Auswahl der wissenschaftlichen Literatur zum Thema „Cover-19 pandemic“

<p class="abstract">Measures to be taken by the clinicians involved in Otology surgery in light of the recent COVID-19 pandemic. Current finding about COVID-19 infection and its relation with SARS-CoV 2 virus is evaluated and possible safety measure guidelines to be taken while doing Otological procedures is reviewed. Wearing PPE kit (N95 mask, double gloves, respirator, eye protection, face shield, gown, shoe cover ), limited attendance to essential personnel, using negative pressure room, using double drape system and proper removal of patient drape after rhinology operation reduces the risk of SARS-CoV 2 virus spread via aerosol into the environment. Emergent and Urgent otology surgery need prompt treatment, thus proper COVID-19 protocols should be maintained while doing otology surgery like wearing PPE ( N95 mask, double gloves, respirator, eye protection, face shield, gown, shoe cover ), limit attendance to essential personnel and use negative pressure room are undertaken. Double draping of the operating site is essential while drilling and suctioning and it’s too carried out under the plastic tent to reduce aerosol spread in the environment. Proper removing of the tent setup, including rolling of patient drape is needed to reduce aerosol spread. Otology surgeries should adhere to general guidelines set for high-risk procedures.</p>

This article covers a lot of topic about coronavirus and covid-19 dental implication. Given the wealth of information about coronavirus, this paper attempted to present in different ways. In the first part of this paper, author cover all about coronavirus and in second part, cover dental implications i.e. case selection for dental treatment, before any dental treatment what protocol used in institutions and dental clinics, how to manage staff and students in institutions and dental clinics, treatment wise recommendations and how to manage covid-19 patient either confirmed cases or suspected cases. Lastly,how to change oral medicine and radiology department setup during and after pandemic. What to accept in future and How too little brighter attitude towards this entire pandemic situation

COVID-19 (‘CO' stands for corona, 'VI' for the virus, and 'D' for disease) has been categorized as a pandemic in March 2020 by WHO. Due to this pandemic, the academic institutions were closed on orders by various state and central government agencies of India. The academic institutions were shut down in between the running academic session. Thus the teachers adopted various online modes for conducting classes to cover the syllabus which was pending. With the help of various technological tools like Zoom, Cisco, Google meet, etc., the academic institution could cover their syllabus. This study was performed to study the student’s perception toward the online classes during COVID-19 Pandemic. The study was performed on the present students who are pursuing Hotel management courses at undergraduate and postgraduate levels from various academic institutions of India. Keywords: COVID-19, Academic, Online classes, perception, Hotel management, Institutions.

The article deals with the impact of the COVID-19 pandemic on the financing of the health care system, and the main challenges to the stability of the financial mechanisms of post-pandemic health care development have been identified. The author substantiates the peculiarities of the crisis of health care financing in the conditions of the current pandemic, further economic recession and decreased fiscal sustainability. The global practice of fiscal response to the manifestations of the COVID-19 pandemic has been systematized and the volumes of the corresponding financing in the countries with insurance and budgetary systems of health care financing have been estimated. The article identifies mechanisms for the transformation and expansion of the fiscal space in the context of expanded financing of the growing need for medical care in the face of new epidemic risks in different countries. Most often, the expansion of a country's fiscal space is carried out by: redistributing the existing amount of government expenditure for health care and redirecting funding flows from financing certain types of medical care to financing programs to overcome and combat COVID-19; changes in the priority of government health expenditure to combat COVID-19 compared to other budget expenditures on the social sphere and economic development; and using national reserve funds and emergency funds. It has been found that in the field of health care, the vast majority of countries have reduced the economic and territorial deprivation of all population groups in access to the diagnosis and treatment of COVID-19. The author emphasizes the weaknesses of insurance based and decentralized health financing mechanisms to respond to the growing need for health care and financial stability during the pandemic. Substantiated the necessity to expand the fiscal space needed to cover the fiscal gap in Ukraine caused by the requirement to increase health care financing in response

