Search results for: wellbeing interventions

Authors: Kika Ioannou Kazamia

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This paper examines the action research cycle of the second phase of longitudinal research on sustainable interior design practices, between two groups of stakeholders, designers and clients. During this phase of the action research, the second step - the change stage - of Lewin’s change management model has been utilized to change values, approaches, and attitudes toward sustainable design practices among the participants. Affective domain learning theory is utilized to attach new values. Learning with the use of information technology, collaborative learning, and problem-based learning are the learning methods implemented toward the acquisition of the objectives. Learning methods, and aims, require the design of interventions with participants' involvement in activities that would lead to the acknowledgment of the benefits of sustainable practices. Interventions are steered to measure participants’ decisions for the worth and relevance of ideas, and experiences; accept or commit to a particular stance or action. The data collection methods used in this action research are observers’ reports, participants' questionnaires, and interviews. The data analyses use both quantitative and qualitative methods. The main beneficial aspect of the quantitative method was to provide the means to separate many factors that obscured the main qualitative findings. The qualitative method allowed data to be categorized, to adapt the deductive approach, and then examine for commonalities that could reflect relevant categories or themes. The results from the data indicate that during the second phase, designers and clients' participants altered their behaviours.

Keywords: design, change, sustainability, learning, practices

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Authors: Rosanna M. Rooney, Sharinaz Hassan, Maryanne McDevitt, Jacob D. Peckover, Robert T. Kane

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Anxiety and depression are the most common mental health problems experienced by Australian children and adolescents. Research into youth mental health points to the importance of considering emotional competence, parental influence on the child’s emotional development, and the fact that cognitions are still developing in childhood when designing and implementing positive psychology interventions. Additionally, research into such interventions has suggested the inclusion of a coaching component aimed at supporting those implementing the intervention enhances the effects of the intervention itself. In light of these findings and given the burden of anxiety and depression in the longer term, it is necessary to enhance the Aussie Optimism Positive Thinking Skills program and evaluate its efficacy in terms of children’s mental health outcomes. It was expected that the enhancement of the emotional and cognitive aspects of the Aussie Optimism Positive Thinking Skills program, the addition of coaching, and the inclusion of a parent manual would lead to significant prevention effects in internalizing problems at post-test, 6- and 18-months after the completion of the intervention. 502 students (9-11 years old) were randomly assigned to the intervention group (n = 347) or control group (n = 155). At each time point (baseline, post-test, 6-month follow-up, and 18-month follow-up), students completed a battery of self-report measures. The ten intervention sessions making up the enhanced Aussie Optimism Positive Thinking Skills program were run weekly. At post-test and 6-month follow-up, the intervention group reported significantly lower depression than the control group, with no group differences at the 18-month follow-up. The intervention group reported significantly lower anxiety than the control group only at the 6-month follow-up, with no group differences in the post-test or at the 18-month follow-up. Results suggest that the enhanced Aussie Optimism Positive Thinking Skills program can reduce depressive and anxious symptoms in the short term and highlight the importance of universally implemented positive psychology interventions.

Keywords: positive psychology, emotional competence, internalizing symptoms, universal implementation

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Authors: Kim Eunha

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This study examined a group-based intervention for alcohol use disorders based on the principles of acceptance and commitment therapy (ACT) in patients (N=22; 63.7% female; M = 38.2 years old; 100% South Korean) in a residential alcohol addiction treatment program. Patients were randomly assigned to either ACT group (receiving the ACT intervention) or control group (receiving treatment as usual). The ACT intervention consisted of four 2-hr group sessions scheduled during two weeks. The first session focused on the negative effects of suppression and avoidance, and a rationale for defusion and acceptance using several of the well-known ACT metaphors (e.g., Two Scales Metaphor, Man in the Hole). The second session taught defusion and acceptance skills through such exercises as mindfulness, cutting a sour fruit, naming one’s thoughts, and physicalizing. The third session included another mindfulness exercise and encouraged the participants to identify their values and set up life goals. The last session included more discussion on values and life goals, especially related to family and intimacy. The effects of the interventions were assessed using intent-to-treat analyses. The ACT interventions resulted in smaller immediate gains in motivation to stay sober and reductions in depression, anxiety, and experiential avoidance. In addition, at a 2-month follow up, those who attended the ACT group reported a lower average level of alcohol consumption and higher treatment attendance compared to the control group. These preliminary findings suggest that additional treatment and testing of ACT for alcohol use disorders will be crucial.

