Economic Adversities Research Articles

A qualitative study of effective collaboration among nurse home visitors, healthcare providers and community support services in the United States.

Collaboration across sectors is needed to improve community health, but little is known about collaborative activities among public health prevention programs. Using the Nurse-Family Partnership® (NFP) home visiting program as context, this qualitative study aimed to describe effective collaboration among nurse home visitors, healthcare providers and community support services to serve families experiencing social and economic adversities. We used grounded theory to characterise collaboration with six purposively sampled NFP sites in the United States through in-depth interviews. We interviewed 73 participants between 2017 and 2019: 50 NFP staff, 18 healthcare providers and 5 other service providers. Interviews were recorded, transcribed, validated and analysed in NVivo 11. Validation steps included inter-coder consistency checks and expert review. Thematic memos were synthesised across sites. Most participants perceived collaboration to be important when serving families with complex needs, but substantial variation existed in the degree to which NFP nurses collaborate with providers dependent on provider type and community context. Factors that contributed to effective collaboration were relational in nature, including leadership commitment and provider champions, shared perceptions of trust, respect and value, and referral partnerships and outreach; organisational in terms of mission congruence between providers; and structural such as policy and system integration that facilitated data sharing and communication channels. These findings provide greater insights into effective cross-sector collaboration and care coordination for families experiencing adversities. Collaboration across sectors to promote health among families experiencing adversities requires intentional efforts by all inter-professional providers and continued commitment among all levels of leadership to coordinate services.

The Stress of the COVID-19 Pandemic: Beyond the Data.

Background The year 2020 will go down in modern history as the one ravaged by a pandemic, the one which humbled the entire world. From the richest and most advanced nations to the poorest and least developed ones, it exposed all of our vulnerabilities. The loss of life, health disparities and economic adversities, aggravated by political and ideological tensions, added multiple layers of stress and anxieties to an already stressed American society.Methods The educational institutions in the United States from the central to the local units demonstrated coherence in leadership, guided with flexibility and compassion, which paved the way for smooth operations. However, anxiety among students and faculty of university and college campuses is undeniable. In-person instruction was halted. Research labs and offices were locked down or operating with limited personnel. Thus, the challenges to have timely instruction and to move the research enterprise forward have been enormous. Provided here is a perspective based on a literature search using PubMed and Google with search words “COVID-19, stress, college students”, “COVID-19, stress, US graduate students”, and “COVID-19, stress, postdoc researchers”.Results This article is an opinion piece, part personal and part peer experiences. It is presented in light of studies suggesting that the COVID-19 pandemic has imposed significant mental stress and anxiety upon students and faculty members within the academy.Conclusion Loss of face-to-face interactions as a result of virtual instructions, lack of in-person mentoring, and loss of research productivity have affected mental health and well-being of the academic community. Despite the challenges of the pandemic, the ingenuity of the human spirit has innovated solutions to catch up on research productivity and to pursue academic excellence.

Immigrant Caregivers: The Double Burden Experience of Immigrants Caring for a Family Member With Severe Mental Illness.

The aim of this study is to examine the factors that shape the burden experience among immigrants caring for a family member with severe mental illness. In-depth semi-structured interviews were conducted with 32 immigrant caregivers from the former Soviet Union in Israel. The interviews were analyzed using qualitative content analysis. The participants described their burden as an accumulation of economic, linguistic, social, emotional, and health-related adversities that negatively affect their coping and adaptation on the personal and familial level. The results showed that the objective and subjective burdens they experience include dimensions pertaining to their role as family caregivers, dimensions pertaining to their immigrant status, and the circular interaction between these two, which intensifies the overall experience of burden. The study proposes a new term-the "double adaptation burden"-that can help promote the design of research, interventions, and policies suited to the multiple challenges of immigrant caregivers.