Background The novel Coronavirus Disease 2019 (COVID-19) pandemic is having a profound impact on global healthcare. Shortages in staff, operating theatre space and intensive care beds has led to a significant reduction in the provision of surgical care. Even vascular surgery, often insulated from resource scarcity due to its status as an urgent specialty, has limited capacity due to the pandemic. Furthermore, many vascular surgical patients are elderly with multiple comorbidities putting them at increased risk of COVID-19 and its complications. There is an urgent need to investigate the impact on patients presenting to vascular surgeons during the COVID-19 pandemic. Methods and analysis The COvid-19 Vascular sERvice (COVER) study has been designed to investigate the worldwide impact of the COVID-19 pandemic on vascular surgery, at both service provision and individual patient level. COVER is running as a collaborative study through the Vascular and Endovascular Research Network (VERN), an independent, international vascular research collaborative with the support of numerous national and international organisations). The study has 3 ‘Tiers’: Tier 1 is a survey of vascular surgeons to capture longitudinal changes to the provision of vascular services within their hospital; Tier 2 captures data on vascular and endovascular procedures performed during the pandemic; and Tier 3 will capture any deviations to patient management strategies from pre-pandemic best practice. Data submission and collection will be electronic using online survey tools (Tier 1: SurveyMonkey® for service provision data) and encrypted data capture forms (Tiers 2 and 3: REDCap® for patient level data). Tier 1 data will undergo real-time serial analysis to determine longitudinal changes in practice, with country-specific analyses also performed. The analysis of Tier 2 and Tier 3 data will occur on completion of the study as per the pre-specified statistical analysis plan.

Abstract Many academics and researchers have responded to the COVID-19 pandemic by forming on-line national and international collaborative groups to rapidly investigate issues of prevention and treatment. This commentary describes the spontaneous formation of an international team of 115 researchers who summarized the literature on safe methods for decontaminating N95 filtering facepiece respirators in response to the supply crisis. The summary reports and fact sheets on the (www.n95decon.org) website have had more than 200 000 unique visits and the organization’s webinars have reached health care professionals from more than 50 countries. The team is extending its mission to cover other personal protective equipment. The success of these collaborations may alter how scientific questions are tackled in the future.

In this paper, the author analyses the impact of the COVID-19 pandemic on internal and external aspects of insurance organizations, and particularly on insurance terms and conditions. The introductory part provides general remarks on the impact of the pandemic on community and economy, also defining the subject of the paper. In the second part, the author explores how insurers responded to new working conditions and behaved in relation to their self-organization and to the public and the insured persons. Particular developments in a macroeconomic and political context relating to covering losses from COVID-19 are also analyzed. The author concludes that a certain delay in making the amendments and supplements to the list of communicable diseases was justified, whereas the main characteristic of extended cover for COVID-19 provided by domestic insurers is not the reimbursement of medical treatment costs but the payment of daily allowance and provision of information and particular services. In addition, the author concludes that wordings used to exclude the risk of communicable diseases may create particular dilemmas as to whether a loss event may be considered insured, depending on the circumstances and time of its occurrence, and depending on the provisions of positive legal regulations.

<p class="abstract">COVID-19 disease was first identified in December 2019 in Wuhan, the capital of China's Hubei province. Amid the ongoing COVID-19 pandemic, India has witnessed a massive surge of coronavirus cases. This study reviews the measures to take by the clinicians involved in rhinology surgery in light of the recent COVID-19 pandemic. The current finding about COVID-19 infection and its relation with severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2) virus is evaluated and possible safety measure guidelines to be taken while doing rhinology procedures is reviewed. The risk of coronavirus 2019 can be largely reduced by wearing personal protective equipment (PPE) kit with powered air purifying respirator, double gloves, eye protection, face shield, gown, shoe covers, limiting attendance to operation theatre, negative pressure room, using negative-pressure otolaryngology viral isolation drape (NOVID) system to cover the patient and proper removal of patient drape after operation. Additionally, low oscillation speeds of microdebrider with continuous suction is associated with low risk of aerosol transmission into the environment. Rhinology and endonasal surgeries are high risk procedures and should adhere to general guidelines set for high-risk procedures. If the proposed protocols are strictly maintained then the risk of getting infected by coronavirus is markedly reduced. In this current scenario is it mandatory to attain the emergent surgical cases with all possible precautions as mentioned and defer the rest of the cases till the pandemic gets over.</p>

The coronavirus (COVID-19) pandemic has severely affected the medical community and stopped the world in its tracks. This review aims to provide the basic information necessary for us, orthopaedic surgeons to prepare ourselves to face this pandemic together. Herein, we cover the background of COVID-19, presentation, investigations, transmission, infection control and touch upon emerging treatments. It is of paramount importance that we should stay vigilant for our patients, our families and ourselves. Adequate infection control measures are necessary during day-to-day clinical work.

