Human resources for health: global crisis and international cooperation.

PubMed

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.

Financial crisis, austerity, and health in Europe.

PubMed

Karanikolos, Marina; Mladovsky, Philipa; Cylus, Jonathan; Thomson, Sarah; Basu, Sanjay; Stuckler, David; Mackenbach, Johan P; McKee, Martin

2013-04-13

The financial crisis in Europe has posed major threats and opportunities to health. We trace the origins of the economic crisis in Europe and the responses of governments, examine the effect on health systems, and review the effects of previous economic downturns on health to predict the likely consequences for the present. We then compare our predictions with available evidence for the effects of the crisis on health. Whereas immediate rises in suicides and falls in road traffic deaths were anticipated, other consequences, such as HIV outbreaks, were not, and are better understood as products of state retrenchment. Greece, Spain, and Portugal adopted strict fiscal austerity; their economies continue to recede and strain on their health-care systems is growing. Suicides and outbreaks of infectious diseases are becoming more common in these countries, and budget cuts have restricted access to health care. By contrast, Iceland rejected austerity through a popular vote, and the financial crisis seems to have had few or no discernible effects on health. Although there are many potentially confounding differences between countries, our analysis suggests that, although recessions pose risks to health, the interaction of fiscal austerity with economic shocks and weak social protection is what ultimately seems to escalate health and social crises in Europe. Policy decisions about how to respond to economic crises have pronounced and unintended effects on public health, yet public health voices have remained largely silent during the economic crisis. Copyright © 2013 Elsevier Ltd. All rights reserved.

Public Health Intelligence: Learning From the Ebola Crisis

PubMed Central

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

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

PubMed

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.

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

PubMed

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

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

PubMed

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

2016-09-01

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

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

PubMed Central

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

2017-01-01

Background 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. Methods 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. Results In fully adjusted models, <3 months (HR: 1.69; 95% CI 1.14 to 2.49), 3–6 months (2.19; 1.43 to 3.37) and >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. Conclusions 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. PMID:28087812

Managing knowledge integration in a national health-care crisis: lessons learned from combating SARS in Singapore.

PubMed

Devadoss, Paul Raj; Pan, Shan Ling; Singh, Shreyan

2005-06-01

The outbreak of Severe Acute Respiratory Syndrome is the first severe and readily transmissible disease to emerge in the 21st century. Often one new infection meant tracing of several people to monitor their health conditions as well. In Singapore, several agencies coordinated their efforts to quickly bring the outbreak under control. The current breed of health-care information systems (HCIS) was not sufficient to handle new information-sharing needs during the crisis. In this paper, we take a look at the measures taken during the crisis in Singapore through a knowledge integration perspective. This perspective reveals interesting implications for HCIS.

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

PubMed

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, <3 months (HR: 1.69; 95% CI 1.14 to 2.49), 3-6 months (2.19; 1.43 to 3.37) and >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/.

[Public health in major socio-economic crisis].

PubMed

Cosmacini, G

2014-01-01

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

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

PubMed

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

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

PubMed Central

2014-01-01

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

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

PubMed

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.

Leaving no one behind: lessons on rebuilding health systems in conflict- and crisis-affected states.

PubMed

Martineau, Tim; McPake, Barbara; Theobald, Sally; Raven, Joanna; Ensor, Tim; Fustukian, Suzanne; Ssengooba, Freddie; Chirwa, Yotamu; Vong, Sreytouch; Wurie, Haja; Hooton, Nick; Witter, Sophie

2017-01-01

Conflict and fragility are increasing in many areas of the world. This context has been referred to as the 'new normal' and affects a billion people. Fragile and conflict-affected states have the worst health indicators and the weakest health systems. This presents a major challenge to achieving universal health coverage. The evidence base for strengthening health systems in these contexts is very weak and hampered by limited research capacity, challenges relating to insecurity and apparent low prioritisation of this area of research by funders. This article reports on findings from a multicountry consortium examining health systems rebuilding post conflict/crisis in Sierra Leone, Zimbabwe, northern Uganda and Cambodia. Across the ReBUILD consortium's interdisciplinary research programme, three cross-cutting themes have emerged through our analytic process: communities, human resources for health and institutions. Understanding the impact of conflict/crisis on the intersecting inequalities faced by households and communities is essential for developing responsive health policies. Health workers demonstrate resilience in conflict/crisis, yet need to be supported post conflict/crisis with appropriate policies related to deployment and incentives that ensure a fair balance across sectors and geographical distribution. Postconflict/crisis contexts are characterised by an influx of multiple players and efforts to support coordination and build strong responsive national and local institutions are critical. The ReBUILD evidence base is starting to fill important knowledge gaps, but further research is needed to support policy makers and practitioners to develop sustainable health systems, without which disadvantaged communities in postconflict and postcrisis contexts will be left behind in efforts to promote universal health coverage.

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

PubMed

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.

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

Code of Federal Regulations, 2010 CFR

2010-01-01

... health crisis. 550.409 Section 550.409 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL... 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...

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

PubMed

Teo, Wendy Zi Wei

2018-07-01

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

Collaboration in crisis: Carer perspectives on police and mental health professional's responses to mental health crises.

PubMed

Brennan, Alice; Warren, Narelle; Peterson, Violeta; Hollander, Yitzchak; Boscarato, Kara; Lee, Stuart

2016-10-01

For many situations involving a mental health crisis, carers (e.g. family or friends) are present and either attempt to help the person overcome the crisis or request assistance from professional services (e.g. mental health or police). Comparatively, little research has explored how carers experience the crisis, the professional response and how the nature of the response, in turn, impacts carers. The current study was conducted to explore these issues during individual interviews with nine carers who had previous contact with police and mental health services during a crisis response. Collected data described the definition and perceived impact of a mental health crisis for carers, how carers had experienced a crisis response from police and mental health services, and how the professional response had impacted on carers. Of importance was the finding that carers were often themselves traumatized by witnessing or being involved in the crisis, however, were rarely offered direct education or support to help them cope or prevent future crises. A number of carers described a reluctance to request assistance from professional services due to previous poor experiences. This highlighted the importance of implementing strategies to deliver more timely, respectful, specialist and collaborative crisis responses to improve carer and consumer outcomes. © 2016 Australian College of Mental Health Nurses Inc.

The Popeye principle: selling child health in the first nutrition crisis.

PubMed

Lovett, Laura

2005-10-01

The cartoon character Popeye the Sailor was capable of superhuman feats of strength after eating a can of spinach. Popeye ate spinach because the association of spinach with strength was a product of the first national nutrition crisis in the United States: the 1920s fight against child malnutrition. Spanning the first three decades of the twentieth century, the malnutrition crisis arose from the confluence of many different events including the invention of nutrition science and new standards for height and weight; international food crises created by world war; the rise of consumerism, advertising, and new forms of mass media; and Progressive reformers' conviction that education was a key component of any solution. The history of the malnutrition crisis presented in this essay synthesizes disparate histories concerning advertising, public health, education, consumerism, philanthropy, and Progressive Era reform with original analysis of a major nutrition education program sponsored by the Commonwealth Fund in the 1920s. Because the character of Popeye came to embody one of the nutritional norms advocated in the 1920s, I refer to the influence of culturally constructed social norms on children's beliefs about health and nutrition as the Popeye Principle. The history of the malnutrition crisis demonstrates the importance of understanding the cultural and economic conditions surrounding childhood nutrition, the use and influence of numerical norms, and the mutually reinforcing influences on children's nutritional norms from their parents, peers, teachers, and culture.

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

PubMed

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

Crisis, leadership, consensus: the past and future federal role in health.

PubMed

Boufford, J I

1999-06-01

This paper touches on patterns of federal government involvement in the health sector since the late 18th century to the present and speculates on its role in the early decades of the 21st century. Throughout the history of the US, government involvement in the health sector came only in the face of crisis, only when there was widespread consensus, and only through sustained leadership. One of the first health-related acts of Congress came about as a matter of interstate commerce regarding the dilemma as to what to do about treating merchant seamen who had no affiliation with any state. Further federal actions were implemented to address epidemics, such as from yellow fever, that traveled from state to state through commercial ships. Each federal action was met with concern and resistance from states' rights advocates, who asserted that the health of the public was best left to the states and localities. It was not until the early part of the 20th century that a concern for social well-being, not merely commerce, drove the agenda for public health action. Two separate campaigns for national health insurance, as well as a rapid expansion of programs to serve the specific health needs of specific populations, led finally to the introduction of Medicaid and Medicare in the 1960s, the most dramatic example of government intervention in shaping the personal health care delivery system in the latter half of the 20th century. As health costs continued to rise and more and more Americans lacked adequate health insurance, a perceived crisis led President Clinton to launch his 1993 campaign to insure every American--the third attempt in this century to provide universal coverage. While the crisis was perceived by many, there was no consensus on action, and leadership outside government was missing. Today, the health care crisis still looms. Despite an economic boom, 1 million Americans lose their health insurance each year, with 41 million Americans, or 15% of the population

Achieving and Sustaining Universal Health Coverage: Fiscal Reform of the National Health Insurance in Taiwan.

PubMed

Lan, Jesse Yu-Chen

2017-12-01

The paper discusses the expansion of the universal health coverage (UHC) in Taiwan through the establishment of National Health Insurance (NHI), and the fiscal crisis it caused. Two key questions are addressed: How did the NHI gradually achieve universal coverage, and yet cause Taiwanese health spending to escalate to fiscal crisis? What measures have been taken to reform the NHI finance and achieve moderate success to date? The main argument of this paper is that the Taiwanese Government did try to implement various reforms to save costs and had moderate success, but the path-dependent process of reform does not allow increasing contribution rates significantly and thereby makes sustainability challenging.

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

PubMed

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.

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

PubMed

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.

Stigma, Obesity, and the Health of the Nation's Children

ERIC Educational Resources Information Center

Puhl, Rebecca M.; Latner, Janet D.

2007-01-01

Preventing childhood obesity has become a top priority in efforts to improve our nation's public health. Although much research is needed to address this health crisis, it is important to approach childhood obesity with an understanding of the social stigma that obese youths face, which is pervasive and can have serious consequences for emotional…

Greece's health crisis: from austerity to denialism.

PubMed

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

2014-02-22

Greece's economic crisis has deepened since it was bailed out by the international community in 2010. The country underwent the sixth consecutive year of economic contraction in 2013, with its economy shrinking by 20% between 2008 and 2012, and anaemic or no growth projected for 2014. Unemployment has more than tripled, from 7·7% in 2008 to 24·3% in 2012, and long-term unemployment reached 14·4%. We review the background to the crisis, assess how austerity measures have affected the health of the Greek population and their access to public health services, and examine the political response to the mounting evidence of a Greek public health tragedy. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

PubMed

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.

PubMed

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.

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

PubMed Central

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

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

PubMed

Ruckert, Arne; Labonté, Ronald

2014-01-06

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

The global financial crisis and health equity: Early experiences from Canada

PubMed Central

2014-01-01

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

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

PubMed

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.

Health outcomes during the 2008 financial crisis in Europe: systematic literature review

PubMed Central

Parmar, Divya; Ioannidis, John P A

2016-01-01

Objective To systematically identify, critically appraise, and synthesise empirical studies about the impact of the 2008 financial crisis in Europe on health outcomes. Design Systematic literature review. Data sources Structural searches of key databases, healthcare journals, and organisation based websites. Review methods Empirical studies reporting on the impact of the financial crisis on health outcomes in Europe, published from January 2008 to December 2015, were included. All selected studies were assessed for risk of bias. Owing to the heterogeneity of studies in terms of study design and analysis and the use of overlapping datasets across studies, studies were analysed thematically per outcome, and the evidence was synthesised on different health outcomes without formal meta-analysis. Results 41 studies met the inclusion criteria, and focused on suicide, mental health, self rated health, mortality, and other health outcomes. Of those studies, 30 (73%) were deemed to be at high risk of bias, nine (22%) at moderate risk of bias, and only two (5%) at low risk of bias, limiting the conclusions that can be drawn. Although there were differences across countries and groups, there was some indication that suicides increased and mental health deteriorated during the crisis. The crisis did not seem to reverse the trend of decreasing overall mortality. Evidence on self rated health and other indicators was mixed. Conclusions Most published studies on the impact of financial crisis on health in Europe had a substantial risk of bias; therefore, results need to be cautiously interpreted. Overall, the financial crisis in Europe seemed to have had heterogeneous effects on health outcomes, with the evidence being most consistent for suicides and mental health. There is a need for better empirical studies, especially those focused on identifying mechanisms that can mitigate the adverse effects of the crisis. PMID:27601477

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

PubMed Central

Mackey, Tim K; Strathdee, Steffanie A

2015-01-01

Introduction 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. Discussion 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. Conclusions 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

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

PubMed

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

PubMed

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.

[The economic-financial crisis and health in Spain. Evidence and viewpoints. SESPAS report 2014].

PubMed

Cortès-Franch, Imma; González López-Valcárcel, Beatriz

2014-06-01

The objectives of the SESPAS 2014 Report are as follows: a) to analyze the impact of the economic crisis on health and health-related behaviors, on health inequalities, and on the determinants of health in Spain; b) to describe the changes in the Spanish health system following measures to address the crisis and assess its potential impact on health; c) to review the evidence on the health impact of economic crises in other countries, as well as policy responses; and d) to suggest policy interventions alternative to those carried out to date with a population health perspective and scientific evidence in order to help mitigate the impact of the economic downturn on health and health inequalities. The report is organized in five sections: 1) the economic, financial and health crisis: causes, consequences, and contexts; 2) the impact on structural determinants of health and health inequalities; 3) the impact on health and health-related behaviors, and indicators for monitoring; 4) the impact on health systems; and 5) the impact on specific populations: children, seniors, and immigrants. There is some evidence on the relationship between the crisis and the health of the Spanish population, health inequalities, some changes in lifestyle, and variations in access to health services. The crisis has impacted many structural determinants of health, particularly among the most vulnerable population groups. Generally, policy responses on how to manage the crisis have not taken the evidence into account. The crisis may contribute to making public policy vulnerable to corporate action, thus jeopardizing the implementation of healthy policies. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Health outcomes during the 2008 financial crisis in Europe: systematic literature review.

PubMed

Parmar, Divya; Stavropoulou, Charitini; Ioannidis, John P A

2016-09-06

 To systematically identify, critically appraise, and synthesise empirical studies about the impact of the 2008 financial crisis in Europe on health outcomes.  Systematic literature review.  Structural searches of key databases, healthcare journals, and organisation based websites.  Empirical studies reporting on the impact of the financial crisis on health outcomes in Europe, published from January 2008 to December 2015, were included. All selected studies were assessed for risk of bias. Owing to the heterogeneity of studies in terms of study design and analysis and the use of overlapping datasets across studies, studies were analysed thematically per outcome, and the evidence was synthesised on different health outcomes without formal meta-analysis.  41 studies met the inclusion criteria, and focused on suicide, mental health, self rated health, mortality, and other health outcomes. Of those studies, 30 (73%) were deemed to be at high risk of bias, nine (22%) at moderate risk of bias, and only two (5%) at low risk of bias, limiting the conclusions that can be drawn. Although there were differences across countries and groups, there was some indication that suicides increased and mental health deteriorated during the crisis. The crisis did not seem to reverse the trend of decreasing overall mortality. Evidence on self rated health and other indicators was mixed.  Most published studies on the impact of financial crisis on health in Europe had a substantial risk of bias; therefore, results need to be cautiously interpreted. Overall, the financial crisis in Europe seemed to have had heterogeneous effects on health outcomes, with the evidence being most consistent for suicides and mental health. There is a need for better empirical studies, especially those focused on identifying mechanisms that can mitigate the adverse effects of the crisis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please

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

PubMed Central

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

Information about Sexual Health on Crisis Pregnancy Center Web Sites: Accurate for Adolescents?

PubMed

Bryant-Comstock, Katelyn; Bryant, Amy G; Narasimhan, Subasri; Levi, Erika E

2016-02-01

The objective of this study was to evaluate the quality and accuracy of sexual health information on crisis pregnancy center Web sites listed in state resource directories for pregnant women, and whether these Web sites specifically target adolescents. A survey of sexual health information presented on the Web sites of crisis pregnancy centers. Internet. Crisis pregnancy center Web sites. Evaluation of the sexual health information presented on crisis pregnancy center Web sites. Themes included statements that condoms are not effective, promotion of abstinence-only education, availability of comprehensive sexual education, appeal to a young audience, provision of comprehensive sexual health information, and information about sexually transmitted infections (STIs). Crisis pregnancy center Web sites provide inaccurate and misleading information about condoms, STIs, and methods to prevent STI transmission. This information might be particularly harmful to adolescents, who might be unable to discern the quality of sexual health information on crisis pregnancy center Web sites. Listing crisis pregnancy centers in state resource directories might lend legitimacy to the information on these Web sites. States should be discouraged from listing Web sites as an accurate source of information in their resource directories. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Effects of the economic crisis on health and healthcare in Greece in the literature from 2009 to 2013: a systematic review.

PubMed

Simou, Effie; Koutsogeorgou, Eleni

2014-04-01

Due to the current economic crisis in Greece, effects on health and healthcare have been reported. The aim of this study was to present a systematic overview of the consequences that the financial crisis has had for health and healthcare in Greece. Systematic literature review was conducted in order to identify articles that were published from January 2009 to March 2013 and explicitly referred to the effects of economic crisis on health or healthcare, in Greece. Data extraction and synthesis was performed with the use of thematic analysis. Thirty-nine studies were considered for further analyses. Various existing and potential relevant effects were identified, including reductions in public health expenditure and changes in healthcare services and the pharmaceutical market, with an increasing number of admissions in public healthcare sector, and efficiency and organizational-related issues being evident, overall. Indications were found for post-crisis deterioration of public health with increasing rates of mental health, suicides, and epidemics, and deterioration of self-rated health. The recent efforts to reform the Greek National Health System have been focusing mainly on short-term effects by reducing expenditure, while the measures imposed seem to have dubious long-term consequences for Greek public health and healthcare. Copyright © 2014 The Authos. Published by Elsevier Ireland Ltd.. All rights reserved.

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

PubMed

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.

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

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 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...

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

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 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...

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

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 1 2012-01-01 2012-01-01 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...

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

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 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?

PubMed

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.

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

PubMed

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

2018-01-10

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

[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].

PubMed

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.

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

PubMed

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.

A national action plan for workforce development in behavioral health.

PubMed

Hoge, Michael A; Morris, John A; Stuart, Gail W; Huey, Leighton Y; Bergeson, Sue; Flaherty, Michael T; Morgan, Oscar; Peterson, Janice; Daniels, Allen S; Paris, Manuel; Madenwald, Kappy

2009-07-01

Across all sectors of the behavioral health field there has been growing concern about a workforce crisis. Difficulties encompass the recruitment and retention of staff and the delivery of accessible and effective training in both initial, preservice training and continuing education settings. Concern about the crisis led to a multiphased, cross-sector collaboration known as the Annapolis Coalition on the Behavioral Health Workforce. With support from the Substance Abuse and Mental Health Services Administration, this public-private partnership crafted An Action Plan for Behavioral Health Workforce Development. Created with input from a dozen expert panels, the action plan outlines seven core strategic goals that are relevant to all sectors of the behavioral health field: expand the role of consumers and their families in the workforce, expand the role of communities in promoting behavioral health and wellness, use systematic recruitment and retention strategies, improve training and education, foster leadership development, enhance infrastructure to support workforce development, and implement a national research and evaluation agenda. Detailed implementation tables identify the action steps for diverse groups and organizations to take in order to achieve these goals. The action plan serves as a call to action and is being used to guide workforce initiatives across the nation.

The health workforce crisis: the brain drain scourge.

PubMed

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.

Nursing in Crisis

ERIC Educational Resources Information Center

Fulcher, Roxanne

2007-01-01

Both the nation's health-care and nursing education systems are in crisis. While the care provided by registered nurses (RNs) is essential to patients' recovery from acute illness and to the effective management of their chronic conditions, the United States is experiencing a nursing shortage that is anticipated to increase as baby boomers age and…

Ideologies in the Swedish health sector today: the crisis of the social democracy.

PubMed

Diderichsen, F

1982-01-01

Sweden has a long tradition of social democracy and corporate cooperation. Social problems are treated as technological questions that always should be solved through rational and neutral means. Today Sweden faces a crisis of economy as well as a crisis of medicine. In the spirit of consensus, the state has proposed a new health reform emphasizing the responsibility of the public health service to prevent disease and provide equal access to care. It is claimed that improved health planning, based on epidemiological knowledge on inequalities, can solve the crisis in medicine within an improved system of primary care and prevention. However, in the context of the current economic crisis, the struggle against health hazards and cuts in public spending has intensified and the gap between the ideology of technological rationalism and reality has widened.

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

PubMed

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.

The Crisis of Capitalism and the Marketisation of Health Care: the Implications for Public Health Professionals

PubMed Central

McKee, Martin; Stuckler, David

2012-01-01

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. PMID:25170470

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

PubMed

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.

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

PubMed

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

2017-08-01

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

The impact of the 1997-98 East Asian economic crisis on health and health care in Indonesia.

PubMed

Waters, Hugh; Saadah, Fadia; Pradhan, Menno

2003-06-01

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 health care. The results are based on primary analysis of Indonesian household survey data and review of a wide range of sources from the Indonesian government and international organizations. Comparisons are drawn with the effects of the crisis in Thailand. The devaluation of the Indonesian currency, the Rupiah, led to inflation and reduced real public expenditures on health. Households' expenditures on health also decreased, both in absolute terms and as a percentage of overall spending. Self-reported morbidity increased sharply from 1997 to 1998 in both rural and urban areas of Indonesia. The crisis led to a substantial reduction in health service utilization during the same time period, as the proportion of household survey respondents reporting an illness or injury that sought care from a modern health care provider declined by 25%. In contrast to Indonesia, health care utilization in Thailand actually increased during the crisis, corresponding to expansion in health insurance coverage. The results suggest that social protection programmes play a critical role in protecting populations against the adverse effects of economic downturns on health and health care.

The Asian currency crisis and the Australian health industry.

PubMed

Barraclough, S

1998-01-01

This article identifies linkages between the Australian health industry and the global economy. It discusses some of the consequences of the Asian currency crisis of 1997-98 for the Australian economy and health industry, with special emphasis upon exports. Devaluation of the Australian dollar will increase the cost of most pharmaceutical and medical imports, but may offer competitive advantages to some Australian exporters. The nascent engagement with Asia of many health industry enterprises is likely to be stifled. It is therefore important for Australian governments, as well as the Australian health industry, to provide intelligence and encouragement to those enterprises that wish to continue their engagement with Asia or resume it when economic equilibrium returns. Markets throughout the world must also be further developed. The crisis may therefore provide the stimulus for re-thinking and re-stating Australian health export policy.

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

PubMed

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.

Changes in Occupational Safety and Health Indices After the Korean Economic Crisis: Analysis of a National Sample, 1991–2007

PubMed Central

Min, Kyoung-Bok; Min, Jin-Young; Park, Jae-Beom; Park, Shin-Goo

2010-01-01

We examined how the deregulation of South Korea's labor laws during the country's 1997 to 1998 economic crisis affected occupational safety and health. Although the economic index improved after the reforms, the total injury rate declined slowly and the incidence of occupational disease increased. The withdrawal of support for occupational safety and health is likely to have a sustained effect on public health. PMID:20339078

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

PubMed

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

Economic Crisis, Austerity Policies, Health and Fairness: Lessons Learned in Spain.

