Listening Skills Training: Application to Crisis Intervention Programs.

ERIC Educational Resources Information Center

Coonfield, Ted J.; And Others

A review of the literature in listening behavior reveals an increasing interest in the importance of listening in the communication process and the therapeutic situation. Since crisis workers are continually confronted with feeling-laden messages in which the implicit, unspoken, and covert content is vital, empathic listening is a necessity. The…

Treatment Outcomes of a Crisis Intervention Program for Dementia with Severe Psychiatric Complications: The Kansas Bridge Project

ERIC Educational Resources Information Center

Johnson, David Kevin; Niedens, Michelle; Wilson, Jessica R.; Swartzendruber, Lora; Yeager, Amy; Jones, Kelly

2013-01-01

Purpose: Although declines in memory and attention are hallmark symptoms of Alzheimer's disease (AD), noncognitive symptoms are prevalent. Over 80% of individuals will experience neuropsychiatric symptoms, which complicates symptom profiles. Research indicates a community-integrated response to dementia crisis can reduce negative consequences…

Employee Assistance Programs in the 1980s: Expanding Career Options for Counselors.

ERIC Educational Resources Information Center

Forrest, Donald V.

1983-01-01

Suggests that Employee Assistance Programs (EAPS) offer new and expanded work opportunities for counselors. Reviews the history of EAPS, current philosophy and program components, and implications for counselors as EAPs move from crisis intervention toward prevention. (JAC)

Piloting a new model of crisis counseling: specialized crisis counseling services in Mississippi after Hurricane Katrina.

PubMed

Jones, Kris; Allen, Mardi; Norris, Fran H; Miller, Christy

2009-05-01

During January-April 2007, Project Recovery, a federally funded crisis counseling program implemented by Mississippi's Department of Mental Health, piloted a new model of Specialized Crisis Counseling Services (SCCS) on the Mississippi Gulf Coast. In this team-based approach, a masters-level counselor trained in a variety of intervention techniques and a resource coordinator worked together with persons whose needs were relatively intense. Compared to regular program (RCCS) participants over the same interval (n = 29,522), SCCS participants (n = 281) were more likely to be female, middle-aged, and at greater risk for severe distress. In a participant survey conducted in both programs over the same week, SCCS participants reported significantly greater benefit than did RCCS participants. A subset of 129 SCCS participants provided pre- and post-participation assessments and showed large improvements in disaster-related distress.

The Global Economic Crisis: Setbacks to the Educational Agenda for the Minority in Sub-Saharan Africa

ERIC Educational Resources Information Center

Ingubu, Moses Shiasha

2010-01-01

This paper captures the impact of the Global Economic Crisis on educational programs serving minority groups in developing countries. It has been established that the most vulnerable groupings include nomadic and pastoralist communities, slum dwellers, children in war zones, and women. Various educational interventions such as mobile schooling,…

Access to healthcare for the most vulnerable migrants: a humanitarian crisis.

PubMed

Pottie, Kevin; Martin, Jorge Pedro; Cornish, Stephen; Biorklund, Linn Maria; Gayton, Ivan; Doerner, Frank; Schneider, Fabien

2015-01-01

A series of Médecins Sans Frontières projects for irregular migrants over the past decade have consistently documented high rates of 14 physical and sexual trauma, extortion and mental illness amidst severe healthcare, food, and housing limitations. Complex interventions were needed to begin to address illness and barriers to healthcare and to help restore dignity to the most vulnerable women, children and men. Promising interventions included mobile clinics, use of cultural mediators, coordination with migrant-friendly entities and NGOs and integrating advocacy programs and mental health care with medical services. Ongoing interventions, research and coordination are needed to address this neglected humanitarian crisis.

32 CFR 1656.5 - Eligible employment.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., park and recreational activities, pollution control and monitoring systems, and disaster relief; (iv... retraining programs, senior citizens activities, crisis intervention and poverty relief; (v) Community...

32 CFR 1656.5 - Eligible employment.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., park and recreational activities, pollution control and monitoring systems, and disaster relief; (iv... retraining programs, senior citizens activities, crisis intervention and poverty relief; (v) Community...

[The Impact of Risk Factors and Effective Factors on Success in Crisis Intervention for Children and Adolescents].

PubMed

Wisiol, Florian; Juen, Barbara; Unterrainer, Christine

2017-05-01

The Impact of Risk Factors and Effective Factors on Success in Crisis Intervention for Children and Adolescents This article focuses on the evaluation of (inpatient) crisis interventions for children and adolescents, who can be admitted into the residential area of the KIZ for up to eight weeks in order to provide acute protection against massive violence, neglect or family conflicts in emergency situations. How successful the crisis intervention is or can be depends on various factors that have been worked out in this study. Various factors have an impact on success in crisis intervention; above all the participation, a good relationship and/or cooperation with the Counselors in the Crisis Intervention Center contribute to a great success. Restoring their own possibilities for action after a massive crisis, the strengthening of self-efficacy in crisis intervention must be considered critically. The young clients see little change here. The crisis intervention must therefore not only focus on its most important function, protection and security, but also on the strengthening of self-esteem and a positive sense of coherence as part of the crisis intervention.

45 CFR 1351.20 - What are the additional requirements under a Runaway and Homeless Youth Program grant?

Code of Federal Regulations, 2010 CFR

2010-10-01

..., such areas as: • Program Management, • Fiscal Management, • Development of coordinated networks of... and Family counseling, and • Crisis intervention techniques. (b) Grantees will be required to...

A School Based Intervention for Combating Food Insecurity and Promoting Healthy Nutrition in a Developed Country Undergoing Economic Crisis: A Qualitative Study

ERIC Educational Resources Information Center

Dalma, A.; Veloudaki, A.; Petralias, A.; Mitraka, K.; Zota, D.; Kastorini, C.-M.; Yannakoulia, M.; Linos, A.

2015-01-01

Introduction: Aiming at reducing the rates of food insecurity and promoting healthy diet for children and adolescents, we designed and implemented the Program on Food Aid and Promotion of Healthy Nutrition-DIATROFI, a school-based intervention program including the daily provision of a free healthy mid-day meal in disadvantaged areas across…

[Provincial public center for crisis intervention and psycho-social rehabilitation. A path towards communitary suicidology].

PubMed

Martínez, Carlos

2014-01-01

This work on the systematic comprehensive approach towards the Prevention and Postvencion of Suicide started to develop back in mid 2011 in Río Gallegos, capital of Santa Cruz Province. The first step on this development was a Pilot Plan for the Training of Professionals and also field intervention. The Center for Crisis Intervention and Psycho-social Rehabilitation was founded eight months later. The case-client in crisis plus family group- undergoes quantitative and qualitative evaluation by means of a triage system, all of which allows starting intensive face-to-face and also phone follow up according to the Crisis Intervention Model. Such intervention is developed by means of the participation in the "Grupo Sostén", the Adolescents Group if the client fits into that age, and also family relationship interviews as well as Multi-family meetings open to the Community. There is also a Community Team in the Center which performs collective assessment in schools, in conjunction with the "Equidad en Redes" Educational Specialty Team, belonging to the Provincial Education Council. The approach takes place on the field, and works as a screening step for the early detection of risk. Such risk is dealt with by means of short term intervention group programs involving the whole of the educational community. When facing situations of committed suicide there are interventions in communities to the interior of the province, fundamentally through the Hospital Team which works as the cluster convener for the social intersectoral frame-work.

Modified crisis intervention for personality disorder.

PubMed

Rudnick, A

1998-01-01

This study proposes that the goal of crisis intervention for persons with personality disorders should be to return them to their pre-crisis level of functioning, even though this is maladaptive. This is contrasted with standard crisis intervention, which aims to return normal or neurotic persons to their pre-crisis normal or neurotic functioning, usually by means of few and short-term therapeutic encounters. The modification proposed costs more time and resources in persons with personality disorders in crisis and fits the intervention to the personality type. This is illustrated by the case of Eve, a patient in crisis, whose pre-crisis functioning was maladaptive because of a dependent personality disorder. The goal of (modified) crisis intervention in this case was to return the patient to her dependent lifestyle, by means of pharmacotherapy combined with intensive supportive psychotherapy during 3-4 months of partial (day) hospitalization. The special nature of crisis in personality disorders is discussed.

An Evaluation of On-Line, Interactive Tutorials Designed to Teach Practice Concepts

ERIC Educational Resources Information Center

Seabury, Brett A.

2005-01-01

This paper presents an evaluation of two on-line-based programs designed to teach practice skills. One program teaches crisis intervention and the other teaches suicide assessment. The evaluation of the use of these programs compares outcomes for two groups of students, one using the interactive program outside a class context and the other using…

Midlife crisis perceptions, experiences, help-seeking, and needs among multi-ethnic malaysian women.

PubMed

Wong, Li Ping; Awang, Halimah; Jani, Rohana

2012-01-01

In the present study, researchers explored attitudes toward midlife crises, experience with midlife crises, help-seeking, and needs among multi-ethnic Malaysian women. A total of 14 focus group discussions were conducted with 89 Malaysian women of different ages and socioeconomic backgrounds. Women expressed concern over physical aging and decline in their physical functional health. Having a midlife crisis was frequently reported. Issues that were frequently reported to trigger a midlife crisis, such as empty nest syndrome, impact of aging on sexual and reproductive function, extended parenthood, caring for aging or ill parents, and career challenges were noted by the study participants (listed here in order of most to least frequently reporting of these themes across the group discussions). Overall, these issues were associated with attitudes about aging. A comparatively less open attitude toward sexual attitudes and help-seeking for sexual problems were found among the Malay and Indian women. This may imply that intervention to increase positive attitudes concerning both sexuality and help-seeking intentions should be culturally specific. The use of religious coping for comfort and consolation was frequently reported; therefore, those providing midlife crisis prevention and intervention programs should consider involving faith-based interventions in the Malaysian setting.

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.

Integrating School-Based and Therapeutic Conflict Management Models at School.

ERIC Educational Resources Information Center

D'Oosterlinck, Franky; Broekaert, Eric

2003-01-01

Explores the possibility of integrating school-based and therapeutic conflict management models, comparing two management models: a school-based conflict management program, "Teaching Students To Be Peacemakers"; and a therapeutic conflict management program, "Life Space Crisis Intervention." The paper concludes that integration might be possible…

The Development of a Multi-Level Model for Crisis Preparedness and Intervention in the Greek Educational System

ERIC Educational Resources Information Center

Hatzichristiou, Chryse; Issari, Philia; Lykitsakou, Konstantina; Lampropoulou, Aikaterini; Dimitropoulou, Panayiota

2011-01-01

This article proposes a multi-level model for crisis preparedness and intervention in the Greek educational system. It presents: a) a brief overview of leading models of school crisis preparedness and intervention as well as cultural considerations for contextually relevant crisis response; b) a description of existing crisis intervention…

Pre-Crisis Intervention Strategies for Reducing Unacceptable Behaviors by Exceptional Students in a Public Elementary School.

ERIC Educational Resources Information Center

Levine-Brown, Linda S.

This report describes the implementation of a data-based program to reduce unacceptable student behaviors and decrease the number of administrative interventions with 21 students with severe emotional disturbances. A computerized database was developed to track classroom and transportation discipline infractions. Students met monthly to review…

PROVE Schools: The Extended School Day Program; A Study in Programming Philosophy & Direction.

ERIC Educational Resources Information Center

Erdman, Richard D.; Manning, Timothy J.

The paper describes the PROVE School, an alternative high school providing behavioral and academic programming using an extended school day concept for profoundly behavior disordered students in Proviso township, Maywood, Illinois. The extended day concept of crisis intervention (in which students are allowed to leave school for the day only when…

Conversations with Youth in Conflict

ERIC Educational Resources Information Center

D'Oosterlinck, Franky; Broekaert, Eric; Denoo, Inge

2006-01-01

Seventeen children and youth in a treatment program in Belgium were interviewed about their experiences in conflict. They shared their theories of behaviour and perceptions of Life Space Crisis Intervention (LSCI) being employed by staff in their setting.

Continuing Education on Suicide Assessment and Crisis Intervention for Social Workers and Other Mental Health Professionals: A Follow-Up Study

ERIC Educational Resources Information Center

Mirick, Rebecca G.; Bridger, Joanna; McCauley, James; Berkowitz, Larry

2016-01-01

Historically, graduate training programs have not taught suicide assessment and intervention skills in depth; therefore, the development of effective continuing education offerings is relevant and necessary for practicing social workers. Although the ability to increase knowledge and confidence is critical, a focus on competency-based education…

Suicide Intervention in the Schools. The Guilford School Practitioners Series.

ERIC Educational Resources Information Center

Poland, Scott

Suicide is the second leading cause of death for teenagers. The rate has increased by 300% since the 1950s. By establishing a comprehensive, well-organized crisis intervention program, schools can do a great deal to prevent teenage suicide, and to help the school community survive if a tragedy cannot be averted. This book provides professionals…

The Efficacy of Crisis Intervention Training for Educators: A Preliminary Study from the United States

ERIC Educational Resources Information Center

Forthun, Larry F.; McCombie, Jeffrey W.

2011-01-01

Professional development in crisis intervention skills can help address the growing needs of schools to train faculty to respond to students in acute crisis. Unlike traditional methods of classroom management, crisis intervention training teaches specific strategies to de-escalate conflict while at the same time addressing the underlying…

American Red Cross Disaster Mental Health Services: Implementation and Recent Developments.

ERIC Educational Resources Information Center

Morgan, Jane

1995-01-01

The American Red Cross (ARC) Disaster Mental Health Services program uses a multidisciplinary approach to deliver crisis intervention to disaster workers and victims after hurricanes. Discusses the impetus for the ARC's development of the program, its early implementation, and ongoing challenges in the further development of this approach to…

An Evaluation of the Employee Assistance Program in the Montgomery County Public School System.

ERIC Educational Resources Information Center

Goldberg, Jo Ann

The Montgomery County public school system presently provides assistance through the Employee Assistance Program (EAP) to troubled employees with problems which affect work performance. EAP's mandate is to provide crisis intervention, prereferral evaluation, information, referral, and follow-up services. From its inception to March, 1981, EAP…

Community Action, Urban Reform, and the Fight against Poverty: The Ford Foundation's Gray Areas Program.

ERIC Educational Resources Information Center

O'Connor, Alice

1996-01-01

Describes the process by which experimental Ford Foundation programs designed to stem the urban crisis evolved into more narrowly constructed interventions to reform service delivery systems and alleviate poverty in inner-city neighborhoods. Related themes are highlighted and limitations caused by problems of institutional constraints, political…

Crisis intervention for people with severe mental illnesses

PubMed Central

Murphy, Suzanne; Irving, Claire B; Adams, Clive E; Driver, Ron

2014-01-01

Background A particularly difficult challenge for community treatment of people with serious mental illnesses is the delivery of an acceptable level of care during the acute phases of severe mental illness. Crisis intervention models of care were developed as a possible solution. Objectives To review the effects of crisis intervention models for anyone with serious mental illness experiencing an acute episode, compared with ‘standard care’. Search methods We updated the 1998, 2003 and 2006 searches with a search of the Cochrane Schizophrenia Group’s Register of trials (2010) which is based on regular searches of CINAHL, EMBASE, MEDLINE, and PsycINFO. Selection criteria We included all randomised controlled trials of crisis intervention models versus standard care for people with severe mental illnesses. Data collection and analysis We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assumed that people who left early from a trial had no improvement. Main results Three new studies have been found since the last review in 2006 to add to the five studies already included in this review. None of the previously included studies investigated crisis intervention alone; all used a form of home care for acutely ill people, which included elements of crisis intervention. However, one of the new studies focuses purely on crisis intervention as provided by Crisis Resolution Home Teams within the UK; the two other new studies investigated crisis houses i.e. residential alternatives to hospitalisation providing home-like environments. Crisis intervention appears to reduce repeat admissions to hospital after the initial ‘index’ crises investigated in the included studies, this was particularly so for mobile crisis teams supporting patients in their own homes. Crisis intervention reduces the number of people leaving the study early, reduces family burden, is a more satisfactory form of care for both patients and families and at three months after crisis, mental state is superior to standard care. We found no differences in death outcomes. Some studies found crisis interventions to be more cost effective than hospital care but all numerical data were either skewed or unusable. No data on staff satisfaction, carer input, complications with medication or number of relapses were available. Authors’ conclusions Care based on crisis intervention principles, with or without an ongoing home care package, appears to be a viable and acceptable way of treating people with serious mental illnesses. If this approach is to be widely implemented it would seem that more evaluative studies are still needed. PMID:22592673

Police Responses to Persons With Mental Illness: Going Beyond CIT Training.

PubMed

Steadman, Henry J; Morrissette, David

2016-10-01

Since 1988, a major development to reduce lethal encounters between police and persons displaying signs of mental illness has been the adoption by many police departments of crisis intervention teams (CITs). Created in Memphis, Tennessee, CIT programs incorporate deescalation training, police-friendly drop-off centers, and linkage to community treatment programs. The authors summarize issues discussed at a recent Substance Abuse and Mental Health Services Administration workshop at which participants highlighted the importance of going beyond CIT training to most effectively include police in a crisis care continuum model. Such an approach focuses on how police can be engaged as partners with behavioral health providers who are designing and implementing services in the crisis care continuum. Reframing the approach to police responses to persons in mental health crises offers the prospect of improving both public health and public safety goals.

Rationale for cannabis-based interventions in the opioid overdose crisis.

PubMed

Lucas, Philippe

2017-08-18

North America is currently in the grips of a crisis rooted in the use of licit and illicit opioid-based analgesics. Drug overdose is the leading cause of accidental death in Canada and the US, and the growing toll of opioid-related morbidity and mortality requires a diversity of novel therapeutic and harm reduction-based interventions. Research suggests that increasing adult access to both medical and recreational cannabis has significant positive impacts on public health and safety as a result of substitution effect. Observational and epidemiological studies have found that medical cannabis programs are associated with a reduction in the use of opioids and associated morbidity and mortality. This paper presents an evidence-based rationale for cannabis-based interventions in the opioid overdose crisis informed by research on substitution effect, proposing three important windows of opportunity for cannabis for therapeutic purposes (CTP) to play a role in reducing opioid use and interrupting the cycle towards opioid use disorder: 1) prior to opioid introduction in the treatment of chronic pain; 2) as an opioid reduction strategy for those patients already using opioids; and 3) as an adjunct therapy to methadone or suboxone treatment in order to increase treatment success rates. The commentary explores potential obstacles and limitations to these proposed interventions, and as well as strategies to monitor their impact on public health and safety. The growing body of research supporting the medical use of cannabis as an adjunct or substitute for opioids creates an evidence-based rationale for governments, health care providers, and academic researchers to consider the implementation and assessment of cannabis-based interventions in the opioid crisis.

The Implementation of Life Space Crisis Intervention as a School-Wide Strategy for Reducing Violence and Supporting Students' Continuation in Public Schools

ERIC Educational Resources Information Center

Ramin, John E.

2011-01-01

The purpose of this study was to explore the effectiveness of implementing Life Space Crisis Intervention as a school-wide strategy for reducing school violence. Life Space Crisis Intervention (LSCI) is a strength-based verbal interaction strategy (Long, Fecser, Wood, 2001). LSCI utilizes naturally occurring crisis situations as teachable…

[Crisis intervention--the summary of a unique interventional program for medical students].

PubMed

Perry, Zvi; Busiba, Ziva; Uziel, Elia; Meiri, Gal

2009-02-01

In their daily work, physicians encounter varied illnesses, often accompanied with an emotional crisis that engulfs both the patient and his/her family. Research has shown that physicians find this part of their occupation extremely harsh, especially when conveying to the patient the initial bad news about his condition. Most medical school curricula published do not have any training programs for medical students in this expertise. The Patient's Rights Act and the current need of patients to be involved in their treatment have made it even more important to train would-be physicians on how to convey bad news. The Faculty of Health Sciences at the Ben-Gurion University is among the pioneers in articulating a formal curriculum on how to convey bad news and crisis intervention. The clinical workshop "Crisis Intervention" is aimed at 2nd year medical students, and has been taught at this school for the last 15 years, confronting these issues head-on. The course is conducted by an expert psychiatrist and an experienced social worker. The course is aimed at providing the students with theoretical background on the crisis and the emotional turmoil caused by medical emergencies, as well as to expose the students to real life crisis situations of patients and their families, thereby exposing them to optimal management of these situations. During this 4-day workshop, students learn how to convey bad news, as well as to understand its impact upon patients and their families. In the workshop emphasis is placed on the ethical and legal issues that evolve when caring for extremely ill patients. In the current article the authors unfold the techniques, theoretical and pedagogical issues of the workshop. The authors used semi-structured questionnaires to evaluate the course, and found that the students considered this workshop to be an interesting and relevant course. Using the results shown, as well as an oral debriefing after the course with class representatives, the authors found that student involvement in different wards has exposed them to various methods of crisis management. The close chaperoning of students by an attending physician, as well as the wards social worker, has shown the students a good example of staff involvement in the patient's emotional turmoil in the midst of his medical crisis. This learning process, which is mainly experiential in nature, and which is reinforced academically by the frontal lectures, as well as learning in small groups and class discussions, has enabled our students to meet and hopefully identify with a more humane perception of the physician, as one whose professionalism is measured not only by his clinical skills, but also by his communication skills.

Attribution Theory and Crisis Intervention Therapy.

ERIC Educational Resources Information Center

Skilbeck, William M.

It was proposed that existing therapeutic procedures may influence attributions about emotional states. Therefore an attributional analysis of crisis intervention, a model of community-based, short-term consultation, was presented. This analysis suggested that crisis intervention provides attributionally-relevant information about both the source…

Identifying the causes, prevention and management of crises in dementia. An online survey of stakeholders.

PubMed

Ledgerd, Ritchard; Hoe, Juanita; Hoare, Zoë; Devine, Mike; Toot, Sandeep; Challis, David; Orrell, Martin

2016-06-01

Crisis situations in dementia can lead to hospital admission or institutionalisation. Offering immediate interventions may help avoid admission, whilst stabilising measures can help prevent future crises. Our objective was to identify the main causes of crisis and interventions to treat or prevent crisis in persons with dementia based on different stakeholder perspectives. An online questionnaire was developed to identify the causes of crisis and appropriate interventions in a crisis. Participants included people with dementia, family carers and staff working in health and social care, including emergency and voluntary sectors, and academia. The results ranked the main causes of crisis, interventions that can prevent a crisis and interventions that can be useful in a crisis. Wandering, falls and infection were highly rated as risk factors for crises across all stakeholder groups. Consumers rated aggression as less important but severity of memory impairment as much more important than the other groups did. Education and support for family carers and home care staff were highly valued for preventing crises. Well-trained home care staff, communication equipment, emergency contacts and access to respite were highly valued for managing crises. We identified triggers and interventions that different stakeholders see as important for crisis in dementia. Recognition of these may be critical to planning effective and accepted support and care for people with dementia. Copyright © 2015 John Wiley & Sons, Ltd.

Crisis Management: Research Summaries

ERIC Educational Resources Information Center

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

2013-01-01

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

Crisis intervention related to the use of psychoactive substances in recreational settings--evaluating the Kosmicare Project at Boom Festival.

PubMed

Carvalho, Maria Carmo; de Sousa, Mariana Pinto; Frango, Paula; Dias, Pedro; Carvalho, Joana; Rodrigues, Marta; Rodrigues, Tania

2014-01-01

Kosmicare project implements crisis intervention in situations related to the use of psychoactive substances at Boom Festival (Portugal). We present evaluation research that aims to contribute to the transformation of the project into an evidence-based intervention model. It relies on harm reduction and risk minimization principles, crisis intervention models, and Grof's psychedelic psychotherapy approach for crisis intervention in situations related to unsupervised use of psychedelics. Intervention was expected to produce knowledge about the relation between substance use and mental health impact in reducing potential risk related to the use of psychoactive substances and mental illness, as well as an impact upon target population's views of themselves, their relationship to substance use, and to life events in general. Research includes data on process and outcome indicators through a mixed methods approach, collected next to a sample of n=176 participants. Sample size varied considerably, however, among different research measures. 52% of Kosmicare visitors reported LSD use. Over 40% also presented multiple drug use. Pre-post mental state evaluation showed statistically significant difference (p<.05) confirming crisis resolution. Crisis episodes that presented no resolution were more often related with mental health outburst episodes, with psychoactive substance use or not. Visitors showed high satisfaction with intervention (n=58) and according to follow-up (n=18) this perception was stable over time. Crisis intervention was experienced as very significant. We discuss limitations and implications of evaluating natural setting based interventions, and the relation between psychoactive substance use and psychopathology. Other data on visitor's profile and vulnerability to crisis showed inconclusive.

Radiology Resident Supply and Demand: A Regional Perspective.

PubMed

Pfeifer, Cory M

2017-09-01

Radiology was subject to crippling deficits in the number of jobs available to graduates of training programs from 2012 through 2015. As the specialty transitions to the assimilation of osteopathic training programs and the welcoming of direct competition from new integrated interventional radiology programs, the assessment of growth in radiology training positions over the 10 years preceding this pivotal time will serve to characterize the genesis of the crisis while inspiring stakeholders to avoid similar negative fluctuations in the future. The number of per capita radiology trainees in each region was derived from data published by the National Resident Matching Program, as were annual match statistics over the years 2012 through 2016. Data regarding new interventional radiology and diagnostic radiology enrollees were also obtained from the National Resident Matching Program. The seven states with the most per capita radiology residents were in the Mid-Atlantic and Northeastern United States in both 2006 and 2016, and three of these seven also showed the greatest per capita growth over the course of the 10 years studied. New radiology programs were accredited during the peak of the job shortage. Integrated interventional radiology training created 24 de novo radiology residents in the 2017 match. Fill rates are weakly positively correlated with program size. Unregulated radiology program growth persisted during the decade leading up to 2016. The region with the fewest jobs available since 2012 is also home to the greatest number of per capita radiology residents. Numerous published opinions during the crisis did not result in enforced policy change. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

45 CFR 96.89 - Exemption from standards for providing energy crisis intervention assistance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Exemption from standards for providing energy crisis intervention assistance. 96.89 Section 96.89 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... from standards for providing energy crisis intervention assistance. The performance standards in...

45 CFR 96.89 - Exemption from standards for providing energy crisis intervention assistance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Exemption from standards for providing energy crisis intervention assistance. 96.89 Section 96.89 Public Welfare Department of Health and Human... from standards for providing energy crisis intervention assistance. The performance standards in...

45 CFR 96.89 - Exemption from standards for providing energy crisis intervention assistance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Exemption from standards for providing energy crisis intervention assistance. 96.89 Section 96.89 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... from standards for providing energy crisis intervention assistance. The performance standards in...

45 CFR 96.89 - Exemption from standards for providing energy crisis intervention assistance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Exemption from standards for providing energy crisis intervention assistance. 96.89 Section 96.89 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... from standards for providing energy crisis intervention assistance. The performance standards in...

45 CFR 96.89 - Exemption from standards for providing energy crisis intervention assistance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Exemption from standards for providing energy crisis intervention assistance. 96.89 Section 96.89 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... from standards for providing energy crisis intervention assistance. The performance standards in...

Strengthening Rural Schools: Training Paraprofessionals in Crisis Prevention and Intervention.

ERIC Educational Resources Information Center

Allen, Melissa; Ashbaker, Betty Y.; Stott, Kathryn A.

The long-term effects of crisis and tragedy can be improved significantly by immediate intervention and emergency mental health services. Providing crisis intervention in rural schools poses challenges related to lack of financial resources, community resources, and trained personnel; isolation of rural schools; and long distances between school…

Financial Bubbles, Real Estate Bubbles, Derivative Bubbles, and the Financial and Economic Crisis

NASA Astrophysics Data System (ADS)

Sornette, Didier; Woodard, Ryan

The financial crisis of 2008, which started with an initially well-defined epicenter focused on mortgage backed securities (MBS), has been cascading into a global economic recession, whose increasing severity and uncertain duration has led and is continuing to lead to massive losses and damage for billions of people. Heavy central bank interventions and government spending programs have been launched worldwide and especially in the USA and Europe, with the hope to unfreeze credit and bolster consumption. Here, we present evidence and articulate a general framework that allows one to diagnose the fundamental cause of the unfolding financial and economic crisis: the accumulation of several bubbles and their interplay and mutual reinforcement have led to an illusion of a "perpetual money machine" allowing financial institutions to extract wealth from an unsustainable artificial process. Taking stock of this diagnostic, we conclude that many of the interventions to address the so-called liquidity crisis and to encourage more consumption are ill-advised and even dangerous, given that precautionary reserves were not accumulated in the "good times" but that huge liabilities were. The most "interesting" present times constitute unique opportunities but also great challenges, for which we offer a few recommendations.

Making Psychology in the Schools Indispensable: Crisis Intervention for Fun and Profit.

ERIC Educational Resources Information Center

Aronin, Loeb

One of the first steps psychologists can take toward making themselves indispensable in the schools is to actively participate in the planning, implementation, and evaluation of crisis intervention teams. Unless effective crisis intervention strategies are instituted, the educational process comes to a standstill. School psychologists need to play…

What Are the Attributes and Duties of the School Crisis Intervention Team?

ERIC Educational Resources Information Center

Gullatt, David E.; Long, Douglas

1996-01-01

Physical measures such as weapons checks and metal detectors are inadequate to forestall school violence. The key to managing crises is a trained, broad-based crisis-intervention team and a crisis-management plan. Team responsibilities include developing an intervention plan, coordinating with community services, educating and training staff, and…

Toward Successful School Crisis Intervention: 9 Key Issues

ERIC Educational Resources Information Center

Jaksec, Charles M., III

2007-01-01

Despite their best and frequently heroic efforts, school crisis intervention teams often find themselves unprepared for the many types of tragedies they face. This timely text prompts crisis intervention team members to reevaluate their beliefs and practices and consider a new approach to dealing with school crises. The author, a longtime school…

Violent behavior of patients admitted in emergency following drug suicidal attempt: a specific staff educational crisis intervention.

PubMed

Cailhol, Lionel; Allen, Michael; Moncany, Anne-Hélène; Cicotti, Andrei; Virgillito, Salvatore; Barbe, Rémy P; Lazignac, Coralie; Damsa, Cristian

2007-01-01

In spite of much effort to create guidelines on the management of violent behavior (VB) in emergency departments, little is known about the impact of such guidelines on a real-life emergency environment. The aim of this study is to investigate the impact of a staff educational crisis intervention (SECI) on the reduction of VB in patients admitted to emergency departments following drug suicidal attempt. The impact of a SECI on VB of patient consulting the ER following a drug suicide attempt was assessed by comparing the occurrence of VB before (5 months) and after (5 months) the introduction of a SECI. A significant reduction in VB (from 17.32% to 7.14%) was found with the comparison of two 5-month periods: before (254 patients) and after (224 patients) the introduction of a SECI program (chi(2)=11.238; P=.0008). These preliminary data suggest the need for further prospective randomized studies aiming to prevent VB in emergency departments by developing specific SECI programs.

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

PubMed

Miller, Laurence

2010-01-01

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

Does teaching crisis resource management skills improve resuscitation performance in pediatric residents?*.

PubMed

Blackwood, Jaime; Duff, Jonathan P; Nettel-Aguirre, Alberto; Djogovic, Dennis; Joynt, Chloe

2014-05-01

The effect of teaching crisis resource management skills on the resuscitation performance of pediatric residents is unknown. The primary objective of this pilot study was to determine if teaching crisis resource management to residents leads to improved clinical and crisis resource management performance in simulated pediatric resuscitation scenarios. A prospective, randomized control pilot study. Simulation facility at tertiary pediatric hospital. Junior pediatric residents. Junior pediatric residents were randomized to 1 hour of crisis resource management instruction or no additional training. Time to predetermined resuscitation tasks was noted in simulated resuscitation scenarios immediately after intervention and again 3 months post intervention. Crisis resource management skills were evaluated using the Ottawa Global Rating Scale. Fifteen junior residents participated in the study, of which seven in the intervention group. The intervention crisis resource management group placed monitor leads 24.6 seconds earlier (p = 0.02), placed an IV 47.1 seconds sooner (p = 0.04), called for help 50.4 seconds faster (p = 0.03), and checked for a pulse after noticing a rhythm change 84.9 seconds quicker (p = 0.01). There was no statistically significant difference in time to initiation of cardiopulmonary resuscitation (p = 0.264). The intervention group had overall crisis resource management performance scores 1.15 points higher (Ottawa Global Rating Scale [out of 7]) (p = 0.02). Three months later, these differences between the groups persisted. A 1-hour crisis resource management teaching session improved time to critical initial steps of pediatric resuscitation and crisis resource management performance as measured by the Ottawa Global Rating Scale. The control group did not develop these crisis resource management skills over 3 months of standard training indicating that obtaining these skills requires specific education. Larger studies of crisis resource education are required.

Specialized disaster behavioral health training: Its connection with response, practice, trauma health, and resilience

PubMed Central

Atkins, Christiana D.; Burnett,, Harvey J.

2016-01-01

Abstract This study examined the relationship between having training in key disaster behavioral health (DBH) interventions and trauma health (compassion fatigue, burnout and compassion satisfaction), resilience, the number of crisis responses participated in within the last year, and the frequency of assembling to practice crisis interventions skills. Data was collected from a convenience sample of disaster behavioral health responders (N = 139) attending a training conference in Michigan. Measures included the Professional Quality of Life Scale, the 14-item Resilience Scale, and a demographic questionnaire. Point biserial correlations revealed that having training in large and small group crisis interventions and individual and peer crisis interventions was significantly correlated with higher resilience and lower levels of burnout. Psychological First Aid was not significantly associated with any of the trauma health variables or with resilience. Compassion fatigue and compassion satisfaction were not significantly associated with DBH training. Chi-square tests for independence found no significant association between key DBH training strategies and the number of crisis responses participated in within the past year and the frequency of assembling to practice crisis interventions skills. These findings suggest that completing training in both, large and small group and individual and peer crisis intervention techniques may help to increase resiliency and reduce burnout among disaster behavioral health providers. PMID:28229015

An Integrated Model of School Crisis Preparedness and Intervention. A Shared Foundation to Facilitate International Crisis Intervention

ERIC Educational Resources Information Center

Jimerson, Shane R.; Brock, Stephen E.; Pletcher, Sarah W.

2005-01-01

In an effort to promote the social and cognitive competence of youth, school psychologists must be prepared to address a multitude of contextual factors and life events that impact children's performance and adjustment in school and subsequent developmental trajectories. The domain of crisis preparedness and intervention has received increased…

The Way Robert Sees It

ERIC Educational Resources Information Center

Freado, Mark D.; Wille, A. Katherine

2007-01-01

Robert, a fifteen-year-old resident in a residential treatment program, was diagnosed with significant hearing impairment. He communicates primarily through American Sign Language, although he speaks relatively well and has some hearing ability. Katie, a youth worker who has participated in Life Space Crisis Intervention (LSCI) training, worked…

Safe, Disciplined, Drug-Free Schools. A Background Paper for the Goals 2000: Educate America Satellite Town Meeting July 20, 1993.

ERIC Educational Resources Information Center

Department of Education, Washington, DC.

What can be done to solve the problem of crime in schools? "Project Freedom," in Wichita, Kansas, is creating programs to help children learn about dangers that come with joining gangs and becoming involved in drugs. A community program in Los Angeles, Community Youth Gang Services," is a crisis intervention team working with…

An emergency cash transfer program promotes weight gain and reduces acute malnutrition risk among children 6-24 months old during a food crisis in Niger

PubMed Central

Bliss, Jessica; Golden, Kate; Bourahla, Leila; Stoltzfus, Rebecca; Pelletier, David

2018-01-01

Background Assessment of the impact of emergency cash transfer programs on child nutritional status has been difficult to achieve due to the considerable logistic and ethical constraints that characterize humanitarian settings. Methods We present the findings from a quasi-experimental longitudinal study of a conditional emergency cash transfer program implemented by Concern Worldwide in 2012 during a food crisis in Tahoua, Niger, in which the use of a concurrent control group permits estimation of the program’s impact on child weight gain. Program beneficiaries received three transfers totaling approximately 65% of Niger’s gross national per capita income; mothers attended mandatory sessions on child and infant feeding and care practices. Dietary and anthropometric data from 211 vulnerable households and children targeted by the intervention were compared with 212 similarly vulnerable control households and children from the same 21 villages. We used multilevel mixed effects regression to estimate changes in weight and weight-for-height Z scores (WHZ) over time, and logistic regression to estimate the probability of acute malnutrition. Results We found the intervention to be associated with a 1.27 kg greater overall weight gain (P < 0.001) and a 1.82 greater overall gain in WHZ (P < 0.001). The odds of having acute malnutrition at the end of the intervention were 25 times higher among children in the comparison group than those in households receiving cash (P < 0.001). Conclusions We conclude that this emergency cash transfer program promoted child weight gain and reduced the risk of acute malnutrition among children in the context of a food crisis. We suspect that the use of strategic conditional terms and a valuable transfer size were key features in achieving this result. Limitations in study design prevent us from attributing impact to particular aspects of the program, and preclude a precise estimation of impact. Future studies of this nature would benefit from pre-baseline measurements, more exhaustive data collection on household characteristics and transfer use, and further investigation into the use of conditional terms in emergency settings. PMID:29497505

Effects of Helper and Caller Characteristics on the Process and Outcome of Telephone Crisis Intervention.

ERIC Educational Resources Information Center

Echterling, Lennis G.; Hartsough, Don M.

Research has examined the relationship of characteristics of crisis telephone workers to their performance. The influence and interaction of the characteristics of both the helper and caller on the telephone crisis intervention and outcome were explored for a sample of 59 calls to a crisis center. Data about the telephone helper (age, sex,…

Adult Sexual Assault Survivors' Experiences with Sexual Assault Nurse Examiners (SANEs)

ERIC Educational Resources Information Center

Fehler-Cabral, Giannina; Campbell, Rebecca; Patterson, Debra

2011-01-01

Sexual assault survivors often feel traumatized by the care received in traditional hospital emergency departments. To address these problems, Sexual Assault Nurse Examiner (SANE) programs were created to provide comprehensive medical care, crisis intervention, and forensic services. However, there is limited research on the actual experiences and…

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.

Emotional First Aid: Crisis Development and Systems of Intervention.

ERIC Educational Resources Information Center

Rosenbluh, Edward S.; And Others

This instructional manual takes a developmental approach toward understanding the psychological, social and behavioral dynamics of human crisis. The manual describes the behavior patterns characterizing various psychological and physical crises, and provides background information and methods of crisis intervention with which to manage each. In…

Intervention among Suicidal Men: Future Directions for Telephone Crisis Support Research.

PubMed

Hunt, Tara; Wilson, Coralie J; Woodward, Alan; Caputi, Peter; Wilson, Ian

2018-01-01

Telephone crisis support is a confidential, accessible, and immediate service that is uniquely set up to reduce male suicide deaths through crisis intervention. However, research focusing on telephone crisis support with suicidal men is currently limited. To highlight the need to address service delivery for men experiencing suicidal crisis, this perspective article identifies key challenges facing current telephone crisis support research and proposes that understanding of the role of telephone crisis helplines in supporting suicidal men may be strengthened by careful examination of the context of telephone crisis support, together with the impact this has on help-provision for male suicidal callers. In particular, the impact of the time- and information-poor context of telephone crisis support on crisis-line staff's identification of, and response to, male callers with thoughts of suicide is examined. Future directions for research in the provision of telephone crisis support for suicidal men are discussed.

Intervention among Suicidal Men: Future Directions for Telephone Crisis Support Research

PubMed Central

Hunt, Tara; Wilson, Coralie J.; Woodward, Alan; Caputi, Peter; Wilson, Ian

2018-01-01

Telephone crisis support is a confidential, accessible, and immediate service that is uniquely set up to reduce male suicide deaths through crisis intervention. However, research focusing on telephone crisis support with suicidal men is currently limited. To highlight the need to address service delivery for men experiencing suicidal crisis, this perspective article identifies key challenges facing current telephone crisis support research and proposes that understanding of the role of telephone crisis helplines in supporting suicidal men may be strengthened by careful examination of the context of telephone crisis support, together with the impact this has on help-provision for male suicidal callers. In particular, the impact of the time- and information-poor context of telephone crisis support on crisis-line staff’s identification of, and response to, male callers with thoughts of suicide is examined. Future directions for research in the provision of telephone crisis support for suicidal men are discussed. PMID:29404319

Comparing Models of Helper Behavior to Actual Practice in Telephone Crisis Intervention: A Silent Monitoring Study of Calls to the U.S. 1-800-SUICIDE Network

ERIC Educational Resources Information Center

Mishara, Brian L.; Chagnon, Francois; Daigle, Marc; Balan, Bogdan; Raymond, Sylvaine; Marcoux, Isabelle; Bardon, Cecile; Campbell, Julie K.; Berman, Alan

2007-01-01

Models of telephone crisis intervention in suicide prevention and best practices were developed from a literature review and surveys of crisis centers. We monitored 2,611 calls to 14 centers using reliable behavioral ratings to compare actual interventions with the models. Active listening and collaborative problem-solving models describe help…

Crisis and Loss: Information for Educators.

ERIC Educational Resources Information Center

Canter, Andrea, Ed.

1999-01-01

Crisis intervention is a vital component of any comprehensive approach to maintaining psychological well being. An active school-based crisis intervention team can make a powerful contribution to a school's sense of community and commitment to taking care of each other. This special edition presents promising practices that may be helpful to…

Crisis on Campus: Eating Disorder Intervention from a Developmental-Ecological Perspective

ERIC Educational Resources Information Center

Taylor, Julia V.; Gibson, Donna M.

2016-01-01

Objective: 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: Participants included University Wellness Center employees responding to the crisis. Methods: Methods…

Assessment of a media campaign and related crisis help line following Hurricane Katrina.

PubMed

Beaudoin, Christopher E

2008-01-01

We evaluated the impact of a media campaign targeting stress and depression following Hurricane Katrina. We specifically examined public response to the campaign's recommendation that people could contact a telephone help line for further assistance if needed. Call data from Via Link allowed us to track trends in 800-number Crisis Line call volume (n = 29,659), which is the number recommended in the media campaign, and 2-1-1 Information and Referral Line call volume (n = 8,035), which is employed in a control-like manner. With data from April 1, 2006, through November 30, 2006, multivariate analysis was used to assess trends and differences among and within pre-intervention, intervention, and post-intervention. Information and Referral Line call volume, which was unrelated to the campaign, did not change over time. In contrast, Crisis Line call volume, which was related to the campaign, increased significantly from pre-intervention to intervention, but not from intervention to post-intervention. Furthermore, the daily rate of Crisis Line call volume was constant during pre-intervention, increased during intervention, but decreased during post-intervention. There is support for the media campaign's influence on public behavior to contact Via Link in regard to stress and depression following Hurricane Katrina. Analysis helps undermine alternative explanations, including general trends in help line call volume and those specific to Crisis Line call volume.

A Reality Rub Crisis Intervention: "I Wish There Was a Law against Belts."

ERIC Educational Resources Information Center

Long, Nicholas J.; Techet, Bonnie

1994-01-01

Presents Life Space Interview (LSI) or Life Space Crisis Intervention (LSCI) with second-grade student from threatening home environment. Uses Reality Rub Intervention Interview, focusing on five variations: distorted perceptions, tunnel vision, faulty thinking, avoidance, and alibi. Describes incident that led to intervention, interview itself,…

Group Work during International Disaster Outreach Projects: A Model to Advance Cultural Competence

ERIC Educational Resources Information Center

West-Olatunji, Cirecie; Henesy, Rachel; Varney, Melanie

2015-01-01

Given the rise in disasters worldwide, counselors will increasingly be called upon to respond. Current accreditation standards require that programs train students to become skillful in disaster/crisis interventions. Group processing to enhance self-awareness and improve conceptualization skills is an essential element of such training. This…

Lessons from the Training Programme for Women with Domestic Violence Experience

ERIC Educational Resources Information Center

Anczewska, Marta; Roszczynska-Michta, Joanna; Waszkiewicz, Justyna; Charzynska, Katarzyna; Czabala, Czeslaw

2013-01-01

It is well recognized that trauma of domestic violence has destructive impact on somatic and mental health--hence quality of life. In Poland today's assistance programs provide a quite wide range of services, including emergency shelter, crisis intervention, support groups and counselling services. While health care providers may be successful at…

Delivery of HIV care during the 2007 post-election crisis in Kenya: a case study analyzing the response of the Academic Model Providing Access to Healthcare (AMPATH) program

PubMed Central

2013-01-01

Background Widespread violence followed the 2007 presidential elections in Kenya resulting in the deaths of a reported 1,133 people and the displacement of approximately 660,000 others. At the time of the crisis the United States Agency for International Development-Academic Model Providing Access to Healthcare (USAID-AMPATH) Partnership was operating 17 primary HIV clinics in western Kenya and treating 59,437 HIV positive patients (23,437 on antiretroviral therapy (ART)). Methods This case study examines AMPATH’s provision of care and maintenance of patients on ART throughout the period of disruption. This was accomplished by implementing immediate interventions including rapid information dissemination through the media, emergency hotlines and community liaisons; organization of a Crisis Response leadership team; the prompt assembly of multidisciplinary teams to address patient care, including psychological support staff (in clinics and in camps for internally displaced persons (IDP)); and the use of the AMPATH Medical Records System to identify patients on ART who had missed clinic appointments. Results These interventions resulted in the opening of all AMPATH clinics within five days of their scheduled post-holiday opening dates, 23,949 patient visits in January 2008 (23,259 previously scheduled), uninterrupted availability of antiretrovirals at all clinics, treatment of 1,420 HIV patients in IDP camps, distribution of basic provisions, mobilization of outreach services to locate missing AMPATH patients and delivery of psychosocial support to 300 staff members and 632 patients in IDP camps. Conclusion Key lessons learned in maintaining the delivery of HIV care in a crisis situation include the importance of advance planning to develop programs that can function during a crisis, an emphasis on a rapid programmatic response, the ability of clinics to function autonomously, patient knowledge of their disease, the use of community and patient networks, addressing staff needs and developing effective patient tracking systems. PMID:24289095

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.

Using ecological theory to evaluate the effectiveness of an indigenous community intervention: A study of Sexual Assault Nurse Examiner (SANE) programs.

PubMed

Campbell, Rebecca; Patterson, Debra; Fehler-Cabral, Giannina

2010-12-01

In recent years, there has been renewed interest among community psychologists in indigenous interventions, which are programs created by local practitioners (rather than researchers) already rooted in their communities. Indigenous interventions have strong ecological validity, but their effectiveness is often unknown because so few are rigorously evaluated. The goal of this project was to use Kelly and Trickett's ecological theory as a conceptual framework for evaluating an indigenous intervention and its mediating mechanisms of effectiveness. The focal intervention was a midwestern Sexual Assault Nurse Examiner (SANE) program, which provides post-assault medical care, crisis intervention, and medical forensic exams for sexual assault survivors. Prior studies of SANE programs have suggested that these interventions may help increase sexual assault prosecution rates. In this case example, we used a mixed methods design to determine if this program contributed to increased prosecution rates, and if so, why. Based on qualitative interviews with key stakeholders, we found substantial evidence for the Principle of Interdependence such that the SANE program strengthened the interconnections between the legal and medical systems, which contributed to increased prosecution. The intervention was effective in these outcomes because it promoted Cycling of Resources throughout the systems and fostered Adaptation of new roles for legal and medical personnel. Moving beyond this specific case example, this paper also examines cross-cutting advantages and struggles of using an ecological approach in the evaluation of indigenous community interventions.

