Search results for: basic cardiac life support

Authors: Khadeeja Munawar, Shamsul Haque

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The claim that traumatic events influence the recalled memories and mental health has received mixed empirical support. This study examines the memories of a sample drawn from Pakistan, a country that has witnessed many life-changing socio-political events, wars, and natural disasters in 72 years of its history. A sample of 210 senior citizens (Mage = 64.35, SD = 6.33) was recruited from Pakistan. The aim was to investigate if participants retrieved more memories related to past traumatic events using a word-cueing technique. Each participant reported ten memories to ten neutral cue words. The results revealed that past traumatic events were not adversely affecting the memories and mental health of participants. When memories were plotted with respect to the ages at which the events happened, a pronounced bump at 11-20 years of age was seen. Memories within as well as outside of the bump were mostly positive. The multilevel logistic regression modelling showed that the memories recalled were personally important and played a role in enhancing resilience. The findings revealed that despite facing an array of ethnic, religious, political, economic, and social conflicts, the participants were resilient, recalled predominantly positive memories, and had intact mental health. The findings have clinical implications in Cognitive Behavioral Therapy (CBT). The patients can be made aware of their negative emotions, troublesome/traumatic memories, and the distorted thinking patterns and their memories can be restructured. The findings can also be used to teach Memory Specificity Training (MEST) by psycho-educating the patients around changes in memory functioning and enhancing the recall of memories, which are more specific, vivid, and filled with sensory details.

Keywords: cognitive behavioral therapy, memories, mental health, resilience, trauma

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Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Civil war in Sri Lanka ended a decade ago, leaving thousands of army veterans permanently disabled following lower-limb amputations. Quantifying long-term functional health and psychological wellbeing will inform the development of tailored home-based rehabilitation intervention. Objectives: To assess the long-term health and quality of life of Sri Lankan soldiers with traumatic lower-limb amputation.Methods and Materials: A comparative cross-sectional study was conducted in five districts of Sri Lanka. Using stratified random sample technique, two groups of 85 participants were selected; group 1, community re-integrated male army veterans with unilateral lower-limb amputation, and group 2, age and sex matched normal healthy individuals. Long-term health and quality of life (QoL) outcomes were assessed and compared between the two groups using self-administered Short-Form Health Survey-36 questionnaire (SF-36) previously validated for use in Sri Lanka. Results: Group 1 were active prosthetic users who had undergone amputation > ten years ago (Mean±SD: 21.7±5.9). The most prevalent comorbidities for group 1 and 2 were hypertension and diabetes (22.4% and 30.6% and 9.4% and 9.8%, respectively). In group 1, injury-associated long-term health outcomes included knee osteoarthritis (18.8%), knee pain (20.0%), and back pain (69.4%). Scores of physical health and psychological wellbeing were 53.1 (IQR 64.4- 43.8) and 63.5 (IQR 73.3- 51.4) for each group, respectively. Scores revealed the highest QoL related to social functioning (75 (IQR 87.5- 62.5)) and the poorest aspects of QoL related to general health (40 (IQR 50- 35)). Prevalence of comorbidities was significantly higher, and QoL outcomes were significantly lower among soldiers compared to normal healthy individuals (p<0.05).Conclusion: Higher prevalence of comorbidities, poor physical health, and lower QoL outcomes were more prevalent in soldiers with lower-limb amputation when compared to healthy counterparts.

Keywords: community-based, disability, health outcomes, quality of life, soldiers

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Authors: Chi-Wai Kan, Kam-Hong Chau, Ho-Shing Law

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Wicking property is important for textile finishing and wears comfort. Good wicking properties can ensure uniformity and efficiency of the textiles treatment. In view of wear comfort, quick wicking fabrics facilitate the evaporation of sweat. Therefore, the wetness sensation of the skin is minimised to prevent discomfort. The testing method for vertical wicking was standardised by the American Association of Textile Chemists and Colorists (AATCC) in 2011. The traditional vertical wicking test involves human error to observe fast changing and/or unclear wicking height. This study introduces optoelectronic devices to achieve an automatic Vertical Wicking Tester (VWT) and reduce human error. The VWT can record the wicking time and wicking height of samples. By reducing the difficulties of manual judgment, the reliability of the vertical wicking experiment is highly increased. Furthermore, labour is greatly decreased by using the VWT. The automatic measurement of the VWT has optoelectronic devices to trace the liquid wicking with a simple operation procedure. The optoelectronic devices detect the colour difference between dry and wet samples. This allows high sensitivity to a difference in irradiance down to 10 μW/cm². Therefore, the VWT is capable of testing dark fabric. The VWT gives a wicking distance (wicking height) of 1 mm resolution and a wicking time of one-second resolution. Acknowledgment: This is a research project of HKRITA funded by Innovation and Technology Fund (ITF) with title “Development of an Automatic Measuring System for Vertical Wicking” (ITP/055/20TP). Author would like to thank the financial support by ITF. Any opinions, findings, conclusions or recommendations expressed in this material/event (or by members of the project team) do not reflect the views of the Government of the Hong Kong Special Administrative Region, the Innovation and Technology Commission or the Panel of Assessors for the Innovation and Technology Support Programme of the Innovation and Technology Fund and the Hong Kong Research Institute of Textiles and Apparel. Also, we would like to thank the support and sponsorship from Lai Tak Enterprises Limited, Kingis Development Limited and Wing Yue Textile Company Limited.

Keywords: AATCC method, comfort, textile measurement, wetness sensation

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Authors: Ujjal Chattaraj, Pbharat Saikumar, Thinley Dorji

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Earth is going to be a planet where no further life can sustain if people continue to pollute the environment. We need energy and fuels everyday for heating and lighting purposes in our life. It’s high time we know this problem and take measures at-least to reduce pollution and take alternative measures for everyday livelihood. Biogas is one of them. It is very essential to define and control the parameters for optimization of biogas production. Biogas plants can be made of different size, but it is very vital to make a biogas which will be cost effective, with greater efficiency (more production) and biogas plants that will sustain for a longer period of time for usage. In this research, experiments were carried out only on cow dung and Chicken manure depending on the substrates people out there (Bhutan) used. The experiment was done within 25 days and was tested for different temperatures and found out which produce more amount. Moreover, it was also statistically tested for their dependency and non-dependency which gave clear idea more on their production.

