Production layout improvement in emergency services: a participatory approach

Volunteer fire department is a service that responds emergency situations in places where there are no military emergency services. These services need to respond quickly, because time is often responsible for the operation success besides work environment and setup time interfere with the prompt response to these calls and care efficiency. The layout design is one factor that interferes with the quick setup. In this case, the spaces arrangement can result in excessive or unnecessary movements; also the equipment provision may hinder the selection and collection of these or even create movement barriers for the workers. This work created a new layout for the emergency assistance service, considering the human factors related to work through the task analysis and workers participation on the alternatives of improvement. The results showed an alternate layout with corridors and minimization of unusable sites, allowing greater flexibility and new possibilities of requirements.     

Improved outcomes following contact with a gambling helpline: the impact of gender on barriers and facilitators

Gambling helplines were developed at a time when evidence for help-seeking was almost entirely based on male gamblers and there is limited evidence that helplines have changed in response to the exponential increase in female gamblers over the past 20 years. The current study aimed to explore the impact of gender on calls to Australian helplines, including caller characteristics, barriers and facilitators to contact as well as call outcomes. We surveyed 170 callers (94% problem gamblers, 61% male) approximately 1 month following their helpline call and found gender differences in terms of age, preferred gambling type, employment and source of referral. Males reported barriers related to pride and problem denial more frequently than females did, and also reported more frequent problems associated with the welfare of others and/or their living arrangements that facilitated their calling. Males and females were equally likely to seek further help from formal, informal and self-help resources. With only 10% of callers not accessing further help, these findings highlight the importance of helplines as a key support for both men and women with gambling problems.     

Les appels abusifs à Police-secours. La responsabilité des usagers mise en cause

Inappropriate calls that clog up emergency switchboards and prevent the emergency services doing their jobs properly, are becoming a growing concern for the professionals concerned. They hold the users of this emergency service responsible for the situation and, more specifically, speak of malicious intentions, incompetence, need for assistance and irresponsibility. The analysis of 3162 emergency calls provides a way of exploring other explanations than those spontaneously adopted by the emergency services, and leads to the conclusion that callers represent only one aspect of the phenomenon, and not necessarily the most important.     

Reflections on Living with Illness, Impairment and Death

This short article calls for new understanding of the experiences of living with illness, impairment and death. It shows clearly, and often painfully, the tensions and contradictions between theory and experience, offering unique insights that hold great potential to help shift the landscape of familiar preoccupations with life, impairment and death.     

Minority status and schooling—John U. Ogbu’s theory and the schooling of ethnic minorities in Europe

This paper discusses the relevance of John U. Ogbu’s cultural‐ecological theory regarding the variability in educational performance of different ethnic minority groups against the background of comparative data on the schooling of ethnic minorities in Europe. Aside from cultural differences and institutional barriers, it addresses the impact of minority group status and community forces on educational achievement. The author calls for more comparative ethnographic research in European countries in order to generate a better understanding of the similarities and differences in educational experiences between various ethnic groups.     

Services Wanted? Understanding the Non-take-up of Social Support at the Local Level

In this study, we investigate why individuals in need of social support refrain from asking for help from social service providers in the third sector. This phenomenon of non-take-up of social support is still underexplored, and our theoretical understanding of it is highly fragmented. Based on psychological, socio-epidemiological, socio-cultural, and public administration research, we distil potential determinants of non-take-up of social support. Based on 55 narratives (individual interviews) and two focus groups (n?=?16) in the Dutch municipality of The Hague, we examine empirical evidence for these determinants. Our results indicate that (perceived) bureaucratic obstacles and the desire to maintain one’s (feeling of) independence are critical barriers to help-seeking behaviour for social support from third sector social service providers. We conclude with a discussion of our findings and their implications for practice and propose new research avenues.     

Motivators and Barriers to Participation of Ethnic Minority Families in a Family-Based HIV Prevention Program

Summary

Involving low-income, ethnic minority families in lengthy HIV prevention programs can be challenging. Understanding the motivators and barriers to involvement may help researchers and practitioners design programs that can be used by populations most at risk for HIV exposure. The present study discusses motivators and barriers to involvement in the Collaborative HIV Prevention and Adolescent Mental Health Project (CHAMP), using data from a sample of 118 families that participated at varying levels in the twelve sessions of the program. Most participants chose motivators that reflect their perceptions of individual and/or family needs (“CHAMP might help me, mine, and other families”), and of characteristics of the program, such as CHAMP staff were friendly, CHAMP was fun. Among barriers to involvement, respondents expressed concerns about confidentiality, and about being judged by program staff. Respondents also reported experiencing many stressful events in their families (e.g., death and violence in the family) that may have been barriers to their involvement. Knowing these motivators and barriers, researchers and practitioners can enhance involvement in HIV prevention programs.     