Keywords: acceptance and commitment therapy, alcohol use disorders, defusion, values

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Authors: Pietro D'Ambrosio, Roberta D'Ambrosio

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The upgrading of the architectural and urban heritage of the urban historic centers almost always involves the planning for the reuse and refunctionalization of the structures. Such interventions have complexities linked to the need to take into account the urban and social context in which the structure and its intrinsic characteristics such as historical and artistic value are inserted. To these, of course, we have to add the need to make a preliminary estimate of recovery costs and more generally to assess the economic and financial sustainability of the whole project of re-socialization. Particular difficulties are encountered during the pre-assessment of costs since it is often impossible to perform analytical surveys and structural tests for both structural conditions and obvious cost and time constraints. The methodology proposed in this work, based on a multidisciplinary and data-driven approach, is aimed at obtaining, at very low cost, reasonably priced economic evaluations of the interventions to be carried out. In addition, the specific features of the approach used, derived from the predictive analysis techniques typically applied in complex IT domains (big data analytics), allow to obtain as a result indirectly the evaluation process of a shared database that can be used on a generalized basis to estimate such other projects. This makes the methodology particularly indicated in those cases where it is expected to intervene massively across entire areas of historical city centers. The methodology has been partially tested during a study aimed at assessing the feasibility of a project for the reuse of the monumental complex of San Massimo, located in the historic center of Salerno, and is being further investigated.

Keywords: evaluation, methodology, restoration, reuse

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Authors: Salman Abdul Majeed, Vidur Solanki, Ruqiya Shama Tareen

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BACKGROUND: The COVID-19 pandemic has affected the way of living as we have known for all strata of society. While disease containment measures imposed by governmental agencies have been instrumental in controlling the spread of the virus, it has had profound collateral impacts on all populations. However, the disruption caused in the lives of one segment of population has been far more damaging than most others: the emotional wellbeing of our child and adolescent populations. This impact was even more pronounced in children who already suffered from neurodevelopmental or psychiatric disorders. In particular, school closures have not only led to profound social isolation, but also negative impacts on normal developmental opportunities and interruptions in mental health services obtained through school systems. It is too soon to understand the full impacts of quarantine, isolation, stress of social detachment and fear of pandemic, but we have started to see the devastating impact on C&A already. This review intends to shed light on the current understanding of psychiatric wellbeing of C&A during COVID-19 pandemic. METHOD: Literature search utilizing key words COVID-19 and children, quarantine and children, social isolation, Loneliness, pandemic stress and children, and mental health of children, disease containment measures was carried out. Over 200 articles were identified, out of which 81 articles were included in this review article. RESULTS: The disruption caused by COVID-19 in the lives of C&A is much more damaging and its impact is far reaching. The C&A ED visits for possible suicide attempts have jumped to 22.3% in 2020 and 39.1% during 2021. One study utilizing T1-weighted structural images, computed the thickness of cortical and subcortical structures including amygdala, hippocampus, and nucleus accumbens. The Peri-COVID group showed reduced cortical and subcortical thickness and more advanced brain aging compared to pre pandemic studies. CONCLUSION: Mental health resources for C&A remain under funded, neglected, and inaccessible to population that needs it most. Children with ongoing mental health disorders were impacted worst, along with those with predisposed biopsychosocial risk factors.

Keywords: COVID-19 and children, quarantine and children, social isolation, Loneliness, pandemic stress and children, disease containment measures, mental health of children

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Authors: Kristen Emory, Jerry Flores

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Purpose: We explore the unique and underrepresented experiences of Indigenous women living in Toronto, Canada, during the first year of the COVID-19 pandemic. The purpose of this study is to better document the impacts of COVID-19 on the mental health and well-being of Indigenous women in Toronto, Canada, in order to better understand unmet needs, as well as lay the groundwork for more targeted research and potential interventions based on these needs. Background: It has been fairly well documented that the COVID-19 pandemic has increased mental health concerns among various populations globally. There have also been numerous studies indicating increases in substance use and abuse in response to the stress of the pandemic. There is also evidence that the COVID-19 pandemic has disproportionately impacted a variety of historically marginalized populations in Canada, the US, and globally, including Indigenous populations. While these studies provide some insight into how the COVID-19 pandemic is impacting the global population, much less is known about the lived experiences of Indigenous populations during the time of COVID-19. Better understanding these experiences will allow public health professionals, governments, and non-governmental organizations better combat health inequities related to the pandemic. Methods: In-depth qualitative semi-structured virtual (due to COVID-19) interviews with 13 Indigenous women were conducted during the first year of the COVID-19 pandemic (2020). Interviews were recorded, transcribed, and analyzed by team members using Dedoose qualitative analysis software. Findings: COVID-19 negatively affected Indigenous females identifying participants’ mental health and corresponding reported increases in substance use. In addition to the daily stress of the unpredictability of life in the time of the COVID-19 pandemic, participants cited job loss, economic concerns, homeschooling, and lack of access to medical resources as primary factors in increasing their stress and decreasing mental health and wellbeing. In response to these stressors, a majority of participants cited coping mechanisms such as increased substance use to help deal with the uncertainty. In particular, alcohol and tobacco emerged as coping mechanisms to help participants cope with stress related to the pandemic (as well as its social and economic toll on respondents' lives). We will present qualitative data to be presented, including participant direct quotes, explaining their experiences with COVID-19, mental health, and increased substance use, as well as analysis and synthesis with the existing scientific evidence base. Conclusion: This research is among the good studies to our knowledge that scientifically explore the impact of COVID-19 on mental health and well-being and corresponding increases in reported substance use.