A case study of care co‐ordination between primary care providers and nurse home visitors to serve young families experiencing adversity in the Northwestern United States

Nurse home visitors in Nurse-Family Partnership® (NFP) work with mothers experiencing social and economic adversities to improve their and their children's health. Collaboration between nurse home visitors and primary care providers (PCPs: healthcare providers and social workers embedded within obstetrics, paediatrics and family medicine practices) can improve service delivery for families experiencing the greatest adversities. However, little is known about how and to what extent PCPs collaborate with home visiting nurses. We conducted a single exploratory case study between April 2019 and February 2020 to better understand how PCPs collaborate with home visiting nurses to meet family needs in one NFP site, purposefully selected for strong collaboration. We conducted in-depth qualitative interviews with 22 PCPs, including 5 nurses, 7 physicians, 7 social workers and 3 non-direct care professionals, including patient navigator and hospital executives. Interviews were recorded, transcribed, validated and coded inductively. Codes were grouped into broader categories and thematic memos across provider role were written to triangulate perspectives. Healthcare providers interacted with home visiting nurses mainly during the referral process, while social workers provided more specific examples of service co-ordination. In this case study, we saw mutual awareness, co-operation and collaboration to serve families with high needs. Even in this case, purposefully selected to represent strong collaboration, there were opportunities to enhance co-ordination to improve the health and social needs of young families experiencing adversity.

Walking the road together? EU polity maintenance during the COVID-19 crisis

This article investigates the ‘conflict parabola’ of the negotiations between EU member states during the COVID-19 pandemic. The crisis reopened the foundational controversy over cross-national solidarity under economic adversities. After a peak of conflict in March–April 2020, the political climate gradually shifted from antagonism to appeasement, creating the conditions necessary for the adoption of the Next Generation EU plan. Building on the negative experiences of past crises, some EU leaders engaged in a strategy of ‘polity maintenance’, i.e. keeping the EU polity together, regardless of interest-based divisions. This strategy mainly rested on public communication. The article documents both conflict and appeasement by analysing a corpus of leaders’ quotes drawn from the press (covering eight countries) and a corpus of speeches by Angela Merkel. The Chancellor made a high political investment in EU polity maintenance, presenting European cohesion as part and parcel of Germany’s national interest.

Hunger, fear, and isolation - A qualitative analysis of media reports of COVID-19-related suicides in India.

Background:India's suicide rates are among the highest in the world and may increase further as a consequence of COVID-19. There is a need to examine which pandemic related stressors may be contributing to suicide, in order to inform the deployment of suicide prevention strategies, for the current as well as future pandemics.Aim:To understand pandemic related stressors contributing to suicide in India.Methods:We identified and conducted a thematic analysis of Internet media reports of COVID-19 related suicides in India between February 1, 2020 (2 days after the first COVID-19 case), and May 31, 2020, (the end of phase four of the nationwide lockdown).Results:Ten pandemic stressors spanning both disease and lockdown-related factors were identified in 291 suicides. Economic hardship was present in a third; other notable stressors were: fear of the virus; isolation; desperation to be connected with loved ones or return home; and craving for alcohol. Men and young people seemed particularly vulnerable to these stressors.Conclusions:COVID-19 related suicides appear to be precipitated by social and economic adversities, mainly associated with containment strategies. These findings need to be confirmed by national suicide data. Suicide prevention strategies should mitigate the impact of recognized stressors in the long term, target high-risk individuals, and offer mental health care alongside containment strategies.

INTERNET GAMING AMONG CHILDREN IN THE TIME OF COVID-19: AN EMERGING PSYCHOLOGICAL PROBLEM

INTERNET GAMING AMONG CHILDREN IN THE TIME OF COVID-19: AN EMERGING PSYCHOLOGICAL PROBLEM

Association between childhood adversities and psychopathology onset throughout the lifespan: Findings from a large metropolitan population