Keywords: digester, mesophilic temperature, organic manure, statistical analysis, thermophilic temperature, t-test

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Authors: Rowena Clemino Alcoba

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Thailand is host to the largest number of refugees in the region. The country has been one of the most accessible points of entry to refugees around the world because it has relatively lenient visa requirements, enabling asylum seekers to enter the country and subsequently search for legal assistance. However, because Thailand is not a signatory to the 1951 Geneva Convention on Refugees which governs the refugee status determination and safeguards several rights of the refugees, there are no national laws or administrative framework on the protection of refugees. Refugees are considered as illegal migrants, and certain groups are permitted to stay temporarily only upon executive discretion. Aside from the documented group of refugees from the Myanmar border, there are many others who came from different parts of the world. They are known as urban refugees believed to be in the thousands and are scattered in the impoverished areas of Bangkok and the suburbs. This study aims to advance understanding of the role of civil society organizations in supporting refugees, with particular focus on urban refugees. Using the method of triangulation in qualitative research, the study investigates the life journey of a refugee family from Pakistan, their difficulties and struggles to survive in perilous situations. The study presents the dynamics of how civil society works and collaborates to fill the gap for much-needed social services. It also discusses the depth and scope of the role of faith actors in the protection and support of this vulnerable sector. The engagement of civil society reveals framework and structure that aims to create long-term impact. The help provided is not merely monetary or material dole-outs but a platform for refugees to integrate with community, develop skills and make productive use of their time.

Keywords: asylum seeker, civil society, faith actors, refugees

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Authors: Z. Goosen, E. J. Cilliers

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Referring to the entire green network within urban environments, at all spatial scales, green infrastructure is considered as an important constituent of sustainable development within urban areas through planning for a healthy environment and simultaneously improving quality of life for the people. Green infrastructure has made its appearance internationally in terms of the infrastructural urban environment focussing on ecological systems and sustaining society while building with nature. Within South Africa, the terminology of green infrastructure has, however, not continuously been entertained, mainly due to more pressing realities and challenges faced within urban areas of South Africa that include but are not limited to basic service provision, financial constraints and a lack of guiding policies and frameworks. But the notion of green infrastructure planning has changes, creating a newfound movement within urban areas of South Africa encouraging green infrastructure for urban resilience. Although green infrastructure is not an entirely new concept within the local context of South Africa, the benefits thereof constantly needs to be identified in order to measure the value of green infrastructure. Consequently challenges faces within urban areas of South Africa, in terms of human and nature, could be restored through focussing on a sustainable green infrastructure approach. This study does not focus on the pressing challenges and realities faced within urban areas of South Africa but rather aims solely on improving a green infrastructure approach within urban areas of South Africa. At the outset, the study will commence by introducing the concept of a green infrastructure approach by means of a local and international comparison. This will ensure an improved conceptual understanding of green infrastructure within a local South African context. The green infrastructure concept will be elaborated on through the inclusion of South African case study evaluations. The selected case studies will illustrate existing green infrastructure implementation within South Africa along with the benefits provided through the implementation thereof in terms of human (the people) and nature (the natural environment). As green infrastructure within South Africa continues to remain a fairly new concept with moderate levels of implementation thereof, room for improving on the approach in terms of implementation and maintenance exist. For this reason, the study will conclude with alternative green infrastructure suggestions and approaches to possibly be enforced within South Africa, led by international best practices.

Keywords: green infrastructure, international best practices, sustainability, urban South Africa

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Authors: Raúl González Muñoz, Essam Shehab, Martin Weinitzke, Chris Fowler, Paul Baguley

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Software applications have become crucial to the aerospace industry, providing a wide range of functionalities and capabilities used during the design, manufacturing and support of aircraft. However, as this criticality increases, so too does the risk for business operations when facing a software failure. Hence, there is a need for new methodologies to be developed to support aerospace companies in effectively managing their software portfolios, avoiding the hazards of business disruption and additional costs. This paper aims to provide a definition of operational software maturity, and how this can be used to assess software operational behaviour, as well as a view on the different aspects that drive software maturity within the aerospace industry. The key research question addressed is, how can operational software maturity monitoring assist the aerospace industry in effectively managing large software portfolios? This question has been addressed by conducting an in depth review of current literature, by working closely with aerospace professionals and by running an industry case study within a major aircraft manufacturer. The results are a software maturity model composed of a set of drivers and a prototype tool used for the testing and validation of the research findings. By utilising these methodologies to assess the operational maturity of software applications in aerospace, benefits in maintenance activities and operations disruption avoidance have been observed, supporting business cases for system improvement.

Keywords: aerospace, software lifecycle, software maintenance, software maturity

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Authors: A. Marais

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A challenging aspect of teaching cello to novice adult learners is finding adequate lesson material and applying relevant teaching methodologies. It could play a crucial role in adult learners' decision to commence or stop taking music lessons. This study contributes to the theory and practises of continuing education. This study is important to lifelong learning, especially with the focus on adult teaching and learning and the difficulties concerning these themes. The research problem identified for this study is we are not aware of adults' life stories; thus, cello lesson material is not always relevant for adult's specific needs for motivation and goals for starting cello lessons. In my experience, an adult does not necessarily want to play children songs when they learn a new instrument. They want material and lessons fitted to adult learners. Adults also learn differently from younger beginners. Adults ask questions such as how and why, while children more readily accept what is being taught. This research creates awareness of adults' musical needs and learning methods. If every adult shares their own story for commencing and continuing with cello lessons, material should be created, revised, or adapted for more individually appropriate lessons. A number of studies show that adults taking music lessons experience a decrease in feelings of loneliness and isolation. It gives adults a sense of wellbeing and can help improve immune systems. The purpose of this research study will be to discover the life stories of adult amateur cellists. At this stage in the research, the life stories of amateur cellists can generally be defined as personal reflections of their motivations for and experiences of commencing and continuing with individual lessons. The findings of this study will contribute to the development of cello lesson material for adult beginners based on their stories. This research could also encourage adults to commence with music lessons and could, in that way, contribute to their quality of life. Music learners become aware of deep spiritual, emotional, and social values incorporated or experienced through musical learning. This will be a qualitative study with a narrative approach making use of oral history. The chosen method will encapsulate the stories of amateur individual adults starting and continuing with cello lessons. The narrative method entails experiences as expressed in lived and told stories of individuals. Oral history is used as part of the narrative method and entails gathering of personal reflections of events and their cause and effects from an individual or several individuals. These findings from this study will contribute to adult amateur cellists' motivations to continue with music lessons and inspire others to commence. The inspiring life stories of the amateur cellists would provide insight into finding and creating new cello lesson material and enhance existing teaching methodologies for adult amateur cellists.