PubMed

Lopez-Valcarcel, Beatriz G; Barber, Patricia

2017-02-01

This paper reviews economic and medical research publications to determine the extent to which the measures applied in Spain to control public health spending following the economic and financial crisis that began in 2008 have affected healthcare utilization, health and fairness within the public healthcare system. The majority of the studies examined focus on the most controversial cutbacks that came into force in mid-2012. The conclusions drawn, in general, are inconclusive. The consequences of this new policy of healthcare austerity are apparent in terms of access to the system, but no systematic effects on the health of the general population are reported. Studies based on indicators of premature mortality, avoidable mortality or self-perceived health have not found clear negative effects of the crisis on public health. The increased demands for co-payment provoked a short-term cutback in the consumption of medicines, but this effect faded after 12-18 months. No deterioration in the health of immigrants after the onset of the crisis was unambiguously detected. The impact of the recession on the general population in terms of diseases associated with mental health is well documented; however, the high levels of unemployment are identified as direct causes. Therefore, social policies rather than measures affecting the healthcare system would be primarily responsible. In addition, some health problems have a clear social dimension, which seems to have become more acute during the crisis, affecting in particular the most vulnerable population groups and the most disadvantaged social classes, thus widening the inequality gap.

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

PubMed

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

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

A Novel Mental Health Crisis Service – Outcomes of Inpatient Data

PubMed Central

McGlennon, D; McDonnell, C

2016-01-01

Introduction 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. Methods 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. Results 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. Discussion 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. PMID:27158159

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

PubMed

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.

Was the economic crisis of 2008 good for Icelanders? Impact on health behaviors.

PubMed

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

2014-03-01

This study uses the 2008 economic crisis in Iceland to identify the effects of a macroeconomic downturn on a range of health behaviors. We use longitudinal survey data that include pre- and post-reports from the same individuals on a range of health-compromising and health-promoting behaviors. We find that the crisis led to large and significant reductions in health-compromising behaviors (such as smoking, drinking alcohol or soft drinks, and eating sweets) and certain health-promoting behaviors (consumption of fruits and vegetables), but to increases in other health-promoting behaviors (consumption of fish oil and recommended sleep). The magnitudes of effects for smoking are somewhat larger than what has been found in past research in other contexts, while those for alcohol, fruits, and vegetables are in line with estimates from other studies. Changes in work hours, real income, financial assets, mortgage debt, and mental health, together, explain the effects of the crisis on some behaviors (such as consumption of sweets and fast food), while the effects of the crisis on most other behaviors appear to have operated largely through price increases. Copyright © 2013 Elsevier B.V. All rights reserved.

THE IMPACT OF CRISIS UPON THE BEHAVIOR OF NATIONS IN THE 1960's.

PubMed

Phillips, W R; Lorimor, T

1974-10-01

This study examines international crises in the 1960's, specifically those crises that occurred between June, 1962 and July, 1968. The conflictual aspects of interacting dyads involved in crises during that period were examined t o discern the conflictual dimensions of national behavior in crises. In addition, conflict behavior was examined for those periods immediately prior to and immediately following crisis situations. This resulted in dimensions of conflict behavior for pre-crisis, during-crisis, and post-crisis periods. The periods were contrasted with one another to gain a better conception of the behavior exhibited in international crises. It was found that the dimensions of behavior change in predictable ways in the shift from one period to another. The behavior of individual dyads does shift in ways which are not predictable by simple linear technique.

[The legal issue of the present occupational physician system in crisis management of health damage].

PubMed

Yuki, Tomoshi; Hakozaki, Yukiya; Yoshinaga, Takeo; Koizumi, Akio

2004-09-01

In present day Japan, when a crisis like the Bhopal accident occurs, due to defects in the current of industrial health law, effective crisis management cannot be taken to minimize health damage in both workers and residents. The current law characterizes industrial health as a part of the welfare service provided by employers for employees. Nevertheless, the company should be liable for all failure and damage including health impairment as a primary party. Moreover, in an emergency crisis, unlike the case of reparations, it is not accepted to argue whether the company should take absolute liability or not. Accordingly, in such cases, we consider it more appropriate to apply the "Polluter Pays Principle" and the principle of "Liability without Fault" to the company's responsibility. By these rules, the company should mobilize their own professionals, who are experts of managing crises, such as occupational physicians and/or industrial health professionals to minimize health damages among citizens in general. The company should take such a social responsibility in a crisis when it is the primary responsible party to the crisis.

Women and the opioid crisis: historical context and public health solutions.

PubMed

Terplan, Mishka

2017-08-01

Driven by a legitimate but overly opioid-focused response to pain, the United States is currently experiencing an opioid crisis, a crisis with parallels to the first opioid epidemic at the turn of the 20th century. Women, particularly white reproductive-age women, are increasingly the face of the opioid crisis. Given the penetration of opioid misuse and addiction across all income and insurance strata, any provider who cares for women needs to be prepared to assess and evaluate opioid use, misuse, and addiction. Although responsible opioid prescribing is essential, treatment capacity must be expanded and be inclusive of the unique needs of women. However, the public and public health response to the opioid crisis must include rolling back the war on drugs. The continued criminalization of the public health issue of drug use and the medical condition of addiction is unethical, ineffective, and inhumane. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

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

PubMed

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.

UN study reports Asian economic crisis has hit women's health.

PubMed

Ciment, J

1999-02-13

A UN Population Fund report, "Southeast Asian Populations in Crisis," revealed that the economic crisis in Southeastern Asia has had a disproportionately adverse effect on the health of women and girls. This has occurred because the industries employing women have been hardest hit and because governments have reduced spending on health care and female education. Thailand, for example, has reduced its AIDS budget by 25% even as increasing numbers of women are pushed into the sex trade by economic necessity. Reproductive health services for adolescents have been hit just as shrinking family budgets are forcing adolescents to drop out of school. The report's authors are calling for a more detailed look at the situation.

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

PubMed

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.

Setting national health goals and targets in the context of a fiscal crisis: the politics of social choice in New Zealand.

PubMed

Beaglehole, R; Davis, P

1992-01-01

The setting of national health goals and targets in New Zealand has taken place in the context of fiscal crisis. The mandate for State intervention for social goals has also been under a sustained ideological challenge. These circumstances, together with other developments within the New Zealand health service, prepared the way for the development of the first set of health goals and targets. Six criteria were used to identify health problems for which goals and targets could be set. Ten areas were included, and specific, timed and quantified targets were set in each area for the year 2000 with shorter term targets for 1995. The Minister of Health gave priority to three areas: tobacco control, secondary prevention of cervical cancer, and reduction of road accident injury and death. An important aspect of the program is that the goals and targets are to be the focus of the annual contract between the Minister of Health (the primary funder of health care) and the Area Health Boards (the primary providers of health care). A matrix of policy options is presented for resource allocation and public health. The case study described represents one solution to the set of policy choices presented by fiscal and ideological challenge; the "new managerialism" has been allied with the "new public health." The authors argue that a combination of ideological renewal and fiscal probity has preserved a vigorous role for the State in health and health care. This matrix of policy options also underlines the necessity to consider health outcomes, as well as organizational goals, in the evaluation of the performance of health systems.

International involvement and national health governance: the basic benefit package in Tajikistan.

PubMed

Rechel, Bernd; Khodjamurodov, Ghafur

2010-06-01

Tajikistan, a Central Asian state of 7.4 million inhabitants, is facing particular health policy challenges: not only is the country the poorest of the former Soviet republics, but its capacity to deal with post-communist transition and economic crisis has been further undermined through civil war and large-scale migration. This paper, examining the introduction of the basic benefit package and formal co-payments, elucidates how international involvement in Tajikistan's health sector has impacted on national health governance. Based on documentary sources and information provided by key informants, we find that external agencies have both strengthened and weakened national health governance. Although they have played a major part in supporting Tajikistan's health sector, these efforts have often been fragmented, as donor coordination was at times less than optimal. A key challenge for national health governance is the limited technical and institutional capacity of the Ministry of Health and further efforts are needed to build national capacity. Copyright 2010 Elsevier Ltd. All rights reserved.

Health system resilience: Lebanon and the Syrian refugee crisis

PubMed Central

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

Lessons Learned From the Crisis in Flint, Michigan Regarding the Effects of Contaminated Water on Maternal and Child Health.

PubMed

Craft-Blacksheare, Melva Gale

The Flint, Michigan water crisis raised awareness about the dangers of lead-tainted drinking water and the role of the nurse in addressing such a crisis. Although lead exposure is dangerous for all people, research indicates that pregnant and nursing women and their infants are especially vulnerable to prenatal and postnatal lead exposure. This information is of national importance because of the aging infrastructure of American cities and the likelihood of similar problems in other locations. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

The health implications of financial crisis: A review of the evidence

PubMed Central

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

2009-01-01

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 20th century: the Great Depression (1929), the Post-communist Depression (early 1990s) and the East Asian financial crisis (late 1990s). 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. PMID:19907678

Sex Education, First Sex and Sexual Health Outcomes in Adulthood: Findings from a Nationally Representative Sexual Health Survey

ERIC Educational Resources Information Center

Bourke, Ashling; Boduszek, Daniel; Kelleher, Caroline; McBride, Orla; Morgan, Karen

2014-01-01

This study investigated the relationship between school sex education and sexual health behaviours at first sex and later in adulthood, using nationally representative data. Respondents were adults from the 2010 Irish Contraception and Crisis Pregnancy Survey, a cross-sectional survey designed to assess knowledge, attitudes and behaviours relating…

Respiratory Health in Migrant Populations: A Crisis Overlooked

PubMed Central

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

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

PubMed

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.

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

PubMed

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.

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

PubMed

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.

Childhood Obesity: A Global Public Health Crisis

PubMed Central

Karnik, Sameera; Kanekar, Amar

2012-01-01

Introduction: Childhood obesity is a major public health crisis nationally and internationally. The prevalence of childhood obesity has increased over few years. It is caused by imbalance between calorie intake and calories utilized. One or more factors (genetic, behavioral, and environmental) cause obesity in children. Physical, psychological, and social health problems are caused due to childhood obesity. Hence, effective intervention strategies are being used to prevent and control obesity in children. The purpose of this manuscript is to address various factors influencing childhood obesity, a variety of interventions and governmental actions addressing obesity and the challenges ahead for managing this epidemic. Methods: In order to collect materials for this review a detailed search of CINAHL, MEDLINE, ERIC, Academic Search Premier databases was carried out for the time period 1999-2011. Results: Some of the interventions used were family based, school based, community based, play based, and hospital based. The effective school-based interventions were seen targeting physical activity along with healthy diet education. The major challenges faced by these intervention programs are financial, along with stigmatization of obese children. Governments along with other health care organizations are taking effective actions like policy changing and environmentally safe interventions for children to improve physical activity. Conclusions: In conclusion, childhood obesity can be tackled at the population level by education, prevention and sustainable interventions related to healthy nutrition practices and physical activity promotion. PMID:22506094

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

PubMed Central

2011-01-01

reported in this article, of the effects of the global financial crisis on a few variables, is important to alert the Ministry of Health on the looming danger of cuts in health funding from domestic and external sources. However, it is even more important for national governments to monitor the effects of the economic crisis and the policy responses on the social determinants of health, health inputs, health system outputs and health system outcomes, e.g. health. PMID:21489284

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

PubMed

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

2011-04-13

effects of the global financial crisis on a few variables, is important to alert the Ministry of Health on the looming danger of cuts in health funding from domestic and external sources. However, it is even more important for national governments to monitor the effects of the economic crisis and the policy responses on the social determinants of health, health inputs, health system outputs and health system outcomes, e.g. health.

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

PubMed

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.

PubMed

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.

Improving maternal, newborn and women's reproductive health in crisis settings

PubMed Central

Chi, Primus Che; Urdal, Henrik; Umeora, Odidika Uj; Sundby, Johanne; Spiegel, Paul; Devane, Declan

2015-01-01

This is the protocol for a review and there is no abstract. The objectives are as follows: To identify, synthesise and evaluate the effects of health system and other interventions aimed at improving maternal, newborn and women's reproductive health in crisis settings.

The route to a national health policy lies through the states.

PubMed Central

Silver, G. A.

1991-01-01

National health program legislation has been becalmed in the Congress for almost 80 years. Despite periodic cries of "crisis," legislation never emerges from committee. Periodically, campaigns have been mounted without success. Tactical efforts to circumvent direct action by legislating bits and pieces of related programs, Medicare and Medicaid, health maintenance organization support, and pre-budgeting, have complicated operation of the medical care system and stimulated intractable cost inflation. For the first 150 years of American history, responsibility for public health and welfare legislation rested with the states. Most public health policies originated in a state or a few states and then later became national legislation. The state efforts were, in effect, natural experiments. After the Depression and the flood of funding from the federal government in subsequent years, the states faded as innovators. It is proposed that funding a few state models to restimulate state initiative in this regard will provide a more effective route to a national health program. PMID:1814058

Long-term Mortality Risk After Hyperglycemic Crisis Episodes in Geriatric Patients With Diabetes: A National Population-Based Cohort Study.

PubMed

Huang, Chien-Cheng; Weng, Shih-Feng; Tsai, Kang-Ting; Chen, Ping-Jen; Lin, Hung-Jung; Wang, Jhi-Joung; Su, Shih-Bin; Chou, Willy; Guo, How-Ran; Hsu, Chien-Chin

2015-05-01

Hyperglycemic crisis is one of the most serious diabetes-related complications. The increase in the prevalence of diabetes in the geriatric population leads to a large disease burden, but previous studies of geriatric hyperglycemic crisis were focused on acute hyperglycemic crisis episode (HCE). This study aimed to delineate the long-term mortality risk after HCE. This retrospective national population-based cohort study reviewed, in Taiwan's National Health Insurance Research Database, data from 13,551 geriatric patients with new-onset diabetes between 2000 and 2002, including 4,517 with HCE (case subjects) (ICD-9 code 250.1 or 250.2) and 9,034 without HCE (control subjects). The groups were compared and followed until 2011. One thousand six hundred thirty-four (36.17%) case and 1,692 (18.73%) control subjects died (P < 0.0001) during follow-up. Incidence rate ratios (IRRs) of death were 2.82 times higher in case subjects (P < 0.0001). The mortality risk was highest in the first month (IRR 26.56; 95% CI 17.97-39.27) and remained higher until 4-6 years after the HCE (IRR 1.49; 95% CI 1.23-1.81). After adjustment for age, sex, selected comorbidities, and monthly income, the mortality hazard ratio was still 2.848 and 4.525 times higher in case subjects with one episode and two or more episodes of hyperglycemic crisis, respectively. Older age, male sex, renal disease, stroke, cancer, chronic obstructive pulmonary disease, and congestive heart failure were independent mortality predictors. Patients with diabetes had a higher mortality risk after HCE during the first 6 years of follow-up. Referral for proper education, better access to medical care, effective communication with a health care provider, and control of comorbidities should be done immediately after HCE. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Accretion, reform, and crisis: a theory of public health politics in New York City.

PubMed Central

Fox, D. M.

1991-01-01

Standard interpretations of the history of public health in New York City in the twentieth century describe either the decline or the growth of the importance accorded to public health activities. To the contrary, public health has, paradoxically, both declined in salience and attracted increasing resources. This article describes the politics of public health in New York City since the 1920s. First it describes events in the history of public health in the context of events in the economy and in city, state, and national politics. Then it proposes three descriptive models for arraying the data about public health politics: accretion, reform, and crisis. Next it describes how the politics of AIDS in New York City in the 1980s was a consequence of the history that produced these three political styles. Finally, it argues that the three political styles are generalizable to the history of public health throughout the United States in the twentieth century. PMID:1814059

Nurse practitioner LEADERSHIP in face of OPIOID CRISIS.

PubMed

Denhartog, Lauren

2017-01-01

Opioid misuse has been a growing problem in Alberta and throughout Canada and the U.S. in recent years. According to Alberta Health, the number of fentanyl-related overdose deaths in Alberta rose from six in 2011 to over 300 in 2016. This alarming increase in substance abuse is a national health crisis.

Economic crisis and mental health.

PubMed

Uutela, Antti

2010-03-01

Literature from the past year was examined to learn whether economic recessions have an effect on mental disorders including depression and suicides. Economic recessions and crises have a context-dependent negative impact on mental health disorders. These appear in low-income and middle-income countries whereas some affluent countries are offering provisions that help unemployed persons to escape the detrimental consequences. The Asian economic crisis led to a sharp unemployment-related increase in suicide mortality in east Asian countries. In European Union countries rising unemployment was associated with significant short-term increases in premature deaths from intentional violence including suicides. It seems that active labour market programmes existing in some Organization for Economic Cooperation and Development countries can prevent some adverse health effects of economic downturns. As mental health consequences of economic crises are context dependent, the current situation needs monitoring. Enough services for those in need should be provided and advocacy for societal support measures is of great importance.

Public health and crisis leadership in the 21st century.

PubMed

Lawton, Luke

2013-05-01

Public health crises are becoming increasingly complex, and as such leaders need to revisit their roles and consider new problems arising for public health today. Dr Luke Lawton, of Redcliffe Hospital in Queensland, Australia examines the nature of leadership and provides some pointers on crisis planning.

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

PubMed Central

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

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

PubMed

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.

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

PubMed

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.

Financial crisis and austerity measures in Greece: their impact on health promotion policies and public health care.

PubMed

Ifanti, Amalia A; Argyriou, Andreas A; Kalofonou, Foteini H; Kalofonos, Haralabos P

2013-11-01

This review study explores the available data relating to the impact of financial crisis and subsequently applied austerity measures on the health care, social services and health promotion policies in Greece. It is evident that Greece is affected more than any other European country by the financial crisis. Unemployment, job insecurity, income reduction, poverty and increase of mental disorders are among the most serious consequences of crisis in the socioeconomic life. The health system is particularly affected by the severe austerity measures. The drastic curtailing of government spending has significantly affected the structure and functioning of public hospitals that cope with understaffing, deficits, drug shortage and basic medical supplies. Moreover, health promotion policies are constrained, inhibiting thus the relevant initiatives toward disease prevention and health promotion education practices. Overall, the current economic situation in Greece and its impact on real life and health care is quite concerning. Policy makers should not disregard the implications that austerity and fiscal policies have on the health sector. Greater attention is needed in order to ensure that individuals would continue getting public health care and having access to preventive and social support services. To face the economic hardship, policy makers are expected to implement human-centered approaches, safeguarding the human dignity and the moral values. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Public Health Crisis: the Need for Primary Prevention in Failed and Fragile States.

PubMed

Quinn, John; Stoeva, Preslava; Zelený, Tomáš; Nanda, Toozy; Tomanová, Alžběta; Bencko, Vladimír

2017-09-01

A new 'normal' in global affairs may be erupting from large global powers to that of non-state actors and proxies committing violence through scaled conflict in a post-Westphalian world generating significant global health policy challenges. Health security of populations are multifactorial and indirectly proportional to war, conflict and disaster. Preventing conflict and avoiding the health vacuum that occurs in war and violence may be best practices for policy makers. This paper considers an approach of applying clinical primary prevention principles to global health policy. Brief policy review of current standards and practices in health security in fragile and failed states and prevention; and definitions discussion. A short case study series are presented with best practices, with risk and outcome review. The global balance of power and order may be shifting through geopolitical transference and inadequate action by major global power brokers. Health security in at risk nation-states may be decreasing as a result. Small scale conflict with large-scale violence threatens health security and may experience increased incidence and prevalence in fragile and failed states. Preventative policy to resuscitate fragile and failed states and prevent further external and internal shocks may support health and promote a positive feedback loop of further state stability and increased health security. Public health policy shift to mitigate state failure and public health crisis in war and conflict through the basis of primary prevention may provide best practices and maximize health security for at risk populations. Copyright© by the National Institute of Public Health, Prague 2017

Reforming the reform: the Greek National Health System in transition.

PubMed

Tountas, Yannis; Karnaki, Panagiota; Pavi, Elpida

2002-10-01

The National Health System (ESY) in Greece, which was established in 1983, is in a state of continuous crisis. This situation is caused mainly by the system's problematic administration, low productivity and inadequate Primary Health Care. These have led the re-elected PASOK government to introduce by the end of 2000 a radical reform of the health system. The 200 reform measures announced by the new Minister of Health and Welfare include changes aiming at: the decentralization of the ESY, the creation of a unified financing system for the social insurance funds, a new management structure in public hospitals, the organization of a Primary Health System in urban areas, and the strengthening of Public Health and Health Promotion. These changes are presented and discussed in this paper.

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

PubMed

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.

Changes in access to health care for immigrants in Catalonia during the economic crisis: Opinions of health professionals and immigrant users.

PubMed

Porthé, Victoria; Vargas, Ingrid; Sanz-Barbero, Belén; Plaza-Espuña, Isabel; Bosch, Lola; Vázquez, Maria Luisa

2016-11-01

Policy measures introduced in Spain during the economic crisis included a reduction in public health expenditure and in healthcare entitlements (RDL16/2012), which affected the general population as a whole, but especially immigrants. This paper analyzes changes in immigrants' access to health care during the economic crisis from the perspective of health professionals (medical and administrative) and immigrants. A qualitative descriptive-interpretative study was conducted in Catalonia through individual interviews with a theoretical sample of health professionals (n=34) and immigrant users (n=20). Thematic analysis was conducted and data quality was ensured through triangulation. Informants described barriers to enter the health system related to reduced healthcare entitlements and a stricter enforcement of administrative requirements: while medical professionals highlighted restrictions to accessing the healthcare continuum, immigrants accentuated barriers to obtaining the individual health card. With regard to use of services, an increase in waiting times due to cutbacks in human resources dominated the informants' discourse. Health professionals pointed out organizational changes to increase efficiency that may improve access to primary care. Informants related lower health services utilization to a deterioration in immigrants' living and working conditions. According to health professionals, these conditions limited the use of services during working hours and led to delays in seeking care and treatment interruptions. Results show an aggravation of pre-existing barriers to health services utilization and, simultaneously, the appearance of new barriers to enter the system. These changes in the healthcare services contradict the equity principles of the national health system (NHS), thus policy decisions are needed to address this problem. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Well Being of Our Nation: An Inter-Generational Vision of Effective Mental Health Services and Supports.

ERIC Educational Resources Information Center

National Council on Disability, Washington, DC.

This report of the National Council on Disability (NCD) examines root causes of the crisis in mental health, specifically the dysfunction of fragmented public systems charged with providing mental health services and supports for children, youth, adults, and senior citizens diagnosed with mental illnesses. Following an introductory chapter,…

INL Director Explains How the National Labs Are Assisting With Japan's Nuclear Crisis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grossenbacher, John

2011-04-14

Idaho National Laboratory's Director John Grossenbacher discusses the types of nuclear expertise and capabilities that exist within the U.S. Department of Energy's national labs to assist with the Japan nuclear crisis. He also explains how the labs will provide long-term research that will uncover lessons learned from the Fukushima nuclear plants. For more information about INL's nuclear energy research, visit http://www.facebook.com/idahonationallaboratory.

INL Director Explains How the National Labs Are Assisting With Japan's Nuclear Crisis

ScienceCinema

Grossenbacher, John

2018-02-06

Idaho National Laboratory's Director John Grossenbacher discusses the types of nuclear expertise and capabilities that exist within the U.S. Department of Energy's national labs to assist with the Japan nuclear crisis. He also explains how the labs will provide long-term research that will uncover lessons learned from the Fukushima nuclear plants. For more information about INL's nuclear energy research, visit http://www.facebook.com/idahonationallaboratory.

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

PubMed

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.

PubMed

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.

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

PubMed

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.

PubMed

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.

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

PubMed

Friedman, Jed; Thomas, Duncan

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

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

PubMed

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.

The differential impact of the financial crisis on Health in Ireland and Greece: A quasi-experimental approach

PubMed Central

Hessel, P; Vandoros, S; Avendano, M

2015-01-01

Objectives Greece and Ireland suffered an economic recession of similar magnitude, but whether their health has deteriorated as a result has not yet been well established. Study design Based on five waves (2006-2010) of the European Union Statistics of Income and Living Conditions (EU-SILC) survey we implemented a difference-in-differences (DID) approach that compared trends in self-rated health in Greece and Ireland before and after the crisis with trends in a control population (Poland) that did not experience a recession and had health trends comparable to both countries before the crisis. Methods Logistic regression using a difference-in-differences (DID) approach. Results A simple examination of trends suggests that there was no significant change in health in Greece or Ireland following the onset of the financial crisis. However, DID estimates that incorporated a control population suggest an increase in the prevalence of poor-self rated health in Greece (OR=1.216; CI=1.11 - 1.32). Effects were most pronounced for older individuals and those living in high-density areas, but effects in Greece were overwhelmingly consistent in different population sub-groups. In contrast, DID estimates revealed no effect of the financial crisis in Ireland (OR=0.97; CI=0.81-1.16). Conclusions Contradicting results from a simple comparison of single-country trends, DID estimates suggest that the financial crisis has led to deterioration of population health trends in Greece but not in Ireland, where policies may have prevented a worsening of health as a result of the recent economic crisis. PMID:25369355

The Research of the Crisis Pre-Warning Management System under the Particularity of Nationalities Universities and Colleges

ERIC Educational Resources Information Center

Wang, Hui

2009-01-01

The nationalities universities and colleges set up the crisis pre-warning management system, not only related to the management of our nationalities universities and colleges and their growth, but also related to the country's national unity plan in some way. However, because of minority students in the particularity of the national cultural…

[Financial crisis and mental health in Greece].