What Adolescents Seeking Help Teach us About a School-Based Counseling Service

Adolescents are reluctant to seek help, especially those at psychopathological risk. School may represent the ideal setting to intercept teens in trouble by reducing some barriers to help-seeking behavior; despite this, some obstacles remain difficult to overcome. The present study, involving a large sample (N?=?2235) of secondary school students, aims to investigate the effectiveness of a counseling service as part of a multifaceted school-based prevention program. The counseling service is assessed by comparing students who asked for help with their peers in terms of their psychosocial characteristics, risk profiles and perceptions of the strategies that professionals adopt in order to reduce the barriers to individual counseling. Our findings reveal the capacity of individual counseling to serve the most vulnerable adolescents, with the exception of students who might be at risk of school drop-out. The effectiveness of the program implementation theory and the strength of particular strategies used to reduce barriers are discussed.     

“A Very Steep Climb”: Therapists’ Perspectives on Barriers to Disclosure of Child Sexual Abuse Experiences for Men

ABSTRACT

Recent studies indicate that men experience unique barriers to disclosure of child sexual abuse. Blind spots held by mental health providers and social service agencies may inadvertently help produce and sustain these barriers. However, therapists who specialize in treating this population may also hold important insights into the barriers clients face. Because delayed and nondisclosure of child sexual abuse have been associated with negative mental health outcomes for adult survivors, understanding these barriers is critical to improve clinical practice and facilitate help-seeking. Using conventional content analysis, this study examined the perceptions of nine therapists who specialize in the treatment of men who were sexually abused in childhood, many of whom are considered pioneers in the field. Analyses identified nine types of barriers, which were organized into three categories: intrapersonal experience (difficult feelings, lack of language, and self-engagement), social milieu (internalized social stigma, negative responses, social loss or judgment, and masculine identity dissonance), and health care environment (structural barriers, relational challenges with therapists, and unhelpful therapeutic strategies). Implications for future research, clinical training, and clinical practice are discussed.     

Indonesian railway accidents--utilizing Human Factors Analysis and Classification System in determining potential contributing factors

The prevalence of Indonesian railway accidents has not been declining, with hundreds of fatalities reported in the past decade. As an effort to help the National Transportation Safety Committee (NTSC), this study was conducted that aimed at understanding factors that might have contributed to the accidents. Human Factors Analysis and Classification System (HFACS) was utilized for this purpose. A total of nine accident reports (provided by the Indonesian NTSC) involving fatalities were studied using the technique. Results of this study indicated 72 factors that were closely related to the accidents. Of these, roughly 22% were considered as operator acts while about 39% were related to preconditions for operator acts. Supervisory represented 14% of the factors, and the remaining (about 25%) were associated with organizational factors. It was concluded that, while train drivers indeed played an important role in the accidents, interventions solely directed toward train drivers may not be adequate. A more comprehensive approach in minimizing the accidents should be conducted that addresses all the four aspects of HFACS.     

Best practices for emergency shelters that serve male populations

Homeless men represent the majority of homeless people. While federal funding priorities have shifted to permanent housing solutions, quality emergency shelters are vital in communities to help these men. To determine the best practices in emergency shelter delivery to homeless men based on top agency representatives’ opinions. Leaders from 21 emergency shelters that serve single men throughout the U.S.A. were interviewed about their facilities, their opinions on the best practices of emergency shelters, and barriers that single men face in exiting homelessness. The main goal of emergency shelters is to offer a welcoming environment. Emergency shelters try to offer a variety of services on-site, but find it difficult to offer medical and dental services at facilities with smaller budgets. Access to beds, showers, drug and alcohol rehabilitation, case management, and access to medical services are seen as vital to the success of the emergency shelter. These emergency shelters have many services in place to help the single male population. The most important services are ones that address the basic needs of human beings first: food, showers, beds, medical services, and storage. Mental health and breaking substance dependency are also priorities.     