Keywords: adult, amateur, cello, education, learning, music, stories

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Authors: Serhat Tuzun, Tufan Demirel

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Multi-Criteria Decision Making (MCDM) is the modelling of real-life to solve problems we encounter. It is a discipline that aids decision makers who are faced with conflicting alternatives to make an optimal decision. MCDM problems can be classified into two main categories: Multi-Attribute Decision Making (MADM) and Multi-Objective Decision Making (MODM), based on the different purposes and different data types. Although various MADM techniques were developed for the problems encountered, their methodology is limited in modelling real-life. Moreover, objective results are hard to obtain, and the findings are generally derived from subjective data. Although, new and modified techniques are developed by presenting new approaches such as fuzzy logic; comprehensive techniques, even though they are better in modelling real-life, could not find a place in real world applications for being hard to apply due to its complex structure. These constraints restrict the development of MADM. This study aims to conduct a comprehensive analysis of preference methods in MADM and propose an approach based on information. For this purpose, a detailed literature review has been conducted, current approaches with their advantages and disadvantages have been analyzed. Then, the approach has been introduced. In this approach, performance values of the criteria are calculated in two steps: first by determining the distribution of each attribute and standardizing them, then calculating the information of each attribute as informational energy.

Keywords: literature review, multi-attribute decision making, operations research, preference method, informational energy

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Authors: Fernanda Mary R. G. Da Silva, Adriana C. F. Mozzambani, Marcelo F. Mello

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Introduction: Sexual assault against children and adolescents is a public health problem with serious consequences on their quality of life, especially for those who develop post-traumatic stress disorder (PTSD). The broad literature in this research area points to greater losses in verbal learning, explicit memory, speed of information processing, attention and executive functioning in PTSD. Objective: To compare the neuropsychological functions of adolescents from 14 to 17 years of age, victims of sexual violence with PTSD with those of healthy controls. Methodology: Application of a neuropsychological battery composed of the following subtests: WASI vocabulary and matrix reasoning; Digit subtests (WISC-IV); verbal auditory learning test RAVLT; Spatial Span subtest of the WMS - III scale; abbreviated version of the Wisconsin test; concentrated attention test - D2; prospective memory subtest of the NEUPSILIN scale; five-digit test - FDT and the Stroop test (Trenerry version) in adolescents with a history of sexual violence in the previous six months, referred to the Prove (Violence Care and Research Program of the Federal University of São Paulo), for further treatment. Results: The results showed a deficit in the word coding process in the RAVLT test, with impairment in A3 (p = 0.004) and A4 (p = 0.016) measures, which compromises the verbal learning process (p = 0.010) and the verbal recognition memory (p = 0.012), seeming to present a worse performance in the acquisition of verbal information that depends on the support of the attentional system. A worse performance was found in list B (p = 0.047), a lower priming effect p = 0.026, that is, lower evocation index of the initial words presented and less perseveration (p = 0.002), repeated words. Therefore, there seems to be a failure in the creation of strategies that help the mnemonic process of retention of the verbal information necessary for learning. Sustained attention was found to be impaired, with greater loss of setting in the Wisconsin test (p = 0.023), a lower rate of correct responses in stage C of the Stroop test (p = 0.023) and, consequently, a higher index of erroneous responses in C of the Stroop test (p = 0.023), besides more type II errors in the D2 test (p = 0.008). A higher incidence of total errors was observed in the reading stage of the FDT test p = 0.002, which suggests fatigue in the execution of the task. Performance is compromised in executive functions in the cognitive flexibility ability, suggesting a higher index of total errors in the alternating step of the FDT test (p = 0.009), as well as a greater number of persevering errors in the Wisconsin test (p = 0.004). Conclusion: The data from this study suggest that sexual violence and PTSD cause significant impairment in the neuropsychological functions of adolescents, evidencing risk to quality of life in stages that are fundamental for the development of learning and cognition.

Keywords: adolescents, neuropsychological functions, PTSD, sexual violence

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Authors: Ana Luiza Aranha

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This paper contributes to the discussions that consider corruption as a challenge to the establishment of more democratically inclusive societies in Latin America. The paper advocates an intrinsic connection between democratic principles and corruption control – it is only possible to achieve just forms of democratic life if accountability institutions are able to control corruption, and therefore control the political exclusions that it brings. Departing from a non-trivial approach to corruption, and recognizing a gap in democratic theory when thinking about this phenomenon, corruption is understood as the breakdown of the democratic inclusive rule, whereby political decisions are made (and actions were taken) in spite of those potentially affected by them. Based on this idea, this paper proposes a new way of measuring corruption, moving away from usual aggregate measures – such as the Corruption Perception Index – and case studies of corruption scandals. The main argument sustains that corruption is intrinsically connected with the ability to be accountable and to provide public justification for the political conduct. The point advocated is that corruption involves a dimension of political exclusion. It generates a private benefit which is, from a democratic point of view, illegitimate, since it benefits some at the expense of the decisions made by the political community. Corruption is then a form of exclusion based on deception and opacity - for corruption, there is no plausible justification. Empirically, the paper uses the audit reports produced by the Brazilian anti-corruption agency (the CGU - Office of the Comptroller General) in its Inspections From Public Lotteries Program to exemplify how we can use this definition to separate corruption cases from mismanagement irregularities. On one side, there is poor management and inefficiencies, and, on the other, corruption, defined by the implausibility of public justifications – because the public officials would have to publicize illegitimate privileges and undue advantages. CGU reports provide the justifications given by the public officials for the irregularities found and also the acceptance or not by the control agency of these justifications. The analysis of this dialogue – between public officials and control agents – makes it possible to divide the irregularities on those that can be publicly justified versus those that cannot. In order to hold public officials accountable for their actions, making them responsible for the exclusions that they may cause (such as corruption), the accountability institutions fulfil an important role in reinforcing and empowering democracy and its basic inclusive condition.