PubMed

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 < 0.001) and emergency unit (R2 = 0,37, p = 0.004) of Eginition Hospital. However, the data from the 4 hospitals of the study revealed a negative correlation between average income and visits to outpatients' departments (R2 = 0.70, p = 0.02) and emergency units (R2 = 0.90, p < 0.001). Furthermore, a significant negative correlation between the average income and suicide rates (R2 = 0.37, p = 0.007), as well as a positive correlation between the average income and divorce rates (R2 = 0.73, p < 0.001) were found. The findings show several similarities with previous surveys in

Hyperglycemic crisis.

PubMed

Van Ness-Otunnu, Ronald; Hack, Jason B

2013-11-01

Hyperglycemic crisis is a metabolic emergency associated with uncontrolled diabetes mellitus that may result in significant morbidity or death. Acute interventions are required to manage hypovolemia, acidemia, hyperglycemia, electrolyte abnormalities, and precipitating causes. Despite advances in the prevention and management of diabetes, its prevalence and associated health care costs continue to increase worldwide. Hyperglycemic crisis typically requires critical care management and hospitalization and contributes to global health expenditures. Diagnostic and resolution criteria and management strategies for diabetic ketoacidosis and hyperosmolar hyperglycemic crisis are provided. A discussion of prevalence, mortality, pathophysiology, risk factors, clinical presentation, differential diagnosis, evaluation, and management considerations for hyperglycemic crisis are included. Emergency physicians confront the most severe sequelae of uncontrolled diabetes and provide crucial, life-saving management. With ongoing efforts from diabetes societies to incorporate the latest clinical research to refine treatment guidelines, management and outcomes of hyperglycemic crisis in the emergency department continue to improve. We provide an overview of the evaluation and treatment of hyperglycemic crisis and offer a concise, targeted management algorithm to aid the practicing emergency physician. Copyright © 2013 Elsevier Inc. All rights reserved.

Analysis of a National Toll Free Suicide Crisis Line in South Africa

ERIC Educational Resources Information Center

Meehan, Sue-Ann; Broom, Yvonne

2007-01-01

The first national toll free suicide crisis line for South Africa was launched in October 2003 with the aim of providing a service dedicated to the prevention of suicide in this country. The intervention was motivated by South Africa's suicide rate which had risen higher than the global suicide rate, with the majority of attempted suicides…

Regional Contagion: Social, Economic, Health and Population Crisis Diffusion

DTIC Science & Technology

2008-04-24

dimensions. Plus, regional neighbors have been impacted-- Chile and Brazil specifically.13,14 Now that the first step is complete, the operational...Argentina’s economics have impacted Brazil and Chile .22 8  Population Contagion The last dimension concerns population strife. Like the social...nations--those that have strong contagion exposure from an Argentine crisis, like Brazil and Chile . Drawing parallels to operational art, the commander

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

PubMed

Kaplan, Tony; Racussen, Lisa

2013-04-01

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

The Response of Vocational Education to the National Energy Crisis. A Special Report.

ERIC Educational Resources Information Center

National Advisory Council on Vocational Education, Washington, DC.

Rationale and recommendations are presented for vocational education's response to the national energy crisis in light of present involvement and future needs. The problem is stated in terms of the need for training programs in the newer energy technologies, including those related to conservation. Federal policies are outlined, specifically the…

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

PubMed

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 Effect on Mental Health of Retiring During the Economic Crisis.

PubMed

Belloni, Michele; Meschi, Elena; Pasini, Giacomo

2016-11-01

This paper investigates the causal impact of retirement on late-life mental health, a growing concern for public health, because major depressive disorders are the second leading cause of disability. We shed light on the role of economic conditions in shaping the effect of retirement on mental health by exploiting time and regional variation in the severity of the economic crisis across 10 European countries during 2004-2013. We use data from four waves of the Survey of Health, Ageing and Retirement in Europe and address the potential endogeneity of the retirement decision to mental health by applying a fixed-effects instrumental variables approach. The results indicate that retirement improves the mental health of men but not that of women. This effect is stronger for blue-collar men working in regions that have been severely hit by the economic crisis. These findings may be explained by the worsening of working conditions and the rise in job insecurity stemming from the economic downturn: under these circumstances, exit from the labour force is perceived as a relief. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

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

PubMed Central

Friedman, Jed; Thomas, Duncan

2015-01-01

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

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

PubMed Central

2012-01-01

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

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

PubMed

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

2012-06-28

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

Resolving the psychiatric bed crisis: a critical analysis of policy.

PubMed

Loader, Katie

The National Service Framework (NSF) for Mental Health in 1999 was central to the modernisation of mental health services under the New Labour government of 1997. It placed an emphasis on universal clinical standards and set out a vision for service developments over the next 10 years. One such proposal was the development of crisis resolution teams, aimed at reducing the psychiatric admissions rate by providing care at home. This article provides a critical analysis of policies relating to the provision of 24-hour access to mental health services, focusing on the specifications for creating crisis resolution teams, as laid out in the NSF for Mental Health and the NHS Plan. First, it looks at the historical context surrounding the policy, examining the content of the NSF and NHS plan and how policy was disseminated and implemented nationally and locally. Then it examines the effects and changes this policy brought about and, specifically, whether it has achieved its aims of reducing the nationwide acute psychiatric inpatient admission rate.

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

PubMed

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.

Sickle Cell Crisis (For Teens)

MedlinePlus

... 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 ...

[THE GLOBAL AND ECONOMIC CRISIS. AND HEALTH MANAGEMENT].

PubMed

del Rey Calero, Juan

2014-01-01

The Global and economic crisis and Health Management The Health care process discussed are 4 steps: assessment, planing, intervention and evaluation. The identify association between social factors linked to social vulnerability (socio economic status, unemployed, poverty) and objective health relate quality of life. The poverty rate is 24.2%, unemployed 26.26%, youth unemployed 56.13%.ratio worker/retired 2.29. Debts 100% GDP The health inequality influence on health related quality of life. The Health System efficiency index. according Bloomber rate (2,013) Spain is 5 degrees in the world, points 68.3 on 100, for the life expectancy 82.3 years, the personal cost of health care 2,271€. Health care 10% GDP (public 7%,private 3%), SS protected population 92.4%, retired person cost 9.2% GDP, p. capita GDP 23,737€. Cost of Care: Hospital/specialist 54%, P. Care 15%, Pharmaceutical 19.8%, P. Health 3.1%.

Achievable steps toward building a National Health Information infrastructure in the United States.

PubMed

Stead, William W; Kelly, Brian J; Kolodner, Robert M

2005-01-01

Consensus is growing that a health care information and communication infrastructure is one key to fixing the crisis in the United States in health care quality, cost, and access. The National Health Information Infrastructure (NHII) is an initiative of the Department of Health and Human Services receiving bipartisan support. There are many possible courses toward its objective. Decision makers need to reflect carefully on which approaches are likely to work on a large enough scale to have the intended beneficial national impacts and which are better left to smaller projects within the boundaries of health care organizations. This report provides a primer for use by informatics professionals as they explain aspects of that dividing line to policy makers and to health care leaders and front-line providers. It then identifies short-term, intermediate, and long-term steps that might be taken by the NHII initiative.

Achievable Steps Toward Building a National Health Information Infrastructure in the United States

PubMed Central

Stead, William W.; Kelly, Brian J.; Kolodner, Robert M.

2005-01-01

Consensus is growing that a health care information and communication infrastructure is one key to fixing the crisis in the United States in health care quality, cost, and access. The National Health Information Infrastructure (NHII) is an initiative of the Department of Health and Human Services receiving bipartisan support. There are many possible courses toward its objective. Decision makers need to reflect carefully on which approaches are likely to work on a large enough scale to have the intended beneficial national impacts and which are better left to smaller projects within the boundaries of health care organizations. This report provides a primer for use by informatics professionals as they explain aspects of that dividing line to policy makers and to health care leaders and front-line providers. It then identifies short-term, intermediate, and long-term steps that might be taken by the NHII initiative. PMID:15561783

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

PubMed

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

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

PubMed

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.

Health disparities by income in Spain before and after the economic crisis

PubMed Central

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

2016-01-01

Little is known about what the economic crisis has done to health disparities by income. 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 (SILC) for the period 2004–2012. We find a modest rise in health inequality by income in Spain in the five 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 over 65s. This suggests that unequal distribution of income protection by age may reduce health inequality in the short run after an economic recession. PMID:27870306

Can Academic Medicine Lead the Way in the Refugee Crisis?

PubMed

Afkhami, Amir A

2016-12-01

The world is currently in the midst of the largest refugee crisis since World War II, with the highest interval of mass displacement in recorded history according to the United Nations. The United States has pledged to maintain its position as one of the world's top resettlement countries in response to this crisis. These new immigrants will arrive with exceptional chronic and acute medical needs, including higher rates of behavioral health disorders. The author describes the health care challenges experienced by refugees seeking asylum in the United States and outlines the ways in which our health care system is currently deficient in helping refugee patients to overcome these challenges. He argues that the academic medical community can change this dynamic by standardizing and expanding instruction in cross-cultural competence and behavioral health screenings throughout the spectrum of medical education. Ensuring the long-term well-being of refugees in the United States, including meeting their mental health needs, will be the best inoculation against the risks of violent extremism which so many fear. With the absence of national leadership on this issue, academic medicine can and should lead the way.

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

PubMed

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.

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

PubMed

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.

Maintaining Small Business Support in Times of Increased Army National Guard Utilization An Impending Crisis

DTIC Science & Technology

2006-02-13

business clientele, additional costs to hire a manager or replacement workers, complete loss of family income, and in extreme situations, bankruptcy, are...USAWC STRATEGY RESEARCH PROJECT MAINTAINING SMALL BUSINESS SUPPORT IN TIMES OF INCREASED ARMY NATIONAL GUARD UTILIZATION: AN IMPENDING CRISIS by...00-00-2005 to 00-00-2006 4. TITLE AND SUBTITLE Maintaining Small Business Support in Times of Increased Army National Guard Utilization An

National Catholic Educational Association: 90 Years, 1904-1994. Meeting Crisis with Confidence (1967-1974).

ERIC Educational Resources Information Center

Koob, C. Albert

1994-01-01

Describes the author's experiences and challenges as president of the National Catholic Educational Association between 1967-74, including the challenges of Vatican II and new developments in education. Indicates that the period, which began in financial and educational crisis, was a period of professional improvement in Catholic education. (MAB)

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

PubMed

Rajmil, Luis; Fernandez de Sanmamed, María-José; Choonara, Imti; Faresjö, Tomas; Hjern, Anders; Kozyrskyj, Anita L; Lucas, Patricia J; Raat, Hein; Séguin, Louise; Spencer, Nick; Taylor-Robinson, David

2014-06-01

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.

[The impact of the economic crisis on health systems of OECD countries].

PubMed

Paris, Valérie

2014-10-01

This paper describes measures adopted by OECD countries in the health sector in response to the economic crisis which began in 2008: increase and diversification of revenues collected for health, increases in user charges, reductions in staff, salaries and prices of health goods and services; and policies aiming to increase health systems efficiency. It then reviews the impact of these policies on health spending trends. © 2014 médecine/sciences – Inserm.

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

PubMed

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.

The malpractice liability crisis.

PubMed

Brenner, R James; Smith, John J

2004-01-01

Most medical malpractice cases are tried under the civil tort of negligence and are often triggered by adverse outcomes. These proceedings are aimed primarily at determining whether the conduct of a health care provider was reasonable. Such legal actions have mostly been subject to state jurisdiction. Increasingly, a number of factors are converging that are threatening the continued practice of medicine in some states and hence patients' access to care. These include higher amounts of monetary damages awarded to successful plaintiffs, consequent rising malpractice premiums, and the threatened economic insolvency of medical liability insurance carriers as a result of the broader economic downturn. The result is a serious public health dilemma. The national scope of the problem has been considered a crisis, which has prompted unprecedented federal legislative proposals directed toward providing new and preemptive parameters for capitated noneconomic damages, restrictions on certain civil procedures affecting lawsuit outcomes, and methods for attorney compensation, which some states have either not previously addressed or found unconstitutional. A survey of different states' problems and common issues should assist the reader in understanding the nature of the crisis and proposed solutions.

Health Care Austerity Measures in Times of Crisis: The Perspectives of Primary Health Care Physicians in Madrid, Spain.

PubMed

Heras-Mosteiro, Julio; Sanz-Barbero, Belén; Otero-Garcia, Laura

2016-01-01

The current financial crisis has seen severe austerity measures imposed on the Spanish health care system, including reduced public spending, copayments, salary reductions, and reduced services for undocumented migrants. However, the impacts have not been well-documented. We present findings from a qualitative study that explores the perceptions of primary health care physicians in Madrid, Spain. This article discusses the effects of austerity measures implemented in the public health care system and their potential impacts on access and utilization of primary health care services. This is the first study, to our knowledge, exploring the health care experiences during the financial crisis of general practitioners in Madrid, Spain. The majority of participating physicians disapproved of austerity measures implemented in Spain. The findings of this study suggest that undocumented migrants should regain access to health care services; copayments should be minimized and removed for patients with low incomes; and health care professionals should receive additional help to avoid burnout. Failure to implement these measures could result in the quality of health care further deteriorating and could potentially have long-term negative consequences on population health. © The Author(s) 2016.

Leading in crisis: lessons for safety leaders.

PubMed

George, William W; Denham, Charles R; Burgess, L Hayley; Angood, Peter B; Keohane, Carol

2010-03-01

The National Quality Forum (NQF) Safe Practices are a group of 34 evidence-based Safe Practices that should be universally used to reduce the risk of harm to patients. Four of these practices specifically address leadership. A recently published book, 7 Lessons for Leading in Crisis, offers practical advice on how to lead in crisis. An analysis of how concepts from the 7 lessons could be applied to the Safe Practices was presented nationally by webinar to assess the audience's reaction to the information. The objective of this article was to present the information and the audience's reaction to it. Recommendations for direct actions that health care leaders can take to accelerate adoption of NQF Safe Practices were presented to health care leaders, followed by an immediate direct survey that used Reichheld's "Net Promoter Score" to assess whether the concepts presented were considered applicable and valuable to the audience. In a separate presentation, the challenges and crises facing nursing leaders were addressed by nursing leaders. Six hundred seventy-four hospitals, with an average of 4.5 participants per hospital, participated in the webinar. A total of 272 safety leaders responded to a survey immediately after the webinar. A Net Promoter Score assessment revealed that 58% of those surveyed rated the value of the information at 10, and 91% scored the value of the webinar to be between 8 and 10, where 10 is considered a strong recommendation that those voting would recommend this program to others. The overwhelmingly high score indicated that the principles presented were important and valuable to this national audience of health care leadership. The 2010 environment of uncertainty and shrinking financial resources poses significant risk to patients and new challenges for leaders at all levels. A values-grounded focus on personal accountability for leading in crisis situations strongly resonates with those interested in or leading patient safety initiatives.

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

PubMed

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.

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

PubMed Central

Rajmil, Luis; Fernandez de Sanmamed, María-José; Choonara, Imti; Faresjö, Tomas; Hjern, Anders; Kozyrskyj, Anita L.; Lucas, Patricia J.; Raat, Hein; Séguin, Louise; Spencer, Nick; Taylor-Robinson, David

2014-01-01

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. PMID:25019121

An Analysis of Secondary Schools' Crisis Management Preparedness: National Implications

ERIC Educational Resources Information Center

Adams, Cheantel M.; Kritsonis, William Allan

2006-01-01

The purpose of this study is to analyze crisis management plans of schools that have experienced crisis situations in the past. The plans used by these schools to manage these crisis situations will be evaluated for their effectiveness or ineffectiveness in re-establishing stability to their organization. With such information, other schools may…

The H1N1 crisis: a case study of the integration of mental and behavioral health in public health crises.

PubMed

Pfefferbaum, Betty; Schonfeld, David; Flynn, Brian W; Norwood, Ann E; Dodgen, Daniel; Kaul, Rachel E; Donato, Darrin; Stone, Brook; Brown, Lisa M; Reissman, Dori B; Jacobs, Gerard A; Hobfoll, Stevan E; Jones, Russell T; Herrmann, Jack; Ursano, Robert J; Ruzek, Josef I

2012-03-01

In substantial numbers of affected populations, disasters adversely affect well-being and influence the development of emotional problems and dysfunctional behaviors. Nowhere is the integration of mental and behavioral health into broader public health and medical preparedness and response activities more crucial than in disasters such as the 2009-2010 H1N1 influenza pandemic. The National Biodefense Science Board, recognizing that the mental and behavioral health responses to H1N1 were vital to preserving safety and health for the country, requested that the Disaster Mental Health Subcommittee recommend actions for public health officials to prevent and mitigate adverse behavioral health outcomes during the H1N1 pandemic. The subcommittee's recommendations emphasized vulnerable populations and concentrated on interventions, education and training, and communication and messaging. The subcommittee's H1N1 activities and recommendations provide an approach and template for identifying and addressing future efforts related to newly emerging public health and medical emergencies. The many emotional and behavioral health implications of the crisis and the importance of psychological factors in determining the behavior of members of the public argue for a programmatic integration of behavioral health and science expertise in a comprehensive public health response.

Rely and Toxic Shock Syndrome: A Technological Health Crisis

PubMed Central

Vostral, Sharra L.

2011-01-01

This essay examines factors leading to the identification of Toxic Shock Syndrome with the bacteria Staphylococcus aureus in 1978 and the specific role of Rely tampons in generating a technologically rooted health crisis. The concept biologically incompatible technology is offered to explain the relationship between constituent bacteria, women’s menstrual cycles, and a reactive technology that converged to create the ideal environment for the S. aureus bacteria to live and flourish in some women. The complicated and reactive relationship of the Rely tampon to emergent disease, corporate interests, public health, and injury law reveals the dangers of naturalizing technologies. PMID:22180682

Public health surveillance and meaningful use regulations: a crisis of opportunity.

PubMed

Lenert, Leslie; Sundwall, David N

2012-03-01

The Health Information Technology for Economic and Clinical Health Act is intended to enhance reimbursement of health care providers for meaningful use of electronic health records systems. This presents both opportunities and challenges for public health departments. To earn incentive payments, clinical providers must exchange specified types of data with the public health system, such as immunization and syndromic surveillance data and notifiable disease reporting. However, a crisis looms because public health's information technology systems largely lack the capabilities to accept the types of data proposed for exchange. Cloud computing may be a solution for public health information systems. Through shared computing resources, public health departments could reap the benefits of electronic reporting within federal funding constraints.

In the Wake of Hurricane Katrina: Delivering Crisis Mental Health Services to Host Communities

ERIC Educational Resources Information Center

Marbley, Aretha Faye

2007-01-01

Throughout the country and especially in Texas, local communities opened their arms to hurricane Katrina evacuees. Like the federal government, emergency health and mental health entities were unprepared for the massive numbers of people needing assistance. Mental health professionals, though armed with a wealth of crisis intervention information,…

Solving the emergency care crisis in America: the power of the law and storytelling.

PubMed

Maa, John

2012-01-01

An Emergency Department visit that ended tragically prompted my yearlong journey to Washington, DC, and emergency rooms across the country to search for solutions to the national crisis in emergency care. I reached the conclusion that the crisis is entirely solvable, and I developed a three-part solution that includes 1) nationally standardizing and coordinating care, 2) prioritizing resources and incentives in the delivery of emergency care, and 3) inspiring young clinicians to careers in emergency care. Physicians across America should now harness the power of storytelling to strengthen both the delivery of patient care and health care reform efforts on Capitol Hill.

National Surveys of Population Health: Big Data Analytics for Mobile Health Monitors.

PubMed

Schatz, Bruce R

2015-12-01

At the core of the healthcare crisis is fundamental lack of actionable data. Such data could stratify individuals within populations to predict which persons have which outcomes. If baselines existed for all variations of all conditions, then managing health could be improved by matching the measuring of individuals to their cohort in the population. The scale required for complete baselines involves effective National Surveys of Population Health (NSPH). Traditionally, these have been focused upon acute medicine, measuring people to contain the spread of epidemics. In recent decades, the focus has moved to chronic conditions as well, which require smaller measures over longer times. NSPH have long utilized quality of life questionnaires. Mobile Health Monitors, where computing technologies eliminate manual administration, provide richer data sets for health measurement. Older technologies of telephone interviews will be replaced by newer technologies of smartphone sensors to provide deeper individual measures at more frequent timings across larger-sized populations. Such continuous data can provide personal health records, supporting treatment guidelines specialized for population cohorts. Evidence-based medicine will become feasible by leveraging hundreds of millions of persons carrying mobile devices interacting with Internet-scale services for Big Data Analytics.

Crisis GIS: Preparing for the Next Volcanic Crisis in the United States

NASA Astrophysics Data System (ADS)

Ramsey, D. W.; Robinson, J. E.; Schilling, S. P.; Schaefer, J. R.; Kimberly, P.; Trusdell, F. A.; Guffanti, M. C.; Mayberry, G. C.; Cameron, C. E.; Smith, J. G.; McIntire, J. A.; Snedigar, S.; Ewert, J. W.

2004-12-01

Geographic Information Systems (GIS) specialists from the Volcano Hazards Program (VHP) of the U.S. Geological Survey (USGS), including personnel at Menlo Park, California, the Cascades Volcano Observatory in Vancouver, Washington, the Alaska Volcano Observatory in Anchorage and Fairbanks, Alaska, the Hawaiian Volcano Observatory in Hawaii National Park, Hawaii, and the Smithsonian Institution Global Volcanism Program in Washington, DC, are developing a GIS response plan in the event of a volcano crisis. This plan, referred to as "Crisis GIS", outlines how VHP can ensure rapid, reliable delivery of spatial and ancillary information for data analysis and visualization at any required location during a volcanic crisis or event within the United States. An effective Crisis GIS needs the capacity to store multiple, large datasets, including: base layer data, elevation data, geologic maps, hazard assessment maps, satellite data, and aerial photography for volcanoes around the U.S. It must be readily accessible by VHP GIS specialists stationed around the Nation. Such a GIS should also support installations of monitoring instruments and telemetry equipment that relay monitoring signals, and provision of updates to public officials, the media, and the public during a crisis. GIS technology has proven to be an invaluable tool for crisis response. Recently, GIS was applied as part of the response efforts to two large-scale crises: the terrorist attacks of September 11, 2001, and the Southern California wildfires of Fall 2003. In each case, GIS was used to organize large quantities of spatial data and to produce electronic and paper maps that illustrated hazards, supported decision making, and communicated developing situations to responsible emergency-management authorities and to the populace affected (Kant, 2002, and Pratt, 2003). VHP GIS specialists are currently testing the software and hardware employed in recent major crisis response efforts and are learning to adapt

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

PubMed

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.

Management of Mental Health Crises Among Youths With and Without ASD: A National Survey of Child Psychiatrists.