The COVID-19 pandemic has brought about unprecedented changes to human lifestyles across the world. The virus and associated social restriction measures have been linked to an increase in mental health conditions. A considerable body of evidence shows that spending time in and engaging with nature can improve human health and wellbeing. Our study explores nature’s role in supporting health during the COVID-19 pandemic. We created web-based questionnaires with validated health instruments and conducted spatial analyses in a geographic information system (GIS). We collected data (n = 1184) on people’s patterns of nature exposure, associated health and wellbeing responses, and potential socioecological drivers such as relative deprivation, access to greenspaces, and land-cover greenness. The majority of responses came from England, UK (n = 993). We applied a range of statistical analyses including bootstrap-resampled correlations and binomial regression models, adjusting for several potential confounding factors. We found that respondents significantly changed their patterns of visiting nature as a result of the COVID-19 pandemic. People spent more time in nature and visited nature more often during the pandemic. People generally visited nature for a health and wellbeing benefit and felt that nature helped them cope during the pandemic. Greater land-cover greenness within a 250 m radius around a respondent’s postcode was important in predicting higher levels of mental wellbeing. There were significantly more food-growing allotments within 100 and 250 m around respondents with high mental wellbeing scores. The need for a mutually-advantageous relationship between humans and the wider biotic community has never been more important. We must conserve, restore and design nature-centric environments to maintain resilient societies and promote planetary health.

The purpose of this study is to examine users ́ opinions regarding the Swedish management of the covid-19 pandemic in two echo chambers, consisting of the comment fields in two ideologically different news pages on Facebook, Aftonbladet and Samtiden. Using a quantitative content analysis in different steps, the study will attempt to answer the following questions: - What opinions are expressed in two eco-chambers regarding the pandemic management in Sweden? -To what extent are these common or not between the echo chambers? The empirical material consists a total of 696 comments which will be analysed and compiled into a result. The result will then be set against two opposing theories, the theory of the Public Sphere and the theory of echo chambers, where these disagree upon whether the two different news pages lead to polarization. Depending on the outcome, the result can be said to be in agreement with one or both of the theories. The result of the study shows that the opinions of the users in the echo chambers are mainly the same which supports the theory of the Public Sphere and the idea of a need for a common consensus in order to maintain a functioning democracy. The opinions concern the subjects Sweden, the Swedish government, the Swedish state epidemiologist Anders Tegnell, the Restrictions and statistic rapports about the death toll in Sweden. The results provide information about the effects of echo chambers in an ongoing pandemic and the overall complexity around the definition of the term.

It deals with the Biosafety Plan of the Department of Social Work - DSS of the Institute of Philosophy, Humanities and Social Sciences - IFCHS of the Federal University of Amazonas - UFAM, prepared by the Planning Commission of the Department of Social Work to the Biosafety Plan's Institute of Philosophy, Human and Social Sciences, instituted by Ordinance nº 5, of June 23, 2020, of the DSS. The presented Biosafety Plan provides guidance on measures to prevent the transmission of COVID-19 which apply to all workplaces and all people in the workplace and which include measures to prevent hygiene and social distance. It aims to preserve lives, aiming to reconcile the return of the presential and remote activities of the DSS / IFCHS, based on surveillance and monitoring, corroborating with the prevention of the spread of the new Coronavirus or Covid-19. Biosafety is understood here as the set of actions aimed at preventing, minimizing or eliminating risks inherent in administrative, teaching, research, extension, innovation, technological development and service provision activities, aiming at the health of human beings, animals , the preservation of the environment and the quality of the results. The plan seeks to cover the various peculiarities of university life, presents guidelines and instructions for the operation and development of classroom activities and distance from professors, administrative staff and students, in the IFCHS space, and, consequently, in the UFAM space. This Plan considers the different approaches for the different sectors of the University, when considering the public service surrounding the department and the institute mentioned and the nature of the activities developed in each sector, in the same way that the “University Biosafety Plan” considers. Federal do Amazonas against the disease pandemic by SARS-COV-2 (COVID-19) ”, approved at the University Council Meeting on July 14, 2020 (Resolution 003/2020 - CONSUNI).

Utilizing the elements described in the previous chapters, this one applies the IPT approach to patients with major depressive disorder in the setting of the Covid-19 pandemic. Major depression is a common sequela of disaster. Major depression is also the disorder for which IPT was first tested and has been most frequently evaluated, and for which it is considered a first line, practice guideline-recommended treatment. Four extended, detailed Covid-19 related case examples cover the three focal IPT problem areas of grief (complicated bereavement), role dispute, and role transition. These cases also underscore the importance of cultural issues in personalizing IPT to the treatment of individuals.