Keywords: accountability, brazil, corruption, democracy

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Authors: Elisabetta Ceretti, Silvia Bonizzoni, Alberto Bonetti, Milena Villarini, Marco Verani, Maria Antonella De Donno, Sara Bonetta, Umberto Gelatti

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Introduction: Air pollution is a global problem. In 2013, the International Agency for Research on Cancer (IARC) classified air pollution and particulate matter as carcinogenic to human. The study of the health effects of air pollution in children is very important because they are a high-risk group in terms of the health effects of air pollution and early exposure during childhood can increase the risk of developing chronic diseases in adulthood. The MAPEC_LIFE (Monitoring Air Pollution Effects on Children for supporting public health policy) is a project founded by EU Life+ Programme which intends to evaluate the associations between air pollution and early biological effects in children and to propose a model for estimating the global risk of early biological effects due to air pollutants and other factors in children. Methods: The study was carried out on 6-8-year-old children living in five Italian towns in two different seasons. Two biomarkers of early biological effects, primary DNA damage detected with the comet assay and frequency of micronuclei, were investigated in buccal cells of children. Details of children diseases, socio-economic status, exposures to other pollutants and life-style were collected using a questionnaire administered to children’s parents. Child exposure to urban air pollution was assessed by analysing PM0.5 samples collected in the school areas for PAHs and nitro-PAHs concentration, lung toxicity and in vitro genotoxicity on bacterial and human cells. Data on the chemical features of the urban air during the study period were obtained from the Regional Agency for Environmental Protection. The project created also the opportunity to approach the issue of air pollution with the children, trying to raise their awareness on air quality, its health effects and some healthy behaviors by means of an educational intervention in the schools. Results: 1315 children were recruited for the study and participate in the first sampling campaign in the five towns. The second campaign, on the same children, is still ongoing. The preliminary results of the tests on buccal mucosa cells of children will be presented during the conference as well as the preliminary data about the chemical composition and the toxicity and genotoxicity features of PM0.5 samples. The educational package was tested on 250 children of the primary school and showed to be very useful, improving children knowledge about air pollution and its effects and stimulating their interest. Conclusions: The associations between levels of air pollutants, air mutagenicity and biomarkers of early effects will be investigated. A tentative model to calculate the global absolute risk of having early biological effects for air pollution and other variables together will be proposed and may be useful to support policy-making and community interventions to protect children from possible health effects of air pollutants.

Keywords: air pollution exposure, biomarkers of early effects, children, public health policy

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Authors: Ahmed Al-Adaileh

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Renewable energy sources, domestic storage systems, controllable loads and machine learning technologies will be key components of future smart homes management systems. An energy management scheme that uses a Deep Learning (DL) approach to support the smart home management systems, which consist of a standalone photovoltaic system, storage unit, heating ventilation air-conditioning system and a set of conventional and smart appliances, is presented. The objective of the proposed scheme is to apply DL-based machine learning to predict various running parameters within a smart home's environment to achieve maximum comfort levels for occupants, reduced electricity bills, and less dependency on the public grid. The problem is using Reinforcement learning, where decisions are taken based on applying the Continuous-time Markov Decision Process. The main contribution of this research is the proposed framework that applies DL to enhance the system's supervised dataset to offer unlimited chances to effectively support smart home systems. A case study involving a set of conventional and smart appliances with dedicated processing units in an inhabited building can demonstrate the validity of the proposed framework. A visualization graph can show "before" and "after" results.

Keywords: smart homes systems, machine learning, deep learning, Markov Decision Process

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Authors: Eti Dwi Wiraningsih, Folashade Agusto, Lina Aryati, Syamsuddin Toaha, Suzanne Lenhart, Widodo, Willy Govaerts

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This paper considers a deterministic model for the transmission dynamics of rabies virus in the wild dogs-domestic dogs-human zoonotic cycle. The effect of vaccination and culling in dogs is considered on the model, then the stability was analysed to get basic reproduction number. We use the next generation matrix method and Routh-Hurwitz test to analyze the stability of the Disease-Free Equilibrium and Endemic Equilibrium of this model.

Keywords: stability analysis, rabies model, vaccination effect, culling in dogs

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Authors: Alida Sandison, Louise A. Stroud

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Narcissism is a personality configuration which has both normal and pathological personality expressions. Narcissism is highly complex, and is linked to a broad field of research. There are both dimensional and categorical conceptualisations of narcissism, and a variety of theoretical formulations that have been put forward to understand the narcissistic personality configuration. Currently, Kernberg’s Object Relations theory is well supported for this purpose. The complexity and particular defense mechanisms at play in the narcissistic personality make it a difficult personality configuration worth further research. Psychobiography as a methodology allows for the exploration of the lived life, and is thus a useful methodology to surmount these inherent challenges. Narcissism has been a focus of academic interest for a long time, and although there is a lot of research done in this area, to the researchers' knowledge, narcissistic dynamics have never been explored within a psychobiographical format. Thus, the primary aim of the research was to explore and describe narcissism in the life of Howard Hughes, with the objective of gaining further insight into narcissism through the use of this unconventional research approach. Hughes was chosen as subject for the study as he is renowned as an eccentric billionaire who had his revolutionary effect on the world, but was concurrently disturbed within his personal pathologies. Hughes was dynamic in three different sectors, namely motion pictures, aviation and gambling. He became more and more reclusive as he entered into middle age. From his early fifties he was agoraphobic, and the social network of connectivity that could reasonably be expected from someone in the top of their field was notably distorted. Due to his strong narcissistic personality configuration, and the interpersonal difficulties he experienced, Hughes represents an ideal figure to explore narcissism. The study used a single case study design, and purposive sampling to select Hughes. Qualitative data was sampled, using secondary data sources. Given that Hughes was a famous figure, there is a plethora of information on his life, which is primarily autobiographical. This includes books written about his life, and archival material in the form of newspaper articles, interviews and movies. Gathered data were triangulated to avoid the effect of author bias, and increase the credibility of the data used. It was collected using Yin’s guidelines for data collection. Data was analysed using Miles and Huberman strategy of data analysis, which consists of three steps, namely, data reduction, data display, and conclusion drawing and verification. Patterns which emerged in the data highlighted the defense mechanisms used by Hughes, in particular that of splitting and projection, in defending his sense of self. These defense mechanisms help us to understand the high levels of entitlement and paranoia experienced by Hughes. Findings provide further insight into his sense of isolation and difference, and the consequent difficulty he experienced in maintaining connections with others. Findings furthermore confirm the effectiveness of Kernberg’s theory in understanding narcissism observing an individual life.

