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Biomedical subjects

George S Everly

Publications and source records attributed to George S Everly.

At least 19 recordsLinked to original sources
PubMed2006

Local public health workers' perceptions toward responding to an influenza pandemic.

BACKGROUND: Current national preparedness plans require local health departments to play an integral role in responding to an influenza pandemic, a major public health threat that the World Health Organization has described as "inevitable and possibly imminent". To understand local public health workers' perceptions toward pandemic influenza response, we surveyed 308 employees at three health departments in Maryland from March-July 2005, on factors that may influence their ability and willingness to report to duty in such an event. RESULTS: The data suggest that nearly half of the local health department workers are likely not to report to duty during a pandemic. The stated likelihood of reporting to duty was significantly greater for clinical (Multivariate OR: 2.5; CI 1.3-4.7) than technical and support staff, and perception of the importance of one's role in the agency's overall response was the single most influential factor associated with willingness to report (Multivariate OR: 9.5; CI 4.6-19.9). CONCLUSION: The perceived risk among public health workers was shown to be associated with several factors peripheral to the actual hazard of this event. These risk perception modifiers and the knowledge gaps identified serve as barriers to pandemic influenza response and must be specifically addressed to enable effective local public health response to this significant threat.

Adult↗
PubMed2006

Effects of medical crisis intervention on anxiety, depression, and posttraumatic stress symptoms: a meta-analysis.

A meta-analysis of 11 studies (N=2124) investigating the impact of individual crisis intervention with medical patients yielded a significant, overall moderate effect size, d=0.44. The strongest effect of individual crisis intervention was on posttraumatic stress symptoms (d=0.57) and anxiety symptoms (d=0.52). Specific moderating factors, such as single versus multiple sessions, single versus multiple components of intervention, and level of interventionists' training, were also analyzed. In sum, the results support highly trained interventionists continuing to provide multi-session interventions in order to mitigate posttraumatic symptomatology following traumatic events.

Anxiety Disorders↗
PubMed2006

An assessment of the construct distinctiveness of stress arousal and burnout.

This study examined the construct and discriminant validity of stress arousal and burnout as measured on the Stress Arousal Scale and the multidimensional role-specific version of the Maslach Burnout Inventory, respectively. The analyses utilized data from 148 individuals randomly selected from a database of 563 respondents to a larger study. The sample responded to a survey sent to members of the American Institute of Certified Public Accountants (AICPA). Sample size used in this study fell within Loehlin's 1992 prescription that for confirmatory factor analysis with two to four factors, a minimum of 100 to 200 cases should be collected. Forty-six respondents indicated that they were partners, principals, or sole practitioners in accounting firms, and 103 indicated that they were staff members (juniors, seniors, or managers). Latent variables were first constructed for the stress arousal and burnout factors. Confirmatory factor analysis was then conducted on the scale data to assess whether the factors would load on their respective underlying theoretical constructs. Finally, a nested model constraining stress arousal and burnout to load on one underlying construct was tested against the hypothesized two-factor model. The results indicated good model fit for the two-factor model and a significant loss of fit for the one-factor model, thus providing strong support for the conceptualization of stress arousal and burnout as distinct constructs.

Accounting↗
PubMed2006

Establishing evidence-informed core intervention competencies in psychological first aid for public health personnel.

A full-scale public health response to disasters must attend to both the physical and mental health needs of affected communities. Public health preparedness efforts can be greatly expanded to address the latter set of needs, particularly in light of the high ratio of psychological to physical casualties that often rapidly overwhelms existing mental health response resources in a large-scale emergency. Psychological first aid--the provision of basic psychological care in the short term aftermath of a traumatic event--is a mental health response skill set that public health personnel can readily acquire with proper training. The application of psychological first aid by public health workers can significantly augment front-line community-based mental health responses during the crisis phase of an event. To help achieve this augmented response, we have developed a set of psychological first aid intervention competencies for public health personnel. These competencies, empirically grounded and based on best practice models and consensus statements from leading mental health organizations, represent a necessary step for developing a public health workforce that can better respond to the psychological needs of impacted populations in disasters.

Clinical Competence↗
PubMed2006

Principles and practical procedures for acute psychological first aid training for personnel without mental health experience.

