Introduction: Mental health patients are a group of population that has predominantly been stigmatized throughout the centuries. Aim: The aim of the present study was to explore attitudes of health professionals in the emergency department towards the mentally ill. Material and Methods: The sample of the study consisted of 278 health professionals working in Emergency Departments. A questionnaire scale O.M.I. (Opinion about Mental Illness) was used for data collection. Data analysis was performed with the statistical package Statistical Package for Social Sciences (SPSS) ver.22. Results: The correlation of five O.M.I. scale factors there is no statistically significant relationship (p-value> 0.05) with the variables sex and years of employment. Age had a statistically significant relationship (p-value=0.034) with the factor "social integration" and has no statistically significant relationship (p-value> 0.05) with the remaining factors O.M.I. scale ("Social discrimination", "social constraint", "social care" and "ground"). In association with education there is a statistically significant relationship with the agents 'social discrimination'(p-value 0.05) with the "social inclusion"(p-value<0.001) and "social care" specialty.The variable has a statistically significant difference (p-value <0.05) the factor "social distinction” (p-value<0.001) between doctors andnurses, in the "social restriction 'among doctors and nurses and between nurses and other disciplines and the factor "social integration"(p-value<0.001) between physicians-nurses and doctors with other specialties. Conclusions: The statistical analysis of the questionnaires (O.M.I. scale) distributed showed that the variables age, educational level, specialty affect the attitudes and perceptions of health professionals towards the mentally ill (negative stops), which form the stigma of mental illness.

Background: This study investigated patient- and caregiver-related predictors of expressed emotion (EE) toward individuals with schizophrenia in families and halfway houses and yet understudied differential effects across settings.Methods: We included 40 individuals with schizophrenia living with their families (“outpatients”) and 40 “inpatients” in halfway houses and recorded the EE of 56 parents or 22 psychiatric nurses, respectively, through Five Minutes Speech Sample. Each outpatient was rated by one to two parents; each inpatient was rated by two to five nurses. As EE ratings had a multilevel structure, EE predictors were investigated in backward stepwise generalized linear mixed models using the “buildmer” R package. We first fitted models including either caregiver- or patient-related predictors in each setting and finally included both types of predictors. Setting-specific patient-related effects were investigated in interaction analyses. Adjustment for multiple tests identified the most robust associations.Results: In multivariate models including either caregiver- or patient-related predictors, nurses’ higher age, shorter work experience and lower inpatients’ negative symptoms robustly predicted higher emotional overinvolvement (EOI). In the final models including both types of predictors, nurses robustly displayed lower EOI (i.e., reduced concern and disengagement) toward inpatients with higher negative symptoms. Several other features were nominally associated with criticism and EOI in each setting. However, no feature robustly predicted criticism in inpatients and criticism/EOI in outpatients after adjustment for multiple tests. In interaction analyses, higher negative symptoms differentially predicted lower EOI in nurses only.Conclusion: Our findings suggest setting-specific pathogenetic pathways of EOI and might help customize psychoeducational interventions to staff in halfway houses.

Expressed emotion (EE) toward patients with schizophrenia is typically reported to be lower in psychiatric halfway houses than in families. This is the first study directly comparing EE between these settings and investigating the pathways mediating EE differences. We included 40 inpatients in halfway houses and 40 outpatients living with their families and recorded 22 psychiatric nurses’ and 56 parents’ EE, respectively, through Five Minutes Speech Samples. Each inpatient was rated by 2–5 nurses and each outpatient by 1–2 parents. As EE ratings had a multilevel structure, generalized linear mixed models were fitted, adjusting for patient-related confounders and caregiver demographics. Mediatory effects were investigated in multilevel structural equation models. Outpatients were younger, less chronic, and better educated, with higher negative symptoms and perceived criticism than inpatients. Nurses were younger and better educated than parents. Before adjustment, EE rates were equally high across settings. After adjusting for patient-related confounders, emotional overinvolvement was significantly higher in parents. However, after also adjusting for caregiver demographics, only criticism was significantly higher in nurses. Patients’ age, negative symptoms, and perceived criticism and caregivers’ age and sex significantly mediated EE group differences. Our findings highlight pathways underlying EE differences between halfway houses and families and underscore the importance of staff and family psychoeducation.