BackgroundChildhood adversities (ECA) are deleterious experiences that can occur during individuals’ development, which has been associated with several negative health outcomes. AimAnalyze the effect of ECA on the onset of DSM-IV disorders throughout life. MethodThe Composite International Diagnostic Interview (CIDI) was used in a stratified, multistage area probability sample of 5037 individuals aged 18 or more to assess the presence of childhood adversities, 20 psychiatric disorders and their ages of onset. Discrete-time survival models were performed to estimate the odds of disorder onset. Data are from the São Paulo Megacity Mental Health Survey, the Brazilian branch of the World Mental Health Survey Initiative. Findings53.6% of the sample experienced at least one ECA, and parental death (16.1%) and physical abuse (16%) were the most reported occurrences. Parental mental illness (OR = 1.99 to 2.27) and family violence (OR = 1.55 to 1.99) were the adversities most consistently associated with psychopathology across all age groups, while economic adversities (OR = 2.71 to 3.30) and parent criminality (OR = 1.72 to 1.77) were associated with psychopathology in individuals whose onset of disorder occurred from age 13 years on. Parental mental disorders and economic adversities were the strongest and most consistent predictors of all four classes of psychopathologies examined in multivariate models controlled for the clustering of adversities. Physical abuse was associated with externalizing disorders, while sexual abuse with internalizing disorders. InterpretationChildhood adversities were consistently associated with mental disorders. Economic adversities and parent mental disorders were predictive of psychopathology even if controlled for type (additive) and type and number of adversities (interactive models). Parental mental disorder and family violence were the main predictors of psychopathology onset across all age groups. Parental mental disorder was the only adversity that predicted all classes of disorders investigated.

Regional Trends in Financing and Growth of Indian MSMEs

The Indian MSME Sector is the major contributor to the national economy providing it resilience to ward off global economic stress and adversities. With around 60 million units of MSME across India, they promote entrepreneurship and boost employment on a large scale. But since Independence, the Small-Scale Industries didn’t get much attention by the Central Government or State Governments. It took almost five decades for the Govt. of India to realize the potential of MSMEs in economic development of the country. The MSMED Act was passed in Parliament in 2006 to enable vibrant growth of Indian MSMEs and separate Ministry of Micro, Small & Medium Enterprises was created. The Reserve Bank of India has acted swiftly to improve the flow of credit to the MSME sector. Banks and NBFCs have come together in a great way to boost formal credit to MSMEs with all such loans qualifying for Priority Sector Lending classification. But still the growth of the MSME sector has not been uniform across different regions of the country. In this paper, we will try to analyze the regional trends in the financing and growth of MSMEs in India. Secondary data available from various Govt. sources are utilized to draw some conclusions regarding the current growth trends of the MSME units. Chi-square tests and correlation analysis are used to quantify the performance parameters of MSMEs. The paper brings out the figures pertaining to growth of MSMEs across rural and urban India. It concludes by emphasizing the need for enhanced growth opportunities for the MSME sector in low-performance states.

Childhood adversity and responses to repeated stress exposure in adulthood: A consideration of cortisol reactivity and habituation patterns in tandem

Childhood adversities (ECA) are deleterious experiences that can occur during individuals’ development, which has been associated with several negative health outcomes.Analyze the effect of ECA on the onset of DSM-IV disorders throughout life.The Composite International Diagnostic Interview (CIDI) was used in a stratified, multistage area probability sample of 5037 individuals aged 18 or more to assess the presence of childhood adversities, 20 psychiatric disorders and their ages of onset. Discrete-time survival models were performed to estimate the odds of disorder onset. Data are from the São Paulo Megacity Mental Health Survey, the Brazilian branch of the World Mental Health Survey Initiative.53.6% of the sample experienced at least one ECA, and parental death (16.1%) and physical abuse (16%) were the most reported occurrences. Parental mental illness (OR = 1.99 to 2.27) and family violence (OR = 1.55 to 1.99) were the adversities most consistently associated with psychopathology across all age groups, while economic adversities (OR = 2.71 to 3.30) and parent criminality (OR = 1.72 to 1.77) were associated with psychopathology in individuals whose onset of disorder occurred from age 13 years on. Parental mental disorders and economic adversities were the strongest and most consistent predictors of all four classes of psychopathologies examined in multivariate models controlled for the clustering of adversities. Physical abuse was associated with externalizing disorders, while sexual abuse with internalizing disorders.Childhood adversities were consistently associated with mental disorders. Economic adversities and parent mental disorders were predictive of psychopathology even if controlled for type (additive) and type and number of adversities (interactive models). Parental mental disorder and family violence were the main predictors of psychopathology onset across all age groups. Parental mental disorder was the only adversity that predicted all classes of disorders investigated.

Women’s Survival in Ghana: What Has Law Got to Do With It?