An intercultural assessment of the type, intensity and number of crisis precipitating factors in three cultures: United States, Brazil and Taiwan.

PubMed

Coler, M S; Hafner, L P

1991-01-01

The precipitating factors of crisis have cultural interpretations that make diagnostic criteria and intervention methods ethnologically different. The crisis precipitating factors of individuals seeking intervention in the Republic of China (Taiwan), Brazil and the United States (U.S.) were investigated toward the end of isolating correlates and discrepancies of ethnic-related precipitants of crisis. The primary objective of the study was to influence crisis intervention in the profession of nursing from the almost universally utilized Western Model, to one that takes cultural uniqueness into account. Stressors and stressor intensities which lead to help-seeking behavior of clients in selected crisis intervention facilities in the three countries were identified. A 60 question instrument ranked client responses according to Axis 4 of the Diagnostic and Statistical Manual-III of the American Psychiatric Association (APA, 1980; 1986). Each item also reflected one of four Human Response Patterns of the North American Nursing Diagnostic Association (NANDA) taxonomy, which was utilized as a clustering device in data analysis. Somatization versus psychologization of crisis precipitating factors was also measured through the NANDA categories. A convenience sample of 30 subjects were queried in each country by nurse interviewers. Data analysis through ANOVA showed cultural uniqueness and mutuality.

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

PubMed

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

2017-01-01

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

A scoping review of crisis teams managing dementia in older people

PubMed Central

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

2017-01-01

Background Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. Methods For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis. Results The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8%) of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors. Conclusion Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required to deliver a standardized care pathway and measurable intervention as part of a large-scale evaluation of effectiveness. PMID:29042760

Recovery and Borderline Personality Disorder: A Description of the Innovative Open Borders Program.

PubMed

Mortimer-Jones, Sheila; Morrison, Paul; Munib, Ahmed; Paolucci, Francesco; Neale, Sonia; Bostwick, Amanda; Hungerford, Catherine

2016-09-01

Although Recovery-oriented approaches to delivering mental health services are now promoted in health services across the globe, there is an ongoing need to adapt these approaches to meet the unique needs of consumers with a diagnosis of borderline personality disorder. The lived experience of borderline personality disorder includes emotional dysregulation, intense and unstable relationships, self-harming behaviours, fear of abandonment, and a limited capacity to cope with stress. These experiences present a range of challenges for those who deliver Recovery-oriented services and advocate the principles of empowerment and self-determination. This paper describes a novel crisis intervention program, "Open Borders," which has been established to meet the unique needs of people with a borderline personality disorder diagnosis. Open Borders is a Recovery-oriented model that is run at a public, state-wide residential facility for mental health consumers in Western Australia, and offers alternative pathways to achieving mental health Recovery, including self-referral and short-term admission to a residential facility. The aims of the program are to break the cycle of hospital admission, reduce rates of self-harm, and support the complex Recovery journey of consumers with a diagnosis of borderline personality disorder. Open Borders provides an exemplar for other health service organisations seeking to establish Recovery-oriented crisis intervention alternatives.

Post-acute crisis text messaging outreach for suicide prevention: a pilot study.

PubMed

Berrouiguet, Sofian; Gravey, Michel; Le Galudec, Mickaël; Alavi, Zarrin; Walter, Michel

2014-07-30

Several post-suicide prevention strategies such as sending postcards or making phone calls have been used to keep in contact with suicide attempters. The continuity of care has been beneficial to the prevention of post-acute suicidal behaviors. The aim of the study was to evaluate the technical feasibility and acceptability of text messaging outreach in post-acute suicide attempters. Eighteen post-suicidal patients were included in a prospective, monocentric, open-label, 2 months pilot study. The text messages were sent from the intranet program that we specially developed for the study. Technical feasibility of this text message intervention was evaluated by the analysis of text message reports. Acceptability of such intervention was evaluated by a standardized phone interview. Our study showed that receiving text messages sent from an intranet program after a suicide attempt is technically possible. This post-crisis outreach program was accepted by the patients who found it to have a positive preventive impact. Text messaging outreach offers several advantages such as lower cost, and easier utilization compared to current post-acute care strategies. We suggest further randomized controlled trials in a large sample of suicidal patients to assess the efficacy of this novel outreach tool for prevention of post-acute suicide. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 8--Crisis Intervention, Drug-Related Problems. Revised.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This training manual for emergency medical technicians, one of 14 modules that comprise the Emergency Victim Care textbook, covers crisis intervention and drug related problems. Objectives stated for the two chapters are for the student to be able to describe: treating common mental disturbances, relating to those suffering a crisis in a…

Classroom Crisis Intervention through Contracting: A Moral Development Model.

ERIC Educational Resources Information Center

Smaby, Marlowe H.; Tamminen, Armas W.

1981-01-01

A counselor can arbitrate problem situations using a systematic approach to classroom intervention which includes meetings with the teacher and students. This crisis intervention model based on moral development can be more effective than reliance on guidance activities disconnected from the actual classroom settings where the problems arise.…

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

Treating Chronic Crisis Bearers and Their Families

ERIC Educational Resources Information Center

Doyle, Averil Marie; Dorlac, Charles

1978-01-01

This article presents a method for family crisis intervention. The goal is extended from restoring the crisis bearing unit to its pre-crisis level of coping to a basic restructuring of maladaptive pre-crisis behaviors. It is aimed at general behavior change as well as resolution of the immediate situation. (Author)

Model testing on the crisis interventions and actions to prevent medical disputes: a Taiwanese nursing perspective.

PubMed

Tzeng, Huey-Ming

2006-05-01

This study investigated the contributions of comprehensiveness and necessity scales on crisis interventions and actions toward nursing practice-related medical disputes in Taiwanese hospitals and institutions' demographic characteristics, to overall satisfaction toward nursing-related crisis management policies and interventions and overall satisfaction toward their institution's crisis management system. In a health-care environment that is focused on cost containment, for overworked nurses and understaffed medical wards, patients still expect nurses to provide high quality, compassionate care. Patients usually regard nurses as the principal link between the technical and interpersonal aspects of their care. However, current hospital systems tend to require patients to be self-reliant in managing their own care. Patient mistrust of medical care providers might have contributed to the current medical error/dispute crisis. In this cross-sectional study, the subjects were nursing directors of Taiwanese hospitals (197 valid subjects). The author developed the questionnaire used in this study. The ordinal logistic regression analyses demonstrated that being a public hospital managed by the government, being a hospital operated by a corporate body, the more comprehensive the technical/structural aspect and the assessment aspect and the more needed the psychological aspect, contribute to higher general satisfaction levels toward nursing-related crisis management. The more comprehensive the strategic aspect and having more acute beds, contributes to higher satisfaction levels with their institution's overall crisis management activities. These findings inferred a possible change in a hospital's resource allocation or power structure when dealing with issues of patient care quality, including nursing practice-related crisis management policies, interventions and actions. RELEVANT TO CLINICAL PRACTICE: A good crisis management system may help to keep a crisis from worsening, which might lead to a serious situation that includes malpractice litigation. It is believed that the questionnaire used in this study may be used as a diagnostic tool for assessing a crisis management system within a hospital's nursing environment.

Schools' mental health responses after Hurricanes Katrina and Rita.

PubMed

Jaycox, Lisa H; Tanielian, Terri L; Sharma, Priya; Morse, Lindsey; Clum, Gretchen; Stein, Bradley D

2007-10-01

After the displacement of students following Hurricanes Katrina and Rita, schools in several states enrolled many students with potential mental health needs. This study sought to understand how schools perceived the mental health needs of these students and what mental health programs they implemented. Mental health personnel at 19 public schools or school systems and 11 private or parochial schools in Louisiana, Alabama, Texas, and Mississippi were interviewed at two time points (spring and fall-winter of 2006). Schools undertook diverse approaches to interventions, depending on the preexisting mental health infrastructure and personnel, the perceived needs of students, and the barriers or facilitators in each system. Interviewees described a rapid and comprehensive approach to the crisis in the immediate aftermath. Shortly afterward, some schools perceived little need for mental health services and refocused on their academic missions. Other school systems perceived student need but were unable to implement trauma-focused programs because staff were not prepared to deliver such services and funding was lacking. However, some systems and schools were able to implement new programs or extend programs to displaced students. Implementation challenges included difficulty communicating with parents, burnout among staff and program implementers, and efforts to balance the needs of the displaced students with those of the preexisting student population. Despite significant efforts to support students affected by the hurricanes, schools were limited in their ability to implement disaster-focused programs. Extension of crisis plans to include precrisis training in mental health programming for students and staff who have ongoing difficulties after a disaster or crisis may be beneficial.

Comparing models of helper behavior to actual practice in telephone crisis intervention: a Silent Monitoring Study of Calls to the U.S. 1-800-SUICIDE Network.

PubMed

Mishara, Brian L; Chagnon, François; Daigle, Marc; Balan, Bogdan; Raymond, Sylvaine; Marcoux, Isabelle; Bardon, Cécile; Campbell, Julie K; Berman, Alan

2007-06-01

Models of telephone crisis intervention in suicide prevention and best practices were developed from a literature review and surveys of crisis centers. We monitored 2,611 calls to 14 centers using reliable behavioral ratings to compare actual interventions with the models. Active listening and collaborative problem-solving models describe help provided. Centers vary greatly in the nature of interventions and their quality according to predetermined criteria. Helpers do not systematically assess suicide risk. Some lives may have been saved but occasionally unacceptable responses occur. Recommendations include the need for quality assurance, development of standardized practices and research relating intervention processes to outcomes.

Helping Callers to the National Suicide Prevention Lifeline Who Are at Imminent Risk of Suicide: Evaluation of Caller Risk Profiles and Interventions Implemented.

PubMed

Gould, Madelyn S; Lake, Alison M; Munfakh, Jimmie Lou; Galfalvy, Hanga; Kleinman, Marjorie; Williams, Caitlin; Glass, Andrew; McKeon, Richard

2016-04-01

Crisis lines are settings where identifying individuals at imminent risk of suicidal behavior and intervening to keep them safe are critical activities. We examined clinical characteristics of crisis callers assessed by telephone crisis helpers as being at imminent risk of suicide, and the interventions implemented with these callers. Data were derived from 491 call reports completed by 132 helpers at eight crisis centers in the National Suicide Prevention Lifeline network. Helpers actively engaged the callers in collaborating to keep themselves safe on 76.4% of calls and sent emergency services without the callers' collaboration on 24.6% of calls. Four different profiles of imminent risk calls emerged. Caller profiles and some helper characteristics were associated with intervention type. Our findings provide a first step toward an empirical formulation of imminent risk warning signs and recommended interventions. © 2015 The American Association of Suicidology.

Challenges and Barriers to Implementing a School-Based Afrocentric Intervention in Urban Schools: A Pilot Study of the Sisters of Nia Cultural Program

ERIC Educational Resources Information Center

Aston, Candice; Graves, Scott, Jr.

2016-01-01

There is growing evidence that African American females are facing an educational crisis in regard to disproportionate discipline practices. African American females are frequently confronted with deeply embedded negative stereotypes that reinforce racial and gender biases both inside and outside of the classroom. One of the known protective…

Promoting Sisterhood: The Impact of a Culturally Focused Program to Address Verbally Aggressive Behaviors in Black Girls

ERIC Educational Resources Information Center

Aston, Candice; Graves, Scott L., Jr.; McGoey, Kara; Lovelace, Temple; Townsend, Tiffany

2018-01-01

New estimates report that Black girls are facing an educational crisis with regard to disproportionate disciplinary practices and academics. To date, there has been very limited research with regard to school-based interventions that have been designed to help Black girls explore both their cultural and gender identity. This is problematic because…

Short-Term Interventions for Long-Term Needs: The Challenge of Bridging Youth and Community Development.

ERIC Educational Resources Information Center

Stephenson, Garry; Morford, Shawn; Berry, Holly

2002-01-01

The Mill City/Gates Youth Development Project operated as a youth-at-risk program in a timber-dependent community during the timber crisis of the early 1990s. Evaluations indicate the youth activities were effective. Community support structures created by the project continue to operate 5 years after the end of funding, indicating a successful…

41 CFR 301-70.909 - What disclosure information must we give to anyone who flies on our Government aircraft?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Group Life Insurance Program does not contain an exclusion of this type. If you are the victim of an air... services, such as crisis intervention, counseling and emotional support. State crime victim compensation may be able to cover crime-related expenses, such as medical costs, mental health counseling, funeral...

Implementation and evaluation of a simulation curriculum for paediatric residency programs including just-in-time in situ mock codes

PubMed Central

Sam, Jonathan; Pierse, Michael; Al-Qahtani, Abdullah; Cheng, Adam

2012-01-01

OBJECTIVE: To develop, implement and evaluate a simulation-based acute care curriculum in a paediatric residency program using an integrated and longitudinal approach. DESIGN: Curriculum framework consisting of three modular, year-specific courses and longitudinal just-in-time, in situ mock codes. SETTING: Paediatric residency program at BC Children’s Hospital, Vancouver, British Columbia. INTERVENTIONS: The three year-specific courses focused on the critical first 5 min, complex medical management and crisis resource management, respectively. The just-in-time in situ mock codes simulated the acute deterioration of an existing ward patient, prepared the actual multidisciplinary code team, and primed the surrounding crisis support systems. Each curriculum component was evaluated with surveys using a five-point Likert scale. RESULTS: A total of 40 resident surveys were completed after each of the modular courses, and an additional 28 surveys were completed for the overall simulation curriculum. The highest Likert scores were for hands-on skill stations, immersive simulation environment and crisis resource management teaching. Survey results also suggested that just-in-time mock codes were realistic, reinforced learning, and prepared ward teams for patient deterioration. CONCLUSIONS: A simulation-based acute care curriculum was successfully integrated into a paediatric residency program. It provides a model for integrating simulation-based learning into other training programs, as well as a model for any hospital that wishes to improve paediatric resuscitation outcomes using just-in-time in situ mock codes. PMID:23372405

Transitioning mental health & psychosocial support: from short-term emergency to sustainable post-disaster development. Humanitarian Action Summit 2011.

PubMed

Patel, P P; Russell, J; Allden, K; Betancourt, T S; Bolton, P; Galappatti, A; Hijazi, Z; Johnson, K; Jones, L; Kadis, L; Leary, K; Weissbecker, I; Nakku, J

2011-12-01

The Working Group (WG) on Mental Health and Psychosocial Support participated in its second Humanitarian Action Summit in 2011. This year, the WG chose to focus on a new goal: reviewing practice related to transitioning mental health and psychosocial support programs from the emergency phase to long-term development. The Working Group's findings draw on a review of relevant literature as well as case examples. The objective of the Working Group was to identify factors that promote or hinder the long term sustainability of emergency mental health and psychosocial interventions in crisis and conflict, and to provide recommendations for transitioning such programs from relief to development. The Working Group (WG) conducted a review of relevant literature and collected case examples based on experiences and observations of working group members in implementing mental and psychosocial programming in the field. The WG focused on reviewing literature on mental health and psychosocial programs and interventions that were established in conflict, disaster, protracted crisis settings, or transition from acute phase to development phase. The WG utilized case examples from programs in Lebanon, the Gaza Strip, Sierra Leone, Aceh (Indonesia), Sri Lanka, and New Orleans (United States). The WG identified five key thematic areas that should be addressed in order to successfully transition lasting and effective mental health and psychosocial programs from emergency settings to the development phase. The five areas identified were as follows: Government and Policy, Human Resources and Training, Programming and Services, Research and Monitoring, and Finance. The group identified several recommendations for each thematic area, which were generated from key lessons learned by working group members through implementing mental health and psychosocial support programs in a variety of settings, some successfully sustained and some that were not.

An Evaluation of the Effects of Life Space Crisis Intervention on the Challenging Behavior of Individual Students

ERIC Educational Resources Information Center

Grskovic, Janice A.; Goetze, Herbert

2005-01-01

This study assessed the effects of Life Space Crisis Interventions on the challenging behavior of four students with learning handicaps attending a special school in Germany. Students were in seventh and tenth grades and exhibited an array of challenging, disruptive classroom behaviors. After the implementation of interventions, major improvement…

Postsuicide Intervention as a Prevention Tool: Developing a Comprehensive Campus Response to Suicide and Related Risk

ERIC Educational Resources Information Center

Cimini, M. Dolores; Rivero, Estela M.

2013-01-01

This chapter explores the critical role of crisis intervention and other support after a suicide has occurred as part of a comprehensive suicide prevention response within college and university campuses. The important components of postsuicide intervention campus crisis response and protocols and the identification of key stakeholders to…

Crisis intervention for people with severe mental illnesses.

PubMed

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

2015-12-03

A particularly difficult challenge for community treatment of people with serious mental illnesses is the delivery of an acceptable level of care during the acute phases of severe mental illness. Crisis-intervention models of care were developed as a possible solution. To review the effects of crisis-intervention models for anyone with serious mental illness experiencing an acute episode compared to the standard care they would normally receive. If possible, to compare the effects of mobile crisis teams visiting patients' homes with crisis units based in home-like residential houses. We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials. There is no language, time, document type, or publication status limitations for inclusion of records in the register. This search was undertaken in 1998 and then updated 2003, 2006, 2010 and September 29, 2014. We included all randomised controlled trials of crisis-intervention models versus standard care for people with severe mental illnesses that met our inclusion criteria. We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assessed risk of bias for included studies and used GRADE to create a 'Summary of findings' table. The update search September 2014 found no further new studies for inclusion, the number of studies included in this review remains eight with a total of 1144 participants. Our main outcomes of interest are hospital use, global state, mental state, quality of life, participant satisfaction and family burden. With the exception of mental state, it was not possible to pool data for these outcomes.Crisis intervention may reduce repeat admissions to hospital (excluding index admissions) at six months (1 RCT, n = 369, RR 0.75 CI 0.50 to 1.13, high quality evidence), but does appear to reduce family burden (at six months: 1 RCT, n = 120, RR 0.34 CI 0.20 to 0.59, low quality evidence), improve mental state (Brief Psychiatric Rating Scale (BPRS) three months: 2 RCTs, n = 248, MD -4.03 CI -8.18 to 0.12, low quality evidence), and improve global state (Global Assessment Scale (GAS) 20 months; 1 RCT, n = 142, MD 5.70, -0.26 to 11.66, moderate quality evidence). Participants in the crisis-intervention group were more satisfied with their care 20 months after crisis (Client Satisfaction Questionnaire (CSQ-8): 1 RCT, n = 137, MD 5.40 CI 3.91 to 6.89, moderate quality evidence). However, quality of life scores at six months were similar between treatment groups (Manchester Short Assessment of quality of life (MANSA); 1 RCT, n = 226, MD -1.50 CI -5.15 to 2.15, low quality evidence). Favourable results for crisis intervention were also found for leaving the study early and family satisfaction. No differences in death rates were found. Some studies suggested crisis intervention to be more cost-effective than hospital care but all numerical data were either skewed or unusable. We identified no data on staff satisfaction, carer input, complications with medication or number of relapses. Care based on crisis-intervention principles, with or without an ongoing homecare package, appears to be a viable and acceptable way of treating people with serious mental illnesses. However only eight small studies with unclear blinding, reporting and attrition bias could be included and evidence for the main outcomes of interest is low to moderate quality. If this approach is to be widely implemented it would seem that more evaluative studies are still needed.

Housing and overdose: an opportunity for the scale-up of overdose prevention interventions?

PubMed

Bardwell, Geoff; Collins, Alexandra B; McNeil, Ryan; Boyd, Jade

2017-12-06

North America is currently experiencing an overdose epidemic due to a significant increase of fentanyl-adulterated opioids and related analogs. Multiple jurisdictions have declared a public health emergency given the increasing number of overdose deaths. In the province of British Columbia (BC) in Canada, people who use drugs and who are unstably housed are disproportionately affected by a rising overdose crisis, with close to 90% of overdose deaths occurring indoors. Despite this alarming number, overdose prevention and response interventions have yet to be widely implemented in a range of housing settings. There are few examples of overdose prevention interventions in housing environments. In BC, for example, there are peer-led naloxone training and distribution programs targeted at some housing environments. There are also "supervised" spaces such as overdose prevention sites (similar to supervised consumption sites (SCS)) located in some housing environments; however, their coverage remains limited and the impacts of these programs are unclear due to the lack of evaluation work undertaken to date. A small number of SCS exist globally in housing environments (e.g., Germany), but like overdose prevention sites in BC, little is known about the design or effectiveness, as they remain under-evaluated. Implementing SCS and other overdose prevention interventions across a range of housing sites provides multiple opportunities to address overdose risk and drug-related harms for marginalized people who use drugs. Given the current overdose crisis rising across North America, and the growing evidence of the relationship between housing and overdose, the continued implementation and evaluation of novel overdose prevention interventions in housing environments should be a public health priority. A failure to do so will simply perpetuate what has proven to be a devastating epidemic of preventable death.

A community long-term hotline therapeutic intervention model for coping with the threat and trauma of war and terror.

PubMed

Gelkopf, Marc; Haimov, Sigal; Lapid, Liron

2015-02-01

Long-term tele-counseling can potentially be a potent intervention mode in war- and terror-related community crisis situations. We aimed to examine a unique long-term telephone-administered intervention, targeting community trauma-related crisis situations by use of various techniques and approaches. 142 participants were evaluated using a non-intrusive by-proxy methodology appraising counselors' standard verbatim reports. Various background measures and elements in the intervention were quantitatively assessed, along with symptomatology and functioning at the onset and end of intervention. About 1/4 of the wide variety of clients called for someone else in addition to themselves, and most called due to a past event rather than a present crisis situation. The intervention successfully reduced posttraumatic stress symptoms and improved functioning. Most interventions included psychosocial education with additional elements, e.g., self-help tools, and almost 60% included also in-depth processes. In sum, tele-counseling might be a viable and effective intervention model for community-related traumatic stress.

Results of Descriptive Study of Crisis Nursery and Respite Care Programs.

ERIC Educational Resources Information Center

Huntington, Gail S.; And Others

This report describes results of an evaluation of respite care programs and crisis nursery programs for children with disabilities, based on survey forms received from 81 programs and site visits to selected programs across the United States. The survey of crisis nursery programs and the survey of respite care programs gathered data on amount of…

Crisis Planning: Survey Results from Hurricane Katrina and Implications for Performance Improvement Professionals

ERIC Educational Resources Information Center

Hutchins, Holly M.; Annulis, Heather; Gaudet, Cyndi

2008-01-01

Modern organizations constantly face unparalleled changes and uncertainty in the competitive world, thus requiring strategic planning to mitigate crisis conditions. Underscoring crisis plans are performance interventions that prepare employees, technological systems, and the organizational culture to effectively respond to a crisis event. However,…

Employing crisis postcards with case management in Kaohsiung, Taiwan: 6-month outcomes of a randomised controlled trial for suicide attempters.

PubMed

Chen, Wei-Jen; Ho, Chi-Kung; Shyu, Shi-Sen; Chen, Cheng-Chung; Lin, Guei-Ging; Chou, Li-Shiu; Fang, Yun-Ju; Yeh, Pin-Yang; Chung, Tieh-Chi; Chou, Frank Huang-Chih

2013-07-17

Suicide attempts constitute a serious clinical problem and have important implications for healthcare resources. The aim of the present study was to evaluate the effectiveness of case management using crisis postcards over a 6-month follow-up period. A randomised controlled trial was conducted in Kaohsiung, Taiwan. Prevention of further suicide attempts was compared between two groups with and without the postcard intervention. The intervention group consisted of 373 participants (139 males, 234 females; age: 39.8 ± 14.0 yrs.). The control group consisted of 388 participants (113 males, 275 females; age: 40.0 ± 16.0 yrs.). A survival analysis was used to test the effectiveness of the crisis postcard intervention for the prevention of suicide reattempts. Per-protocol and intention-to-treat analyses were conducted. The intention-to-treat analysis indicated that the crisis postcard had no effect (hazard ratio = 0.84; 95% CI = 0.56 - 1.29), whereas the per-protocol analysis showed a strong benefit for the crisis postcard (hazard ratio = 0.39; 95% CI = 0.21 - 0.72). Although the results of the present study indicated that the postcard intervention did not reduce subsequent suicide behaviour, our study provides an alteration to the postcard intervention. Further studies need to be conducted to clarify whether this type of intervention can reduce subsequent suicidal behaviour, with a particular focus on reducing the rate of loss to follow-up.

Measuring trainer fidelity in the transfer of suicide prevention training

PubMed Central

Cross, Wendi F.; Pisani, Anthony R.; Schmeelk-Cone, Karen; Xia, Yinglin; Tu, Xin; McMahon, Marcie; Munfakh, Jimmie Lou; Gould, Madelyn S.

2014-01-01

Background Finding effective and efficient models to train large numbers of suicide prevention interventionists, including ‘hotline’ crisis counselors, is a high priority. Train-the-trainer (TTT) models are widely used but understudied. Aims To assess the extent to which trainers following TTT delivered the Applied Suicide Intervention Skills Training (ASIST) program with fidelity, and to examine fidelity across two trainings and seven training segments. Methods We recorded and reliably rated trainer fidelity, defined as adherence to program content and competence of program delivery, for 34 newly trained ASIST trainers delivering the program to crisis center staff on two separate occasions. A total of 324 observations were coded. Trainer demographics were also collected. Results On average, trainers delivered two-thirds of the program. Previous training was associated with lower levels of trainer adherence to the program. 18% of trainers' observations were rated as solidly competent. Trainers did not improve fidelity from their first to second training. Significantly higher fidelity was found for lectures and lower fidelity was found for interactive training activities including asking about suicide and creating a safe plan. Conclusions We found wide variability in trainer fidelity to the ASIST program following TTT and few trainers had high levels of both adherence and competence. More research is needed to examine the cost-effectiveness of TTT models. PMID:24901061

Effects of Supervision in the Training of Nonprofessional Crisis-Intervention Counselors

ERIC Educational Resources Information Center

Doyle, William W., Jr.; And Others

1977-01-01

This study evaluated three major models currently used by crisis-intervention centers to train and supervise nonprofessional counselors. Training groups included preservice training only (PSO), preservice training and delayed supervision (PSD), and preservice training and immediate supervision (PSI). Findings indicate most learning by…

[Community intervention during economic disasters].

PubMed

de León, O A

1991-03-01

A political conflict forced banks to close down in Panama during March 1988. Thus, thousand of families were unable to meet their most basic needs during that lapse of time. This paper describes a community intervention program that was set up in the midst of such an economic disaster. That program emphasized mental health consultation techniques to help devising an effective organizational action as well as developing standards to determine needs, and a clear-cut two-way communication with the affected families. The incidence of emotional disorder was assessed with the Self Report Questionnaire, and crisis intervention was offered to any people who should apply for it. Cognitive responses, coping behaviors, and social supports were also assessed. Results showed that those individuals excluded from a full participation in their culture were much more likely to develop emotional disorders. Finding that affected people showed a scarce self-help behavior was interpreted as a feature of the transcultural transaction between affected people, and professionals.

School Psychology in the New Millennium: Constructing and Implementing a Blueprint for Intervening in Crises Involving Disasters and/or Violence.

ERIC Educational Resources Information Center

Tramonte, Michael R.

This paper offers advice to school psychologists concerning the future of their profession in relation to crisis intervention. Crisis intervention will be more of a priority as the year 2000 approaches; therefore school psychologists need to expand their role and change their focus to include intervention to all children. School psychologists need…

Crisis in Context Theory: An Ecological Model

ERIC Educational Resources Information Center

Myer, Rick A.; Moore, Holly B.

2006-01-01

This article outlines a theory for understanding the impact of a crisis on individuals and organizations. Crisis in context theory (CCT) is grounded in an ecological model and based on literature in the field of crisis intervention and on personal experiences of the authors. A graphic representation denotes key components and premises of CCT,…

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

PubMed

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

2017-06-01

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

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.

Life Space Crisis Intervention and Functional Behavioral Assessment: The Guiding Models.

ERIC Educational Resources Information Center

McGowan, Lawrence P.

2002-01-01

The Conflict Cycle employed in Life Space Crisis Intervention offers a model for conducting functional assessment with students facing disciplinary action for behavior that may be related to emotional disturbance and other disabilities. This article analyzes the Conflict Cycle, using principles from cognitive behavioral science. (Contains 13…

Triangulating Information from Recurrent Crises

ERIC Educational Resources Information Center

Verte, Lotte; De Moor, Gerrit

2013-01-01

Life Space Crisis Intervention (LSCI) is a therapeutic, verbal strategy for intervention with students in crisis. It explores a student's reactions to stressful events to gain insight into thinking, feelings, and behavior in order to strengthen resilience and self-esteem (Long, Wood, & Fecser, 2001). By exploring timelines of challenging…

Walk in Balance: Training Crisis Intervention Team Police Officers as Compassionate Warriors

ERIC Educational Resources Information Center

Chopko, Brian A.

2011-01-01

Crisis Intervention Teams (CIT) were developed to enable law enforcement officers to effectively and compassionately respond to calls involving people experiencing psychiatric distress. Mental health professionals responsible for training CIT officers are in a unique position to promote the compassionate treatment of those experiencing psychiatric…

Impact of Physical Activity Intervention Programs on Self-Efficacy in Youths: A Systematic Review

PubMed Central

Cataldo, Rosa; John, Janice; Chandran, Latha; Pati, Susmita; Shroyer, A. Laurie W.

2013-01-01

Lack of physical activity has contributed to the nation's childhood obesity crisis, but the impact of physical activity on self-efficacy as a mediator of behavior change has not been examined. This systematic review (SR) describes the published evidence related to the impact of physical activity intervention programs on self-efficacy among youths. From January 2000 to June 2011, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to identify publications from PubMed, PsychInfo, Web of Knowledge, and the Cochran Database of Systematic Reviews. The Cochrane Population, Intervention, Control, Outcome, Study Design (PICOS) approach guided this SR articles selection and evaluation process. Of the 102 publications screened, 10 original studies matched the SR inclusion criteria. The types of physical activity interventions and self-efficacy assessments for these 10 studies were diverse. Of the 10 included articles, 6 articles identified an improvement in post-self-efficacy assessments compared to baseline and 4 showed no effect. In conclusion, physical activity intervention programs may improve self-efficacy in youths. A standardized approach to classify and measure self-efficacy is required. Further research is needed to quantify the association of self-efficacy ratings after completing physical activity interventions with objective health improvements, such as weight loss. PMID:24555151

Crisis Intervention and the Military Family: A Model Installation Program.

DTIC Science & Technology

1988-03-07

abuse to less serious problems like budget management and good parenting techniques. Family dysfunction is defined in two categories: High and low...serious problems like budget management and good parenting techniques. Family dysfunction is defined in two categories: High and low intensity conflict. The...system activated to deal with the problem through the Family N, Advocacy Case Management Team. It is an excellent system that protects, helps and

Therapeutic Interpersonal Behavior in the Crisis Situation: An Empirical Study of Coping Responses.

ERIC Educational Resources Information Center

DeWine, Sue; Alderton, Steven

Research in crisis intervention has prescribed how trained but non-professional individuals should and do act in a crisis situation. The present study, however, focused on the types of responses untrained helpers use to respond to the crisis of another individual. Results indicate that types of responses vary significantly, with probing and…

75 FR 53303 - Notice of Public Hearing

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-31

... FINANCIAL CRISIS INQUIRY COMMISSION Notice of Public Hearing AGENCY: Financial Crisis Inquiry Commission. ACTION: Notice. SUMMARY: The next public hearing of the Financial Crisis Inquiry Commission (FCIC) is titled ``Too Big to Fail: Expectations and Impact of Extraordinary Government Intervention and the...

Educational program in crisis management for cardiac surgery teams including high realism simulation.

PubMed

Stevens, Louis-Mathieu; Cooper, Jeffrey B; Raemer, Daniel B; Schneider, Robert C; Frankel, Allan S; Berry, William R; Agnihotri, Arvind K

2012-07-01

Cardiac surgery demands effective teamwork for safe, high-quality care. The objective of this pilot study was to develop a comprehensive program to sharpen performance of experienced cardiac surgical teams in acute crisis management. We developed and implemented an educational program for cardiac surgery based on high realism acute crisis simulation scenarios and interactive whole-unit workshop. The impact of these interventions was assessed with postintervention questionnaires, preintervention and 6-month postintervention surveys, and structured interviews. The realism of the acute crisis simulation scenarios gradually improved; most participants rated both the simulation and whole-unit workshop as very good or excellent. Repeat simulation training was recommended every 6 to 12 months by 82% of the participants. Participants of the interactive workshop identified 2 areas of highest priority: encouraging speaking up about critical information and interprofessional information sharing. They also stressed the importance of briefings, early communication of surgical plan, knowing members of the team, and continued simulation for practice. The pre/post survey response rates were 70% (55/79) and 66% (52/79), respectively. The concept of working as a team improved between surveys (P = .028), with a trend for improvement in gaining common understanding of the plan before a procedure (P = .075) and appropriate resolution of disagreements (P = .092). Interviewees reported that the training had a positive effect on their personal behaviors and patient care, including speaking up more readily and communicating more clearly. Comprehensive team training using simulation and a whole-unit interactive workshop can be successfully deployed for experienced cardiac surgery teams with demonstrable benefits in participant's perception of team performance. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Pastoral crisis intervention with children: recognizing and responding to the spiritual reaction of children.

PubMed

McPherson, Kenneth F

2004-01-01

Many individuals struggle to express their thoughts and feelings following a crisis situation. When these feelings include questions related to spiritual issues such as bad things happening to good people, meaning in life and its tragedies, and the very existence of a caring and loving God, people shut down even more tightly. Imagine how much greater this difficulty becomes for those who lack the ability to verbalize what they are experiencing. Many of our most widely used crisis intervention models rely on verbal techniques to elicit people's thoughts and feelings about stressful incidents they've just experienced. The main focus of this paper is to provide alternative techniques for eliciting the thoughts and feelings of children during traumatic times. The paper reviews basic principles of pastoral crisis intervention (PCI), presents typical spiritual reactions of children to trauma by age groups, presents Crisis Response Play Therapy (CRPT) as one alternative method that bypasses the need for verbalization, and proposes the use of similar experiential techniques for special needs populations, including adults, who have difficulty giving voice to their experiences.

Training for disaster recovery: a review of training programs for social workers after the tsunami.

PubMed

Rowlands, Allison

2006-01-01

This paper describes a range of training programs for social workers and other recovery workers following the Indian Ocean Tsunami of December 2004. These programs were developed and implemented by the author in Singapore, and with collaboration from Indonesian colleagues, in Indonesia. The content is outlined and the rationale behind the development of the programs is presented. The theoretical bases for the diversity of interventions are argued. A course module for both undergraduate and postgraduate social work education is also described, as inclusion of crisis and disaster recovery management in professional courses is necessary to prepare practitioners for their inevitable involvement in responding to emergencies.

Neurolinguistic programming as an adjunct to other psychotherapeutic/hypnotherapeutic interventions.

PubMed

Field, E S

1990-01-01

The therapeutic dissociative techniques of "anchoring" and "three-part dissociation," neurolinguistic programming (NLP) treatment paradigms incorporating the idea of division into ego states, are effective in crisis intervention and as a stimulus for catharsis. Using the anchoring technique in the first session, a patient with severe anxiety, manifested by episodes of hyperactivity, was able to superimpose inner resources upon the situations which led to the episodes. Utilizing three-part dissociation, the patient experienced the hyperactive episodes "for the very last time" and terminated them permanently. Hypnotic exploration and ideomotor signaling were used with a patient presenting with uncomfortable feelings associated with intense anger. After the origin of the anger was determined, a three-part dissociation produced an abreaction and catharsis. Interaction at a cognitive level integrated the feelings and knowledge into personal consciousness.

Using Literature to Teach Crisis Intervention

ERIC Educational Resources Information Center

Deering, Catherine Gray

2018-01-01

This article presents a unique approach for teaching crisis intervention in that it involves students reading novels and autobiographies to use as case studies in order to apply the theories and concepts. A rationale for the use of literature as a projective device to help students experience personal growth and to target the affective domain of…

How Long Is a Minute? The Importance of a Measured Plan of Response to Crisis Situations

ERIC Educational Resources Information Center

Bickel, Perry S.

2010-01-01

Physical interventions for special education students in crisis remains a controversial concept. The first minute of a crisis situation represents the most crucial time to prevent injury or the exacerbation of injury. Although preventing violence and escalation of negative emotions is the first step in crisis management, school staff also must be…

Costs and savings associated with implementation of a police crisis intervention team.

PubMed

El-Mallakh, Peggy L; Kiran, Kranti; El-Mallakh, Rif S

2014-06-01

Police crisis intervention teams (CIT) have demonstrated their effectiveness in reducing injury to law enforcement personnel and citizens and the criminalization of mental illness; however, their financial effect has not been fully investigated. The objective of the study was to determine the total costs or total savings associated with implementing a CIT program in a medium-size city. The costs and savings associated with the implementation of a CIT program were analyzed in a medium-size city, Louisville, Kentucky, 9 years after the program's initiation. Costs associated with officer training, increased emergency psychiatry visits, and hospital admissions resulting from CIT activity were compared with the savings associated with diverted hospitalizations and reduced legal bookings. Based on an average of 2400 CIT calls annually, the overall costs associated with CIT per year were $2,430,128 ($146,079 for officer training, $1,768,536 for hospitalizations of patients brought in by CIT officers, $508,690 for emergency psychiatry evaluations, and $6823 for arrests). The annual savings of the CIT were $3,455,025 ($1,148,400 in deferred hospitalizations, $2,296,800 in reduced inpatient referrals from jail, and $9825 in avoided bookings and jail time). The balance is $1,024,897 in annual cost savings. The net financial effect of a CIT program is of modest benefit; however, much of this analysis was based on estimates and average length of stay. Furthermore, the costs and savings associated with officer or citizen injuries were not included because there was inadequate information about their prevalence and costs. Finally, this analysis does not take into account the nonmonetary gains of a CIT program.

The Continuing Infant Mortality Crisis in Illinois. Part 1. Hearing before the Select Committee on Children, Youth, and Families. House of Representatives, One Hundredth Congress, First Session (Springfield, Illinois, October 5, 1987).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Children, Youth, and Families.

Testimony concerned: (1) difficulties and successes in obtaining private and public medical services experienced by Illinois citizens with health problems during pregancy; (2) Illinois' efforts to deal with high infant mortality, including descriptions of intervention programs, excerpts from the data report of Illinois' 1988 Human Services Plan,…

Strengthening the evidence base for health programming in humanitarian crises.

PubMed

Ager, A; Burnham, G; Checchi, F; Gayer, M; Grais, R F; Henkens, M; Massaquoi, M B F; Nandy, R; Navarro-Colorado, C; Spiegel, P

2014-09-12

Given the growing scale and complexity of responses to humanitarian crises, it is important to develop a stronger evidence base for health interventions in such contexts. Humanitarian crises present unique challenges to rigorous and effective research, but there are substantial opportunities for scientific advance. Studies need to focus where the translation of evidence from noncrisis scenarios is not viable and on ethical ways of determining what happens in the absence of an intervention. Robust methodologies suited to crisis settings have to be developed and used to assess interventions with potential for delivery at scale. Strengthening research capacity in the low- to middle-income countries that are vulnerable to crises is also crucial. Copyright © 2014, American Association for the Advancement of Science.

School-Based Crisis Intervention: Preparing All Personnel to Assist. Practical Intervention in the Schools Series

ERIC Educational Resources Information Center

Heath, Melissa Allen; Sheen, Dawn

2005-01-01

When a student is in dire need of emotional support, caring adults in the school can make a difference. This essential resource helps practitioners prepare all school personnel to respond sensitively and effectively to children and adolescents in crisis. Packed with user-friendly features--including over 50 reproducible tools--the book provides…

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.

Rapid assessment of the HIV/AIDS crisis in racial and ethnic minority communities: an approach for timely community interventions.

PubMed

Needle, Richard H; Trotter, Robert T; Singer, Merrill; Bates, Christopher; Page, J Bryan; Metzger, David; Marcelin, Louis H

2003-06-01

The US Department of Health and Human Services, in collaboration with the Congressional Black Caucus, created a new initiative to address the disproportionate ongoing HIV/AIDS crisis in racial/ethnic minority populations. This initiative included deploying technical assistance teams through the Office of HIV/AIDS Policy. The teams introduced rapid assessment and response methodologies and trained minority communities in their use. The first 3 eligible cities (Detroit, Miami, and Philadelphia) focused assessments in small geographic areas, using multiple methodologies to obtain data. Data from the first 3 eligible cities provided critical information about changing the dynamics of the HIV/AIDS epidemic at the local level, including program and policy changes and infrastructure redeployment targeted at the most serious social and environmental conditions.

Which Helper Behaviors and Intervention Styles Are Related to Better Short-Term Outcomes in Telephone Crisis Intervention? Results from a Silent Monitoring Study of Calls to the U.S. 1-800-SUICIDE Network

ERIC Educational Resources Information Center

Mishara, Brian L.; Chagnon, Francois; Daigle, Marc; Balan, Bogdan; Raymond, Sylvaine; Marcoux, Isabelle; Bardon, Cecile; Campbell, Julie K.; Berman, Alan

2007-01-01

A total of 2,611 calls to 14 helplines were monitored to observe helper behaviors and caller characteristics and changes during the calls. The relationship between intervention characteristics and call outcomes are reported for 1,431 crisis calls. Empathy and respect, as well as factor-analytically derived scales of supportive approach and good…

Managed Migration: The Caribbean Approach to Addressing Nursing Services Capacity

PubMed Central

Salmon, Marla E; Yan, Jean; Hewitt, Hermi; Guisinger, Victoria

2007-01-01

Objective To (1) provide a contextual analysis of the Caribbean region with respect to forces shaping the current and emerging nursing workforce picture in the region; (2) discuss country-specific case(s) within the Caribbean; and (3) describe the Managed Migration Program as a potential framework for addressing regional and global nurse migration issues. Principal Findings The Caribbean is in the midst of a crisis of shortages of nurses with an average vacancy rate of 42 percent. Low pay, poor career prospects, and lack of education opportunities are among the reasons nurses resign. Many of these nurses look outside the region for job opportunities in the United Kingdom, Canada, the United States, and other countries. Compounding the situation is the lack of resources to train nurses to fill the vacancies. The Managed Migration Program of the Caribbean is a multilateral, cross-sector, multi-interventional, long-term strategy for developing and maintaining an adequate supply of nurses for the region. Conclusions The Managed Migration Program of the Caribbean has made progress in establishing regional support for addressing the nursing shortage crisis and developing a number of interesting initiatives such as training for export and temporary migration. Recommendations to move the Managed Migration Program of the Caribbean forward focus on advocacy, integration of the program into regional policy decisions, and integration of the program with regional health programming. PMID:17489919

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.

The Psychology of a Crisis: An Opportunity To Learn.

ERIC Educational Resources Information Center

Whiting, Peggy P.

1998-01-01

Crisis events may be viewed as expected, sudden, or catastrophic. Survivors have common needs: recognition of loss, soothing of fear, a sense of what happened, expression of feelings, assistance with adjustment, shared closure rituals, and ways to remember. Schools' crisis-response plans should include intervention and postintervention activities…

The Rhetoric of Terrorism and Media Response to the "Crisis in Iran."

ERIC Educational Resources Information Center

Palmerton, Patricia R.

1988-01-01

Examines television news coverage of the first days of the 1979 Iranian hostage crisis. Discovers patterns that reinforce terrorist strategy by focusing causation for the crisis on institutional targets and suggesting that military intervention would reestablish control. Suggests that media portrayals of terrorist events support the rhetorical…

Psychological first aid training for the faith community: a model curriculum.

PubMed

McCabe, O Lee; Lating, Jeffrey M; Everly, George S; Mosley, Adrian M; Teague, Paula J; Links, Jonathan M; Kaminsky, Michael J

2007-01-01

Traditionally faith communities have served important roles in helping survivors cope in the aftermath of public health disasters. However, the provision of optimally effective crisis intervention services for persons experiencing acute or prolonged emotional trauma following such incidents requires specialized knowledge, skills, and abilities. Supported by a federally-funded grant, several academic health centers and faith-based organizations collaborated to develop a training program in Psychological First Aid (PFA) and disaster ministry for members of the clergy serving urban minorities and Latino immigrants in Baltimore, Maryland. This article describes the one-day training curriculum composed of four content modules: Stress Reactions of Mind-Body-Spirit, Psychological First Aid and Crisis Intervention, Pastoral Care and Disaster Ministry, and Practical Resources and Self Care for the Spiritual Caregiver Detailed descriptions of each module are provided, including its purpose; rationale and background literature; learning objectives; topics and sub-topics; and educational methods, materials and resources. The strengths, weaknesses, and future applications of the training template are discussed from the vantage points of participants' subjective reactions to the training.

Strengths and virtues and the development of resilience: A qualitative study in Suriname during a time of economic crisis.

PubMed

Hendriks, Tom; Graafsma, Tobi; Hassankhan, Aabidien; Bohlmeijer, Ernst; de Jong, Joop

2018-03-01

Resilience can be described as the capacity to deal with adversity and traumatic events. The current economic situation in Suriname and its social economic consequences may demand a great amount of resilience for people living in Suriname. In this explorative study, we examined the relation between strengths and resilience among the three major ethnic groups in Suriname. Semi-structured interviews were conducted with 25 participants. We sought to gather viewpoints from community representatives, health care professionals and academic scholars about the personal resources used by people in Suriname to help them deal with the consequences of the current socio-economic crisis. We identified major five strengths that were associated with resilience: religiousness, hope, harmony, acceptance and perseverance. While these strengths contribute to the development of resilience, they can under certain circumstances have an ambiguous influence. Our findings suggest that religiousness is the bedrock strength for the development of resilience in Suriname. We recommend that future positive psychological interventions in non-Western countries integrate positive activities with religious elements into program interventions to achieve a better cultural fit.

Changes in mortality after the recent economic crisis in South Korea.

PubMed

Kim, Hanjoong; Song, Young Jong; Yi, Jee Jeon; Chung, Woo Jin; Nam, Chung Mo

2004-07-01

To examine the changes in all cause mortality and cause-specific mortality after the economic crisis in South Korea. Monthly mortality data for an entire country was used and intervention analysis applied to compare mortality after the crisis with mortality which would have occurred if the trends before the crisis had continued. All cause mortality began to increase about 1 year after the crisis, while cardiovascular increased immediately. Transport accidents decreased significantly during the year following the crisis and then regressed towards the pre-economic crisis level. Suicides increased rapidly and maintained an upward trend but subsequently reduced towards the pre-economic crisis level. This study has shown an evidence of a relationship between economic crisis and mortality.