The COVID-19 outbreak has caused a global health emergency and economic slowdown. The negative impact of COVID-19 has mostly been experienced by entrepreneurs. This is because entrepreneurs in the COVID-impacted sectors such as tourism are likely to lose 50% to 80% of their turnover. As a result, businesses around the world need to come up with sustainable and innovative solutions to avoid economic disruptions due to pandemics like COVID-19. To remain sustainable, businesses redirected their production to products and services that contributed to the fight against COVID-19. Thus, businesses adopted modern work practices that are based on deliverable rather than time spent at workplaces. Globally, many companies have turned to ICTs to deliver their products and services to customers using online platforms. This chapter argues that businesses need insurances that cover financial losses due to pandemic outbreaks. Hence, universities need to take the lead in research to advise businesses on the strategies to be undertaken during a crisis like COVID-19.

The introduction sets the stage for the book to follow: it describes the 2020 Covid-19 pandemic; the losses, risks, and life changes it is entailing; and their psychological consequences. A crisis evokes strong, distressing feelings and symptoms. The introduction presents interpersonal psychotherapy (IPT), a proven, time-limited treatment for mood, anxiety, and posttraumatic disorders, as likely to be a helpful response to this crisis. IPT is a life event–based therapy for symptoms due to an overwhelming global series of life events. The brief introduction alerts the reader to the main psychiatric consequences of major life disruption and trauma: anxiety, depression, and posttraumatic stress, which succeeding chapters will cover. It describes the forced switch to tele-psychotherapy and provides a rationale for why interpersonal therapy is likely to benefit many people sustaining these losses.

Journalists play a critical role in the dissemination of health information to the public. This chapter explores the challenges created by COVID-19 for journalists in Pakistan. It also examines how the pandemic has shed light on the disparities and safety risks in the Pakistani journalism and exposed fault lines in journalism practices in the country. The authors randomly selected 50 profiles of journalists from the Khyber Pakhtunkhwa province of Pakistan and analyzed the publicly available posts they created or shared on their profiles (n= 823). They found that the journalists were mainly concerned about their own well-being and the well-being of their families. They received threats for covering COVID-19 related stories. They were not trained enough to cover a health crisis like COVID-19, and therefore, a majority of the journalists did not follow standard operating procedures outlined by the Government of Pakistan. They suggest that the Government of Pakistan view these journalists as essential workers and frame precautions from healthcare organizations.

This chapter aims to analyze the role of leadership and related work factors caused by COVID-19, the impact on employee effectiveness, and workforce performance in the workplace. Several studies have examined the effect of such crises in different sectors and countries that shed an interesting comparison and distinction. Still, there is limited research published on the workplace's impact due to COVID-19 concerning employee productivity. However, most studies highlight different independent variables on employees and the organization's work effectiveness. A limited number of systemic research studies have led to various studies conducted based on new theoretical frameworks. The literature on change management's effectiveness during such a pandemic is not widely available. Future research should cover various factors such as motivation, remuneration, global environment, employee stress, health and safety, and HRM policies. Moreover, demographic variables should be taken into account as studies have briefly found that some age groups are affected differently than others.

Description of metaphorical models’ semantic nature of is one of the urgent tasks in linguistics, because metaphors, firstly, identify key objects, events and spheres of life, and secondly, significantly affect the renewal of lexical and stylistic potential of languages. The article aims to explore the essence of metaphorical rethinking of reality under the influence of key media messages for 2020 and early 2021 year – the COVID-19 pandemic and accompanying risks. Linguistic-stylistic and semantic analysis of media messages allowes to identify metaphors-neologisms – linguistic contexts that are born in our time of destructive virus and other threats, examples of key (frequent) words in these contexts, as well as to clarify the ways to update existing semantic spaces of metaphorical field in modern English. Metaphors in the analyzed newspaper articles are mainly used to describe political and economic events, health and evironmentsl issues, agricultural matters, trade, and occasionally cover cultural and sporting events, however, all semantic topics are interrelated due to the impact of the global risks of our time.

This chapter focuses on the benefits of incorporating asynchronous tasks, activities, components in the teaching of IB English A: Literature Yr. 1. Taking into consideration the unique challenges of the new syllabus, the author shows how asynchronous teaching/learning may enable teachers to cover in depth many literary texts, by running concurrently F2F/synchronous and asynchronous classes. Particular emphasis is placed on how low-immediacy and low-bandwidth tools may contribute to teacher-student and student-student collaboration. The author also reflects on how the use of asynchronous components smoothened the transition to an exclusively online learning environment after the closing of the schools due to the COVID-19 pandemic.