Keywords: mental health, covid-19, indigenous, inequity, anxiety, depression, stress

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Authors: William Marquis, Fang Dong

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There has been a growing concern in recent years over the economic and social effects of adult video gaming. It has been estimated that the number of people who played video games during the COVID-19 pandemic is close to three billion, and there is evidence that this form of entertainment is here to stay. Many people are concerned that this growing use of time could crowd out time that could be spent on alternative forms of entertainment with family, friends, sports, and other social activities that build community. For example, recent studies of children suggest that playing videogames crowds out time that could be spent on homework, watching TV, or in other social activities. Similar studies of adults have shown that video gaming is negatively associated with earnings, time spent at work, and socializing with others. The primary objective of this paper is to examine how time adults spend on video gaming could displace time they could spend working and on activities that enhance their health and well-being. We use data from the American Time Use Survey (ATUS), maintained by the Bureau of Labor Statistics, to analyze the effects of time-use decisions on three measures of well-being. We pool the ATUS Well-being Module for multiple years, 2010, 2012, 2013, and 2021, along with the ATUS Activity and Who files for these years. This pooled data set provides three broad measures of well-being, e.g., health, life satisfaction, and emotional well-being. Seven variants of each are used as a dependent variable in different multivariate regressions. We add to the existing literature in the following ways. First, we investigate whether the time adults spend in video gaming crowds out time spent working or in social activities that promote health and life satisfaction. Second, we investigate the relationship between adult gaming and their emotional well-being, also known as negative or positive affect, a factor that is related to depression, health, and labor market productivity. The results of this study suggest that the time adult gamers spend on video gaming has no effect on their supply of labor, a negligible effect on their time spent socializing and studying, and mixed effects on their emotional well-being, such as increasing feelings of pain and reducing feelings of happiness and stress.

Keywords: online gaming, health, social capital, emotional wellbeing

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Authors: Mariana Mangas, Yaroslava Martins, Ana Charraz, Ana Matos Pires

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Introduction: Health literacy empowers people of knowledge, motivation and skills to access, understand, evaluate and mobilize information relating to health. Although the benefits of public knowledge of physical disease are widely accepted, knowledge about mental disorder has been compatibly neglected. Nowadays there is considerably evidence that literacy is of great importance for the promotion of health and prevention of mental illness. Objective: Disclosure the concept and importance of mental health literacy and introduce the literacy program of Psychiatry Service of Hospital José Joaquim Fernandes. Methodology: A search was conducted on PubMed, using keywords “literacy” and “mental health”. A description of mental health literacy interventions implemented on Psychiatry Service of Hospital José Joaquim Fernandes was performed, namely, psychoeducation programs for depression and bipolar disorder. Results and discussion: Health literacy enables patient to be able to actively participate in his treatment. The improving of mental health literacy can promote early identification of mental disorders, improve treatment results, increase the use of health services and allow the community to take action to achieve better mental health. Psychoeducation is very useful in improving the course of disease and in reducing the number of episodes and hospitalizations. Bipolar patients who received psychoeducation and pharmacotherapy have no relapses during the program and last year. Conclusion: Mental health literacy is not simply a matter of having knowledge, rather, it is knowledge linked to action which can benefit mental health.

Keywords: mental health, literacy, psychoeducation, knowledge, empowerment

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Authors: Emre Kishalı, Neslihan TürkmenoğLu Bayraktar

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Historical buildings may face various impacts throughout their life cycle. There have been environmental, structural, public works actions on old monuments influencing sustainability and maintenance issues. As a result, ancient monuments can have been undergone various changes in the context of restoration and repair. Currently, these buildings face integrated conditions including city planning macro solutions, old intervention methods, modifications in building envelope and artefacts in terms of conservation. Moreover, documentation of phases is an essential for assessing the historical building, yet it can result in highly complicated and interwoven issues. Herein, two monuments constructed in the 16th century are selected as case studies in Kocaeli, Turkey which are located in different micro climatic conditions and/or exposed to different interventions and which are important for the city as cultural property. Pertev Paşa Mosque (also known as Yenicuma Mosque) -constructed by Architect Sinan-; Gebze Çoban Mustafa Paşa Mosque -constructed in 1523 and known as the work of Architect Sinan but various names asserted as the architect of building according to resources. Active water infiltration and damages, recent material interventions, hidden niches, and foundation techniques of the mosque are investigated via Infrared Thermography under the project of 114K284, “Non-Destructive Test Applications, in the Context of Planned Conservation, through Historical Mosques of Kocaeli: Coban Mustafa Pasa Mosque, Fevziye Mosque and Pertev Pasa Mosque” funded by TUBITAK. It is aimed to reveal active deteriorations on building elements generated by unwanted effects of structural and climatic conditions, historical interventions, and modifications by monitoring the variation of surface temperature and humidity by IRT visualization method which is an important non- destructive process for investigation of monuments in the conservation field in the context of planned conservation. It is also concluded that in-situ monitoring process via IRT through different climatic conditions give substantial information on the behaviour of the envelope to the physical environmental conditions by observation of thermal performance, degradations. However, it is obvious that monitoring of historical buildings cannot be pursued by implementing a single non-destructive technique to have complete data of the structure.