Keywords: Howard Hughes, narcissism, narcissistic defenses, object relations

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Authors: Sharon Jackson White

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Purpose: Nurse practitioners (NPs) practicing within hospital medicine play a significant role in caring for patients who might benefit from palliative care (PC) services. Using the Theory of Planned Behavior, the purpose of this study was to examine the relationships among facilitators to referral, barriers to referral, self-efficacy with end-of-life discussions, history of referral, and referring to PC among NPs in hospital medicine. Hypotheses: 1) Perceived facilitators to referral will be associated with a higher history of referral and a higher number of referrals to PC. 2) Perceived barriers to referral will be associated with a lower history of referral and a lower number of referrals to PC. 3) Increased self-efficacy with end-of-life discussions will be associated with a higher history of referral and a higher number of referrals to PC. 4) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the history of referral to PC. 5) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the number of referrals to PC. Significance: Previous studies of referring patients to PC within the hospital setting care have focused on physician practices. Identifying factors that influence NPs referring hospitalized patients to PC is essential to ensure that patients have access to these important services. This study incorporates the SNRS mission of advancing nursing research through the dissemination of research findings and the promotion of nursing science. Methods: A cross-sectional, predictive correlational study was conducted. History of referral to PC, facilitators to referring to PC, barriers to referring to PC, self-efficacy in end-of-life discussions, and referral to PC were measured using the PC referral case study survey, facilitators and barriers to PC referral survey, and self-assessment with end-of-life discussions survey. Data were analyzed descriptively and with Pearson’s Correlation, Spearman’s Rho, point-biserial correlation, multiple regression, logistic regression, Chi-Square test, and the Mann-Whitney U test. Results: Only one facilitator (PC team being helpful with establishing goals of care) was significantly associated with referral to PC. Three variables were statistically significant in relation to the history of referring to PC: “Inclined to refer: PC can help decrease the length of stay in hospital”, “Most inclined to refer: Patients with serious illnesses and/or poor prognoses”, and “Giving bad news to a patient or family member”. No predictor variables contributed a significant variance in the number of referrals to PC for all three case studies. There were no statistically significant results showing a relationship between the history of referral and referral to PC. All five hypotheses were partially supported. Discussion: Findings from this study emphasize the need for further research on NPs who work in hospital settings and what factors influence their behaviors of referring to PC. Since there is an increase in NPs practicing within hospital settings, future studies should use a larger sample size and incorporate hospital medicine NPs and other types of NPs that work in hospitals.

Keywords: palliative care, nurse practitioners, hospital medicine, referral

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Authors: Shin-Jer Yang, Kai-Tai Yang

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In response to a changing world and the fast growth of the Internet, more and more enterprises are replacing web-based services with cloud-based ones. Multi-tenancy technology is becoming more important especially with Software as a Service (SaaS). This in turn leads to a greater focus on the application of Identity and Access Management (IAM). Conventional Near-Field Communication (NFC) based verification relies on a computer browser and a card reader to access an NFC tag. This type of verification does not support mobile device login and user-based access management functions. This study designs an NFC-based third-party cloud identity and access management scheme (NFC-IAM) addressing this shortcoming. Data from simulation tests analyzed with Key Performance Indicators (KPIs) suggest that the NFC-IAM not only takes less time in identity identification but also cuts time by 80% in terms of two-factor authentication and improves verification accuracy to 99.9% or better. In functional performance analyses, NFC-IAM performed better in salability and portability. The NFC-IAM App (Application Software) and back-end system to be developed and deployed in mobile device are to support IAM features and also offers users a more user-friendly experience and stronger security protection. In the future, our NFC-IAM can be employed to different environments including identification for mobile payment systems, permission management for remote equipment monitoring, among other applications.

Keywords: cloud service, multi-tenancy, NFC, IAM, mobile device

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Authors: S. Mhamdi, O. Brendel, P. Montpied, K. Ben Yahia, N. Saouyah, B. Hasnaoui, E. Dreyer

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Leaf Life Span (LLS) is used to classify trees into two main groups: evergreen and deciduous species. It varies according to the forms of life between taxonomic groups. Co-occurrence of deciduous and evergreen oaks is common in some Mediterranean type climate areas. Nevertheless, in the Tunisian forests, there is no enough information about the functional inter-specific diversity among oak species, especially in the mixed stand marked by the simultaneous presence of Q. suber L., Q. canariensis Willd. and their hybrid (Q. afares), the latter being an endemic oak species threatened with extinction. This study has been conducted to estimate the LLS, the relative growth rate, and the count of different growth flushes of samplings in semi-controlled conditions. Our study took 17 months, with an observation's interval of 4 weeks. The aim is to characterize and compare the hybrid species to the parental ones. Differences were observed among species, both for phenology and growth. Indeed, Q. suber saplings reached higher total height and number of growth flushes then Q. canariensis, while Q. afares showed much less growth flushes than the parental species. The LLS of parental species has exceeded the duration of the experiment, but their hybrid lost all leaves on all cohorts. The short LLSs of hybrid species are in accordance with this phenology in the field, but for Q. canariensis there was a contrast with observations in the field where phenology is strictly annual. This study allowed us to differentiate the hybrid from both parental species.

Keywords: leaf life span, growth, hybrid, Q. afares Pomel, Q. suber L., Q.canariensis Willd