PubMed

Kalb, Luther G; Stuart, Elizabeth A; Mandell, David S; Olfson, Mark; Vasa, Roma A

2017-10-01

This study compared management by child psychiatrists of mental health crises among youths with and without autism spectrum disorder (ASD). A custom online mental health crisis services survey was administered to members of the American Academy of Child and Adolescent Psychiatry. The survey probed three domains of crisis management: willingness to work with youths with a history of mental health crisis, comfort level in managing a mental health crisis, and availability of external resources during a crisis. Child psychiatrists reporting on management of youths with ASD (N=492) and without ASD (N=374) completed the survey. About 75% of psychiatrists in both groups were willing to accept a child with a history of a mental health crisis in their practice. During a crisis, psychiatrists caring for youths with ASD had less access to external consultation resources, such as a crisis evaluation center or other mental health professionals, compared with those caring for youths without ASD. Psychiatrists also expressed concerns about the ability of emergency department professionals and emergency responders to manage mental health crises among youths in a safe and developmentally appropriate manner, particularly among those with ASD. Child psychiatrists are in need of more external resources to manage youths with ASD who are experiencing a mental health crisis. There is also a need to develop best practice procedures for emergency responders who are working with youths experiencing a mental health crisis.

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

PubMed

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.

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

PubMed

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.

Mortality rates or sociomedical indicators? The work of the League of Nations on standardizing the effects of the Great Depression on health.

PubMed

Garcia, Monica

2014-01-01

This article explores the first international effort by the League of Nations Health Organization (LNHO) to standardize the study of the effects of the economic crisis of the 1930s on health. Instead of analysing this effort with the benefit of hindsight, this article takes into account the actors' perspectives and, therefore, it relies on the documents produced by the LNHO and public health experts of the 1930s, as well as on the historical scholarship on this subject. This article shows that, despite the declining death rates in Europe and in the US during the crisis, the LNHO considered that death rates concealed a more subtle effect of the crisis on health; hence, they launched a project aimed at making the effect visible. It describes the LNHO programme and the guidelines and methods set out by the organization in 1932 to observe this subtle effect through sociomedical investigations. The results of these surveys are summarized and the article discusses how the eugenic arguments used to explain them were not accepted by the LNHO. The article also shows how some members of the LNHO considered the results of the sociomedical surveys inconclusive and questioned the usefulness of socioeconomic indicators; in so doing, they raised concerns about the intervention of the LNHO in national matters and about the risks of crossing the established limits between science and politics. This article shows that an historical analysis, which takes into account the points of view of the actors involved, illuminates the factors that led the LNHO to conclude that mortality rates were the best method for measuring the effects of the economic crisis on health and that, as they were declining, the Great Depression was not having any deleterious effect on public health.

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

PubMed

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.

The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain.

PubMed

Giovanella, Lígia; Stegmüller, Klaus

2014-11-01

The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date), and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms' impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems.

Economic crisis and nursing in Spain.

PubMed

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.

Integrating oral health into Haiti's National Health Plan: from disaster relief to sustainable development.

PubMed

Estupiñán-Day, Saskia; Lafontant, Christina; Acuña, Maria Cecilia

2011-11-01

In 2010, Haiti suffered three devastating national emergencies: a 7.0 magnitude earthquake that killed over 200 000 and injured 300 000; a cholera outbreak that challenged recovery efforts and caused more deaths; and Hurricane Tomas, which brought additional destruction. In the aftermath, the Pan American Health Organization (PAHO) reoriented its technical cooperation to face the myriad of new challenges and needs. Efforts included support and technical assistance to the Ministry of Health and Population of Haiti and coordination of actions by the United Nations Health Cluster. This Special Report focuses specifically on the PAHO Regional Oral Health Program's call to action in Haiti and the institutional partnerships that were developed to leverage resources for oral health during this critical time and beyond. To date, achievements include working with Haiti's private sector, dental schools, public health associations, and other stakeholders, via the Oral Health of Haiti (OHOH) Coalition. The OHOH aims to meet the immediate needs of the dental community and to rebuild the oral health component of the health system; to provide dental materials and supplies to oral health sites in affected areas; and to ensure that the "Basic Package of Health Services" includes specific interventions for oral health care and services. The experience in Haiti serves as a reminder to the international community of how important linking immediate/short-term disaster-response to mid- and longterm strategies is to building a health system that provides timely access to health services, including oral health. Haiti's humanitarian crisis became an important time to rethink the country's health system and services in terms of the right to health and the concepts of citizenship, solidarity, and sustainable development.

The Relationship between Caregiver Capacity and Intensive Community Treatment for Children with a Mental Health Crisis

ERIC Educational Resources Information Center

Epstein, Richard A.; Jordan, Neil; Rhee, Yong Joo; McClelland, Gary M.; Lyons, John S.

2009-01-01

We studied 9,220 children referred to a comprehensive mental health crisis stabilization program to examine the impact of caregiver capacity on crisis worker decisions to refer children for intensive community-based treatment as opposed to inpatient psychiatric hospitalization. Due to the different role of caregivers in the child welfare system,…

The Shifting Space of Ontology: Appeals to Crisis and the Reformulation of Nation, Race, and Biology in Educational Reform

ERIC Educational Resources Information Center

Kung, Sunhye

2018-01-01

This article considers a conflated ontological space where national projections named Koreanness are conjoined through national educational reform discourses associated with "excellence" and "equality." It focuses on the shifting educational reform narratives that made appeals to notions of crisis before and after the IMF…

[THE CRISIS PHENOMENA AND HEALTH].

PubMed

Tishuk, E A

2015-01-01

The analysis was carried out concerning impact of cyclicity of social economic development on population health of the Russian Federation. The conclusions are made related to necessity of determining priorities of development of national system of population health care.

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

PubMed

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.

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.

PubMed

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.

The formation and application of an overseas mental health crisis intervention team, Part II: Application.

PubMed

Young, S A; Holden, M S

1991-09-01

In the preceding article, the authors described the formation of an overseas mental health crisis intervention team. In this paper, the application of the United States Southern Command Crisis Intervention Team in the aftermath of a recent tragedy in Panama is described. A chronology of the disaster, involving two helicopter crashes which left 11 dead, is presented. The intervention that followed is described in detail. The emphasis is on four main areas: education, identification, process, and follow-up. The authors present their experience in an effort to provide an intervention strategy for other isolated mental health providers.

Public Health Surveillance and Meaningful Use Regulations: A Crisis of Opportunity

PubMed Central

Sundwall, David N.

2012-01-01

The Health Information Technology for Economic and Clinical Health Act is intended to enhance reimbursement of health care providers for meaningful use of electronic health records systems. This presents both opportunities and challenges for public health departments. To earn incentive payments, clinical providers must exchange specified types of data with the public health system, such as immunization and syndromic surveillance data and notifiable disease reporting. However, a crisis looms because public health’s information technology systems largely lack the capabilities to accept the types of data proposed for exchange. Cloud computing may be a solution for public health information systems. Through shared computing resources, public health departments could reap the benefits of electronic reporting within federal funding constraints. PMID:22390523

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

PubMed

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.

Libyan National Health Services The Need to Move to Management-by-Objectives

PubMed Central

El Taguri, A; Elkhammas, EA; Bakoush, O; Ashammakhi, N; Baccoush, M; Betilmal, I

2008-01-01

In the last four decades, there has been a substantial horizontal expansion of health services in Libya. This resulted in improvement in morbidity and mortality, in particularly those related to infectious disease. However, measures such as the national performance gap indicator reveal an underperforming health system. In this article, we discuss aspects related to the Libyan health system and its current status including areas of weakness. Overcoming current failures and further improvement are unlikely to occur spontaneously without proper planning. Defining community health problems, identifying unmet needs, surveying resources to meet them, establishing SMART (specific, measurable, achievable, and realistic and time specific) objectives, and projecting administrative action to accomplish the proposed programs, are a must. The health system should rely on newer approaches such as management-by-objectives and risk-management rather than the prevailing crisis-management attitude. PMID:21499467

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

PubMed

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.

I'm not a doctor but I play one on TV: E.R. and the place of contemporary health care in fixing crisis.

PubMed

Lepofsky, Jonathan; Nash, Sally; Kaserman, Bonnie; Gesler, Wil

2006-06-01

This paper is an examination of the popular TV drama E.R. What is notable for health geographers about E.R. is how the show offers a representation of health care and the role of place in creating ways to provide care. Indeed, the place of health care-the emergency room-is the point of reference for the show's weekly dramas and centers the activity on the screen. We posit that the show's success stems from how crisis has become a central component of discourses about health care and that E.R. offers one highly seductive interpretation of how to deal with crisis in health care and care delivery. E.R. provides a representation of crisis by constructing three scales of intervention as the best sites to respond to and fix crisis: bodies, medical networks, and the urban social relations of the city. Order is designed around these scales which serve to map out where medical interventions can be made within the discursive regime of crisis. What E.R. provides is a powerful, if limited, "realistic" portrayal about the role of health care today-a role that is increasingly considered to be shaped by the need to intervene in crisis.

Solving the Emergency Care Crisis in America: The Power of the Law and Storytelling

PubMed Central

Maa, John

2012-01-01

An Emergency Department visit that ended tragically prompted my yearlong journey to Washington, DC, and emergency rooms across the country to search for solutions to the national crisis in emergency care. I reached the conclusion that the crisis is entirely solvable, and I developed a three-part solution that includes 1) nationally standardizing and coordinating care, 2) prioritizing resources and incentives in the delivery of emergency care, and 3) inspiring young clinicians to careers in emergency care. Physicians across America should now harness the power of storytelling to strengthen both the delivery of patient care and health care reform efforts on Capitol Hill. PMID:23012606

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

PubMed

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.

Impact of the economic crisis on health-related behaviors in Italy.

PubMed

Mattei, Giorgio; De Vogli, Roberto; Ferrari, Silvia; Pingani, Luca; Rigatelli, Marco; Galeazzi, Gian Maria

2017-11-01

Evidence exists supporting the impact of the Great Recession on health-related behaviors internationally, though few studies are available concerning the Italian population. To assess the impact of the late 2000s economic crisis on health-related behaviors linked to population mental health in Italy. Descriptive study. Health indicators came from the Italian Institute of Statistics database (years 2000-2015). Statistics performed by means of linear regression models. Increased smokers (β = 1.68, p = .03), heavy smokers, that is, people smoking 11-20 cigarettes per day (β = 2.18, p = .04) or more than 20 cigarettes per day (β = 1.04, p < .01) and mean number of smoked cigarettes per day (β = 0.56, p = .02) were noticeable. Also, prevalence of overweight increased (β = 0.91, p = .04), while the Italian families' expenditure for alcoholic beverages decreased (β = -812.80, p = .01). Alcohol consumption decreased (β = -0.60, p < .01), especially in men (β = -0.95, p < .01); binge drinking increased in years 2009-2010. No change was noticeable in the diet indicators collected. The economic crisis may have increased smoking, overweight and binge drinking in Italy (though data on the latter phenomenon are not conclusive), and reduced overall alcohol consumption.

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

PubMed

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.

Economic crisis and inequalities in health systems in the countries of Southern Europe.

PubMed

Serapioni, Mauro

2017-09-28

The current article addresses the issue of health system inequalities in the countries of Southern Europe, specifically Spain, Greece, Italy, and Portugal. The study resulted from a non-systematic literature review, based on the scoping review proposal. We begin by presenting a brief contextualization of the social welfare state systems in these European countries, highlighting the principal specificities and differences in relation to other European welfare state systems. Next, we describe the health systems in the four countries, emphasizing the respective reform processes and the main health inequalities that have characterized them before and during the economic crisis. The crisis and austerity policies have greatly increased the level of dissatisfaction with healthcare provision in these countries, particularly in Greece and Portugal. In this sense, we conduct a comparative discussion of the health inequalities, identifying both common trends and differences. In the four countries, the social gradient (particularly in education, income, and labor) represents the principal determinant of health inequalities, while not ruling out geographic inequalities in access to health services as the result of different levels of economic development in the various regions. Finally, we discuss the recent debate in the international literature on the relationship between different welfare state systems and health inequalities, and precisely the critique of the use of welfare state typologies as a determinant of health and health inequalities.

The Kurt Cobain suicide crisis: perspectives from research, public health, and the news media.

PubMed

Jobes, D A; Berman, A L; O'Carroll, P W; Eastgard, S; Knickmeyer, S

1996-01-01

The suicide of rock star Kurt Cobain in 1994 raised immediate concerns among suicidologists and the public at large about the potential for his death to spark copycat suicides, especially among vulnerable youth. The Seattle community, where Cobain lived and died, was especially affected by his sudden death. An overview of Cobain's life and death is presented and various crisis center and community-based interventions that occurred are discussed. Preliminary data collected from the Seattle Medical Examiner's Office and from the Seattle Crisis Center to assess the potential impact of Cobain's death on completed suicides and the incidence of suicide crisis calls are presented. The data obtained from the Seattle King County area suggest that the expected "Werther effect" apparently did not occur, but there was a significant increase in suicide crisis calls following his death. It is hypothesized that the lack of an apparent copycat effect in Seattle may be due to various aspects of the media coverage, the method used in Cobain's suicide, and the crisis center and community outreach interventions that occurred. The Cobain suicide and the role of media influence on copycat suicides are further discussed in commentaries from public health and news media perspectives.

[Crisis in human resources for health: millennium development goals for maternal and child health threatened].

PubMed

Beltman, Jogchum J; Stekelenburg, Jelle; van Roosmalen, Jos

2010-01-01

International migration of health care workers from low-income countries to the West has increased considerably in recent years, thereby jeopardizing the achievements of The Millennium Development Goals, especially number 4 (reduction of child mortality) and 5 (improvement of maternal health).This migration, as well as the HIV/AIDS epidemic, lack of training of health care personnel and poverty, are mainly responsible for this health care personnel deficit. It is essential that awareness be raised amongst donors and local governments so that staffing increases, and that infection prevention measures be in place for their health care personnel. Western countries should conduct a more ethical recruitment of health care workers, otherwise a new millennium development goal will have to be created: to reduce the human resources for health crisis.

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

PubMed

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.

Responding to a crisis: a stakeholder analysis of community health organizations.

PubMed

Savage, Grant T; Dunkin, Jeri W; Ford, David M

2004-01-01

On May 11, 2001, the Bureau of Primary Health Care notified West Alabama Health Services, doing business as Family HealthCare of Alabama, that it was terminating $6 million in grants due to non-compliance and amid allegations of financial mismanagement and fraud. West Alabama Health Services, a not-for-profit organization, operated 19 community health centers that provided preventive and primary care services for 17 counties in Alabama. This disruption of health services engendered considerable stakeholder debate. Within this context, the authors examine how a small, newly established rural health center and a well-established, federally qualified community health center responded to this crisis. The authors use a stakeholder analysis framework to highlight how key relationships with stakeholders may change with the perceived credibility of the organizational leaders and the legitimacy of their actions.

Help, Resources and Information: National Opioids Crisis

MedlinePlus

... HHS 5-POINT STRATEGY TO COMBAT THE OPIOIDS CRISIS BETTER ADDICTION PREVENTION, TREATMENT, AND RECOVERY SERVICES BETTER DATA BETTER PAIN MANAGEMENT BETTER TARGETING OF OVERDOSE REVERSING DRUGS BETTER RESEARCH ...

Impact of the financial crisis on health research financing: towards a new model?

PubMed

Combe, Caroline Gans

2009-08-01

The financial crisis led to a deep crisis in the economic-organizations model as it has been widely known and shared for centuries. Organizations appear to be ill-fitted for the coming challenges and common citizens' aspirations. The health sector is emblematic of this novel contest and, if able to offer answers, might become an organizational reference. However, the game is far from being won; the sector is, like others, at a crossroads as certain interests used to leverage the power of governmental regulation to protect their own economic strength might not yet be ready to evolve.

An evaluation of crisis hotline outcomes. Part 1: Nonsuicidal crisis callers.

PubMed

Kalafat, John; Gould, Madelyn S; Munfakh, Jimmie Lou Harris; Kleinman, Marjorie

2007-06-01

The effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' crisis state from the beginning to the end of their calls to eight centers in the U.S. and intermediate outcomes within 3 weeks of their calls, was evaluated. Between March 2003 and July 2004, 1,617 crisis callers were assessed during their calls and 801 (49.5%) participated in the followup assessment. Significant decreases in callers' crisis states and hopelessness were found during the course of the telephone session, with continuing decreases in crisis states and hopelessness in the following weeks. A majority of callers were provided with referrals and/or plans of actions for their concerns and approximately one third of those provided with mental health referrals had followed up with the referral by the time of the follow-up assessment. While crisis service staff coded these callers as nonsuicidal, at follow-up nearly 12% of them reported having suicidal thoughts either during or since their call to the center. The need to conduct suicide risk assessments with crisis callers and to identify strategies to improve referral follow-up is highlighted.

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

PubMed

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.

A Framework and Methodology for Navigating Disaster and Global Health in Crisis Literature

PubMed Central

Chan, Jennifer L.; Burkle, Frederick M.

2013-01-01

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. Methods: 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

Adverse effect of the financial crisis in Greece on perinatal factors.

PubMed

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.

Influences on call outcomes among Veteran callers to the National Veterans Crisis Line

PubMed Central

Britton, Peter C.; Bossarte, Robert M.; Thompson, Caitlin; Kemp, Janet; Conner, Kenneth R.

2016-01-01

This evaluation examined the association of caller and call characteristics with proximal outcomes of Veterans Crisis Line calls. From October 1-7, 2010, 665 Veterans with recent suicidal ideation or a history of attempted suicide called the Veterans Crisis Line, 646 had complete data and were included in the analyses. A multivariable multinomial logistic regression was conducted to identify correlates of a favorable outcome, either a resolution or a referral, when compared to an unfavorable outcome, no resolution or referral. A multivariable logistic regression was used to identify correlates of responder-rated caller risk in a subset of calls. Approximately 84% of calls ended with a favorable outcome, 25% with a resolution and 59% with a referral to a local health care provider. Calls from high-risk callers had greater odds of ending with a referral than without a resolution or referral, as did weekday calls (6:00 am to 5:59 pm EST, Monday through Friday). Responders used caller intent to die and the absence of future plans to determine caller risk. Findings suggest that the Veterans Crisis Line is a useful mechanism for generating referrals for high-risk Veteran callers. Responders appeared to use known risk and protective factors to determine caller risk. PMID:23611446

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

NASA Astrophysics Data System (ADS)

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

Health and rescue services management system during a crisis event

PubMed Central

Nicolaidou, Iolie; Hadjichristofi, George; Kyprianou, Stelios; Christou, Synesios; Constantinou, Riana

2016-01-01

Τhe performance of rescuers and personnel handling major emergencies or crisis events can be significantly improved through continuous training and through technology support. The work done in order to create a system has been discussed which can support both resources and victims during a crisis or major emergency event. More specifically, the system supports real-time management of firefighter teams, rescue teams, health services, and victims during a major disaster. It can be deployed in an ad hoc manner in the disaster area, as a stand-alone infrastructure (using its own telecommunications and power). It mainly consists of a control station, which is installed in the area command centre, the firefighters units, the rescuers units, the ambulance vehicles units, and the telemedicine units that can be used in order to support victim handling at the casualties clearing station. The system has been tested and improved through continuous communication with experts and through professional exercises; the results and conclusions are presented. PMID:27733928

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

PubMed

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.

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

PubMed

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.

National health spending trends in 1996. National Health Accounts Team.

PubMed

Levit, K R; Lazenby, H C; Braden, B R

1998-01-01

The National Health Accounts, produced annually by the Health Care Financing Administration's Office of the Actuary, present estimates for 1960-1996 of nationwide spending for health care and the sources funding that care. This year's estimates set two records: Spending topped $1 trillion for the first time, and expenditure growth slowed to the lowest rate seen in thirty-seven years of measuring health care spending--4.4 percent. The combination of decelerating health spending and a growing economy has kept national health spending as a share of the nation's gross domestic product unchanged for the fourth consecutive year.

Afghanistan's population: planning to avoid a crisis.

PubMed

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.

Comprehensive health workforce planning: re-consideration of the primary health care approach as a tool for addressing the human resource for health crisis in low and middle income countries.

PubMed

Munga, Michael A; Mwangu, Mughwira A

2013-04-01

Although the Human Resources for Health (HRH) crisis is apparently not new in the public health agenda of many countries, not many low and middle income countries are using Primary Health Care (PHC) as a tool for planning and addressing the crisis in a comprehensive manner. The aim of this paper is to appraise the inadequacies of the existing planning approaches in addressing the growing HRH crisis in resource limited settings. A descriptive literature review of selected case studies in middle and low income countries reinforced with the evidence from Tanzania was used. Consultations with experts in the field were also made. In this review, we propose a conceptual framework that describes planning may only be effective if it is structured to embrace the fundamental principles of PHC. We place the core principles of PHC at the centre of HRH planning as we acknowledge its major perspective that the effectiveness of any public health policy depends on the degree to which it envisages to address public health problems multi-dimensionally and comprehensively. The proponents of PHC approach in planning have identified inter-sectoral action and collaboration and comprehensive approach as the two basic principles that policies and plans should accentuate in order to make them effective in realizing their pre-determined goals. Two conclusions are made: Firstly, comprehensive health workforce planning is not widely known and thus not frequently used in HRH planning or analysis of health workforce issues; Secondly, comprehensiveness in HRH planning is important but not sufficient in ensuring that all the ingredients of HRH crisis are eliminated. In order to be effective and sustainable, the approach need to evoke three basic values namely effectiveness, efficiency and equity.

Expanding the Crisis Planning Function: Introducing Elements of Risk Communication to Crisis Communication Practice.

ERIC Educational Resources Information Center

Williams, David E.; Olaniran, Bolanle A.

1998-01-01

Suggests use of elements of risk communication by crisis communication practitioners facing increasing industrial reliance on new technologies which might be associated with potential health/environment harm. Studies a small company crisis which reveals that elements of anticipation, public involvement/trust, technological comparison, and media…

The Impact of Integrating Crisis Teams into Community Mental Health Services on Emergency Department and Inpatient Demand.

PubMed

Jespersen, Sean; Lawman, Bronwyn; Reed, Fiona; Hawke, Kari; Plummer, Virginia; Gaskin, Cadeyrn J

2016-12-01

This investigation focused on the impact of integrating crisis team members into community mental health services on emergency department and adult mental health inpatient unit demand within an Australian public health service. Mixed methods were used including (a) the comparison of service use data with that of two other comparable services (both of which had community-based crisis teams), (b) surveys of (i) patients and carers and (ii) staff, and (c) focus groups with staff. The numbers of emergency department presentations with mental health conditions and adult mental health inpatient separations increased 13.9 and 5.7 %, respectively, from FY2006/07 to FY2012/13. Between the three services, there were minimal differences in the percentages of presentations with mental health conditions, the distribution of mental health presentations across a 24-h period, and the triage categories assigned to these patients. Survey participants reported that patients used the emergency department due to the urgency of situations, perceptions that gaining access to mental health services would take less time, and the unavailability of mental health services when help is needed. Staff identified several issues (e.g. inappropriate referrals) that may be unnecessary in increasing emergency department demand. The integration of crisis team members into community mental health services does not seem to have produced an increase in emergency department admissions or inpatient separations beyond what might be expected from population growth. The potential may exist, however, to reduce emergency department admissions through addressing the issue of inappropriate referrals.

Advancing environmental health surveillance in the US through a national human biomonitoring network.

PubMed

Latshaw, Megan Weil; Degeberg, Ruhiyyih; Patel, Surili Sutaria; Rhodes, Blaine; King, Ewa; Chaudhuri, Sanwat; Nassif, Julianne

2017-03-01

The United States lacks a comprehensive, nationally-coordinated, state-based environmental health surveillance system. This lack of infrastructure leads to: • varying levels of understanding of chemical exposures at the state & local levels • often inefficient public health responses to chemical exposure emergencies (such as those that occurred in the Flint drinking water crisis, the Gold King mine spill, the Elk river spill and the Gulf Coast oil spill) • reduced ability to measure the impact of public health interventions or environmental policies • less efficient use of resources for cleaning up environmental contamination Establishing the National Biomonitoring Network serves as a step toward building a national, state-based environmental health surveillance system. The Network builds upon CDC investments in emergency preparedness and environmental public health tracking, which have created advanced chemical analysis and information sharing capabilities in the state public health systems. The short-term goal of the network is to harmonize approaches to human biomonitoring in the US, thus increasing the comparability of human biomonitoring data across states and communities. The long-term goal is to compile baseline data on exposures at the state level, similar to data found in CDC's National Report on Human Exposure to Environmental Chemicals. Barriers to success for this network include: available resources, effective risk communication strategies, data comparability & sharing, and political will. Anticipated benefits include high quality data on which to base public health and environmental decisions, data with which to assess the success of public health interventions, improved risk assessments for chemicals, and new ways to prioritize environmental health research. Copyright © 2016 Elsevier GmbH. All rights reserved.