Keywords: IRT, non-destructive test, planned conservation, mosque

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Authors: Robin Root

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A fundamental premise of medical anthropology is that clinical phenomena are simultaneously cultural, political, and economic: none more so than the linked acronyms HIV/AIDS. For the medical researcher, HIV/AIDS signals an epidemiological pandemic and a pathophysiology. For persons diagnosed with an HIV-related condition, the acronym often conjures dread, too often marking and marginalizing the afflicted irretrievably. Critical medical anthropology is uniquely equipped to theorize the linkages that bind individual and social wellbeing to global structural and culture-specific phenomena. This paper reports findings from an anthropological study of HIV/AIDS in Swaziland, site of the highest HIV prevalence in the world. The project, initiated in 2005, has documented experiences of HIV/AIDS, religiosity, and treatment and care as well as drought and famine. Drawing on interviews with Swazi religious and traditional leaders about their experiences of leadership amidst worsening economic conditions, environmental degradation, and an ongoing global health crisis, the paper provides uncommon insights for global health practitioners whose singular paradigm for designing and delivering interventions is biomedically-based. In contrast, this paper details the role of local leaders in mediating extreme social suffering and resilience in ways that medical science cannot model but which radically impact how sickness is experienced and health services are delivered and accessed. Two concepts help to organize the paper’s argument. First, a ‘moral economy of language’ is central to showing up the implicit ‘technologies of knowledge’ that inhere in scientific and religious discourses of HIV/AIDS; people draw upon these discourses strategically to navigate highly vulnerable conditions. Second, Paulo Freire’s ethnographic focus on a culture’s 'dangerous words' opens up for examination how ‘sex’ is dangerous for religion and ‘god’ is dangerous for science. The paper interrogates hegemonic and ‘lived’ discourses, both biomedical and religious, and contributes to an important literature on the moral economies of health, a framework of explication and, importantly, action appropriate to a wide-range of contemporary global health phenomena. The paper concludes by asserting that it is imperative that global health planners reflect upon and ‘check’ their hegemonic policy platforms by, one, collaborating with local authoritative agents of ‘what sickness means and how it is best treated,’ and, two, taking account of the structural barriers to achieving good health.

Keywords: Africa, biomedicine, HIV/AIDS, qualitative research , religion

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Authors: Arielle Ferdinand

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A plant-based diet focuses on foods from plant sources, limiting or altogether omitting animal products. Some of the most common chronic illnesses seen in primary care are hypertension, hyperlipidemia, and diabetes type II. These common chronic illnesses can often be debilitating, costly, time-consuming, and, when left untreated, can lead to an early death. Treatment and maintenance of care are also labor intensive for the patient. They are often required to have at least four blood pressure checks yearly and a hemoglobin A1C checked quarterly. Though preventative interventions and prevention education should be included in patient visits in the primary care setting, education about dietary interventions, such as a plant-based diet, also yields positive outcomes for patients who already have hypertension, hyperlipidemia, and diabetes mellitus type 2. Evidence will show that incorporating a plant-based diet results in decreased blood pressure, as well as decreased levels of LDL-C, improved post-prandial glucose levels, and a reduction in HbA1C. It is cost-effective for the patient by generally lower grocery costs, and it can either reduce or prevent the need to pay for more office visits and pharmacotherapy. Incorporating this method of dietary changes is an easy intervention during a primary care office visit that would greatly benefit the patient in many ways.

Keywords: plant-based, nutrition, diabetes, hyperlipidemia

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Authors: Chrysanthos Maraveas, Argiris Plesias, Garyfalia G. Triantafyllou, Konstantinos Petronikolos

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The current paper presents a structural assessment and proposals for retrofit of the National Youth Foundation Building, an existing reinforced concrete (RC) building in the city of Igoumenitsa, Greece. The building is scheduled to be renovated in order to create a Municipal Cultural Center. The bearing capacity and structural integrity have been investigated in relation to the provisions and requirements of the Greek Retrofitting Code (KAN.EPE.) and European Standards (Eurocodes). The capacity of the existing concrete structure that makes up the two central buildings in the complex (buildings II and IV) has been evaluated both in its present form and after including several proposed architectural interventions. The structural system consists of spatial frames of columns and beams that have been simulated using beam elements. Some RC elements of the buildings have been strengthened in the past by means of concrete jacketing and have had cracks sealed with epoxy injections. Static-nonlinear analysis (Pushover) has been used to assess the seismic performance of the two structures with regard to performance level B1 from KAN.EPE. Retrofitting scenarios are proposed for the two buildings, including type Λ steel bracings and placement of concrete shear walls in the transverse direction in order to achieve the design-specification deformation in each applicable situation, improve the seismic performance, and reduce the number of interventions required.