Most authorities agree that mass disasters leave in their wake a need for some form of acute mental health services. However, a review of current literature on crisis intervention and disaster mental health reveals differing points of view on the methods that should be employed (Raphael, 1986; NIMH, 2002). Nevertheless, there appears to be virtual universal endorsement, by relevant authorities, of the value of acute "psychological first aid" (American Psychiatric Association, 1954; USDHHS, 2004; Raphael, 1986; NIMH, 2002; Institute of Medicine, 2003; WHO, 2003; DoD/VAPTSD, 2004; Ritchie, et al., 2004; Friedman, Hamblin, Foa, & Charney, 2004). Psychological first aid (PFA), as an acute mental health intervention, seems uniquely applicable to public health settings, the workplace, the military, mass disaster venues, and even the demands of more well circumscribed critical incidents, e.g., dealing with the psychological aftermath of accidents, robberies, suicide, homicide, or community violence. In this document, we shall introduce the notion of psychological first aid (PFA) as one aspect of a psychological continuum of care, offer a rudimentary definition of PFA, and provide the reader with a practicalframework for its implementation utilizing the individual psychological first aid (iPFA)format. The goal of this paper is to better prepare public health, public safety, and other disaster response personnel who do not possess formal clinical mental health degrees or specialized training to provide iPFA services to primary and secondary disaster victims.

Clinical Competence↗
PubMed2006

Expanding disaster mental health response: a conceptual training framework for public health professionals.

The available research literature suggests that in disasters, individuals presenting acutely with psychologically-related complaints tend to outnumber those presenting with physical symptoms directly stemming from the injury-causing agent or event. This acute "mental health surge" can rapidly overwhelm existing community mental health resources, especially in the context of terrorism. Training professionals from outside the traditional mental health workforce in basic psychological crisis intervention may promote more efficient use of mental health services through a gatekeeper process of early intervention and appropriate referrals to mental health specialists. With their experience in patient and client services at the community level, public health professionals represent a cohort well-suited for training in and delivery of acute mental health services in disasters. In this paper, we outline a conceptual model and rationale for training public health professionals in basic crisis-oriented mental health functions (psychological first aid) in order to augment community-based mental health services for affected populations in a disaster.

Clinical Competence↗
PubMed2006

Is there a duty for private employers to provide emergency mental health care services?

This article presents a discussion of whether employers in private companies have a duty to provide an emergency action plan with a mental health component for its employees. It discusses basic negligence concepts and focuses mainly on the "duty of care" component of negligence. It then applies the negligence concepts to private employers and discusses how private companies arguably might have a duty under the laws of negligence to provide employees with an emergency action plan, specifically a plan including mental health provisions.

Disaster Planning↗
PubMed2005

Applying educational gaming to public health workforce emergency preparedness.

From natural disasters to terrorism, the demands of public health emergency response require innovative public health workforce readiness training. This training should be competency-based yet flexible, and able to foster a culture of professional and personal readiness more traditionally seen in non-public health first-response agencies. Building on the successful applications of game-based models in other organizational development settings, the Johns Hopkins Center for Public Health Preparedness piloted the Road Map to Preparedness curriculum in 2003. Over 1500 employees at six health departments in Maryland have received training via this program through November 2004. Designed to assist public health departments in creating and implementing a readiness training plan for their workforce, the Road Map to Preparedness uses the core competencies of the Centers for Disease Control and Prevention for all public health workers as its basic framework.

Disaster Planning↗
PubMed2005

Applying risk perception theory to public health workforce preparedness training.

Since 9/11, public health has seen a progressive culture change toward a 24/7 emergency response organizational model. This transition entails new expectations for public health workers, including (1) a readiness and willingness to report to duty in emergencies and (2) an ability to effectively communicate risk to an anxious public about terrorism or naturally occurring disasters. To date, however, research on readiness education for health department workers has focused little attention upon the risk perceptions that may influence their willingness to report to duty during disasters, as well as their ability to provide effective emergency risk communication to the public. Here, we apply risk perception factors to explore the potential barriers and remedies to effective public health workforce emergency response.

Attitude of Health Personnel↗
PubMed2005

Identification and evaluation of mental health and psychosocial preparedness resources from the Centers for Public Health Preparedness.

An exemplar group of disaster mental health subject matter experts was formed as part of the CDC Center for Public Health Preparedness program to develop a "toolkit" of relevant CPHP disaster mental health training and education curricula and resources. The group developed a charter, compiled relevant CPHP training materials, developed an objective review template, and collectively reviewed the assembled resources. Curricular reviews were presented at a March 2005 meeting where an asset matrix was developed to categorize and compare the training and education curricula and resources. This article describes findings and next steps for toolkit development and refinement. Some recommendations for the toolkit identified thus far are to develop standardized disaster mental health nomenclature, add training exercises to the array of CPHP training and education resources, develop disaster mental health competencies for public health workers, add more advanced trainings to the current repertoire, and add resources to the toolkit during the coming years. The group also plans to disseminate the mental health/psychosocial preparedness toolkit to practice partners engaged in training disaster response personnel.

Disaster Planning↗
PubMed2005

Fostering human continuity: an essential element in workplace crisis intervention.