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Authors: Jessica J. Gillies

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Awareness of the tragedy that is human trafficking has increased exponentially over the past two decades. The four pillars widely recognised as global solutions to the problem are prevention, prosecution, protection, and partnership between government and non-government organisations. While ‘sex-trafficking’ initially received major attention, this focus has shifted to other industries that conceal broader experiences of exploitation. However, within the regions of focus for this study, namely Australia and Thailand, trafficking for the purpose of sexual exploitation remains the commonly uncovered narrative of criminal justice investigations. In these regions anti-trafficking action is characterised by government-led prevention and prosecution efforts; whereas protection and reintegration practices have received criticism. Typically, non-government organisations straddle the critical chasm between policy and practice; therefore, they are perfectly positioned to contribute valuable experiential knowledge toward understanding how both sectors can support survivors in the post-trafficking experience. The aim of this research is to inform improved partnerships throughout government and non-government post-trafficking services by illuminating gaps in protection and reintegration initiatives. This research will explore government and non-government responses to human trafficking in Thailand and Australia, in order to understand how meaning is constructed in this context and how the construction of meaning effects survivors in the post-trafficking experience. A qualitative, three-stage methodology was adopted for this study. The initial stage of enquiry consisted of a discursive analysis, in order to deconstruct the broader discourses surrounding human trafficking. The data included empirical papers, grey literature such as publicly available government and non-government reports, and anti-trafficking policy documents. The second and third stages of enquiry will attempt to further explore the findings of the discourse analysis and will focus more specifically on protection and reintegration in Australia and Thailand. Stages two and three will incorporate process observations in government and non-government survivor support services, and semi-structured interviews with employees and volunteers within these settings. Two key findings emerged from the discursive analysis. The first exposed conflicting feminist arguments embedded throughout anti-trafficking discourse. Informed by conflicting feminist discourses on sex-work, a discursive relationship has been constructed between sex-industry policy and anti-trafficking policy. In response to this finding, data emerging from the process observations and semi-structured interviews will be interpreted using a feminist theoretical framework. The second finding progresses from the construction in the first. The discursive construction of sex-trafficking appears to have had influence over perceptions of the legitimacy of survivors, and therefore the support they receive in the post-trafficking experience. For example; women who willingly migrate for employment in the sex-industry, and on arrival are faced with exploitative conditions, are not perceived to be deserving of the same support as a woman who is not coerced, but rather physically forced, into such circumstances, yet both meet the criteria for a victim of human trafficking. The forthcoming study is intended to contribute toward building knowledge and understanding around the implications of the construction of legitimacy; and contextualise this in reference to government led protection and reintegration support services for survivors in the post-trafficking experience.

Keywords: Australia, government, human trafficking, non-government, reintegration, Thailand

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Authors: Ebtissem Sassi, Abdellatif Benabdelhafid, Sami Hammami

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Congestion, pollution and space misuse are the major risks in the hinterland. Management of these risks is a major issue for all the actors intervening in territory management. A good mastery of these risks is based on the consideration of environmental and physical constraints since the implementation of a policy integrates simultaneously an efficient use, territorial resources, and financial resources which become increasingly rare. Yet, this balance can be difficult to establish simultaneously by all the actors. Indeed, every actor has often the tendency to favor these objectives in detriment to others. In this framework, we have fixed the objective of designing and achieving a model which will centralize multidisciplinary data and serve the analysis tool as well as a decision support tool. In this article, we will elaborate some methodological axes allowing the good management of the territory system through (i) determination of the structural factors of the decision support system, (ii) integration of methods tools favoring the territorial decisional process. Logistics territory geographic information system is a model dealing with this issue. The objective of this model is to facilitate the exchanges between the actors around a common question which was the research subject of human sciences researchers (geography, economy), nature sciences (ecology) as well as finding an optimal solution for simultaneous responses to all these objectives.

Keywords: complexity, territory, logistics, territory planning, conceptual model, GIS, MCA

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Authors: H. Jung, N. Kim, B. Kang, J. Choe

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History matching is a crucial procedure for predicting reservoir performances and making future decisions. However, it is difficult due to uncertainties of initial reservoir models. Therefore, it is important to have reliable initial models for successful history matching of highly heterogeneous reservoirs such as channel reservoirs. In this paper, we proposed a novel scheme for regenerating geological models using support vector machine (SVM) and principal component analysis (PCA). First, we perform PCA for figuring out main geological characteristics of models. Through the procedure, permeability values of each model are transformed to new parameters by principal components, which have eigenvalues of large magnitude. Secondly, the parameters are projected into two-dimensional plane by multi-dimensional scaling (MDS) based on Euclidean distances. Finally, we train an SVM classifier using 20% models which show the most similar or dissimilar well oil production rates (WOPR) with the true values (10% for each). Then, the other 80% models are classified by trained SVM. We select models on side of low WOPR errors. One hundred channel reservoir models are initially generated by single normal equation simulation. By repeating the classification process, we can select models which have similar geological trend with the true reservoir model. The average field of the selected models is utilized as a probability map for regeneration. Newly generated models can preserve correct channel features and exclude wrong geological properties maintaining suitable uncertainty ranges. History matching with the initial models cannot provide trustworthy results. It fails to find out correct geological features of the true model. However, history matching with the regenerated ensemble offers reliable characterization results by figuring out proper channel trend. Furthermore, it gives dependable prediction of future performances with reduced uncertainties. We propose a novel classification scheme which integrates PCA, MDS, and SVM for regenerating reservoir models. The scheme can easily sort out reliable models which have similar channel trend with the reference in lowered dimension space.

Keywords: history matching, principal component analysis, reservoir modelling, support vector machine

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Authors: Tsang K. L. V., Lewis L. A., Griffith S., Tucker P.

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Background: Many children with high-incidence disabilities, such as autism spectrum disorder (ASD), struggle to participate in the community in a socially acceptable manner. There are limitations for clinical settings to provide natural, real-life scenarios for them to practice the life skills needed to meet their real-life challenges. Virtual reality (VR) offers potential solutions to resolve the existing limitation faced by clinicians to create simulated natural environments for their clients to generalize the facilitated skills. Research design: The research aimed to develop a prototype of an interactive VR system to provide realistic and immersive environments for clients to practice skills. The descriptive qualitative methodology is employed to design and develop the Artificial Interactive Reality Unified System (AIRUS) prototype, which provided insights on how to use advanced VR technology to create simulated real-life social scenarios and enable users to interact with the objects and people inside the virtual environment using natural eye-gazes, hand and body movements. The eye tracking (e.g., selective or joint attention), hand- or body-tracking (e.g., repetitive stimming or fidgeting), and facial tracking (e.g., emotion recognition) functions allowed behavioral data to be captured and managed in the AIRUS architecture. Impact of project: Instead of using external controllers or sensors, hand tracking software enabled the users to interact naturally with the simulated environment using daily life behavior such as handshaking and waving to control and interact with the virtual objects and people. The newly developed AIRUS protocol offers opportunities for breakthroughs in future VR-based psychosocial assessment and intervention in occupational therapy. Implications for future projects: AI technology can allow more efficient data capturing and interpretation of object identification and human facial emotion recognition at any given moment. The data points captured can be used to pinpoint our users’ focus and where their interests lie. AI can further help advance the data interpretation system.

Keywords: occupational therapy, psychosocial assessment and intervention, simulated interactive environment, virtual reality

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Authors: Shruti Motiwale, Xianlin Zhou, Reuben H. Kraft

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Military and sports personnel are often required to wear heavy helmets for extended periods of time. This leads to excessive cyclic loads on the neck and an increased chance of injury. Computational models offer one approach to understand and predict the time progression of disc degeneration under severe cyclic loading. In this paper, we have applied an analytic non-linear damage evolution model to estimate damage evolution in an intervertebral disc due to cyclic loads over decade-long time periods. We have also proposed a novel strategy for inclusion of recovery in the damage model. Our results show that damage only grows 20% in the initial 75% of the life, growing exponentially in the remaining 25% life. The analysis also shows that it is crucial to include recovery in a damage model.

