Prolonged Crisis Research Articles

From COVID-19 to Health System Reform: Qualitative Insights on Resilience and Lessons Learned from Finland

Abstract The pressure of COVID-19 on health system functioning has made policies to strengthen health system resilience a major theme of research. Accordingly, crises like COVID-19 can be seen as windows of opportunity for health system reforms to enhance health system resilience. In Finland, COVID-19 arrived on the eve of a major health system reform. In 2023 running health and social services will be transferred from 309 municipalities to 22 counties. While the reform was framed before the pandemic, we explore how lessons from COVID-19 matter for the future reform. Our results come from interviews of 53 top managers and civil servants in the year one of COVID-19, representing municipalities, municipal healthcare authorities and state agencies. The results offer a lookout to how national and local healthcare leaders view pandemic responses in connection to the future reform. Finland fared well in the pandemic compared to many countries e.g. in terms of excess deaths. However, our results reveal a tension between major issues in managing COVID-19 and implementing the reform. While the data suggest that dealing with a prolonged crisis proved challenging due to lack of trust, communication, and transparency between national and subnational actors in the health system, the dominant lessons learned and needs for reform among the interviewees build upon obvious fixes, such as ensuring supply of PPEs and ICU beds for the next pandemic. While being important in preparedness, these can build a legacy not tackling the root causes of lacking resilience and can be inconsistent with reform goals. The pandemic provides an opportunity to analyse the reformed system from a new viewpoint and may reveal weaknesses not considered in reform planning. Reforms can impact health system resilience in positive and negative ways. While different shocks may open new avenues for system transformation, they can also create path dependencies weakening the systems’ ability to prepare for unknown threats.

COVID-19 and service innovation strategies of tourism and hospitality SMEs in an emerging country

PurposeThis study aims to examine the impact of COVID-19 on tourism and hospitality small and medium-sized enterprises (SMEs) in an emerging country located in Latin America and identifies service innovation strategies adopted by these firms to survive a prolonged crisis.Design/methodology/approachA qualitative investigation was conducted drawing on a framework of imposed service innovation. Data were obtained from in-depth interviews with owners/managers of 20 SMEs in the hospitality and tourism sector in Chile.FindingsFindings show that the effect of COVID-19 on SMEs includes a decline in demand due to lockdowns and restrictions, with minimal government support. Tourism and hospitality SMEs developed different service innovation strategies to confront the crisis, and several businesses were even able to exploit new opportunities for future growth.Originality/valueThe effect of COVID-19 and SMEs' service innovation strategies to confront a prolonged crisis is a topic that is largely unexplored, particularly in the tourism and hospitality sector. The findings contribute to the literature on emerging markets, crisis management and SME innovation in tourism and hospitality. The findings provide managerial implications for SME managers, governments and policymakers.

Why Ukrainians Are Rallying Around Democracy

In democratizing countries it seems to make sense that any prolonged crisis will turn citizens away from democracy, from its "rules of the game," and from the institutions tasked with upholding them. If ever there was such a country, surely it is Ukraine. Long beset by political instability and corruption, it has in recent years seen its crises become biblical: pestilence (in the form of covid-19) and war (in the form of Russian aggression and later the all-out Russian invasion launched on 24 February 2022). Instead of losing confidence in democracy as the best form of government, however, Ukrainian citizens have done the opposite, survey research from the MOBILISE Project reveals a staggering 35 percentage-point rise in Ukrainians' support for democracy over just three years. Ukrainians moved toward greater support for democracy between 2019 and 2022 precisely because ordinary citizens were able to observe democracy in action and working even in the face of major compounding crises.