Pollution's Price--The Cost in Human Health

ERIC Educational Resources Information Center

Newill, Vaun A.

1973-01-01

Discusses the detrimental effects of air pollution, and especially sulfur dioxide, on human health. Any relaxation of existing national air pollution standards because of the energy crisis could be costly in terms of the nation's health. (JR)

National Health Information Center

MedlinePlus

... About ODPHP National Health Information Center National Health Information Center The National Health Information Center (NHIC) is ... of interest View the NHO calendar . Federal Health Information Centers and Clearinghouses Federal Health Information Centers and ...

[Assessing aggression in patients of the mental health crisis service].

PubMed

Penterman, E J M; Nijman, H L I

2009-01-01

Care workers of the outreach psychiatric crisis team are frequently confronted with aggressive patients. To prevent dangerous situations from developing it could be advantageous to have in place a method of risk assessment that is based on information about patients before they are actually contacted by the crisis team. To test the predictive validity of an instrument specifically designed to assess the risks of aggression from severely disturbed psychiatric patients before they are seen by the crisis team. Over a period of two years and prior to any outreach contact with patients in crisis situations a Checklist of Risks to the Crisis team (CRC) was completed. Then, following outreach contact with the patient any perceived aggression was recorded by means of the Staff Observation Aggression Scale-Revised (SOAS-R). Aggressive behaviour by patients was observed during 51 of 499 crisis contacts with members of the outreach crisis team. On the basis of three factors in the CRC, namely the clinical assessment on a visual-analogue scale, an estimate of the number of aggressive persons in the vicinity of the crisis patient concerned and the reporting of crises by the patient himself, it was possible to predict outwardly directed aggression with a sensitivity of 74% and a specificity of 84%. Although the findings still need to be reproduced, an instrument such as the crc could be very useful to members of the crisis service.

Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis

PubMed Central

DiNicolantonio, James J; Wilson, William

2018-01-01

Because serum magnesium does not reflect intracellular magnesium, the latter making up more than 99% of total body magnesium, most cases of magnesium deficiency are undiagnosed. Furthermore, because of chronic diseases, medications, decreases in food crop magnesium contents, and the availability of refined and processed foods, the vast majority of people in modern societies are at risk for magnesium deficiency. Certain individuals will need to supplement with magnesium in order to prevent suboptimal magnesium deficiency, especially if trying to obtain an optimal magnesium status to prevent chronic disease. Subclinical magnesium deficiency increases the risk of numerous types of cardiovascular disease, costs nations around the world an incalculable amount of healthcare costs and suffering, and should be considered a public health crisis. That an easy, cost-effective strategy exists to prevent and treat subclinical magnesium deficiency should provide an urgent call to action. PMID:29387426

Mental Health Services to Rural Consumers. Lessons Learned from a Four Year Iowa Farm Crisis Project.

ERIC Educational Resources Information Center

Link, Emerson A.

The Southwest Iowa Mental Health Center recently completed a 4-year project to increase use of mental health services by normally reluctant rural populations and to increase coping ability among persons affected by the farm crisis. During the first 2 years, program goals included aggressive outreach to potential patients, mental health education…

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

PubMed

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.

PubMed

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.

A qualitative study on primary health care responses to intimate partner violence during the economic crisis in Spain.

PubMed

Otero-García, Laura; Briones-Vozmediano, Erica; Vives-Cases, Carmen; García-Quinto, Marta; Sanz-Barbero, Belén; Goicolea, Isabel

2018-06-15

The objective of this study was to explore how health professionals perceived the effect of the economic crisis and associated austerity measures on the detection of and cares for intimate partner violence (IPV) in primary care in Spain. Qualitative study designed using semi-structured interviews carried out with 145 health professionals in 16 primary health care centres in different regions of Spain. An inductive thematic analysis was made of the transcriptions. Three main themes were identified: 'Women endure more violence during times of economic crisis', 'Fewer resources, fewer professionals and less time to respond to IPV' and 'Professionals' motivation as a requirement to respond to IPV'. Professionals perceived that economic precariousness triggered violence against women and made women more hesitant to put an end to violent relationships. They also reported that the austerity measures applied to primary health care negatively affected their ability to detect and adequately care for cases of IPV due to a heavy workload, reduced human resources, difficulties in training and the loss of resources to which women could be referred. To counteract these obstacles, health professionals' motivation played a vital role in the response to IPV. Institutional efforts to organize awareness programmes and training in order to improve and promote early diagnosis, care and rehabilitation of these women cannot stop during times of crisis and primary health care centres should facilitate health professionals' access to these programmes.

Effects of the economic crisis and social support on health-related quality of life: first wave of a longitudinal study in Spain

PubMed Central

Fernandez, Ana; Garcia-Alonso, Judith; Royo-Pastor, Concepción; Garrell-Corbera, Immaculada; Rengel-Chica, Jordi; Agudo-Ugena, Josep; Ramos, Alberto; Mendive, Juan Manuel

2015-01-01

Background Economic recession affects quality of life by increasing rates of mental disorders in particular. Social support can be an important protective factor. Aim To estimate the impact of being personally affected by an economic crisis on health-related quality of life (HRQoL), taking into account the possible buffering effect of perceived social support. Design and setting Data from the first wave (March 2012 to November 2012) of the ‘Social Support and Quality of Life Study’, a longitudinal study carried out in a primary health care centre in a deprived neighbourhood of Barcelona, Spain. Method A total of 143 participants were assessed using the 12-item Short-Form Health Survey, the List of Threatening Experiences and the Duke Social Support scales. The effect of economic crisis on mental and physical HRQoL was assessed using ordinary least squares regression models to test the interaction between social support and having experienced an economic crisis. Results There was no statistical association between having suffered an economic crisis and physical HRQoL. The interaction between social support and economic crisis was also tested without finding any statistical association. An interaction was detected between social support and economic crisis in relation to mental HRQoL; those who had low levels of social support and had also experienced an economic crisis had the lowest levels of mental HRQoL. Conclusion Social support constitutes a safety net that offers protection against the adverse effect of economic recessions on mental health. Primary care professionals are in a key position to promote social activities and to strengthen social networks in the community. PMID:25733442

Effects of a Crisis Intervention Team (CIT) training program upon police officers before and after Crisis Intervention Team training.

PubMed

Ellis, Horace A

2014-02-01

In communities across the United States and internationally, police officers frequently come into contact with individuals experiencing mental health crisis despite not having the skills to safely intervene. This often results in officers resorting to excessive or even deadly force. The Crisis Intervention Team (CIT) is heralded as a revolutionary and transformative intervention to correct this gap in practice. Several previous interdisciplinary national and international studies, including criminology and sociology, have examined these concepts using quantitative and qualitative methodological designs, however, no prior nursing studies have been done on this topic. The purpose of this study was to determine the effect of CIT training on police officers' knowledge, perception, and attitude toward persons with mental illness. Twenty five police officers participated. An explorative, quasi experimental, descriptive design was used to collect the data on the three major concepts. Results on knowledge about mental illness improved at p<.0125 (p<.05 after Bonferroni correction). Perception scores improved at p<.0125 (p<.05 after Bonferroni correction), and attitudes were more favorable at p<.0125 (p<.05 after Bonferroni correction). The results of this study validated the CIT program as an innovative community health program that benefits law enforcement, consumers, mental health professionals, and stakeholders. © 2013 Elsevier Inc. All rights reserved.

Coping with Crisis across the Lifespan: The Role of a Telephone Hotline

ERIC Educational Resources Information Center

Ingram, Stephanie; Ringle, Jay L.; Hallstrom, Kristen; Schill, David E.; Gohr, Virginia M.; Thompson, Ronald W.

2008-01-01

We describe over 300,000 crisis calls made to a large national hotline over a 5-year period. Callers consisted of males and females between the ages of 10 and 89. Overall, a slight majority of callers were first time callers (52%) and most (73%) sought assistance with issues related to parenting, youth concerns, and mental health. Across the…

75 FR 54755 - National Childhood Obesity Awareness Month, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... Part III The President Proclamation 8554--National Childhood Obesity Awareness Month, 2010 #0; #0... of September 1, 2010 National Childhood Obesity Awareness Month, 2010 By the President of the United... the health and well-being of our children. We now face a national childhood obesity crisis, with...

Lessons for Physicians from Flint's Water Crisis.

PubMed

Carravallah, Laura A; Reynolds, Lawrence A; Woolford, Susan J

2017-10-01

Physicians form a vital front in recognizing unusual clinical presentations that could herald a health threat. In the Flint water crisis, physicians can be credited with playing critical roles in both uncovering the crisis and providing leadership when government failed to respond effectively. Yet most physicians in Flint were not formally trained in advocacy or leadership and might have recognized the health implications of the crisis more quickly had they received formal environmental health training. Furthermore, connections to other professional disciplines-and to the community-are vital for effective responses to environmental health threats. We explore some lessons learned in Flint that might help expedite resolution of future environmental health crises, particularly those involving aging infrastructure and diminished or dysfunctional regulation or oversight. © 2017 American Medical Association. All Rights Reserved.

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

PubMed

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.

Educational quality and the crisis of educational research

NASA Astrophysics Data System (ADS)

Heyneman, Stephen

1993-11-01

This paper was designed not as a research product but as a speech to comparative education colleagues. It argues that there is a crisis of educational quality in many parts of the world, and that there is a parallel crisis in the quality of educational research and statistics. Compared to other major public responsibilities in health, agriculture, population and family planning, educational statistics are poor and often getting worse. Our international and national statistical institutions are impoverished, and we as a profession have been part of the problem. We have been so busy arguing over differing research paradigms that we have not paid sufficient attention to our common professional responsibilities and common professional goals. The paper suggests that we, as professionals interested in comparative education issues, begin to act together more on these common and important issues.

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

PubMed

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.

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

MedlinePlus

... Some People Who Were Treated with hGH Health Alert: Adrenal Crisis Causes Death in Some People Who ... a medical ID card and wear a Medic-Alert bracelet to tell emergency workers that you lack ...

Facing the Crisis: Third World Agriculture in the 1980s.

ERIC Educational Resources Information Center

Singh, Ajit; Tabatabai, Hamid

1990-01-01

Examines how developing nations' agrarian economy fared in the 1980s in the wake of the world economic crisis. Discusses how the economic crisis affected agricultural development and whether the performance of the agrarian economy was responsible for the economic crisis. (JOW)

The future of the welfare state: crisis myths and crisis realities.

PubMed

Castles, Francis G

2002-01-01

Accounts of the future of the welfare state are often presented in crisis terms. Some commentators identify globalization as a force that has already led to a major retreat by the state and is likely to lead to further downsizing of the public sector. Others see the future burden of an aging population as creating huge public expenditure pressures that can be countered only by increased parsimony in most areas of spending. Although both crisis scenarios contain elements of truth, analysis of recent public expenditure trends shows that both are substantially exaggerated as general representations of likely developments over the next two or three decades. However, unnoticed by most commentators, a real, longer-term crisis is beginning to make itself felt. This crisis arises, in part, from the demographic impact of a cultural transformation in the labor market, in progress for several decades. Extreme scenarios of possible consequences over the next 50 to 100 years include population implosion, mass migration, increasingly dangerous eruptions of right-wing populism, and, possibly, territorial conflict between developed and underdeveloped nations. This is not a crisis of the welfare state but rather a crisis for which the welfare state may be an essential part of the answer. The only way Western societies can lessen the future impact of the ongoing cultural transformation of the labor market is through the redesign of welfare state institutions to confront these new challenges.

Public mental health crisis management and Section 136 of the Mental Health Act.

PubMed

O'Brien, Aileen; Sethi, Faisil; Smith, Mark; Bartlett, Annie

2018-05-01

The interface between mental health services and the criminal justice system presents challenges both for professionals and patients. Both systems are stressed and inherently complex. Section 136 of the Mental Health Act is unusual being both an aspect of the Mental Health Act and a power of arrest. It has a long and controversial history related to concerns about who has been detained and how the section was applied. More recently, Section 136 has had a public profile stemming from the use of police cells as places of safety for young, mentally disturbed individuals. This paper explores the current state of health of this piece of legislation. Specifically, we consider whether alternative approaches are more suitable for those individuals in crisis and/or distress who come into contact with the police. This requires careful thought as to the proper role of both health and criminal justice professionals who are daily grappling with an ethically contentious domain of multiagency work. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Are long-term psychiatric patients causing more crisis consultations outside office hours in mental health care?

PubMed

Dekker, J; Theunissen, J; Van, R; Kikkert, M; van der Post, L; Zoeteman, J; Peen, J

2013-09-01

As well as an improvement in community services, the de-institutionalization of patients receiving long-term psychiatric care can lead to marginally staffed mental health services, more homelessness, rising admission rates and more people in prison cells. It is assumed that an imbalance between community and hospital care for chronic patients puts pressure on crisis services. In this study, the central question is whether patients receiving long-term psychiatric care in Amsterdam do indeed put pressure on the city's emergency mental health services. We compare the pressure exerted by this group with the pressure resulting from the use of these services by all registered patients. Data were taken from the client registration systems of three mental health organizations in Amsterdam in the period from 2000 to 2004. Inclusion criteria for long-term psychiatric patients were age above 19 years and uninterrupted receipt of mental health care for a minimum of two successive years. Annually, 6%-8% of all non-long-term patients experienced a crisis outside office hours in the period under investigation; this was 4%-6% for long-term patients. The non-long-term patients accounted for 83% of crisis contacts outside office hours over the entire study period, with long-term patients accounting for 17%. The assumption that crises are more prevalent in long-term patients in the community seems to be an example of stigmatization rather than an observation based on fact.

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.

PubMed

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

PubMed Central

2013-01-01

Background 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. Methods 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. Results 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. Conclusions The three aspects of resilience proved a useful categorisation of performance measurement though there is overlap between them. Transformatory

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

PubMed

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

The Refugee Crisis, Non-Citizens, Border Politics and Education

ERIC Educational Resources Information Center

Gerrard, Jessica

2017-01-01

In the midst of the most serious refugee crisis since WWII, nation states are buttressing their borders. This paper explores the border politics of the nation state in response to the refugee crisis. Drawing on the work of Susan Sontag, Judith Butler and Imogen Tyler it considers the ways in which the imagery of the pain and suffering of Others is…

Counselors as Consultants during a National Crisis.

ERIC Educational Resources Information Center

Kaplan, Leslie S.; And Others

1993-01-01

Describes how counselors served as consultants to school division that had large student population of military dependents during Persian Gulf War. Examines impact of Persian Gulf War on the school division and its students and presents model for counselors who serve as consultants during crisis. Discusses counselors working as team with teachers,…

The correlation between stress and economic crisis: a systematic review

PubMed Central

Mucci, Nicola; Giorgi, Gabriele; Roncaioli, Mattia; Fiz Perez, Javier; Arcangeli, Giulio

2016-01-01

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). PMID:27143898

The correlation between stress and economic crisis: a systematic review.

PubMed

Mucci, Nicola; Giorgi, Gabriele; Roncaioli, Mattia; Fiz Perez, Javier; Arcangeli, Giulio

2016-01-01

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).

Examining national trends in worker health with the National Health Interview Survey.

PubMed

Luckhaupt, Sara E; Sestito, John P

2013-12-01

To describe data from the National Health Interview Survey (NHIS), both the annual core survey and periodic occupational health supplements (OHSs), available for examining national trends in worker health. The NHIS is an annual in-person household survey with a cross-sectional multistage clustered sample design to produce nationally representative health data. The 2010 NHIS included an OHS. Prevalence rates of various health conditions and health behaviors among workers based on multiple years of NHIS core data are available. In addition, the 2010 NHIS-OHS data provide prevalence rates of selected health conditions, work organization factors, and occupational exposures among US workers by industry and occupation. The publicly available NHIS data can be used to identify areas of concern for various industries and for benchmarking data from specific worker groups against national averages.

[Depression telephone helpline: help seeking during the financial crisis].

PubMed

Economou, M; Peppou, L E; Louki, E; Komporozos, A; Mellou, A; Stefanis, C

2012-01-01

Mental health telephone help-lines usually play a significant role in mental health services system. Their importance is substantiated during periods of financial crisis, where the mental health of the population is gravely inflicted. Media reports have documented a large increase in calls made to mental health telephone help-lines around the world as a corollary to the global economic crisis; however, a systematic investigation of this observation is still lacking. In this context, the present study endeavours to fill this gap in the literature, while it adds strength to the handful of studies which have empirically supported the impact of the financial crisis on mental health in Greece. Data were extracted from information gleaned during the calls made to the Depression Telephone Helpline of the Greek University Mental Health Research Institute. The information entailed the reason for calling, the socio-demographic and clinical profile of the person with mental health problems, his/her previous and current contacts with mental health professionals and the treatment he/she might be receiving. The results showed a steep increase in calls with direct or indirect reference to the economic crisis during the first half of 2010 and onwards. The callers who referred to the economic crisis manifested depressive symptomatology of clinical significance to a greater degree than callers who made no such reference. The latter exhibited increased levels of distress and agitation as well as drug/alcohol misuse. Concomitantly, a higher frequency of depressive symptomatology was discerned among the unemployed, whereas employed people were found to experience anxiety symptoms to a higher degree. The impact of the financial crisis on the mental health of the Greek population has been considerable, underscoring in this way the importance of mental health help-lines as emotional buffers and as guides for timely and appropriate service use in response to the emerging mental health

The Crisis in Mental Health Research.

ERIC Educational Resources Information Center

Brown, Bertram S.

Presented is a speech by Bertram Brown, director of the National Institute of Mental Health, on the effects of decreased federal funding of mental health research. Brown notes that there has been a 56% slash in the purchasing power of the research grant program when inflation is accounted for. It is suggested that causes of the dwindling support…

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

PubMed

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

2015-11-01

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

How States Are Tackling the Opioid Crisis

PubMed Central

Zur, Julia; Mulvaney-Day, Norah; von Klimo, Melinda Campopiano; Selmi, Elizabeth; Harwood, Henrick

2017-01-01

Objectives: We used data from the 2015 National Association of State Alcohol and Drug Abuse Directors Web-based questionnaire and other sources to demonstrate the range and scope of state initiatives being used to deal with the opioid crisis in the United States. Methods: State alcohol and drug agency directors and designated senior agency managers responded to the questionnaire, which asked respondents about recent opioid-related state-level public health initiatives at their agencies. Results: State alcohol and drug agencies in all 50 states and the District of Columbia responded, all of which reported that prescription drug misuse was a high priority or the highest priority area for their agencies. Of the 51 respondents, states reported initiatives to educate the general public (n = 48), prescribers (n = 31), patients and families (n = 24), and pharmacists (n = 22) about the risks of opioids. In addition, 29 states had increased funding for medication-assisted treatment of opioid addiction, 28 had expanded the availability of naloxone (an opioid antidote), 26 had established guidelines for safe opioid prescribing, 23 had launched requirements for prescriber use of prescription monitoring programs, 23 had passed Good Samaritan laws to protect those helping treat overdoses, and 14 had enacted legislation to regulate pain clinics. Conclusions: US state alcohol and drug agencies demonstrated a robust response to the opioid crisis in the United States. They have pursued and expanded on an array of evidence-based initiatives aimed at the opioid crisis. Future public health efforts should focus on maintenance and further expansion of high-quality, evidence-based practices, policies, and programs. PMID:28152337

How States Are Tackling the Opioid Crisis.

PubMed

Wickramatilake, Shalini; Zur, Julia; Mulvaney-Day, Norah; Klimo, Melinda Campopiano von; Selmi, Elizabeth; Harwood, Henrick

We used data from the 2015 National Association of State Alcohol and Drug Abuse Directors Web-based questionnaire and other sources to demonstrate the range and scope of state initiatives being used to deal with the opioid crisis in the United States. State alcohol and drug agency directors and designated senior agency managers responded to the questionnaire, which asked respondents about recent opioid-related state-level public health initiatives at their agencies. State alcohol and drug agencies in all 50 states and the District of Columbia responded, all of which reported that prescription drug misuse was a high priority or the highest priority area for their agencies. Of the 51 respondents, states reported initiatives to educate the general public (n = 48), prescribers (n = 31), patients and families (n = 24), and pharmacists (n = 22) about the risks of opioids. In addition, 29 states had increased funding for medication-assisted treatment of opioid addiction, 28 had expanded the availability of naloxone (an opioid antidote), 26 had established guidelines for safe opioid prescribing, 23 had launched requirements for prescriber use of prescription monitoring programs, 23 had passed Good Samaritan laws to protect those helping treat overdoses, and 14 had enacted legislation to regulate pain clinics. US state alcohol and drug agencies demonstrated a robust response to the opioid crisis in the United States. They have pursued and expanded on an array of evidence-based initiatives aimed at the opioid crisis. Future public health efforts should focus on maintenance and further expansion of high-quality, evidence-based practices, policies, and programs.

The impact of out-of-pocket payments on health care inequity: the case of national health insurance in South Korea.

PubMed

Lee, Weon-Young; Shaw, Ian

2014-07-18

The global financial crisis of 2008 has led to the reinforcement of patient cost sharing in health care policy. This study aimed to explore the impact of direct out-of pocket payments (OOPs) on health care utilization and the resulting financial burden across income groups under the South Korean National Health Insurance (NHI) program with universal population coverage. We used the fourth Korean National Health and Nutrition Examination Survey (KNHNES-IV) and the Korean Household Income and Expenditure Survey (KHIES) of 2007, 2008 and 2009. The Horizontal Inequity Index (HIwv) and the average unit OOPs were used to measure income-related inequity in the quantitative and qualitative aspects of health care utilization, respectively. For financial burden, the incidence rates of catastrophic health expenditure (CHE) were compared across income groups. For outpatient and hospital visits, there was neither pro-poor or pro-rich inequality. The average unit OOPs of the poorest quintile was approximately 75% and 60% of each counterpart in the richest quintile in the outpatient and inpatient services. For the CHE threshold of 40%, the incidence rates were 5.7%, 1.67%, 0.72%, 0.33% and 0.27% in quintiles I (the poorest quintile), II, III, IV and V, respectively. Substantial OOPs under the NHI are disadvantageous, particularly for the lowest income group in terms of health care quality and financial burden.

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

PubMed

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.

Are the nation's hospitals facing a capital crisis?

PubMed

Johnsson, J

1990-07-20

Are hospitals facing a capital crisis? Wall Street is taking a long, hard look at hospitals' bottom lines--and many analysts don't like what they see. Hospitals' increasing reliance on long-term debt, lower debt-service coverage ratios, and weakening performance indicators all signal a potentially volatile situation for some sectors of the field. Which hospitals are at risk? Experts point to hospitals in Southern California and New York. But others say that hospitals in moderate-size cities with 250 beds and $40 million or more in long-term debt are vulnerable. However, 40 percent of the 600 CEOs who responded to our Hamilton/KSA survey agree that the continued erosion of reimbursement will require a government bailout similar to the savings and loan industry. "A great deal depends on public policy," says Darrel Brownell, executive vice-president and chief financial officer, Memorial Health Services, a two-hospital system based in Long Beach, CA. "The government has the ability to maintain the industry in a stable condition, or it has the ability to force it into a bailout situation."

Declining death rates from hyperglycemic crisis among adults with diabetes, U.S., 1985-2002.