International cooperation in dealing with epidemics and pandemics was developed significantly during the 20th century. In 1921, following the Spanish influenza pandemic, the League of Nations Health Organization (LNHO) was created, a precursor to the World Health Organization (WHO) which was subsequently established in 1948. The purpose of these international efforts was to coordinate actions in order to improve citizens’ health as well as to prevent and constrain the transmission of dangerous diseases. Their contribution has been particularly important in preventing and protecting against pandemic crises through specific interventions-regulations which set limits and rules. This paper focuses on the contribution of the World Health Organization (WHO) and the League of Nations Health Organization (LNHO) in preventing and responding to major epidemic and pandemic crises over the last hundred years. A focus will be placed on the management of pandemic crises or risks, specifically HIV, cholera (in Yugoslavia in the 1970s), SARS-CoV, H1N1, Ebola, Zika and SARS-CoV2. The purpose of this paper is to highlight the contribution of the WHO and the LNHO in responding to pandemics and dangerous epidemics, by focusing on the political-organizational framework they adopted in terms of international health cooperation and of individual responses-policy measures. International cooperation in dealing with epidemics and pandemics was developed significantly during the 20th century. In 1921, following the Spanish influenza pandemic, the League of Nations Health Organization (LNHO) was created, a precursor to the World Health Organization (WHO) which was subsequently established in 1948. The purpose of these international efforts was to coordinate actions in order to improve citizens’ health as well as to prevent and constrain the transmission of dangerous diseases. Their contribution has been particularly important in preventing and protecting against pandemic crises through specific interventions-regulations which set limits and rules. This paper focuses on the contribution of the World Health Organization (WHO) and the League of Nations Health Organization (LNHO) in preventing and responding to major epidemic and pandemic crises over the last hundred years. A focus will be placed on the management of pandemic crises or risks, specifically HIV, cholera (in Yugoslavia in the 1970s), SARS-CoV, H1N1, Ebola, Zika and SARS-CoV2. The purpose of this paper is to highlight the contribution of the WHO and the LNHO in responding to pandemics and dangerous epidemics, by focusing on the political-organizational framework they adopted in terms of international health cooperation and of individual responses-policy measures.

Purpose: This study systematically searched for differential correlates of criticism vs. emotional overinvolvement (EOI) towards patients with schizophrenia in families and halfway houses, which have only incidentally been reported in previous research. Identified patterns were compared across settings. Methods: We included 40 inpatients with schizophrenia living in halfway houses and 40 outpatients living with their families and recorded the expressed emotion (EE) of 22 psychiatric nurses or 56 parents, respectively, through Five Minutes Speech Samples. Each nurse rated 1–12 inpatients and each inpatient was rated by 2–5 nurses. Each outpatient was rated by one or both parents. As EE ratings had a multilevel structure, weighted Spearman correlations of criticism and EOI with various patient- and caregiver-related characteristics were calculated and compared with Meng’s z-test. Results: Criticism was weakly negatively correlated with EOI in nurses but negligibly in parents. Distinct patterns of significant differential correlates arose across settings. Outpatients’ aggressive behavior and parents’ related burden were mainly associated with higher criticism. Inpatients’ symptoms (agitation/aggression, negative and other psychotic symptoms) and nurses’ burnout (Depersonalization) were mainly associated with lower EOI. Inpatients’ perceived criticism and outpatients’ previous suicide attempts were equally associated with higher criticism and lower EOI (mirror correlations). Finally, various inpatient attributes (older age, chronicity, unemployment and smoking) triggered higher EOI only. Inpatients’ age, psychopathology (esp. agitation/aggression and negative symptoms) and perceived criticism survived adjustment for multiple comparisons. Conclusion: Our findings suggest setting-specific pathogenetic pathways of criticism and EOI and might help customize psychoeducational interventions to staff and families.