Keywords: earthquake resistance, pushover analysis, reinforced concrete, retrofit, strengthening

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Authors: Yasaman Mohammadi

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Executive functions are a critical component of goal-directed behavior, encompassing a diverse set of cognitive processes such as working memory, cognitive flexibility, and inhibitory control. These functions are known to decline with age, but the precise mechanisms underlying this decline remain unclear. This paper provides an in-depth review of recent research investigating age-related changes in executive functions, drawing on insights from neuroimaging, genetics, and cognitive neuroscience. Through an interdisciplinary approach, this paper offers a nuanced understanding of the complex interplay between neural mechanisms, genetic factors, and cognitive processes that contribute to executive function decline in aging. Here, we investigate how different neuroimaging methods, like functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), have helped scientists better understand the brain bases for age-related declines in executive function. Additionally, we discuss the role of genetic factors in mediating individual differences in executive functions across the lifespan, as well as the potential for cognitive interventions to mitigate age-related decline. Overall, this paper presents a comprehensive and integrative view of the current state of knowledge regarding age-related changes in executive functions. It underscores the need for continued interdisciplinary research to fully understand the complex and dynamic nature of executive function decline in aging, with the ultimate goal of developing effective interventions to promote healthy cognitive aging.

Keywords: executive functions, aging, neuroimaging, cognitive neuroscience, working memory, cognitive training

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Authors: Tania Lisboa, Angela Voyajolu, Adam Ockelford

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The positive impact of music on the development of children with autism is widely acknowledged: music offers a unique channel for communication, wellbeing and self-regulation, as well as access to culture and a means of creative engagement. Yet, no coherent program exists for parents, carers and teachers to follow with their children in the early years, when the need for interventions is often most acute. Hence, research and the development of resources is urgently required. Autism is a project with children on the autism spectrum. The project aims at promoting the participants’ engagement with music through involvement in specially-designed musical activities with parents and carers. The main goal of the research is to verify the effectiveness of newly designed resources and strategies, which are based on the Sounds of Intent in the Early Years (SoI-EY) framework of musical development. This is a pilot study, comprising case studies of five children with autism in the early years. The data comprises semi-structured interviews, observations of videos, and feedback from parents on resources. Interpretative Phenomenological Analysis was chosen to analyze the interviews. The video data was coded in relation to the SoI-EY framework. The feedback from parents was used to evaluate the resources (i.e. musical activity cards). The participants’ wider development was also assessed through selected elements of the Early Years Foundation Stage (EYFS), a national assessment framework used in England: specifically, communication, language and social-emotional development. Five families of children on the autism spectrum (aged between 4-8 years) participated in the pilot. The research team visited each family 4 times over a 3-month period, during which the children were observed, and musical activities were suggested based on the child’s assessed level of musical development. Parents then trialed the activities, providing feedback and gathering further video observations of their child’s musical engagement between visits. The results of one case study will be featured in this paper, in which the evidence suggests that specifically tailored musical activity may promote communication and social engagement for a child with language difficulties on the autism spectrum. The resources were appropriate for the children’s involvement in musical activities. Findings suggest that non-specialist musical engagement with family and carers can be a powerful means to foster communication. The case study featured in this paper illustrates this with a child of limited verbal ability. There is a need for further research and development of resources that can be made available to all those working with children on the autism spectrum.

Keywords: autism, development, music education, resources

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Authors: Fatma Ahmed, Heba Mostafa, Bassem Ramdan, Azza El-Soussi

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Background: World Health Organization stated that by 2020 cardiac disease will be the number one cause of death worldwide and estimates that 25 million people per year will suffer from heart disease. Cardiac surgery is considered an effective treatment for severe forms of cardiovascular diseases that cannot be treated by medical treatment or cardiac interventions. In spite of the benefits of cardiac surgery, it is considered a major stressful experience for patients who are candidate for surgery. Prehabilitation can decrease incidences of postoperative complications as it prepares patients for surgical stress through enhancing their defenses to meet the demands of surgery. When patients anticipate the postoperative sequence of events, they will prepare themselves to act certain behaviors, identify their roles and actively participate in their own recovery, therefore, anxiety levels are decreased and functional capacity is enhanced. Prehabilitation programs can comprise interventions that include physical exercise, psychological prehabilitation, nutritional optimization and risk factor modification. Physical exercises are associated with improvements in the functioning of the various physiological systems, reflected in increased functional capacity, improved cardiac and respiratory functions and make patients fit for surgical intervention. Prehabilitation programs should also prepare patients psychologically in order to cope with stress, anxiety and depression associated with postoperative pain, fatigue, limited ability to perform the usual activities of daily living through acting in a healthy manner. Notwithstanding the benefits of psychological preparations, there are limited studies which investigated the effect of psychological prehabilitation to confirm its effect on psychological, quality of life and physiological outcomes of patients who had undergone cardiac surgery. Aim of the study: The study aims to determine the effect of prehabilitation interventions on outcomes of patients undergoing cardiac surgeries. Methods: Quasi experimental study design was used to conduct this study. Sixty eligible and consenting patients were recruited and divided into two groups: control and intervention group (30 participants in each). One tool namely emotional, physiological, clinical, cognitive and functional capacity outcomes of prehabilitation intervention assessment tool was utilized to collect the data of this study. Results: Data analysis showed significant improvement in patients' emotional state, physiological and clinical outcomes (P < 0.000) with the use of prehabilitation interventions. Conclusions: Cardiac prehabilitation in the form of providing information about surgery, circulation exercise, deep breathing exercise, incentive spirometer training and nutritional education implemented daily by patients scheduled for elective open heart surgery one week before surgery have been shown to improve patients' emotional state, physiological and clinical outcomes.

