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The purpose of this paper is to develop a model to assess and rank the financial risk of a municipal government (“municipality”). Financial risk is the likelihood that a municipality will experience financial distress.

Logistic regression is used with financial indicators to assess the level of financial risk. Then, the municipalities are ranked according to their financial risk. As predictor variables for the regression model, indicators are used that were developed by a Pennsylvania state agency to monitor the financial condition of municipalities.

Financial risk is positively associated with debt service, population, tax effort, and public service on roadways, while negatively correlated with intergovernmental revenues, operating position, user charges, capital outlays, fund balances, and tax revenue concentration. The financial risk model is able to correctly classify up to 99 percent of municipalities as either at risk or not at risk of financial distress.

The financial risk model was developed using data from one state in the USA. Further research is needed to test the model’s application to other states and countries.

Financial risk is on the rise since the Great Recession. This study may be used by municipal managers, citizens, creditors, and regulators to assess and rank the financial risk of a municipality.

This study provides a method of classifying municipalities as either at risk or not at risk of financial distress. Previous models of the financial condition of municipalities do not provide a method of assessing and ranking financial risk.

This paper investigates the financial risk factors associated with fiscal distress in local governments. We hypothesize that fiscal distress is positively correlated with revenue concentration and debt usage, while negatively correlated with administrative costs and entity resources. The regression model results in a prediction of the likelihood of fiscal distress, which correctly classifies up to 91% of the sample as fiscally distressed or not. The model also allows for an analysis of the impact of a change in a risk factor on the likelihood of fiscal distress. A decrease in intergovernmental revenues as a percent of total revenues and an increase in administrative expenditures as a percent of total expenditures have the biggest influences on reducing the likelihood of fiscal distress.

This paper uses survival analysis to investigate fiscal distress in special district governments. We hypothesize that fiscal distress is positively correlated with revenue concentration and debt usage, and negatively correlated with organizational slack and entity resources. Our model addresses differences in district functions, financing and legislation. Our regression model predicts the likelihood of fiscal distress and correctly classifies 93.4 percent of the districts as fiscally distressed or not. The results show that the most important indicator of fiscal distress is a low level of capital expenditures relative to total revenues and bond proceeds. The information needed to predict fiscal distress is publicly available, making our model useful in the prevention, detection, and mitigation of fiscal distress in U.S. districts.

In June 1999, the Government Accounting Standards Board issued Government Accounting Standards Board Statement No. 34 - Basic Financial Statements and Management's Discussion and Analysis for State and Local Governments (GASB 34) to improve the transparency and accountability of governments. This study examines the adoption of GASB 34 in local governments where the state government does not mandate GAAPcompliant financial reporting. The findings show low adoption rates among small, rural, local governments and high adoption rates among large, urban, local governments. Factors such as occupational specialization, government type, and a history of GAAP-compliant financial reporting are positively associated with adoption.

Recent reports by the Institute of Medicine (IOM) signal a substantial yet unrealized deficit in patient safety innovation and improvement. With the aim of reducing this dilemma, we provide an introductory account of clinical error resulting from poorly designed systems by reviewing the relevant health care, management, psychology, and organizational accident sciences literature. First, we discuss the concept of health care error and describe two approaches to analyze error proliferation and causation. Next, by applying transdisciplinary evidence and knowledge to health care, we detail the attributes fundamental to constructing safer health care systems as embedded components within the complex adaptive environment. Then, the Health Care Error Proliferation Model explains the sequence of events typically leading to adverse outcomes, emphasizing the role that organizational and external cultures contribute to error identification, prevention, mitigation, and defense construction. Subsequently, we discuss the critical contribution health care leaders can make to address error as they strive to position their institution as a high reliability organization (HRO). Finally, we conclude that the future of patient safety depends on health care leaders adopting a system philosophy of error management, investigation, mitigation, and prevention. This change is accomplished when leaders apply the basic organizational accident and health care safety principles within their respective organizations.

Interdisciplinary approaches to health education are becoming increasingly common. Here, the authors describe an arts-based approach designed by academics and artists to both supplement the study of mental illness and support the individual mental health of undergraduate and postgraduate university students, by raising the visibility of mental illness in an innovative way.

Through workshops, university students were guided in a sensory and physical way to discuss psychological health and vulnerability. This was followed by the creation of physical representations of mental distress through art pieces.

Students were able to design their own art pieces and discuss mental health issues in an open and creative way. Students reported that the arts-based initiative was beneficial to their practice as future professionals and provided a holistic learning experience. At the same time, artists were able to generate powerful images which facilitated further discussions within the faculty.

This project provides an innovative model for workshops which could be employed to raise the visibility of common mental health disorders among university students while providing a safe space to discuss and support wellbeing. Additionally, variations could be implemented to enhance the teaching of affective disorders within a university curriculum.

This paper presents the results of collaboration between academics and artists, who together generated an innovative way to both support students' mental health and provide an alternative way to supplement experiential learning about common mental health conditions such as anxiety and depression.

When fighting the burden of overweight and obesity, diet remains a powerful preventive factor. The purpose of this paper is to stimulate more efficient interventions on diet change by synthesising knowledge of previous weight loss programmes based on the use of digital devices.

Following the preferred reporting items for systematic reviews and meta-analyses approach, a systematic literature review through five databases was undertaken focussed on the assessment of studies oriented towards diet change that incorporated digital devices including computers, tablets, mobile phones, portable and non-portable tracking devices. In total, 15 empirical studies (2004–2018) were identified and examined for efficacy and presence of theory and behaviour change techniques.

Digital devices supporting weight loss programmes have evolved rapidly over the past 15 years, from reminders using the short message system to self-quantification through mobile applications. Nine studies show a significant difference between conditions, in favour or one (or more) intervention arm. The remaining studies failed to find significance between conditions but were using a comparison with an active intervention, potentially indicating equivalent efficacy. A low level of theory use and use of behavioural techniques was evident.

The literature review is limited to studies that have scientifically evaluated the (potential) weight loss associated with the weight loss intervention. This review could be put into perspective with other complementary research, in particular, qualitative research aimed at exploring participants’ motivations to use (or not) digital devices to lose weight.

Given their low cost and the size of the overweight population, it appears that public health policies could integrate digital devices more strongly in their efforts to combat obesity. Social marketing can add its expertise to medical-based programmes which in return bring their need for more quantitative evaluation of the efficacy of the interventions.

Few previous reviews have examined the extent of the efficiency in digital diet change programmes. The review shows that, in general, digital interventions can support weight loss for adults; however, more studies are required to provide a strong evidence base for efficacy. Given their low cost and the size of the overweight population, public health policies could integrate these devices more strongly in their efforts to combat obesity. A theory-driven social marketing perspective could enhance development ensuring interventions are effective and valued by users.