COVID-19 is a pandemic which has spread to all parts of the world. Detection of COVID infection is crucial to prevent the spread further. Contactless healthcare systems are essential which can be implemented with Cloud computing. Privacy and security of the medical image data transferred through untrusted channels cannot be ensured. The main aim is to secure the medical details when transferring them from the end device to the cloud and vice versa using image steganography. The medical lung images are masked under a normal and natural cover images.

Since long before the Covid-19 pandemic emerged in 2020, civic space has been changing all over the globe, generally becoming more restricted and hazardous. The pandemic brought the suspension of many fundamental freedoms in the name of the public good, providing cover for a deepening of authoritarian tendencies but also spurring widespread civic activism on issues suddenly all the more important, ranging from emergency relief to economic impacts. Research partners in the Action for Empowerment and Accountability (A4EA)'s Navigating Civic Space in a Time of Covid project have explored these dynamics through real-time research embedded in civil society in Mozambique, Nigeria, and Pakistan, grounded in a close review of global trends.

The article explores the key vocabulary of 2020 in the network space of Ukraine. Texts of journalistic, official-business style, analytical publications of well-known journalists on current topics are analyzed. Extralinguistic factors of new word formation, their adaptation to the sphere of special and socio-political vocabulary of the Ukrainian language are determined. Examples show modern impressions in the media, their stylistic use and impact on public opinion in a pandemic. New meanings of foreign expressions, media terminology, peculiarities of translation of neologisms from English into Ukrainian have been clarified. According to the materials of the online media, a «dictionary of the coronavirus era» is provided. The journalistic text functions in the media on the basis of logical judgments, credible arguments, impressive language. Its purpose is to show the socio-political problem, to sharpen its significance for society and to propose solutions through convincing considerations. Most researchers emphasize the influential role of journalistic style, which through the media shapes public opinion on issues of politics, economics, education, health care, war, the future of the country. To cover such a wide range of topics, socio-political vocabulary is used first of all – neutral and emotionally-evaluative, rhetorical questions and imperatives, special terminology, foreign words. There is an ongoing discussion in online publications about the use of the new foreign token «lockdown» instead of the word «quarantine», which has long been learned in the Ukrainian language. Research on this topic has shown that at the initial stage of the pandemic, the word «lockdown» prevailed in the colloquial language of politicians, media personalities and part of society did not quite understand its meaning. Lockdown, in its current interpretation, is a restrictive measure to protect people from a dangerous virus that has spread to many countries; isolation of the population («stay in place») in case of risk of spreading Covid-19. In English, US citizens are told what a lockdown is: «A lockdown is a restriction policy for people or communities to stay where they are, usually due to specific risks to themselves or to others if they can move and interact freely. The term «stay-at-home» or «shelter-in-place» is often used for lockdowns that affect an area, rather than specific locations». Content analysis of online texts leads to the conclusion that in 2020 a special vocabulary was actively functioning, with the appropriate definitions, which the media described as a «dictionary of coronavirus vocabulary». Media broadcasting is the deepest and pulsating source of creative texts with new meanings, phrases, expressiveness. The influential power of the word finds its unconditional embodiment in the media. Journalists, bloggers, experts, politicians, analyzing current events, produce concepts of a new reality. The world is changing and the language of the media is responding to these changes. It manifests itself most vividly and emotionally in the network sphere, in various genres and styles.