Normalising Hồ Chí Minh in Vietnamese cinema, 1990–2020: Ideology, popular appeal, and the market economy

The article discusses the representation of Hồ Chí Minh in modern Vietnamese cinema from 1990 to the present. The first feature film on Hồ Chí Minh's life was produced only in 1990, 31 years after his death. Since then, 6 more films have appeared. I explore the reasons why there were no feature films about Hồ Chí Minh before 1990 and why they eventually began to appear. I address the filmmakers’ attempts to reintroduce Hồ Chí Minh, especially to younger generations who know of him only through propaganda depicting him as a celibate paragon of virtue and through viewing his embalmed body in the Mausoleum he had objected to. I argue that these cinematographic projects to promote Hồ Chí Minh to younger Vietnamese have done very little to develop, or even maintain, his personal cult, a cult that the state endeavours to exploit to (re)establish its connection to the people, to overcome a prolonged crisis of legitimacy, and to garner popular support for the continuing leadership of the Vietnamese Communist Party. The market economy and openness to the world have inevitably undermined the Hồ Chí Minh cult and ideological constructs supporting it.

Power, politics and improvisation: Learning during a prolonged crisis.

The COVID-19 pandemic has caught most organizations off guard. They have had to adapt their operations rapidly, and with the pandemic persisting, continuously improvise. While such an external jolt to organizations might unsettle operations, it does not remove the fact that organizations are sites of power relations and political activity. In this article, we examine the influence of power and politics on learning from improvisation, through a qualitative longitudinal case study of an Australian university during COVID-19. We trace improvisations with the use of the social media platform WeChat, which was eventually adopted, after several changes in forms of improvisation, as part of the response to the COVID-19 pandemic. Our study contributes to the literature on learning from improvisation, and explains how different forms of improvisation morph into one another under the simultaneous influence of power relations and learning.

The school education, ritual customs, and reciprocity associated with self-regulating hand hygiene practices during COVID-19 in Japan

BackgroundThe role of social ties, other-regarding preferences, and cultural traits in boosting community resilience and minimizing citizens’ vulnerability to crises such as COVID-19 is increasingly being recognized. However, little is presently known about the possible routes through which such personal preferences and cultural norms pertinent to social behaviors are formulated. Thus, in this paper, factors that can be potentially associated with individuals to self-regulate strict hand hygiene practices before the pandemic, during the state of emergency, and after the state of emergency was lifted in Japan are investigated. Focus is given to the handwashing education in primary school, a cultural practice originating from the old Shinto tradition, and individuals’ reciprocal inclinations. As people in Japan are known to be highly conscious of hygiene in all aspects of their daily life and are less likely to contract an infection, evidence obtained in this specific context could contribute to the better understanding of individuals’ health-related behaviors in general, and during crises in particular.MethodsUsing the data derived from a four-wave nationwide longitudinal online survey, we examined the extent to which elementary school education, childhood cultural experiences at shrines, and individual other-regarding preferences are associated with self-regulating hand hygiene practices prior to the pandemic and people’s efforts to comply with the government-imposed measures aimed at preventing the spread of COVID-19 infection during the state of emergency. We also investigated the long-term trends in the relationships among these factors (i.e., after the abolishment of the state of emergency) using panel data.ResultsOur findings reveal that childhood education and cultural experiences related to handwashing practices, as well as reciprocal inclinations, are significantly associated with Japanese attitudes toward personal hygiene (beyond handwashing practices) prior to, during, and after the state of emergency. In recognition of the possible effects of recall bias and measurement errors, several important attempts to mitigate these issues were made to strengthen the value of our findings.ConclusionsThe importance of school education received during childhood, as well as culture and other-regarding preferences, in the individual attitudes toward hand hygiene in adulthood highlighted in this study contributes to the better understanding of the role that these factors play in the variations in voluntary compliance with strict hand hygiene practices before and during an uncertain and prolonged crisis.