In the 21st century, women around the world continue to face societal, economic, and sexual adversities, even as the “#MeToo” and “Time’s Up” movements appear to have excited a new tone toward the fight for gender equality and female empowerment. In this context, and in the broader context of liberating women from the oppressive shackles of a world that seems to punish women for their mere existence, this article tackles issues which are mainly peculiar to Ghana, and which have an impact on the equality, empowerment, and survival of women. The article discusses the laws, policies, and regulations that have been established to improve the lives of women in Ghana. It also examines the scourge of dangerous, discriminatory practices such as female genital mutilation, the banishment of suspected witches, and inhumane widowhood rites, which are detrimental to the survival of women in Ghana. The article recognizes that the lack of sustained growth in women’s progress globally, and specifically in Ghana, is due in large part to these discriminatory practices that have muted the voices and perspectives of women in decision-making. The law, therefore, is not enough. Some of the pivotal roles nongovernmental organizations (NGOs) have played to empower women include campaigns to repeal legislation adversely affecting women’s inheritance and to improve the fairness of the Parliamentary process, efforts toward the elimination of trokosi, and the initiatives to protect women suspected of witchcraft from humiliation and banishment.

La enseñanza del arte electrónico mexicano: Alternativas para escenarios locales

La enseñanza del arte electrónico es la puerta de entrada a la comprensión de los distintos recursos científicos y tecnológicos, así como la entrada a redes o comunidades de desarrollo de conocimientos en línea, las cuales cubren la necesidad de obtener un conocimiento específico. El arte electrónico puede hacer posible la entrada a estos recursos, entre otros, necesarios para el avance de un grupo social o de la sociedad en conjunto. La educación universitaria en países en vías de desarrollo está supeditada a estándares nacionales e internacionales arcaicos en la implementación de rediseños o para la creación de nuevos programas de estudio, lo que obstaculiza la introducción de nuevas carreras del área artística, cuya base es la flexibilidad para la selección de contenidos, debido al cambio constante que experimentan las diferentes corrientes artísticas, verbigracia, la reutilización de recursos y materiales en el arte electrónico. Este artículo reflexiona sobre las desventajas de las guías institucionales para la creación de programas educativos y las ventajas de implementar nuevas normas que contribuyan a la flexibilidad de los planes de estudio.

A Research Agenda on the Sexual and Reproductive Health Dimensions of the COVID-19 Pandemic in Africa.

The outbreak of the novel coronavirus disease, COVID-19, was first reported in Wuhan in Hubei province of China in December 2019. It has since spread across the world, and as of 30th March 2020 reached over 150 countries, with a total of 693,224 confirmed cases and 33,106 deaths1. Of these totals, 42 countries in Africa had reported 3,486 confirmed cases and 60 deaths. The epicenter of the epidemic has shifted several times since mid-February 2020 from China to Iran, and then to Western Europe (Italy and Spain in particular), and is presently in the United States of America. The expectation is that the next big waves of infections will be in Africa and South America2. In the absence of an effective therapy or vaccine and without pre-existing immunity there are several reasons to anticipate more severe adverse consequences of large outbreaks of COVID-19 in Africa including for the sexual and reproductive health of vulnerable women and young people. The high burden of communicable and non-communicable diseases like malaria, HIV, tuberculosis, Lassa fever and diabetes as well as weak and under-resourced health systems, high levels of poverty, poor housing, limited access to clean water and sanitation, inadequate transport and energy infrastructure, and high population mobility would inevitably result in far more devastating economic, social and health fall-outs from the pandemic in Africa3. This near-inevitability of disproportionate COVID-associated social, health and economic adversities even if some African countries end up with relatively small total numbers of confirmed cases is because the huge health system deficits, weak national economies, and lower standards of living far outweigh all of the hypothesized advantages from having younger populations and hotter climatic conditions4.