Family-Based Crisis Intervention with Suicidal Adolescents in the Emergency Room: A Pilot Study

ERIC Educational Resources Information Center

Wharff, Elizabeth A.; Ginnis, Katherine M.; Ross, Abigail M.

2012-01-01

The prevailing model of care for psychiatric patients in the emergency room (ER) is evaluation and disposition, with little or no treatment provided. This article describes the results of a pilot study of a family-based crisis intervention (FBCI) for suicidal adolescents and their families in a large, urban pediatric ER. FBCI is an intervention…

Strategies to Reduce Hospitalizations of Children With Medical Complexity Through Complex Care: Expert Perspectives.

PubMed

Coller, Ryan J; Nelson, Bergen B; Klitzner, Thomas S; Saenz, Adrianna A; Shekelle, Paul G; Lerner, Carlos F; Chung, Paul J

Interventions to reduce disproportionate hospital use among children with medical complexity (CMC) are needed. We conducted a rigorous, structured process to develop intervention strategies aiming to reduce hospitalizations within a complex care program population. A complex care medical home program used 1) semistructured interviews of caregivers of CMC experiencing acute, unscheduled hospitalizations and 2) literature review on preventing hospitalizations among CMC to develop key drivers for lowering hospital utilization and link them with intervention strategies. Using an adapted version of the RAND/UCLA Appropriateness Method, an expert panel rated each model for effectiveness at impacting each key driver and ultimately reducing hospitalizations. The complex care program applied these findings to select a final set of feasible intervention strategies for implementation. Intervention strategies focused on expanding access to familiar providers, enhancing general or technical caregiver knowledge and skill, creating specific and proactive crisis or contingency plans, and improving transitions between hospital and home. Activities aimed to facilitate family-centered, flexible implementation and consideration of all of the child's environments, including school and while traveling. Tailored activities and special attention to the highest utilizing subset of CMC were also critical for these interventions. A set of intervention strategies to reduce hospitalizations among CMC, informed by key drivers, can be created through a structured, reproducible process. Both this process and the results may be relevant to clinical programs and researchers aiming to reduce hospital utilization through the medical home for CMC. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Effectiveness and cost-effectiveness of admissions to women's crisis houses compared with traditional psychiatric wards: pilot patient-preference randomised controlled trial.

PubMed

Howard, L; Flach, C; Leese, M; Byford, S; Killaspy, H; Cole, L; Lawlor, C; Betts, J; Sharac, J; Cutting, P; McNicholas, S; Johnson, S

2010-08-01

Women's crisis houses have been developed in the UK as a less stigmatising and less institutional alternative to traditional psychiatric wards. To examine the effectiveness and cost-effectiveness of women's crisis houses by first examining the feasibility of a pilot patient-preference randomised controlled trial (PP-RCT) design (ISRCTN20804014). We used a PP-RCT study design to investigate women presenting in crisis needing informal admission. The four study arms were the patient preference arms of women's crisis house or hospital admission, and randomised arms of women's crisis house or hospital admission. Forty-one women entered the randomised arms of the trial (crisis house n = 19, wards n = 22) and 61 entered the patient-preference arms (crisis house n = 37, ward n = 24). There was no significant difference in outcomes (symptoms, functioning, perceived coercion, stigma, unmet needs or quality of life) or costs for any of the groups (randomised or preference arms), but women who obtained their preferred intervention were more satisfied with treatment. Although the sample sizes were too small to allow definite conclusions, the results suggest that when services are able to provide interventions preferred by patients, those patients are more likely to be satisfied with treatment. This pilot study provides some evidence that women's crisis houses are as effective as traditional psychiatric wards, and may be more cost-effective.

Crisis Nursery and Respite Care Programs: Site Visit Results of Staff and Family Interviews (Winter and Spring of 1991).

ERIC Educational Resources Information Center

Huntington, Gail S.; And Others

Visits were made to selected respite care and crisis nursery programs in order to describe the programs and services they offered to families of young children with special needs and to learn more about the families who used the services and the staff who provided them. The visits to 10 crisis nurseries and 24 respite care programs resulted in…

Crisis Intervention and Counseling by Telephone. Second Edition.

ERIC Educational Resources Information Center

Lester, David, Ed.

This extensively revised second edition provides a practical framework for offering immediate problem-solving assistance by telephone to persons in crisis. The text offers specific techniques to deal with out-of-control situations with the highly important initial steps to protect the caller, the crisis worker, and the community. The scope of the…

Development and Reliability of the Comprehensive Crisis Plan Checklist

ERIC Educational Resources Information Center

Aspiranti, Kathleen B.; Pelchar, Taylor K.; McCLeary, Daniel F.; Bain, Sherry K.; Foster, Lisa N.

2011-01-01

It is of vital importance that children are educated in a safe environment. Every school needs to have a well-developed crisis management document containing plans for prevention, intervention, and postvention. We developed the Comprehensive Crisis Plan Checklist (CCPC) to serve as a valuable tool that can be used to assist practitioners with…

The Crisis Response to a School-Based Hostage Event: A Case Study

ERIC Educational Resources Information Center

Crepeau-Hobson, Franci; Summers, Laura L.

2011-01-01

During the past two decades there has been increased public, professional, and legislative interest in school crisis prevention and intervention. It is recommended that comprehensive crisis teams be established at the school, district, and community levels. A case study was conducted in which interviews were utilized to facilitate an increased…

The growth of chronic conditions: Search for solutions to the problem.

PubMed

Mednis, Dmitry

2017-06-25

The chronic conditions growth is determined by an increase of cases of adaptive system imbalance following a recent disease. One of its most significant causes is decrease of crisis importance (a stage of disease) as a moderator of a qualitative changeover of an adaptive system. The contemporary treatment methods increase efficiency of pre-crises adaptive responses, but simultaneously they equalize the crisis to a level, which is insufficient for complete after-crisis alignment of body defenses. But the crisis is the very key to a solution to a chronic conditions problem. One of the ways of the problem solving is medical interventions, which cause sparing provocation crisis and a successive changeover of an adaptive system. Based on this it is worth reviewing critically, studying and developing the existing experience of bio-regulatory therapy, where the principle of sparing provocation is often used. The new term definitions, such as "medical intervention", "health problems", "crisis" are described in terms of biomedicine. The patients and physicians should be motivated to deal with chronic conditions correction and the aforesaid sets new tasks before a health care system.

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.

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

PubMed

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

2017-07-01

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

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.

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

PubMed

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

2016-01-01

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

Rapid Assessment of the HIV/AIDS Crisis in Racial and Ethnic Minority Communities: An Approach for Timely Community Interventions

PubMed Central

Needle, Richard H.; Trotter, Robert T.; Singer, Merrill; Bates, Christopher; Page, J. Bryan; Metzger, David; Marcelin, Louis H.

2003-01-01

Objectives. The US Department of Health and Human Services, in collaboration with the Congressional Black Caucus, created a new initiative to address the disproportionate ongoing HIV/AIDS crisis in racial/ethnic minority populations. Methods. This initiative included deploying technical assistance teams through the Office of HIV/AIDS Policy. The teams introduced rapid assessment and response methodologies and trained minority communities in their use. Results. The first 3 eligible cities (Detroit, Miami, and Philadelphia) focused assessments in small geographic areas, using multiple methodologies to obtain data. Conclusions. Data from the first 3 eligible cities provided critical information about changing the dynamics of the HIV/AIDS epidemic at the local level, including program and policy changes and infrastructure redeployment targeted at the most serious social and environmental conditions. PMID:12773364

Group crisis intervention for children during ongoing war conflict.

PubMed

Thabet, Abdel Aziz; Vostanis, Panos; Karim, Khalid

2005-08-01

The aim of this study was to evaluate the short-term impact of a group crisis intervention for children aged 9-15 years from five refugee camps in the Gaza Strip during ongoing war conflict. Children were selected if they reported moderate to severe posttraumatic stress reactions, and were allocated to group intervention (N=47) encouraging expression of experiences and emotions through storytelling, drawing, free play and role-play; education about symptoms (N=22); or no intervention (N=42). Children completed the CPTSD-RI and the CDI pre- and post-intervention. No significant impact of the group intervention was established on children's posttraumatic or depressive symptoms. Possible explanations of the findings are discussed, including the continuing exposure to trauma and the non-active nature of the intervention.

Trauma Center Based Youth Violence Prevention Programs: An Integrative Review.

PubMed

Mikhail, Judy Nanette; Nemeth, Lynne Sheri

2016-12-01

Youth violence recidivism remains a significant public health crisis in the United States. Violence prevention is a requirement of all trauma centers, yet little is known about the effectiveness of these programs. Therefore, this systematic review summarizes the effectiveness of trauma center-based youth violence prevention programs. A systematic review of articles from MEDLINE, CINAHL, and PsychINFO databases was performed to identify eligible control trials or observational studies. Included studies were from 1970 to 2013, describing and evaluating an intervention, were trauma center based, and targeted youth injured by violence (tertiary prevention). The social ecological model provided the guiding framework, and findings are summarized qualitatively. Ten studies met eligibility requirements. Case management and brief intervention were the primary strategies, and 90% of the studies showed some improvement in one or more outcome measures. These results held across both social ecological level and setting: both emergency department and inpatient unit settings. Brief intervention and case management are frequent and potentially effective trauma center-based violence prevention interventions. Case management initiated as an inpatient and continued beyond discharge was the most frequently used intervention and was associated with reduced rearrest or reinjury rates. Further research is needed, specifically longitudinal studies using experimental designs with high program fidelity incorporating uniform direct outcome measures. However, this review provides initial evidence that trauma centers can intervene with the highest of risk patients and break the youth violence recidivism cycle. © The Author(s) 2015.

Descriptive study of older adults encountered by crisis intervention team (CIT) law enforcement officers.

PubMed

Tyuse, Sabrina W; Cooper-Sadlo, Shannon; Underwood, Sarah E

2017-01-01

Increasingly, older adults who experience a mental health crisis come to the attention of crisis intervention team (CIT) law enforcement officers. These encounters are due largely to a lack of local mental health care resources. With few options available, individuals call 911 for assistance when an older adult exhibits alarming behavior. This article provides a profile of older adults encountered by CIT officers, identifies the reasons for the 911 call for assistance, and finds what predictors are associated with outcomes of those encounters. We found that these older adults were mostly female, Caucasian, diagnosed with depression, and attempting or threatening suicide.

Crisis Intervention with Older Persons: State of the Art and Clinical Applications.

ERIC Educational Resources Information Center

Duffy, Michael

A basic tenet of this paper is that the concept of crisis and crisis management has developed as a central issue within the fields of community psychiatry, psychology, and mental health, but that little systematic attention has been devoted to a particular subgroup at risk, i.e., older persons. Both theoretical background and clinical implications…

Crisis Response in the Public Schools: A Survey of School Psychologists' Experiences and Perceptions

ERIC Educational Resources Information Center

Adamson, Austin D.; Peacock, Gretchen Gimpel

2007-01-01

In this study, 228 school psychologists completed a survey regarding crisis intervention teams and plans. The majority of respondents indicated their schools had crisis plans (95.1%) and teams (83.6%). The most common team activities endorsed by participants involved providing direct assistance and services to students, staff, and the media. The…

Exercise and Fall Prevention: Narrowing the Research-to-Practice Gap and Enhancing Integration of Clinical and Community Practice.

PubMed

Li, Fuzhong; Eckstrom, Elizabeth; Harmer, Peter; Fitzgerald, Kathleen; Voit, Jan; Cameron, Kathleen A

2016-02-01

Falls in older adults are a global public health crisis, but mounting evidence from randomized controlled trials shows that falls can be reduced through exercise. Public health authorities and healthcare professionals endorse the use of evidence-based, exercise-focused fall interventions, but there are major obstacles to translating and disseminating research findings into healthcare practice, including lack of evidence of the transferability of efficacy trial results to clinical and community settings, insufficient local expertise to roll out community exercise programs, and inadequate infrastructure to integrate evidence-based programs into clinical and community practice. The practical solutions highlighted in this article can be used to address these evidence-to-practice challenges. Falls and their associated healthcare costs can be reduced by better integrating research on exercise intervention into clinical practice and community programs. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

[Domestic violence against women of a crisis intervention population - forms of violence and risk factors].

PubMed

Nyberg, E; Stieglitz, R-D; Flury, M; Riecher-Rössler, A

2013-06-01

BACKGROUND AND HYPOTHESES: Domestic violence is common and can lead to severe physical and psychological problems. Thus, we have investigated the frequency of occurrence, forms and risk factors of domestic violence against female patients on a crisis intervention ward. 115 women were screened with the "screening spouse violence" (SPG) and the "index of spouse abuse" (ISA). The life time prevalence concerning spouse violence was 70 %. Out of 74 women who were currently living in a relationship 28 (38 % )were victims of violence in the last 12 months prior to their admission. Women who experienced violence had a significantly lower level of education. Screening for domestic violence in female patients in the field of crisis intervention and psychiatry should become a standard of "good clinical practice". © Georg Thieme Verlag KG Stuttgart · New York.

Implementation and use of a crisis hotline during the treatment as usual and universal screening phases of a suicide intervention study.

PubMed

Arias, Sarah A; Sullivan, Ashley F; Miller, Ivan; Camargo, Carlos A; Boudreaux, Edwin D

2015-11-01

Although research suggests that crisis hotlines are an effective means of mitigating suicide risk, lack of empirical evidence may limit the use of this method as a research safety protocol. This study describes the use of a crisis hotline to provide clinical backup for research assessments. Data were analyzed from participants in the Emergency Department Safety and Follow-up Evaluation (ED-SAFE) study (n=874). Socio-demographics, call completion data, and data available on suicide attempts occurring in relation to the crisis counseling call were analyzed. Pearson chi-squared statistic for differences in proportions were conducted to compare characteristics of patients receiving versus not receiving crisis counseling. P<0.05 was considered statistically significant. Overall, there were 163 counseling calls (6% of total assessment calls) from 135 (16%) of the enrolled subjects who were transferred to the crisis line because of suicide risk identified during the research assessment. For those transferred to the crisis line, the median age was 40 years (interquartile range 27-48) with 67% female, 80% white, and 11% Hispanic. Increasing demand for suicide interventions in diverse healthcare settings warrants consideration of crisis hotlines as a safety protocol mechanism. Our findings provide background on how a crisis hotline was implemented as a safety measure, as well as the type of patients who may utilize this safety protocol. Copyright © 2015 Elsevier Inc. All rights reserved.

Implementation and Use of a Crisis Hotline During the Treatment as Usual and Universal Screening Phases of a Suicide Intervention Study

PubMed Central

Arias, Sarah A.; Sullivan, Ashley F.; Miller, Ivan; Camargo, Carlos A.; Boudreaux, Edwin D.

2015-01-01

Background Although research suggests that crisis hotlines are an effective means of mitigating suicide risk, lack of empirical evidence may limit the use of this method as a research safety protocol. Purpose This study describes the use of a crisis hotline to provide clinical backup for research assessments. Methods Data were analyzed from participants in the Emergency Department Safety and Follow-up Evaluation (ED-SAFE) study (n=874). Socio-demographics, call completion data, and data available on suicide attempts occurring in relation to the crisis counseling call were analyzed. Pearson chi-squared statistic for differences in proportions were conducted to compare characteristics of patients receiving versus not receiving crisis counseling. P<0.05 was considered statistically significant. Results Overall, there were 163 counseling calls (6% of total assessment calls) from 135 (16%) of the enrolled subjects who were transferred to the crisis line because of suicide risk identified during the research assessment. For those transferred to the crisis line, the median age was 40 years (interquartile range 27–48) with 67% female, 80% white, and 11% Hispanic. Conclusions Increasing demand for suicide interventions in diverse healthcare settings warrants consideration of crisis hotlines as a safety protocol mechanism. Our findings provide background on how a crisis hotline was implemented as a safety measure, as well as the type of patients who may utilize this safety protocol. PMID:26341724

Community Disasters, Psychological Trauma, and Crisis Intervention.

PubMed

Boscarino, Joseph A

The current issue of International Journal of Emergency Mental Health and Human Resilience is focused on community disasters, the impact of trauma exposure, and crisis intervention. The articles incorporated include studies ranging from the World Trade Center disaster to Hurricane Sandy. These studies are related to public attitudes and beliefs about disease outbreaks, the impact of volunteerism following the World Trade Center attacks, alcohol misuse among police officers after Hurricane Katrina, posttraumatic stress disorder after Hurricane Sandy among those exposed to the Trade Center disaster, compassion fatigue and burnout among trauma workers, crisis interventions in Eastern Europe, and police officers' use of stress intervention services. While this scope is broad, it reflects the knowledge that has emerged since the Buffalo Creek and Chernobyl catastrophes, to the more recent Hurricane Katrina and Sandy disasters. Given the current threat environment, psychologists, social workers, and other providers need to be aware of these developments and be prepared to mitigate the impact of psychological trauma following community disasters, whether natural or man-made.

The effects of crisis plans for patients with psychotic and bipolar disorders: a randomised controlled trial.

PubMed

Ruchlewska, A; Mulder, C L; Smulders, R; Roosenschoon, B J; Koopmans, G; Wierdsma, A

2009-07-09

Crises and (involuntary) admissions have a strong impact on patients and their caregivers. In some countries, including the Netherlands, the number of crises and (involuntary) admissions have increased in the last years. There is also a lack of effective interventions to prevent their occurrence. Previous research has shown that a form of psychiatric advance statement - joint crisis plan - may prevent involuntary admissions, but another study showed no significant results for another form. The question remains which form of psychiatric advance statement may help to prevent crisis situations. This study examines the effects of two other psychiatric advance statements. The first is created by the patient with help from a patient's advocate (Patient Advocate Crisis Plan: PACP) and the second with the help of a clinician only (Clinician facilitated Crisis Plan: CCP). We investigate whether patients with a PACP or CCP show fewer emergency visits and (involuntary) admissions as compared to patients without a psychiatric advance statement. Furthermore, this study seeks to identify possible mechanisms responsible for the effects of a PACP or a CCP. This study is a randomised controlled trial with two intervention groups and one control condition. Both interventions consist of a crisis plan, facilitated through the patient's advocate or the clinician respectively.Outpatients with psychotic or bipolar disorders, who experienced at least one psychiatric crisis during the previous two years, are randomly allocated to one of the three groups. Primary outcomes are the number of emergency (after hour) visits, (involuntary) admissions and the length of stay in hospital. Secondary outcomes include psychosocial functioning and treatment satisfaction. The possible mediator variables of the effects of the crisis plans are investigated by assessing the patient's involvement in the creation of the crisis plan, working alliance, insight into illness, recovery style, social support, locus of control, service engagement and coping with crises situations. The interviews take place before randomisation, nine month later and finally eighteen months after randomisation. This study examines the effects of two types of crisis plans. In addition, the results offer an understanding of the way these advance statements work and whether it is more effective to include a patients' advocate in the process of creating a psychiatric advance statement. These statements may be an intervention to prevent crises and the use of compulsion in mental health care. The strength and limitations of this study are discussed. Current Controlled Trails NTR1166.

Academic/State/Federal collaborations and the improvement of practices in disaster mental health services and evaluation.

PubMed

Watson, Patricia J; Ruzek, Josef I

2009-05-01

Academic, state, and federal agencies collaborated over the last 9 years to improve disaster mental health services and evaluation. This process, which included literature reviews, a number of expert panels, and case studies, is described. The products resulting from this process have included the development of a systematic cross-site evaluation of the federally funded crisis counseling program and field guides for interventions aimed at providing services to distressed individuals in the immediate aftermath of disasters and to individuals needing resilience skills training weeks or months after the event. Future improvement of disaster mental health services calls for continued research, evaluation, training, and intervention development.

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.

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

ERIC Educational Resources Information Center

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

2012-01-01

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

The 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.

Cultural issues in an Outpatient Program for stimulant abusers.

PubMed

Pérez-Arce, P; Carr, K D; Sorensen, J L

1993-01-01

Cocaine abuse has created widespread problems, especially in poor urban ethnic minority communities. This article discusses the cultural issues in delivering a cocaine treatment program to a predominantly minority patient population. The Stimulant Treatment Outpatient Program (STOP) of San Francisco General Hospital's Substance Abuse Services was established in 1990 as a public service clinic. Many program elements apply equally well to various cultural groups, including individual and group counseling, limited time in treatment, and crisis intervention. Culturally linked clinical issues include provision of a supportive infrastructure, role models in leadership positions, understanding the cultural influences in patients' lives, and establishing communication links with Cultural themes are discussed as they apply to treating African-Americans, Latinos, Asian-Americans, Native Americans, and clients of different genders. Programmatic outcome indicators, including program attrition, suggest that different cultural groups benefit differentially from the treatment.

Abortion in late Imperial China: routine birth control or crisis intervention?

PubMed

Sommer, Matthew H

2010-01-01

In late imperial China, a number of purported methods of abortion were known; but who actually attempted abortion and under what circumstances? Some historians have suggested that abortion was used for routine birth control, which presupposes that known methods were safe, reliable, and readily available. This paper challenges the qualitative evidence on which those historians have relied, and presents new evidence from Qing legal sources and modern medical reports to argue that traditional methods of abortion (the most common being abortifacient drugs) were dangerous, unreliable, and often cost a great deal of money. Therefore, abortion in practice was an emergency intervention in a crisis: either a medical crisis, in which pregnancy threatened a woman's health, or a social crisis, in which pregnancy threatened to expose a woman's extramarital sexual relations. Moreover, abortion was not necessarily available even to women who wanted one.

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

The Humanitarian Situation in Syria: A Snapshot in the Third Year of the Crisis

PubMed Central

Doocy, Shannon; Delbiso, Tefera D.; Guha-Sapir, Debarati

2015-01-01

Between April and June 2014, International Orthodox Christian Charities (IOCC), an International NGO, and the Greek Orthodox Patriarchate of Antioch and All the East (GOPA) conducted a needs assessment of Syrians affected by the crisis with the objective of gaining a better understanding of humanitarian needs and assistance priorities. Findings suggest that interventions that increase access to non-food items, food, medication and education should be prioritized where cost was the primary barrier to accessing goods and services. Cash transfer programs and direct provision of material assistance should be considered, though the most appropriate assistance modality is likely to vary by sector, location and the preferences and prior experience of donors and implementing organizations. Renewed international commitment to funding humanitarian assistance efforts in Syria and neighboring countries where the burden of refugees is greatest is essential from both a human rights perspective and in terms of maintaining stability in the region. PMID:25821647

The humanitarian situation in syria: a snapshot in the third year of the crisis.

PubMed

Doocy, Shannon; Delbiso, Tefera D; Guha-Sapir, Debarati

2015-03-03

Between April and June 2014, International Orthodox Christian Charities (IOCC), an International NGO, and the Greek Orthodox Patriarchate of Antioch and All the East (GOPA) conducted a needs assessment of Syrians affected by the crisis with the objective of gaining a better understanding of humanitarian needs and assistance priorities. Findings suggest that interventions that increase access to non-food items, food, medication and education should be prioritized where cost was the primary barrier to accessing goods and services. Cash transfer programs and direct provision of material assistance should be considered, though the most appropriate assistance modality is likely to vary by sector, location and the preferences and prior experience of donors and implementing organizations. Renewed international commitment to funding humanitarian assistance efforts in Syria and neighboring countries where the burden of refugees is greatest is essential from both a human rights perspective and in terms of maintaining stability in the region.

Phaeochromocytoma [corrected] crisis.

PubMed

Whitelaw, B C; Prague, J K; Mustafa, O G; Schulte, K-M; Hopkins, P A; Gilbert, J A; McGregor, A M; Aylwin, S J B

2014-01-01

Phaeochromocytoma [corrected] crisis is an endocrine emergency associated with significant mortality. There is little published guidance on the management of phaeochromocytoma [corrected] crisis. This clinical practice update summarizes the relevant published literature, including a detailed review of cases published in the past 5 years, and a proposed classification system. We review the recommended management of phaeochromocytoma [corrected] crisis including the use of alpha-blockade, which is strongly associated with survival of a crisis. Mechanical circulatory supportive therapy (including intra-aortic balloon pump or extra-corporeal membrane oxygenation) is strongly recommended for patients with sustained hypotension. Surgical intervention should be deferred until medical stabilization is achieved. © 2013 John Wiley & Sons Ltd.

Research Summaries

ERIC Educational Resources Information Center

Brock, Stephen E., Ed.

2009-01-01

This article presents summaries of two recent crisis management publications: (1) "Social Validity of the CISM Model for School Crisis Intervention," summarized by Jack R. Dempsey; and (2) "School Violence: Associations With Control, Security/Enforcement, Educational/Therapeutic Approaches, and Demographic Factors," summarized by Ashlee Barton.…

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.

Interventions for treating painful sickle cell crisis during pregnancy.

PubMed

Martí-Carvajal, Arturo J; Peña-Martí, Guiomar E; Comunián-Carrasco, Gabriella; Martí-Peña, Arturo J

2009-01-21

Sickle cell disease is a group of genetic haemoglobin disorders. All over the world, about 300,000 children with these disorders are born each year. Acute sickle cell pain episodes are the most common cause of hospitalisation. Pregnancy in women with sickle cell disease is associated with an increased incidence of maternal and fetal morbidity and mortality. The painful crisis is a severe complication of this illness, and it requires several interventions: packed red cell transfusion, fluid replacement therapy, analgesic drugs, oxygen therapy and steroids; but the approach is not standardised. To assess the effectiveness and safety of different regimens of packed red cell transfusion, oxygen therapy, fluid replacement therapy, analgesic drugs, and steroids for the treatment of painful sickle cell crisis during pregnancy. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (December 2007), the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Register (October 2007), LILACS database (1982 to December 2007) and the following web sites: ClinicalTrials.gov (http://www.clinicaltrials.gov) (December 5, 2007); Current Controlled Trials (http://controlled-trials.com/) (December 5, 2007), and Sistema de Información Esencial en Terapéutica y Salud (http://www.icf.uab.es/informacion/Papyrus/sietes.asp) (December 1, 2007). We also handsearched the European Haematology Association conference (June 2007), the American Society of Hematology conference (December 2007) and reference lists of all retrieved articles. We intended to include randomised clinical trials. We intended to summarise data by standard Cochrane Collaboration methodologies. We could not find any randomised clinical trials on interventions (packed red cell transfusion, oxygen therapy, fluid replacement therapy, analgesic drugs, and steroids) for the treatment of painful sickle cell crisis during pregnancy. This review found no randomised clinical trials on the safety and efficacy of interventions for treating painful sickle cell crisis during pregnancy. The effects of interventions need to be tested in randomised clinical trials.

[Second victim : Critical incident stress management in clinical medicine].

PubMed

Schiechtl, B; Hunger, M S; Schwappach, D L; Schmidt, C E; Padosch, S A

2013-09-01

Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second victim of an adverse event. Psychological distress may not only have a long lasting impact on quality of life of the physician or caregiver involved but it may also affect the ability to provide safe patient care in the aftermath of adverse events. A literature review was performed to obtain information on care giver responses to medical errors and to determine possible supportive strategies to mitigate negative consequences of an adverse event on the second victim. An internet search and a search in Medline/Pubmed for scientific studies were conducted using the key words "second victim, "medical error", "critical incident stress management" (CISM) and "critical incident stress reporting system" (CIRS). Sources from academic medical societies and public institutions which offer crisis management programs where analyzed. The data were sorted by main categories and relevance for hospitals. Analysis was carried out using descriptive measures. In disaster medicine and aviation navigation services the implementation of a CISM program is an efficient intervention to help staff to recover after a traumatic event and to return to normal functioning and behavior. Several other concepts for a clinical crisis management plan were identified. The integration of CISM and CISM-related programs in a clinical setting may provide efficient support in an acute crisis and may help the caregiver to deal effectively with future error events and employee safety.

A crisis management quality improvement initiative in a children's psychiatric hospital: design, implementation, and outcome.

PubMed

Paccione-Dyszlewski, Margaret R; Conelea, Christine A; Heisler, Walter C; Vilardi, Jodie C; Sachs, Henry T

2012-07-01

Behavioral crisis management, including the use of seclusion and restraint, is the most high risk process in the psychiatric care of children and adolescents. The authors describe hospital-wide programmatic changes implemented at a children's psychiatric hospital that aimed to improve the quality of crisis management services. Pre/post quantitative and qualitative data suggest reduced restraint and seclusion use, reduced patient and staff injury related to crisis management, and increased patient satisfaction during the post-program period. Factors deemed beneficial in program implementation are discussed.

Research Summaries

ERIC Educational Resources Information Center

Brock, Stephen E., Ed.

2009-01-01

This article presents summaries of four recent crisis management publications: (1) "Crisis Intervention for Children/Caregivers Exposed to Intimate Partner Violence," summarized by Donna DeVaughn Kreskey; (2) "Predictors of Trauma Reactions Following the 9/11 Terrorist Attacks," summarized by Kelly O'Connor; (3) "Cognitive Coping Styles and PTSD…

Adolescents from families of divorce: vulnerability to physiological and psychological disturbances.

PubMed

Thompson, P

1998-03-01

Multiple factors contribute to the vulnerability of adolescents to physiological and psychological disturbances following parental divorce. These include father absence, interparental conflict, economic distress, multiple life stressors, parent adjustment, and short-term crisis. Clinical and societal problems manifested in these vulnerable adolescents are discussed. Systems theory is used to explain this vulnerability of adolescents and to identify appropriate interventions and policies to promote health in this population. Policies recommended include required divorce mediation, early referrals for family and sibling therapy, and school programs to identify and support those most vulnerable.

What evidence exists for initiatives to reduce risk and incidence of sexual violence in armed conflict and other humanitarian crises? A systematic review.

PubMed

Spangaro, Jo; Adogu, Chinelo; Ranmuthugala, Geetha; Powell Davies, Gawaine; Steinacker, Léa; Zwi, Anthony

2013-01-01

Sexual violence is highly prevalent in armed conflict and other humanitarian crises and attracting increasing policy and practice attention. This systematic review aimed to canvas the extent and impact of initiatives to reduce incidence, risk and harm from sexual violence in conflict, post-conflict and other humanitarian crises, in low and middle income countries. Twenty three bibliographic databases and 26 websites were searched, covering publications from 1990 to September 2011 using database-specific keywords for sexual violence and conflict or humanitarian crisis. The 40 included studies reported on seven strategy types: i) survivor care; ii) livelihood initiatives; iii) community mobilisation; iv) personnel initiatives; v) systems and security responses; vi) legal interventions and vii) multiple component interventions. Conducted in 26 countries, the majority of interventions were offered in African countries. Despite the extensive literature on sexual violence by combatants, most interventions addressed opportunistic forms of sexual violence committed in post-conflict settings. Only one study specifically addressed the disaster setting. Actual implementation of initiatives appeared to be limited as was the quality of outcome studies. No studies prospectively measured incidence of sexual violence, although three studies provided some evidence of reductions in association with firewood distribution to reduce women's exposure, as did one program to prevent sexual exploitation and abuse by peacekeeping forces. Apparent increases to risk resulted from lack of protection, stigma and retaliation associated with interventions. Multiple-component interventions and sensitive community engagement appeared to contribute to positive outcomes. Significant obstacles prevent women seeking help following sexual violence, pointing to the need to protect anonymity and preventive strategies. This review contributes a conceptual framework for understanding the forms, settings, and interventions for conflict and crisis-related sexual violence. It points to the need for thorough implementation of initiatives that build on local capacity, while avoiding increased risk and re-traumatisation to survivors of sexual violence.

What Evidence Exists for Initiatives to Reduce Risk and Incidence of Sexual Violence in Armed Conflict and Other Humanitarian Crises? A Systematic Review

PubMed Central

Spangaro, Jo; Adogu, Chinelo; Ranmuthugala, Geetha; Powell Davies, Gawaine; Steinacker, Léa; Zwi, Anthony

2013-01-01

Sexual violence is highly prevalent in armed conflict and other humanitarian crises and attracting increasing policy and practice attention. This systematic review aimed to canvas the extent and impact of initiatives to reduce incidence, risk and harm from sexual violence in conflict, post-conflict and other humanitarian crises, in low and middle income countries. Twenty three bibliographic databases and 26 websites were searched, covering publications from 1990 to September 2011 using database-specific keywords for sexual violence and conflict or humanitarian crisis. The 40 included studies reported on seven strategy types: i) survivor care; ii) livelihood initiatives; iii) community mobilisation; iv) personnel initiatives; v) systems and security responses; vi) legal interventions and vii) multiple component interventions. Conducted in 26 countries, the majority of interventions were offered in African countries. Despite the extensive literature on sexual violence by combatants, most interventions addressed opportunistic forms of sexual violence committed in post-conflict settings. Only one study specifically addressed the disaster setting. Actual implementation of initiatives appeared to be limited as was the quality of outcome studies. No studies prospectively measured incidence of sexual violence, although three studies provided some evidence of reductions in association with firewood distribution to reduce women's exposure, as did one program to prevent sexual exploitation and abuse by peacekeeping forces. Apparent increases to risk resulted from lack of protection, stigma and retaliation associated with interventions. Multiple-component interventions and sensitive community engagement appeared to contribute to positive outcomes. Significant obstacles prevent women seeking help following sexual violence, pointing to the need to protect anonymity and preventive strategies. This review contributes a conceptual framework for understanding the forms, settings, and interventions for conflict and crisis-related sexual violence. It points to the need for thorough implementation of initiatives that build on local capacity, while avoiding increased risk and re-traumatisation to survivors of sexual violence. PMID:23690945

Post-Traumatic Stress Disorder in Children: Suggested Intervention.

ERIC Educational Resources Information Center

Csapo, Marg

1991-01-01

This paper reviews literature-based techniques of intervention with posttraumatic stress disorder in children, including such techniques as crisis intervention, in vitro flooding, communication training, physical mastery, perspective taking, elimination of self-blame, and self-calming. (JDD)

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.

Research Summaries

ERIC Educational Resources Information Center

Brock, Stephen E., Ed.

2012-01-01

In this column, members of the NASP Crisis Management in the Schools Interest Group provide summaries of three studies relevant to school crisis response. The first study investigated the prevalence of posttraumatic stress disorder (PTSD) among rescue workers. The second article explored the Child and Family Traumatic Stress Intervention, which is…

Characteristics of the Biopsychosocial Crisis of Infertility.

ERIC Educational Resources Information Center

Cook, Ellen Piel

1987-01-01

Presents a framework for understanding the crisis of infertility which is characterized by extensive anxiety, damaged self-esteem, grief, uncertainty about the future, and estranged relationships with each other and with family and friends. Proposes some interventions appropriate to helpers from a variety of disciplines. (ABB)

Can we build an efficient response to the prescription drug abuse epidemic? Assessing the cost effectiveness of universal prevention in the PROSPER trial.

PubMed

Crowley, D Max; Jones, Damon E; Coffman, Donna L; Greenberg, Mark T

2014-05-01

Prescription drug abuse has reached epidemic proportions. Nonmedical prescription opioid use carries increasingly high costs. Despite the need to cultivate efforts that are both effective and fiscally responsible, the cost-effectiveness of universal evidence-based-preventive-interventions (EBPIs) is rarely evaluated. This study explores the performance of these programs to reduce nonmedical prescription opioid use. Sixth graders from twenty-eight rural public school districts in Iowa and Pennsylvania were blocked by size and geographic location and then randomly assigned to experimental or control conditions (2002-2010). Within the intervention communities, prevention teams selected a universal family and school program from a menu of EBPIs. All families were offered a family-based program in the 6th grade and received one of three school-based programs in 7th-grade. The effectiveness and cost-effectiveness of each school program by itself and with an additional family-based program were assessed using propensity and marginal structural models. This work demonstrates that universal school-based EBPIs can efficiently reduce nonmedical prescription opioid use. Further, findings illustrate that family-based programs may be used to enhance the cost-effectiveness of school-based programs. Universal EBPIs can effectively and efficiently reduce nonmedical prescription opioid use. These programs should be further considered when developing comprehensive responses to this growing national crisis. Copyright © 2014 Elsevier Inc. All rights reserved.

40 CFR 166.49 - Public notice of crisis exemptions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Public notice of crisis exemptions... PROGRAMS EXEMPTION OF FEDERAL AND STATE AGENCIES FOR USE OF PESTICIDES UNDER EMERGENCY CONDITIONS Crisis Exemptions § 166.49 Public notice of crisis exemptions. (a) Periodic notices. At least quarterly, the...

Community-based school feeding during Indonesia's economic crisis: implementation, benefits, and sustainability.

PubMed

Studdert, Lisa J; Soekirman; Rasmussen, Kathleen M; Habicht, Jean-Pierre

2004-06-01

The Indonesian Government initiated a community-based national school-feeding program in 1996. Implementation was decentralized and involved multiple participants. In 1998 we evaluated the implementation of the program and the perceived benefits for community stakeholders using a survey of principals in 143 randomly selected schools and follow-up with in-depth interviews and observations in a subsample of 16 communities. The evaluation covered the period of the 1998 Asian economic crisis, affording the opportunity to assess its impact on the program. The program was implemented in all targeted schools, with excellent community participation. Feeding was sustained through the crisis, in spite of a dramatic escalation in food costs. The families of schoolchildren, farmers, and those who prepared food received economic benefits. The snacks replaced those sold at schools and were of better nutritional value. The children benefited because the snacks compensated for losses in the home diet resulting from the economic crisis. Characteristics of the program that may be important in explaining its success include the involvement of a range of community stakeholders, engagement with existing village administrative structures, scope for local community adaptation and innovation, and the use of local foods that dispersed benefits and ensured sustained implementation during the crisis.

Impact of the economic crisis and increase in food prices on child mortality: exploring nutritional pathways.

PubMed

Christian, Parul

2010-01-01

The current economic crisis and food price increase may have a widespread impact on the nutritional and health status of populations, especially in the developing world. Gains in child survival over the past few decades are likely to be threatened and millennium development goals will be harder to achieve. Beyond starvation, which is one of the causes of death in famine situations, there are numerous nutritional pathways by which childhood mortality can increase. These include increases in childhood wasting and stunting, intrauterine growth restriction, and micronutrient deficiencies such as that of vitamin A, iron, and zinc when faced with a food crisis and decreased food availability. These pathways are elucidated and described. Although estimates of the impact of the current crisis on child mortality are yet to be made, data from previous economic crises provide evidence of an increase in childhood mortality that we review. The current situation also emphasizes that there are vast segments of the world's population living in a situation of chronic food insecurity that are likely to be disproportionately affected by an economic crisis. Nutritional and health surveillance data are urgently needed in such populations to monitor both the impacts of a crisis and of interventions. Addressing the nutritional needs of children and women in response to the present crisis is urgent. But, ensuring that vulnerable populations are also targeted with known nutritional interventions at all times is likely to have a substantial impact on child mortality.

A family systems nursing intervention model for paediatric health crisis.

PubMed

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

2012-03-01

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

Use of expenditure analysis to enhance returns on investments in HIV services.

PubMed

Honermann, Brian; O'Hagan, Richael

2017-09-01

Globally, the response to the HIV epidemic is at a crisis point. International investments in the HIV response have been essentially flat for 8 years and domestic budgets in low and middle-income countries - still recovering from the global recession - have not been able to fill the resource gap to drive a full-fledged HIV response. Still, efficiencies and prioritization of evidence-based interventions enable a significant scale-up of treatment, but millions more people remain without treatment. This review looks at recent data and research to evaluate interventions that may help close gaps in service provision that undermine testing and treatment programs. The President's Emergency Plan for AIDS Relief recently began publicly releasing vast programmatic and expenditure data. These data reveal potential efficiency gaps in testing and treatment programs, particularly in the area of linkage and retention. Interventions such as HIV self-testing have been proposed to help, but whether they can deliver better results remains unclear. Same-day initiation on treatment improves initiation, retention, and viral suppression rates. Near real-time analysis of data and active response is critical in improving efficiencies in programs. More investment in implementation research is necessary to improve linkage to care and treatment to reach 90-90-90 goals.

Suicide: Issues of Prevention, Intervention, and Facilitation.

ERIC Educational Resources Information Center

Nelson, Franklyn L.

1984-01-01

Discusses the concept of suicide intervention which allows for the possibility of death facilitation as well as prevention. A proposed suicide intervention model is contrasted with the goals and methods of existing suicide prevention and crisis counseling services. (JAC)

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.

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

PubMed

Leferink, K; Bergold, J B

1996-11-01

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

Crisis Workers' Attributions for Domestic Violence.

ERIC Educational Resources Information Center

Madden, Margaret E.

Attributions affect coping with victimization. Battered women who blame their husbands' moods are less likely to leave than are women who blame their husbands' permanent characteristics for the violence. Abused women often have repeated contacts with crisis intervention workers and the attitudes of those workers may affect the attributions made by…

Including School Resource Officers in School-Based Crisis Intervention: Strengthening Student Support

ERIC Educational Resources Information Center

James, Richard K.; Logan, Joan; Davis, Scott A.

2011-01-01

This article discusses the importance of trained police officers, School Resource Officers (SROs), participating in school-based crisis response efforts. These efforts, mostly preventative in nature, mitigate and de-escalate trauma for students exposed to a wide variety of challenging situations. Scenarios are presented with dialogue between…

International Programs of U.S. Colleges and Universities: Priorities for the Seventies.

ERIC Educational Resources Information Center

Perkins, James A.

The thaw in the cold war, financial crisis, and rising visibility of serious domestic problems have combined to reduce support for international programs of US colleges and universities. This monograph examines circumstances behind the present crisis, reassesses the goals and structure of international programs, and suggests new directions such…

Comprehensive long-term management program for asthma: effect on outcomes in adult African-Americans.

PubMed

Kelso, T M; Abou-Shala, N; Heilker, G M; Arheart, K L; Portner, T S; Self, T H

1996-06-01

To determine if a comprehensive long-term management program, emphasizing inhaled corticosteroids and patient education, would improve outcomes in adult African-American asthmatics a nonrandomized control trial with a 2-year intervention was performed in a university-based clinic. Inclusion criteria consisted of (> or = 5) emergency department (ED) visits or hospitalizations (> or = 2) during the previous 2 years. Intervention patients were volunteers; a comparable control group was identified via chart review at hospitals within the same area and time period as the intervention patients. Individualized doses of beclomethasone with a spacer, inhaled albuterol "as needed," and crisis prednisone were the primary therapies. Environmental control, peak flow monitoring, and a partnership with the patient were emphasized. Detailed patient education was an integral part of management. Control patients received usual care from local physicians. ED visits and hospitalizations for 2 years before and 2 years during the intervention period were compared. Quality of life (QOL) measurements were made at baseline and every 6 months in the intervention group. Study group (n = 21) had a significant reduction in ED visits (2.3 +/- 0.2 pre-intervention versus 0.6 +/- 0.2 post-intervention; P = 0.0001). Control group (n = 18) did not have a significant change in ED visits during the 2-year post-intervention period (2.6 +/- 0.2 pre-intervention versus 2.0 +/- 0.2 post-intervention; P = 0.11). Both groups had significant reductions in hospitalizations, but the study group had a greater reduction. Sixty-two percent of study patients had complete elimination of ED visits and hospitalizations, whereas no control patients had total elimination of the need for institutional acute care. QOL in the study patients revealed significant improvements for most parameters. A comprehensive long-term management program emphasizing inhaled corticosteroids combined with other state-of-the-art management, including intensive patient education, improves outcomes in adult African-American asthmatics.

Integrating school-based and therapeutic conflict management models at schools.

PubMed

D'Oosterlinck, Franky; Broekaert, Eric

2003-08-01

Including children with emotional and behavioral needs in mainstream school systems leads to growing concern about the increasing number of violent and nonviolent conflicts. Schools must adapt to this evolution and adopt a more therapeutic dimension. This paper explores the possibility of integrating school-based and therapeutic conflict management models and compares two management models: a school-based conflict management program. Teaching Students To Be Peacemakers; and a therapeutic conflict management program, Life Space Crisis Intervention. The authors conclude that integration might be possible, but depends on establishing a positive school atmosphere, the central position of the teacher, and collaborative and social learning for pupils. Further implementation of integrated conflict management models can be considered but must be underpinned by appropriate scientific research.

The Development of Behavior Control Competency in Preadolescence: A Case Vignette

ERIC Educational Resources Information Center

Cooper, Atha J.; And Others

1972-01-01

The utility of a crisis intervention approach for helping preadolescents build competency in behavior control is demonstrated. The following dimensions are highlighted: immediacy of intervention, trust relationship, structural interventions, facilitating versus controlling, problem solving orientation, and mobilization of group membership…

Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project.

PubMed

Ranebennur, Virupax; Gaikwad, Sanjeevsingh; Ramesh, Sowmya; Bhende, Amrita

2014-01-01

It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility, and literacy, for effective human immunodeficiency virus (HIV) prevention. This paper describes and examines the association of the Aastha HIV/sexually transmitted infection (STI) prevention project in Mumbai and Thane, India, on the relationship between vulnerability and behavioral outcomes. Data were drawn from the Behavioural Tracking Survey, a cross-sectional behavioral study conducted in 2010 with 2,431 FSWs recruited in Mumbai and Thane. The key independent measures used were program exposure and "vulnerability index", a composite index of literacy, factors of dependence (alternative livelihood options, current debt, and children), and aspects of sex work (mobility and duration in sex work). Dependent measures included service uptake, self-confidence, self-identity, and individual agency. Logistic regression analysis was used to examine the study objectives. Of the analytical sample of 2,431 FSWs, 1,295 (53.3%) were categorized as highly vulnerable. Highly vulnerable FSWs who were associated with the Aastha program for more than a year were more likely to have accessed crisis-response services in the past 6 months (adjusted odds ratio [AOR] 2.2, 95% confidence interval [CI] 1.4-3.6; P<0.001), to have visited a clinic to get a checkup for STI symptoms (AOR 2.4, 95% CI 1.2-4.8; P<0.015), not to be ashamed to disclose identity as an FSW to health workers (AOR 2.1, 95% CI 1.2-3.5; P<0.008), and to be confident in supporting a fellow FSW in crisis (AOR 1.7, 95% CI 1.0-2.8, P<0.033) compared to those less vulnerable with similar exposure to the Aastha program. It is critical for HIV/STI interventions to consider vulnerabilities of FSWs at project inception and address them with focused strategies, including a segmented service-delivery model and community involvement, in order to strengthen the structural response to HIV prevention.

Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project

PubMed Central

Ranebennur, Virupax; Gaikwad, Sanjeevsingh; Ramesh, Sowmya; Bhende, Amrita

2014-01-01

Background It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility, and literacy, for effective human immunodeficiency virus (HIV) prevention. This paper describes and examines the association of the Aastha HIV/sexually transmitted infection (STI) prevention project in Mumbai and Thane, India, on the relationship between vulnerability and behavioral outcomes. Materials and methods Data were drawn from the Behavioural Tracking Survey, a cross-sectional behavioral study conducted in 2010 with 2,431 FSWs recruited in Mumbai and Thane. The key independent measures used were program exposure and “vulnerability index”, a composite index of literacy, factors of dependence (alternative livelihood options, current debt, and children), and aspects of sex work (mobility and duration in sex work). Dependent measures included service uptake, self-confidence, self-identity, and individual agency. Logistic regression analysis was used to examine the study objectives. Results Of the analytical sample of 2,431 FSWs, 1,295 (53.3%) were categorized as highly vulnerable. Highly vulnerable FSWs who were associated with the Aastha program for more than a year were more likely to have accessed crisis-response services in the past 6 months (adjusted odds ratio [AOR] 2.2, 95% confidence interval [CI] 1.4–3.6; P<0.001), to have visited a clinic to get a checkup for STI symptoms (AOR 2.4, 95% CI 1.2–4.8; P<0.015), not to be ashamed to disclose identity as an FSW to health workers (AOR 2.1, 95% CI 1.2–3.5; P<0.008), and to be confident in supporting a fellow FSW in crisis (AOR 1.7, 95% CI 1.0–2.8, P<0.033) compared to those less vulnerable with similar exposure to the Aastha program. Conclusion It is critical for HIV/STI interventions to consider vulnerabilities of FSWs at project inception and address them with focused strategies, including a segmented service-delivery model and community involvement, in order to strengthen the structural response to HIV prevention. PMID:24600249

The Impact of Caller Gender on Telephone Crisis-Helpline Workers' Interpretation of Suicidality in Caller Vignettes.

PubMed

Hunt, Tara; Wilson, Coralie J; Caputi, Peter; Wilson, Ian; Woodward, Alan

2018-04-23

Telephone crisis-line workers (TCWs) are trained in a variety of techniques and skills to facilitate the identification of suicidal callers. One factor that may influence the implementation of these skills is gender. This study used an experimental design to explore whether helpline callers being identified as male or female is associated with TCWs’ ratings of callers’ potential for suicide risk and TCWs’ intention to use support- or intervention-oriented skills with callers. Data were collected using an online self-report survey in an Australian sample of 133 TCWs. The results suggest that under some circumstances the callers’ gender might influence TCWs’ intention to use intervention-oriented skills with the caller. Implications for the training of telephone crisis workers, and those trained in suicide prevention more broadly are discussed.

An Introduction to the Model of Crisis Intervention Procedure for Borderline Patients (CIP-BP): A Case Study.

PubMed

Koweszko, Tytus; Gierus, Jacek; Więdłocha, Magdalena; Mosiołek, Anna; Szulc, Agata

2017-06-01

Borderline personality disorder is highly associated with suicidal behaviors. The authors of the current case study present the introduction model of original Crisis Intervention Procedure for Borderline Patients (CIP-BP) which is a method focused on restoring emotional balance, reducing the severity of symptoms and the risk of suicidal behavior, as well as developing optimum solutions for further action. Its aim is to enable the patient to regain control of their emotional memory, increase autonomy and restore important interpersonal relations by using the original resources of this person. The procedure aims at providing nursing personnel with a practical tool to effectively avert the crisis and prevent further decompensation of BPD patients. Further pre-post study is required to determine the effectiveness of the procedure. Copyright © 2017 Elsevier Inc. All rights reserved.

The Impact of Caller Gender on Telephone Crisis-Helpline Workers’ Interpretation of Suicidality in Caller Vignettes

PubMed Central

Wilson, Coralie J.; Caputi, Peter; Woodward, Alan

2018-01-01

Telephone crisis-line workers (TCWs) are trained in a variety of techniques and skills to facilitate the identification of suicidal callers. One factor that may influence the implementation of these skills is gender. This study used an experimental design to explore whether helpline callers being identified as male or female is associated with TCWs’ ratings of callers’ potential for suicide risk and TCWs’ intention to use support- or intervention-oriented skills with callers. Data were collected using an online self-report survey in an Australian sample of 133 TCWs. The results suggest that under some circumstances the callers’ gender might influence TCWs’ intention to use intervention-oriented skills with the caller. Implications for the training of telephone crisis workers, and those trained in suicide prevention more broadly are discussed. PMID:29690628

25 CFR 36.70 - What terms do I need to know?

Code of Federal Regulations, 2011 CFR

2011-04-01

..., personal well-being by: (1) Providing early intervention services, coordinating crisis intervention and... problems; and (4) Referring students with behavioral needs that require professional medical care to an...

The impact of experiential exercises on communication and relational skills in a suicide prevention gatekeeper-training program for college resident advisors.

PubMed

Pasco, Susan; Wallack, Cory; Sartin, Robert M; Dayton, Rebecca

2012-01-01

In an effort to identify students at risk for suicide, many colleges are implementing suicide prevention training for campus gatekeepers. This study evaluated the efficacy of a 3-hour, experiential-based gatekeeper training that included an emphasis on enhancing communication skills and relational connection in addition to the didactic foci of standard gatekeeper training. Sixty-five college student resident advisors (RAs) were trained with Campus Connect. The training was dismantled to examine the specific contribution of experiential exercises on training outcomes. Compared to didactic training alone, following participation in experiential exercises RAs' training outcome scores exhibited additional improvement on the Suicide Intervention Response Inventory-2 and a 14-item self-report measure of self-efficacy for specific suicide- and crisis-related knowledge and skills. In gatekeeper training, experiential exercises emphasizing awareness and empathic responding and practice of these skills contribute to an improvement in crisis response skills above and beyond that of didactic training alone.

SHPPS 2006 School Health Policies and Programs Study--Crisis Preparedness, Response, and Recovery

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2007

2007-01-01

The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief presents data on crisis preparedness, response, and recovery as it pertains to health services, mental health and social services, nutrition…

Self-Evaluation Handbook for Hotlines and Youth Crisis Centers.

ERIC Educational Resources Information Center

Baizerman, Michael; And Others

This handbook is a response to Hotline and Youth Crisis Center staff who asked for a guidebook for doing program evaluation. A cross-section of Hotline workers in three Minnesota centers was monitored to define issues and problems or concerns about their programs. The actual program methods used were determined and utilized to formalize a method…

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.

Interventions for Challenging Behavior in Residential Settings.

ERIC Educational Resources Information Center

Stancliffe, Roger J.; Lakin, K. Charlie; Hayden, Mary F.

1999-01-01

A study investigated the use of different interventions for 151 individuals with mental retardation in residential care: Individualized Habilitation Plan objectives concerning challenging behavior, one-to-one crisis intervention in the preceding 30 days, and behavior management professional services in the preceding 6 months. Externalized…

Psychosocial and financial aspects of lung transplantation.

PubMed

Smolin, T L; Aguiar, L J

1996-09-01

This article summarizes the many psychosocial phases a patient will encounter during his or her transplantation experience and the ways the social worker can assist during this time. These include supportive services such as facilitating support groups and orientation programs, counseling, and crisis intervention. Also of importance is the financing of lung transplantation and its many associated costs, such as immunosuppressive medications and temporary housing. With the rise in managed care, the role of the transplant financial coordinator is of increasing importance from both a fiscal perspective and customer service standpoint for both the patient and the institution.

Crisis in the Workplace: The Role of the Occupational Social Worker.

ERIC Educational Resources Information Center

Ribner, David S.

1993-01-01

Notes that Israeli economy underwent dramatic and generally negative changes during Gulf War. Examines socioeconomic impact of war and efforts of occupational social workers to cope with needs of Israeli workers. Examines techniques of crisis intervention in context of pervasive atmosphere of change and uncertainty. Concludes with look at…

Preparation, Action, Recovery: A Conceptual Framework for Counselor Preparation and Response in Client Crises

ERIC Educational Resources Information Center

McAdams, Charles R.; Keener, Harry J.

2008-01-01

Despite increasing requirements for counselor proficiency in crisis response, there is an absence in the standards for counselor preparation, certification, and supervision of consistent criteria on which best practice in crisis prevention and intervention, and postcrisis recovery can be gauged. The authors present a conceptual framework that…

Securing PREPaRE Training in Your District

ERIC Educational Resources Information Center

Reeves, Melissa; Cowan, Katherine C.

2008-01-01

The PREPaRE Crisis Prevention and Intervention Curriculum is the first comprehensive curriculum developed and offered by NASP. PREPaRE's purpose is to build the capacity of schools at the local level to prevent, prepare for, respond to, and recover from crisis events. Embedded in this primary goal is the ability to foster systems change consistent…

Resources in Crisis Intervention: School, Family and Community Applications.

ERIC Educational Resources Information Center

Sandoval, Jonathan, Ed.

Originally developed to respond to the Desert Storm/Persian Gulf War, this resource book provides information designed to help parents, teachers, and service providers to plan and implement a comprehensive response to meeting children's emotional needs during a crisis. Contributors are experts on different kinds of crises that school age children…

The School Psychologist's Role in Leading Multidisciplinary School-Based Threat Assessment Teams

ERIC Educational Resources Information Center

Kelly, Shawna Rader

2018-01-01

School psychologists have long been regarded for their expertise in the assessment, evaluation, and delivery of mental and behavioral health services for children in schools. Given the growing attention to school safety, crisis prevention, and crisis intervention, school psychologists are also increasingly called upon to assist with systems-level…

What You See Is Not What You Get

ERIC Educational Resources Information Center

White-McMahon, Meredith

2010-01-01

When upset, 15-year-old Peter overreacts, dumping verbal hostility on everyone, even those trying to help. Peter's attempt to see the principal--who was out of the office--led to an emotionally explosive crisis. In this life space crisis intervention (LSCI), staff calmly tried to help Peter clarify distorted reality. But patient questioning raised…

Teaching Qualitative Research Methods through Service-Learning

ERIC Educational Resources Information Center

Machtmes, Krisanna; Johnson, Earl; Fox, Janet; Burke, Mary S.; Harper, Jeannie; Arcemont, Lisa; Hebert, Lanette; Tarifa, Todd; Brooks, Roy C., Jr.; Reynaud, Andree L.; Deggs, David; Matzke, Brenda; Aguirre, Regina T. P.

2009-01-01

This paper is the result of a voluntary service-learning component in a qualitative research methods course. For this course, the service-learning project was the evaluation of the benefits to volunteers who work a crisis hotline for a local crisis intervention center. The service-learning course model used in this paper most closely resembles the…

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,…

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.

The effect of weather on mood, productivity, and frequency of emotional crisis in a temperate continental climate

NASA Astrophysics Data System (ADS)

Barnston, A. G.

1988-06-01

A group of 62 mostly university student subjects kept structured diaries of their feelings and their productivity for six weeks in Illinois in early autumn. During the same period, daily frequency of telephone calls to a crisis intervention service in the same community was monitored, and complete daily weather data for the vicinity were provided by a local meteorological research facility. Major findings are as follows. The weather appears to influence mood and productivity, but only to a smallextent compared with the aggregate of all other controlling factors. Males show a relatively stronger effect than females. Psychologically troubled people generally appear to be more affected by weather than university students. The students and the crisis intervention service clients with “mild” problems tend to be stressed more when the weather is unstable, cloudy, warm and humid, and least stressed during sunny, dry, cool weather with rising barometric pressure. The crisis service clients with “severe” problems react oppositely to these two weather types. The meaning of these and other results and the strengths and weaknesses of this study's design are discussed.

The effectiveness of crisis resource management and team debriefing in resuscitation education of nursing students: A randomised controlled trial.

PubMed

Coppens, Imgard; Verhaeghe, Sofie; Van Hecke, Ann; Beeckman, Dimitri

2018-01-01

The aim of this study was to investigate (i) whether integrating a course on crisis resource management principles and team debriefings in simulation training, increases self-efficacy, team efficacy and technical skills of nursing students in resuscitation settings and (ii) which phases contribute the most to these outcomes. Crisis resource management principles have been introduced in health care to optimise teamwork. Simulation training offers patient safe training opportunities. There is evidence that simulation training increases self-efficacy and team efficacy but the contribution of the different phases like crisis resource management principles, simulation training and debriefing on self-efficacy, team efficacy and technical skills is not clear. Randomised controlled trial in a convenience sample (n = 116) in Belgium. Data were collected between February 2015-April 2015. Participants in the intervention group (n = 60) completed a course on crisis resource management principles, followed by a simulation training session, a team debriefing and a second simulation training session. Participants in the control group (n = 56) only completed two simulation training sessions. The outcomes self-efficacy, team efficacy and technical skills were assessed after each simulation training. An ancillary analysis of the learning effect was conducted. The intervention group increased on self-efficacy (2.13%, p = .02) and team efficacy (9.92%, p < .001); the control group only increased significantly on team efficacy (4.5%, p = .001). The intervention group scored significantly higher on team efficacy (8.49%, p < .001) compared to the control group. Combining crisis resource management principles and team debriefings in simulation training increases self-efficacy and team efficacy. The debriefing phase contributes the most to these effects. By partnering with healthcare settings, it becomes possible to offer interdisciplinary simulation training that can increase patient safety. © 2017 John Wiley & Sons Ltd.

Evaluation of a Crisis-Preparedness Training Program for the Faculty of a Private Elementary School

ERIC Educational Resources Information Center

Boyle, Marybeth N.

2010-01-01

The purpose of this study was to determine the effectiveness of a training program for the faculty of a private elementary school on executing the protocols, roles, and responsibilities defined in the institution's crisis-management plan. A formal training program for the faculty had not been developed, and administrators had no measure by which…

75 FR 69871 - Homeowners Assistance Program-Application Processing

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-16

... relocating during the mortgage crisis; and Service member homeowners undergoing Permanent Change of Station (PCS) moves during the mortgage crisis. DATES: Effective Date: January 18, 2011. FOR FURTHER... financial stability and increase quality of life for those impacted by the mortgage crisis. The Department...

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.

The Crisis in Air Pollution Manpower Development

ERIC Educational Resources Information Center

Moeller, Dade W.

1974-01-01

Three studies conducted by the National Air Pollution Manpower Development Advisory Committee concluded there is a crisis in air pollution manpower development within the United States today. The studies investigated the existing federal manpower program, air pollution educational requirements and the quality of graduate level university programs.…

The nursing process in crisis-oriented psychiatric home care.

PubMed

Boomsma, J; Dingemans, C A; Dassen, T W

1997-08-01

Crisis-oriented psychiatric home care is a recent development in the Dutch mental health care system. Because of the difference between psychiatric care in the home and in the hospital, an action research project was initiated. This project was directed at the nursing process and the nurses' role and skills in psychiatric home care. The main goal of the project was to describe and to standardize nursing diagnoses and interventions used in crisis-oriented and long-term psychiatric home care. The development of supporting methods of assessment and intervention were also important aspects of this project. In this article a crisis-oriented psychiatric home care programme and the first developmental research activities within this programme are described. To support the nursing process, the development of a nursing record and an assessment-format, based on Gordon's Functional Health Patterns (FHP), took place. By means of content analysis of 61 nursing records, the most frequently stated nursing diagnoses, based upon the North American Nursing Diagnosis Association (NANDA) taxonomy, were identified. The psychiatric diagnostic categories of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) were also collected. The most common categories found were those of mood disorders and schizophrenia or psychotic disorders. Seventy-five per cent of the nursing diagnoses showed up within four FHP: role-relationship, coping-stress tolerance, self-perception/self-concept and activity-exercise. The nursing diagnosis of 'ineffective individual coping' was stated most frequently. This is not surprising because of the similarities in the definitions of this nursing diagnosis and the concept of 'crisis' to which the psychiatric home care programme is oriented. Further research activities will be focused on standardization of nursing diagnosis and the interventions that nurses undertake in this type of care.

[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.

Protecting Pakistan's health during the global economic crisis.

PubMed

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

2012-03-01

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

Home-Based Crisis Therapy: A Comparative Outcome Study.

ERIC Educational Resources Information Center

Rowland, Charity; And Others

Substitute care for a child at risk has been been associated with psychological distress in the child and his family and a drain on public finances. To investigate the cost effectiveness and ultimate influence on family intactness of home-based family crisis intervention, 77 low income, inner city families with an adolescent child at risk of…

School Crisis Response: Expecting the Unexpected.

ERIC Educational Resources Information Center

Lichtenstein, Robert; And Others

1994-01-01

The typical administrator certification program does not devote specific attention to shootings, suicide, terminal illness, and natural disasters. A crisis of major proportion calls for enlightened leadership: a take-charge manner, combined with effective teamwork and delegation of vital operations. Crisis teams should exist at regional, district,…

Volunteer and user evaluation of the National Sexual Assault Online Hotline.

PubMed

Finn, Jerry; Garner, Michelle D; Wilson, Jen

2011-08-01

The National Sexual Assault Online Hotline (NSAOH) is a new model for delivery of rape and sexual assault crisis services through a secure, confidential chat-based online hotline. This paper presents a program evaluation drawn from volunteer counselor and user perceptions and experiences during the second year of operation of the NSAOH. Outcome data are presented from 731 session evaluations submitted by 94 volunteers and session evaluations from 4609 user sessions collected between June 1, 2008 and May 30, 2009. Evaluation includes ratings of usefulness, topics discussed, length of sessions, services provided, and session difficulties. The results indicate that the model is viable and useful, and the majority of volunteers and users are satisfied. Volunteer knowledge and skills are strongly associated with satisfaction with the hotline. Nevertheless, one-fifth of volunteers rate their session as not useful and users rate 8.2% of volunteers low in knowledge and skills. NSAOH is reaching many who have not previously sought services or did not resolve issues through other means. Findings suggest the importance of preparing volunteers in both crisis intervention and a wide variety of long-term issues related to sexual assault. Recommendations for program development, evaluation, and further research are presented. Copyright © 2010 Elsevier Ltd. All rights reserved.

Evaluating the Crisis Response Strategies of a University Basketball Program: How Do Reactions Differ Based on Apologies, Crisis Severity, and Team Identification?

ERIC Educational Resources Information Center

Isaacson, Thomas E.

2012-01-01

Negative news about collegiate sports teams in the United States is nearly unavoidable for most universities. The sheer number of athletes involved in multiple programs at major universities increases the likelihood of problems. American football programs alone include rosters of 100 or more players, and the total number of athletes at National…

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

PubMed

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

2005-01-01

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

The looming retirement crisis.

PubMed

Walker, D M

1997-06-01

A retirement crisis looms in the United States due to a number of recent and emerging trends that affect government retirement programs, employer- and union-sponsored retirement benefits and personal savings arrangements. The crisis can be averted, but only with well-thought-out action on a number of issues, particularly Social Security and Medicare reform.

The effect of happiness training on self-esteem in the mothers of children with cleft lip and palate in Isfahan 2015.

PubMed

Hemati, Zeinab; Derakhshande, Fateme; Abbasi, Samira; Kiani, Davood

2017-01-01

Birth of a child with cleft lip and palate, as a crisis, can affect family relationships and interactions seriously and hence self-esteem in family members. The present study was conducted to investigate the effect of a happiness training program on self-esteem in the mothers of children with cleft lip and palate. In this quasi-experimental study, 64 mothers of children with cleft lip and palate referring to health-care team in the Isfahan University Medical Sciences were enrolled by convenience random sampling. Then, the program of happiness training was implemented within 10 sessions, and a questionnaire of demographic characteristics and Coopersmith Self-Esteem Inventory was filled out before and 2 months after the last session. The data were analyzed by descriptive and analytical statistics (paired t -test, independent t -test, Chi-square, and Mann-Whitney) in SPSS 20 (SPSS Inc: Chicago). The mean age of the mothers in intervention and control groups was 33.3 ± 6.3 and 33.5 ± 5.8 years, respectively. The mean age of the children in the intervention and control groups was 6.34 ± 3.37 and 5.03 ± 3.36 years. Independent t -test indicated a significant difference in self-esteem mean score after training in the intervention and control groups. Moreover, paired t -test indicated a significant difference in self-esteem mean score between before and after training in the intervention group. In the light of the effect of happiness training on the promotion of self-esteem in children with cleft lip and palate, this program can be used as a care intervention to reduce psychological and mental problems and to enhance adjustment in parents.

Which helper behaviors and intervention styles are related to better short-term outcomes in telephone crisis intervention? Results from a Silent Monitoring Study of Calls to the U.S. 1-800-SUICIDE Network.

PubMed

Mishara, Brian L; Chagnon, François; Daigle, Marc; Balan, Bogdan; Raymond, Sylvaine; Marcoux, Isabelle; Bardon, Cécile; Campbell, Julie K; Berman, Alan

2007-06-01

A total of 2,611 calls to 14 helplines were monitored to observe helper behaviors and caller characteristics and changes during the calls. The relationship between intervention characteristics and call outcomes are reported for 1,431 crisis calls. Empathy and respect, as well as factor-analytically derived scales of supportive approach and good contact and collaborative problem solving were significantly related to positive outcomes, but not active listening. We recommend recruitment of helpers with these characteristics, development of standardized training in those methods that are empirically shown to be effective, and the need for research relating short-term outcomes to long-term effects.

Family Crisis Intervention in War Contexts: A Case Study of a Traumatised Palestinian Family

ERIC Educational Resources Information Center

Veronese, Guido; Said, Mahmud S.; Castiglioni, Marco

2014-01-01

The aim of this study was to analyse the phases of an innovative in vivo exposure intervention in which all family members were present at the scene of a traumatic incident. Clinical practice has borne out the efficacy of family intervention and its benefits for traumatised individuals and family groups. The intervention discussed here was…

A Behavioral Framework for Managing Massive Airline Flight Disruptions through Crisis Management, Organization Development, and Organization Learning

NASA Astrophysics Data System (ADS)

Larsen, Tulinda Deegan

In this study the researcher provides a behavioral framework for managing massive airline flight disruptions (MAFD) in the United States. Under conditions of MAFD, multiple flights are disrupted throughout the airline's route network, customer service is negatively affected, additional costs are created for airlines, and governments intervene. This study is different from other studies relating to MAFD that have focused on the operational, technical, economic, financial, and customer service impacts. The researcher argues that airlines could improve the management of events that led to MAFD by applying the principles of crisis management where the entire organization is mobilized, rather than one department, adapting organization development (OD) interventions to implement change and organization learning (OL) processes to create culture of innovation, resulting in sustainable improvement in customer service, cost reductions, and mitigation of government intervention. At the intersection of crisis management, OD, and OL, the researcher has developed a new conceptual framework that enhances the resiliency of individuals and organizations in responding to unexpected-yet-recurring crises (e.g., MAFD) that impact operations. The researcher has adapted and augmented Lalonde's framework for managing crises through OD interventions by including OL processes. The OD interventions, coupled with OL, provide a framework for airline leaders to manage more effectively events that result in MAFD with the goal of improving passenger satisfaction, reducing costs, and preventing further government intervention. Further research is warranted to apply this conceptual framework to unexpected-yet-recurring crises that affect operations in other industries.

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.

“Hitting the wall”: Lived experiences of mental health crises

PubMed Central

Karlsson, Bengt; Lofthus, Ann-Mari; Davidson, Larry

2011-01-01

Background As Norway moves toward the provision of home-based crisis response, knowledge is needed about understandings of mental health crisis and effective ways of addressing crises within the home. Objective To elicit and learn from service users’ experiences about the subjective meanings of crisis and what kind of help will be most effective in resolving mental health crises. Theoretical A phenomenological-hermeneutic cooperative inquiry method was used to elicit and analyse focus group responses from mental health service users who had experienced crises. Results Findings clustered into three themes: (1) Crisis as multifaceted and varied experiences; (2) losing the skills and structure of everyday life; and (3) complexities involved in family support. Conclusion Several aspects of crises require an expansion of the biomedical model of acute intervention to include consideration of the personal and familial meaning of the crisis, attention to the home context, and activities of daily living that are disrupted by the crisis, and ways for the person and the family to share in and learn from resolution of the crisis. PMID:22140400

A Crisis in Space--A Futuristic Simulation Using Creative Problem Solving.

ERIC Educational Resources Information Center

Clode, Linda

1992-01-01

An enrichment program developed for sixth-grade gifted students combined creative problem solving with future studies in a way that would simulate real life crisis problem solving. The program involved forecasting problems of the future requiring evacuation of Earth, assuming roles on a spaceship, and simulating crises as the spaceship traveled to…

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…

Crisis Intervention by Social Workers in Fire Departments: An Innovative Role for Social Workers

ERIC Educational Resources Information Center

Cacciatore, Joanne; Carlson, Bonnie; Michaelis, Elizabeth; Klimek, Barbara; Steffan, Sara

2011-01-01

This article describes a unique use of social workers as crisis response team (CRT) members in a nontraditional host setting, municipal fire departments in Arizona. The role of modern-day firefighters has changed dramatically and now includes responding to a wide variety of crises and emergencies other than fires, such as motor vehicle accidents,…

Crisis Management/Death and Dying: Coping with Terminal Illness in the International Student Community.

ERIC Educational Resources Information Center

Eichenfield, Gregg A.; Audas, Millie

The success of crisis intervention work with international students is highly dependent not only on the skill of the professional staff involved, but also the availability and use of other student services that may be provided to the International Student Services (ISS) Office. There are many cultural issues that must be considered when counseling…

Racial/ethnic minority children's use of psychiatric emergency care in California's Public Mental Health System.

PubMed

Snowden, Lonnie R; Masland, Mary C; Libby, Anne M; Wallace, Neal; Fawley, Kya

2008-01-01

We examined rates and intensity of crisis services use by race/ethnicity for 351,174 children younger than 18 years who received specialty mental health care from California's 57 county public mental health systems between July 1998 and June 2001. We used fixed-effects regression for a controlled assessment of racial/ethnic disparities in children's use of hospital-based services for the most serious mental health crises (crisis stabilization services) and community-based services for other crises (crisis intervention services). African American children were more likely than were White children to use both kinds of crisis care and made more visits to hospital-based crisis stabilization services after initial use. Asian American/Pacific Islander and American Indian/Alaska Native children were more likely than were White children to use hospital-based crisis stabilization services but, along with Latino children, made fewer hospital-based crisis stabilization visits after an initial visit. African American children used both kinds of crisis services more than did White children, and Asian Americans/Pacific Islander and American Indians/Alaska Native children visited only when they experienced the most disruptive and troubling kind of crises, and made nonrecurring visits.

Disaster Relief and Crisis Intervention with Deaf Communities: Lessons Learned from the Japanese Deaf Community.

PubMed

Takayama, Kota

2017-01-01

During natural disasters and crises, the deaf and hard of hearing community might not have full accessibility to all of the information shared with the larger hearing community. This could be due to the lack of awareness among social work professionals about these cultural and linguistic needs of this minority population. The purpose of this article is to explore the challenges faced by the deaf community and to discuss culturally and linguistically appropriate crisis intervention and mobilization to natural disaster situations based on the experiences of the Japanese deaf communities affected by the Kobe and Tohoku earthquakes.

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, lacking coverage. Private premiums are going up again as federal programs are capped and the lack of a federal framework for quality assurance leads to growing problems of access and quality that will need to be addressed as we enter the 21st century. What role will government play?

Homicidal Events Among Mexican American Street Gangs

PubMed Central

Valdez, Avelardo; Cepeda, Alice; Kaplan, Charles

2010-01-01

This article examines the complexity of street gang homicides and focuses on situational factors that lead to gang members’ susceptibility to this violent behavior within the context of a disadvantaged minority community. This study is based on an analysis of 28 homicides involving Mexican American gang members. The absence of immigrant youth involvement in these types of violent crimes is discussed. Findings demonstrate how locally embedded social processes associated with specific gang types, ecology, drugs, circumstances, and motives unfold into homicidal events. These findings may contribute to the development of street-based social programs focused on gang mediation, dispute resolution, and crisis intervention. PMID:21218188

STAT! A four-step approach to nursing recruitment and retention in a tertiary pediatric setting.

PubMed

Smart, Gail; Kotzer, Anne Marie

2003-01-01

Recruiting nurses in today's health care environment is more challenging than ever before. A four-step, long-term strategic approach to nursing recruitment and retention was developed and implemented at The Children's Hospital (TCH) in Denver. STAT! Student and Employee Recruitment, Teaching the Specialty, Active Mentorship, and Time to Listen, denotes the urgency and significance of the current nursing shortage crisis and the need for immediate intervention to a critical health care problem. A combined effort within and across departments has led to the program's success, and new strategies continue to be designed and implemented to attract and retain the best and the brightest.

Characterizing emergency admissions of patients with sickle cell crisis in NHS brent: observational study

PubMed Central

Green, Stuart A; AlJuburi, Ghida; Majeed, Azeem; Okoye, Ogo; Amobi, Carole; Banarsee, Ricky; Phekoo, Karen J

2012-01-01

Objectives To characterize emergency admissions for patients with sickle cell crisis in NHS Brent and to determine which patients and practices may benefit most from primary care intervention. Design Observational study Setting Emergency departments attended by residents of the London borough of Brent Participants Patients with sickle cell disease registered with a general practitioner (GP) in the borough of Brent Main outcome measures Analysis of admissions between January 2008 and July 2010 that included length of stay (average and <2 days versus ≥2 days) by age group and registered GP practice. Results Thirty six percent of sickle cell disease admission spells resulted in a length of stay of less than two days. Seventy four percent of total bed days are associated with patients with more than one admission during the period of analysis, i.e. multiple admissions. Two general practices in Brent were identified as having the highest number of patients admitted to the emergency department for sickle cell crisis and may benefit most from primary care intervention. Discussion Patients with short length of stay and multiple admissions may be potentially amenable to primary care intervention. The practices which have the highest numbers of sickle cell disease patients who frequently seek emergency care will be earmarked for an education intervention designed to help further engage general practitioners in the care and management of their sickle cell patients. PMID:22768371

Characterizing emergency admissions of patients with sickle cell crisis in NHS brent: observational study.

PubMed

Green, Stuart A; Aljuburi, Ghida; Majeed, Azeem; Okoye, Ogo; Amobi, Carole; Banarsee, Ricky; Phekoo, Karen J

2012-06-01

To characterize emergency admissions for patients with sickle cell crisis in NHS Brent and to determine which patients and practices may benefit most from primary care intervention. Observational study Emergency departments attended by residents of the London borough of Brent Patients with sickle cell disease registered with a general practitioner (GP) in the borough of Brent Analysis of admissions between January 2008 and July 2010 that included length of stay (average and <2 days versus ≥2 days) by age group and registered GP practice. Thirty six percent of sickle cell disease admission spells resulted in a length of stay of less than two days. Seventy four percent of total bed days are associated with patients with more than one admission during the period of analysis, i.e. multiple admissions. Two general practices in Brent were identified as having the highest number of patients admitted to the emergency department for sickle cell crisis and may benefit most from primary care intervention. Patients with short length of stay and multiple admissions may be potentially amenable to primary care intervention. The practices which have the highest numbers of sickle cell disease patients who frequently seek emergency care will be earmarked for an education intervention designed to help further engage general practitioners in the care and management of their sickle cell patients.

Perceptions of a peer suicide prevention program by inmates and professionals working in prisons.

PubMed

Auzoult, Laurent; Abdellaoui, Sid

2013-01-01

Suicide prevention is a major challenge for penal institutions in many countries. The traditional approach relies on the expertise of health professionals and is supplemented by the intervention of other professionals and the inmates themselves. New methods of suicide prevention based on peer support have been developed in recent years. Peer prevention programs rely on the ability of inmates to identify suicide risk. This study examines perceived suicide risk among inmates and explores possible explanations. 54 inmates and 17 professionals working in prisons responded to a questionnaire. The peer prevention program was found to change inmates' expectations of support in the event of a suicide crisis. The study also found that the inmates involved in the program tended to underestimate the risk of suicide. The perception of the prevention program and the level of self-consciousness were found to account for the underestimation of suicide risk. Support for inmates involved in suicide prevention programs must take into account their isolation in prison. The training provided to inmates must also consider the biases affecting the assessment of risk.

[Crisis unit at the general hospital: Determinants of further hospitalization].

PubMed

Norotte, C; Omnès, C; Crozier, C; Verlyck, C; Romanos, M

2017-10-01

The availability of short-stay beds for brief admission (less than 72hours) of crisis patients presenting to the emergency room is a model that has gained a growing interest because it allows time for developing alternatives to psychiatric hospitalization and favors a maintained functioning in the community. Still, the determinants influencing the disposition decision at discharge after crisis intervention remain largely unexplored. The primary objective of this study was to determine the factors predicting aftercare dispositions at crisis unit discharge: transfer for further hospitalization or return to the community. Secondary objectives included the description of clinical and socio-demographic characteristics of patients admitted to the crisis unit upon presentation to the emergency room. All patients (n=255) admitted to the short-stay unit of the emergency department of Rambouillet General Hospital during a one-year period were included in the study. Patient characteristics were collected in a retrospective manner from medical records: patterns of referral, acute stressors, presenting symptoms, initial patient demand, Diagnostic and Statistical Manual, 5th edition (DSM-5) disorders, psychiatric history, and socio-demographic characteristics were inferred. Logistic regression analysis was used to determine the factors associated with hospitalization decision upon crisis intervention at discharge. Following crisis intervention at the short-stay unit, 100 patients (39.2%) required further hospitalization and were transferred. Statistically significant factors associated with a higher probability of hospitalization (P<0.05) included the patient's initial wish to be hospitalized (OR=4.28), the presence of a comorbid disorder (OR=3.43), a referral by family or friends (OR=2.89), a history of psychiatric hospitalization (OR=2.71) and suicidal ideation on arrival in the emergency room (OR=2.26). Conversely, significant factors associated with a lower probability of hospitalization were the presence of a personality disorder (OR=0.31), a precipitating conflict situation (OR=0.41), age between 20 and 39 years (OR=0.42), being employed (OR=0.49). Our study confirms that clinical factors such as the presence of a personality disorder or the context of a precipitating conflict situation are predictive of a community return. Interestingly, it points out the importance of the patient's initial wish in the hospitalization decision. Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

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.

People, Power, and Participation. The Communities in Crisis Programme, 1986-9: An Evaluative Report.

ERIC Educational Resources Information Center

Batten, Julie

Communities in Crisis is a British training program for unemployed adults that was developed in response to the needs of community organizations in areas where community programs have few resources. Its underlying philosophy focuses on motivating and encouraging long-term unemployed people to take initiatives and reflect on their progress. The…

Exploring the Socio-Politics of the Greek Debt Crisis in a Primary Art Classroom: A Political Cartooning Project

ERIC Educational Resources Information Center

Christopoulou, Martha

2013-01-01

This article reports on an event-driven case study which took the form of a curriculum intervention in order to examine how a class of fifth-graders understood, interpreted and commented visually on the Greek debt crisis. Considering art education as a safe place where students can critically investigate through relevant visual culture genres…

A Survey Study of PREPaRE Workshop Participants' Application of Knowledge, Confidence Levels, and Utilization of School Crisis Response and Recovery Training Curriculum

ERIC Educational Resources Information Center

Lazzaro, Brian R.

2013-01-01

This survey study investigated the effects of the National Association of School Psychologists PREPaRE Workshop 2 training on workshop participants. PREPaRE is a comprehensive crisis prevention and intervention model that is specifically designed for schools. This study evaluated the impact of the PREPaRE model and the training of school…

75 FR 36506 - Final Rule Regarding Amendment of the Temporary Liquidity Guarantee Program To Extend the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-28

... percent or more of their assets. II. Interim Rule While the immediate financial crisis that led to the... facing community banks have intensified as the lingering consequences of the 2008 financial crisis and... financial crisis and recession are expected to persist for some time, especially as the magnitude of...

[A unit for emergency psychiatry and crisis intervention--concepts, structure and initial experiences].

PubMed

Feuerlein, W; Bronisch, T; Fürmaier, A

1983-03-01

The article reports on a ward with 12 beds which has been set up for emergency cases in psychiatry or for immediate intervention in case of a crisis experienced by a patient. In the theoretical part of this article, it is explained that crisis situations are present in most of the psychiatric emergency patients. The article then goes briefly into the fundamentals of therapeutic strategy in such patients: A therapy which helps to uncover hidden conflicts, the pros and cons of therapy focussed on conflict and on supportive measures; as well as a therapy which supports and promotes the ego. This is followed by a comparison of the ward with corresponding facilities in Germany and abroad and a description of their structure, their patients and their function within a psychiatric care system. The concluding part of the article is devoted to a description of the authors' initial experiences and impressions gained during their work with the ward patients, quoting several examples.

Managing crises through organisational development: a conceptual framework.

PubMed

Lalonde, Carole

2011-04-01

This paper presents a synthesis of the guiding principles in crisis management in accordance with the four configurational imperatives (strategy, structure, leadership and environment) defined by Miller (1987) and outlines interventions in organisational development (OD) that may contribute to their achievement. The aim is to build a conceptual framework at the intersection of these two fields that could help to strengthen the resilient capabilities of individuals, organisations and communities to face crises. This incursion into the field of OD--to generate more efficient configurations of practices in crisis management--seems particularly fruitful considering the system-wide application of OD, based on open-systems theory (Burke, 2008). Various interventions proposed by OD in terms of human processes, structural designs and human resource management, as well as strategy, may help leaders, members of organisations and civil society apply effectively, and in a more sustainable way, the crisis management guiding principles defined by researchers. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

The impact of a natural disaster on altruistic behaviour and crime.

PubMed

Lemieux, Frederic

2014-07-01

Institutional altruism in the form of a public-sector intervention and support for victims and social altruism generated by mutual aid and solidarity among citizens constitute a coming together in a crisis. This coming together and mutual support precipitate a decrease in crime rates during such an event. This paper presents an analysis of daily fluctuations in crime during the prolonged ice storms in Quebec, Canada, in January 1998 that provoked an electrical blackout. Of particular interest are the principal crisis-related influences on daily crime patterns. A first series of analyses examines the impact of altruistic public-sector mobilisation on crime. A significant decline in property crime rates was noticed when cheques were distributed to crisis victims in financial need in Montérégie, and hence they were attributable to public intervention (institutional altruism). Moreover, the rate of social altruism (financial donations), which was more substantial in adjoining rather than distant regions, was inversely proportional to crime rates. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Organizational restructuring, government control and loss of legitimacy following an organizational crisis: the case of Israel's nonprofit human services.

PubMed

Mano, Rita; Rosenberg, Dennis

2014-01-01

The study explores organizational restructuring following the occurrence of a crisis. Restructuring activities following an intervention are considered here to be indicators of an organization's loss of legitimacy because they have lost their independent status, a basic characteristic of nonprofit human settings. The study shows that according to the Resource Based View of organization restructuring--experienced as downsizing, neglecting and abandoning of projects--organizations are affected by (a) government intervention in decision making; (b) higher demands for accountability; and (c) higher evaluations of performance gaps. On the basis of the study of a sample of 138 Nonprofit Human Services in Israel, the results show that the higher the level of restructuring, the higher the level of legitimacy. However, organization location in metropolitan areas moderates the link between restructuring and legitimacy loss. We conclude that Israel's nonprofit human services being overly dependent on goverhment funding are more prone to restructuring and losing legitimacy following organizational crisis.

Prevention of Targeted School Violence by Responding to Students' Psychosocial Crises: The NETWASS Program.

PubMed

Leuschner, Vincenz; Fiedler, Nora; Schultze, Martin; Ahlig, Nadine; Göbel, Kristin; Sommer, Friederike; Scholl, Johanna; Cornell, Dewey; Scheithauer, Herbert

2017-01-01

The standardized, indicated school-based prevention program "Networks Against School Shootings" combines a threat assessment approach with a general model of prevention of emergency situations in schools through early intervention in student psychosocial crises and training teachers to recognize warning signs of targeted school violence. An evaluation study in 98 German schools with 3,473 school staff participants (M age  = 46.2 years) used a quasi-experimental comparison group design with three measurement points (pre, post, and 7 months followup) with schools randomly allocated to implementation conditions. The study found increases in teachers' expertise and evaluation skills, enhanced abilities to identify students experiencing a psychosocial crisis, and positive secondary effects (e.g., teacher-student interaction, feelings of safety). © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

The impact of a school food aid program on household food insecurity

PubMed Central

Petralias, Athanassios; Papadimitriou, Eleni; Riza, Elena; Karagas, Margaret R.; Zagouras, Alexia B.A.

2016-01-01

Background: We had a unique opportunity to establish the extent of food insecurity and the potential impact of a large-scale school-based nutritional program, in low-socioeconomic status districts of Greece, during the current economic crisis. Methods: Around 162 schools with 25 349 students participated during the 2012–2013 school year. Each student received a daily healthy meal designed by nutrition specialists. Food insecurity levels, measured using the Food Security Survey Module were assessed at baseline and after a 1–8-month intervention period. Pre–post intervention responses were matched at an individual level. Results: Around 64.2% of children’s households experienced food insecurity at baseline. This percentage decreased to 59.1% post-intervention, P < 0.001. On an individual level, food insecurity score diminished by 6.5%, P < 0.001. After adjustment for various socioeconomic factors, for each additional month of participation, the odds of reducing the food insecurity score increased by 6.3% (OR = 1.06, 95% CI: 1.02–1.11). Those experiencing food insecurity with hunger at baseline were more likely to improve food insecurity score than those who did not (OR = 3.51, 95%CI: 2.92–4.21). Conclusion: Children and families residing in low socioeconomic areas of Greece, experience high levels of food insecurity. Our findings suggest that participation in a school-based food aid program may reduce food insecurity for children and their families in a developed country in times of economic hardship. PMID:26873860

Joint crisis plans for people with borderline personality disorder: feasibility and outcomes in a randomised controlled trial.

PubMed

Borschmann, Rohan; Barrett, Barbara; Hellier, Jennifer M; Byford, Sarah; Henderson, Claire; Rose, Diana; Slade, Mike; Sutherby, Kim; Szmukler, George; Thornicroft, Graham; Hogg, Joanna; Moran, Paul

2013-05-01

People with borderline personality disorder frequently experience crises. To date, no randomised controlled trials (RCTs) of crisis interventions for this population have been published. To examine the feasibility of recruiting and retaining adults with borderline personality disorder to a pilot RCT investigating the potential efficacy and cost-effectiveness of using a joint crisis plan. An RCT of joint crisis plans for community-dwelling adults with borderline personality disorder (trial registration: ISRCTN12440268). The primary outcome measure was the occurrence of self-harming behaviour over the 6-month period following randomisation. Secondary outcomes included depression, anxiety, engagement and satisfaction with services, quality of life, well-being and cost-effectiveness. In total, 88 adults out of the 133 referred were eligible and were randomised to receive a joint crisis plan in addition to treatment as usual (TAU; n = 46) or TAU alone (n = 42). This represented approximately 75% of our target sample size and follow-up data were collected on 73 (83.0%) participants. Intention-to-treat analysis revealed no significant differences in the proportion of participants who reported self-harming (odds ratio (OR) = 1.9, 95% CI 0.53-6.5, P = 0.33) or the frequency of self-harming behaviour (rate ratio (RR) = 0.74, 95% CI 0.34-1.63, P = 0.46) between the two groups at follow-up. No significant differences were observed between the two groups on any of the secondary outcome measures or costs. It is feasible to recruit and retain people with borderline personality disorder to a trial of joint crisis plans and the intervention appears to have high face validity with this population. However, we found no evidence of clinical efficacy in this feasibility study.

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.

Teach Me How to Talk

ERIC Educational Resources Information Center

Goorix, Katrien; D'Oosterlinck, Franky; Spriet, Eline; Freado, Mark; Broekaert, Eric

2012-01-01

Preschool children and toddlers often display emotional and behavioral problems. Without early intervention, these difficulties can lead to serious problems in later years. This research from Belgium explores how Life Space Crisis Intervention and Developmental Therapy-Developmental Teaching can inform work with these young children. (Contains 2…

Commentary: Advancing an implementation science agenda on mental health and psychosocial responses in war-affected settings: comment on trials of a psychosocial intervention for youth affected by the Syrian crisis - by Panter-Brick et al. (2018).

PubMed

Betancourt, Theresa S; Fazel, Mina

2018-05-01

Syria's civil conflict has created the largest humanitarian disaster of our time, causing massive population displacement, tremendous exposure to trauma, and loss. Advancing the mental health and psychosocial responses of war-affected populations both during acute humanitarian emergencies and in post-conflict transition is imperative in forging a constructive implementation agenda. This study makes an important contribution in building evidence toward effective interventions to advance the mental health and well-being of those affected by the Syrian crisis. Using an innovative approach, this work demonstrates that a thoughtful, ethical, and scientifically valid trial can be carried out in the midst of mass displacement. Further research is urgently needed on the effectiveness of interventions for vulnerable populations, with a growing need to embed studies of evidence-based mental health interventions within humanitarian responses. © 2018 Association for Child and Adolescent Mental Health.

Practical Action Programs in Education: Highlights of the Third National Conference on General Systems Education.

ERIC Educational Resources Information Center

Southern Connecticut State Coll., New Haven. Center for Interdisciplinary Creativity.

In this collection of papers Harold G. Cassidy outlines the conceptual framework for the conference which is based on a systems approach to development of practical action programs in education. A basic model is presented as a basis for shifting from the post-crisis to the pre-crisis approach to curriculum development and educational…

Federal and state fiscal crisis: impact on children.

PubMed

Waldman, H Barry; Perlman, Steven P

2003-01-01

Federal and state governments are in the midst of a fiscal crisis that has led to cuts--which may increase in the future--in vital programs for the health and welfare of children. The impact of these reductions is considered in terms of the current economic and social environment of children who rely on many of these programs for needed services.

Debriefing decreases mental workload in surgical crisis: A randomized controlled trial.

PubMed

Boet, Sylvain; Sharma, Bharat; Pigford, Ashlee-Ann; Hladkowicz, Emily; Rittenhouse, Neil; Grantcharov, Teodor

2017-05-01

Mental workload is the amount of mental effort involved in performing a particular task. Crisis situations may increase mental workload, which can subsequently negatively impact operative performance and patient safety. This study aims to measure the impact of learning through debriefing and a systematic approach to crisis on trainees' mental workload in a simulated surgical crisis. Twenty junior surgical residents participated in a high-fidelity, simulated, postoperative crisis in a surgical ward environment (pretest). Participants were randomized to either an instructor-led debriefing, including performance feedback (intervention; n = 10) or no debriefing (control; n = 10). Subjects then immediately managed a second simulated crisis (post-test). Mental workload was assessed in real time during the scenarios using a previously validated, wireless, vibrotactile device. Mental workload was represented by subject response times to the vibrations, which were recorded and analyzed using the Mann-Whitney U test. Participants in the debriefing arm had a significantly reduced median response time in milliseconds (post-test minus pretest -695, quartile range -2,136 to -297) compared to participants in the control arm (42, -1,191 to 763), (between-arm difference P = .049). Debriefing after simulated surgical crisis situations may improve performance by decreasing trainee's mental workload during a subsequent simulated surgical crisis. Copyright © 2016 Elsevier Inc. All rights reserved.

Early crisis nontechnical skill teaching in residency leads to long-term skill retention and improved performance during crises: A prospective, nonrandomized controlled study.