Keywords: cervical spine, computational biomechanics, damage evolution, intervertebral disc, continuum damage mechanics

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Authors: Ibragim Issabekov, Byron Crape, Lyazzat Toleubekova

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Background: Palliative care substantially improves the quality of life of terminally-ill patients. Symptom control is one of the keystones in the management of patients in palliative care settings, lowering distress as well as improving the quality of life of patients with end-stage diseases. The most common symptoms causing significant distress for patients are pain, nausea and vomiting, increased respiratory secretions and mental health issues like depression. Aims are: 1. to identify best practices in symptom management in palliative patients in accordance with internationally approved guidelines and compare aforementioned with actual practices in Kazakhstan; to evaluate the criteria for assessing symptoms in terminally-ill patients, 2. to review the availability and utilization of pharmaceutical agents for pain control, management of excessive respiratory secretions, nausea, and vomiting, and delirium and 3. to develop recommendations for the systematic approach to end-of-life symptom management in Kazakhstan. Methods: The use of qualitative research methods together with systematic literature review have been employed to provide a rigorous research process to evaluate current approaches for symptom management of palliative patients in Kazakhstan. Qualitative methods include in-depth semi-structured interviews of the healthcare professionals involved in palliative care provision. Results: Obstacles were found in appropriate provision of palliative care. Inadequate education and training to manage severe symptoms, poorly defined laws and regulations for palliative care provision, and a lack of algorithms and guidelines for care were major barriers in the effective provision of palliative care. Conclusion: Assessment of palliative care in this medium-income transitional-economy country is one of the first steps in the initiation of integration of palliative care into the existing health system. Achieving this requires identifying obstacles and resolving these issues.

Keywords: end-of-life care, middle income country, palliative care, symptom control

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Authors: Parth Mehta, Vedasri Bai Khavala, Prabhu Rajagopal, Tiju Thomas

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There is an increasing need for alternative clean fuels, and hydrogen (H₂) has long been considered a promising solution with a high calorific value (142MJ/kg). However, the storage of H₂ and expensive processes for its generation have hindered its usage. Sodium borohydride (NaBH₄) can potentially be used as an economically viable means of H₂ storage. Thus far, there have been attempts to optimize the life of NaBH₄ (half-life) in aqueous media by stabilizing it with sodium hydroxide (NaOH) for various pH values. Other reports have shown that H₂ yield and reaction kinetics remained constant for all ratios of H₂O to NaBH₄ > 30:1, without any acidic catalysts. Here we highlight the importance of pH and H₂O: NaBH₄ ratio (80:1, 40:1, 20:1 and 10:1 by weight), for NaBH₄ stabilization (half-life reaction time at room temperature) and corrosion minimization of H₂ reactor components. It is interesting to observe that at any particular pH>10 (e.g., pH = 10, 11 and 12), the H₂O: NaBH₄ ratio does not have the expected linear dependence with stability. On the contrary, high stability was observed at the ratio of 10:1 H₂O: NaBH₄ across all pH>10. When the H₂O: NaBH₄ ratio is increased from 10:1 to 20:1 and beyond (till 80:1), constant stability (% degradation) is observed with respect to time. For practical usage (consumption within 6 hours of making NaBH₄ solution), 15% degradation at pH 11 and NaBH₄: H₂O ratio of 10:1 is recommended. Increasing this ratio demands higher NaOH concentration at the same pH, thus requiring a higher concentration or volume of acid (e.g., HCl) for H₂ generation. The reactions are done with tap water to render the results useful from an industrial standpoint. The observed stability regimes are rationalized based on complexes associated with NaBH₄ when solvated in water, which depend sensitively on both pH and NaBH₄: H₂O ratio.

Keywords: hydrogen, sodium borohydride, stability optimization, H₂O:NaBH₄ ratio

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Authors: Freya Harding, Anne Gatuguta, Chi Eziefula

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Introduction Research shows the quality of experiences of pregnancy, birth, and postpartum impacts the health and well-being of the mother and baby. This is recognised by the WHO in their recommendations ‘Intrapartum care for a positive childbirth experience’. The COVID-19 pandemic saw the transformation of the NHS Maternity services to prevent the transmission of COVID-19. Physical and social isolation may have affected women’s experiences of pregnancy, birth and postpartum; especially those of healthcare. Examples of such changes made to the NHS include both the reduction in volume of face-to-face consultations and restrictions to visitor time in hospitals. One notable detriment due to these changes was the absence of a partner during certain stages of birth. The aim of this study was to explore women’s experiences of pregnancy, birth, and postnatal period during the COVID-19 pandemic in the UK. Methods We collected qualitative data from women who had given birth during the COVID-19 pandemic. In-depth, semi-structured interviews were conducted with twelve participants recruited from mother and baby groups in Southeast England. Data were audio-recorded, transcribed verbatim, and analysed thematically using both inductive and deductive approaches. Ethics permission was granted from Brighton and Sussex Medical School (ER/BSMS9A83/1). Results Interviews were conducted with 12 women who gave birth between May 2020 and February 2021. Ages of the participants ranged between 28 and 42 years, most of which were white British, with one being Asian British. All participants were heterosexual and either married or co-habiting with their partner. Five participants worked in the NHS, and all participants had professional occupations. Women felt inadequately supported both socially and medically. An appropriate sense of control over their own birthing experience was lacking. Safety mechanisms, such as in-person visits from the midwife, had no suitable alternatives in place. Serious health issues were able to “slip through the net.” Mental health conditions in some of those interviewed worsened or developed. Similarly, reduced support from partners during birth and during the immediate postpartum period at the hospital, coupled with reduced ward staffing, resulted in some traumatic experiences; particularly for women who had undergone caesarean section. However, some unexpected positive effects were reported; one example being that partners were able to spend more time with their baby due to furlough schemes and working from home. Similarly, emergency care was not felt to have been compromised. Overall, six themes emerged: (1) Self-reported traumatic experiences, (2) Challenges of caring for a baby with reduced medical and social support, (3) Unexpected benefits to the parenting experience, (4) The effects of a sudden change in medical management (5) Poor communication from healthcare professionals (6) Social change; with subthemes of support accessing medical care, the workplace, family and friends, and antenatal & baby groups. Conclusions The results indicate that the healthcare system was unable to adequately deliver maternity care to facilitate positive pregnancy, birth, and postnatal experiences during the heights of the pandemic. The poor quality of such experiences has been linked an increased risk of long-term health complications in both the mother and child.

