterns of contacts which are created due to the flow of messages and information shared among participating actors. Contemporary organizations are now commonly viewed as dynamic systems of adaptation and evolution containing several parts, which interact with one another both in internal and in external environment. Although there is limited consensus among researchers on the precise definition of organizational crisis, there is evidence of shared meaning: crisis produces individual crisis, crisis can be associated with positive or negative conditions, crises can be situations having been precipitated quickly or suddenly or situations that have developed over time and are predictable etc. In this research, we study the power-law behavior of an organizational email communication network during crisis from complexity perspective. Power law simply describes that, the probability that a randomly selected node has k links (i.e. degree k) follows P(k)∼k, where γ is the degree exponent. We used social network analysis tools and techniques to analyze the email communication dataset. We tested two propositions: (1) as organization goes through crisis, a few actors, who are prominent or more active, will become central, and (2) the daily communication network as well as the actors in the communication network exhibit power-law behavior. Our preliminary results support these two propositions. The outcome of this study may provide significant advancement in exploring organizational communication network behavior during crisis.

Expanding Suicide Crisis Services to Text and Chat.

Science.gov (United States)

Predmore, Zachary; Ramchand, Rajeev; Ayer, Lynsay; Kotzias, Virginia; Engel, Charles; Ebener, Patricia; Kemp, Janet E; Karras, Elizabeth; Haas, Gretchen L

2017-07-01

Crisis support services have historically been offered by phone-based suicide prevention hotlines, but are increasingly becoming available through alternative modalities, including Internet chat and text messaging. To better understand differences in the use of phone and chat/text services. We conducted semistructured interviews with call responders at the Veterans Crisis Line who utilize multimodal methods to respond to veterans in crisis. Responders indicated that veterans may access the chat/text service primarily for reasons that included a desire for anonymity and possible inability to use the phone. Responders were divided on whether callers and chatters presented with different issues or risk of suicide; however, they suggested that veterans frequently use chat/text to make their first contact with mental health services. We spoke with call responders, not the veterans themselves. Additionally, as this is qualitative research, applicability to other settings may be limited. While new platforms offer promise, participants also indicated that chat services can supplement phone lines, but not replace them.

Urinary Tract Infection Associated with a Celiac Crisis: A Preceding or Precipitating Event?

Science.gov (United States)

Tiwari, Abhinav; Qamar, Khola; Sharma, Himani; Almadani, Sameh Bashar

2017-01-01

Celiac crisis is a rare life-threatening presentation of celiac disease that manifests as profuse diarrhea, hypoproteinemia, and severe metabolic disturbances. It may be precipitated by a general immune stimulus such as surgery, infection, or pregnancy. We report the case of a 26-year-old woman who presented with a celiac crisis, potentially triggered by a preceding urinary tract infection. Metabolic derangement is caused by malabsorption and profuse diarrhea, which can be unremitting unless the celiac crisis is recognized, and treatment with gluten restriction is initiated.

Manifesto for a healthy and health-creating society.

Science.gov (United States)

Crisp, Nigel; Stuckler, David; Horton, Richard; Adebowale, Victor; Bailey, Sue; Baker, Maureen; Bell, John; Bird, John; Black, Carol; Campbell, Jane; Davies, Janet; Henry, Heather; Lechler, Robert; Mawson, Andrew; Maxwell, Patrick H; McKee, Martin; Warwick, Cathy

2016-12-10

Brexit and the troubled state of the NHS call for re-thinking the UK's approach to health. The EU referendum vote reveals deep social divisions as well as presenting the country with important decisions and negotiations about the future. At the same time, health problems are growing; the NHS faces severe financial constraints and appears to lurch from crisis to crisis, with leaving the European Union likely to exacerbate many problems including staffing issues across the whole sector. However, new scientific developments and digital technology offer societies everywhere massive and unprecedented opportunities for improving health. It is vital for the country that the NHS is able to adopt these discoveries and see them translated into improved patient care and population health, but also that the UK benefits from its capabilities and strengths in these areas. Copyright © 2016 Elsevier Ltd. All rights reserved.

Celiac Disease Presenting as Profound Diarrhea and Weight Loss ? A Celiac Crisis

OpenAIRE

Bul, Vadim; Sleesman, Brett; Boulay, Brian

2016-01-01

Patient: Male, 46 Final Diagnosis: Celiac crisis Symptoms: Abdominal pain ? chronic diarrhea ? lightheadedness ? weakness ? weight loss Medication: ? Clinical Procedure: ? Specialty: Gastroenterology and Hepatology Objective: Rare disease Background: Celiac disease is a hypersensitivity enteropathy that can have various presentations in adults. Rarely, patients can present with severe lab abnormalities, dehydration and weight loss caused by celiac disease ? a celiac crisis. Case Report: A 46-...

A scoping review of crisis teams managing dementia in older people.

Science.gov (United States)

Streater, Amy; Coleston-Shields, Donna Maria; Yates, Jennifer; Stanyon, Miriam; Orrell, Martin

2017-01-01

Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis. The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8%) of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors. Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required to deliver a standardized care pathway and measurable intervention as part of a large-scale evaluation of effectiveness.

Managing crisis: the role of primary care for people with serious mental illness.

Science.gov (United States)

Lester, Helen; Tritter, Jonathan Q; Sorohan, Helen

2004-01-01

More than 30% of patients with serious mental illness in the United Kingdom now receive all their health care solely from primary care. This study explored the process of managing acute mental health crises from the dual perspective of patients and primary care health professionals. Eighteen focus groups involving 45 patients, 39 general practitioners, and eight practice nurses were held between May and November 2002 in six Primary Care Trusts across the British West Midlands. The topic guide explored perceptions of gold standard care, current issues and critical incidents in receiving/providing care, and ideas on improving services. Themes relevant to the management of acute crisis included issues of process, such as access, advocacy, communication, continuity, and coordination of care; the development of more structured care that might reduce the need for crisis responses; and issues raised by the development of a more structured approach to care. Access to services is a complicated yet crucial feature of managing care in a crisis, with patients identifying barriers at the level of primary care and health professionals at the interface with secondary care. The development of more structured systems as a solution may generate its own ethical and pragmatic challenges.

Ontario FIT - From poster child to industry crisis

International Nuclear Information System (INIS)

Roeper, Uwe

2011-01-01

Ortech is a consulting firm that provides engineering services to investors and developers in planning and operating solar, wind and water projects. This study discusses the issues involved in the renewable energy Feed-in Tariff (FIT) program in Ontario. Initially hailed as the poster child of innovative renewable programs in North America, the FIT program has been under increasing attack from political parties, anti wind groups and legal suits. The reason was the negative media coverage of noise, birdlife and health effects. Criticism was first voiced over health concerns and lack of consultation. Local governments and the legislature debated these issues and began to split along political lines over them. The lack of public support was because there was insufficient effort put into creating public awareness. Boosting grass-roots support by creating awareness is a recommendation of the paper, which also emphasises the need for a win-win strategy when the government is involved. It can be concluded that the FIT program has gone from poster child to industry crisis but has provided several learning opportunities along the way.

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