PubMed

Doumouras, Aristithes G; Engels, Paul T

2017-07-01

Medical error is common in crises, and the majority of observed errors are nontechnical in nature. The long-term impact of teaching crisis nontechnical skills to residents has not been evaluated. The objective of this study was to determine the effect of simulation-based teaching of crisis nontechnical skills compared to controls one year after initial teaching. This was a prospective study using both historical controls and a before-and-after methodology to evaluate the effect of a high-fidelity simulation curriculum that used crisis resource management principles to teach nontechnical skills. Postgraduate year 2 and 3 residents were invited to take part in a prospective training course over 2 years. The primary outcome was leader performance evaluated by expert raters using the previously validated 7-point Ottawa Global Rating Scale. Overall, 23 residents performed 30 simulations over the 2 years with the intervention group of 7 residents being assessed in both years. After adjustment, the postgraduate year 3 intervention group who received training the previous year had significantly higher overall performance scores than all postgraduate year 2 scores (1.09 95% confidence interval 0.70-1.47, P < .001) and the historical postgraduate year 3 cohort who received no prior training (1.20, 95% confidence interval 0.37-2.03, P = .005). There was no decay of skills noted over the course of the study. Postgraduate year 3 residents who had prior training had significantly improved crisis performance compared to historical postgraduate year 3 controls and untrained postgraduate year 2 residents. There were no significant differences between the crisis performance of postgraduate year 2 residents and the untrained postgraduate year 3 controls. This confirms the beneficial effect and long-term retention after crisis nontechnical skill training. Copyright © 2016 Elsevier Inc. All rights reserved.

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,…

Virtual Golden Foods Corporation: Generic Skills in a Virtual Crisis Environment (A Pilot Study)

ERIC Educational Resources Information Center

Godat, Meredith

2007-01-01

Workplace learning in a crisis-rich environment is often difficult if not impossible to integrate into programs so that students are able to experience and apply crisis management practices and principles. This study presents the results of a pilot project that examined the effective use of a virtual reality (VR) environment as a tool to teach…

How Prepared Are America's Colleges and Universities for Major Crises? Assessing the State of Crisis Management

ERIC Educational Resources Information Center

Mitroff, Ian I.; Diamond, Michael A.; Alpaslan, Murat C.

2006-01-01

This article outlines a set of recommendations to college and university leaders and governing bodies on how to develop crisis-management systems to ensure that their institutions are as well prepared as possible for a wide range of crises. These recommendations are based, in part, on crisis-management programs developed for various business…

Combating Terrorism: Issues in Managing Counterterrorist Programs

DTIC Science & Technology

2000-04-06

major effort to develop a national strategy, to date the strategy does not include a clear desired outcome to be achieved. Resources to combat...Federal exercises, in contrast to earlier years, are now practicing crisis and consequence management simultaneously and including state and local...categories—crisis management and consequence management. Crisis management includes efforts to stop a terrorist attack, arrest terrorists, and gather

Adaptability in Crisis Management: The Role of Organizational Structure

DTIC Science & Technology

2013-06-01

individuals to make optimal decisions under constraints of high risk, uncertainty, high workload, and time pressure (see, e.g., Brehmer, 2007 ). There is...et al., 2003; Hallam & Stammers , 1981). For instance, Hallam and Stammers (1981) showed that the impact of variations in task complexity on team...each team member. FIRESCOPE, a commonly used crisis intervention plan developed in California (Office of Emergency Services, 2007 ) is a good

Student Discipline Intervention Strategies: A Case Study of Two Institutions' Processes Utilized to Resolve Misconduct of Students Who Concomitantly Experience a Mental Health Crisis

ERIC Educational Resources Information Center

Dickstein, Gary G.

2011-01-01

This study contributes to the research regarding processes and procedures utilized by two institutions of higher education to respond to students who participate in inappropriate behavior and who are concomitantly experiencing a mental health crisis. A case study analysis of two institutions of higher education was used to examine this issue. The…

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 before crisis point. There was evidence of benefits for liaison psychiatry teams in improving service-related outcomes in emergency departments, but this was often limited by potential confounding in most studies. There was limited evidence regarding models to improve urgent and emergency access to crisis care to guide police officers in their Mental Health Act responsibilities. There was positive evidence on clinical effectiveness and cost-effectiveness of crisis resolution teams but variability in implementation. Current work from the Crisis resolution team Optimisation and RElapse prevention study aims to improve fidelity in delivering these models. Crisis houses and acute day hospital care are also currently recommended by NICE. There was a large evidence base on promoting recovery with a range of interventions recommended by NICE likely to be important in helping people stay well. Most evidence was rated as low or very low quality, but this partly reflects the difficulty of conducting research into complex interventions for people in a mental health crisis and does not imply that all research was poorly conducted. However, there are currently important gaps in research for a number of stages of the crisis care pathway. Particular gaps in research on access to support before crisis point and urgent and emergency access to crisis care were found. In addition, more high-quality research is needed on the clinical effectiveness and cost-effectiveness of mental health crisis care, including effective components of inpatient care, post-discharge transitional care and Community Mental Health Teams/intensive case management teams. This study is registered as PROSPERO CRD42014013279. The National Institute for Health Research HTA programme.

The effect of the late 2000s financial crisis on suicides in Spain: an interrupted time-series analysis.

PubMed

Lopez Bernal, James A; Gasparrini, Antonio; Artundo, Carlos M; McKee, Martin

2013-10-01

The current financial crisis is having a major impact on European economies, especially that of Spain. Past evidence suggests that adverse macro-economic conditions exacerbate mental illness, but evidence from the current crisis is limited. This study analyses the association between the financial crisis and suicide rates in Spain. An interrupted time-series analysis of national suicides data between 2005 and 2010 was used to establish whether there has been any deviation in the underlying trend in suicide rates associated with the financial crisis. Segmented regression with a seasonally adjusted quasi-Poisson model was used for the analysis. Stratified analyses were performed to establish whether the effect of the crisis on suicides varied by region, sex and age group. The mean monthly suicide rate in Spain during the study period was 0.61 per 100 000 with an underlying trend of a 0.3% decrease per month. We found an 8.0% increase in the suicide rate above this underlying trend since the financial crisis (95% CI: 1.009-1.156; P = 0.03); this was robust to sensitivity analysis. A control analysis showed no change in deaths from accidental falls associated with the crisis. Stratified analyses suggested that the association between the crisis and suicide rates is greatest in the Mediterranean and Northern areas, in males and amongst those of working age. The financial crisis in Spain has been associated with a relative increase in suicides. Males and those of working age may be at particular risk of suicide associated with the crisis and may benefit from targeted interventions.

Intervention LSCI Skills for Parents

ERIC Educational Resources Information Center

Whitson, Signe; Chambers, J. C.

2014-01-01

Life Space Crisis Intervention (LSCI) is a set of skills that helps adults turn problem situations into learning opportunities for kids. LSCI views conflicts or stressful incidents as opportunities for learning, growth, insight, and change. This training provides parents with tools for building positive relationships with their children and…

Can a Public Scholarship Program Successfully Reduce School Drop-Outs in a Time of Economic Crisis? Evidence from Indonesia

ERIC Educational Resources Information Center

Cameron, Lisa

2009-01-01

This paper evaluates the role played by Indonesia's Social Safety Net Scholarships Program in reducing school drop-out rates during the Asian financial crisis. The expectation was that many families would find it difficult to keep their children in school and drop-out rates would be high. The scholarships are found to have been effective in…

Family Therapy of Deaf Parents and Hearing Children: A New Dimension in Psychotherapeutic Intervention

ERIC Educational Resources Information Center

Robinson, Luther D.; Weathers, Olethia D.

1974-01-01

Severe weight loss, psychological problems, and failure in school of a hearing 10-year-old boy led to crisis intervention by a psychiatrist/social worker team during 6 months of successful conjoint family psychotherapy for the boy, his deaf parents, and hearing siblings. (LC)

School Psychology Services: Community-Based, First-Order Crisis Intervention during the Gulf War.

ERIC Educational Resources Information Center

Klingman, Avigdor

1992-01-01

Examines the community-based mental health preventive measures undertaken by the school psychology services in response to the missile attacks on Israel during the Gulf War. Attempts to report and delineate the major assumptions and components of some of the key interventions. (Author/NB)

Evaluation of indicated suicide risk prevention approaches for potential high school dropouts.

PubMed Central

Thompson, E A; Eggert, L L; Randell, B P; Pike, K C

2001-01-01

OBJECTIVES: This study evaluated the efficacy of 2 indicated preventive interventions, postintervention and at 9-month follow-up. METHODS: Drawn from a pool of potential high school dropouts, 460 youths were identified as being at risk for suicide and participated in 1 of 3 conditions randomly assigned by school: (1) Counselors CARE (C-CARE) (n = 150), a brief one-to-one assessment and crisis intervention; (2) Coping and Support Training (CAST) (n = 155), a small-group skills-building and social support intervention delivered with C-CARE; and (3) usual-care control (n = 155). Survey instruments were administered pre-intervention, following C-CARE (4 weeks), following CAST (10 weeks), and at a 9-month follow-up. RESULTS: Growth curve analyses showed significant rates of decline in attitude toward suicide and suicidal ideation associated with the experimental interventions. C-CARE and CAST, compared with usual care, also were effective in reducing depression and hopelessness. Among females, reductions in anxiety and anger were greater in response to the experimental programs. CAST was most effective in enhancing and sustaining personal control and problem-solving coping for males and females. CONCLUSIONS: School-based, indicated prevention approaches are feasible and effective for reducing suicidal behaviors and related emotional distress and for enhancing protective factors. PMID:11344882

Addressing NCDs through research and capacity building in LMICs: lessons learned from tobacco control.

PubMed

Sturke, Rachel; Vorkoper, Susan; Duncan, Kalina; Levintova, Marya; Parascondola, Mark

2016-01-01

Confronting the global non-communicable diseases (NCDs) crisis requires a critical mass of scientists who are well versed in regional health problems and understand the cultural, social, economic, and political contexts that influence the effectiveness of interventions. Investments in global NCD research must be accompanied by contributions to local research capacity. The National Institutes of Health (NIH) and the Fogarty International Center have a long-standing commitment to supporting research capacity building and addressing the growing burden of NCDs in low- and middle-income countries. One program in particular, the NIH International Tobacco and Health Research and Capacity Building Program (TOBAC program), offers an important model for conducting research and building research capacity simultaneously. This article describes the lessons learned from this unique funding model and demonstrates how a relatively modest investment can make important contributions to scientific evidence and capacity building that could inform ongoing and future efforts to tackle the global burden of NCDs.

Addressing NCDs through research and capacity building in LMICs: lessons learned from tobacco control

PubMed Central

Sturke, Rachel; Vorkoper, Susan; Duncan, Kalina; Levintova, Marya; Parascondola, Mark

2016-01-01

Confronting the global non-communicable diseases (NCDs) crisis requires a critical mass of scientists who are well versed in regional health problems and understand the cultural, social, economic, and political contexts that influence the effectiveness of interventions. Investments in global NCD research must be accompanied by contributions to local research capacity. The National Institutes of Health (NIH) and the Fogarty International Center have a long-standing commitment to supporting research capacity building and addressing the growing burden of NCDs in low- and middle-income countries. One program in particular, the NIH International Tobacco and Health Research and Capacity Building Program (TOBAC program), offers an important model for conducting research and building research capacity simultaneously. This article describes the lessons learned from this unique funding model and demonstrates how a relatively modest investment can make important contributions to scientific evidence and capacity building that could inform ongoing and future efforts to tackle the global burden of NCDs. PMID:27545455

Youth in crisis: dimensions of self-destructive conduct among adolescent prisoners.

PubMed

Johnson, R

1978-01-01

Self-mutilation and attempted suidcide among adolescent prisoners are explored in relation to concrete coping tests posed in prison and to self-esteem problems posed by failure of external (family) and internal (peer) support systems. Crisis sequences are traced using verbatim excerpts from interviews with self-destructive prisoners and conceptualized in terms of enduring adolescent needs and concerns. Some general observations regarding strategies of intervention with crisisprone prisoners are included.

Teen Depression and Suicide, A SILENT CRISIS.

PubMed

Kroning, Maureen; Kroning, Kayla

2016-01-01

Adolescent depression is a serious problem affecting 10.7% of all teens and 29.9% of high school students; 17% of high school students have contemplated suicide. Yet, depression in teens is often unrecognized. This article relays the tragic death of a 17-year-old, along with symptoms of depression and suicide in adolescents; DSM-5 criteria for depression; treatments including protective factors, psychotherapy, and medications; and imparts interventions for addressing this huge but silent crisis.

Malnutrition in emergencies: the framing of nutrition concerns in the humanitarian appeals process, 1992 to 2009.

PubMed

Webb, Patrick

2009-12-01

This paper examines how nutrition has been used to raise humanitarian relief resources through the United Nations appeals process, from 1992 to early 2009. Recent calls for "nutrition safety nets" as a response to the world food price crisis reflect a growing recognition of nutrition as a key element in crisis management, not simply as a metric of how bad things have become. The evolution in thinking about the role of nutrition in emergency programming is reflected in changes in how nutrition has been conceptualized and presented in the consolidated appeals process. Based on a desk review, supported by key informant interviews, the paper highlights important changes that include an increasing distinction that separates nutrition from food, water, and health; the importance of synergies across sectors; increased emphasis on "essential packages" of inputs and services versus stand-alone activities; the importance of technical rigor in food and nutrition assessment and surveys; the need for technical competency and capacity in the design and management of nutrition interventions; and the importance of planning for long-term change even in delivering a short-term response. There has also been growing emphasis on specificity in objectives--a trend linked to demand for more accountability across the humanitarian system. Enhanced emergency preparedness will require further capacity building and improved systems for surveillance and data management. Without more systematic, targeted attention to pre-crisis malnutrition, the resources needed to tackle nutrition problems during emergencies will continue to grow.

Suicide bereavement and postvention in major suicidology journals: lessons learned for the future of postvention.

PubMed

Andriessen, Karl

2014-01-01

Since the seminal publications of Shneidman (1969) and Cain (1972), suicide bereavement and postvention have attracted increasing research interest. To examine the topics of suicide bereavement and postvention in the core international suicidology journals, since their inception until mid-2013, in order to reveal the number of postvention articles throughout the years, their geographic distribution, and the topics of suicide bereavement and postvention that have been published. The online databases of four journals (Crisis, The Journal of Crisis Intervention and Suicide Prevention; Suicide and Life-Threatening Behavior [SLTB]; Archives of Suicide Research; and Suicidology Online) as well as the tables of content of all issues were searched. The number of articles and the countries of origin were quantified, and articles were categorized according to their content. The search identified 144 postvention articles, published during the past 40 years, almost exclusively in two journals (Crisis and SLTB). The majority of articles were (co-)authored by authors from Anglo-Saxon, Western countries. Articles were categorized in three groups: characteristics of suicide bereavement (n = 73), postvention programs (n = 66), and definition/theory and epidemiology of survivors (n = 5). Articles on suicide bereavement and postvention have been published mostly in two suicidology journals, albeit in modest numbers, and from a limited number of mostly Western countries. Our understanding of suicide bereavement and the provision of survivor support might benefit from the development of consensual definitions and from studies in other parts of the world.

International perspectives on the physical inactivity crisis--structural solutions over evidence generation?

PubMed

Bauman, Adrian; Finegood, Diane T; Matsudo, Victor

2009-10-01

Many programs to increase physical activity have been evaluated in developed countries, where 'leisure time physical activity' is the most frequent domain for interventions. In developing countries, and also with reference to global obesity prevention, different kinds of interventions targeting 'total physical activity' are needed. This requires efforts across agencies and sectors, and in the domains of work, active transport, reduced sitting time, as well as leisure time physical activity promotion. In considering possible solutions, this commentary examined the use of complex systems, where integrated efforts across sectors and agencies might, in combination, contribute to increasing total physical activity. The key sets of actions required globally to increase physical activity were, in our opinion, [i] efforts to disseminate individual-level behavior change programs to reach much larger populations rather than volunteers, [ii] social marketing and mass communication campaigns to change social norms in the community and among professionals and policymakers, [iii] efforts to influence the social and physical environment to make them more conducive to physical activity, and [iv] the development and implementation of national physical activity plans and strategies, with sufficient timelines and resources to achieve measurable change.

Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system.

PubMed

Peters, Roger H; Young, M Scott; Rojas, Elizabeth C; Gorey, Claire M

2017-07-01

Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This population is at high risk for recidivism and presents numerous challenges to those working in the justice system. To provide a contemporary review of the existing research and examine key issues and evidence-based treatment and supervision practices related to CODs in the justice system. We reviewed COD research involving offenders that has been conducted over the past 20 years and provide an analysis of key findings. Several empirically supported frameworks are available to guide services for offenders who have CODs, including Integrated Dual Disorders Treatment (IDDT), the Risk-Need-Responsivity (RNR) model, and Cognitive-Behavioral Therapy (CBT). Evidence-based services include integrated assessment that addresses both sets of disorders and the risk for criminal recidivism. Although several evidence-based COD interventions have been implemented at different points in the justice system, there remains a significant gap in services for offenders who have CODs. Existing program models include Crisis Intervention Teams (CIT), day reporting centers, specialized community supervision teams, pre- and post-booking diversion programs, and treatment-based courts (e.g., drug courts, mental health courts, COD dockets). Jail-based COD treatment programs provide stabilization of acute symptoms, medication consultation, and triage to community services, while longer-term prison COD programs feature Modified Therapeutic Communities (MTCs). Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs.

Harnessing the language of overdose prevention to advance evidence-based responses to the opioid crisis.

PubMed

Collins, Alexandra B; Bluthenthal, Ricky N; Boyd, Jade; McNeil, Ryan

2018-05-01

Language has significant implications for how we view and respond to public health issues. Conventional moralistic messaging around drug use stigmatizes people who use drugs and inhibits the implementation of evidence-based harm reduction interventions that do not condemn drug use. However, within the context of the unprecedented North American opioid overdose crisis, we argue that shifting conventional moral messaging around overdose prevention and response strategies is key to supporting the rapid roll-out of evidence-based harm reduction interventions. Reframing overdose prevention to highlight the imperative to address the ongoing public health emergency is an important first step in implementing urgently needed response strategies. Copyright © 2018 Elsevier B.V. All rights reserved.

Beliefs about causes of schizophrenia among police officers before and after crisis intervention team training.

PubMed

Demir, Berivan; Broussard, Beth; Goulding, Sandra M; Compton, Michael T

2009-10-01

This study examined the ways in which beliefs about the causes of schizophrenia change after crisis intervention team (CIT) training of police officers. Comparisons of pre- and post-training scores from 159 officers revealed a decrease in endorsement of items pertaining to personal/family/social stressors and items inconsistent with contemporary conceptions of risk, as well as an increase in endorsement of items consistent with modern biological conceptions of the causation of schizophrenia. Changes in causal beliefs were associated with personal and family history of psychiatric treatment among officers. Findings indicate a need for further research in this area, and suggest that some characteristics of officers may be associated with an increased capacity for knowledge/attitudinal change during CIT training.

Internal displacement in Colombia: Fifteen distinguishing features.

PubMed

Shultz, James M; Ceballos, Ángela Milena Gómez; Espinel, Zelde; Oliveros, Sofia Rios; Fonseca, Maria Fernanda; Florez, Luis Jorge Hernandez

2014-01-01

This commentary aims to delineate the distinguishing features of conflict-induced internal displacement in the nation of Colombia, South America. Even as Colombia is currently implementing a spectrum of legal, social, economic, and health programs for "victims of armed conflict," with particular focus on internally displaced persons (IDPs), the dynamics of forced migration on a mass scale within this country are little known beyond national borders.   The authors of this commentary are embarking on a global mental health research program in Bogota, Colombia to define best practices for reaching the displaced population and implementing sustainable, evidence-based screening and intervention for common mental disorders. Presenting the defining characteristics of internal displacement in Colombia provides the context for our work and, more importantly, conveys the compelling and complex nature of this humanitarian crisis. We attempt to demonstrate Colombia's unique position within the global patterning of internal displacement.

Internal displacement in Colombia

PubMed Central

Shultz, James M; Ceballos, Ángela Milena Gómez; Espinel, Zelde; Oliveros, Sofia Rios; Fonseca, Maria Fernanda; Florez, Luis Jorge Hernandez

2014-01-01

This commentary aims to delineate the distinguishing features of conflict-induced internal displacement in the nation of Colombia, South America. Even as Colombia is currently implementing a spectrum of legal, social, economic, and health programs for “victims of armed conflict,” with particular focus on internally displaced persons (IDPs), the dynamics of forced migration on a mass scale within this country are little known beyond national borders.   The authors of this commentary are embarking on a global mental health research program in Bogota, Colombia to define best practices for reaching the displaced population and implementing sustainable, evidence-based screening and intervention for common mental disorders. Presenting the defining characteristics of internal displacement in Colombia provides the context for our work and, more importantly, conveys the compelling and complex nature of this humanitarian crisis. We attempt to demonstrate Colombia’s unique position within the global patterning of internal displacement. PMID:28228997

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.

Reduction of Seclusion and Restraint in an Inpatient Psychiatric Setting: A Pilot Study.

PubMed

Blair, Ellen W; Woolley, Stephen; Szarek, Bonnie L; Mucha, Theodore F; Dutka, Olga; Schwartz, Harold I; Wisniowski, Jeff; Goethe, John W

2017-03-01

The authors describe a quality and safety initiative designed to decrease seclusion/restraint (S/R) and present the results of a pilot study that evaluated the effectiveness of this program. The study sample consisted of consecutive admissions to a 120-bed psychiatric service after the intervention was implemented (October 2010-September 2012, n = 8029). Analyses compared S/R incidence and duration in the study sample to baseline (consecutive admissions during the year prior to introduction of the intervention, October 2008-September 2009, n = 3884). The study intervention, which used evidence-based therapeutic practices for reducing violence/aggression, included routine use of the Brøset Violence Checklist, mandated staff education in crisis intervention and trauma informed care, increased frequency of physician reassessment of need for S/R, formal administrative review of S/R events and environmental enhancements (e.g., comfort rooms to support sensory modulation). Statistically significant associations were found between the intervention and a decrease in both the number of seclusions (p < 0.01) and the duration of seclusion per admission (p < 0.001). These preliminary results support the conclusion that this intervention was effective in reducing use of seclusion. Further study is needed to determine if these prevention strategies are generalizable, the degree to which each component of the intervention contributes to improve outcome, and if continuation of the intervention will further reduce restraint use.

Methods and design of a 10-week multi-component family meals intervention: a two group quasi-experimental effectiveness trial.

PubMed

Rogers, Catherine; Anderson, Sarah E; Dollahite, Jamie S; Hill, Tisa F; Holloman, Chris; Miller, Carla K; Pratt, Keeley J; Gunther, Carolyn

2017-01-09

Given the ongoing childhood obesity public health crisis and potential protective effect of family meals, there is need for additional family meals research, specifically experimental studies with expanded health outcomes that focus on the at-risk populations in highest need of intervention. Future research, specifically intervention work, would also benefit from an expansion of the target age range to include younger children, who are laying the foundation of their eating patterns and capable of participating in family meal preparations. The purpose of this paper is to address this research gap by presenting the objectives and research methods of a 10-week multi-component family meals intervention study aimed at eliciting positive changes in child diet and weight status. This will be a group quasi-experimental trial with staggered cohort design. Data will be collected via direct measure and questionnaires at baseline, intervention completion (or waiting period for controls), and 10-weeks post-intervention. Setting will be faith-based community center. Participants will be 60 underserved families with at least 1, 4-10 year old child will be recruited and enrolled in the intervention (n = 30) or waitlist control group (n = 30). The intervention (Simple Suppers) is a 10-week family meals program designed for underserved families from racial/ethnic diverse backgrounds. The 10, 90-min program lessons will be delivered weekly over the dinner hour. Session components include: a) interactive group discussion of strategies to overcome family meal barriers, plus weekly goal setting for caregivers; b) engagement in age-appropriate food preparation activities for children; and c) group family meal for caregivers and children. Main outcome measures are change in: child diet quality; child standardized body mass index; and frequency of family meals. Regression models will be used to compare response variables results of intervention to control group, controlling for confounders. Analyses will account for clustering by family and cohort. Significance will be set at p < 0.05. This is the first experimentally designed family meals intervention that targets underserved families with elementary school age children and includes an examination of health outcomes beyond weight status. Results will provide researchers and practitioners with insight on evidence-based programming to aid in childhood obesity prevention. NCT02923050 . Registered 03 October 2016. Retrospectively registered.

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 the technology for volcano crisis response.

Crisis management aspects of bam catastrophic earthquake: review article.

PubMed

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

2015-01-01

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

Program Use and Outcome Change in a Web-Based Trauma Intervention: Individual and Social Factors.

PubMed

Wang, Zhiyun; Wang, Jianping; Maercker, Andreas

2016-09-09

Insight into user adherence to Web-based intervention programs and into its relationship to intervention effect is needed. The objective of this study was to examine use of a Web-based self-help intervention program, the Chinese version of My Trauma Recovery (CMTR), among Chinese traumatized individuals, and to investigate the relationship between program use and user characteristics before the intervention and change in outcomes after the intervention and at 3-months' follow-up. The sample consisted of 56 urban survivors of different trauma types and 90 rural survivors of the 2008 Sichuan earthquake, who used the CMTR in 1 month on their own or guided by volunteers in a counseling center. Predictors were demographics (sex, age, highest education, marital status, and annual family income), health problems (trauma duration, posttraumatic symptoms, and depression), psychological factors (coping self-efficacy), and social factors (social functioning impairment and social support). Program use was assessed by general program usage (eg, number of visiting days) and program adherence (eg, webpages completed in modules). Outcome measures were the Posttraumatic Diagnostic Scale (PDS), Symptom Checklist 90-Depression (SCL-D), Trauma Coping Self-Efficacy scale (CSE), Crisis Support Scale (CSS), and Social Functioning Impairment questionnaire (SFI) adopted from the CMTR. (1) Program use: rural participants had a larger total number of visiting days (F1,144=40.50, P<.001) and visited more program modules in 1 month (χ(2)3=73.67, P<.001) than urban participants. (2) Predictors and program use: total number of visiting days was correlated with CSS at pretest (r=.22, P=.009), and total number of completed webpages was associated with SFI at pretest (r=.19, P=.02). Number of webpages completed in modules was correlated with all demographic, disease severity, psychological, and social factors at pretest. (3) Program use and outcomes change: in general, use of the triggers and self-talk modules showed a consistent positive association with improvement in PDS, SCL-D, SFI, and CSE. The relaxation module was associated with positive change in PDS, but with negative change in CSS and SFI. The professional help module was associated with positive change in SCL-D, but its use on the first day was associated with negative change in CSS and CSE. The unhelpful coping module was associated with negative change in SFI. The mastery tools module showed a consistent association with negative change in PDS and SCL-D. These findings suggest that both individual (eg, demographic, health problems, psychological) and social factors (eg, social functioning, social support) should be considered when delivering Web-based interventions, particularly in collectivist cultures. Specific program adherence indicators (eg, webpages completed in each module, activity types completed), rather than general program usage indicators (eg, total number or time of visiting), should be developed to examine the effectiveness of various program modules or elements. Australian New Zealand Clinical Trials Registry: ACTRN12611000951954; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=343399 (Archived by WebCite at http://www.webcitation.org/6G7WyNODk).

Musical "Tune-Ups" for Couples: Brief Treatment Interventions

ERIC Educational Resources Information Center

Duba, Jill D.; Roseman, Christopher

2012-01-01

Some couples seek counseling to address warning signs. They may not be facing a relationship crisis but may be more concerned about where they are headed. Hence, a marriage makeover may not necessarily be needed, but instead couples in counseling may benefit from something rejuvenating. In such cases, brief interventions or techniques may be…

High School Students' Experiences of Bullying and Victimization and the Association with School Health Center Use

ERIC Educational Resources Information Center

Lewis, Catherine; Deardorff, Julianna; Lahiff, Maureen; Soleimanpour, Samira; Sakashita, Kimi; Brindis, Claire D.

2015-01-01

Background: Bullying and victimization are ongoing concerns in schools. School health centers (SHCs) are well situated to support affected students because they provide crisis intervention, mental health care, and broader interventions to improve school climate. This study examined the association between urban adolescents' experiences of…

Refugee-Teacher-Train-Refugee-Teacher Intervention Research in Malaysia: Promoting Classroom Management and Teacher Self-Care

ERIC Educational Resources Information Center

O'Neal, Colleen R.; Gosnell, Nicole M.; Ng, Wai Sheng; Ong, Edward

2018-01-01

Given the current refugee crisis, the development of sustainable postconflict refugee education systems and supports is essential. The present study reports Resilient Refugee Education (RRE) intervention effects on refugee teacher confidence and knowledge of classroom management, in addition to refugee teacher self-care in Malaysia. We compared…

The impact of a school food aid program on household food insecurity.

PubMed

Petralias, Athanassios; Papadimitriou, Eleni; Riza, Elena; Karagas, Margaret R; Zagouras, Alexia B A; Linos, Athena

2016-04-01

We had a unique opportunity to establish the extent of food insecurity and the potential impact of a large-scale school-based nutritional program, in low-socioeconomic status districts of Greece, during the current economic crisis. Around 162 schools with 25 349 students participated during the 2012-2013 school year. Each student received a daily healthy meal designed by nutrition specialists. Food insecurity levels, measured using the Food Security Survey Module were assessed at baseline and after a 1-8-month intervention period. Pre-post intervention responses were matched at an individual level. Around 64.2% of children's households experienced food insecurity at baseline. This percentage decreased to 59.1% post-intervention,P< 0.001. On an individual level, food insecurity score diminished by 6.5%,P< 0.001. After adjustment for various socioeconomic factors, for each additional month of participation, the odds of reducing the food insecurity score increased by 6.3% (OR = 1.06, 95% CI: 1.02-1.11). Those experiencing food insecurity with hunger at baseline were more likely to improve food insecurity score than those who did not (OR = 3.51, 95%CI: 2.92-4.21). Children and families residing in low socioeconomic areas of Greece, experience high levels of food insecurity. Our findings suggest that participation in a school-based food aid program may reduce food insecurity for children and their families in a developed country in times of economic hardship. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association.

Ghosts of Crisis Past.

ERIC Educational Resources Information Center

Klopfer, Leopold E.; Champagne, Audrey B.

1990-01-01

Discussed is the history of school science curriculum reform from the Sputnik era to 1990. The relationship between the crisis in the 1950s and 1990 is addressed. A list of curriculum development programs for all levels and special needs students is included. (KR)

Explaining the unexplainable: designing a national strategy on classroom communication concerning the 22 July terror attack in Norway

PubMed Central

Schultz, Jon-Håkon; Langballe, Åse; Raundalen, Magne

2014-01-01

Background In the context of crisis and disasters, school-aged children are a vulnerable group with fewer coping resources than adults. The school is a key arena for preventive interventions; teachers can be given a key role in large-scale school-based interventions following a man-made or natural disaster. Objectives This paper describes a practical example of designing a school-based population-level intervention. Methods The preventive measures were delivered as a national communication strategy between teachers and pupils aged 6–19 concerning the terror attack on 22 July 2011 in Norway. The strategy is based on principles from international research. Results The presentation contributes to the discussion of defining the teacher's role in school-based crisis interventions and dealing with high-intensity media coverage of war, terror, and catastrophes. Conclusions The presentation provides educational and psychological perspectives on how teachers can take an active role in helping pupils to deal with such events through two approaches: the therapeutic approach, to restore calm and feelings of safety; and the educational approach, to foster reflection and deeper understanding. PMID:25018859

Explaining the unexplainable: designing a national strategy on classroom communication concerning the 22 July terror attack in Norway.

PubMed

Schultz, Jon-Håkon; Langballe, Ase; Raundalen, Magne

2014-01-01

In the context of crisis and disasters, school-aged children are a vulnerable group with fewer coping resources than adults. The school is a key arena for preventive interventions; teachers can be given a key role in large-scale school-based interventions following a man-made or natural disaster. This paper describes a practical example of designing a school-based population-level intervention. The preventive measures were delivered as a national communication strategy between teachers and pupils aged 6-19 concerning the terror attack on 22 July 2011 in Norway. The strategy is based on principles from international research. The presentation contributes to the discussion of defining the teacher's role in school-based crisis interventions and dealing with high-intensity media coverage of war, terror, and catastrophes. THE PRESENTATION PROVIDES EDUCATIONAL AND PSYCHOLOGICAL PERSPECTIVES ON HOW TEACHERS CAN TAKE AN ACTIVE ROLE IN HELPING PUPILS TO DEAL WITH SUCH EVENTS THROUGH TWO APPROACHES: the therapeutic approach, to restore calm and feelings of safety; and the educational approach, to foster reflection and deeper understanding.

10 CFR 707.4 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... counseling and assessment, crisis intervention, referral to outside treatment facilities, and follow-up... terms of a valid prescription, or other uses authorized by law. Management and Operating Contract means...

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

PubMed

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

2015-12-01

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

Opioid Crisis: No Easy Fix to Its Social and Economic Determinants.

PubMed

Dasgupta, Nabarun; Beletsky, Leo; Ciccarone, Daniel

2018-02-01

The accepted wisdom about the US overdose crisis singles out prescribing as the causative vector. Although drug supply is a key factor, we posit that the crisis is fundamentally fueled by economic and social upheaval, its etiology closely linked to the role of opioids as a refuge from physical and psychological trauma, concentrated disadvantage, isolation, and hopelessness. Overreliance on opioid medications is emblematic of a health care system that incentivizes quick, simplistic answers to complex physical and mental health needs. In an analogous way, simplistic measures to cut access to opioids offer illusory solutions to this multidimensional societal challenge. We trace the crisis' trajectory through the intertwined use of opioid analgesics, heroin, and fentanyl analogs, and we urge engaging the structural determinants lens to address this formidable public health emergency. A broad focus on suffering should guide both patient- and community-level interventions.

Crisis as opportunity: international health work during the economic depression.

PubMed

Borowy, Iris

2008-01-01

The economic depression of the 1930s represented the most important economic and social crisis of its time. Surprisingly, its effect on health did not show in available morbidity and mortality rates. In 1932, the League of Nations Health Organisation embarked on a six-point program addressing statistical methods of measuring the effect and its influence on mental health and nutrition and establishing ways to safeguard public health through more efficient health systems. Some of these studies resulted in considerations of general relevance beyond crisis management. Unexpectedly, the crisis offered an opportunity to reconsider key concepts of individual and public health.

Use of crisis management interventions among suicidal patients: Results of a randomized controlled trial.

PubMed

Bryan, Craig J; May, Alexis M; Rozek, David C; Williams, Sean R; Clemans, Tracy A; Mintz, Jim; Leeson, Bruce; Burch, T Scott

2018-05-10

Previous research supports the efficacy of the crisis response plan (CRP) for the reduction of suicidal behaviors as compared to treatment as usual (TAU). Patient perspectives and use of the CRP, and their relationship to later suicidal thoughts, remain unknown. A secondary analysis of a randomized clinical trial comparing a standard CRP (S-CRP), a CRP enhanced with reasons for living (E-CRP), and TAU in a sample of 97 active-duty U.S. Army personnel was conducted. Participants were asked about their use, perceptions, and recall of each intervention. Generalized estimating equations were used to test the conditional effects of intervention use, perceptions, and recall on severity of suicide ideation during follow-up. Across all treatment groups, over 80% of participants retained their written CRP up to 6 months later, but less than 25% had the written plan in their physical possession at the time of each assessment. Participants in S-CRP and E-CRP were more likely to recall self-management strategies and sources of social support. Participants in TAU were more likely to recall use of professional healthcare services and crisis management services. All three interventions were rated as highly useful. More frequent use of the E-CRP and recall of its components were associated with significantly reduced suicide ideation as compared to TAU. Both CRPs have high acceptability ratings. The effect of both CRPs on reduced suicide ideation is associated with patient recall of components. More frequent use of the E-CRP is associated with larger reductions in suicide ideation. © 2018 Wiley Periodicals, Inc.

Psychiatric disposition of patients brought in by crisis intervention team police officers.

PubMed

Strauss, Gordon; Glenn, Mark; Reddi, Padma; Afaq, Irfan; Podolskaya, Anna; Rybakova, Tatyana; Saeed, Osman; Shah, Vital; Singh, Baljit; Skinner, Andrew; El-Mallakh, Rif S

2005-04-01

As part of an effort to improve police interactions with mentally ill citizens, and improve mental health care delivery to subjects in acute distress, the University of Louisville, in conjunction with the Louisville Metro Police, established the crisis intervention team (CIT). CIT is composed of uniformed officers who receive extensive training in crisis intervention and psychiatric issues and who are preferentially called to investigate police calls that may involve a mentally ill individual. In an effort to determine the characteristics of the individuals brought to the emergency psychiatric service (EPS) by CIT officers, a comparative (CIT vs. mental inquest warrant [MIW, a citizen-initiated court order to bring someone for psychiatric evaluation because of concerns regarding dangerousness] vs non-CIT/non-MIW), descriptive evaluation was performed. With the exception of a higher rate of schizophrenic subjects brought in by CIT (43.0% vs. 22.1%, non-CIT, P = .002), the demographics, diagnosis, and disposition of CIT-referred subjects were not different in any way from non-CIT patients. Subjects referred on MIWs were more likely to be admitted to a psychiatric hospital than non-MIW patients (71.6% vs. 34.8%, P < .0001), but CIT-referred hospitalization rates were not different from hospitalization rates of self-referred subjects (20.7% vs. 33.3%, ns). CIT officers appear to do a good job at identifying patients in need of psychiatric care.

Coping with Crisis.

ERIC Educational Resources Information Center

Akenhead, James; Andreani, Alan

2002-01-01

School officials put a crisis communications plan into action after two Ohio students died and a third became critically ill from meningitis in May 2001. A mass immunization program prevented a major outbreak, and rumor control helped calm the public's fears. Recounts things learned from the experience. (MLF)

Effects of the economic crisis on smoking prevalence and number of smokers in the USA.

PubMed

Gallus, Silvano; Ghislandi, Simone; Muttarak, Raya

2015-01-01

Scanty and controversial information is available on the impact of macroeconomic fluctuations on smoking behaviour. No study has quantified the effects of fiscal crises on smoking prevalence. This study aimed to investigate the effects of the 2007-2008 economic crisis on smoking prevalence and number of smokers in the USA. Using data from the repeated Behavioural Risk Factor Surveillance System (BRFSS) surveys in pre-crisis (2005-2007) and post-crisis (2009-2010) periods on a total of 1,981,607 US adults, we separated the expected (after allowance for the demographic growth of the US population, secular smoking prevalence trends and changes in sociodemographic characteristics) from the unexpected (assumed attributable to the economic crisis) changes in the number of smokers across different employment statuses. Joinpoint regression analysis revealed no significant changes in smoking prevalence trends over the period 2005-2010. The crisis resulted in an increase in the number of smokers in the US by 0.6 million. This is largely due to an unexpected decrease of 1.7 million smokers among employed and an increase of 2.4 million smokers among unemployed individuals, whose smoking prevalence also remains extremely high in the post-crisis period (32.6%). The 2008 financial crisis had a weak effect on smoking prevalence. The pro-cyclical relationship (ie, the crisis results in a lower number of smokers) found among the employed is offset by the counter-cyclical relationship (ie, the crisis results in a higher number of smokers) found among unemployed individuals. Public health interventions should specifically target those in unemployment, particularly in hard times. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring.

PubMed

Lay, Barbara; Salize, Hans Joachim; Dressing, Harald; Rüsch, Nicolas; Schönenberger, Thekla; Bühlmann, Monika; Bleiker, Marco; Lengler, Silke; Korinth, Lena; Rössler, Wulf

2012-09-05

The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients. However, the effectiveness of such interventions in terms of more robust criteria (e.g., admission rates) has not been sufficiently analysed in larger study samples. The current study aims to evaluate an intervention programme for patients at high risk of compulsory admission to psychiatric hospitals. Effectiveness will be assessed in terms of a reduced number of psychiatric hospitalisations and days of inpatient care in connection with involuntary psychiatric admissions as well as in terms of cost-containment in inpatient mental health care. The intervention furthermore intends to reduce the degree of patients' perceived coercion and to increase patient satisfaction, their quality of life and empowerment. This paper describes the design of a randomised controlled intervention study conducted currently at four psychiatric hospitals in the Canton of Zurich. The intervention programme consists of individualised psycho-education focusing on behaviours prior to and during illness-related crisis, the distribution of a crisis card and, after inpatient admission, a 24-month preventive monitoring of individual risk factors for compulsory re-admission to hospital. All measures are provided by a mental health care worker who maintains permanent contact to the patient over the course of the study. In order to prove its effectiveness the intervention programme will be compared with standard care procedures (control group). 200 patients each will be assigned to the intervention group or to the control group. Detailed follow-up assessments of service use, psychopathology and patient perceptions are scheduled 12 and 24 months after discharge. Innovative interventions have to be established to prevent patients with mental disorders from undergoing the experience of compulsory admission and, with regard to society as a whole, to reduce the costs of health care (and detention). The current study will allow for a prospective analysis of the effectiveness of an intervention programme, providing insight into processes and factors that determine involuntary placement.

Microvascular oxygen consumption during sickle cell pain crisis.

PubMed

Rowley, Carol A; Ikeda, Allison K; Seidel, Miles; Anaebere, Tiffany C; Antalek, Matthew D; Seamon, Catherine; Conrey, Anna K; Mendelsohn, Laurel; Nichols, James; Gorbach, Alexander M; Kato, Gregory J; Ackerman, Hans

2014-05-15

Sickle cell disease is an inherited blood disorder characterized by chronic hemolytic anemia and episodic vaso-occlusive pain crises. Vaso-occlusion occurs when deoxygenated hemoglobin S polymerizes and erythrocytes sickle and adhere in the microvasculature, a process dependent on the concentration of hemoglobin S and the rate of deoxygenation, among other factors. We measured oxygen consumption in the thenar eminence during brachial artery occlusion in sickle cell patients and healthy individuals. Microvascular oxygen consumption was greater in sickle cell patients than in healthy individuals (median [interquartile range]; sickle cell: 0.91 [0.75-1.07] vs healthy: 0.75 [0.62-0.94] -ΔHbO2/min, P < .05) and was elevated further during acute pain crisis (crisis: 1.10 [0.78-1.30] vs recovered: 0.88 [0.76-1.03] -ΔHbO2/min, P < .05). Increased microvascular oxygen consumption during pain crisis could affect the local oxygen saturation of hemoglobin when oxygen delivery is limiting. Identifying the mechanisms of elevated oxygen consumption during pain crisis might lead to the development of new therapeutic interventions. This trial was registered at www.clinicaltrials.gov as #NCT01568710.

Development and Evaluation of Veteran Supportive Supervisor Training (VSST): Improving Reintegration of the Oregon National Guard and Reserves in the Workplace

DTIC Science & Technology

2014-03-01

addressing stigma , stereotyping and discrimination in the workplace  Asking for or listening to all employees suggestions about the work environment...after deployment. o Military spouses and partners felt unprepared for their service member’s return from military duty o Suicide, PTSD and stigma ...Masters of Social Work and Public Health; Health Administration & Policy • Mental Health First Aid Training • Crisis Intervention Training, Crisis Clinic of

[Hypertensive crisis in kidney patients].

PubMed

Scrivano, Jacopo; Giuliani, Anna; Pettorini, Laura; Punzo, Giorgio; Mene', Paolo; Pirozzi, Nicola

2011-01-01

The classification and management of hypertensive crisis have been recently reviewed in the context of both European and American guidelines. The key points for proper blood pressure control in severe arterial hypertension are: 1 - Distinction between urgent intervention and emergencies 2 - Choice of the best drug(s) 3 - Choice of the correct route of administration. In patients with renal disease, beside the common causes of hypertension/ hypertensive crises, kidney-specific causes should be taken into account such as renal parenchymal hypertension, renovascular hypertension, sclerodermic crises, and preeclampsia.

Military Intervention in Latin America: Analysis of the 1965 Crisis in the Dominican Republic.

DTIC Science & Technology

1983-06-03

General Marcos A. Rivera Cuesta, the Army Chief of Staff, told Reid on Saturday morning, 24 April 1965, that Lieutenant Colonels Hernando Ramirez and...On Guerrilla Warfare. Translation by Department of the Army. New York: Fredrick A. Praeger, Inc., 1961. Herring, Hubert . A History of Latin America...Draper, Theodore, "The Roots of the Dominican Crisis", The New Leader, Vol. XLVIII, No. 11, May 24, 1965. Herring, Hubert , "Scandal of the Caribbean

77 FR 61772 - Agency Information Collection Activities: Proposed Collection; Comment Request, Crisis Counseling...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-11

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2012-0031; OMB No. 1660-0085] Agency Information Collection Activities: Proposed Collection; Comment Request, Crisis Counseling Assistance and Training Program AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice...

78 FR 9711 - Agency Information Collection Activities; Submission for OMB Review; Comment Request: Crisis...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-11

... Request: Crisis Counseling Assistance and Training Program AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice. SUMMARY: The Federal Emergency Management Agency (FEMA) will submit the... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID: FEMA-2012-0031...

HIV prevention in Africa: programs and populations served by non-governmental organizations.

PubMed

Benotsch, Eric G; Stevenson, L Yvonne; Sitzler, Cheryl A; Kelly, Jeffrey A; Makhaye, Gethwana; Mathey, Eric Dodji; Somlai, Anton M; Brown, Kevin D; Amirkhanian, Yuri; Fernandez, M Isabel; Opgenorth, Karen M

2004-08-01

The AIDS epidemic in Africa remains an urgent health crisis. Non-governmental organizations (NGOs) in Africa play a critical role in the delivery of HIV prevention services and assistance to persons living with AIDS. African NGOs are conducting numerous HIV prevention programs with several at-risk populations, yet their efforts have only rarely been systematically documented. To address this gap in the literature, the authors surveyed one NGO in each of 29 African countries regarding their HIV prevention activities and populations served. This report provides details concerning HIV prevention activities across the continent and describes in detail innovative programs from Togo and South Africa. NGOs in the present sample operate with modest budgets and small staff sizes, yet conduct programs that reach large segments of their communities. NGOs were most likely to report community-level interventions such as peer-education or community outreach. Faced with an epidemic where the main transmission occurs via heterosexual activity, African NGOs were most likely to direct their attention to the general public and to youth. NGOs in Africa are struggling to implement sustainable, cost-effective programs with few resources. Strengthening the infrastructure and capacity of these key agencies is crucial to fighting the AIDS epidemic in Africa.

School, Community, and Family Working Together to Address Childhood Obesity: Perceptions from the KOALA Lifestyle Intervention Study

ERIC Educational Resources Information Center

Smibert, Asa; Abbott, Rebecca; Macdonald, Doune; Hogan, Anna; Leong, Gary

2010-01-01

Epidemiological data on childhood obesity has prompted a significant response from both governments and academics seeking to recommend solutions to the reported "crisis". The "Kinder Overweight Active Living Action" (KOALA) healthy lifestyle programme is a randomized obesity prevention and intervention study designed to provide an understanding of…

Total and Marginal Cost Analysis for a High School Based Bystander Intervention

ERIC Educational Resources Information Center

Bush, Joshua L.; Bush, Heather M.; Coker, Ann L.; Brancato, Candace J.; Clear, Emily R.; Recktenwald, Eileen A.