Keywords: emotional recovery, clinical recovery, coronary artery bypass grafting patients, prehabilitation

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Authors: Carl van Walraven, Meltem Tuna

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Background: Network meta-analysis (NMA) quantifies the relative efficacy of 3 or more interventions from studies containing a subgroup of interventions. This study applied the analytical approach of NMA to quantify the relative accuracy of prediction models with distinct inclusion criteria that are evaluated on a common population (‘concurrent external validation’). Methods: We simulated binary events in 5000 patients using a known risk function. We biased the risk function and modified its precision by pre-specified amounts to create 15 prediction models with varying accuracy and distinct patient applicability. Prediction model accuracy was measured using the Scaled Brier Score (SBS). Overall prediction model accuracy was measured using fixed-effects methods that accounted for model applicability patterns. Prediction model accuracy was summarized as the Network Relative Model Accuracy (NeRMA) Score which ranges from -∞ through 0 (accuracy of random guessing) to 1 (accuracy of most accurate model in concurrent external validation). Results: The unbiased prediction model had the highest SBS. The NeRMA score correctly ranked all simulated prediction models by the extent of bias from the known risk function. A SAS macro and R-function was created to implement the NeRMA Score. Conclusions: The NeRMA Score makes it possible to quantify the accuracy of binomial prediction models having distinct inclusion criteria in a concurrent external validation.

Keywords: prediction model accuracy, scaled brier score, fixed effects methods, concurrent external validation

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Authors: Bonguen Onouck Rolande Carole, Ndongo Barthelemy

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The climate change effects on the Lake Chad, coupled with population growth, have pushed large masses of people of various origins towards the lower part of the lower Logonewatershed in search of the benefits of environmental services, causing pressure on the environment and its resources. Economic services are therefore threatened, and the decrease in resources contributes to the deterioration of the social wellbeing resulting to conflicts among/between local communities, immigrants, displaced people, and foreigners. This paper is an information contribution on ethnical conflicts drivers in the area and the provided local management mechanisms such can help mitigate present or future conflicts in similar areas. It also prints out the necessity to alleviate water access deficit and encourage good practices for the population wellbeing. In order to meet the objective, in 2018, through the interface of the World Bank-Cameroon project-PULCI, data were collected on the field directly by discussing with the population and visiting infrastructures, indirectly by a questionnaire survey. Two administrative divisions were chosen (Logoneet Chari, Mayo-Danay) in which targeted localities were Zina, Mazera, Lahai, Andirni near the Waza Park and Yagoua, Tekele, Pouss, respectively. Due to some sociocultural and religious reasons, some information were acquired through the traditional chiefs. A desk study analysis based on resources access and availability conflicts history, and management mechanism was done. As results, roots drivers of ethnical conflicts are struggles over natural resources access, and the possibility of conflicts increases as the scarcity and vulnerabilities persist, creating more sociocultural gaps and tensions. The mitigation mechanisms though fruitful, are limited. There is poor documentation on the topic, the resources management policies of this basin are unsuitable and ineffective for some. Therefore, the restoration of environmental and ecosystems, the mitigation of climate change effects, and food insecurity are the challenges that must be met to alleviate conflicts in these localities.

Keywords: ethnic, communities, conflicts, mitigation mechanisms, natural resources, logone basin