Korean Buddhist International Aid Work: A Critical Comparison of the Join Together Society and the Global Community Association (Good Hands)

This paper critically scrutinizes the history and activities of South Korea’s two largest Buddhist international aid organizations, namely, the Join Together Society, founded in 1991 by Venerable Pomnyun, leader of Korea’s independent Jungto Society order of lay Buddhists, and the Global Community Association (Jiguchon Gongsaenghoe, Good Hands), founded by former Jogye Order president, Venerable Wolju (1935–2021). It examines the origins, organizations, and activities of both organizations, followed by a comparison of their similarities and differences, along with a discussion of their respective relationships to Korean Buddhist mainstream life and the advantages and disadvantages of each. They are significant, not only for the many benefits they have brought to their target communities abroad but also for what they represent to the Korean Buddhist community at home. As the Korean Buddhist establishment continues to grapple with a prolonged crisis of falling membership and loss of relevance within Korea’s increasingly agnostic society, the long-term sustainability of Korean Buddhist international efforts remains an open question. Nevertheless, the two organizations represent new visions for the modes of meaningful Buddhist praxis and engagement with the modern world that have a strong appeal to Korea’s younger, urbanized Buddhist laity. The further support and expansion of such activities by the Buddhist establishment might aid in reversing the current downward trends of belief.

The psychological impact of COVID-19 pandemic on healthcare workers.

BackgroundAs unprecedented and prolonged crisis, healthcare workers (HCWs) are at high risk of developing psychological disorders. We investigated the psychological impact of COVID-19 pandemic on HCWs.MethodsThis cross-sectional study randomly recruited 439 HCWs in Hunan Cancer Hospital via a web-based sampling method from June 1st 2021 to March 31st 2022. Anxiety and depression levels were measured using Hospital Anxiety and Depression Scale (HADS). The Post Traumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) was used to assess the presence and severity of PTSD. Fear was measured by modified scale of SARS. Data were collected based on these questionnaires. Differences in fear, anxiety, depression and PTSD among HCWs with different clinical characteristics were analyzed using a multivariate analysis of variance. The Cronbach's alpha scores in our samples were calculated to evaluate the internal consistency of HADS, fear scale and PCL-5.ResultsThe prevalence of anxiety, depression, and PTSD in HCWs was 15.7, 9.6, and 12.8%, respectively. Females and nurses were with higher fear level (P < 0.05) and higher PTSD levels (P < 0.05). Further analysis of female HCWs revealed that PTSD levels in the 35–59 years-old age group were higher than that in other groups; while married female HCWs were with increased fear than single HCWs. The internal consistency was good, with Cronbach's α = 0.88, 0.80 and 0.84 for HADS, fear scale, and PCL, respectively.ConclusionGender, marital status, and age are related to different level of psychological disorders in HCWs. Clinical supportive care should be implemented for specific group of HCWs.

Fear of COVID-19 Impact on Professional Quality of Life among Mental Health Workers.

Several studies have examined the impact of the COVID-19 pandemic on healthcare workers’ mental health, but only a few have investigated its detrimental effect on the mental well-being of mental health workers (MHWs). Background: The current study aimed to explore the effect of the fear of COVID-19 (FCV-19) on professional quality of life dimensions, namely compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in MHWs above and beyond sociodemographic and professional factors. Methods: Hierarchical linear regression models were employed to examine the relationship of extreme FCV-19 with CS, BO, and STS in MHWs (n = 224), after considering sociodemographic variables as potential confounding factors. Extreme FCV-19 was operationalized as a binary variable with a cut-off score of ≥16.5 considered as extreme fear. Results: We found that extreme FCV-19 in MHWs is linked with increased compassion fatigue (BO and STS), and this relationship is exacerbated by younger age in regard to BO and by female gender concerning STS. CS remains unaffected by severe FCV-19, and it is higher in older participants. Conclusion: Organizational support is required to protect MHWs’ mental well-being and ensure the quality of care they provide during prolonged crises, such as the COVID-19 pandemic. Measures that intensify a sense of safety, protection, and control against COVID-19 infections in mental health services should be included in the recommendations that may reduce BO and STS among MHWs.