2018-01-01

Costs of providing the Green Dot bystander-based intervention, shown to be effective in the reduction of sexual violence among Kentucky high school students, were estimated based on data from a large cluster-randomized clinical trial. Rape Crisis Center Educators were trained to provide Green Dot curriculum to students. Implementing Green Dot in…

Mapping the Maze: An Art Therapy Intervention following Disclosure of Sexual Abuse

ERIC Educational Resources Information Center

Pifalo, Terry

2009-01-01

Disclosures of child sexual abuse create an immediate crisis within the child's family unit. Reactions of nonoffending caregivers in particular may prevent them from being emotionally available to respond immediately to the needs of the child victim. This article describes an art therapy intervention of visual mapping used in a support group of…

Influences of Constructivist-Oriented Nutrition Education on Urban Middle School Students' Nutrition Knowledge, Self-Efficacy, and Behaviors

ERIC Educational Resources Information Center

McCaughtry, Nate; Fahlman, Mariane; Martin, Jeffrey J.; Shen, Bo

2011-01-01

Background: Health professionals are looking to nutrition-based youth health interventions in K-12 schools to combat the growing obesity crisis; however, none have explored the influences of interventions guided by constructivist learning theory. Purpose: This study examined the influences of a constructivist-oriented nutrition education program…

Drug checking: a potential solution to the opioid overdose epidemic?

PubMed

Bardwell, Geoff; Kerr, Thomas

2018-05-25

North America is experiencing an overdose epidemic driven in part by the proliferation of illicitly-manufactured fentanyl and related analogues. In response, communities are scaling up novel overdose prevention interventions. Included are drug checking technologies. Drug checking technologies aim to identify the contents of illicit drugs. These technologies vary considerably in terms of cost, accuracy, and usability, and while efforts are now underway to implement drug checking programs for people who inject drugs, there remains a lack of rigorous evaluation of their impacts. Given the ongoing overdose crisis and the urgent need for effective responses, research on drug checking should be prioritized. However, while such research should be supported, it should be completed before these technologies are widely implemented.

Telephone Crisis Support Workers' Psychological Distress and Impairment.

PubMed

Kitchingman, Taneile A; Wilson, Coralie J; Caputi, Peter; Wilson, Ian; Woodward, Alan

2018-01-01

In order to respond to crises with appropriate intervention, crisis workers are required to manage their own needs as well as the needs of those they respond to. A systematic review of the literature was conducted to examine whether telephone crisis support workers experience elevated symptoms of psychological distress and are impaired by elevated symptoms. Studies were identified in April 2015 by searching three databases, conducting a gray literature search, and forward and backward citation chaining. Of 113 identified studies, seven were included in the review. Results suggest that that telephone crisis support workers experience symptoms of vicarious traumatization, stress, burnout, and psychiatric disorders, and that they may not respond optimally to callers when experiencing elevated symptoms of distress. However, definitive conclusions cannot be drawn due to the paucity and methodological limitations of available data. While the most comprehensive search strategy possible was adopted, resource constraints meant that conference abstracts were not searched and authors were not contacted for additional unpublished information. There is an urgent need to identify the impact of telephone crisis support workers' role on their well-being, the determinants of worker well-being in the telephone crisis support context, and the extent to which well-being impacts their performance and caller outcomes. This will help inform strategies to optimize telephone crisis support workers' well-being and their delivery of support to callers.

Early metabolic crisis-related brain atrophy and cognition in traumatic brain injury.

PubMed

Wright, Matthew J; McArthur, David L; Alger, Jeffry R; Van Horn, Jack; Irimia, Andrei; Filippou, Maria; Glenn, Thomas C; Hovda, David A; Vespa, Paul

2013-09-01

Traumatic brain injury often results in acute metabolic crisis. We recently demonstrated that this is associated with chronic brain atrophy, which is most prominent in the frontal and temporal lobes. Interestingly, the neuropsychological profile of traumatic brain injury is often characterized as 'frontal-temporal' in nature, suggesting a possible link between acute metabolic crisis-related brain atrophy and neurocognitive impairment in this population. While focal lesions and diffuse axonal injury have a well-established role in the neuropsychological deficits observed following traumatic brain injury, no studies to date have examined the possible contribution of acute metabolic crisis-related atrophy in the neuropsychological sequelae of traumatic brain injury. In the current study we employed positron emission tomography, magnetic resonance imaging, and neuropsychological assessments to ascertain the relationship between acute metabolic crisis-related brain atrophy and neurocognitive outcome in a sample of 14 right-handed traumatic brain injury survivors. We found that acute metabolic crisis-related atrophy in the frontal and temporal lobes was associated with poorer attention, executive functioning, and psychomotor abilities at 12 months post-injury. Furthermore, participants with gross frontal and/or temporal lobe atrophy exhibited numerous clinically significant neuropsychological deficits in contrast to participants with other patterns of brain atrophy. Our findings suggest that interventions that reduce acute metabolic crisis may lead to improved functional outcomes for traumatic brain injury survivors.

Swedish austerity: benefits at risk.

PubMed

Carroll, E

1993-01-01

The Swedish welfare state is facing the greatest threat since its inception. Attacks stem from the country's sharp economic downturn since 1989 and the related currency crisis of September 1992. Politicians of the right and left have responded to the economic crisis by initiating cutbacks in social welfare programs and supporting policies that will lead to a massive transfer of income from working people to corporations. The focus on cutting social programs is misplaced. The Swedish economy flourished for decades with the network of social service programs in place; the welfare state cannot be blamed for economic problems that have only recently arisen.

Emergency care in case of acute psychotic and/or manic symptoms: Lived experiences of patients and their families with the first interventions of a mobile crisis team. A phenomenological study.

PubMed

Daggenvoorde, Thea H; Gijsman, Harm J; Goossens, Peter J J

2017-09-27

To explore the lived experiences of patients with a psychotic or bipolar disorder and their families with emergency care during the first contact with a mobile crisis team. Open individual interviews were held with ten patients and ten family members. Content data-analysis was conducted. Communication and cooperation was difficult in several cases. Personal crisis plans were not always used. Stigma was felt, especially when police-assistance was needed. A calm, understanding attitude was appreciated. Focus explicitly on communication with the patient, despite the acute condition, enhances the chance of cooperation. Taking time for contact is important. © 2017 Wiley Periodicals, Inc.

Adolescent suicide: a response to developmental crisis.

PubMed

Gilead, M P; Mulaik, J S

1983-01-01

Suicide is an increasing problem among adolescents. Developmental concerns and inability to resolve problems stemming from feelings of alienation are often at the core of an adolescent's suicide attempt. Nurses can be instrumental in primary prevention by educating the public about persons at risk for suicide, in helping parents deal more effectively with children's growth, and by supporting programs in the school system and other agencies that help young people communicate with others and resolve problems before they become crises. The nurse can also play an important role in secondary prevention through participation in or referral to hotline services, through intervention in the emergency service, or in community mental health programs or inpatient treatment programs. The psychiatric nurse specialist, in particular, can play a very significant role in the treatment of the adolescent in a suicidal crisis and also in consultation with other nurses and professionals who may assess suicidal risk in young people in the community. Finally, tertiary prevention may be necessary to help families and friends resolve their grief over the loss if a family member or close friend has succeeded at a suicide attempt. Feelings of guilt, anxiety, anger, and depression are usually present in the surviving family members of a successful suicide. They need to be given the opportunity to talk about the events leading up to the suicide, their feelings about the persons involved, especially the lost person, and to ventilate their anger, guilt, and sadness. The rising rate of suicide or suicide attempts among this country's adolescents--the third cause of death among adolescents--cries out for stronger support systems for our young people.(ABSTRACT TRUNCATED AT 250 WORDS)

Cognitive behavioural therapy and mindfulness for stress and burnout: a waiting list controlled pilot study comparing treatments for parents of children with chronic conditions.

PubMed

Anclair, Malin; Lappalainen, Raimo; Muotka, Joona; Hiltunen, Arto J

2018-03-01

Parents of children with chronic conditions often experience a crisis with serious mental health problems for themselves as a consequence. The healthcare focus is on the children; however, the parents often worry about their children's health and future but are seldom offered any counselling or guidance. The aim of this study was to investigate the effectiveness of two group-based behavioural interventions on stress and burnout among parents of children with chronic conditions. After a waiting list control period (n = 28), parents were offered either a cognitive behavioural (CBT, n = 10) or a mindfulness program (MF, n = 9). Both interventions decreased significantly stress and burnout. The within-group effect sizes were large in both interventions (CBT, g = 1.28-1.64; MF, g = 1.25-2.20). Hence, the results of this pilot study show that treating a group using either CBT or mindfulness can be an efficient intervention for reducing stress levels and burnout in parents of children with chronic conditions. © 2017 The Authors Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

Randomised controlled trial of the clinical and cost-effectiveness of a peer-delivered self-management intervention to prevent relapse in crisis resolution team users: study protocol

PubMed Central

Mason, Oliver; Osborn, David; Henderson, Claire; Marston, Louise; Ambler, Gareth; Pilling, Stephen; Morant, Nicola; Gray, Richard; Weaver, Tim; Nolan, Fiona; Lloyd-Evans, Brynmor

2017-01-01

Introduction Crisis resolution teams (CRTs) provide assessment and intensive home treatment in a crisis, aiming to offer an alternative for people who would otherwise require a psychiatric inpatient admission. They are available in most areas in England. Despite some evidence for their clinical and cost-effectiveness, recurrent concerns are expressed regarding discontinuity with other services and lack of focus on preventing future relapse and readmission to acute care. Currently evidence on how to prevent readmissions to acute care is limited. Self-management interventions, involving supporting service users in recognising and managing signs of their own illness and in actively planning their recovery, have some supporting evidence, but have not been tested as a means of preventing readmission to acute care in people leaving community crisis care. We thus proposed the current study to test the effectiveness of such an intervention. We selected peer support workers as the preferred staff to deliver such an intervention, as they are well-placed to model and encourage active and autonomous recovery from mental health problems. Methods and analysis The CORE (CRT Optimisation and Relapse Prevention) self-management trial compares the effectiveness of a peer-provided self-management intervention for people leaving CRT care, with treatment as usual supplemented by a booklet on self-management. The planned sample is 440 participants, including 40 participants in an internal pilot. The primary outcome measure is whether participants are readmitted to acute care over 1 year of follow-up following entry to the trial. Secondary outcomes include self-rated recovery at 4 and at 18 months following trial entry, measured using the Questionnaire on the Process of Recovery. Analysis will follow an intention to treatment principle. Random effects logistic regression modelling with adjustment for clustering by peer support worker will be used to test the primary hypothesis. Ethics and dissemination The CORE self-management trial was approved by the London Camden and Islington Research Ethics Committee (REC ref: 12/LO/0988). A Trial Steering Committee and Data Monitoring Committee oversee the progress of the study. We will report on the results of the clinical trial, as well as on the characteristics of the participants and their associations with relapse. Trial registration number ISRCTN 01027104;pre-results stage. PMID:29079602

CRISIS2012: An Updated Tool to Compute Seismic Hazard

NASA Astrophysics Data System (ADS)

Ordaz, M.; Martinelli, F.; Meletti, C.; D'Amico, V.

2013-05-01

CRISIS is a computer tool for probabilistic seismic hazard analysis (PSHA), whose development started in the late 1980's at the Instituto de Ingeniería, UNAM, Mexico. It started circulating outside the Mexican borders at the beginning of the 1990's, when it was first distributed as part of SEISAN tools. Throughout the years, CRISIS has been used for seismic hazard studies in several countries in Latin America (Mexico, Guatemala, Belize, El Salvador, Honduras, Nicaragua, Costa Rica, Panama, Colombia, Venezuela, Ecuador, Peru, Argentina and Chile), and in many other countries of the World. CRISIS has always circulated free of charge for non-commercial applications. It is worth noting that CRISIS has been mainly written by people that are, at the same time, PSHA practitioners. Therefore, the development loop has been relatively short, and most of the modifications and improvements have been made to satisfy the needs of the developers themselves. CRISIS has evolved from a rather simple FORTRAN code to a relatively complex program with a friendly graphical interface, able to handle a variety of modeling possibilities for source geometries, seismicity descriptions and ground motion prediction models (GMPM). We will describe some of the improvements made for the newest version of the code: CRISIS 2012.These improvements, some of which were made in the frame of the Italian research project INGV-DPC S2 (http://nuovoprogettoesse2.stru.polimi.it/), funded by the Dipartimento della Protezione Civile (DPC; National Civil Protection Department), include: A wider variety of source geometries A wider variety of seismicity models, including the ability to handle non-Poissonian occurrence models and Poissonian smoothed-seismicity descriptions. Enhanced capabilities for using different kinds of GMPM: attenuation tables, built-in models and generalized attenuation models. In the case of built-in models, there is, by default, a set ready to use in CRISIS, but additional custom GMPMs may be freely developed and integrated without having to recompile the core code. Therefore, the users can build new external classes implementing custom GMPM modules by adhering to the programming-interface specification, which is delivered as part of the executable program. On the other hand, generalized attenuation models are non-parametric probabilistic descriptions of the ground motions produced by individual earthquakes with known magnitude and location. In the context of CRISIS, a generalized attenuation model is a collection of probabilistic footprints, one for each of the events considered in the analysis. Each footprint gives the geographical distribution of the intensities produced by this event. CRISIS permits now the inclusion of local site effects in hazard computations. Site effects are given to CRISIS in terms of amplification factors that depend on site location, period, and ground-motion level (in order to account for soil non-linearity). Enhanced capabilities to make logic-tree computations and to produce seismic disaggregation charts. A new presentation layer, developed for accessing the same functionalities of the desktop version via web (CRISISWeb). Examples will be presented and the program will be made available to all interested persons.

Psychoanalytic Thoughts on the European Refugee Crisis and the Other.

PubMed

Volkan, Vamık D

2017-12-01

There are many aspects-political, economic, legal, medical, cultural, religious-of the present refugee crisis in Europe. Difficulties at border crossings, settlement programs, life-saving issues, and security measures come to mind immediately, but the refugee crisis also needs to be examined from a psychological angle. This paper outlines psychoanalytic findings on voluntary and forced immigration and human responses to the Other. Change in the twenty-first century is occurring at an unprecedented pace and scale. Globalization, incredible advances in communication technology, fast travel, recourse limitations, terrorist activities, and now the refugee crisis in Europe make psychoanalytic investigation of the Other a necessity.

42 CFR 51d.6 - How will applications be evaluated and awarded?

Code of Federal Regulations, 2012 CFR

2012-10-01

... provided (e.g., outreach, crisis counseling, public education on stress management and crisis mental health... involved in addressing the precipitating event (e.g., emergency management agencies, law enforcement... Directorate within the Federal Emergency Management Agency (FEMA), the Safe and Drug Free Schools Program...

42 CFR 51d.6 - How will applications be evaluated and awarded?

Code of Federal Regulations, 2014 CFR

2014-10-01

... provided (e.g., outreach, crisis counseling, public education on stress management and crisis mental health... involved in addressing the precipitating event (e.g., emergency management agencies, law enforcement... Directorate within the Federal Emergency Management Agency (FEMA), the Safe and Drug Free Schools Program...

42 CFR 51d.6 - How will applications be evaluated and awarded?

Code of Federal Regulations, 2011 CFR

2011-10-01

... provided (e.g., outreach, crisis counseling, public education on stress management and crisis mental health... involved in addressing the precipitating event (e.g., emergency management agencies, law enforcement... Directorate within the Federal Emergency Management Agency (FEMA), the Safe and Drug Free Schools Program...

42 CFR 51d.6 - How will applications be evaluated and awarded?

Code of Federal Regulations, 2013 CFR

2013-10-01

... provided (e.g., outreach, crisis counseling, public education on stress management and crisis mental health... involved in addressing the precipitating event (e.g., emergency management agencies, law enforcement... Directorate within the Federal Emergency Management Agency (FEMA), the Safe and Drug Free Schools Program...

ERCMExpress. Volume 1, Issue 1

ERIC Educational Resources Information Center

US Department of Education, 2005

2005-01-01

This is the inaugural issue of the Emergency Response and Crisis Management (ERCM) Technical Assistance Center's "ERCMExpress," and it focuses on the new technical assistance center. The center will support 243 grantees funded under the Emergency Response and Crisis Management program in managing and implementing their projects, and in sustaining…

International labor migration and financial crisis in Korea.

PubMed

Hyunho, S

1999-06-01

Although the Korean economy became severely depressed because of the financial crisis in November 1997, most foreign migrant workers in the country opted to stay rather than return to their home countries. This study examined the causes of their relative immobility at both the macro- and microlevel through the use of government statistics and survey data. The first section of this study explored in- and outflows of migrant workers in relation to labor market conditions and government interventions before and after the crisis. The second section looked into the effects of the crisis on the companies employing migrant workers, while the final section investigated the effects of the crisis on migrant workers. The findings of this study indicated that the amnesty measure, which was a major government policy to reduce the number of illegal sojourners, exerted some positive effect in the first months after the crisis. Employment and income opportunities at origin countries are important factors determining mobility. Moreover, manufacturing companies still prefer to hire migrant workers before native workers because of cheaper wages for the former. Overall, most migrant workers, regardless of their sojourn status, desire to stay in Korea because of two main reasons: 1) their total earnings are less than their migration costs; 2) they cannot get a job in their home country.

Socio economic crisis and mortality. Epidemiological testimony of the financial collapse of Argentina.

PubMed

Gurfinkel, Enrique P; Bozovich, Gerardo E; Dabbous, Omar; Mautner, Branco; Anderson, Frederick

2005-12-13

Natural disasters, war, and terrorist attacks, have been linked to cardiac mortality. We sought to investigate whether a major financial crisis may impact on the medical management and outcomes of acute coronary syndromes. We analyzed the Argentine cohort of the international multicenter Global Registry of Acute Coronary Events (GRACE). The primary objective was to estimate if there was an association between the financial crisis period (April 1999 to December 2002) and in- hospital cardiovascular mortality, with the post-crisis period (January 2003 to September 2004) as the referent. Each period was defined according to the evolution of the Gross Domestic Product. We investigated the demographic characteristics, diagnostic and therapeutic procedures, morbidity and mortality. We analyzed data from 3220 patients, 2246 (69.8%) patients in the crisis period and 974 (30.2%) in the post-crisis frame. The distribution of demographic and clinical baseline characteristics were not significantly different between both periods. During the crisis period the incidence of in-hospital myocardial infarction was higher (6.9% Vs 2.9%; p value < 0.0001), as well as congestive heart failure (16% Vs 11%; p value < 0.0001). Time to intervention with angioplasty was longer during the crisis, especially among public sites (median 190 min Vs 27 min). The incidence proportion of mortality during hospitalization was 6.2% Vs 5.1% after crisis. The crude OR for mortality was 1.2 (95% C.I. 0.87, 1.7). The odds for mortality were higher among private institutions {1.9 (95% C.I. 0.9, 3.8)} than for public centers {1.2 (95% C.I. 0.83, 1.79)}. We did not observe a significant interaction between type of hospital and crisis. Our findings suggest that the financial crisis may have had a negative impact on cardiovascular mortality during hospitalization, and higher incidence of medical complications.

Socio economic crisis and mortality. Epidemiological testimony of the financial collapse of Argentina

PubMed Central

Gurfinkel, Enrique P; Bozovich, Gerardo E; Dabbous, Omar; Mautner, Branco; Anderson, Frederick

2005-01-01

Background Natural disasters, war, and terrorist attacks, have been linked to cardiac mortality. We sought to investigate whether a major financial crisis may impact on the medical management and outcomes of acute coronary syndromes. Methods We analyzed the Argentine cohort of the international multicenter Global Registry of Acute Coronary Events (GRACE). The primary objective was to estimate if there was an association between the financial crisis period (April 1999 to December 2002) and in- hospital cardiovascular mortality, with the post-crisis period (January 2003 to September 2004) as the referent. Each period was defined according to the evolution of the Gross Domestic Product. We investigated the demographic characteristics, diagnostic and therapeutic procedures, morbidity and mortality. Results We analyzed data from 3220 patients, 2246 (69.8%) patients in the crisis period and 974 (30.2%) in the post-crisis frame. The distribution of demographic and clinical baseline characteristics were not significantly different between both periods. During the crisis period the incidence of in-hospital myocardial infarction was higher (6.9% Vs 2.9%; p value < 0.0001), as well as congestive heart failure (16% Vs 11%; p value < 0.0001). Time to intervention with angioplasty was longer during the crisis, especially among public sites (median 190 min Vs 27 min). The incidence proportion of mortality during hospitalization was 6.2% Vs 5.1% after crisis. The crude OR for mortality was 1.2 (95% C.I. 0.87, 1.7). The odds for mortality were higher among private institutions {1.9 (95% C.I. 0.9, 3.8)} than for public centers {1.2 (95% C.I. 0.83, 1.79)}. We did not observe a significant interaction between type of hospital and crisis. Conclusion Our findings suggest that the financial crisis may have had a negative impact on cardiovascular mortality during hospitalization, and higher incidence of medical complications. PMID:16351728

Post-Traumatic Stress Disorder (PDQ)

MedlinePlus

... with post-traumatic stress need early treatment with methods that are used to treat other trauma victims. ... symptoms of post-traumatic stress. The crisis intervention method aims to relieve distress and help the patient ...

Countywide implementation of crisis intervention teams: Multiple methods, measures and sustained outcomes.

PubMed

Kubiak, Sheryl; Comartin, Erin; Milanovic, Edita; Bybee, Deborah; Tillander, Elizabeth; Rabaut, Celeste; Bisson, Heidi; Dunn, Lisa M; Bouchard, Michael J; Hill, Todd; Schneider, Steven

2017-09-01

The crisis intervention team (CIT) is a tool that can be used to foster pre-booking diversion of individuals with mental illness from the criminal justice system and into community treatment services. Although CIT is often implemented solely as the training of law enforcement officers, the model stipulates that CIT is a vehicle for collaboration with community stakeholders who share a similar philosophy, as well as expanded mental health services offering a 24 hour-seven days per week drop-off option for law enforcement officers. This case study presents the countywide implementation of CIT and expands previous findings on the prevalence of officer interaction with persons with mental health issues and CIT training outcomes, including changes in officer perception of individuals with mental health issues. Furthermore, analysis of the disposition of calls for officer assistance coded as mental health or suicide found significant increases in officer drop-offs to the mental health crisis center post-CIT training. Interrupted time series analysis determined that this change has been sustained over time, perhaps owing to the unique communication between county law enforcement and mental health staff. Implications for policy and practice are discussed. Copyright © 2017 John Wiley & Sons, Ltd.

Education for Today's Ecological Crisis

ERIC Educational Resources Information Center

Singer, S. Fred

1970-01-01

Describes the university's role in providing education for the ecological crisis, and divides environmental sciences into two major areas: basic and applied. Proposes a curriculum leading to a B.S. degree in physics consisting of a two-year honor physics program followed by specialization in environmental and planetary sciences (EPS). (PR)

Stop Rape Crisis Center: An Exemplary Project.

ERIC Educational Resources Information Center

Whitcomb, Debra; And Others

An exemplary project, the Stop Rape Crisis Center in Baton Rouge, Louisiana, which was initially funded by the Law Enforcement Assistance Administration (LEAA), is described. Issues addressed include the following: (1) initlal start-up and continuing program assessment; (2) staffing and the use of volunteers; (3) coordination with law enforcement…

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

PubMed

Silove, Derrick; Ventevogel, Peter; Rees, Susan

2017-06-01

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

The contemporary refugee crisis: an overview of mental health challenges

PubMed Central

Silove, Derrick; Ventevogel, Peter; Rees, Susan

2017-01-01

There has been an unprecedented upsurge in the number of refugees worldwide, the majority being located in low‐income countries with limited resources in mental health care. This paper considers contemporary issues in the refugee mental health field, including developments in research, conceptual models, social and psychological interventions, and policy. Prevalence data yielded by cross‐sectional epidemiological studies do not allow a clear distinction to be made between situational forms of distress and frank mental disorder, a shortcoming that may be addressed by longitudinal studies. An evolving ecological model of research focuses on the dynamic inter‐relationship of past traumatic experiences, ongoing daily stressors and the background disruptions of core psychosocial systems, the scope extending beyond the individual to the conjugal couple and the family. Although brief, structured psychotherapies administered by lay counsellors have been shown to be effective in the short term for a range of traumatic stress responses, questions remain whether these interventions can be sustained in low‐resource settings and whether they meet the needs of complex cases. In the ideal circumstance, a comprehensive array of programs should be provided, including social and psychotherapeutic interventions, generic mental health services, rehabilitation, and special programs for vulnerable groups. Sustainability of services, ensuring best practice, evidence‐based approaches, and promoting equity of access must remain the goals of future developments, a daunting challenge given that most refugees reside in settings where skills and resources in mental health care are in shortest supply. PMID:28498581

Life Space Crisis Intervention: "Why Do Us Kids Have to Suffer?"

ERIC Educational Resources Information Center

Jump, Tricia; Fecser, Frank A.

2009-01-01

This Reclaiming Intervention is an excellent example of the notion that life is a watercolor. Tricia Jump's interview demonstrates how a patient, caring adult can bring comfort and hope to a child experiencing some very difficult and painful life events. KC, a ten year old girl, is typical of many children whose home lives are turbulent. In some…

Proceedings from Bridging Health Disparities to Address the Opioid Epidemic: A Symposium at the Warren Alpert Medical School of Brown University.

PubMed

Dumenco, Luba; Monteiro, Kristina; Mello, Michael; Collins, Sally; Operario, Don; Scanlan, Karen; Dollase, Richard; George, Paul

2017-04-03

In response to the unprecedented rates of illicit drug use, including opioid addiction and overdose in Rhode Island, local healthcare institutions, led by the Warren Alpert Medical School (AMS) of Brown University, collaborated to present "Bridging Health Disparities to Address the Opioid Epidemic." This symposium sought to educate a wide array of healthcare providers and professionals around opioid use disorder, including the state of the opioid crisis in Rhode Island, national efforts around opioid misuse and how providers can work together to stem the opioid crisis in the state. The symposium included a keynote session which aimed to increase knowledge and decrease stigma. This was followed by two rounds of breakout sessions which focused on various components of opioid disorder treatment. We elicited feedback from participants in order to plan further interventions to educate providers in Rhode Island around the opioid epidemic. Primary Results: Initial feedback was positive. More importantly, this workshop allowed us to identify gaps in knowledge amongst healthcare providers in Rhode Island in order to plan further interventions for healthcare providers, including physicians, around opioid misuse, in Rhode Island. This symposium is one of the first steps that a consortium of healthcare institutions, including AMS, will take to address the opioid crisis in Rhode Island. Feedback from the event was elicited to identify gaps in healthcare provider knowledge and will be used to design and implement further interventions. [Full article available at http://rimed.org/rimedicaljournal-2017-04.asp].

MATES in Construction: Impact of a Multimodal, Community-Based Program for Suicide Prevention in the Construction Industry

PubMed Central

Gullestrup, Jorgen; Lequertier, Belinda; Martin, Graham

2011-01-01

A large-scale workplace-based suicide prevention and early intervention program was delivered to over 9,000 construction workers on building sites across Queensland. Intervention components included universal General Awareness Training (GAT; general mental health with a focus on suicide prevention); gatekeeper training provided to construction worker volunteer ‘Connectors’; Suicide First Aid (ASIST) training offered to key workers; outreach support provided by trained and supervised MIC staff; state-wide suicide prevention hotline; case management service; and postvention support provided in the event of a suicide. Findings from over 7,000 workers (April 2008 to November 2010) are reported, indicating strong construction industry support, with 67% building sites and employers approached agreeing to participate in MIC. GAT participants demonstrated significantly increased suicide prevention awareness compared with a comparison group. Connector training participants rated MIC as helpful and effective, felt prepared to intervene with a suicidal person, and knew where to seek help for a suicidal individual following the training. Workers engaged positively with the after-hours crisis support phone line and case management. MIC provided postvention support to 10 non-MIC sites and sites engaged with MIC, but not yet MIC-compliant. Current findings support the potential effectiveness and social validity of MIC for preventing suicide in construction workers. PMID:22163201

Building on mental health training for law enforcement: strengthening community partnerships.

PubMed

Campbell, Jorien; Ahalt, Cyrus; Hagar, Randall; Arroyo, William

2017-09-11

Purpose The purpose of this paper is to describe the current state of law enforcement training related to the high number of interactions with persons with mental illness, and to recommend next steps in preparing law enforcement to effectively meet this challenge. Design/methodology/approach The authors reviewed the current literature on relevant law enforcement training programs, focusing primarily on crisis intervention team (CIT) training, and used the case example of California to identify opportunities to improve and enhance law enforcement preparedness for the challenge of responding to persons with mental illness. Findings Broad-based community partnerships working together to develop programs that meet the local needs of both those with mental illness and law enforcement, the availability of mental health treatment centers with no-refusal policies, and a coordinating person or agency to effectively liaise among stakeholders are critical enhancements to CIT training. Originality/value As increasing attention is paid to adverse interactions between police and vulnerable populations, this paper identifies policies that would build on existing training programs to improve police responses to persons with mental illness.

Crisis-transitions in athletes: current emphases on cognitive and contextual factors.

PubMed

Stambulova, Natalia B

2017-08-01

During the last decade, the field of athlete career research has seen much expansion. Researchers established the holistic lifespan and ecological approaches, introduced cultural praxis of athletes' careers paradigm, and updated the taxonomy of athletes' transitions. However, recent transition research focused mainly on the transition process and factors contributing to successful transitions, while crisis-transitions and factors contributing to ineffective coping have been largely ignored. The aim of this paper is to facilitate relevant research and practice through (1) positioning athletes' developmental crises within the context of the current transition literature, (2) introducing two new approaches (termed 'cognitive turn' and 'cultural turn') with a potential to enhance our understanding of the phenomenon, and (3) outlining crisis-coping interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Efficacy of "seeking safety" in a Dutch population of traumatized substance-use disorder outpatients: study protocol of a randomized controlled trial.

PubMed

Kok, Tim; de Haan, Hein A; van der Meer, Margreet; Najavits, Lisa M; DeJong, Cor A J

2013-06-04

Traumatic experiences and, more specifically, posttraumatic stress disorder (PTSD) are highly prevalent among substance use disorder (SUD) patients. This comorbidity is associated with worse treatment outcomes in substance use treatment programs and more crisis interventions. International guidelines advise an integrated approach to the treatment of trauma related problems and SUD. Seeking Safety is an integrated treatment program that was developed in the United States. The aim of the current study is to test the efficacy of this program in the Netherlands in an outpatient SUD population. A randomized controlled trial (RCT) will be used to test the efficacy of Seeking Safety compared to Cognitive Behavioral Therapy (CBT) in a population of SUD outpatients. Each treatment will consist of 12 group sessions. The primary outcome measure will be substance use severity. Secondary outcome measures are PTSD and trauma symptoms, coping skills, functioning, and cognitions. Questionnaires will be administered at the start of treatment, at the end of treatment (three months after the start of treatment) and at follow-up (six months after the start of treatment). This study protocol presents a RCT in which the efficacy of an integrated treatment for comorbid PTSD and SUD, Seeking Safety, is evaluated in a SUD outpatient population compared to CBT. It is expected that the intervention group will show significantly more improvement in substance use severity compared to the control group at end-of-treatment and at follow-up. Furthermore, a lower drop-out rate is expected for the intervention group. If the intervention proves to be effective, it can be implemented. A cost-effectiveness analysis will be conducted to evaluate the two treatments. The protocol for this study is registered with the Netherlands Trial Register with number NTR3084 and approved by the local medical ethical committee (METC\\11270.haa).

[The liaison psychiatry approach of the psychiatric crisis, urgencies and emergencies].

PubMed

Tenconi, Juan Cristóbal

2003-01-01

The purpose of this paper is to differentiate crisis, emergencies and urgencies within the frame of Liaison psychiatry. It begins with the definition of each one of the terms, later the emphasis is put in the clinical characteristics of each one of these situations. These characteristics are determined by the patient and the therapeutic team. At last therapeutic guidelines are stated, which allow more precision in the intervention, in function of the direct involvement of these situations in the development and evolution of the patients.

Hypertensive crisis-induced electrocardiographic changes: a case series

PubMed Central

2009-01-01

Introduction Myocardial injury is one of the most notorious complications of a hypertensive crisis. Key electrocardiograph signs used to detect cardiac injury such as ST segment changes and cardiac arrhythmias usually indicate acute ongoing end-organ damage. Lack of early signs to predict end-organ damage might lead to a delay in the initiation of therapy and selection of the incorrect therapeutic strategy. Case presentation We describe five cases of tall, hyper acute symmetrical T-waves alone or accompanied by other electrocardiograph abnormalities in five healthy participants: three women aged 52, 60 and 62-years and two men aged 49 and 66-years, during a tyramine-monoamine oxidase-inhibitor interaction, phase I clinical trial. T-wave changes appeared early during the course of the hypertensive crisis and were attributed to subendocardial ischemia. The changes were transient and reverted to baseline in parallel with a fall in blood pressure. Conclusion Recognition of tall symmetrical T-waves in early phases of hypertensive crisis heralds commencement of myocardial damage. This calls for prompt medical intervention to avoid an impending irreversible myocardial injury. It is our belief that these findings will add new insight into the management of hypertensive crisis and will open avenues of further investigation. PMID:19918270

Hypertensive crisis-induced electrocardiographic changes: a case series.

PubMed

Farha, Khalid Abou; van Vliet, André; van Marle, Sjoerd; Vrijlandt, Patrick; Westenbrink, Daan

2009-08-20

Myocardial injury is one of the most notorious complications of a hypertensive crisis. Key electrocardiograph signs used to detect cardiac injury such as ST segment changes and cardiac arrhythmias usually indicate acute ongoing end-organ damage. Lack of early signs to predict end-organ damage might lead to a delay in the initiation of therapy and selection of the incorrect therapeutic strategy. We describe five cases of tall, hyper acute symmetrical T-waves alone or accompanied by other electrocardiograph abnormalities in five healthy participants: three women aged 52, 60 and 62-years and two men aged 49 and 66-years, during a tyramine-monoamine oxidase-inhibitor interaction, phase I clinical trial. T-wave changes appeared early during the course of the hypertensive crisis and were attributed to subendocardial ischemia. The changes were transient and reverted to baseline in parallel with a fall in blood pressure. Recognition of tall symmetrical T-waves in early phases of hypertensive crisis heralds commencement of myocardial damage. This calls for prompt medical intervention to avoid an impending irreversible myocardial injury. It is our belief that these findings will add new insight into the management of hypertensive crisis and will open avenues of further investigation.

Top Management Team Crisis Communication after Claims of Sexual Harassment

ERIC Educational Resources Information Center

Bull Schaefer, Rebecca A.; Crosswhite, Alicia M.

2018-01-01

Both sexual harassment and managerial crisis communication are important topics in undergraduate, graduate, and executive programs. This article describes a group role-play exercise that engages students in the process of responding to a public claim of workplace sexual harassment and requires small groups to share their reactions within a press…

A School Voucher Program for Baltimore City

ERIC Educational Resources Information Center

Lips, Dan

2005-01-01

Baltimore City's public school system is in crisis. Academically, the school system fails on any number of measures. The city's graduation rate is barely above 50 percent and students continually lag well behind state averages on standardized tests. Adding to these problems is the school system's current fiscal crisis, created by years of fiscal…

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…

Nurse Practitioner Residency Programs: An Educational Journey

ERIC Educational Resources Information Center

Rys, Gregory P.

2016-01-01

Primary care is in a state of crisis due to the lack of clinicians and increasing numbers of insured patients. Encouraging more students to go directly through school for their doctor of nursing practice degree and nurse practitioner (NP) certifications is one proposal to alleviate this crisis. However, this approach would deliver graduates with…

75 FR 1041 - Office of Safe and Drug-Free Schools; Overview Information; Grants for the Integration of Schools...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-08

... received or receives a grant under the Department of Education's Readiness and Emergency Management for Schools (REMS) program (CFDA 84.184E), formerly known as the Emergency Response and Crisis Management... prevention, diagnosis, and treatment services to students. (2) Enhancing the availability of crisis...

The Economic Crisis of 1968 and the Waning of the "American Century."

ERIC Educational Resources Information Center

Collins, Robert M.

1996-01-01

Maintains that the escalating costs of international commitments (primarily the Vietnam War) and domestic programs resulted in a chronic balance-of-payments deficit that signaled the end of "growth liberalism." Provides an in-depth look at Lyndon Johnson's efforts to address this crisis amidst growing political opposition. (MJP)

Freshman English: The New Crisis and the Old Solutions.

ERIC Educational Resources Information Center

Smith, Ron

The new crisis in freshman English is reflected in recent resolutions by the Modern Language Association and by individual colleges and universities to reinstate composition requirements. Too many composition programs, however, are a waste of money and time which traps the composition teacher into accountability for students' success or failure.…

Environmental Crisis: Root Causes and Opportunities for Solution.

ERIC Educational Resources Information Center

Horn, Barbara, Ed.

Proceedings of the 18th Annual Conference of the Conservation Education Association, held in Ann Arbor, Michigan, August, 1971, are reported in this booklet. Utilizing the theme - The Environmental Crisis: Root Causes and Opportunities for Solution - the program was aimed at environmental problems where we live; the urban area. It dealt with…

45 CFR 1351.1 - Significant terms.

Code of Federal Regulations, 2011 CFR

2011-10-01

... homeless youth project is or will be located. (c) Coordinated networks of agencies means an association of...-term (maximum of 15 days) room and board and core crisis intervention services, on a 24-hour basis, by...

45 CFR 1351.1 - Significant terms.

Code of Federal Regulations, 2012 CFR

2012-10-01

... homeless youth project is or will be located. (c) Coordinated networks of agencies means an association of...-term (maximum of 15 days) room and board and core crisis intervention services, on a 24-hour basis, by...

45 CFR 1351.1 - Significant terms.

Code of Federal Regulations, 2014 CFR

2014-10-01

... homeless youth project is or will be located. (c) Coordinated networks of agencies means an association of...-term (maximum of 15 days) room and board and core crisis intervention services, on a 24-hour basis, by...

45 CFR 1351.1 - Significant terms.

Code of Federal Regulations, 2013 CFR

2013-10-01

... homeless youth project is or will be located. (c) Coordinated networks of agencies means an association of...-term (maximum of 15 days) room and board and core crisis intervention services, on a 24-hour basis, by...

Adolescent pregnancy.

PubMed

Short, J D; Slusher, I L

1994-01-01

Kentucky has the fourth highest percentage of infants born to teenage mothers in the US. Risk factors for adolescent pregnancy are poor academic performance, family history of adolescent pregnancy, absence of one or both biological parents in the home, troubled family relationships, family violence, history of substance abuse, and poor self-concept. Pregnancy adds new developmental requirements to the continual developmental crisis of adolescence. Some of these developmental requirements are dealing with pregnancy and birth of a child and peer and family reactions and relationships. Pregnant teens are at high risk for anemia, preeclampsia, preterm delivery, and low birth weight infants. The health care team must assess the abilities, needs, practices, and priorities of teens. Nurses should promote health and positive health practices in teens. They should focus on prevention of adolescent pregnancy and on meeting the needs of pregnant teens. Adolescent pregnancy interventions include education and adolescent-centered special programs. Peer groups, role playing, videos, and computer games are individualized and effective education techniques for teens. Formal adolescent pregnancy prevention programs are abstinence education, knowledge-based programs, and clinic-focused or school-based programs. A combination of approaches is more effective than using just one approach. Adolescent pregnancy prevention interventions should promote the value of education, discourage substance abuse, and provide counseling for victims of child abuse. Pregnant teens should receive prenatal care as soon as possible. One health care agency should combine physical care, psychosocial support, and education for teens. Kentucky schools help pregnant teens continue their education and help them obtain information and support for care for themselves and their babies. Nurses can be effective at reducing the number of unwanted teen pregnancies.

Using Simulation to Implement an OR Cardiac Arrest Crisis Checklist.

PubMed

Dagey, Darleen

2017-01-01

Crisis checklists are cognitive aids used to coordinate care during critical events. Simulation training is a method to validate process improvement initiatives such as checklist implementation. In response to concerns staff members expressed regarding their comfort level when responding to infrequent occurrences such as cardiac arrest and other OR emergencies, the OR Comprehensive Unit-based Safety Program team at our facility decided to institute the use of crisis checklists in the OR during critical events. We provided 90-minute education sessions, simulation opportunities, and debriefings to help staff members become more comfortable using these checklists. Based on program evaluations, 80% of staff members who participated in the training expressed an increased comfort level when caring for a patient in cardiac arrest. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring

PubMed Central

2012-01-01

Background The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients. However, the effectiveness of such interventions in terms of more robust criteria (e.g., admission rates) has not been sufficiently analysed in larger study samples. The current study aims to evaluate an intervention programme for patients at high risk of compulsory admission to psychiatric hospitals. Effectiveness will be assessed in terms of a reduced number of psychiatric hospitalisations and days of inpatient care in connection with involuntary psychiatric admissions as well as in terms of cost-containment in inpatient mental health care. The intervention furthermore intends to reduce the degree of patients’ perceived coercion and to increase patient satisfaction, their quality of life and empowerment. Methods/Design This paper describes the design of a randomised controlled intervention study conducted currently at four psychiatric hospitals in the Canton of Zurich. The intervention programme consists of individualised psycho-education focusing on behaviours prior to and during illness-related crisis, the distribution of a crisis card and, after inpatient admission, a 24-month preventive monitoring of individual risk factors for compulsory re-admission to hospital. All measures are provided by a mental health care worker who maintains permanent contact to the patient over the course of the study. In order to prove its effectiveness the intervention programme will be compared with standard care procedures (control group). 200 patients each will be assigned to the intervention group or to the control group. Detailed follow-up assessments of service use, psychopathology and patient perceptions are scheduled 12 and 24 months after discharge. Discussion Innovative interventions have to be established to prevent patients with mental disorders from undergoing the experience of compulsory admission and, with regard to society as a whole, to reduce the costs of health care (and detention). The current study will allow for a prospective analysis of the effectiveness of an intervention programme, providing insight into processes and factors that determine involuntary placement. Trial registration Current Controlled Trials ISRCTN63162737. PMID:22946957

Toward mHealth Brief Contact Interventions in Suicide Prevention: Case Series From the Suicide Intervention Assisted by Messages (SIAM) Randomized Controlled Trial.

PubMed

Berrouiguet, Sofian; Larsen, Mark Erik; Mesmeur, Catherine; Gravey, Michel; Billot, Romain; Walter, Michel; Lemey, Christophe; Lenca, Philippe

2018-01-10

Research indicates that maintaining contact either via letter or postcard with at-risk adults following discharge from care services after a suicide attempt (SA) can reduce reattempt risk. Pilot studies have demonstrated that interventions using mobile health (mHealth) technologies are feasible in a suicide prevention setting. The aim of this study was to report three cases of patients recruited in the Suicide Intervention Assisted by Messages (SIAM) study to describe how a mobile intervention may influence follow-up. SIAM is a 2-year, multicenter randomized controlled trial conducted by the Brest University Hospital, France. Participants in the intervention group receive SIAM text messages 48 hours after discharge, then at day 8 and day 15, and months 1, 2, 3, 4, 5, and 6. The study includes participants aged 18 years or older, who have attended a participating hospital for an SA, and have been discharged from the emergency department (ED) or a psychiatric unit (PU) for a stay of less than 7 days. Eligible participants are randomized between the SIAM intervention messages and a control group. In this study, we present three cases from the ongoing SIAM study that demonstrate the capability of a mobile-based brief contact intervention for triggering patient-initiated contact with a crisis support team at various time points throughout the mobile-based follow-up period. Out of the 244 patients recruited in the SIAM randomized controlled trial, three cases were selected to illustrate the impact of mHealth on suicide risk management. Participants initiated contact with the emergency crisis support service after receiving text messages up to 6 months following discharge from the hospital. Contact was initiated immediately following receipt of a text message or up to 6 days following a message. This text message-based brief contact intervention has demonstrated the potential to reconnect suicidal individuals with crisis support services while they are experiencing suicidal ideation as well as in a period after receiving messages. As follow-up phone calls over an extended period of time may not be feasible, this intervention has the potential to offer simple technological support for individuals following discharge from the ED. ClinicalTrials.gov NCT02106949; https://clinicaltrials.gov/ct2/show/NCT02106949 (Archived by WebCite at http://www.webcitation.org/6wMtAFL49). ©Sofian Berrouiguet, Mark Erik Larsen, Catherine Mesmeur, Michel Gravey, Romain Billot, Michel Walter, HUGOPSY Network, Christophe Lemey, Philippe Lenca. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 10.01.2018.

Toward mHealth Brief Contact Interventions in Suicide Prevention: Case Series From the Suicide Intervention Assisted by Messages (SIAM) Randomized Controlled Trial

PubMed Central

Mesmeur, Catherine; Gravey, Michel; Billot, Romain; Walter, Michel; Lemey, Christophe; Lenca, Philippe

2018-01-01

Background Research indicates that maintaining contact either via letter or postcard with at-risk adults following discharge from care services after a suicide attempt (SA) can reduce reattempt risk. Pilot studies have demonstrated that interventions using mobile health (mHealth) technologies are feasible in a suicide prevention setting. Objective The aim of this study was to report three cases of patients recruited in the Suicide Intervention Assisted by Messages (SIAM) study to describe how a mobile intervention may influence follow-up. Methods SIAM is a 2-year, multicenter randomized controlled trial conducted by the Brest University Hospital, France. Participants in the intervention group receive SIAM text messages 48 hours after discharge, then at day 8 and day 15, and months 1, 2, 3, 4, 5, and 6. The study includes participants aged 18 years or older, who have attended a participating hospital for an SA, and have been discharged from the emergency department (ED) or a psychiatric unit (PU) for a stay of less than 7 days. Eligible participants are randomized between the SIAM intervention messages and a control group. In this study, we present three cases from the ongoing SIAM study that demonstrate the capability of a mobile-based brief contact intervention for triggering patient-initiated contact with a crisis support team at various time points throughout the mobile-based follow-up period. Results Out of the 244 patients recruited in the SIAM randomized controlled trial, three cases were selected to illustrate the impact of mHealth on suicide risk management. Participants initiated contact with the emergency crisis support service after receiving text messages up to 6 months following discharge from the hospital. Contact was initiated immediately following receipt of a text message or up to 6 days following a message. Conclusions This text message–based brief contact intervention has demonstrated the potential to reconnect suicidal individuals with crisis support services while they are experiencing suicidal ideation as well as in a period after receiving messages. As follow-up phone calls over an extended period of time may not be feasible, this intervention has the potential to offer simple technological support for individuals following discharge from the ED. Trial Registration ClinicalTrials.gov NCT02106949; https://clinicaltrials.gov/ct2/show/NCT02106949 (Archived by WebCite at http://www.webcitation.org/6wMtAFL49) PMID:29321126

The crisis in human capital

NASA Technical Reports Server (NTRS)

Kersey, E. D. K.; Kersey, Judith A.