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Authors: Karen Eastman

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More youths and young adults with autism spectrum disorder (ASD) have been entering the workforce in recent years. Historically, students with ASD struggle after leaving high school and experience lower rates of employment, with social skills continuing to be the most problematic area of concern. Special education teachers may find it challenging to identify effective combinations of evidence-based practices (EBPs) and supports to best guide these students. One EBP, Peer Mediated Instruction and Intervention (PMII) has been well documented in the literature as being effective for younger students with autism but not researched as much with older students and adults, particularly in work settings. A need to combine PMII with other EBPs has been identified as a way to achieve a greater positive impact rather than any practice alone. A multiple baseline across skills design was used in this research project with two participants in different settings. PMII was combined with Visual Supports, with typical peers being trained in both practices. PMII is an evidence-based practice used to address social concerns by training peers without disabilities as to how they can provide feedback to and support, the student with ASD with social interactions in structured settings. The peers without disabilities were the instructors, while the adults facilitated the social situations and provided support to both the peers and students with ASD when needed. Because many individuals with ASD learn best with visual input, rather than using only the spoken word (verbal directions and feedback), Visual Supports were used in conjunction with PMII. Visual Supports can include written words, pictures, symbols, videos, or objects. In this project, the Visual Supports used were written social scripts, videos, Stop and Think signs, written reminder cards, a school map, and a pictorial task analysis of work tasks. Variables that may affect intervention outcomes in this project included attendance at school and school-based work settings for both the students with ASD and the peers without disabilities and behaviors and responses from others in the settings. Qualitative data was also collected from observations and surveys with peers about the process and their role. Data indicated that the students with ASD responded more positively to redirection and support from their peers than to teachers and staff and showed an increase in positive interactions with others. Those surveyed indicated a positive attitude toward and response to the use of peer interventions with visual supports.

Keywords: autism, social skills, vocational training, peer interventions

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Authors: Elnaz Alimi, Keriakoula Andriopoulos, Sam Boyer, Weronika Zuczek

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Occupational therapists can use coaching strategies to guide parents in providing therapy for their children with developmental disabilities. Evidence from various fields has shown increased parental self-efficacy and positive child outcomes as benefits of home and community-based parent coaching models. A literature review was conducted to investigate the effectiveness of parent coaching interventions delivered in home and community settings for children with developmental disabilities ages 0-12, on a variety of parent and child outcomes. CINAHL Plus, PsycINFO, PubMed, OTseeker were used as databases. The inclusion criteria consisted of: children with developmental disabilities ages 0-12 and their parents, parent coaching models conducted in the home and community, and parent and child outcomes. Studies were excluded if they were in a language other than English and published before 2000. Results showed that parent coaching interventions led to more positive therapy outcomes in child behaviors and symptoms related to their diagnosis or disorder. Additionally, coaching strategies had positive effects on parental satisfaction with therapy, parental self-efficacy, and family dynamics. Findings revealed decreased parental stress and improved parent-child relationships. Further research on parent coaching could involve studying the feasibility of coaching within occupational therapy specifically, incorporating cultural elements into coaching, qualitative studies on parental satisfaction with coaching, and measuring the quality of life outcomes for the whole family.

Keywords: coaching model, developmental disabilities, occupational therapy, pediatrics

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Authors: David Bakker, Nikki Rickard

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Smartphone apps hold immense potential as mental health and wellbeing tools. Support can be made easily accessible and can be used in real-time while users are experiencing distress. Furthermore, data can be collected to enable machine learning and automated tailoring of support to users. While many apps have been developed for mental health purposes, few have adhered to evidence-based recommendations and even fewer have pursued experimental validation. This paper details the development and experimental evaluation of an app, MoodMission, that aims to provide support for low moods and anxiety, help prevent clinical depression and anxiety disorders, and serve as an adjunct to professional clinical supports. MoodMission was designed to deliver cognitive behavioural therapy for specifically reported problems in real-time, momentary interactions. Users report their low moods or anxious feelings to the app along with a subjective units of distress scale (SUDS) rating. MoodMission then provides a choice of 5-10 short, evidence-based mental health strategies called Missions. Users choose a Mission, complete it, and report their distress again. Automated tailoring, gamification, and in-built data collection for analysis of effectiveness was also included in the app’s design. The development process involved construction of an evidence-based behavioural plan, designing of the app, building and testing procedures, feedback-informed changes, and a public launch. A randomized controlled trial (RCT) was conducted comparing MoodMission to two other apps and a waitlist control condition. Participants completed measures of anxiety, depression, well-being, emotional self-awareness, coping self-efficacy and mental health literacy at the start of their app use and 30 days later. At the time of submission (November 2016) over 300 participants have participated in the RCT. Data analysis will begin in January 2017. At the time of this submission, MoodMission has over 4000 users. A repeated-measures ANOVA of 1390 completed Missions reveals that SUDS (0-10) ratings were significantly reduced between pre-Mission ratings (M=6.20, SD=2.39) and post-Mission ratings (M=4.93, SD=2.25), F(1,1389)=585.86, p < .001, np2=.30. This effect was consistent across both low moods and anxiety. Preliminary analyses of the data from the outcome measures surveys reveal improvements across mental health and wellbeing measures as a result of using the app over 30 days. This includes a significant increase in coping self-efficacy, F(1,22)=5.91, p=.024, np2=.21. Complete results from the RCT in which MoodMission was evaluated will be presented. Results will also be presented from the continuous outcome data being recorded by MoodMission. MoodMission was successfully developed and launched, and preliminary analysis suggest that it is an effective mental health and wellbeing tool. In addition to the clinical applications of MoodMission, the app holds promise as a research tool to conduct component analysis of psychological therapies and overcome restraints of laboratory based studies. The support provided by the app is discrete, tailored, evidence-based, and transcends barriers of stigma, geographic isolation, financial limitations, and low health literacy.