Political Economy of Exclusion: State-Based Incitement of Intolerance as a Distraction from a Downturn in the Economy

AbstractMiddle East scholars have traditionally attributed the survival of monarchs in the Gulf to the use of financial appeasements fueled by oil revenues. With rampant political insecurity in the region and the revolutionary fervor present after the Arab Spring, leaders have gone beyond the traditional rentier state system to ensure political survival by playing on the sentiments of sectarianism and identity politics. This paper argues that religious sectarianism is not only a question of attitudes and sentiments toward a religious minority but also a politically motivated state mechanism used to maintain the status quo and ensure an extended legitimation of power. We argue that the state often capitalizes on people's fear of economic adversities to incite sectarian exclusions of religious minorities, this is especially evident in times of economic hardships. With survey data from the Arab Barometer, we examined such political psychology in Saudi Arabia in 2011, at the onset of the Arab Spring. We found that Sunni Muslim sentiments of sectarian exclusion toward the Shi‘a minority could be attributed to not just religiosity but also state crafted incitement by the Saudi government. In particular, our results show that state-based sectarian intolerance was in part fueled by the government's scapegoating of the Shi‘a communities during times of economic downturns.

Food-related well-being in times of crisis: Conceptual considerations and empirical findings for Syrian refugees in Germany

Migration to a new country generally entails a variety of social and economic adversities, often reflected in food practices. This paper aims to explore the hedonic dimension of well-being in a food context among a diasporic Syrian community in Stuttgart, Germany. A conceptual framework that integrates the three aspects of well-being (hedonic, psychological and social) with goals for food consumption (functional, symbolic and hedonic) was developed as a guide for the exploration. The research design used semi-structured interviews with 34 Syrian refugees and content-based analysis to obtain a detailed and profound understanding of the relational links between food and well-being. Findings reveal the affective and cognitive components of hedonic well-being and the overall perception of a good food-related life concerning food purchasing, preparation, eating and post-eating. Satisfaction in food-related life was found to be associated with food availability and accessibility, physical health and body functioning, positive emotions, sensory experience, social relationships and overall life satisfaction. The insights gained from this research help to elucidate the concept of food-related well-being in the case of conflict and displacement and to find strategies to promote the well-being of refugees.

Children facing natural, economic and public health crisis in Europe: The risks of a predictable unpredictability.

This opening article for the volume dedicated to the diversity of paediatric healthcare systems in Europe, discusses the topic of children facing natural, economic, and public health crises in Europe. The natural and economic adversities and public health crises, which have repeatedly stormed the globe during the past twenty years, have often unveiled a low degree of self-sufficiency and a high degree of unpreparedness by European countries. It is always the case that the most vulnerable take the brunt, and these adverse events have shown their effects and a negative direct impact particularly on the population aged 0–18 years, with important implications for families and communities. The article discusses a rational approach to properly confront future public health emergencies and crises in general. The authors stress the concept that such approaches should be built on past negative experiences, in order to explore, identify, and make clear which are the priorities governing the disaster management activities at all levels in this population group. The authors conclude that safeguarding the health of children could be effectively accomplished by developing adequate, shared emergency management strategies. Improving pediatric preparedness approaches with the use of emergency measures and ongoing collaboration will facilitate a better and more efficient response, able to effectively care for the needs of children in actual crises.

Exploración de instrumentos que evalúan recursos resilientes en población infantil argentina

Las adversidades sociales, económicas, físicas y psicológicas a las que están expuestos algunos grupos poblacionales infantiles, comprometen seriamente su desarrollo y desempeño, restándoles bienestar y calidad de vida. En los últimos años, se ha otorgado gran relevancia a los estudios dedicados al concepto de resiliencia y su medición por el aporte que este constructo ha provisto para entender la forma en que los individuos pueden sobrellevar las situaciones de crisis e infortunio y aun salir fortalecidos a pesar de las circunstancias. La identificación y el diagnóstico de los recursos resilientes se ha vuelto entonces una meta de gran significación para la disciplina psicológica. El objetivo de este estudio fue sistematizar la información referida a instrumentos de medición creados y validados en los últimos años para la evaluación de fortalezas o recursos resilientes en niños de la Argentina. Para la recolección de datos, se analizaron diferentes estudios científicos, entre ellos artículos de revistas, tesis de grado y posgrado, identificando así 17 instrumentos de medición para evaluar recursos resilientes en el periodo de la niñez. Todos ellos presentan propiedades psicométricas apropiadas y permiten explorar de manera válida y confiable la presencia de numerosos recursos resilientes en los niños argentinos.