1991-01-01

This overview discusses the current shortfalls in the U.S. national education system with attention to their effects on the aerospace industry and potential remedies. Student-achievement and literacy rates are examined to compare U.S. students to those of other countries, and the sociological and cultural phenomena are listed which can contribute to deficiencies in learning. Intervention programs for young children and for students in math and science are discussed, and corporate mechanisms are described which support scholarly activities. Also examined are teaching resources provided by government agencies that deal with science and technology. The general conclusion of the paper is that the efforts to date are insufficient because they do not address education levels across the country. It is suggested that corporations and communities rather than federal and state governments address the educational shortfalls.

Intensive home treatment for patients in acute psychiatric crisis situations: a multicentre randomized controlled trial.

PubMed

Cornelis, Jurgen; Barakat, Ansam; Dekker, Jack; Schut, Tessy; Berk, Sandra; Nusselder, Hans; Ruhl, Nikander; Zoeteman, Jeroen; Van, Rien; Beekman, Aartjan; Blankers, Matthijs

2018-02-27

Hospitalization is a common method to intensify care for patients experiencing a psychiatric crisis. A short-term, specialised, out-patient crisis intervention by a Crisis Resolution Team (CRT) in the Netherlands, called Intensive Home Treatment (IHT), is a viable intervention which may help reduce hospital admission days. However, research on the (cost-)effectiveness of alternatives to hospitalisation such as IHT are scarce. In the study presented in this protocol, IHT will be compared to care-as-usual (CAU) in a randomized controlled trial (RCT). CAU comprises low-intensity outpatient care and hospitalisation if necessary. In this RCT it is hypothesized that IHT will reduce inpatient days by 33% compared to CAU while safety and clinical outcomes will be non-inferior. Secondary hypotheses are that treatment satisfaction of patients and their relatives are expected to be higher in the IHT condition compared to CAU. A 2-centre, 2-arm Zelen double consent RCT will be employed. Participants will be recruited in the Amsterdam area, the Netherlands. Clinical assessments will be carried out at baseline and at 6, 26 and 52 weeks post treatment allocation. The primary outcome measure is the number of admission days. Secondary outcomes include psychological well-being, safety and patients' and their relatives' treatment satisfaction. Alongside this RCT an economic evaluation will be carried out to assess the cost-effectiveness and cost-utility of IHT compared to CAU. RCTs on the effectiveness of crisis treatment in psychiatry are scarce and including patients in studies performed in acute psychiatric crisis care is a challenge due to the ethical and practical hurdles. The Zelen design may offer a feasible opportunity to carry out such an RCT. If our study finds that IHT is a safe and cost-effective alternative for CAU it may help support a further decrease of in-patient bed days and may foster the widespread implementation of IHT by mental health care organisations internationally. The trial is registered in the Netherlands Trial Register as # NTR-6151 . Registered 23 November 2016.

Personal responsibility or shared responsibility: What is the appropriate role of the law in obesity prevention?

PubMed

Brooks, Benjamin

2015-09-01

Sensitive to allegations of "nanny state" paternalism, Australian governments support the doctrine that combating obesity is a matter of personal responsibility. Policy-makers endorse the "holistic" approach to obesity prevention, with a view to managing both sides of the nutritional energy equation. This paradigm allows the food and drinks industry to deflect its contributory responsibility for the epidemic and to avoid more stringent regulatory intervention beyond existing self-regulatory and corporate social responsibility regimes. This article argues that the industry must bear shared responsibility for the extent of the obesity crisis, although it cannot bear sole responsibility It defends the public interest case for more invasive, government-led regulation, reframing the crisis as one of public not individual burdens. Mindful of the political risk associated with unfocused calls for regulatory intervention, it articulates a set of regulatory principles to ensure that the interests of consumers and industry are properly acknowledged prior to further regulatory intervention. Finally, the article clarifies the subject, object and content of possible regulatory initiatives, offering an evaluation of their efficacy, practicality and fairness.

Evaluation of high blood pressure and obesity among US coal miners participating in the Enhanced Coal Workers' Health Surveillance Program.

PubMed

Casey, Megan Lauren; Fedan, Kathleen B; Edwards, Nicole; Blackley, David J; Halldin, Cara N; Wolfe, Anita L; Laney, Anthony Scott

2017-08-01

Since 2005, the Enhanced Coal Workers' Health Surveillance Program (ECWHSP) has offered respiratory examinations to coal miners in a mobile examination unit. As little is known about the cardiovascular health of coal miners, we describe the prevalence of high blood pressure (BP) and obesity among ECWHSP participants. During 2015, 1402 ECWHSP health examinations were performed. The prevalence of BP consistent with hypertension (systolic BP ≥ 140 mm Hg or diastolic BP ≥ 90 mm Hg), prehypertension (systolic BP 120-139 mm Hg or diastolic BP 80-89 mm Hg), and hypertensive crisis (systolic BP ≥ 180 mm Hg or diastolic BP ≥ 110 mm Hg) were calculated and compared with the US adult population using standardized morbidity ratios (SMRs). Most participants were male (N = 1317, 94%), White (N = 1303, 93%) and non-Hispanic (N = 1316, 94%). Thirty-one percent (N = 440) of participants had BP in the hypertensive range and 87% (N = 1215) were overweight/obese. Twenty-four participants (2%) had a BP reading consistent with a hypertensive crisis. Prevalence of obesity (52%, SMR = 1.52, 95% confidence interval = 1.41-1.64) and BP consistent with hypertension (31%, SMR = 1.60, 95% confidence interval = 1.45-1.76) was higher than the US adult population.The prevalence of obesity and BP consistent with hypertension in this population of coal miners is substantial, indicating a need for cardiovascular health interventions in coal mining communities. Published by Elsevier Inc.

Creating a pro-active health care system to combat chronic diseases in Sri Lanka: the central role of preventive medicine and healthy lifestyle behaviors.

PubMed

Sagner, Michael; Arena, Ross; McNeil, Amy; Brahmam, Ginnela N V; Hills, Andrew P; De Silva, H Janaka; Karunapema, R P Palitha; Wijeyaratne, Chandrika N; Arambepola, Carukshi; Puska, Pekka

2016-10-01

The current burden and future escalating threat of chronic diseases, constitutes the major global public health challenge. In Sri Lanka, cardiovascular diseases account for the majority of annual deaths. Data from Sri Lanka also indicate a high incidence and prevalence of pre-diabetes and diabetes; 1 in 5 adults have elevated blood sugar in Sri Lanka. It is well established that chronic diseases share four primary behavioral risk factors: 1) tobacco use; 2) unhealthy diet; 3) physical inactivity; and 4) harmful use of alcohol. Evidence has convincingly shown that replacing these behavioral risk factors with the converse, healthy lifestyle characteristics, decrease the risk of poor outcomes associated with chronic disease by 60 to 80%. In essence, prevention or reversal of these behavioral risk factors with effective healthy lifestyle programing and interventions is the solution to the current chronic disease crisis. Expert commentary: Healthy lifestyle is medicine with global applicability, including Sri Lanka and the rest of the South Asia region. This policy statement will discuss the chronic disease crisis in Sri Lanka, its current policies and action implemented to promote healthy lifestyles, and further recommendations on preventive medicine and healthy lifestyle initiatives that are needed to move forward.

Public health the leading force of the Indonesian response to the HIV/AIDS crisis among people who inject drugs

PubMed Central

Mesquita, Fabio; Winarso, Inang; Atmosukarto, Ingrid I; Eka, Bambang; Nevendorff, Laura; Rahmah, Amala; Handoyo, Patri; Anastasia, Priscillia; Angela, Rosi

2007-01-01

Issue Indonesia has an explosive HIV/AIDS epidemic starting from the beginning of this century, and it is in process to build its response. Reported AIDS cases doubled from 2003 – 2004, and approximately 54% of these cases are in people who inject drugs. Setting Indonesia is the 4th largest country in population in the world, a predominantly Muslim country with strong views on drug users and people living with HIV/AIDS. Globally speaking, Indonesia has one of the most explosive epidemics in recent years. The project IHPCP (Indonesia HIV/AIDS Prevention and Care Project) is a joint support project (primarily AusAID-based) that works in partnership with the Government of Indonesia. IHPCP has been a key player of in the country's response, particularly pioneering NSP; stimulating and supporting methadone programs, and being key in promoting ARV for people who currently inject drugs. The project works via both the public health system and NGOs. Outcomes It is still early to measure the impact of current interventions; however, this paper describes the current status of Indonesia's response to the HIV/AIDS crisis among people who inject drugs, and analyses future challenges of the epidemic in Indonesia. PMID:17306033

Alternative approaches for studying humanitarian interventions: propensity score methods to evaluate reintegration packages impact on depression, PTSD, and function impairment among child soldiers in Nepal.

PubMed

Kohrt, B A; Burkey, M; Stuart, E A; Koirala, S

2015-01-01

Ethical, logistical, and funding approaches preclude conducting randomized control trials (RCTs) in some humanitarian crises. A lack of RCTs and other intervention research has contributed to a limited evidence-base for mental health and psychosocial support (MHPS) programs after disasters, war, and disease outbreaks. Propensity score methods (PSMs) are an alternative analysis technique with potential application for evaluating MHPS programs in humanitarian emergencies. PSMs were used to evaluate impacts of education reintegration packages (ERPs) and other (vocational or economic) reintegration packages (ORPs) v. no reintegration programs on mental health of child soldiers. Propensity scores were used to determine weighting of child soldiers in each of the three treatment arms. Multiple linear regression was used to estimate adjusted changes in symptom score severity on culturally validated measures of depression, post-traumatic stress disorder (PTSD), and functional impairment from baseline to 1-year follow-up. Among 258 Nepali child soldiers participating in reintegration programs, 54.7% completed ERP and 22.9% completed ORP. There was a non-significant reduction in depression by 0.59 (95% CI -1.97 to 0.70) for ERP and by 0.60 (95% CI -2.16 to 0.96) for ORP compared with no treatment. There were non-significant increases in PTSD (1.15, 95% CI -1.55 to 3.86) and functional impairment (0.91, 95% CI -0.31 to 2.14) associated with ERP and similar findings for ORP (PTSD: 0.66, 95% CI -2.24 to 3.57; functional impairment (1.05, 95% CI -0.71 to 2.80). In a humanitarian crisis in which a non-randomized intervention assignment protocol was employed, the statistical technique of PSMs addressed differences in covariate distribution between child soldiers who received different integration packages. Our analysis did not demonstrate significant changes in psychosocial outcomes for ERPs and ORPs. We suggest the use of PSMs in evaluating non-randomized interventions in humanitarian crises when non-randomized conditions are not utilized.

A theory-based primary health care intervention for women who have left abusive partners.

PubMed

Ford-Gilboe, Marilyn; Merritt-Gray, Marilyn; Varcoe, Colleen; Wuest, Judith

2011-01-01

Although intimate partner violence is a significant global health problem, few tested interventions have been designed to improve women's health and quality of life, particularly beyond the crisis of leaving. The Intervention for Health Enhancement After Leaving is a comprehensive, trauma informed, primary health care intervention, which builds on the grounded theory Strengthening Capacity to Limit Intrusion and other research findings. Delivered by a nurse and a domestic violence advocate working collaboratively with women through 6 components (safeguarding, managing basics, managing symptoms, cautious connecting, renewing self, and regenerating family), this promising intervention is in the early phases of testing.

Marital crises in oncology patients. An approach to initial intervention by primary clinicians.

PubMed

Peteet, J; Greenberg, B

1995-05-01

Life-threatening illnesses such as cancer may precipitate marital crises in vulnerable relationships, and oncology clinicians often feel uncertain about how to approach them. This paper presents a framework for initial intervention based on the nature of the principal threat to the relationship. Immature relationships need distance and support for their identity as a couple; hostile dependent couples need to find consensus in order to structure communication; physically abusive relationships require monitoring in order to promote safety; and estranged couples need help in understanding their disappointment and identifying available support. Clinicians working in oncology can help couples in crisis by promoting a realistic balance of independence and dependence, clarifying the complexity of factors contributing to the crisis, considering referral for couples treatment, communicating with the team while respecting patients' confidences, and by choosing clear and compatible clinical roles. Primary clinicians can stabilize and treat marital crises, but need access to medically knowledgeable couples' therapists.

Nursing interventions for children with a parent in the intensive care unit.

PubMed

Baker, C; Nieswiadomy, R M; Arnold, W K

1988-07-01

Hospitalization of a family member in an intensive care unit is a stressful event for the entire family. Nurses should be concerned not only with the hospitalized patient but with the family, as a unit. Attention is often focused on the patient and to a lesser extent on the spouse. The needs of the children may be neglected. To reduce the long-term negative effects of the crisis event on the life of the child, appropriate interventions should be made at the time of the crisis. It is important for nurses to recall emotional and cognitive phases of growth and development when counseling parents. This information is used to help the nonhospitalized parent identify the needs of the child. The nurse can act as a resource person for this parent in planning strategies that will prevent or alleviate problems for the child.

[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.

Model Programs to Address Obesity and Cardiometabolic Disease: Interventions for Suboptimal Nutrition and Sedentary Lifestyles.

PubMed

Nash, Mark S; Kressler, Jochen

2016-09-01

Problems posed by obesity-related endocrine diseases embody a national health crisis. Caloric excess and sedentary lifestyle from which they develop also pose significant challenges for rehabilitation providers. Almost two thirds of the U.S. population are currently overweight or obese, a number that has increased by >10% within the last decade and is expected to grow. An overweight body habitus is strongly associated with clinical hazards, including cardiometabolic syndrome, diabetes hypertension, and coronary artery disease. The component health risks of the cardiometabolic syndrome include coalescing of risk factors that predict a health calamity unless effective interventions can be developed and widely adopted. Obesity by itself is now considered an American Diabetes Association-qualified disability, but it is also disturbingly prevalent in other physical disability groupings of adults and children. This monograph describes successes of the Diabetes Prevention Program (DPP), a National Institutes of Health multisite randomized controlled trial that reported significant weight reduction and a 58% decreased incidence of type-2 diabetes accompanying 1 year of structured lifestyle intervention. This treatment benefit (1) exceeded that of metformin pharmacotherapy, (2) was so powerful that the trial was closed before reaching endpoints, and (3) was judged cost-effective for the patient and society. The DPP roadmap incorporating physical activity, diet, and behavioral approaches has been widely adapted to specific community, faith, racial, ethnic, school, and national populations with excellent outcomes success. The lockstep physical activity approach, activity prescription, and long-term success of the program are described and compared with other programs to illustrate effective countermeasures for the pandemics of obesity and obesity-related cardioendocrine disease. We will illustrate adaptation of the DPP for a cohort of persons with disability from spinal cord injury and the benefits observed. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Simulation-based crisis resource management training for pediatric critical care medicine: a review for instructors.

PubMed

Cheng, Adam; Donoghue, Aaron; Gilfoyle, Elaine; Eppich, Walter

2012-03-01

To review the essential elements of crisis resource management and provide a resource for instructors by describing how to use simulation-based training to teach crisis resource management principles in pediatric acute care contexts. A MEDLINE-based literature source. OUTLINE OF REVIEW: This review is divided into three main sections: Background, Principles of Crisis Resource Management, and Tools and Resources. The background section provides the brief history and definition of crisis resource management. The next section describes all the essential elements of crisis resource management, including leadership and followership, communication, teamwork, resource use, and situational awareness. This is followed by a review of evidence supporting the use of simulation-based crisis resource management training in health care. The last section provides the resources necessary to develop crisis resource management training using a simulation-based approach. This includes a description of how to design pediatric simulation scenarios, how to effectively debrief, and a list of potential assessment tools that instructors can use to evaluate crisis resource management performance during simulation-based training. Crisis resource management principles form the foundation for efficient team functioning and subsequent error reduction in high-stakes environments such as acute care pediatrics. Effective instructor training is required for those programs wishing to teach these principles using simulation-based learning. Dissemination and integration of these principles into pediatric critical care practice has the potential for a tremendous impact on patient safety and outcomes.

Assessing refugee healthcare needs in Europe and implementing educational interventions in primary care: a focus on methods.

PubMed

Lionis, Christos; Petelos, Elena; Mechili, Enkeleint-Aggelos; Sifaki-Pistolla, Dimitra; Chatzea, Vasiliki-Eirini; Angelaki, Agapi; Rurik, Imre; Pavlic, Danica Rotar; Dowrick, Christopher; Dückers, Michel; Ajdukovic, Dean; Bakic, Helena; Jirovsky, Elena; Mayrhuber, Elisabeth Sophie; van den Muijsenbergh, Maria; Hoffmann, Kathryn

2018-02-08

The current political crisis, conflicts and riots in many Middle Eastern and African countries have led to massive migration waves towards Europe. European countries, receiving these migratory waves as first port of entry (POE) over the past few years, were confronted with several challenges as a result of the sheer volume of newly arriving refugees. This humanitarian refugee crisis represents the biggest displacement crisis of a generation. Although the refugee crisis created significant challenges for all national healthcare systems across Europe, limited attention has been given to the role of primary health care (PHC) to facilitate an integrated delivery of care by enhancing care provision to refugees upon arrival, on transit or even for longer periods. Evidence-based interventions, encompassing elements of patient-centredness, shared decision-making and compassionate care, could contribute to the assessment of refugee healthcare needs and to the development and the implementation of training programmes for rapid capacity-building for the needs of these vulnerable groups and in the context of integrated PHC care. This article reports on methods used for enhancing PHC for refugees through rapid capacity-building actions in the context of a structured European project under the auspices of the European Commission and funded under the 3rd Health Programme by the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA). The methods include the assessment of the health needs of all the people reaching Europe during the study period, and the identification, development, and testing of educational tools. The developed tools were evaluated following implementation in selected European primary care settings.

[PSYCHOTHERAPEUTIC INTERVENTIONS IN PATIENTS WITH AUTO-AGGRESSIVE BEHAVIOR DURING THE FIRST PSYCHOTIC EPISODE].

PubMed

Mudrenko, I; Potapov, A; Sotnikov, D; Kolenko, O; Kmyta, A

2017-09-01

In this article the formation of psychopathological predictors auto-aggressive behavior in patients with a first psychotic episode were identified, which became "targets" in the framework of a comprehensive emergency suicide assistance to conduct the crisis psychotherapy. The work was done on the basis of the Sumy regional psychoneurologic dispensary, where 100 patients with a first psychotic episode were examined: 52 of them (core group) had suicidal symptoms and 48 (control group) had not. According to the test results of severity of auto-aggressive predictors (pre-suicidal syndrome) to clinicopsychopathological predictors of auto-aggressive behavior include: the narrowing of the cognitive function (p≤0,001), the avoidance of interpersonal contact (r≤0,001), the presence of affective (p≤0,001) and vegetative (p≤0,01) violations, the autoaggression of moderate severity (p≤0,001) and impulsivity (p≤0,001). Patients of the core group with the auto-aggressive behavior (n=58) completed a course of a crisis psychotherapy comprising the stages of crisis support, crisis intervention and increase the adaptation layer. After a psychotherapy course levels of aggression (6,45±0,41), auto-aggression (of 9,68±0,67), disorders in the affective sphere (18,58±0,66) and impulsivity (of 4,23±0,30) decreased, which was manifested in increasing tolerance to emotional stress factors, control over their emotions and reduce their affective valence (p≤0,001). The expansion of interpersonal interaction, the increase of patients social activity, the blood relationships establishment (of 9,23±0,40) was observed.

Using Mentoring and Professional Development Approaches to Educate Urban Mathematics Teachers

ERIC Educational Resources Information Center

Fraser-Abder, Pamela

2005-01-01

Due to the dearth of qualified professional teachers, policymakers and professional development programs need to focus on improving the quality of high school mathematics teaching in order to diffuse this crisis. In the middle of this crisis, the demand for new teachers is predicted to rise significantly in the next ten years. Based on the…

The Speech Discipline in Crisis - - A Cause for Hope.

ERIC Educational Resources Information Center

Lanigan, Richard L.

Speech communication is a distinct discipline, but one in a healthy state of conflict between theory and practice. The crisis in the speech discipline (and in academic generally) exists because speech does not present itself as a consumable value; quality program decisions are not made; speech is often conceived as only one subject matter; general…

Structure and Spontaneity: Pedagogical Tensions in the Construction of a Simulation of the Cuban Missile Crisis.

ERIC Educational Resources Information Center

Pace, David; And Others

1990-01-01

Describes a 5-day simulation workshop on the Cuban Missile Crisis developed for 60 secondary school students participating in the Indiana University summer gifted and talented program. Uses role playing and game situations to teach critical thinking. Finds these techniques effective in providing a sense of power and competence. (NL)

The Crisis among Contemporary American Adolescents: A Call for the Integration of Research, Policies, and Programs.

ERIC Educational Resources Information Center

Lerner, Richard M.; And Others

1994-01-01

Points out the growing crisis among American adolescents, with approximately half of adolescents at moderate or greater risk for engaging in unsafe sexual behaviors, teenage pregnancy, and teenage child-bearing; drug and alcohol use and abuse; school underachievement, failure, and dropout; and delinquency and crime. Calls for increased research on…

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…

Noncombatant Evacuation Operations: Department of State’s Lessons Learned Program

DTIC Science & Technology

2016-06-10

student author and do not necessarily represent the views of the U.S. Army Command and General Staff College or any other U.S. governmental agency...68 viii ACRONYMS AAR After Action Review CALL Center for Army Lessons Learned CMS Crisis Management Support CMU Crisis Management ...Knowledge Management Chart .......................................................................25 Figure 5. Organization Chart

ORGANIZATION OF SCHOOLS TO PROVIDE ACADEMIC AID AND THERAPEUTIC COUNSELING TO DISADVANTAGED CHILDREN.

ERIC Educational Resources Information Center

ROSEMAN, MARTHA O.

THE HELPING TEACHER, OR CRISIS TEACHER, PROGRAM WAS INITIATED TO SERVE CULTURALLY DEPRIVED AND DISTURBED CHILDREN IN ELEMENTARY SCHOOL. IT (1) ASSISTED THE UNDERACHIEVER, (2) PROVIDED GUIDANCE, COUNSELING, AND LIFE SPACE INTERVIEWING TO A CHILD IN CRISIS, AND (3) DEFINED AND IMPROVED THE MENTAL HYGIENE OF STUDENTS AND STAFF. ASSISTANCE WAS OFFERED…

Randomised controlled trial of the clinical and cost-effectiveness of a peer-delivered self-management intervention to prevent relapse in crisis resolution team users: study protocol.

PubMed

Johnson, Sonia; Mason, Oliver; Osborn, David; Milton, Alyssa; Henderson, Claire; Marston, Louise; Ambler, Gareth; Hunter, Rachael; Pilling, Stephen; Morant, Nicola; Gray, Richard; Weaver, Tim; Nolan, Fiona; Lloyd-Evans, Brynmor

2017-10-27

Crisis resolution teams (CRTs) provide assessment and intensive home treatment in a crisis, aiming to offer an alternative for people who would otherwise require a psychiatric inpatient admission. They are available in most areas in England. Despite some evidence for their clinical and cost-effectiveness, recurrent concerns are expressed regarding discontinuity with other services and lack of focus on preventing future relapse and readmission to acute care. Currently evidence on how to prevent readmissions to acute care is limited. Self-management interventions, involving supporting service users in recognising and managing signs of their own illness and in actively planning their recovery, have some supporting evidence, but have not been tested as a means of preventing readmission to acute care in people leaving community crisis care. We thus proposed the current study to test the effectiveness of such an intervention. We selected peer support workers as the preferred staff to deliver such an intervention, as they are well-placed to model and encourage active and autonomous recovery from mental health problems. The CORE (CRT Optimisation and Relapse Prevention) self-management trial compares the effectiveness of a peer-provided self-management intervention for people leaving CRT care, with treatment as usual supplemented by a booklet on self-management. The planned sample is 440 participants, including 40 participants in an internal pilot. The primary outcome measure is whether participants are readmitted to acute care over 1 year of follow-up following entry to the trial. Secondary outcomes include self-rated recovery at 4 and at 18 months following trial entry, measured using the Questionnaire on the Process of Recovery. Analysis will follow an intention to treatment principle. Random effects logistic regression modelling with adjustment for clustering by peer support worker will be used to test the primary hypothesis. The CORE self-management trial was approved by the London Camden and Islington Research Ethics Committee (REC ref: 12/LO/0988). A Trial Steering Committee and Data Monitoring Committee oversee the progress of the study. We will report on the results of the clinical trial, as well as on the characteristics of the participants and their associations with relapse. ISRCTN 01027104;pre-results stage. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Application of a model for the development of a mental health service delivery collaboration between police and the health service.

PubMed

Laing, Robert; Halsey, Rebecca; Donohue, David; Newman, Claire; Cashin, Andrew

2009-05-01

Changing societal trends have revealed an increased prevalence of mental illness and diminished health resources from which to offer services. This has lead to a need to develop new and more efficient police and health service models of practice. Services offered by the police department in the management of mental health crisis in the community are essential in minimising the risk of individuals with mental health problems causing harm to themselves or a member of the public. In addressing the difficulties associated with police playing an important role in the management of mental health crisis in the community, but having little training in mental health issues, this paper discusses a proposed innovation for New South Wales police in Australia through the development of a Crisis Intervention Team model.

The Lebanese-Syrian crisis: impact of influx of Syrian refugees to an already weak state.

PubMed

Cherri, Zeinab; Arcos González, Pedro; Castro Delgado, Rafael

2016-01-01

Lebanon, a small Middle Eastern country facing constant political and national unity challenges with a population of approximately 300,000 Palestinian and Iraqi refugees, has welcomed more than 1.2 million Office of the United Nations Commissioner for Refugees (UNHCR)-registered Syrian refugees since 2012. The Government of Lebanon considers individuals who crossed Lebanese-Syrian borders since 2011 as "displaced", emphasizing its long-standing position that Lebanon is not a state for refugees, refusing to establish camps, and adopting a policy paper to reduce their numbers in October 2014. Humanitarian response to the Syrian influx to Lebanon has been constantly assembling with the UNHCR as the main acting body and the Lebanon Crisis Response Plan as the latest plan for 2016. Review of secondary data from gray literature and reports focusing on the influx of Syrian refugees to Lebanon by visiting databases covering humanitarian response in complex emergencies. Limitations include obtaining majority of the data from gray literature and changing statistics due to the instability of the situation. The influx of Syrian refugees to Lebanon, an already weak and vulnerable state, has negatively impacted life in Lebanon on different levels including increasing demographics, regressing economy, exhausting social services, complicating politics, and decreasing security as well as worsened the life of displaced Syrians themselves. Displaced Syrians and Lebanese people share aggravating hardships of a mutual and precarious crisis resulting from the Syrian influx to Lebanon. Although a lot of response has been initiated, both populations still lack much of their basic needs due to lack of funding and nonsustainable program initiatives. The two major recommendations for future interventions are to ensure continuous and effective monitoring and sustainability in order to alleviate current and future suffering in Lebanon.

The Lebanese–Syrian crisis: impact of influx of Syrian refugees to an already weak state

PubMed Central

Cherri, Zeinab; Arcos González, Pedro; Castro Delgado, Rafael

2016-01-01

Background Lebanon, a small Middle Eastern country facing constant political and national unity challenges with a population of approximately 300,000 Palestinian and Iraqi refugees, has welcomed more than 1.2 million Office of the United Nations Commissioner for Refugees (UNHCR)-registered Syrian refugees since 2012. The Government of Lebanon considers individuals who crossed Lebanese–Syrian borders since 2011 as “displaced”, emphasizing its long-standing position that Lebanon is not a state for refugees, refusing to establish camps, and adopting a policy paper to reduce their numbers in October 2014. Humanitarian response to the Syrian influx to Lebanon has been constantly assembling with the UNHCR as the main acting body and the Lebanon Crisis Response Plan as the latest plan for 2016. Methods Review of secondary data from gray literature and reports focusing on the influx of Syrian refugees to Lebanon by visiting databases covering humanitarian response in complex emergencies. Limitations include obtaining majority of the data from gray literature and changing statistics due to the instability of the situation. Results The influx of Syrian refugees to Lebanon, an already weak and vulnerable state, has negatively impacted life in Lebanon on different levels including increasing demographics, regressing economy, exhausting social services, complicating politics, and decreasing security as well as worsened the life of displaced Syrians themselves. Conclusion Displaced Syrians and Lebanese people share aggravating hardships of a mutual and precarious crisis resulting from the Syrian influx to Lebanon. Although a lot of response has been initiated, both populations still lack much of their basic needs due to lack of funding and nonsustainable program initiatives. The two major recommendations for future interventions are to ensure continuous and effective monitoring and sustainability in order to alleviate current and future suffering in Lebanon. PMID:27471417

Responding to the Crisis of Accountability: A Review of Program Assessment Methods.

ERIC Educational Resources Information Center

Haley, Eric; Jackson, DeForrest

The advertising program at the University of Tennessee, Knoxville (UTK) has at least 12 measures of program assessment, which serve as a basis for discussion rather than as a prescription for an effective assessment program. The program assessment methods are accrediting, internal program review, teaching evaluations, a university survey of…

Improving police response to persons with mental illness: A Multi-level conceptualization of CIT

PubMed Central

Watson, Amy C; Morabito, Melissa Schaefer; Draine, Jeffrey; Ottati, Victor

2009-01-01

The large numbers of people with mental illness in jails and prisons has fueled policy concern in all domains of the justice system. This includes police practice, where initial decisions to involve persons in the justice system or divert them to mental health services are made. One approach to focus police response in these situations is the implementation of Crisis Intervention Teams (CIT). The CIT model is being implemented widely, with over 400 programs currently operating. While the limited evidence on CIT effectiveness is promising, research on CIT is limited in scope and conceptualization-much of it focusing on officer characteristics and training. In this paper we review the literature on CIT and present a conceptual model of police response to persons with mental illness that accounts for officer, organizational, mental health system and community level factors likely to influence implementation and effectiveness of CIT and other approaches. By moving our conceptualizations and research in this area to new levels of specificity, we may contribute more to effectiveness research on these interventions. PMID:18632154

Structural Competency in the U.S. Healthcare Crisis: Putting Social and Policy Interventions Into Clinical Practice.

PubMed

Hansen, H; Metzl, J

2016-06-01

This symposium of the Journal of Bioethical Inquiry illustrates structural competency: how clinical practitioners can intervene on social and institutional determinants of health. It will require training clinicians to see and act on structural barriers to health, to adapt imaginative structural approaches from fields outside of medicine, and to collaborate with disciplines and institutions outside of medicine. Case studies of effective work on all of these levels are presented in this volume. The contributors exemplify structural competency from many angles, from the implications of epigenetics for environmental intervention in personalized medicine to the ways clinicians can act on fundamental causes of disease, address abuses of power in clinical training, racially desegregate cities to reduce health disparities, address the systemic causes of torture by police, and implement harm-reduction programs for addiction in the face of punitive drug laws. Together, these contributors demonstrate the unique roles that clinicians can play in breaking systemic barriers to health and the benefit to the U.S. healthcare system of adopting innovations from outside of the United States and outside of clinical medicine.

The Battered Teacher

ERIC Educational Resources Information Center

Bloch, Alfred M.

1977-01-01

Methods for the prevention and control of stress and trauma in physically assaulted teachers include preparedness training, formation of crisis intervention teams, and morale-improving techniques such as staff support, rotation of teaching assignments, and direct access to schoolboards for grievance reports. (MJB)

[Crisis of the professional ethics at educational system of Bosnia and Herzegovina and its relationship].

PubMed

Ziga, Jusuf; Masić, Izet

2005-01-01

In the structure of ruining of the social values system, in post war Bosnia and Herzegovina we possess the worrying degradation of the professional morals in the educational performance: irreal examination, intervention, bribe, sexual black mail and similar. That confirmed the results of the extensive examination which recently was realized on this subject. The negative crisis effects of the professional morals in the educational system will, surely, at the social plan, more long-term reflect. Because, it is no about only in the intelectual-expert, than also about the educational component of personality forming.

NIAAA's rapid response to college drinking problems initiative: reinforcing the use of evidence-based approaches in college alcohol prevention.

PubMed

Dejong, William; Larimer, Mary E; Wood, Mark D; Hartman, Roger

2009-07-01

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) created the Rapid Response to College Drinking Problems initiative so that senior college administrators facing an alcohol-related crisis could get assistance from well-established alcohol researchers and NIAAA staff. Based on a competitive grant process, NIAAA selected five teams of research scientists with expertise in college drinking research. NIAAA then invited college administrators to propose interventions to address a recently experienced alcohol-related problem. Between September 2004 and September 2005, NIAAA selected 15 sites and paired each recipient college with a scientific team. Together, each program development/evaluation team, working closely with NIAAA scientific staff, jointly designed, implemented, and evaluated a Rapid Response project. This supplement reports the results of several Rapid Response projects, plus other findings of interest that emerged from that research. Eight articles present evaluation findings for prevention and treatment interventions, which can be grouped by the individual, group/interpersonal, institutional, and community levels of the social ecological framework. Additional studies provide further insights that can inform prevention and treatment programs designed to reduce alcohol-related problems among college students. This article provides an overview of these findings, placing them in the context of the college drinking intervention literature. College drinking remains a daunting problem on many campuses, but evidence-based strategies-such as those described in this supplement-provide hope that more effective solutions can be found. The Rapid Response initiative has helped solidify the necessary link between research and practice in college alcohol prevention and treatment.

Systematic review of the evidence on the effectiveness of sexual and reproductive health interventions in humanitarian crises.

PubMed

Warren, Emily; Post, Nathan; Hossain, Mazeda; Blanchet, Karl; Roberts, Bayard

2015-12-18

This systematic review aims to evaluate evidence on the effectiveness of sexual and reproductive health (SRH) interventions delivered in humanitarian crises. Crisis affected low-income or middle-income countries. Crisis-affected populations in low-income or middle-income countries. Peer-reviewed and grey literature sources were systematically searched for relevant papers detailing interventions from 1 January 1980 until the search date on 30 April 2013. Data from included studies were then extracted, and the papers' quality evaluated using criteria based on modified STROBE and CONSORT checklists. Primary outcomes include, but are not limited to, changes in morbidity, mortality, sexually transmitted infection (STI) diagnosis or gender-based violence. Secondary outcomes include, but are not limited to, reported condom use or skilled attendance at birth. Primary outputs include, but are not limited to, condoms distributed or education courses taught. Of 7149 returned citations, 15 studies met the inclusion criteria. Only one randomised controlled trial was identified. The remaining observational studies were of moderate quality, demonstrating limited use of controls and inadequate attempts to address bias. Evidence of effectiveness was available for the following interventions: impregnated bed nets for pregnant women, subsidised refugee healthcare, female community health workers, and tiered community reproductive health services. The limited evidence base for SRH interventions highlights the need for improved research on the effectiveness of public health interventions in humanitarian crises. While interventions proven efficacious in stable settings are being used in humanitarian efforts, more evidence is required to demonstrate the effectiveness of delivering and scaling-up such interventions in humanitarian crises. 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/

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.

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.

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.

Psychological explanations and interventions for indifference to greening hospitals.

PubMed

Topf, Margaret

2005-01-01

Attention has increasingly been given to "greening" the environment, that is, to engaging in environmentally responsible behavior. Applied to hospitals, greening is collective interdisciplinary organizational behavior that reduces environmental hazards and overconsumption. An environmental crisis in hospitals is described. A number of individual and group psychological phenomena are detailed to explain the current absence of widespread greening in hospitals. Social and environmental psychology concepts for behavior change are combined to provide a model consisting of hospital administration and staff interventions to green this setting. Successful examples of these interventions are provided.

Two Studies of a Faculty in Crisis: The CSU Crisis and California's Future

ERIC Educational Resources Information Center

Civil Rights Project / Proyecto Derechos Civiles, 2011

2011-01-01

The fundamental asset of a university is its faculty. Without faculty working with students, the university is just a set of buildings. The faculty design and teach the courses, keep the educational program updated, and work with students to help them gain the skills and knowledge they need to prepare for their careers or professional education.…

Congress Prepares for Student-Loan Crisis, while Declaring It Unlikely

ERIC Educational Resources Information Center

Field, Kelly

2008-01-01

Several months into a credit crunch that has led at least 20 lenders to leave the guaranteed loan program or suspend their lending operations, lawmakers have begun to respond with a sense of urgency, even as they seek to reassure students and parents that a crisis is unlikely and that federal student loans will still be available this fall. In the…

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…

Open Distance Learning for Development: Lessons from Strengthening Research Capacity on Gender, Crisis Prevention, and Recovery

ERIC Educational Resources Information Center

Babu, Suresh Chandra; Ferguson, Jenna; Parsai, Nilam; Almoguera, Rose

2013-01-01

This paper documents the experience and lessons from implementing an e-learning program aimed at creating research capacity for gender, crisis prevention, and recovery. It presents a case study of bringing together a multidisciplinary group of women professionals through both online and face-to-face interactions to learn the skills needed to be a…

Adolescent Literacy

ERIC Educational Resources Information Center

Ippolito, Jacy, Ed.; Steele, Jennifer L., Ed.; Samson, Jennifer F., Ed.

2012-01-01

"Adolescent Literacy" initially appeared as a special issue of the "Harvard Educational Review". It explores key issues and debates in the adolescent literacy crisis, the popular use of cognitive strategies, and disciplinary and content-area literacy. Also examined are alternative forms of literacy, afterschool interventions, new instruction…

The impact of the 2008 economic crisis on the increasing number of young psychiatric inpatients.

PubMed

Medel-Herrero, Alvaro; Gomez-Beneyto, Manuel

2017-11-21

Little is published about the impact of the 2008 economic crisis on mental health services in Spain. An interrupted time series analysis was conducted to investigate a potential short-term association between the 2008 economic crisis and the number of psychiatric hospital admissions. The timing of the intervention (April 2008) was based on observed changes in Gross Domestic Product (GDP). Data on 1,152,880 psychiatric inpatients from the national Hospital Morbidity Survey, 69 months before and after the onset of the economic crisis (April 2008), were analyzed. Age-adjusted psychiatric (ICD9 290-319) hospital discharge rates significantly increased from April 2008, matching the onset of the crisis, especially for inpatients aged 15-24 years old and to a less extend for inpatients aged 25-34 years old. Other age groups were not affected. There was a significant increase in diagnoses for disturbance of conduct and emotions, depression, neurotic and personality disorders and alcohol and drug disorders; however, diagnoses for mental retardation and organic psychosis for 15-34 years old inpatients were unaffected. Psychiatric hospital admissions abruptly increased in April 2008, coinciding with the onset of the economic crisis. We identified age groups and diagnoses affected. Increased hospitalizations were found only at the age-ranges most affected by the rise in unemployment. The diagnoses affected were those most sensitive to environmental changes. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Rites of passage and healing efficacy: an ethnographic study of an intimate partner violence intervention.

PubMed

Wozniak, Danielle F

2009-01-01

Concepts of health or healing remain conspicuously absent in intimate partner violence intervention literature and practice within the USA. Instead, interventions generally end with 'equilibrium' or 'maintenance' in which women are no longer in crisis and are no longer in a violent relationship. But this ignores an important and necessary trajectory for intervention - healing. Following the logic of Van Gennep (1960) and Turner (1969), I suggest that most interventions leave women in a state of liminality, struggling to develop an alternative social and interpersonal identity to that of 'victim of abuse', or a 'survivor of violence'. This paper examines final stage healing as a rite of passage effected in an experimental women-centred intervention.

Implementation and evaluation of a simulation curriculum for paediatric residency programs including just-in-time in situ mock codes.

PubMed

Sam, Jonathan; Pierse, Michael; Al-Qahtani, Abdullah; Cheng, Adam

2012-02-01

To develop, implement and evaluate a simulation-based acute care curriculum in a paediatric residency program using an integrated and longitudinal approach. Curriculum framework consisting of three modular, year-specific courses and longitudinal just-in-time, in situ mock codes. Paediatric residency program at BC Children's Hospital, Vancouver, British Columbia. The three year-specific courses focused on the critical first 5 min, complex medical management and crisis resource management, respectively. The just-in-time in situ mock codes simulated the acute deterioration of an existing ward patient, prepared the actual multidisciplinary code team, and primed the surrounding crisis support systems. Each curriculum component was evaluated with surveys using a five-point Likert scale. A total of 40 resident surveys were completed after each of the modular courses, and an additional 28 surveys were completed for the overall simulation curriculum. The highest Likert scores were for hands-on skill stations, immersive simulation environment and crisis resource management teaching. Survey results also suggested that just-in-time mock codes were realistic, reinforced learning, and prepared ward teams for patient deterioration. A simulation-based acute care curriculum was successfully integrated into a paediatric residency program. It provides a model for integrating simulation-based learning into other training programs, as well as a model for any hospital that wishes to improve paediatric resuscitation outcomes using just-in-time in situ mock codes.

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

PubMed

Wood, Jennifer D; Beierschmitt, Laura

2014-01-01

Law enforcement officers continue to serve on the front lines as mental health interventionists, and as such have been subject to a wave of "first generation" reform designed to enhance their crisis response capabilities. Yet, this focus on crisis intervention has not answered recent calls to move "upstream" and bolster early intervention in the name of long-term recovery. This paper reports on findings from an action research project in Philadelphia aimed at exploring opportunities for enhanced upstream engagement. Study methods include spatial analyses of police mental health transportations from an eight year period (2004-2011) and qualitative data from twenty-three "framing conversations" with partners and other stakeholders, seven focus groups with police and outreach workers, five key informant interviews as well as document reviews of the service delivery system in Philadelphia. Recommendations include the need to move beyond a focus on what police can do to a wider conception of city agencies and business stakeholders who can influence vulnerable people and vulnerable spaces of the city. We argue for the need to develop shared principles and rules of engagement that clarify roles and stipulate how best to enlist city resources in a range of circumstances. Since issues of mental health, substance use and disorder are so tightly coupled, we stress the importance of establishing a data-driven approach to crime and disorder reduction in areas of the city we term "hotspots of vulnerability". In line with a recovery philosophy, such an approach should reduce opportunities for anti-social behavior among the "dually labeled" in ways consistent with "procedural justice". Furthermore, crime and disorder data flowing from police and security to behavioral health analysts could contribute to a more focused case management of "repeat utilizers" across the two systems. Our central argument is that a twin emphasis on "case management" and "place management" may provide the pillars needed to move upstream and strengthen interventions along a continuum of engagement. Copyright © 2014 Elsevier Ltd. All rights reserved.

Pathways to Male Transactional Sex in Mumbai, India.

PubMed

Srivastava, Ankur; Goldbach, Jeremy T

2017-10-27

The article explores pathways to male transactional sex, focusing on entering, soliciting practices, role of pimps, client characteristics, and negotiations. Little scientific literature exists regarding male transactional sex in India, who represent a high-risk group for HIV infection. Case studies with 10 men who engage in transactional sex were conducted, who were recruited using purposive snowball sampling and interviewed at a social service organization. Participants differed in their sexual identity, sex roles, soliciting practices, and clients. Most of them listed economic crisis as their reason for entering transactional sex. Strategies to find clients included self-solicitation and referrals, while pimps played a major role in solicitation, negotiations, and events of crisis. The relationship among men who engage in transactional sex, pimps, and clients involves points of negotiation, opportunities, and limitations. HIV prevention should focus on identifying and addressing the groups' unique needs and working with pimps on risk-reduction strategies and crisis interventions.

Opioid Crisis: No Easy Fix to Its Social and Economic Determinants

PubMed Central

Beletsky, Leo; Ciccarone, Daniel

2018-01-01

The accepted wisdom about the US overdose crisis singles out prescribing as the causative vector. Although drug supply is a key factor, we posit that the crisis is fundamentally fueled by economic and social upheaval, its etiology closely linked to the role of opioids as a refuge from physical and psychological trauma, concentrated disadvantage, isolation, and hopelessness. Overreliance on opioid medications is emblematic of a health care system that incentivizes quick, simplistic answers to complex physical and mental health needs. In an analogous way, simplistic measures to cut access to opioids offer illusory solutions to this multidimensional societal challenge. We trace the crisis’ trajectory through the intertwined use of opioid analgesics, heroin, and fentanyl analogs, and we urge engaging the structural determinants lens to address this formidable public health emergency. A broad focus on suffering should guide both patient- and community-level interventions. PMID:29267060

The Influence of Skill Development Training Program for Spiritual Care of Elderly Individual on Elderly Care Technician Students' Perception of Spiritual Support.

PubMed

Bulduk, Serap; Usta, Esra; Dinçer, Yeliz

2017-06-01

Spiritual care means helping an individual protect, maintain and gain all the dimensions of his/her existence. Elderly care technicians face numerous cases or crisis situations in which elderly individuals from different backgrounds question the meaning and value of life. Elderly care technicians must acknowledge that the spirituality is an important element in the way an elderly individual receives healthcare and they must be equipped for this matter. This study was conducted in order to examine the influence of "Skill Development Training Program for Spiritual Care of Elderly Individual," which was carried out with students from elderly care program, on the perception of spirituality support in a pretest-posttest quasi-experimental study design with control group. As the data collection form, "Spiritual Support Perception" (SSP) scale was used. The mean scores of the intervention group after the training and after one month are 50.39 ± 5.34 and 51.13 ± 4.98, respectively, and those of the control group are 43.16 ± 4.83 and 42.72 ± 4.48. A statistically significant difference was found between the mean scores of the intervention group from the pretest and the posttests immediately after the training and one month after the training (f = 94.247, p = 0.001). In the control group, however, there was no significant change in the SSP mean scores (f = 0.269, p = 0.77). As a result, this study pointed out the necessity of such training programs for healthcare professionals to make a distinction between their professional duties and their own personalities in order to offer spiritual care to the elderly individual.

School intervention related to school and community violence.

PubMed

Jaycox, Lisa H; Stein, Bradley D; Wong, Marleen

2014-04-01

Schools are well positioned to facilitate recovery for students exposed to community or school violence or other traumatic life events affecting populations of youth. This article describes how schools can circumvent several key barriers to mental health service provision, outcomes that school interventions target, and the role of the family in school-based services. It includes a description of the history of schools in facilitating recovery for students exposed to traumatic events, particularly related to crisis intervention, and the current status of early intervention and strategies for long-term recovery in the school setting. Challenges and future directions are also discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

Randomised controlled trial of joint crisis plans to reduce compulsory treatment for people with psychosis: economic outcomes.