PubMed

Wang, Jing; Williams, Desmond E; Narayan, K M Venkat; Geiss, Linda S

2006-09-01

To examine trends in death rates for hyperglycemic crisis (diabetic ketoacidosis or hyperglycemic hyperosmolar state) among adults with diabetes in the U.S. from 1985 to 2002. Deaths with hyperglycemic crisis as the underlying cause were identified from national mortality data. Death rates were calculated using estimates of adults with diabetes from the National Health Interview Survey as the denominator and age adjusted to the 2000 U.S. population. The trends from 1985 to 2002 were tested using joinpoint regression analysis. Deaths due to hyperglycemic crisis dropped from 2,989 in 1985 to 2,459 in 2002. During the time period, age-adjusted death rates decreased from 42.4 to 23.8 per 100,000 adults with diabetes (4.4% decrease per year, P for trend <0.01). Death rates declined in all age-groups, with the greatest decrease occurring among individuals aged > or =65 years. Age-adjusted death rates fell for all race-sex subgroups, with black men experiencing the smallest decline. About one-fifth of deaths occurred at home or on arrival at the hospital, and the death rates for hyperglycemic crisis occurring at these places declined only modestly over time (2.1% decrease per year, P for trend = 0.049). Overall death rates due to hyperglycemic crisis among adults with diabetes have declined in the U.S. However, scope for further improvement remains, especially to further reduce death rates among black men and to prevent deaths occurring at home.

Greece Financial Crisis and Quality of Life.

PubMed

Mechili, Aggelos E; Kalokairinou, Athena; Kaitelidou, Dafni; Diomidous, Marianna

2015-01-01

The last six years the global community is facing an economic crisis that first appeared in USA. This crisis has a lot of impacts especially in health sector. Unemployment, job insecurity and the loss of disposable income have a significant impact in health too. The main objective of this research was to investigate the quality of life of the general population in Greece during the financial crisis. To collect the data it has been used the Greek version of Short Form (36) Health Survey (SF-36v2). In general, income, level of education, cohabitation and parenthood had a significant impact in quality of life. As a conclusion, unemployed participants' score was lower in the entire dimensions and in the two summary scales too.

The Vulnerability of Occupational Health and Safety to Deregulation: The Weakening of Information Regulations during the Economic Crisis in Korea.

PubMed

Jhang, Won Gi

2018-05-01

This study was conducted to investigate the causes and consequences of the vulnerability of occupational health and safety (OHS) regulations to deregulation during a period of economic crisis in the Republic of Korea. Analysis of Korea's national regulation database revealed that the vulnerability of OHS regulations to deregulation was related to the fact that OHS policy included many regulations without direct deregulatory impacts on workers. The most affected victim of this characteristic was information regulation that provided a legal basis for government's monitoring and inspection of OHS activities. The massive relaxation of information regulation has the potential to weaken government oversight and to tempt businesses to hide industrial accidents. Since changes in regulations without direct deregulatory impacts are not easily identifiable by workers, careful monitoring of deregulation is necessary to prevent policy impacts harmful to workers' health and safety.

National health expenditures, 1989

PubMed Central

Lazenby, Helen C.; Letsch, Suzanne W.

1990-01-01

Spending for health care in the United States grew to $604.1 billion in 1989, an increase of 11.1 percent from the 1988 level. Growth in national health expenditures has been edging upward since 1986, when the annual growth in the health care bill was 7.7 percent. Health care spending continues to command a larger and larger proportion of the resources of the Nation: In 1989, 11.6 percent of the Nation's output, as measured by the gross national product, was consumed by health care, up from 11.2 percent in 1988. PMID:10113559

[Crisis Intervention in a Health Care Hospital for Child and Adolescent Psychiatry].

PubMed

Burchard, Falk; Diebenbusch, Teresa

2017-01-01

Crisis Intervention in a Health Care Hospital for Child and Adolescent Psychiatry In the past years the pressure in society and psychological problems in Germany have risen up. This can especially be verified by the great influx of utilization of child and adolescent psychiatric clinics through the admission of crisis. In this connection social disadvantaged female adolescents with a low socio-economic status, students of the secondary school, children in care and the ones whose parents have to manage their upbringing alone are preferentially affected. These developments require a fast adaptation of the supply system to the transformed demands, in particular in terms of outpatient treatment, as well as a closely and structured cooperation between the youth welfare and child and adolescent psychiatric clinics in their function as systems of help. In the script statistical data and adaptive approaches of a supply department of child and adolescent psychiatry are presented.

The Financial Crisis in the Community College.

ERIC Educational Resources Information Center

Lombardi, John

The author examines the financial crisis in community colleges on a national scale in this first paper in a projected long-range study of this crucial topic. Economic causes contributing to the crisis include inflation, rising enrollments, and such labor-intensive aspects as spiraling labor and security costs, and increasing demands for funds by…

A tale of loss of privilege, resilience and change: the impact of the economic crisis on physicians and medical services in Portugal.

PubMed

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

2016-09-01

That the current economic crisis is having an impact on population health and healthcare utilisation across Europe is fairly established; how national health systems and markets are reacting is however still poorly understood. Drawing from the economic literature we conducted 21 interviews with physicians, policy-makers and healthcare managers in Portugal, to explore their perceptions on the impact of the crisis on the country's market medical services, on physicians' motivation, and the ensuing coping strategies. Interviews were recorded, transcribed and analysed using NVivo software. We show that despite the crisis, few physicians reported considering leaving the public sector and the country, and very diverse coping strategies are emerging, depending on the respective employment institutions and seniority. In spite of the changes in patient case-mix, demand for medical services may not have necessarily increased, having shifted from public to private, with many highlighting the contribution of the current crisis in consolidating the private sector. In order to maintain their pre-crisis living standards amidst deteriorating salaries and increasing controls, hospital physicians have resorted to strategies such as shifting hours to the private, and primary care ones to anticipating their retirement. Migration was reported to be an option only for the younger and older doctors. Our study suggests the existence of resilience among Portuguese physicians and in the country's market for medical services, which, if corroborated by further research, will need to be taken into account by national health policies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Assessing aggression risks in patients of the ambulatory mental health crisis team.

PubMed

Penterman, Berry; Nijman, Henk

2011-08-01

During outreaching crisis visits, crisis team members run the risk of being confronted with aggressive behavior from their patients. To prevent dangerous situations, a method to assess risks in advance, on the basis of information received before the visit to the patient in crisis, could prove useful. During a two-year period, crisis team members completed a checklist before visiting patients in psychiatric crises. After each crisis visit, if there had been any aggression, this was recorded by means of the SOAS-R. In 51 of 499 crisis visits (10%) aggression was documented. The results indicate that the predictive validity of the presented checklist for occurrences of aggression may be fair-to-good. Use of the checklist in everyday crisis team practice seems recommendable as it structures the way risks are assessed before entering a potentially dangerous situation.

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

PubMed

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

2016-12-01

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

[Impact of the economic crisis on the right to a healthy diet. SESPAS report 2014].

PubMed

Antentas, Josep Maria; Vivas, Esther

2014-06-01

The present article analyzes the impact of the economic crisis on food consumption in Spain, the most affected social profiles, and the consequences of changing patterns of food consumption on health. This article is based on official reports and previous empirical studies. The crisis has affected diet and food consumption. Families are attempting to spend less money on food. Food insecurity is rising and the most affected groups are those spending a higher proportion of their income on food. Cuts in food spending run parallel with unhealthy eating habits that encourage obesity. Consequently, the crisis contributes to undermining the right to a healthy diet, recognized by the International Covenant on Economic, Social and Cultural Rights of the United Nations. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

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

PubMed

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.

PubMed

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.

The protracted waste crisis and physical health of workers in Beirut: a comparative cross-sectional study.

PubMed

Morsi, Rami Z; Safa, Rawan; Baroud, Serge F; Fawaz, Cherine N; Farha, Jad I; El-Jardali, Fadi; Chaaya, Monique

2017-04-11

Since July 2015, Lebanon has been experiencing a waste management crisis. Dumpsites in inhabited areas and waste burning have emerged due to the waste accumulation, further adding to the gravity of the situation. However, the association between the crisis and health of the population has not been scientifically reported. A comparative cross-sectional study was conducted to assess whether exposure to open dumpsites and waste burning is associated with acute health symptoms. The study sample included 221 male workers between the ages of 18-60 years selected from two areas chosen based on their proximity to a garbage dumpsite and waste burning. 110 workers were exposed to a garbage dumpsite and waste burning, and 111 workers were not. Data were collected via a face-to-face interview using a newly developed validated structured questionnaire. Chi-square tests were used to check for statistically significant differences between exposure and covariates. Multivariable analyses using multiple logistic regression were used to compare health symptoms between exposed and unexposed workers adjusting for potential confounders. The prevalence of acute health symptoms was greater among the exposed workers than the non-exposed workers, including gastrointestinal, respiratory, dermatological and constitutional symptoms. Controlling for confounding variables, such as age, insurance, family support, residence near dumpsite, work site, and smoking, a minimum odds ratio (OR) of 4.30 was obtained when comparing the exposed population to those non-exposed. The strong association between improper waste management and physical health calls for immediate attention by the government, stakeholders and community members to find optimal solutions for this waste management crisis and set immediate priority interventions such as regular waste collection, volume reduction and recycling performance improvement. However, the long recall period may have underestimated our results.

Technology Education Tackles Energy Crisis.

ERIC Educational Resources Information Center

Cutshall, Sandy

2002-01-01

Describes the solar-hydrogen technologies at the East Valley Institute of Technology, the only technology center in the nations that offers this class. Describes its focus on solving the energy crisis. (JOW)

Principal Experiences with Crisis Management Professional Development, Collaboration, and Implementation of the National Incident Management System Phases of Emergency Management

ERIC Educational Resources Information Center

Naradko, Anthony M.

2017-01-01

The purpose of this qualitative single-subject case study was to identify the elements critical to crisis management professional development for school principals; the factors influencing the implementation of the National Incident Management System Phases of Emergency Management (2010) for principals; and the necessary elements for fostering…

Reach Higher, America: Overcoming Crisis in the U.S. Workforce. Report of the National Commission on Adult Literacy

ERIC Educational Resources Information Center

National Commission on Adult Literacy (NJ1), 2008

2008-01-01

Education drives the economy. Almost a decade into the 21st Century, America faces a choice: It can invest in the basic education and skills of its workforce and remain competitive in today's global economy, or it can continue to overlook glaring evidence of a national crisis and move further down the path to decline. In this report, the National…

The consequences of the economic crisis in radiology.

PubMed

2015-12-01

The effects of the economic crisis have led to complex problems in radiology. The crisis has led to a reduction in the turnover of imaging equipment. This reflects on the quantity and quality of output, an aspect which is worsened by the contraction of the radiology market, late payments on supplies, and competitive procurement of medical goods centralized on a regional or national level. Many local and national institutions have operated with significant reductions of reimbursement for procedures, forcing a reorganization of facilities, manpower, and equipment. The reduction in operating margins of the industry has resulted in a reduction of invested capital for projects of industrial R&D and direct or indirect sponsorship. The quality of care will be affected with less comfortable conditions, reduction of local availability of radiologists, and failure to invest in lower dose equipment to control population medical radiation exposure. The crisis resulted in a reduction in the number of graduates in medicine and scholarships for specialization induced by linear cuts will result in a drastic reduction of radiological specialists. This will favour the development of teleradiology services, with the risk of accelerating the demedicalisation of radiology departments, and isolation of the professionals. • The economic crisis has led to reduction in the turnover of imaging equipment. • The economic crisis has led to reductions of reimbursement for procedures. • The economic crisis has led to reductions in operating margins of the industry. • The economic crisis has led to contraction of quantity and quality of output. • The economic crisis resulted in demedicalisation of radiology departments and isolation of professionals.

The Impact of the Global Financial Crisis on Japan's Higher Education

ERIC Educational Resources Information Center

Huang, Futao

2011-01-01

This paper deals with the impact of the global financial crisis on Japan's economy, especially on its higher education. The first section provides an overview of Japan's national economy with a focus on the impact of the global financial crisis on the national economy, then the author touches on the impact on the Japanese government's finances,…

A descriptive evaluation of the Seattle Police Department's crisis response team officer/mental health professional partnership pilot program.

PubMed

Helfgott, Jacqueline B; Hickman, Matthew J; Labossiere, Andre P

2016-01-01

The Seattle Police Department (SPD) recently enhanced their response to individuals in behavioral crisis through a pilot Crisis Response Team (CRT) consisting of dedicated Crisis Intervention Team (CIT) officers (OFC) paired with a Mental Health Professional (MHP). This study presents results of an incident-based descriptive evaluation of the SPD's CRT pilot program, implemented from 2010 to 2012. The purpose of the evaluation was to determine the value-added by the MHP in cases involving individuals in behavioral crisis as well as the effectiveness of the CRT program with regard to resolution time, repeat contacts, and referral to services. Data were collected from SPD general offense and supplemental reports for a 12-month segment of the program. Key variables included incident location, case clearance, repeat contacts, linkages to services, and case disposition. Results of analyses of general offense and supplemental reports are presented and implications for future development of the OFC/MHP partnership are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Addressing the epidemiologic transition in the former Soviet Union: strategies for health system and public health reform in Russia.

PubMed Central

Tulchinsky, T H; Varavikova, E A

1996-01-01

OBJECTIVES. This paper reviews Russia's health crisis, financing, and organization and public health reform needs. METHODS. The structure, policy, supply of services, and health status indicators of Russia's health system are examined. RESULTS. Longevity is declining; mortality rates from cardiovascular diseases and trauma are high and rising; maternal and infant mortality are high. Vaccine-preventable diseases have reappeared in epidemic form. Nutrition status is problematic. CONCLUSIONS. The crisis relates to Russia's economic transition, but it also goes deep into the former Soviet health system. The epidemiologic transition from a predominance of infectious to noninfectious diseases was addressed by increasing the quantity of services. The health system lacked mechanisms for epidemiologic or economic analysis and accountability to the public. Policy and funding favored hospitals over ambulatory care and individual routine checkups over community-oriented preventive approaches. Reform since 1991 has centered on national health insurance and decentralized management of services. A national health strategy to address fundamental public health problems is recommended. PMID:8604754

National health expenditures, 1983

PubMed Central

Gibson, Robert M.; Levit, Katharine R.; Lazenby, Helen; Waldo, Daniel R.

1984-01-01

Although growing more slowly than in recent years, spending for health continued to account for an increasing share of the Nation's gross national product. In 1983, spending for health amounted to 10.8 percent of the gross national product, or $1,459 per person. Public programs financed 40 percent of all personal health care spending. Medicare and Medicaid expended $91 billion in benefits, 29 percent of all spending for personal health. New estimates of spending in calendar year 1983, along with revised measures of the benefits paid by private health insurers, are presented here. PMID:10310949

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

PubMed

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

National Health Expenditures, 1979

PubMed Central

Gibson, Robert M

1980-01-01

Outlays for health care in the nation reached $212.2 billion in calendar year 1979—12.5 percent higher than in 1978, according to preliminary figures compiled by the Health Care Financing Administration. This estimate represented $943 per person in the United States and was equal to 9.0 percent of the Gross National Product. This latest report in the annual series representing national health expenditures provides detailed estimates of health care spending by type of service and method of financing. PMID:10309255

Economic growth and health progress in Italy: 30 years of National Health Service.

PubMed

Vannelli, Alberto; Buongiorno, Massimo; Zanardo, Michele; Basilico, Valerio; Capriata, Giulio; Rossi, Fabrizio; Pruiti, Vincenzo; Battaglia, Luigi

2012-01-01

On December 23 of 1978, during first Italian recession since the end of World War II, Parliament voted for Law 833 that gives birth to the Italian National Public Health Services (SSN) as the new and alternative model of health care system. It was the beginning of the match of Italian health care with the world class level of the public health care. Each crisis requires solidarity and actions. Maintaining levels of health and other social expenditures is critical to protect life and livelihood and to boost productivity. The purpose of the present study is to establish an alternative point of view to demonstrate that Gross Domestic Product, is a function of health care expenditure. The chronology of the events was created by using the laws published on "Gazzetta Ufficiale" (GU). In order to analyze the corporate effectiveness and efficiency, we have divided the SSN into its three main components, namely resources (input), services (output) and performances (outcome). Health services have certainly been pioneers and are still today standard-bearers of a challenge which has borne its fruits. According to the "Organization for Economic Co-operation and Development", SSN ranks second in the world classification of the return on the health care services in 2000. The World Health Organization has published in 2005 the same result: SSN ranks second in the world for ability and quality of the health care in relationship to the resources invested The continuous reforms of health care system introduced stability to the Italian system more than others countries. Success of SSN function rooted in the ability of system to adapt assuring mechanism of positive feed-back correction. In the future SSN, will required new set of reforms, such as redefinition of structures and mechanisms of governance, strategic plans, clinical administrations.

Assessing the impact of the monetary crisis and natural disasters on women's health and nutrition in Indonesia.

PubMed

Iskandar, M

1998-05-01

This article assesses the impact of the monetary crisis and natural disasters on women's health and nutrition in Indonesia as described by Dr. Meiwita Iskandar. Since there is a deficit in funding, the author claims, it is likely that hospitals will refuse operations. This will increase the risk of maternal death due to the inaccessibility of obstetric care facilities. As the cost of medicinesincluding oral contraceptiveshas doubled, more women are expected to patronize traditional healers and medicines, as these will be cheaper. Furthermore, an increase in food prices will severely affect the health and nutrition of low-income women and girls. As a result of the crisis, young women will be married off and even forced into prostitution in order to earn money for the family. Thus, the author urges the Ministry of Health and other government ministries to take action in planning interventions in anticipation of these health impacts. There is a need for them to create public health programs, health care services, subsidies for food and medicines, and job creation strategies. The rights of women workers need to be better protected by the law, and the private sector must be encouraged to help provide affordable food and basic health services.

Economic Crisis, Restrictive Policies, and the Population’s Health and Health Care: The Greek Case

PubMed Central

Giannakopoulos, Stathis; Gavana, Magda; Ierodiakonou, Ioanna; Waitzkin, Howard; Benos, Alexis

2013-01-01

The global economic crisis has affected the Greek economy with unprecedented severity, making Greece an important test of the relationship between socioeconomic determinants and a population’s well-being. Suicide and homicide mortality rates among men increased by 22.7% and 27.6%, respectively, between 2007 and 2009, and mental disorders, substance abuse, and infectious disease morbidity showed deteriorating trends during 2010 and 2011. Utilization of public inpatient and primary care services rose by 6.2% and 21.9%, respectively, between 2010 and 2011, while the Ministry of Health’s total expenditures fell by 23.7% between 2009 and 2011. In a time of economic turmoil, rising health care needs and increasing demand for public services collide with austerity and privatization policies, exposing Greece’s population health to further risks. PMID:23597358

Responding to the Medical Malpractice Insurance Crisis: A National Risk Management Information System

PubMed Central

Wess, Bernard P.; Jacobson, Gary

1987-01-01

In the process of forming a new medical malpractice reinsurance company, the authors analyzed thousands of medical malpractice cases, settlements, and verdicts. The evidence of those analyses indicated that the medical malpractice crisis is (1)emerging nation- and world-wide, (2)exacerbated by but not primarily a result of “predatory” legal action, (3)statistically determined by a small percentage of physicians and procedures, (4)overburdened with data but poor on information, (5)subject to classic forms of quality control and automation. The management information system developed to address this problem features a tiered data base architecture to accommodate medical, administrative, procedural, statistical, and actuarial analyses necessary to predict claims from untoward events, not merely to report them.

Economic recession and health inequalities in Japan: analysis with a national sample, 1986–2001

PubMed Central

Kondo, N; Subramanian, S V; Kawachi, I; Takeda, Y; Yamagata, Z

2009-01-01

Objective Little is known about whether economic crises widen health inequalities. Japan experienced more than 10 years of economic recession beginning in the 1990s. The question of whether socioeconomic-based inequality in self-rated health widened after the economic crisis was examined. Design, setting and participants Repeated cross-sectional survey design. Two pooled datasets from 1986 and 1989 and from 1998 and 2001 were analysed separately, and temporal change was examined. The study took place in Japan among the working-age population (20–60 years old). The two surveys consisted of 168 801 and 150 016 people, respectively, with about an 80% response rate. Results The absolute percentages of people reporting poor health declined across all socioeconomic statuses following the crisis. However, after controlling for confounding factors, the odds ratio (OR) for poor self-rated health (95% confidence intervals) among middle-class non-manual workers (clerical/sales/service workers) compared with the highest class workers (managers/administrators) was 1.02 (0.92 to 1.14) before the crisis but increased to 1.14 (1.02 to 1.29) after the crisis (p for temporal change = 0.02). The association was stronger among males. The adjusted ORs among professional workers and young female homemakers also marginally increased over time. Unemployed people were twice as likely to report poor health compared with the highest class workers throughout the period. Self-rated health of people with middle to higher incomes deteriorated in relative terms following the crisis compared with that of lower income people. Conclusions Self-rated health improved in absolute terms for all occupational groups even after the economic recession. However, the relative disparity increased between the top and middle occupational groups in men. PMID:18791043

School Crisis Teams within an Incident Command System

ERIC Educational Resources Information Center

Nickerson, Amanda B.; Brock, Stephen E.; Reeves, Melissa A.

2006-01-01

Despite the increasing attention given to the need for schools to be prepared to respond in a variety of crisis situations, there is a lack of information about how to coordinate with multiple agencies following a crisis. This article describes the U. S. Department of Homeland Security's (2004) National Incident Management System and its Incident…

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

PubMed

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.

Medical Education and the Rural Health Crisis: A Personal Perspective from Experiences in Five States.

ERIC Educational Resources Information Center

Vanselow, Neal A.

1990-01-01

A solution to the rural health crisis will require not only changes in student selection, curriculum, and training location but also strengthening of the rural economy, improved reimbursement to rural hospitals and primary care physicians, and increased sensitivity among leaders of the medical profession to rural community and practitioner needs.…

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

PubMed

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.

Innovative infrastructure in New Jersey: using health education professionals to inform and educate during a crisis.

PubMed

Taylor, Laura; Miro, Suzanne; Bookbinder, Sylvia H; Slater, Thomas

2008-10-01

Federal funding supports the growth and development of public health infrastructure and preparedness. The New Jersey Department of Health and Senior Services used federal funds to increase local public health infrastructure that included the hiring of health educators or risk communicators (HERCs). The HERCs are a diverse group of health and communications professionals trained in emergency communication. They provide crisis information regarding pubic health threats. Over the years, the role and duties of HERCs have expanded from bioterrorism to all-hazards approach and emerging infections public health preparedness, including pandemic influenza. This article describes how HERCs are used in the New Jersey public health infrastructure.

Responding to the Unthinkable: School Crisis Response and Recovery

ERIC Educational Resources Information Center

Cowan, Katherine C.; Rossen, Eric

2014-01-01

The mental health implications of crisis exposure have emerged as a critical and challenging facet of school safety and crisis response, expanding our focus to encompass both psychological and physical safety, as well as prevention and recovery. Best practice reflects this evolution in our understanding and encompasses the continuum of crisis and…

The Office of the National Nurse: leadership for a new era of prevention.

PubMed

Mills, Teri; Schneider, Alisa

2007-02-01

The American health care system is in a crisis of soaring costs and epidemics of preventable diseases; poor health literacy contributes to these problems. In spite of the need for change, the system is resistant. Efforts to address the crisis must focus on new ways of educating the public to understand their health and how to prevent illness. Nurses calling for leadership, innovation, and inspiration are uniting behind the proposal for an Office of the National Nurse to serve as the vehicle for the delivery of accurate and accessible health information to all Americans to reduce the incidence of preventable diseases.

Crisis and emergency risk communication as an integrative model.

PubMed

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.

A thematic review and a policy-analysis agenda of Electronic Health Records in the Greek National Health System.