Emergency Relief (ER) is a Department of Social Services (DSS) funded program, delivered by 197 community organisations (ER Providers) across Australia, to assist people facing a financial crisis with financial/material aid and referrals to other support programs. ER has been playing this important role in Australian communities since 1979. Without ER, more people living in Australia who experience a financial crisis might face further harm such as crippling debt or homelessness. The Emergency Relief National Coordination Group (NCG) was established in April 2020 at the start of the COVID-19 pandemic to advise the Minister for Families and Social Services on the implementation of ER. To inform its advice to the Minister, the NCG partnered with the Institute for Governance at the University of Canberra to conduct research to understand the issues and challenges faced by ER Providers and Service Users in local contexts across Australia. The research involved a desktop review of the existing literature on ER service provision, a large survey which all Commonwealth ER Providers were invited to participate in (and 122 responses were received), interviews with a purposive sample of 18 ER Providers, and the development of a program logic and theory of change for the Commonwealth ER program to assess progress. The surveys and interviews focussed on ER Provider perceptions of the strengths, weaknesses, future challenges, and areas of improvement for current ER provision. The trend of increasing case complexity, the effectiveness of ER service delivery models in achieving outcomes for Service Users, and the significance of volunteering in the sector were investigated. Separately, an evaluation of the performance of the NCG was conducted and a summary of the evaluation is provided as an appendix to this report. Several themes emerged from the review of the existing literature such as service delivery shortcomings in dealing with case complexity, the effectiveness of case management, and repeat requests for service. Interviews with ER workers and Service Users found that an uplift in workforce capability was required to deal with increasing case complexity, leading to recommendations for more training and service standards. Several service evaluations found that ER delivered with case management led to high Service User satisfaction, played an integral role in transforming the lives of people with complex needs, and lowered repeat requests for service. A large longitudinal quantitative study revealed that more time spent with participants substantially decreased the number of repeat requests for service; and, given that repeat requests for service can be an indicator of entrenched poverty, not accessing further services is likely to suggest improvement. The interviews identified the main strengths of ER to be the rapid response and flexible use of funds to stabilise crisis situations and connect people to other supports through strong local networks. Service Users trusted the system because of these strengths, and ER was often an access point to holistic support. There were three main weaknesses identified. First, funding contracts were too short and did not cover the full costs of the program—in particular, case management for complex cases. Second, many Service Users were dependent on ER which was inconsistent with the definition and intent of the program. Third, there was inconsistency in the level of service received by Service Users in different geographic locations. These weaknesses can be improved upon with a joined-up approach featuring co-design and collaborative governance, leading to the successful commissioning of social services. The survey confirmed that volunteers were significant for ER, making up 92% of all workers and 51% of all hours worked in respondent ER programs. Of the 122 respondents, volunteers amounted to 554 full-time equivalents, a contribution valued at $39.4 million. In total there were 8,316 volunteers working in the 122 respondent ER programs. The sector can support and upskill these volunteers (and employees in addition) by developing scalable training solutions such as online training modules, updating ER service standards, and engaging in collaborative learning arrangements where large and small ER Providers share resources. More engagement with peak bodies such as Volunteering Australia might also assist the sector to improve the focus on volunteer engagement. Integrated services achieve better outcomes for complex ER cases—97% of survey respondents either agreed or strongly agreed this was the case. The research identified the dimensions of service integration most relevant to ER Providers to be case management, referrals, the breadth of services offered internally, co-location with interrelated service providers, an established network of support, workforce capability, and Service User engagement. Providers can individually focus on increasing the level of service integration for their ER program to improve their ability to deal with complex cases, which are clearly on the rise. At the system level, a more joined-up approach can also improve service integration across Australia. The key dimensions of this finding are discussed next in more detail. Case management is key for achieving Service User outcomes for complex cases—89% of survey respondents either agreed or strongly agreed this was the case. Interviewees most frequently said they would provide more case management if they could change their service model. Case management allows for more time spent with the Service User, follow up with referral partners, and a higher level of expertise in service delivery to support complex cases. Of course, it is a costly model and not currently funded for all Service Users through ER. Where case management is not available as part of ER, it might be available through a related service that is part of a network of support. Where possible, ER Providers should facilitate access to case management for Service Users who would benefit. At a system level, ER models with a greater component of case management could be implemented as test cases. Referral systems are also key for achieving Service User outcomes, which is reflected in the ER Program Logic presented on page 31. The survey and interview data show that referrals within an integrated service (internal) or in a service hub (co-located) are most effective. Where this is not possible, warm referrals within a trusted network of support are more effective than cold referrals leading to higher take-up and beneficial Service User outcomes. However, cold referrals are most common, pointing to a weakness in ER referral systems. This is because ER Providers do not operate or co-locate with interrelated services in many cases, nor do they have the case management capacity to provide warm referrals in many other cases. For mental illness support, which interviewees identified as one of the most difficult issues to deal with, ER Providers offer an integrated service only 23% of the time, warm referrals 34% of the time, and cold referrals 43% of the time. A focus on referral systems at the individual ER Provider level, and system level through a joined-up approach, might lead to better outcomes for Service Users. The program logic and theory of change for ER have been documented with input from the research findings and included in Section 4.3 on page 31. These show that ER helps people facing a financial crisis to meet their immediate needs, avoid further harm, and access a path to recovery. The research demonstrates that ER is fundamental to supporting vulnerable people in Australia and should therefore continue to be funded by government.