The experience of mothering a preterm: a prolonged crisis with the potential for personal growth

ABSTRACT Objective and background The nine months of pregnancy allow mothers to plan for the birth of their child practically and emotionally. A very preterm birth, which is generally unexpected and requires the infant’s stay in the Neonatal Intensive Care Unit (NICU), is perceived as a crisis by most mothers. This study sought to investigate the significance for the mother of the combined experience of a very preterm birth and the infant’s stay in the NICU two-three years after the birth. Methods Using qualitative methodology, semi-structured in-depth interviews were conducted with 13 mothers (age 26–44) whose infants were born at 24–32 weeks. The analysis adopted the approach of multi-level listening to the diverse voices of the interviewees. Results Four core themes emerged: negative feelings about the preterm birth; the NICU experience as a crisis; long-term effects of the very preterm birth and NICU experience; personal growth following the preterm birth and NICU. Discussion In view of the findings, we discuss the meaning of the circumstances surrounding preterm birth on motherhood, and offer recommendations for practitioners.

A lasting crisis affects R&D decisions of smaller firms: the Greek experience

We use the prolonged Greek crisis as a case study to understand how a lasting economic shock affects the innovation strategies of firms in economies with moderate innovation activities. Adopting the 3-stage CDM model, we explore the link between R&D, innovation, and productivity for different size groups of Greek manufacturing firms during the prolonged crisis. At the first stage, we find that the continuation of the crisis is harmful for the R&D engagement of smaller firms while it increased the willingness for R&D activities among the larger ones. At the second stage, among smaller firms the knowledge production remains unaffected by R&D investments, while among larger firms the R&D decision is positively correlated with the probability of producing innovation, albeit the relationship is weakened as the crisis continues. At the third stage, innovation output benefits only larger firms in terms of labor productivity, while the innovation-productivity nexus is insignificant for smaller firms during the lasting crisis.

Depressive Symptoms in Mothers With Infants: The Quantitative Evidence of the Association of COVID-19 Crisis-Related Factors in Japan.

This study explores the depressive symptoms in postpartum women during the coronavirus disease 2019 (COVID-19) crisis in Japan. An online survey conducted from May 31 to June 6, 2020 resulted in 3073 responses obtained from mothers with infants < 12 mo. The point prevalence of the Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 9 was 28.66% for primipara and 25.83% for multipara. Logistic regression analysis indicated a negative association between the COVID-19 crisis and EPDS ≥ 9; specifically, decreased social support and financial concern were identified as risk factors. The COVID-19-related experiences significantly increased the score of each factor of EPDS, ie, anxiety, anhedonia, and depression. During the COVID-19 crisis, the number of mothers who faced depreciation in social support and income had increased. Moreover, spending their perinatal period during the crisis increased the propensity of facing unexpected changes, such as changes of hospitals for delivery, or cancellation of parenting classes. These multiple factors were associated with an elevated risk of depression in postpartum women. In a prolonged crisis, postpartum mental health should be treated carefully with the prevention of infection.

Role of an Integrated Care System during COVID-19 and beyond: a qualitative study with recommendations to inform future development

ObjectiveIntegrated Care Systems (ICSs) have recently been implemented across England to better meet health and social care needs through partnership working between clinical commissioning groups, local authorities, and health and...

Group processes and interoperability: A longitudinal case study analysis of the UK's civil contingency response to Covid‐19

Our case study explored a Local Resilience Forum's (LRF) civil contingency response to COVID‐19 in the United Kingdom. We undertook 19 semistructured ethnographic longitudinal interviews, between March 25, 2020 and February 17, 2021, with a Director of a Civil Contingencies Unit and a Chief Fire Officer who both played key roles within their LRF. Within these interviews, we focused on their strategic level decision‐making and how their relationship with national government impacted on local processes and outcomes. Using a form of grounded theory, our data describe the chronological evolution of an increasingly effective localized approach toward outbreak control and a growing resilience in dealing with concurrent emergency incidents. However, we also highlight how national government organizations imposed central control on aspects of the response in ways that undermined or misaligned with local preparedness. Thus, during emergencies, central governments can undermine the principle of subsidiarity and damage the ways in which LRFs can help scaffold local resilience. Our work contributes to the theoretical understanding of the social psychological factors that can shape the behaviour of responder agencies during a prolonged crisis. In particular, the implications of our analysis for advancing our conceptual understanding of strategic decision‐making during emergencies are discussed.