PubMed

Barrett, Barbara; Waheed, Waquas; Farrelly, Simone; Birchwood, Max; Dunn, Graham; Flach, Clare; Henderson, Claire; Leese, Morven; Lester, Helen; Marshall, Max; Rose, Diana; Sutherby, Kim; Szmukler, George; Thornicroft, Graham; Byford, Sarah

2013-01-01

Compulsory admission to psychiatric hospitals may be distressing, disruptive to patients and families, and associated with considerable cost to the health service. Improved patient experience and cost reductions could be realised by providing cost-effective crisis planning services. Economic evaluation within a multi-centre randomised controlled trial comparing Joint Crisis Plans (JCP) plus treatment as usual (TAU) to TAU alone for patients aged over 16, with at least one psychiatric hospital admission in the previous two years and on the Enhanced Care Programme Approach register. JCPs, containing the patient's treatment preferences for any future psychiatric emergency, are a form of crisis intervention that aim to mitigate the negative consequences of relapse, including hospital admission and use of coercion. Data were collected at baseline and 18-months after randomisation. The primary outcome was admission to hospital under the Mental Health Act. The economic evaluation took a service perspective (health, social care and criminal justice services) and a societal perspective (additionally including criminal activity and productivity losses). The addition of JCPs to TAU had no significant effect on compulsory admissions or total societal cost per participant over 18-months follow-up. From the service cost perspective, however, evidence suggests a higher probability (80%) of JCPs being the more cost-effective option. Exploration by ethnic group highlights distinct patterns of costs and effects. Whilst the evidence does not support the cost-effectiveness of JCPs for White or Asian ethnic groups, there is at least a 90% probability of the JCP intervention being the more cost-effective option in the Black ethnic group. The results by ethnic group are sufficiently striking to warrant further investigation into the potential for patient gain from JCPs among black patient groups. Current Controlled Trials ISRCTN11501328.

A retrospective quasi-experimental study of a community crisis house for patients with severe and persistent mental illness.

PubMed

Siskind, Dan; Harris, Meredith; Kisely, Steve; Brogan, James; Pirkis, Jane; Crompton, David; Whiteford, Harvey

2013-07-01

There is increasing international evidence that crisis houses can reduce the time spent in acute psychiatric inpatient units for patients with severe and persistent mental illness, at a lower cost and in an environment preferable to patients. We evaluated the Alternatives to Hospitalisation (AtH) program, a crisis house operating in outer suburban Brisbane. One hundred and ninety-three AtH patients were compared to 371 matched controls admitted to a peer hospital district acute psychiatric unit. Hospitalisations, demographics and illness acuity were compared one year before and after an acute index episode of residential care involving hospital and/or AtH. Hospital bed-days during the index episode were compared between AtH participants and controls. The cost of bed-days averted was compared to the cost of providing the AtH program. AtH participants spent 5.35 fewer days in hospital during the index episode than controls, after adjustment for illness acuity, living conditions, marital status and emergency department (ED) presentations. Per patient cost of averted psychiatric inpatient bed-days, $5948.22, was higher than the per patient cost of providing AtH, $3071.44. AtH participants had higher levels of illness acuity, ED presentations and acute psychiatric admissions than controls in the year after the index episode. For acutely unwell, stably housed patients, able to be managed outside of a secure facility, a crisis house program can reduce acute psychiatric bed-days, providing a cost saving for mental health services.

Telephone-based low intensity therapy after crisis presentations to the emergency department is associated with improved outcomes.

PubMed

Bidargaddi, Niranjan; Bastiampillai, Tarun; Allison, Stephen; Jones, Gabrielle M; Furber, Gareth; Battersby, Malcolm; Richards, David

2015-10-01

In Australia there is an overwhelming need to provide effective treatment to patients presenting to the Emergency Department (ED) in mental health crisis. We adapted Improving Access to Psychological Therapies service model (IAPT) from the National Health Service (NHS) method for the large scale delivery of psychological therapies throughout the United Kingdom to an Australian ED setting. This telephone-based low intensity therapy was provided to people presenting in crisis to the EDs with combinations of anxiety, depression, substance use, and suicidal thinking. This uncontrolled study utilised session-by-session, before-and-after measures of anxiety and depression via Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7). Of 347 eligible post-crisis ED referred patients, 291 (83.9%) engaged with the IAPT team. Most patients (65%) had attended the ED previously on an average of 3.9 (SD = 6.0) occasions. Two hundred and forty one patients received an average of 4.1 (SD = 2.3) contacts of low-intensity psychological therapies including 1.2 (SD = 1.7) community outreach visits between 20th Oct 2011 and 31st Dec 2012. Treated patients reported clinically significant improvements in anxiety, depression and suicidal ideation. Uncontrolled effect sizes were moderate for anxiety (0.6) and depression (0.6). The Australian ED IAPT program demonstrated that the UK IAPT program could be adapted for emergency mental health patients and be associated with similar clinical benefits as the original program. The Flinders Medical Centre IAPT program received Emergency Department project funding from the Australian Commonwealth Government through the Council of Australian Governments (COAG) and the South Australian Government initiative, Every Patient Every Service (EPES). © The Author(s) 2015.

Cultural differences in dealing with critical incidents.

PubMed

Leonhardt, Jörg; Vogt, Joachim

2009-01-01

This article discusses the cultural aspects of High Reliability Organizations (HROs), such as air navigation services. HROs must maintain a highly professional safety culture and constantly be prepared to handle crises. The article begins with a general discussion of the concept of organizational culture. The special characteristics of HROs and their safety culture is then described. Finally the article illustrates how Critical Incident Stress Management (CISM) is becoming an ingrained feature of the organizational culture in air traffic control systems. Critical Incident Stress Management is a prevention program that can successfully guard against the negative effects of critical incidents. The CISM program of DFS (Deutsche Flugsicherung) was recently evaluated by the University of Copenhagen. This evaluation not only confirmed the successful prevention of negative effects at the operation's employee level (especially air traffic controllers), but also showed a sustained improvement of its safety culture and its overall organizational performance. The special aspects of cross-cultural crisis intervention and the challenges it faces, as well as the importance of prevention programs, such as CISM, are illustrated using the examples of two aircraft accidents: the crash landing of a calibration aircraft and the Lake Constance air disaster.

The Runaway Crisis: Is Family Therapy the Answer?

ERIC Educational Resources Information Center

Ostensen, Kay Wickett

1981-01-01

Presents research on the relationship of two family counseling models (one with temporary foster placement, one without) to the recidivism of runaway teenagers. Research shows the Brief Family Intervention counseling model to be a statistically viable tool in deterring repeated runaway episodes. (Author)

Smart-Mouth Kids: Taking the Sting Out of Verbal Aggression.

ERIC Educational Resources Information Center

Hewitt, Mary Beth

1998-01-01

Describes how a Life Space Crisis Intervention works to educate school personnel and students about verbal aggression. By analyzing insults, it is possible to avoid being hurt and thrown off focus, thus keeping perspective on the issues at hand. (MKA)

Role of the police in linking individuals experiencing mental health crises with mental health services

PubMed Central

2012-01-01

Background The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing contact. Methods Police records were searched for calls regarding individuals with acute mental health needs and police handling of these calls. Mental healthcare contact data were retrieved from a Psychiatric Case Register. Results The police were called upon for mental health crisis situations 492 times within the study year, involving 336 individuals (i.e. 1.7 per 1000 inhabitants per year). Half of these individuals (N=162) were disengaged from mental health services, lacking regular care contact in the year prior to the crisis (apart from contact for crisis intervention). In the month following the crisis, 21% of those who were previously disengaged from services had regular care contact, and this was more frequent (49%) if the police had contacted the mental health services during the crisis. The influence of police referral to the services was still present the following year. However, for the majority (58%) of disengaged individuals police did not contact the mental health services at the time of crisis. Conclusions The police deal with a substantial number of individuals experiencing a mental health crisis, half of whom are out of contact with mental health services, and police play an important role in linking these individuals to services. Training police officers to recognise and handle mental health crises, and implementing practical models of cooperation between the police and mental health services in dealing with such crises may further improve police referral of individuals disengaged from mental health services. PMID:23072687

Juxtaposed Integration Matrix: A Crisis Communication Tool

DTIC Science & Technology

2005-05-19

Integration Matrix: A Crisis Communication Tool 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR (S) 5d. PROJECT NUMBER 5e...for their patience and understanding when Daddy had to do schoolwork. The views expressed in this article are those of the author and do not reflect...62 APPENDIX A JUXTAPOSED INTEGRATION MATRIX TRAINING GUIDE ............................64 B QUESTIONNAIRE WORKSHEET

Confronting the Quiet Crisis: How Chief State School Officers Are Advancing Quality Early Childhood Opportunities

ERIC Educational Resources Information Center

Council of Chief State School Officers, 2012

2012-01-01

In 2009, the Council of Chief State School Officers (CCSSO) adopted a new policy statement on early childhood education. Based on the work of a task force of 13 chiefs, "A Quiet Crisis: The Urgent Need to Build Early Childhood Systems and Quality Programs for Children Birth to Age Five" presents a compelling argument for why public…

Social Networks in Crisis Response: Trust is Vital

DTIC Science & Technology

2016-06-01

response community as a whole. iv  2014 search for Malaysia Airlines Flight 370 (MH370)  2012 South Sudan WASH crisis  2004 Indian...Meteorological and Oceanographic MH370 Malaysia Airlines Flight 370 MOT Malaysia Ministry of Transportation xiv MSF Doctors Without Borders...States Navy WASH Water, Sanitation, and Hygiene WCO World Health Organization country offices WFP World Food Program WHO World Health Organization

[Science in a crisis. Medical countermeasures in Ebola virus disease, 2016: lessons learned and perspectives].

PubMed

Malvy, D

2016-10-01

In 2013, the world began to witness an unprecedented Ebola epidemic in West Africa that was smoldering by early 2016. Under this urgent circumstance, the global scientific community organized and made progress in identifying potential preventive countermeasures and therapeutics and accelerated the development of those promising interventions. Trials of experimental interventions soon emerged as a key component of the global response. Hence, an interdisciplinary issue ensued concerning how best to assess clinical safety and effectiveness of potential interventions prior to or concurrent with their broad use in humans. Key issues rely on the close collaboration between research and clinical teams involved in care in the field. Indeed, it is of prime importance to consider cultural dimensions when aiming to build trust within communities and flexibility to adapt trial procedures to field constraints. Trials implemented during the outbreak crisis illustrates challenging inputs for producing scientific and ethical gains for the benefits of vulnerable populations in the context of an international emerging or re-emerging infectious disease event. This includes rapid implementation of clinical research studies from the early phase of the next global outbreak on the basis of practical and ready-to-apply innovative methodological framework built during interepidemic periods.

Integrating Psychosocial Programs in Multisector Responses to International Disasters

ERIC Educational Resources Information Center

Diaz, Joseph Orlando Prewitt

2008-01-01

This article describes the role of psychosocial support programs in American Red Cross-sponsored humanitarian assistance efforts in international disasters. The American Red Cross psychosocial support program consists of four specific components: participatory crisis assessment, dealing with survivors' root shock, community mobilization, and…

Naloxone for heroin, prescription opioid, and illicitly made fentanyl overdoses: Challenges and innovations responding to a dynamic epidemic.

PubMed

Fairbairn, Nadia; Coffin, Phillip O; Walley, Alexander Y

2017-08-01

Community-based overdose prevention programs first emerged in the 1990's and are now the leading public health intervention for overdose. Key elements of these programs are overdose education and naloxone distribution to people who use opioids and their social networks. We review the evolution of naloxone programming through the heroin overdose era of the 1990's, the prescription opioid era of the 2000's, and the current overdose crisis stemming from the synthetic opioid era of illicitly manufactured fentanyl and its analogues in the 2010's. We present current challenges arising in this new era of synthetic opioids, including variable potency of illicit drugs due to erratic adulteration of the drug supply with synthetic opioids, potentially changing efficacy of standard naloxone formulations for overdose rescue, potentially shorter overdose response time, and reports of fentanyl exposure among people who use drugs but are opioid naïve. Future directions for adapting naloxone programming to the dynamic opioid epidemic are proposed, including scale-up to new venues and social networks, new standards for post-overdose care, expansion of supervised drug consumption services, and integration of novel technologies to detect overdose and deliver naloxone. Copyright © 2017 Elsevier B.V. All rights reserved.

Improving the mental health of rural New South Wales communities facing drought and other adversities.

PubMed

Hart, Craig Richard; Berry, Helen Louise; Tonna, Anne Maree

2011-10-01

NSW has just experienced its worst drought in a century. As years passed with insufficient rain, drought-related mental health problems became evident on farms. Our objective is to describe how, in response, the Rural Adversity Mental Health Program was introduced in 2007 to raise awareness of drought-related mental health needs and help address these needs in rural and remote NSW. The program has since expanded to include other forms of rural adversity, including recent floods. Rural NSW. DESIGN, PARTICIPANTS, INTERVENTIONS: Designed around community development principles, health, local service networks and partner agencies collaborated to promote mental health, education and early intervention. Strategies included raising mental health literacy, organising community social events and disseminating drought-related information. Priority areas were Aboriginal communities, older farmers, young people, women, primary health care and substance use. Over 3000 people received mental health literacy training in the four years of operation from 2007 to 2010. Stakeholders collaborated to conduct hundreds of mental health-related events attended by thousands of people. A free rural mental health support telephone line provided crisis help and referral to rural mental health-related services. Drought affected mental health in rural NSW. A community development model was accepted and considered effective in helping communities build capacity and resilience in the face of chronic drought-related hardship. Given the scale, complexity and significance of drought impacts and rural adjustment, and the threats posed by climate change, a long-term approach to funding such programs would be appropriate. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

Addressing the Child and Maternal Mortality Crisis in Haiti through a Central Referral Hospital Providing Countrywide Care

PubMed Central

Jacobs, Lee D; Judd, Thomas M; Bhutta, Zulfiqar A

2016-01-01

The neonatal, infant, child, and maternal mortality rates in Haiti are the highest in the Western Hemisphere, with rates similar to those found in Afghanistan and several African countries. We identify several factors that have perpetuated this health care crisis and summarize the literature highlighting the most cost-effective, evidence-based interventions proved to decrease these mortality rates in low- and middle-income countries. To create a major change in Haiti’s health care infrastructure, we are implementing two strategies that are unique for low-income countries: development of a countrywide network of geographic “community care grids” to facilitate implementation of frontline interventions, and the construction of a centrally located referral and teaching hospital to provide specialty care for communities throughout the country. This hospital strategy will leverage the proximity of Haiti to North America by mobilizing large numbers of North American medical volunteers to provide one-on-one mentoring for the Haitian medical staff. The first phase of this strategy will address the child and maternal health crisis. We have begun implementation of these evidence-based strategies that we believe will fast-track improvement in the child and maternal mortality rates throughout the country. We anticipate that, as we partner with private and public groups already working in Haiti, one day Haiti’s health care system will be among the leaders in that region. PMID:26934625

Addressing the Child and Maternal Mortality Crisis in Haiti through a Central Referral Hospital Providing Countrywide Care.

PubMed

Jacobs, Lee D; Judd, Thomas M; Bhutta, Zulfiqar A

2016-01-01

The neonatal, infant, child, and maternal mortality rates in Haiti are the highest in the Western Hemisphere, with rates similar to those found in Afghanistan and several African countries. We identify several factors that have perpetuated this health care crisis and summarize the literature highlighting the most cost-effective, evidence-based interventions proved to decrease these mortality rates in low- and middle-income countries.To create a major change in Haiti's health care infrastructure, we are implementing two strategies that are unique for low-income countries: development of a countrywide network of geographic "community care grids" to facilitate implementation of frontline interventions, and the construction of a centrally located referral and teaching hospital to provide specialty care for communities throughout the country. This hospital strategy will leverage the proximity of Haiti to North America by mobilizing large numbers of North American medical volunteers to provide one-on-one mentoring for the Haitian medical staff. The first phase of this strategy will address the child and maternal health crisis.We have begun implementation of these evidence-based strategies that we believe will fast-track improvement in the child and maternal mortality rates throughout the country. We anticipate that, as we partner with private and public groups already working in Haiti, one day Haiti's health care system will be among the leaders in that region.

Associations between exposure to intimate partner violence, armed conflict, and probable PTSD among women in rural Côte d'Ivoire.

PubMed

Gupta, Jhumka; Falb, Kathryn L; Carliner, Hannah; Hossain, Mazeda; Kpebo, Denise; Annan, Jeannie

2014-01-01

Objectives were to assess associations between intimate partner violence (IPV), violence during armed conflict (i.e. crisis violence), and probable post-traumatic stress disorder (PTSD). Using a sample of 950 women in rural Côte d'Ivoire, logistic generalized estimating equations assessed associations between IPV and crisis violence exposures with past-week probable PTSD. Over one in 5 (23.4%) women reported past-year IPV, and over one in 4 women (26.5%) reported experiencing IPV prior to the past year (i.e. remote IPV). Crisis violence was experienced by 72.6% of women. In adjusted models including demographics, crisis violence (overall and specific forms), and IPV (remote and past-year), women who reported past-year IPV had 3.1 times the odds of reporting probable past-week PTSD (95%CI: 1.8-5.3) and those who reported remote IPV had 1.6 times the odds (95%CI: 0.9-2.7). Violent exposures during the crisis were not significantly associated with probable PTSD (any crisis violence: aOR: 1.04 (0.7-1.5); displacement: aOR: 0.9 (95%CI: 0.5-1.7); family victimization during crisis: aOR: 1.1 (95%CI: 0.8-1.7); personal victimization during crisis: aOR: 1.7 (95%CI: 0.7-3.7)). Past-year IPV was more strongly associated with past-week probable PTSD than remote IPV and violence directly related to the crisis. IPV must be considered within humanitarian mental health and psychosocial programming.

Leadership Theory for School Psychologists: Leading for Systems Change

ERIC Educational Resources Information Center

Burns, Matthew K.; Preast, June L.; Kilpatrick, Kayla D.; Taylor, Crystal N.; Young, Helen; Aguilar, Lisa; Allen, Amanda; Copeland, Christa; Haider, Aqdas; Henry, Lauren

2017-01-01

School psychologists are often seen as leaders in schools. They lead data teams, problem-solving teams, multidisciplinary evaluation teams, and crisis response teams. They are also perceived as leaders regarding intervention, multitiered systems of support, behavior support, collaboration, consultation, special education, assessment, and…

Review of Medicine in Special Education: The Crisis of Diagnosis: Need for Intervention

ERIC Educational Resources Information Center

Freeman, Roger D.

1971-01-01

The review summarizes theoretical issues involved in the diagnosis of handicapping conditions, describes reactions of family members, outlines principles of management for physicians, and examines aspects of anticipatory counseling where partial or total loss of a child is foreseen. (GW)

The Arboretum: A living laboratory

Treesearch

Constance I. Millar

1977-01-01

...The Arboretum must be viable...the Arboretum must be dynamic, offering programs, new programs, and repeat programs, to share the knowledge that we have accumulated..." Francis Ching, Director, Los Angeles State and County Arboretum.¹ ¹Excerpt from: Proceedings of a Symposium: The Urban Arboretum in a Time of Crisis....

[What are hospitals and primary care doing to mitigate the social impact of serious adverse events].

PubMed

Mira, José Joaquín; Carrillo, Irene; Lorenzo, Susana

To explore what hospitals and primary care (PC) are doing to reduce the negative social impact of a serious adverse event (AE). We surveyed 195 hospital (n=113) and PC (n=82) managers from eight autonomous communities to explore the level of implementation of five interventions recommended after an AE to protect the reputation of healthcare institutions. Most institutions (70, 45.2% PC, and 85, 54.8% hospitals) did not have a crisis plan to protect their reputation after an AE. Internal (p=0.0001) and external (p=0.012) communications were addressed better in PC than in hospitals. Very few institutions had defined the managers' role in case of an AE (10.7% hospitals versus 6.25% PC). A majority of healthcare institutions have not planned crisis intervention after an AE with severe consequences nor have they defined plans to recover citizens' trust after an AE. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Developing the Pieta House Suicide Intervention Model: a quasi-experimental, repeated measures design.

PubMed

Surgenor, Paul Wg; Freeman, Joan; O'Connor, Cindy

2015-01-01

While most crisis intervention models adhere to a generalised theoretical framework, the lack of clarity around how these should be enacted has resulted in a proliferation of models, most of which have little to no empirical support. The primary aim of this research was to propose a suicide intervention model that would resolve the client's suicidal crisis by decreasing their suicidal ideation and improve their outlook through enhancing a range of protective factors. The secondary aim was to assess the impact of this model on negative and positive outlook. A quasi-experimental, pre-test post-test repeated measures design was employed. A questionnaire assessing self-esteem, depression, and positive and negative suicidal ideation was administered to the same participants pre- and post- therapy facilitating paired responses. Multiple analysis of variance and paired-samples t-tests were conducted to establish whether therapy using the PH-SIM had a significant effect on the clients' negative and positive outlook. Analyses revealed a statistically significant effect of therapy for depression, negative suicidal ideation, self-esteem, and positive suicidal ideation. Negative outlook was significantly lower after therapy and positive outlook significantly higher. The decreased negative outlook and increased positive outlook following therapy provide some support for the proposed model in fulfilling its role, though additional research is required to establish the precise role of the intervention model in achieving this.

Crisis management systems: staff nurses demand more support from their supervisors.

PubMed

Tzeng, Huey-Ming; Yin, Chang-Yi

2008-08-01

This study illustrates the contributions of the necessity, comprehensiveness, and difference (between necessity and comprehensiveness) levels of crisis management systems to participants' general satisfaction with their working institutions' nursing-related crisis management activities. Crisis management systems include strategic, technical/structural, assessment, public communication, and psychological/cultural aspects. An effective institutional crisis management system might help to decrease the number of incidents related to medical disputes or to prevent a crisis from worsening and becoming disastrous. A cross-sectional survey was administered during a nursing conference held in Taipei, Taiwan, on June 27, 2005. Two hundred ninety questionnaires were distributed, and 121 were retrieved (response rate, 41.7%; nursing administrators and staff). Univariate and multivariate analyses were performed. Ordinal logistic regression analyses show that being a public hospital managed by the government and having more difference on the strategic aspect between the necessity and comprehensiveness levels contribute to lower satisfaction with nursing-related crisis management activities (Nagelkerke R(2) = .441). In addition, staff nurses perceive higher necessity levels on all five aspects compared to nursing administrators. This study provides important insights into how the policies and activities of a medical institution's crisis management system can be prioritized and implemented. It is also important for students in nursing programs and for currently employed nurses to learn how to manage disputes related to nursing practice, so that early resolution can be achieved and crises can be avoided. These results suggest that staff nurses demand more support from their supervisors.

The IGY and the Satellite Race: A Reconsideration of a Cold War Crisis that Never Should Have Been

NASA Astrophysics Data System (ADS)

Launius, R. D.

2006-05-01

In October 1957 the Soviet Union launched the first Earth-circling artificial satellite and the crisis that resulted led to numerous actions in the United States aimed at "remediating" a Cold War crisis. This included the establishment of a separate civilian space agency charged with the conduct of an official program of scientific and technological space exploration, consolidation of Department of Defense space activities, the passage of the National Defense Education Act, the creation of a Presidential Science Advisor, and a host of lesser actions. The politics of these changes is fascinating, and has been interpreted as an appropriate political response to a unique crisis situation. Interest groups, all for differing reasons, prodded national leaders to undertake large-scale efforts, something the president thought unnecessarily expensive and once set in place impossible to dismantle. But was the Sputnik crisis truly a crisis in any real sense? Was it made into one by interest groups who used it for their own ends? This paper will trace briefly some of the major themes associated with the IGY and Sputnik and describe the political construction of the crisis as it emerged in 1957- 1958. It will also discuss something about the transformation of federal science and technology that took place in the aftermath of the "crisis" and how it set in train a series of processes and policies that did not unravel until the end of the Cold War.

Myxedema coma: a new look into an old crisis.

PubMed

Mathew, Vivek; Misgar, Raiz Ahmad; Ghosh, Sujoy; Mukhopadhyay, Pradip; Roychowdhury, Pradip; Pandit, Kaushik; Mukhopadhyay, Satinath; Chowdhury, Subhankar

2011-01-01

Myxedema crisis is a severe life threatening form of decompensated hypothyroidism which is associated with a high mortality rate. Infections and discontinuation of thyroid supplements are the major precipitating factors while hypothermia may not play a major role in tropical countries. Low intracellular T3 leads to cardiogenic shock, respiratory depression, hypothermia and coma. Patients are identified on the basis of a low index of suspicion with a careful history and examination focused on features of hypothyroidism and precipitating factors. Arrythmias and coagulation disorders are increasingly being identified in myxedema crisis. Thyroid replacement should be initiated as early as possible with careful attention to hypotension, fluid replacement and steroid replacement in an intensive care facility. Studies have shown that replacement of thyroid hormone through ryles tube with a loading dose and maintenance therapy is as efficacious as intravenous therapy. In many countries T3 is not available and oral therapy with T4 can be used effectively without major significant difference in outcomes. Hypotension, bradycardia at presentation, need for mechanical ventilation, hypothermia unresponsive to treatment, sepsis, intake of sedative drugs, lower GCS and high APACHE II scores and Sequential Organ Failure Assessment (SOFA) scores more than 6 are significant predictors of mortality in myxedema crisis. Early intervention in hypothyroid patients developing sepsis and other precipitating factors and ensuring continued intake of thyroid supplements may prevent mortality and morbidity associated with myxedema crisis.

Myxedema Coma: A New Look into an Old Crisis

PubMed Central

Mathew, Vivek; Misgar, Raiz Ahmad; Ghosh, Sujoy; Mukhopadhyay, Pradip; Roychowdhury, Pradip; Pandit, Kaushik; Mukhopadhyay, Satinath; Chowdhury, Subhankar

2011-01-01

Myxedema crisis is a severe life threatening form of decompensated hypothyroidism which is associated with a high mortality rate. Infections and discontinuation of thyroid supplements are the major precipitating factors while hypothermia may not play a major role in tropical countries. Low intracellular T3 leads to cardiogenic shock, respiratory depression, hypothermia and coma. Patients are identified on the basis of a low index of suspicion with a careful history and examination focused on features of hypothyroidism and precipitating factors. Arrythmias and coagulation disorders are increasingly being identified in myxedema crisis. Thyroid replacement should be initiated as early as possible with careful attention to hypotension, fluid replacement and steroid replacement in an intensive care facility. Studies have shown that replacement of thyroid hormone through ryles tube with a loading dose and maintenance therapy is as efficacious as intravenous therapy. In many countries T3 is not available and oral therapy with T4 can be used effectively without major significant difference in outcomes. Hypotension, bradycardia at presentation, need for mechanical ventilation, hypothermia unresponsive to treatment, sepsis, intake of sedative drugs, lower GCS and high APACHE II scores and Sequential Organ Failure Assessment (SOFA) scores more than 6 are significant predictors of mortality in myxedema crisis. Early intervention in hypothyroid patients developing sepsis and other precipitating factors and ensuring continued intake of thyroid supplements may prevent mortality and morbidity associated with myxedema crisis. PMID:21941682

Preparing Peacekeepers: An Analysis of the African Contingency Operations, Training, and Assistance Program Command and Staff Operational Skills Course

ERIC Educational Resources Information Center

Karis, Daniel Gerald

2010-01-01

The United States (U.S.) response to events in Africa in the 1990s--warlords in Somalia, the genocide in Rwanda, the crisis in Burundi, and the destruction of the U.S. embassies in Kenya and Tanzania--was the development of the African Crisis Response Initiative (ACRI) followed by the African Contingency Operations Training and Assistance (ACOTA)…

An Analysis of the Role of Social Safety Net Scholarships in Reducing School Drop-Out during the Indonesian Economic Crisis. Innocenti Working Papers.

ERIC Educational Resources Information Center

Cameron, Lisa A.

This paper uses regression and matching techniques to evaluate Indonesia's Social Safety Net Scholarships Programme. The scholarships program was developed to try to prevent large numbers of children from dropping out of school as a result of the Asian financial crisis. The expectation was that many families would find it difficult to keep their…

Growing Right Onto Wellness (GROW): A Family-Centered, Community-Based Obesity Prevention Randomized Controlled Trial for Preschool Child-Parent Pairs

PubMed Central

Po’e, Eli K.; Heerman, William J.; Mistry, Rishi S.; Barkin, Shari L.

2013-01-01

Growing Right Onto Wellness (GROW) is a randomized controlled trial that tests the efficacy of a family-centered, community-based, behavioral intervention to prevent childhood obesity among preschool-aged children. Focusing on parent-child pairs, GROW utilizes a multi-level framework, which accounts for macro (i.e., built-environment) and micro (i.e., genetics) level systems that contribute to the childhood obesity epidemic. Six hundred parent-child pairs will be randomized to a 3-year healthy lifestyle intervention or a 3-year school readiness program. Eligible children are enrolled between ages 3 and 5, are from minority communities, and are not obese. The principal site for the GROW intervention is local community recreation centers and libraries. The primary outcome is childhood Body Mass Index (BMI) trajectory at the end of the three-year study period. In addition to other anthropometric measurements, mediators and moderators of growth are considered, including genetics, accelerometry, and diet recall. GROW is a staged intensity intervention, consisting of intensive, maintenance, and sustainability phases. Throughout the study, parents build skills in nutrition, physical activity, and parenting, concurrently forming new social networks. Participants are taught goal-setting, self-monitoring, and problem solving techniques to facilitate sustainable behavior change. The GROW curriculum uses low health literacy communication and social media to communicate key health messages. The control arm is administered to both control and intervention participants. By conducting this trial in public community centers, and by implementing a family-centered approach to sustainable healthy childhood growth, we aim to develop an exportable community-based intervention to address the expanding public health crisis of pediatric obesity. PMID:24012890

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

PubMed

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

2018-07-01

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

The emergency telephone conversation in the context of the older person in suicidal crisis: a qualitative study.

PubMed

Deuter, Kate; Procter, Nicholas; Rogers, John

2013-01-01

Suicide in older people is a significant public health issue with a predicted future increase. Contemporary research directs considerable attention toward physical, mental, and social risk factors that contribute to suicidality in older people; still, little is understood about the fundamental meanings that older people in suicidal crisis attribute to these factors. The aim of this qualitative study was to describe, analyze, and compare counselors' and older peoples' perceptions of the suicidal crisis during an emergency telephone conversation. Data collection consisted of individual interviews with telephone counselors (N = 7) working within an emergency mental health triage service, and listening to telephone calls (N = 14) received by the service responding to people aged 65 years and over in suicidal crisis. Triangulation of the two data sets resulted in the emergence of three key themes. We found (1) congruence in the way risk factors were perceived by counselors and communicated during telephone conversations, (2) dissension between counselors' perceptions of end-of-life issues and older people's feelings of ambivalence about wanting to die and not knowing what to do and (3) the need for working side-by-side with the older person, exploring acute changes and immediate capacity for change. An explicit focus on risk factors alone may preclude counselors from gaining a deeper understanding of suicidal crisis in an older person's life. This research has begun to capture and illuminate how telephone counselors can deliver effective crisis intervention as older people struggle and make meaning through their suffering.

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.

The aftermath of an industrial disaster.

PubMed

Elklit, A

1997-01-01

An explosion in a Danish supertanker under construction in 1994 caused the death of six workers and injured 15. Six months later 270 workers took part in this study, which analyses the relationships between objective stressors, the workers' own feelings and the reactions of their families after the explosion together with training, attitude to the workplace, general out-look, and received crisis help. Traumatisation, coping style and crisis support was assessed via the Impact of Event Scale (IES), the Coping Styles Questionnaire (CSQ) and the Crisis Support Scale (CSS). Emotionally, workers and their families were strongly affected by the explosion. The IES-score was 17.6 and the invasion score 9.1. The degree of traumatisation was higher in the group who had an 'audience position' than in the group who was directly hit by the explosion. Training in rescue work did not protect against adverse effects. Rescue work had a strong impact on the involved. Social support was a significant factor, that seems to buffer negative effects. High level of social integration, effective leadership in the situation, and professional crisis intervention characterised the disaster situation. All the same, 41 per cent of the workers reached the caseness criteria by Horowitz (IES > or = 19).

St George Acute Care Team: the local variant of crisis resolution model of care.

PubMed

Cupina, Denise D; Wand, Anne P F; Phelan, Emma; Atkin, Rona

2016-10-01

The objective of this study was to describe functioning and clinical activities of the St George Acute Care Team and how it compares to the typical crisis resolution model of care. Descriptive data including demographics, sources of referral, type of clinical intervention, length of stay, diagnoses and outcomes were collected from records of all patients who were discharged from the team during a 10 week period. There were 677 referrals. The team's functions consisted of post-discharge follow-up (31%), triage and intake (30%), case management support (23%) and acute community based assessment and treatment (16%). The average length of stay was 5 days. The majority of patients were diagnosed with a mood (23%) or a psychotic (25%) disorder. Points of contrast to other reported crisis resolution teams include shorter length of stay, relatively less focus on direct clinical assessment and more telephone follow-up and triage. St George Acute Care Team provides a variety of clinical activities. The focus has shifted away from the original model of crisis resolution care to meet local and governmental requirements. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Whose STEM? Disrupting the Gender Crisis within STEM

ERIC Educational Resources Information Center

Heybach, Jessica; Pickup, Austin

2017-01-01

This article challenges implicit understandings of scientific inquiry and gender within contemporary responses to the underrepresentation of women in science, technology, engineering, and mathematics (STEM). Failing to recognize the gendered history of science, and thus STEM disciplines, we argue that much research and curricular interventions are…

Community Crisis Intervention; A Training Manual.

ERIC Educational Resources Information Center

Batson, Ruth; Peters, Lyda

This manual is designed to help community mental health workers to intervene effectively in community crises, particularly school desegregation. The rationale for involving mental health personnel in community crises is explained. The need for expertise among such workers is emphasized, and strategies for gaining this expertise are outlined. Also…

Counseling Psychology in the Justice System.

ERIC Educational Resources Information Center

Binder, Arnold; Binder, Virginia L.

1983-01-01

Presents an overview of pscyhological counseling for offenders. The 12 articles of this special issue deal with counseling before trial, in prison, and after release and also crisis intervention for police officers. Other topics include the juvenile justice system, juvenile diversion, ethics, and the economics of service delivery. (JAC)

Elements of Successful School Reentry after Psychiatric Hospitalization

ERIC Educational Resources Information Center

Clemens, Elysia V.; Welfare, Laura E.; Williams, Amy M.

2011-01-01

Psychiatric hospitalization is an intensive intervention designed to stabilize adolescents who are experiencing an acute mental health crisis. Reintegrating to school after discharge from psychiatric hospitalization can be overwhelming for many adolescents (E. V. Clemens, L. E. Welfare, & A. M. Williams, 2010). The authors used a consensual…

LSCI in a School Setting: Final Results

ERIC Educational Resources Information Center

Forthun, Larry F.; McCombie, Jeff W.; Payne, Caroline

2009-01-01

Life Space Crisis Intervention (LSCI) is a competency-based approach to intervening with adolescents, particularly within the schools, who are experiencing emotional pain, psychological distress, or behavioral disruption in their personal lives. LSCI is used to help classroom teachers, guidance counselors, administrators, and other school staff to…

Adaptation to Pregnancy: Some Implications for Individual and Family Mental Health.

ERIC Educational Resources Information Center

Valentine, Deborah

1982-01-01

Discusses pregnancy from four perspectives: as a normative crisis period; as a developmental process including both the pregnant woman and the expectant father; as an experience affecting marital relationships, including the presence of family violence; and as a context for prevention and intervention. (RH)

Discipline in the School. Crisis Intervention Series.

ERIC Educational Resources Information Center

Hartwig, Eric P.; Ruesch, Gary M.

Despite the significant amount of attention given to student description, a serious controversy remains regarding the procedures that constitute effective discipline. This book is designed to meet the need for systematic investigation of the parameters of appropriate disciplinary practices for all students. It helps administrators formulate,…

Conflict resolution with end of life decisions in critical care settings.

PubMed

Murphy, C; Sweeney, M A

1995-01-01

This demonstration will present the key modules from an innovative videodisc-based program that was designed as an educational tool for health care professionals. It provides a resource for learning to deal with patients and families regarding the increasing problematic area of end-of-life-decisions. Tough Choices: Ethics, the Elderly, and Life-Sustaining Technologies is an interactive program that combines abstract ethical approaches with the realistic drama of a critical care setting. The format integrates scientific facts about the patient with value questions regarding the utilization of life-sustaining technologies. The unique program provides health care personnel with strategies on how to guide family decision-making as well as examples of the various interventions. This interactive multimedia program opens up an opportunity for health care providers to participate in a clinical case in which life and death decisions are made. Learners can explore various perspectives and treatment options within the framework of the dramatic case presentation without the usual time constraints or worries about causing harm to patients. The program involves learners in a variety of ethical and legal dilemmas that centers around a patient, her family, and a variety of health care professionals. Dramatic advances in the development of life-sustaining medical technologies have given hope to many people whose conditions would have meant certain death only a few years ago. As access to the technologies has expanded, concern for their appropriate utilization has become an issue worthy of increasing attention. Questions about the benefits of life-sustaining treatments are being raised in many quarters, particularly when the technology is viewed as a modern means of postponing death and prolonging suffering. Tough Choices brings to life the story of Irene Sullivan, an elderly widow who has an unexpected heart attack. Suddenly, her very existence depends on the life-support provided by mechanical ventilation and cardiopulmonary resuscitation (CPR). This is a growing area of concern since more than half of the patients who receive CPR and tube feedings and one third of the people receiving mechanical ventilation are 65 or over. Mrs. Sullivan's health care team is forced to deal with the opposing viewpoints of several close family members regarding the utilization of advanced medical technology. The interactive program invites viewers to explore the complex ethical and legal dilemmas involved in making life-and-death decisions about her care. It also permits immediate access to supportive resources in three areas: the clinical chart, abstracts of relevant research studies on life-sustaining technologies, and information from the professional literature on advance directives. The program incorporates practical steps involved in implementing the Patient Self-Determination Act as it follows the patient from the time of hospitalization through a series of life-threatening crises. Two very different aspects of the role of the health care professionals were explored: a crisis mode which covers the steps in managing a full-blown crisis situation, and a prevention mode which analyzes steps that could have been followed to keep an ethical crisis from occurring. The strong role models for practice display many of the characteristics that the helping professions need to foster in an atmosphere of healthcare reform.

Educational Outreach to Opioid Prescribers: The Case for Academic Detailing.

PubMed

Trotter Davis, Margot; Bateman, Brian; Avorn, Jerry

2017-02-01

Nonmedical use of opioid medications constitutes a serious health threat as the rates of addiction, overdoses, and deaths have risen in recent years. Increasingly, inappropriate and excessively liberal prescribing of opioids by physicians is understood to be a central part of the crisis. Public health officials, hospital systems, and legislators are developing programs and regulations to address the problem in sustained and systematic ways that both insures effective treatment of pain and appropriate limits on the availability of opioids. Three approaches have obtained prominence as means of avoiding excessive and inappropriate prescribing, including: providing financial incentives to physicians to change their clinical decision through pay-for-performance contracts, monitoring patient medications through Prescription Drug Monitoring Programs, and educational outreach to physicians. A promising approach to educational outreach to physicians is an intervention known as "academic detailing." It was developed in the 1980s to provide one-on-one educational outreach to physicians using similar methods as the pharmaceutical industry that sends "detailers" to market their products to physician practices. Core to academic detailing, however, is the idea that medical decisions should be based on evidence-based information, including managing conditions with updated assessment measures, behavioral, and nonpharmacological interventions. With the pharmaceutical industry spending billions of dollars to advertise their products, individual practitioners can have difficulty gathering unbiased information, especially as the number of approved medications grows each year. Academic detailing has successfully affected the management of health conditions, such as atrial fibrillation, chronic obstructive pulmonary disease, and recently, has targeted physicians who prescribe opioids. This article discusses the approach as a potentially effective preventative intervention to address the epidemic of opioid overuse.Key words: Opioid abuse, opioid misuse, academic detailing, health policy, interactive education,prevention.

Creating a Successful Child Care Substitute Program. Program Services Papers.

ERIC Educational Resources Information Center

North Carolina Partnership for Children, Raleigh.

In efforts to address child care provider concerns about the staffing crisis, many Smart Start counties in North Carolina are seeking to implement substitute programs to promote release time for child caregivers to return to school or to cover staff illness and leave time. This type of substitute program involves the use of regularly employed,…

Denmark's National Family Guidance Program: A Preventive Mental Health Program for Children and Families.

ERIC Educational Resources Information Center

Wagner, Marsden

This document describes Denmark's 10-year (1965-75) program of cost-effective provision of social services to crisis families with children under the Danish 1964 Child and Youth Welfare Act. The program, voluntary and open to all families, provided preventive psychosocial services for children based on a family support system. The background to…

Replacing revolving door: a collaborative approach to treating individuals in crisis.

PubMed

Lauer, Michelle; Brownstein, Rose

2008-06-01

The Crisis Assessment and Psychiatric Emergency Services (CAPES) unit was designed to improve the quality of psychiatric treatment, contain costs, and provide relief to overburdened psychiatric inpatient and emergency services in Delaware. This innovative program is the result of collaboration between public and private agencies to treat individuals in crisis. The myriad factors that contributed to a broken system and instigated Delaware's search for a solution are discussed in this article. The CAPES unit has resulted in improved communication among providers, decreased committal rates, better linkage to appropriate levels of care, increased safety, and improved coordination of services. Clinical implications for nursing practice include providing more holistic care in a safer environment.

Associations between Exposure to Intimate Partner Violence, Armed Conflict, and Probable PTSD among Women in Rural Côte d’Ivoire

PubMed Central

Gupta, Jhumka; Falb, Kathryn L.; Carliner, Hannah; Hossain, Mazeda; Kpebo, Denise; Annan, Jeannie

2014-01-01

Background Objectives were to assess associations between intimate partner violence (IPV), violence during armed conflict (i.e. crisis violence), and probable post-traumatic stress disorder (PTSD). Methods Using a sample of 950 women in rural Côte d’Ivoire, logistic generalized estimating equations assessed associations between IPV and crisis violence exposures with past-week probable PTSD. Results Over one in 5 (23.4%) women reported past-year IPV, and over one in 4 women (26.5%) reported experiencing IPV prior to the past year (i.e. remote IPV). Crisis violence was experienced by 72.6% of women. In adjusted models including demographics, crisis violence (overall and specific forms), and IPV (remote and past-year), women who reported past-year IPV had 3.1 times the odds of reporting probable past-week PTSD (95%CI: 1.8–5.3) and those who reported remote IPV had 1.6 times the odds (95%CI: 0.9–2.7). Violent exposures during the crisis were not significantly associated with probable PTSD (any crisis violence: aOR: 1.04 (0.7–1.5); displacement: aOR: 0.9 (95%CI: 0.5–1.7); family victimization during crisis: aOR: 1.1 (95%CI: 0.8–1.7); personal victimization during crisis: aOR: 1.7 (95%CI: 0.7–3.7)). Conclusion Past-year IPV was more strongly associated with past-week probable PTSD than remote IPV and violence directly related to the crisis. IPV must be considered within humanitarian mental health and psychosocial programming. PMID:24823492

Effectiveness of a Treatment Involving Soft Tissue Techniques and/or Neural Mobilization Techniques in the Management of Tension-Type Headache: A Randomized Controlled Trial.

PubMed

Ferragut-Garcías, Alejandro; Plaza-Manzano, Gustavo; Rodríguez-Blanco, Cleofás; Velasco-Roldán, Olga; Pecos-Martín, Daniel; Oliva-Pascual-Vaca, Jesús; Llabrés-Bennasar, Bartomeu; Oliva-Pascual-Vaca, Ángel

2017-02-01

To evaluate the effects of a protocol involving soft tissue techniques and/or neural mobilization techniques in the management of patients with frequent episodic tension-type headache (FETTH) and those with chronic tension-type headache (CTTH). Randomized, double-blind, placebo-controlled before and after trial. Rehabilitation area of the local hospital and a private physiotherapy center. Patients (N=97; 78 women, 19 men) diagnosed with FETTH or CTTH were randomly assigned to groups A, B, C, or D. (A) Placebo superficial massage; (B) soft tissue techniques; (C) neural mobilization techniques; (D) a combination of soft tissue and neural mobilization techniques. The pressure pain threshold (PPT) in the temporal muscles (points 1 and 2) and supraorbital region (point 3), the frequency and maximal intensity of pain crisis, and the score in the Headache Impact Test-6 (HIT-6) were evaluated. All variables were assessed before the intervention, at the end of the intervention, and 15 and 30 days after the intervention. Groups B, C, and D had an increase in PPT and a reduction in frequency, maximal intensity, and HIT-6 values in all time points after the intervention as compared with baseline and group A (P<.001 for all cases). Group D had the highest PPT values and the lowest frequency and HIT-6 values after the intervention. The application of soft tissue and neural mobilization techniques to patients with FETTH or CTTH induces significant changes in PPT, the characteristics of pain crisis, and its effect on activities of daily living as compared with the application of these techniques as isolated interventions. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Transition of chaotic motion to a limit cycle by intervention of economic policy: an empirical analysis in agriculture.

PubMed

Sakai, Kenshi; Managi, Shunsuke; Vitanov, Nikolay K; Demura, Katsuhiko

2007-04-01

This paper investigates the transition of dynamics observed in an actual real agricultural economic dataset. Lyapunov spectrum analysis is conducted on the data to distinguish deterministic chaos and the limit cycle. Chaotic and periodic oscillation were identified before and after the second oil crisis, respectively. The statitonarity of the time series is investigated using recurrence plots. This shows that government intervention might reduce market instability by removing a chaotic market's long-term unpredictability.

Strategy in Fragmented Civil Wars: Iraq, Syria, and the Challenge of External Intervention

DTIC Science & Technology

2014-05-01

20 “Popular Protest in North Africa and the Middle East (VII): The Syrian Regime’s Slow-motion Suicide ," The International Crisis Group, Jul 13, 2011...56 Benotman and Blake, “Jebhat al-Nusra," 3. 57 “Popular Protest in North Africa and the Middle East (VII): The Syrian Regime’s Slow-Motion Suicide ...ing the temptation to overreach. In these cases, external intervention has utility to the de- gree it advances the policy goal. This is highly context

Public health works: blood donation in urban China.

PubMed

Adams, Vincanne; Erwin, Kathleen; Le, Phuoc V

2009-02-01

Recent shifts in the global health infrastructure warrant consideration of the value and effectiveness of national public health campaigns. These shifts include the globalization of pharmaceutical research, the rise of NGO-funded health interventions, and the rise of biosecurity models of international health. We argue that although these trends have arisen as worthwhile responses to actual health needs, it is important to remember the key role that public health campaigns can play in the promotion of national health, especially in developing nations. Focusing on an example set by China in response to a public health crisis surrounding the national need for a clean and adequate blood supply and the inadvertent spread of HIV by way of blood donation in the early 1990's, we argue that there is an important role for strong national public health programs. We also identify the key factors that enabled China's response to this burgeoning epidemic to be, in the end, largely successful.

Defense Reform: Supporting the Whole-of-Government Approach in Tomorrow’s Crisis

DTIC Science & Technology

2017-03-29

government approach to trans-regional, multi-domain, and multi-functional threats. In addition to keeping military and political focus on broader...structure with more subordinate commands and less multi-domain and multi-functional integration, or in this case , vertical integration. Relying on ... APPROACH IN TOMORROW’S CRISIS 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Lt Col John B