Associations Between Two Domains of Social Adversity and Recovery Among Persons with Serious Mental Illnesses Being Treated in Community Mental Health Centers

As mental health services are increasingly embracing the recovery model, we conducted a study to better understand how social adversity impacts recovery. We also examined how associations between social adversity and recovery are influenced (moderated or mediated) by symptom severity. Data on seven social adversity measures, eight recovery measures, and symptom severity were collected from 300 English-speaking participants, ages 18-65years, with a diagnosis of a psychotic or mood disorder, from five community mental health agencies in diverse neighborhoods in Washington, D.C. We employed standard correlation, exploratory factor analyses, analysis of variance, and hierarchic regression procedures. Diagnostic category and gender impacted Home Environment Adversities (e.g., food insecurity, perceived neighborhood disorder), the diagnostic category-by-gender interaction influenced Social and Economic Adversities (e.g., years of education and income), and gender affected Recovery. Controlling for diagnostic category and gender, Social and Economic Adversities accounted for 1.7% of variance in Recovery, while Home Environment Adversities accounted for 8.6% (their joint influence was 3.4%). Although symptom severity did not moderate these associations, it partially mediated the effect of Social and Economic Adversities on Recovery, and substantially mediated the effect of Home Environment Adversities on Recovery. The extent to which patients with serious mental illnesses experience recovery may be meaningfully influenced not only by symptoms, but by their social and environmental circumstances.

Temporal decomposition of life years lived with disability in India: a growing demographic concern

BackgroundTo draw optimal benefits of the demographic dividend, healthy life years of the young adults is a growing concern in India. Rising prevalence of chronic non-communicable diseases among the younger population is responsible for increasing the life years lived with disability among them and for affecting their productivity in turn. This study measures the disability burden in various Indian sub-populations and assesses the contribution of disability to the change in person years lived with a disability during 2001–11.MethodsData from the Census of India, 2001 and 2011 was used for estimating the age distribution and disability prevalence among males and females. The Sample Registration System was used for age-specific mortality rate to calculate the life table for 15 states in India. Life years Lived with Disability (LLD) were estimated using the Sullivan method. The extension of Arriaga method was used to decompose change in life years lived with disability into Mortality and Disability Effect (ME and DE, respectively). Positive ME explains improvement in life years due to decline in mortality rate and a negative DE explains a decline in disability incidence in 2001–11.ResultsAt national level, the disability prevalence has increased from 2001 to 2011. The prevalence of disability and the share of LLD to Life Expectancy (LE) is higher for males. High and medium fertility states scored highest on living with disability to LE ratio and measured DE in the decomposition analysis. At the national level, the DE increased in the age groups of 20–35 years. It was higher among the females. The states that are in the advanced stages of demographic transition show a negative DE.ConclusionThe study highlights expansion of DE in prime productive years of life, especially among females, in medium and high fertility states. Decline in skilled employment and productivity can be two major economic adversities due to increasing DE in working ages. Disability among young and working age population needs to be prioritised as most of the Indian states stand at crucial stages of demographic transitions.

The relationship between disability and suicide: prospective evidence from the Ten to Men cohort

People with disabilities often face a range of social and economic adversities. Evidence suggests that these disadvantages result in poorer mental health. Some research also indicates that people with disabilities are more likely experience thoughts about suicide than people without disability, although most of this research is based on small cross-sectional samples. We explored the relationship between self-reported disability (measured at baseline) and likelihood of reporting thoughts of suicide (measured at follow up) using a large longitudinal cohort of Australian males. A logistic regression model was conducted with thoughts of suicide within the past 12 months (yes or no) as the outcome and disability as the exposure. The models adjusted for relevant confounders, including mental health using the SF-12 MCS, and excluded males who reported thoughts of suicide at baseline. After adjustment, there was a 1.48 (95% CI: 0.98-2.23, P = 0.063) increase in the odds of thoughts of suicide among men who also reported a disability. The size of association was similar to that of being unemployed. Males reporting disability may also suffer from thoughts of suicide. We speculate that discrimination may be one explanation for the observed association. More research on this topic is needed.