Professional Help-Seeking for Gambling Problems: Awareness,Barriers and Motivators for Treatment

Despite the negative consequences associated with gambling, few problem gamblers seek professional help. This study aimed to examine awareness of professional sources of help and help-seeking behaviour amongst regular and problem gamblers. Australian gamblers (N = 730) were recruited from the general population, multicultural gambling venues, and gambling helplines and treatment services. Surveys measured awareness of professional help services, help-seeking behaviour and motivators and barriers to seeking help. Gamblers demonstrated low awareness of professional help services. Problem gamblers born in Australia or who were divorced were more likely to seek help. Problem gamblers who were reluctant to seek help due to a desire solve the problem on their own and feeling ashamed for themselves or their family pride were more likely to have overcome these barriers to seek help. However, significant barriers related to denial of problem severity and concerns about the ability to access low cost services that cater for multicultural populations predicted a lower likelihood of having sought help. Public education should aim to de-mystify the treatment process and educate gamblers about symptoms of problem gambling to reduce shame, stigma, and denial and encourage help-seeking. Ongoing education and promotion of help services is required to increase awareness of the resources available, including targeted promotions to increase awareness of relevant services among specific populations.     

Does Where I Live Affect Whether I Apply? The Contextual Determinants of Applying for Deferred Action for Childhood Arrivals

The Deferred Action for Childhood Arrivals (DACA) program provides temporary relief from deportation and legal work authorization for eligible undocumented youth in the United States. This study investigates the factors that help or hinder undocumented youth in applying for DACA. We focus on contexts of reception to understand the determinants of DACA applications, as studies of previous legalization programs indicate that the communities in which immigrants live help shape application decisions. Our analysis shows that more immigrant‐serving organizations in a state translate into more applications, that DACA implementation rates are not statistically significantly lower in states with hostile policy climates, and that socioeconomic factors are most significantly related to DACA applications. In identifying the collective factors that influence applying to DACA, we demonstrate that the structural opportunities and barriers present in receiving locales shape undocumented youths’ decisions to regularize their immigration status, which has significant implications for their resulting incorporation trajectories.     

Urban impacts on tropical island streams: Some key aspects influencing ecosystem response

Improving our understanding of the impacts of urbanization on tropical island streams is critical as urbanization becomes a dominant feature in tropical areas. Although the ??urban stream syndrome?? has been successful in summarizing urban impacts on streams, the response of some island streams is different to that expected. Here we review available information on urban impacts to tropical island streams and describe unique responses to urbanization. We identified three key aspects that play particularly important or unique roles in determining tropical-island stream integrity: biotic response to water pollution, movement barriers along the stream network, and altered geomorphology that results in habitat loss. As expected, water pollution negatively impacts stream ecosystems in tropical islands and in some regions impacts can be severe, as untreated wastewaters are directly discharged into streams. While aquatic insects show the expected responses to pollution, other native fauna (e.g., shrimps and fishes) appear to be less impacted by moderate levels of pollution. Movement barriers along the stream network are especially important as much of the tropical island fauna have diadromous (either amphidromous or catadromous) life histories. Most native freshwater mollusks, shrimps, and fishes inhabiting tropical islands are diadromous and depend on unimpeded connections between freshwater and marine environments to complete their life cycles. The presence of these species in urban streams is best explained by longitudinal connectivity rather than by the degree of urban impact. Finally, in streams that remain connected to marine environments, the presence of native shrimps and fishes is strongly related to the physical habitat. Fish assemblages in channelized and severely altered stream reaches are almost completely devoid of native fauna and tend to be dominated by non-native species. In contrast, relatively diverse shrimp and fish assemblages can be found in reaches that retain their physical habitat complexity, even when they are impacted by urbanization. Our understanding of urban impacts on tropical island streams remains limited. However, the identification of key aspects can help us better understand urban impacts on streams in tropical islands, and best focus our management and research efforts to protect these unique ecosystems.     

Dissemination as success: Local emergency management communication practices

Local emergency managers are charged by the U.S. Department of Homeland Security to increase the number of community members with emergency plans and kits. This outcome remains unrealized in part based upon in-depth interviews with 37 emergency managers in eight states revealing that emergency managers conceptualize communication as dissemination rather than as a process of research and evaluation. This study calls for local emergency managers to conduct outcome evaluations of risk communication campaigns to increase public participation.     