Keywords: pregnancy, birth, postpartum, postnatal, COVID-19, maternity, social support, qualitative, pandemic

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Authors: Timothy Francis Grant

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There are conflicting purposes at play with the design of sustainable packaging which include material reduction, recycling compatibility, use of secondary content and performance of the package in protecting and delivering the product. Life Cycle Assessment (LCA) is able to evaluate these different strategies against environmental metrics such as climate change, land and water use and marine litter pollution. However, LCA has traditionally been too time consuming and expensive to be used effectively in packaging design process. To make LCA practical for packaging technologist and designers a simplified tool is needed to make LCA possible for non-environmental specialists. The Packaging Quick Evaluation Tool (PIQET) is a web-based solution for undertaking LCA of new and existing packaging designs considering the global supply chain and impacts from cradle to grave. PIQET is based on a pre-calculated LCA database covering the materials and processes involved in the packaging lifecycle from cradle to grave. This includes both virgin materials and recycled content, conversion of materials into packaging, and the transportation of packaging to the product filling. In addition, PIQET assesses the impacts once the package is filled looking at storage, transport and product loss through the supply chain. When applied to consumer packaging light weight packages which are note recyclable have lower impacts than more recyclable packages which have a higher mass. Its also apparent that for many products the impacts of product failure and product loss are more important environmentally compared to packaging material efficiency.

Keywords: Climate change, Life Cycle Assessment, Marine litter, Packaging sustainability

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Authors: Gregory Michael McMahon

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Risk management for the purposes of minimizing the damages from the operations of dams has met with opposition emerging from organisations and authorities, and their practitioners. It appears that the cause may be a misunderstanding of risk management arising from exchanges that mix deterministic thinking with risk-centric thinking and that do not separate uncertainty from reliability and accuracy from probability. This paper sets out those misunderstandings that arose from dam operations at Wivenhoe in 2011, using a comparison of outcomes that have been based on the methodology and its rules and those that have been operated by applying misunderstandings of the rules. The paper addresses the performance of one risk-centric Flood Manual for Wivenhoe Dam in achieving a risk management outcome. A mixture of engineering, administrative, and legal factors appear to have combined to reduce the outcomes from the risk approach. These are described. The findings are that a risk-centric Manual may need to assist administrations in the conduct of scenario training regimes, in responding to healthy audit reporting, and in the development of decision-support systems. The principal assistance needed from the Manual, however, is to assist engineering and the law to a good understanding of how risks are managed – do not assume that risk management is understood. The wider findings are that the critical profession for decision-making downstream of the meteorologist is not dam engineering or hydrology, or hydraulics; it is risk management. Risk management will provide the minimum flood damage outcome where actual rainfalls match or exceed forecasts of rainfalls, that therefore risk management will provide the best approach for the likely history of flooding in the life of a dam, and provisions made for worst cases may be state of the art in risk management. The principal conclusion is the need for training in both risk management as a discipline and also in the application of risk management rules to particular dam operational scenarios.

Keywords: risk management, flood control, dam operations, deterministic thinking

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Authors: E. J. Spamer, J. M. Van Zyl, MHA Combrinck

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The Unit for Open Distance Learning (UODL) at the North-West University (NWU), South Africa was established in 2013 with its main function to deliver open distance learning (ODL) programmes to approximately 30 000 students from the Faculties of Education Sciences, Health Sciences, Theology and Arts and Culture. Quality operational and administrative processes are key components in the delivery of these programmes and they need to function optimally for students to be successful in their studies. Operational and administrative processes include aspects such as applications, registration, dissemination of study material, availability of electronic platforms, the management of assessment, and the dissemination of important information. To be able to ensure and enhance quality during these processes, it is vital to determine students’ perceptions with regards to these mentioned processes. A questionnaire was available online and also distributed to the 63 tuition centres. The purpose of this research was to determine the perceptions of ODL students from NWU regarding operational and administrative processes. 1903 students completed and submitted the questionnaire. The data was quantitatively analysed and discussed. Results indicated that the majority of students are satisfied with the operational and administrative processes; however, the results also indicated some areas that need improvement. The data gathered is important to identify strengths and areas for improvement and form part of a bigger strategy of qualitative assurance at the UODL.

Keywords: administrative support, ODL programmes, quantitative study, students' perceptions

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Authors: Alexis Winfield, Carly Sugar, Barbara Fenesi

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The COVID-19 pandemic uprooted regular routines forcing many children to learn from home, requiring many adults to work from home, and cutting families off from support outside the home. Public health restrictions associated with the pandemic caused widespread psychological distress, including depression and anxiety, increased fear, panic, and stress. These trends are particularly concerning for families raising neuroatypical children, such as those with Attention-Deficit Hyperactivity Disorder (ADHD), as these children are already more likely than their typically developing peers to experience comorbid mental health issues and to experience greater distress when required to stay indoors. Families with children who have ADHD are also at greater risk for experiencing heightened familial stress due to the challenges associated with managing ADHD behavioural symptoms, greater parental discord and divorce, and greater financial difficulties compared to other families. The current study engaged families comprised of at least one child diagnosed with ADHD to elucidate 1) the unique ways that the COVID-19 pandemic affected their mental health and 2) the specific barriers these families faced to maintaining optimal mental wellbeing. A total of 33 participants (15 parent-child dyads) engaged in virtual interviews. Content analysis revealed that the most frequently identified mental health effects for families were increased child anxiety and disconnectedness, as well as deteriorating parental mental health. The most frequently identified barriers to maintaining optimal mental well-being were lack of routine, lack of social interaction and social support, and uncertainty and fear. Findings underscore areas of need during times of large-scale social isolation, bring voice to the families of children with ADHD, and contribute to our understanding of the pandemic’s impact on the wellbeing of vulnerable families. This work contributes to a growing body of research aimed at creating safeguards to support mental wellbeing for vulnerable families during times of crisis.

Keywords: attention-deficit hyperactivity disorder, COVID-19, mental health, vulnerable families

Procedia PDF Downloads 283