PubMed

Emmanouilidou, Maria; Burke, Maria

2013-01-01

The increasing pressure to improve healthcare outcomes and reduce costs is driving the current agenda of governments at worldwide level and calls for a fundamental reform of the status quo of health systems. This is especially the case with the Greek NHS (National Health System), a system in continuous crisis, and with the recent ongoing financial turbulence under intensive scrutiny. Technological innovations and Electronic Health Records (EHR) in particular, are recognised as key enablers in mitigating the existing burdens of healthcare. As a result, EHR is considered a core component in technology-driven reform processes. Nonetheless, the successful implementation and adoption of EHR proves to be a challenging task due to a mixture of technological, organisational and political issues. Drawing upon experiences within the European Union (EU) healthcare setting and the Greek NHS the paper proposes a conceptual framework as a policy-analysis agenda for EHR interventions in Greece. While the context of discussion is Greece, the paper aims to also derive useful insights to healthcare policy-makers around the globe. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The 1956 Suez Crisis and the United Nations

DTIC Science & Technology

2004-06-17

formally given them the “ scarlet letter.” He then proceeds to describe the crisis as “the first time that permanent members of the Security Council had...less fanfare. Jubilant crowds of Egyptians replaced them. By midday on 23 December, the merriment reached a fevered pitch when units of the “defeated

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

PubMed

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

2016-03-22

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

The role of international NGOs in health systems strengthening: the case of Timor-Leste.

PubMed

Mercer, Mary Anne; Thompson, Susan M; de Araujo, Rui Maria

2014-01-01

Achieving the United Nations Millennium Development Goals for health will require that programs supporting health in developing countries focus on strengthening national health care systems. However, the dominant neoliberal model of development mandates reduced public spending on health and other social services, often resulting in increased funding for nongovernmental organizations (NGOs) at the expense of support for government systems. East Timor, later Timor-Leste, is an example of a post-crisis country where international NGO efforts were initially critical to providing relief efforts to a traumatized population. Those groups were not prepared to help develop and support a standardized Timorese national health plan, however, and the cost of their support was unsustainable in the long term. In response, local authorities designed and implemented a post-crisis NGO phase-over plan that addressed risks to service disruption and monitored the process. Since then, some NGOs have worked collaboratively with the Ministry of Health to support specific efforts and initiatives under a framework provided by the ministry. Timor-Leste has shown that ministries of health can facilitate an effective transition of NGO support from crisis to development if they are allowed to plan and manage the process.

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

PubMed

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.

PubMed

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?

PubMed

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.

School Crisis Aftermath: Care for the Caregivers

ERIC Educational Resources Information Center

Paine, Cathy Kennedy

2009-01-01

"Professional" crisis caregivers (e.g., emergency responders, mental health providers, medical professionals, victim assistance counselors, and faith leaders) are trained to handle exposure to images of destruction and loss and to help victims or survivors cope with the impact of a crisis. They try to help individuals, schools, and communities…

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

PubMed

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.

[Sex Differences of Perceived Health before and During the Economic Crisis (2007 and 2011). Spain].

PubMed

Calzón Fernández, Silvia; Fernández Ajuria, Alberto; López Del Amo González, María Puerto; Martín Martín, José Jesús

2017-02-16

Several studies show the association between economic crises, unemployment and health income. However, it is necessary to differentiate their impact according to gender. The objective of this study was to analyze the effect that the economic crisis, unemployment and income may have had on the perceived health of men and women in Spain. A cross-sectional study was conducted combining data from the 2007 and 2011 Living Conditions Surveys, which collect data from 43,900 adult individuals up to 65 years of age. A multivariate logistic regression analysis was performed, for the whole population as for each sex. The dependent variable was perceived health and the independent variables were income level, employment status, education level, chronic illness, and the year in which the survey was performed. Perceived health improved over the period under consideration, from 75.1% in 2007 to 83%,0 in 2011. Unemployment significantly increased the chances of reporting perceived bad health in men [OR=1.45; CI95%:1.26-1.67] but not in women [OR=1.20; CI95%:0.99-1.47]. ORs of perceived bad health were higher for women than for men in the lower-income [1.81; IC95%1,56-2,11 against 1.70; IC95%:1,46-1,97. 2011] was related to a lower probability of poor perceived health in both men [OR=0.41, CI95%: 0.37-0.46] and women [OR=0.39 ; CI95%:0.35-0.44]. The association of the economic crisis with perceived health was similar in men and women. Unemployment was a risk factor for perceived bad health in the case of men. Available income, education level, and the presence of chronic illness had a larger influence as determinants of perceived bad health for women than they did for men.

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

PubMed

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.

Assessment of pre-crisis and syn-crisis seismic hazard at Campi Flegrei and Mt. Vesuvius volcanoes, Campania, southern Italy

NASA Astrophysics Data System (ADS)

Convertito, Vincenzo; Zollo, Aldo

2011-08-01

In this study, we address the issue of short-term to medium-term probabilistic seismic hazard analysis for two volcanic areas, Campi Flegrei caldera and Mt. Vesuvius in the Campania region of southern Italy. Two different phases of the volcanic activity are considered. The first, which we term the pre-crisis phase, concerns the present quiescent state of the volcanoes that is characterized by low-to-moderate seismicity. The second phase, syn-crisis, concerns the unrest phase that can potentially lead to eruption. For the Campi Flegrei case study, we analyzed the pattern of seismicity during the 1982-1984 ground uplift episode (bradyseism). For Mt. Vesuvius, two different time-evolutionary models for seismicity were adopted, corresponding to different ways in which the volcano might erupt. We performed a site-specific analysis, linked with the hazard map, to investigate the effects of input parameters, in terms of source geometry, mean activity rate, periods of data collection, and return periods, for the syn-crisis phase. The analysis in the present study of the pre-crisis phase allowed a comparison of the results of probabilistic seismic hazard analysis for the two study areas with those provided in the Italian national hazard map. For the Mt. Vesuvius area in particular, the results show that the hazard can be greater than that reported in the national hazard map when information at a local scale is used. For the syn-crisis phase, the main result is that the data recorded during the early months of the unrest phase are substantially representative of the seismic hazard during the whole duration of the crisis.

A Review of the Centers for Disease Control and Prevention's Response to the HIV/AIDS Crisis Among Blacks in the United States, 1981–2009

PubMed Central

Jones, Rhondette L.; Wolitski, Richard J.; Cleveland, Janet C.; Dean, Hazel D.; Fenton, Kevin A.

2009-01-01

Among US racial/ethnic groups, Blacks are at the highest risk of acquiring HIV/AIDS. In response, the Centers for Disease Control and Prevention (CDC) has launched the Heightened National Response to Address the HIV/AIDS Crisis Among African Americans, which seeks to engage public and nonpublic partners in a synergistic effort to prevent HIV among Blacks. The CDC also recently launched Act Against AIDS, a campaign to refocus attention on the domestic HIV/AIDS crisis. Although the CDC's efforts to combat HIV/AIDS among Blacks have achieved some success, more must be done to address this crisis. New initiatives include President Obama's goal of developing a National HIV/AIDS Strategy to reduce HIV incidence, decrease HIV-related health disparities, and increase access to care, especially among Blacks and other disproportionately affected populations. PMID:19797748

The global increase in dental caries. A pending public health crisis.

PubMed

Bagramian, Robert A; Garcia-Godoy, Franklin; Volpe, Anthony R

2009-02-01

A current review of the available epidemiological data from many countries clearly indicates that there is a marked increase in the prevalence of dental caries. This global increase in dental caries prevalence affects children as well as adults, primary as well as permanent teeth, and coronal as well as root surfaces. This increase in dental caries signals a pending public health crisis. Although there are differences of opinion regarding the cause of this global dental caries increase, the remedy is well known: a return to the public health strategies that were so successful in the past, a renewed campaign for water fluoridation, topical fluoride application, the use of fluoride rinses, a return to school oral health educational programs, an emphasis on proper tooth brushing with a fluoride dentifrice, as well as flossing, a proper diet and regular dental office visits. If these remedies are not initiated, there could be a serious negative impact upon the future oral health (and systemic health) of the global community, as well as a strain on the dental profession along with a major increase in the cost of dental services.

Defining Crisis in Families of Individuals with Autism Spectrum Disorders

ERIC Educational Resources Information Center

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…

Health, economic crisis, and austerity: A comparison of Greece, Finland and Iceland.

PubMed

Tapia Granados, José A; Rodriguez, Javier M

2015-07-01

Reports have attributed a public health tragedy in Greece to the Great Recession and the subsequent application of austerity programs. It is also claimed that the comparison of Greece with Iceland and Finland-where austerity policies were not applied-reveals the harmful effect of austerity on health and that by protecting spending in health and social budgets, governments can offset the harmful effects of economic crises on health. We use data on life expectancy, mortality rates, incidence of infectious diseases, rates of vaccination, self-reported health and other measures to examine the evolution of population health and health services performance in Greece, Finland and Iceland since 1990-2011 or 2012-the most recent years for which data are available. We find that in the three countries most indicators of population health continued improving after the Great Recession started. In terms of population health and performance of the health care system, in the period after 2007 for which data are available, Greece did as good as Iceland and Finland. The evidence does not support the claim that there is a health crisis in Greece. On the basis of the extant evidence, claims of a public health tragedy in Greece seem overly exaggerated. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

PubMed

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 < 0.0001) in C3G-4G sales was observed, compared with a significant increase of 30 % (p < 0.0001) in C1G-2G 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 < 0.0001). Finally, taking all types of contraceptive 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

The future of UK healthcare: problems and potential solutions to a system in crisis.

PubMed

Montgomery, H E; Haines, A; Marlow, N; Pearson, G; Mythen, M G; Grocott, M P W; Swanton, C

2017-08-01

The UK's Health System is in crisis, central funding no longer keeping pace with demand. Traditional responses-spending more, seeking efficiency savings or invoking market forces-are not solutions. The health of our nation demands urgent delivery of a radical new model, negotiated openly between public, policymakers and healthcare professionals. Such a model could focus on disease prevention, modifying health behaviour and implementing change in public policy in fields traditionally considered unrelated to health such as transport, food and advertising. The true cost-effectiveness of healthcare interventions must be balanced against the opportunity cost of their implementation, bolstering the central role of NICE in such decisions. Without such action, the prognosis for our healthcare system-and for the health of the individuals it serves-may be poor. Here, we explore such a new prescription for our national health. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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

PubMed

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.

[Attempted suicide during the financial crisis in Athens].

PubMed

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

Specialists without spirit: crisis in the nursing profession.

PubMed Central

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

Same-sex sexual relationships in the national social life, health and aging project: making a case for data collection.

PubMed

Brown, Maria T; Grossman, Brian R

2014-01-01

This study describes the previously unexplored subsample of respondents who reported at least 1 same-sex sexual relationship (SSSR) in the National Social Life, Health, and Aging Project (NSHAP). The NSHAP collected data from 3,005 adults (aged 57-85). Approximately 4% (n = 102) of respondents reported at least one SSSR. These sexual minority elders were younger, more educated, were more likely to be working, had fewer social supports, and better physical health. Results may indicate crisis competence in sexual minority elders. Collecting sexual orientation and gender identity data in larger, US-based probability samples would inform the development of appropriate community-based services and supports.

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

PubMed

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.

A Suffering Generation: Six Factors Contributing to the Mental Health Crisis in North American Higher Education

ERIC Educational Resources Information Center

Kruisselbrink Flatt, Alicia

2013-01-01

The number of students on university and college campuses that are struggling with depression, anxiety, suicidal thoughts, and psychosis across North America is rising (Gallagher, 2008). This intensification of students' psychological needs has become a mental health crisis. The age at which many mental disorders manifest themselves is between 18…

Mental health crisis and respite services: service user and carer aspirations.

PubMed

Lyons, C; Hopley, P; Burton, C R; Horrocks, J

2009-06-01

There is emerging evidence that crisis resolution services can provide alternatives to hospital admission, reducing demand on inpatient beds. Following a public consultation exercise in Lancashire (England), a team of nurses undertook a study, using interactive research methodology, to gain an understanding of how users and carers define a crisis and what range of crisis services, resources and interventions service users and carers thought would help avoid unnecessary hospital admission. Data collection comprised postal questionnaires and 24 group meetings with service users and carers, which were held during 2006. Data were analysed, and seven themes were identified: (1) definitions of a crisis; (2) access to services; (3) interventions; (4) range of services required (before, during and after crisis); (5) place of treatment; (6) recovery and rehabilitation; and (7) community support. We conclude that expressed preferences of service users and carers for pre-emptive services that are delivered flexibly will present a challenge for service commissioners and providers, particularly where stringent access criteria are used. Home-based pre-emptive services that reduce the need for unnecessary hospital treatment may avoid progression to social exclusion of service users.

The influence of the economic crisis on the association between unemployment and health: an empirical analysis for Spain.

PubMed

Urbanos-Garrido, Rosa M; Lopez-Valcarcel, Beatriz G

2015-03-01

To estimate the impact of (particularly long-term) unemployment on the overall and mental health of the Spanish working-age population and to check whether the effects of unemployment on health have increased or been tempered as a consequence of the economic crisis. We apply a matching technique to cross-sectional microdata from the Spanish Health Survey for the years 2006 and 2011-2012 to estimate the average treatment effect of unemployment on self-assessed health (SAH) in the last year, mental problems in the last year and on the mental health risk in the short term. We also use a differences-in-differences estimation method between the two periods to check if the impact of unemployment on health depends on the economic context. Unemployment has a significant negative impact on both SAH and mental health. This impact is particularly high for the long-term unemployed. With respect to the impact on mental health, negative effects significantly worsen with the economic crisis. For the full model, the changes in effects of long-term unemployment on mental problems and mental health risk are, respectively, 0.35 (CI 0.19-0.50) and 0.20 (CI 0.07-0.34). Anxiety and stress about the future associated with unemployment could have a large impact on individuals' health. It may be necessary to prevent health deterioration in vulnerable groups such as the unemployed, and also to monitor specific health risks that arise in recessions, such as psychological problems.

Helping Callers to the National Suicide Prevention Lifeline Who Are at Imminent Risk of Suicide: The Importance of Active Engagement, Active Rescue, and Collaboration Between Crisis and Emergency Services

PubMed Central

Draper, John; Murphy, Gillian; Vega, Eduardo; Covington, David W; McKeon, Richard

2015-01-01

In 2012, the SAMHSA-funded National Suicide Prevention Lifeline (Lifeline) completed implementation of the first national Policy for Helping Callers at Imminent Risk of Suicide across its network of crisis centers. The policy sought to: (1) provide a clear definition of imminent risk; (2) reflect the state of evidence, field experience, and promising practices related to reducing imminent risk through hotline interventions; and (3) provide a uniform policy and approach that could be applied across crisis center settings. The resulting policy established three essential principles: active engagement, active rescue, and collaboration between crisis and emergency services. A sample of the research and rationale that underpinned the development of this policy is provided here. In addition, policy implementation, challenges and successes, and implications for interventions to help Lifeline callers at imminent risk of suicide are detailed. PMID:25270689

Antimicrobial stewardship through a one health lens: Observations from Washington State

USDA-ARS?s Scientific Manuscript database

Antibiotic resistance is a global health crisis that threatens patient care, public health, agriculture, economic growth and national security. It has recently attracted increasing attention from healthcare professionals, public health officials, federal governments, international agencies, the publ...

Impact of the global financial crisis on employed Australian baby boomers: a national survey.

PubMed

O'Loughlin, Kate; Humpel, Nancy; Kendig, Hal

2010-06-01

This paper examines the impact of the global financial crisis (GFC) on employed Australian baby boomers. A nationally representative sample of 1009 boomers aged 50-64 years completed a survey by telephone interview mid 2009. Compared with 1 year ago, 38.9% of working boomers reported being financially worse off and this was more so for women (42.4%) than men (35.6%). Following the GFC, 41.4% of women and 31.9% of men had decided to postpone their retirement plans. The GFC is affecting the retirement preparations and plans of Australia's baby boomers. Policy implications include reduced resources for retirement needs, and uneven and differential impacts for those with interrupted employment histories, notably women.

Crisis, What Crisis?

ERIC Educational Resources Information Center

Jones, Ken

2010-01-01

Responding to the recent work of Andrew Gamble, the article discusses the extent to which the British situation can be described in terms of crisis. It suggests that an essential element of crisis is that of political and social contestation, and explores the terms on which contestation is taking shape in and around British education.

Today's fentanyl crisis: Prohibition's Iron Law, revisited.

PubMed

Beletsky, Leo; Davis, Corey S

2017-08-01

More than a decade in the making, America's opioid crisis has morphed from being driven by prescription drugs to one fuelled by heroin and, increasingly, fentanyl. Drawing on historical lessons of the era of National Alcohol Prohibition highlights the unintended, but predictable impact of supply-side interventions on the dynamics of illicit drug markets. Under the Iron Law of Prohibition, efforts to interrupt and suppress the illicit drug supply produce economic and logistical pressures favouring ever-more compact substitutes. This iatrogenic progression towards increasingly potent illicit drugs can be curtailed only through evidence-based harm reduction and demand reduction policies that acknowledge the structural determinants of health. Copyright © 2017 Elsevier B.V. All rights reserved.

Electronic gaming and the obesity crisis.

PubMed

Calvert, Sandra L; Staiano, Amanda E; Bond, Bradley J

2013-01-01

Children and adolescents in the United States and in many countries are projected to have shorter life spans than their parents, partly because of the obesity crisis engulfing the developed world. Exposure to electronic media is often implicated in this crisis because media use, including electronic game play, may promote sedentary behavior and increase consumption of high-calorie foods and beverages that are low in nutritional value. Electronic games, however, may increase children's physical activity and expose them to healthier foods. We examine the role of electronic games in the pediatric obesity crisis and their contribution to more favorable health outcomes. Copyright © 2013 Wiley Periodicals, Inc., A Wiley Company.

Electronic Gaming and the Obesity Crisis

PubMed Central

Calvert, Sandra L.; Staiano, Amanda E.; Bond, Bradley J.

2014-01-01

Children and adolescents in the United States and in many countries are projected to have shorter life spans than their parents, partly because of the obesity crisis engulfing the developed world. Exposure to electronic media is often implicated in this crisis because media use, including electronic game play, may promote sedentary behavior and increase consumption of high-calorie foods and beverages that are low in nutritional value. Electronic games, however, may increase children’s physical activity and expose them to healthier foods. We examine the role of electronic games in the pediatric obesity crisis and their contribution to more favorable health outcomes. PMID:23483693

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

PubMed

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.

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

PubMed

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.

A Window of Opportunity for the Transformation of National Mental Health Policy in Turkey Following Two Major Earthquakes

PubMed Central

Munir, Kerim; Ergene, Tuncay; Tunaligil, Verda; Erol, Nese

2011-01-01

Striking at the nation’s highly populated industrial heartlands, two massive earthquakes in 1999 killed over 25,000 people in Turkey. The economic cost and the humanitarian magnitude of the disaster were unprecedented in the country’s history. The crisis also underscored a major flaw in the organization of mental health services in the provinces that were left out of the 1961 reforms that aimed to make basic health services available nationwide. In describing the chronology of the earthquakes and the ensuing national and international response, this article explains how the public and governmental experience of the earthquakes has created a window of opportunity, and perhaps the political will, for significant reform. There is an urgent need to integrate mental health and general health services, and to strengthen mental health services in the country’s 81 disparate provinces. As Turkey continues her rapid transformation in terms of greater urbanization, higher levels of public education, and economic and constitutional reforms associated with its projected entry into the European Union, there have also been growing demands for better, and more equitably distributed, health care. A legacy of the earthquakes is that they exposed the need for Turkey to create a coherent, clearly articulated national mental health policy. PMID:15371066

National health expenditures, 1985

PubMed Central

Waldo, Daniel R.; Levit, Katharine R.; Lazenby, Helen

1986-01-01

Slower price inflation in 1985 translated into slower growth of national health expenditures, but underlying growth in the use of goods and services continued along historic trends. Coupled with somewhat sluggish growth of the gross national product, this adherence to trends pushed the share of our Nation's output accounted for by health spending to 10.7 percent. Some aspects of health spending changed: Falling use of hospital services was offset by rising hospital profits and increased use of other health care services. Other aspects remained the same: Both the public sector and the private sector continued efforts to contain costs, efforts that have affected and will continue to affect not only the providers of care but the users of care as well. PMID:10311775

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

PubMed

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.

Poverty and private health expenditures in Italian households during the recent crisis.

PubMed

Sarti, Simone; Terraneo, Marco; Tognetti Bordogna, Mara

2017-03-01

The global financial crisis that began in 2008 had an overall effect on the health behaviours of Italian households. Aggregate private health expenditures have decreased while the citizens have increasingly been asked to share health costs. The reduction of households' health expenditure could have serious consequences for health, especially if it concerns the most vulnerable people. The aim of this paper is to analyse the relation between poverty and household health expenditure, considering regional and social group variations. The data used stem from the "Family Expenditure Survey" collected by the Italian Statistical Institute (ISTAT) from 1997 to 2013. Results of multivariate analysis controlling for potential socio-demographic confounders show that the propensity to spend for poor families is decreased in the last years compared to not poor households. Meanwhile, among the households who spend, the average expenditure in euro seems to have been more stable over time. This is an alarming signal for the health of the most vulnerable households. These conditions could result in a gradual deterioration of health in poor families, which is likely to increase the burden on health systems in future. Hence, at this moment public intervention does not seem able to alleviate this situation. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Enhancing services response to crisis incidents involving veterans: a role for law enforcement and mental health collaboration.

PubMed

Weaver, Christopher M; Joseph, David; Dongon, Shara N; Fairweather, Amy; Ruzek, Josef I

2013-02-01

When crisis situations involving veterans occur, responding police officers find themselves playing an important role in the spectrum of health and mental health services for those veterans. Crisis response training can help officers respond in a manner that increases safety and optimizes outcomes for all people involved. Yet, current crisis response police training models are only accessible to select officers. Nor do they emphasize the unique challenges and strengths that impact veterans who experience acute symptoms of mental illness. In the current study, we report the results from the first generation of training, collaboratively designed to enhance officers' (a) knowledge of relevant topics, including posttraumatic stress disorder and traumatic brain injury, (b) attitudes about veterans, and (c) and skills helpful in identifying and deescalating veterans and referring them to treatment. Officers completed in-class evaluations (N = 314), and a subsample (n = 53) completed 3-month follow-up evaluations. Pre- versus posttest comparisons indicated significant improvements in total score, and individually in knowledge, attitudes, and skills. Consistent with previous literature, the specific in-class gains were not retained on follow-up. However, responding officers widely endorsed use of de-escalation techniques during, and a positive impact of the training on, their interactions with veterans in the 3 months following the training. Implications for future training and policy are discussed.

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.

PubMed

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].

PubMed

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.

PubMed

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.

The formation and application of an overseas mental health crisis intervention team, Part I: Formation.

PubMed

Young, S A; Holden, M S

1991-09-01

The creation of an overseas mental health crisis intervention team is described. The authors discuss the unique aspects of an overseas low intensity conflict environment and the importance of immediate mental health responses to disaster situations in such theaters. Key elements in the formation of the team are the use of local resources, command endorsement, and an emphasis on education of commanders and team members. Examples are cited of other military response team deployments. The authors present their experience in Panama as a model for other providers in similar environments.

Are you ready? Crisis leadership in a hyper-VUCA environment.

PubMed

Alkhaldi, Khaldoon H; Austin, Meredith L; Cura, Boris A; Dantzler, Darrell; Holland, Leslie; Maples, David L; Quarrelles, Jamie C; Weinkle, Robert K; Marcus, Leonard J

2017-01-01

The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes. The overall goal of the project is to increase the ability of the crisis leaders to more effectively and efficiently navigate crisis events resulting in more efficient and effective response and recovery. Three research questions were developed to assess the following: thoughts of integrating a crisis leader advisor position; development of a crisis leader advisor certification program; and attributes of crisis leader advisors. A qualitative research methodology using a phenomenological approach was employed. Forty-one participants were purposefully selected and administered a short, online survey consisting of 11 questions. Data were analyzed using percentage analysis, weighted sums, and inductive thematic analysis. The project team found an overwhelming support for the crisis leader advisor position and the crisis leader advisor certification program. Additionally, experience and trustworthiness ranked among the top sought after attributes of a crisis leader advisor. The team recommendations included (1) implement a crisis leaders advisor guide/framework; (2) create a formal crisis leader advisor position in national incident management system; (3) implement a crisis leader advisor certification framework; (4) benchmark established advisor programs; and (5) implement a framework to match leaders and advisors.