News from throughout the world illustrates how disasters are impacting people during their commute and at the workplace. Now more than ever employers must ensure that personnel have the tools to deal with the impacts of these critical events. This article outlines how organizations can build psychological infrastructure in their corporate culture to foster resilience in the workplace.

Crisis Intervention↗
PubMed2005

Integration of cognitive and personality-based conceptualization and treatment of psychological trauma.

In the wake of the numerous terrorist attacks and horrific natural disasters that have occurred beginning on September 11, 2001, there has been increased interest in the effects of trauma, including posttraumatic stress disorder (PTSD). The purpose of this article is to provide an overview of a synergistic multicomponent approach to therapy that incorporates the integrated use of cognitive and personality-guided approaches to conceptualizing and treating psychological trauma. With Millon's personality classification system serving as a foundation, a case example is provided along with an explanation of the therapeutic stages beginning with establishing the therapeutic alliance to decreasing hyperarousal to restoring assumptive worldviews.

Attitude to Health↗
PubMed2004

PTSD reactions and functioning of American Airlines flight attendants in the wake of September 11.

The authors explore the psychological reactions and functional coping responses of American Airlines (AA) flight attendants, a unique at-risk group of people in the war on terrorism, in the aftermath of the September 11 attacks. Demographic characteristics and standardized questionnaires, including the Posttraumatic Stress Disorder Checklist and the Psychotherapy Outcome Assessment and Monitoring System--Trauma Version, were sent in June 2002 to approximately 26,000 AA flight attendants. Of the 2050 respondents, 18.2% reported symptoms consistent with probable posttraumatic stress disorder (PTSD). Those living alone were 1.48 times more likely to have a probable PTSD diagnosis than those living with someone else. Age or years of service as a flight attendant did not predict probable PTSD; however, marital status did. Substance abuse was not endorsed as a coping strategy. Given the traumatic events experienced by AA flight attendants, and persistent threats of future terrorist attacks, these results reveal that additional assessment and treatment interventions for stress-related symptoms in this population seem warranted.

Adaptation, Psychological↗
PubMed2004

PTSD reactions and coping responses of East Coast and West Coast American Airlines flight attendants after September 11: a possible psychological contagion effect?

Psychological reactions and functional coping of East Coast and West Coast-based flight attendants were compared after the attacks on September 11. Demographics and standardized questionnaires were sent in June 2002 to approximately 26,000 flight attendants. The 2,050 returned surveys were separated into East Coast-based flight crews (513 from Boston, New York, and Washington, DC) and West Coast-based flight crews (353 from Los Angeles and San Francisco). Despite demographic differences between the flight crews, most notably that the East Coast members were more than twice as likely to know someone who perished in the wake of September 11, there was no difference between them regarding probable PTSD (19.1% and 18.3%, respectively) or life functioning. We suggest that a psychological contagion effect occurred in this at-risk group of workers in the war on terrorism. Public health implications, including multicomponent treatment interventions, are suggested.

Adaptation, Psychological↗
PubMed2004

Psychiatry and terrorism: the profession's role in disaster response planning.

While America wages the "war" on terrorism and endeavors to protect the physical safety of its citizens, it is imperative to plan for the population's mental health needs in future terrorist/disaster scenarios. The importance of psychiatry's potential role in preparing the community for the psychological impact of terrorism is underscored against the historical backdrop of the field being "carved out" from the organization, delivery, and financing of health services in our society. A practical framework is offered for designing an organization's mental health disaster plan, including recommendations for strategic infrastructure and tactical response capabilities. Finally, the unique features of clinical practice with disaster victims are noted, including intra-clinician conflicts between professional/community interests and personal/family obligations during acute disaster events.

Disaster Planning↗
PubMed2004

Pastoral crisis intervention: a word of caution.

Pastoral crisis intervention may be thought of as the functional integration of crisis intervention and pastoral support. In effect, the practice of pastoral crisis intervention largely represents the use of faith-based interventions refined and augmented through the use of an emergency mental health delivery context. The value of pastoral crisis intervention seems apparent in situations involving death, serious injury, mass disasters, and cataclysmic events such as war. However, as with any form of crisis intervention, or even psychotherapy, there is a potential for harm. This paper explores this notion.

Crisis Intervention↗
PubMed2003

Pastoral crisis intervention in response to terrorism.

Pastoral crisis intervention may be thought of as the functional integration of crisis intervention and pastoral support. In effect, the practice of pastoral crisis intervention largely represents the use of faith-based interventions refined and augmented through the use of an emergency mental health delivery context. The value of pastoral crisis intervention seems apparent in situations involving death, serious injury, mass disasters, and cataclysmic events such as war. Nowhere, however, is pastoral crisis intervention potentially more useful than in response to real or threatened terrorism.

Community Mental Health Services↗