Networks of culture creatives in Patras: the relevance of cultural lag

ABSTRACT This paper addresses the challenges posed by the early discourse of the creative city in the case of Patras, a regional city of Greece and European Capital of Culture in 2006 before the prolonged economic crisis in Greece. We focus on the relevance and the forms of cultural creation and artistic networking for the creative city rather than on innovation hubs and technological creativity. We develop a qualitative study of culture creatives in the city to examine the potential of local cultural and artistic agents, social groups and institutions to enhance networking and clustering in the urban milieu, which is also influenced or distorted by city planning capacities and politics. The culture management study identifies several constraints and frictions related to the potential transformation of cultural networks to clusters and analyzes the relevance of cultural lag in the literature of creative cities and urban regeneration. The constraints are discussed within a framework of cultural and institutional lag, which characterize city stakeholders. The study identifies practices that enable organizational facilitation and capacity for proactive culture creation, creative networking and potential clustering. Those activities support culture-led socio-economic urban regeneration planning and inspire the potential making of a creative city.

Experience of the eventual model application for logistics infrastructure assets’ location in Ukraine and its regions

Relevance of the problem. Russia's military invasion in Ukraine induced the issue of logistics optimization at the national and regional level. Now, despite the fact of ongoing hostility in Ukraine, it is necessary to build new and optimized logistics system. It is an important component of the country's infrastructure, and its economy`s recovery, which will prevent a prolonged crisis and create the conditions for sustainable development. Problem statement. Conceptual principles of the updated logistics infrastructure building at the regional and national levels require the development of measures for their practical implementation in the process of state reconstruction. This necessitates the development and justification of the algorithm for its application in Ukraine in the future. Analysis of recent research. Analysis of the current position of logistics in Ukraine after the beginning of hostility and Russian aggression has been made. Given that the hostility continues, and there are temporarily occupied territories as well, characterized by the unrated damage and destruction of logistics infrastructure, the official data for the only region completely freed from invaders, namely Kyiv region, has been analyzed. Unsolved parts of the general problem. Thus, quick national logistics infrastructure recovery needs theoretical, methodological and practical justification of the renewed structure at the national and regional level. Study task and objective. The eventual model will be applied in the study to solve the practical task, namely to use the developed methodology and algorithm for selecting potential locations of regional distribution logistics centers to determine their location as the basis of a new logistics map of Ukraine. The main material (study results). Practical adaptation of the developed model for the renewed logistics infrastructure system of Ukraine has been described in the study. Expertise research method has been used to make the territorial binding of the location of regional distribution logistics centers network. On the basis of an expert survey, not only Kyiv, but four other potential locations of regional distribution logistics centers have been identified. It is advisable to redistribute freight flows across the territory of Ukraine through them. They are Odesa, Lviv, Dnipro, and Kharkiv. These centers are the main transport routes connecting Western and Eastern Europe, and Asia. Thus, the distribution model of trade flows and logistics load throughout Ukraine could be forecasted as follows: Central region -&gt; the city of Dnipro; Eastern region the city of Kharkiv; Western region -&gt; the city of Lviv; Southern region -&gt; the city of Odesa; Northern region -&gt; the city of Kyiv. Conclusions. The developed practical algorithm of the renewed system of logistics infrastructure of Ukraine considering its regional features will allow to modernize national economy and its warehouse logistics taking into account foreign experience of similar structural institutions and country`s social-economic characteristics. The proposed and substantiated model with cluster approach has practical topological relationship to specific regions and country in general.

팬데믹시대 선호되는 아이메이크업 이미지에 관한 연구

This study attempted to investigate the trend of eye makeup which has drawn more attention after people started to wear a mask in the pandemic era. For this, 4 most common eye makeup images were suggested, and a questionnaire survey was performed against a total of 398 women in their 10-50s living in Seoul &amp; Gyeonggi, Gwangju &amp; Jeolla and Jeju. The collected data were analyzed by frequency analysis and cross-tabulation analysis, using SPSS 21.0, and the results found the followings: In the advent of the COVID-19 pandemic, lip makeup has been skipped while eye makeup has been more emphasized. In terms of a preferred eye makeup image, ‘natural (57.8%)’ was the highest, followed by ‘classic (24.6%)’, ‘cute (13.1%)’ and ‘sexy (4.5%)’. In other words, a natural image was most preferred. As the COID-19 pandemic becomes a prolonged crisis, more people started to recognize the importance of eye makeup. In fact, 70.4% were positive about the trend and future of eye makeup.