Motivators for Seeking Gambling-Related Treatment Among Ontario Problem Gamblers

A random digit dialing telephone survey was used to interview 8,467 adults in Ontario, Canada. The NODS-CLiP was used to identify a representative sample of 730 gamblers (54.3% male, mean age 45.3 years) with possible past year gambling problems in order to explore factors that might affect disordered gamblers’ motivators for seeking gambling-related help. A final sample of 526 gamblers provided useable data on possible reasons for and barriers to seeking help, awareness of services, self-perception of gambling problems and experience with help-seeking. Financial and relationship issues were the most frequently volunteered motivators. However, over two-thirds of the respondents could not think of a reason for seeking help. Gamblers who had self-admitted or more severe problems, who knew how to get help, who were employed and had more education, and who identified possible barriers to seeking help were more likely to suggest motivators, especially financial ones. More research is recommended on gamblers’ trajectory towards recognition of a gambling problem, the process of overcoming specific barriers to treatment, and the role of social advantage (e.g., education and employment), in order to devise educational campaigns that will encourage earlier help-seeking among disordered gamblers.     

Emergency departments and street-involved youth: factors influencing utilization

Homeless youth often have untreated health problems and experience barriers to care. Existing evidence suggests that homeless youth use emergency departments (EDs) more frequently than other youth. We hypothesized that street youth with access to primary care services would be less likely to utilize EDs for health care. Data were drawn from a study of housing security and changes to it over time among 150 youth (16–20 years) recruited from service agencies for street-involved youth. Our findings show that those with access to primary care were actually more likely to use the ED, suggesting that access may encourage further engagement with the health care system. Findings support the need to better understand why access to primary care increases ED use and what could be done to change this pattern.     

Efficacy of a Web‐based Intervention for Concerned Spouses of Service Members and Veterans with Alcohol Misuse

Concerned partners (CPs) of service members and veterans who misuse alcohol face help‐seeking barriers and mental health problems. We used multiple regression to evaluate the efficacy of Partners Connect, a four‐session web‐based intervention (WBI) to address military CPs’ mental health and communication. We randomized 312 CPs to the WBI or a control group. Five months later, WBI CPs reported significant reductions in their anxiety and increases in their social support compared to control CPs. Intervention dose was also associated with improved WBI CP outcomes. Partners Connect appears to fill a need for families who face help‐seeking barriers and provides an alternative to traditional care for those who may not otherwise seek help.     

Contact networks in the emergency department: Effects of time,environment, patient characteristics,and staff role

Emergency departments play a critical role in the public health system, particularly in times of pandemic. Infectious patients presenting to emergency departments bring a risk of cross-infection to other patients and staff through close proximity interactions or contacts. To understand factors associated with cross-infection risk, we measured close proximity interactions of emergency department staff and patients by radiofrequency identification in a working emergency department. The number of contacts (degree) is not related to patient demographic characteristics. However, the amount of time in close proximity (weighted degree) of patients with ED personnel did differ, with black patients having approximately 15 min more contact with staff than non-white patients. Patients arriving by EMS had fewer contacts with other patients than patients arriving by other means. There are differences in the number of contacts based on staff role and arrival mode. When crowding is low, providers have the most contact time with patients, while administrative staff have the least. However, when crowding is high, this differential is reversed. The effect of arrival mode is modified by the extent of crowding. When crowding is low, patients arriving by EMS had longer contact with administrative staff, compared to patients arriving by other means. However, when crowding is high, patients arriving by EMS had less contact with administrative staff compared to patients arriving by other means. Our findings should help designers of emergency care focus on higher risk situations for transmission of dangerous pathogens in an emergency department. For instance, the effects of arrival and crowding should be considered as targets for engineering or architectural interventions that could artificially increase social distances.     

An ecological approach to facilitate successful employment outcomes among people with multiple chemical sensitivity

Many adults with multiple chemical sensitivity (MCS) must prematurely exit the workforce because of the severity of their MCS symptoms, the resulting disability stigma, and their unmet needs for on-the-job accommodations. To help individuals with MCS continue working or re-enter employment, rehabilitation professionals must understand the barriers resulting in unemployment and implement interventions to reduce or remove those barriers. In this article, the Ecological Model of Career Development is presented as a scheme for identifying barriers and implementing rehabilitation interventions to improve the employment outcomes among people with MCS.