Are you ready? Crisis leadership in a hyper-VUCA environment.

PubMed

Alkhaldi, Khaldoon H; Austin, Meredith L; Cura, Boris A; Dantzler, Darrell; Holland, Leslie; Maples, David L; Quarrelles, Jamie C; Weinkle, Robert K; Marcus, Leonard J

The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes. The overall goal of the project is to increase the ability of the crisis leaders to more effectively and efficiently navigate crisis events resulting in more efficient and effective response and recovery. Three research questions were developed to assess the following: thoughts of integrating a crisis leader advisor position; development of a crisis leader advisor certification program; and attributes of crisis leader advisors. A qualitative research methodology using a phenomenological approach was employed. Forty-one participants were purposefully selected and administered a short, on-line survey consisting of 11 questions. Data were analyzed using percentage analysis, weighted sums, and inductive thematic analysis. The project team found an overwhelming support for the crisis leader advisor position and the crisis leader advisor certification program. Additionally, experience and trustworthiness ranked among the top sought after attributes of a crisis leader advisor. The team recommendations included (1) implement a crisis leaders advisor guide/framework; (2) create a formal crisis leader advisor position in national incident management system; (3) implement a crisis leader advisor certification framework; (4) benchmark established advisor programs; and (5) implement a framework to match leaders and advisors.

Are you ready? Crisis leadership in a hyper-VUCA environment.

PubMed

Alkhaldi, Khaldoon H; Austin, Meredith L; Cura, Boris A; Dantzler, Darrell; Holland, Leslie; Maples, David L; Quarrelles, Jamie C; Weinkle, Robert K; Marcus, Leonard J

The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes. The overall goal of the project is to increase the ability of the crisis leaders to more effectively and efficiently navigate crisis events resulting in more efficient and effective response and recovery. Three research questions were developed to assess the following: thoughts of integrating a crisis leader advisor position; development of a crisis leader advisor certification program; and attributes of crisis leader advisors. A qualitative research methodology using a phenomenological approach was employed. Forty-one participants were purposefully selected and administered a short, on-line survey consisting of 11 questions. Data were analyzed using percentage analysis,weighted sums, and inductive thematic analysis. The project team found an overwhelming support for the crisis leader advisor position and the crisis leader advisor certification program. Additionally, experience and trustworthiness ranked among the top sought after attributes of a crisis leader advisor. The team recommendations included (1) implement a crisis leaders advisor guide/framework; (2) create a formal crisis leader advisor position in national incident management system; (3) implement a crisis leader advisor certification framework; (4) benchmark established advisor programs; and (5) implement a framework to match leaders and advisors.

Learning Crisis Unit through Post-Crisis: Characteristics and Mechanisms

ERIC Educational Resources Information Center

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…

Towards National eHealth Implementation--a comparative study on WHO/ITU National eHealth Strategy Toolkit in Iran.

PubMed

Riazi, Hossein; Jafarpour, Maryam; Bitaraf, Ehsan

2014-01-01

Experiences has shown that utilization of ICT in health sector requires national commitment and planned efforts to make the best use of existing capacity. Establishing the main directions as well as planning the detailed steps needed are key to achieving longer-term goals such as health sector efficiency, reform or more fundamental transformation. Collaboration between the health and ICT sectors, both public and private, is central to this effort. As the major United Nations agencies for health and telecommunications respectively, the World Health Organization (WHO) and the International Telecommunication Union (ITU) have recognized the importance of collaboration for eHealth in their global resolutions, which encourage countries to develop national eHealth strategies; the National eHealth Strategy Toolkit is the proof of these recommendations. In this study a mapping of eHealth components in WHO/ITU National eHealth Strategy Toolkit and our national eHealth vision is presented.

Gender, money and professional identity: medical social work and the coming of the British National Health Service.

PubMed

Gosling, George Campbell

2018-01-01

The arrival of the British National Health Service (NHS) in 1948 heralded significant changes for all health workers, but the establishment of a 'free' health service was especially meaningful for the hospital almoners-or medical social workers, as they were starting to be known-who had previously been responsible for the assessment and collection of patient payments. It was on this basis they had gained a foothold in the hospital, capitalising on gendered assumptions of financial understanding and behaviour. Yet what might have caused an identity crisis was embraced. This was a dual strategy of both repositioning the profession in alignment with the planned NHS and of asserting an enhanced professional status by distancing themselves from the handling of payment. It was an episode in the history of this distinctly female profession that speaks to women's historic relationship with money.

Portrayal of the Human Resource Crisis and Accountability in Healthcare: A Qualitative Analysis of Ugandan Newspapers

PubMed Central

Wojczewski, Silvia; Willcox, Merlin; Mubangizi, Vincent; Hoffmann, Kathryn; Peersman, Wim; Niederkrotenthaler, Thomas; Natukunda, Silvia; Maling, Samuel; Maier, Manfred; Mant, David; Kutalek, Ruth

2015-01-01

Background Uganda is one of the 57 countries with a critical shortage of health workers. The aim of this study was to determine how the human resources and health service crisis was covered in Ugandan newspapers and, in particular, how the newspapers attributed accountability for problems in the health services. Methods We collected all articles related to health workers and health services for the calendar year 2012 in the two largest national newspapers in Uganda (collection on daily basis) and in one local newspaper (collection on weekly basis). These articles were analysed qualitatively regarding the main themes covered and attribution of accountability. Results The two more urban national newspapers published 229 articles on human resources and health services in Uganda (on average over two articles per week), whereas the local more rural newspaper published only a single article on this issue in the 12 month period. The majority of articles described problems in the health service without discussing accountability. The question of accountability is raised in only 46% of articles (106 articles). The responsibility of the government was discussed in 50 articles (21%), and negligence, corruption and misbehaviour by individual health workers was reported in 56 articles (25%). In the articles about corruption (n=35), 60% (21 articles) mention corruption by health workers and 40% (14 articles) mention corruption by government officials. Six articles defended the situation of health workers in Uganda. Conclusions The coverage of accountability in the Ugandan newspapers surveyed is insufficient to generate informed debate on what political actions need to be taken to improve the crisis in health care and services. There exists not only an “inverse care law” but also an “inverse information law”: those sections of society with the greatest health needs and problems in accessing quality health care receive the least information about health services. PMID

Portrayal of the human resource crisis and accountability in healthcare: a qualitative analysis of ugandan newspapers.

PubMed

Wojczewski, Silvia; Willcox, Merlin; Mubangizi, Vincent; Hoffmann, Kathryn; Peersman, Wim; Niederkrotenthaler, Thomas; Natukunda, Silvia; Maling, Samuel; Maier, Manfred; Mant, David; Kutalek, Ruth

2015-01-01

Uganda is one of the 57 countries with a critical shortage of health workers. The aim of this study was to determine how the human resources and health service crisis was covered in Ugandan newspapers and, in particular, how the newspapers attributed accountability for problems in the health services. We collected all articles related to health workers and health services for the calendar year 2012 in the two largest national newspapers in Uganda (collection on daily basis) and in one local newspaper (collection on weekly basis). These articles were analysed qualitatively regarding the main themes covered and attribution of accountability. The two more urban national newspapers published 229 articles on human resources and health services in Uganda (on average over two articles per week), whereas the local more rural newspaper published only a single article on this issue in the 12 month period. The majority of articles described problems in the health service without discussing accountability. The question of accountability is raised in only 46% of articles (106 articles). The responsibility of the government was discussed in 50 articles (21%), and negligence, corruption and misbehaviour by individual health workers was reported in 56 articles (25%). In the articles about corruption (n=35), 60% (21 articles) mention corruption by health workers and 40% (14 articles) mention corruption by government officials. Six articles defended the situation of health workers in Uganda. The coverage of accountability in the Ugandan newspapers surveyed is insufficient to generate informed debate on what political actions need to be taken to improve the crisis in health care and services. There exists not only an "inverse care law" but also an "inverse information law": those sections of society with the greatest health needs and problems in accessing quality health care receive the least information about health services.

Effects of the financial crisis and Troika austerity measures on health and health care access in Portugal.

PubMed

Legido-Quigley, Helena; Karanikolos, Marina; Hernandez-Plaza, Sonia; de Freitas, Cláudia; Bernardo, Luís; Padilla, Beatriz; Sá Machado, Rita; Diaz-Ordaz, Karla; Stuckler, David; McKee, Martin

2016-07-01

Although Portugal has been deeply affected by the global financial crisis, the impact of the recession and subsequent austerity on health and to health care has attracted relatively little attention. We used several sources of data including the European Union Statistics for Income and Living Conditions (EU-SILC) which tracks unmet medical need during the recession and before and after the Troika's austerity package. Our results show that the odds of respondents reporting having an unmet medical need more than doubled between 2010 and 2012 (OR=2.41, 95% CI 2.01-2.89), with the greatest impact on those in employment, followed by the unemployed, retired, and other economically inactive groups. The reasons for not seeking care involved a combination of factors, with a 68% higher odds of citing financial barriers (OR=1.68, 95% CI 1.32-2.12), more than twice the odds of citing waiting times and inability to take time off work or family responsibilities (OR 2.18, 95% CI 1.20-3.98), and a large increase of reporting delaying care in the hope that the problem would resolve on its own (OR=13.98, 95% CI 6.51-30.02). Individual-level studies from Portugal also suggest that co-payments at primary and hospital level are having a negative effect on the most vulnerable living in disadvantaged areas, and that health care professionals have concerns about the impact of recession and subsequent austerity measures on the quality of care provided. The Portuguese government no longer needs external assistance, but these findings suggest that measures are now needed to mitigate the damage incurred by the crisis and austerity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

ERIC Educational Resources Information Center

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…

National Health Expenditures, 1982

PubMed Central

Gibson, Robert M.; Waldo, Daniel R.; Levit, Katharine R.

1983-01-01

Rapid growth in the share of the nation's gross national product devoted to health expenditure has heightened concern over the survival of government entitlement programs and has led to debate of the desirability of current methods of financing health care. In this article, the authors present the data at the heart of the issue, quantifying spending for various types of health care in 1982 and discussing the sources of funds for that spending. PMID:10310273

National Health Expenditures, 1978

PubMed Central

Gibson, Robert M.

1979-01-01

Outlays for health care in the Nation reached $192.4 billion in calendar year 1978--13 percent higher than in 1977, according to preliminary figures compiled by the Health Care Financing Administration. This estimate represented $863 per person in the United States and was equal to 9.1 percent of the GNP. This latest report in the annual series representing national health expenditures provides detailed estimates of health care spending by type of service and method of financing. Revised estimates are presented extending back to 1965. PMID:10309049

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Food insecurity and mental health: surprising trends among community health volunteers in Addis Ababa, Ethiopia during the 2008 food crisis.

PubMed

Maes, Kenneth C; Hadley, Craig; Tesfaye, Fikru; Shifferaw, Selamawit

2010-05-01

The 2008 food crisis may have increased household food insecurity and caused distress among impoverished populations in low-income countries. Policy researchers have attempted to quantify the impact that a sharp rise in food prices might have on population wellbeing by asking what proportion of households would drop below conventional poverty lines given a set increase in prices. Our understanding of the impact of food crises can be extended by conducting micro-level ethnographic studies. This study examined self-reported household food insecurity (FI) and common mental disorders (CMD) among 110 community health AIDS care volunteers living in Addis Ababa, Ethiopia during the height of the 2008 food crisis. We used generalized estimating equations that account for associations between responses given by the same participants over 3 survey rounds during 2008, to model the longitudinal response profiles of FI, CMD symptoms, and socio-behavioral and micro-economic covariates. To help explain the patterns observed in the response profiles and regression results, we examine qualitative data that contextualize the cognition and reporting behavior of AIDS care volunteers, as well as potential observation biases inherent in longitudinal, community-based research. Our data show that food insecurity is highly prevalent, that is it associated with household economic factors, and that it is linked to mental health. Surprisingly, the volunteers in this urban sample did not report increasingly severe FI or CMD during the peak of the 2008 food crisis. This is a counter-intuitive result that would not be predicted in analyses of population-level data such as those used in econometrics simulations. But when these results are linked to real people in specific urban ecologies, they can improve our understanding of the psychosocial consequences of food price shocks. Copyright 2010 Elsevier Ltd. All rights reserved.

Building the national health information infrastructure for personal health, health care services, public health, and research

PubMed Central

Detmer, Don E

2003-01-01

Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII) offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries). The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security) framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin PMID:12525262

Financial Management during Crisis (For Parents)

MedlinePlus

... can find themselves on the brink of financial free-fall when medical expenses pile up. Even so, maintaining your family's financial health is not impossible. With organization and careful planning, you can learn to manage your money during a medical crisis. Costs of Health Care ...

Crisis on campus: Eating disorder intervention from a developmental-ecological perspective.

PubMed

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.

Serious crisis in the practice of international health by the World Health Organization: the Commission on Social Determinants of Health.

PubMed

Banerji, Debabar

2006-01-01

The Commission on Social Determinants of Health (CSDH) is the latest effort by the World Health Organization to improve health and narrow health inequalities through action on social determinants. The CSDH does not note that much work has already been done in this direction, does not make a sufficient attempt to analyze why earlier efforts failed to yield the desired results, and does not seem to have devised approaches to ensure that it will be more successful this time. The CSDH intends to complement the work of the earlier WHO Commission on Macroeconomics and Health, which has not had the desired impact, and it is unclear how the CSDH can complement work that suffers from such serious infirmities. Inadequacies of both commissions reflect a crisis in the practice of international health at the WHO, stemming from a combination of unsatisfactory administrative practices and lack of technical competence to provide insights into the problems afflicting the most needy countries. Often the WHO has ended up distorting the rudimentary health systems of the poor countries, by pressuring them into accepting health policies, plans, and programs that lack sound scientific bases. The WHO no longer seems to take into account historical and political factors when it sets out to improve the health situation in low-income countries--which is supposed to be the focus of the CSDH. An alternative approach is suggested.

How Teacher Educators Can Address Our Nation's Financial Crisis

ERIC Educational Resources Information Center

Dowdell, John; McElfresh, Dwight; Sikula, John

2009-01-01

This article from Ashland University reports on what one university, well known for its Teacher Education programs, is doing in an economically depressed state to address our country's financial crisis. Ohio has mandated that financial literacy be taught in high schools by 2010. Reported herein is what is being done to prepare teachers for this…

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... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Government-Owned Inventions; Availability for Licensing AGENCY: Public Health Service, National Institutes of Health, HHS. ACTION: Notice... the indicated licensing contact at the Office of Technology Transfer, National Institutes of Health...

Defining crisis in families of individuals with autism spectrum disorders

PubMed Central

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 diagnosed with autism spectrum disorder. Thematic analysis revealed that crisis is characterized by factors influencing four major areas: demands, internal capabilities, external resources, and subjective appraisal. Understanding what crisis means to families of individuals with autism spectrum disorder can help inform effective preventative and crisis services. PMID:24254639

The financial crisis and the expected effects on vaccinations in Europe: a literature review.

PubMed

Maltezou, Helena C; Lionis, Christos

2015-07-01

Starting in 2008 several European countries experienced a financial crisis. Historically, diseases whose prevention and treatment depend highly on the continuity of healthcare re-emerge during political and financial crises. Evidence suggests that the current financial crisis has had an impact on the health and welfare of Europeans and that population health status and morbidity as well as mortality patterns may change in the coming years. At the same time decisions about expenditure for health services may impact the ability of public health providers to respond. It is expected that the current crisis will further exacerbate socioeconomic and health inequalities and novel vulnerable groups will emerge in addition to existing ones. We review the available evidence and discuss how the current crisis may have an impact on vaccine-preventable diseases and influence vaccination coverage rates in Europe.

Helping callers to the National Suicide Prevention Lifeline who are at imminent risk of suicide: the importance of active engagement, active rescue, and collaboration between crisis and emergency services.

PubMed

Draper, John; Murphy, Gillian; Vega, Eduardo; Covington, David W; McKeon, Richard

2015-06-01

In 2012, the SAMHSA-funded National Suicide Prevention Lifeline (Lifeline) completed implementation of the first national Policy for Helping Callers at Imminent Risk of Suicide across its network of crisis centers. The policy sought to: (1) provide a clear definition of imminent risk; (2) reflect the state of evidence, field experience, and promising practices related to reducing imminent risk through hotline interventions; and (3) provide a uniform policy and approach that could be applied across crisis center settings. The resulting policy established three essential principles: active engagement, active rescue, and collaboration between crisis and emergency services. A sample of the research and rationale that underpinned the development of this policy is provided here. In addition, policy implementation, challenges and successes, and implications for interventions to help Lifeline callers at imminent risk of suicide are detailed. © 2014 The Authors. Suicide and Life-Threatening Behavior published by Wiley Periodicals, Inc. on behalf of American Association of Suicidology.

National Health Care Skill Standards.

ERIC Educational Resources Information Center

National Consortium on Health Science and Technology Education, Okemos, MI.

This document presents the National Health Care Skill Standards, which were developed by the National Consortium on Health Science and Technology and West Ed Regional Research Laboratory, in partnership with educators and health care employers. The document begins with an overview of the purpose and benefits of skill standards. Presented next are…

Crisis engagement in mental health: a New Zealand Māori contribution.

PubMed

Drury, Nick; Munro, Te Ata

2008-10-01

The active engagement of clients in mental health services offers far greater chances of successful outcomes. When clients do not actively engage in treatment, their risk of becoming part of the population of 'high users' is greater. The 'high users' consume a disproportionate share of health resources, which may prevent other potential clients from accessing services. Engagement can be particularly challenging in crisis situations, which is how many clients attracting psychotic diagnoses first enter the service. New Zealand Māori bring a transcendent quality to the idea of 'respect for Other', which would make it sacrilegious to overpower Other in most situations. This paper reviews a growing body of literature indicating how we might integrate an enhanced respect or reverence of Other into clinical practice. This includes the idea of engaging more frequently with the social network when building rapport with an individual is particularly challenging. There is some evidence that services adopting this kind of approach are more economical.

National health expenditures, 1991

PubMed Central

Letsch, Suzanne W.; Lazenby, Helen C.; Levit, Katharine R.; Cowan, Cathy A.

1992-01-01

Spending for health care rose to $751.8 billion in 1991, an increase of 11.4 percent from the 1990 level. National health expenditures as a share of gross domestic product increased to 13.2 percent, up from 12.2 percent in 1990. The health care sector exhibited strong growth, despite slow growth in the overall economy. This combination resulted in the largest increase in the share of the Nation's output consumed by health care in the past three decades. In this article, the authors present estimates of health spending in the United States for 1991. The authors also examine reasons for the unusually large growth in Medicaid expenditures and highlight recent trends in the hospital sector. PMID:10127445

Listening to doctors on patients' use of healthcare during the crisis: uncovering a different picture and drawing lessons from Portugal.

PubMed

Correia, T; Carapinheiro, G; Carvalho, H; Silva, J M; Vieira, J

2017-06-01

The consequences of financial crises on patients' use of healthcare have been widely discussed. This paper seeks to ascertain whether the position of key players, i.e. doctors, may reveal realities other than those officially reported about the 2008 financial crisis. In 2013-14, a national survey of doctors was conducted in Portugal, which received international assistance in the wake of the financial crisis. An exploratory model comprising descriptive statistics, regression and independence analyses focused on doctors' experience of patients' use of medications, consultations, exams and treatment services, and whether they stopped treatments. According to doctors, an unspecified number of patients experienced difficulties using healthcare as more patients requested prescriptions for cheaper medications or simply stopped treatments. Significant variations were found according to speciality, years of practice and sector of activity. Cost-containment mechanisms are regarded as necessary. However, the evidence indicated a side effect, i.e. a decrease in patients' ability to use healthcare, including in the National Health Service (NHS). It also highlighted the need to listen to health professionals as key informants on patient's behaviour and the daily functioning of health services. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Community Health Crisis: Solving the Nurse Shortage.

ERIC Educational Resources Information Center

Vitiello, Erie

2003-01-01

Describes how Los Rios Community College District (LRCCD), California, the major provider of nursing graduates to the Sacramento area, addressed the issue of the nursing shortage crisis. LRCCD faced the dual issues of student/faculty ratio restrictions of 10/1 and funding that accommodated a 40/1 ratio. Describes LRCCD's new off-campus,…

Flood, disaster, and turmoil: social issues in cleft and craniofacial care and crisis relief.

PubMed

Strauss, Ronald P; van Aalst, John A; Fox, Lynn; Stein, Margot; Moses, Michael; Cassell, Cynthia H

2011-11-01

To examine social issues in the conduct of cleft and craniofacial care through relief programs in disrupted crisis contexts. Social, health policy, and ethical analyses. At best, craniofacial team care is multidisciplinary, coordinated, and sustained, requiring a long-term relationship between team members, patients, and families. Disasters and societal turmoil interrupt such relationships, causing craniofacial care to become a secondary concern. Providing craniofacial team care in a crisis setting requires rebuilding disrupted coordination and communication. Crisis relief care involves a complex set of expectations and responsibilities and raises issues such as (1) quality assurance, infection control, appropriate standards of care, and follow-up care/continuity; (2) equity of access to services and clinical ethics in the context of war and/or deprivation; (3) training of visitors in the local nation or site; (4) disciplinary composition of teams, interprofessional communication/rivalry, and credentials of clinicians; (5) ownership of the site and local visitor relations; (6) fundraising and marketing strategies; and (7) ethical issues in the doctor-patient relationship. Specific ethical standards for international cleft and craniofacial care delivery also apply to domestic and global crisis relief contexts. Guidance on issues related to professional experience, informed consent, and continuity of care will help care providers address social and ethical issues raised in crisis relief programs. This paper proposes that the Position Paper of the American Cleft Palate-Craniofacial Association (ACPA) on International Treatment Programs should be used as a template to develop and disseminate a set of standards that apply to crisis relief.

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

PubMed

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.

National Health Care Skill Standards.

ERIC Educational Resources Information Center

Far West Lab. for Educational Research and Development, San Francisco, CA.

This booklet contains draft national health care skill standards that were proposed during the National Health Care Skill Standards Project on the basis of input from more than 1,000 representatives of key constituencies of the health care field. The project objectives and structure are summarized in the introduction. Part 1 examines the need for…

Crisis prevention and management during SARS outbreak, Singapore.

PubMed

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.

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

PubMed

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.

PubMed

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.

Utilization of medical care following the Three Mile Island crisis.

PubMed Central

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. PMID:6691524

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

ERIC Educational Resources Information Center

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…

Access to Oral Health Care: A National Crisis and Call for Reform.

PubMed

Bersell, Catherine H

2017-02-01

Purpose: According to the report Healthy People 2020, oral health is integral to overall health and access to dental services is essential to promoting and maintaining good oral health. Yet, those who need dental care the most are often the least likely to receive it. The dental hygiene profession is poised to play a pivotal role in the resolution of oral health disparities. The purpose of this manuscript is to examine the critical issue of access to oral health care in the United States from various perspectives and consider potential implications for dental professionals and the oral health care system. This report focuses on major underserved and vulnerable populations and highlights several barriers that significantly affect the ability to access and navigate the oral health care system. These include low socioeconomic status; the shortage and maldistribution of dentists; a lack of professional training regarding current evidence-based oral health guidelines; deficient continuity of care due to inadequate interdisciplinary collaboration; low oral health literacy; and patient perceptions and misconceptions about preventive dental care. This report also contains an update on provider participation in Medicaid; the state of children's oral health; and emerging workforce models, state initiatives, and legislative reforms. Recommendations increasing access to care require local, state, and federal stakeholders to combine forces that take advantage of the existing dental hygiene workforce, utilize innovative delivery models, improve license reciprocity, reduce prohibitive supervision, and expand the dental hygiene scope of practice. The major focus of future research will be on the implementation of mid-level oral health care providers. Dental hygienists are an integral part of the access to care solution and have a great opportunity to lead the call to action and fulfill the American Dental Hygienists' Association's mandate that oral health care is the right of all