Turning Vulnerability into Resilience during Covid-19: Investigating Indonesian MSMEs Business Resilience Drivers

The Covid-19 pandemic that has spread since the beginning of 2020 is considered a "Black Swan" event because it appears unexpectedly, is difficult to predict and occurs not within the normal expected range and has a very extreme impact. The Covid-19 pandemic brought people to enter an era full of turbulence called VUCA, or stands for "volatile, uncertain, complex and ambiguous". The implementation of social mobility restriction policies to overcome the rate of viral infections led the community to enter a prolonged health, social and economic crisis. One of the worst affected sectors is MSME.In Indonesia alone, MSMEs have a significant role in the economy because they contribute 61.07% of GDP and absorb 97% of the total workforce (Kementerian Kordinator Bidang Perekonomian Republik Indonesia, 2021). However, the MSME Performance survey during the COVID-19 pandemic showed that during the pandemic, 94.69% of businesses experienced a decrease in sales, and 85.42% of MSME respondents also stated that their business was likely to last only one year since the pandemic took place (Lembaga Ilmu Pengetahuan Indonesia, 2020). The results showed that small and medium-sized enterprises (SMEs) are particularly vulnerable to failure in continuous shifts and unpredictable events (Pal et al., 2014), like Covid-19. SMEs are also the most affected in times of crisis and the least prepared of all organizations. Furthermore, the study of How SMEs prepare and respond to emergencies is still not much explored (Sullivan-Taylor &amp; Branicki, 2011). Keywords: MSME Business Resilience, Covid-19, Cost of Technology Adoption, Technology Perceived Usefulness, Government Support

Internal Rebordering in the European Union: Postfunctionalism Revisited

The EU has been under severe strain as a free-travel area. The migration crisis of the mid-2010s and the current Covid-19 pandemic have exerted a negative impact on the freedom of movement in the EU and the undisturbed crossing of internal borders within the Schengen area. Direct effects and long-term consequences of the prolonged crisis have shown that the dynamics of integration, which are determined by spillover effects of transnational processes, are counterposed by a politicization of domestically-embedded issues of security governance. This assumption underpins the postfunctionalist approach to European integration proposed originally by Hooghe and Marks. The tendency towards longstanding derogations from the Schengen regime, termed “internal rebordering,” should be juxtaposed with efforts of the European Commission towards a full restoration of the Schengen area without controls at internal borders. The argument developed in this article holds that internal rebordering has been embedded in the logic of the EU as an area of freedom, security, and justice comprising the Schengen area as its territorial manifestation. The rebordering processes in the EU and in the Schengen area have questioned the principle of “constraining dissensus” underlaying the postfunctionalist approach.

Supporting oneself: The tensions of navigating a prolonged crisis among Spanish youth

Spanish youth’s process of transition to adult life illustrates the complex effects of a prolonged economic crisis that emerged in 2008 and exacerbated an already precarious labour market. In this article, we approach this panorama of social change from the perspective of the young individuals who find themselves immersed in this passage from one crisis to another – from a global economic crisis to COVID-19 – and between two symbolic realities, one marked by individualism and the other by individualisation. Based on a discourse analysis of 20 in-depth interviews and three focus groups with young adults, conducted between 2018 and 2019 for a publicly funded RDI project, we analyse how the process of individualisation tied to a self-sufficient model of human agency may contribute to an increased reliance on individual solutions to social problems. Furthermore, we underline how these individualised pathways involve a dependency on multiple supports which are characterised by a series of tensions. Consequently, we seek to elucidate the manner in which vulnerable young workers navigate, both interpretively and practically, the trials of social life as well as the expectations associated with individualism/individualisation within a context of crisis and uncertainty.