Keywords: anxiety, app, CBT, cognitive behavioural therapy, depression, eHealth, mission, mobile, mood, MoodMission

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Authors: Malizgani Paul Chavula

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Background: Comprehensive sexuality education (CSE) plays a critical role in promoting youth and adolescents’ sexual and reproductive health and well-being. However, little is known about the enablers and barriers affecting the integration of CSE into educational programmes. The aim of this review is to explore positive and negative factors influencing the integration of CSE into national curricula and educational systems in low- and middle-income countries. Methods: We conducted a systematic literature review (January 2010 to August 2022). The results accord with the Preferred Reporting Items for Systematic Reviews and Meta-analysis standards for systematic reviews. Data were retrieved from the PubMed, Cochrane, Google Scholar, and Web of Hinari databases. The search yielded 431 publications, of which 23 met the inclusion criteria for full-text screening. The review is guided by an established conceptual framework that incorporates the integration of health innovations into health systems. Data were analyzed using a thematic synthesis approach. Results: The magnitude of the problem is evidenced by sexual and reproductive health challenges such as high teenage pregnancies, early marriages, and sexually transmitted infections. Awareness of these challenges can facilitate the development of interventions and the implementation and integration of CSE. Reported aspects of the interventions include core CSE content, delivery methods, training materials and resources, and various teacher-training factors. Reasons for adoption include perceived benefits of CSE, experiences and characteristics of both teachers and learners, and religious, social, and cultural factors. Broad system characteristics include strengthening links between schools and health facilities, school and community-based collaboration, coordination of CSE implementation, and the monitoring and evaluation of CSE. Ultimately, the availability of resources, national policies and laws, international agendas, and political commitment will impact upon the extent and level of integration. Conclusion: Social, economic, cultural, political, legal, and financial contextual factors influence the implementation and integration of CSE into national curricula and educational systems. Stakeholder collaboration and involvement in the design and appropriateness of interventions is critical.

Keywords: comprehensive sexuality education, factors, integration, sexual reproductive health rights

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Authors: Lee Jin-Eui, Kim Jin-OK, Han Seung-Hoon, Kim Nam-Jo

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Recently, there has been a growing interest in wellbeing where individuals pursue a healthy life. About the half of world population is living in cities, and the urban environment is negatively affecting the mental health of modern people. The stress level of urban dwellers continues to increase, and they pursue nature-based recreation activities to relieve their stresses. It was found that activities in green spaces are improving concentration, relieving mental stress, and positively affecting physical activities and social relationship, thus enhancing the quality of life. For that reason, studies have been continuously conducted on the role of nature, which is a green space for pursuing health and relieving the stress of urban dwellers. Therefore, this study investigated the effect of experiencing a restoration from nature-based outdoor recreation activities of urban dwellers on their quality of life for the groups with high and low-stress levels. The results of the analysis against visitors who trekked and climbed Mt. Bukhan National Park in Seoul, South Korea showed that the effect of perceiving restorative environment on relaxation, calmness and subjective vitality, and the effect of relaxation and calmness on the quality of life were similar in both groups. However, it was found that subjective vitality affected the quality of life in the group with the high-stress group, while it did not show a significant result in the low-stress group. This is because the high-stress group increased their belief in the future and themselves and vitality through nature-based outdoor activities, which in turn affected their quality of life, while people in the low-stress group normally have subjective vitality in their daily lives, not affected by nature-based outdoor recreation. This result suggests that urban dwellers feel relaxed and calm through nature-based outdoor recreation activities with perceived restorative environment, and such activities enhance their quality of life. Therefore, a wellbeing policy is needed to enhance the quality of life of citizens by creating green spaces in city centers for the promotion of public health.

Keywords: healing tourism, nature-based outdoor recreation, perceived restorative environment, quality of life

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Authors: Rekha S., S. J. Nalini, S. Bhuvana, S. Kanmani, Vidhya Venugopal

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Introduction: Pregnant women's occupational heat exposure has been linked to foetal abnormalities and pregnancy complications. The presence of heat in the workplace is expected to lead to Adverse Pregnancy Outcomes (APO), especially in tropical countries where temperatures are rising and workplace cooling interventions are minimal. For effective interventions, in-depth understanding and evidence about occupational heat stress and APO are required. Methodology: Approximately 800 pregnant women in and around Chennai who were employed in jobs requiring moderate to hard labour participated in the cohort research. During the study period (2014-2019), environmental heat exposures were measured using a Questemp WBGT monitor, and heat strain markers, such as Core Body Temperature (CBT) and Urine Specific Gravity (USG), were evaluated using an Infrared Thermometer and a refractometer, respectively. Using a valid HOTHAPS questionnaire, self-reported health symptoms were collected. In addition, a postpartum follow-up with the mothers was done to collect APO-related data. Major findings of the study: Approximately 47.3% of pregnant workers have workplace WBGTs over the safe manual work threshold value for moderate/heavy employment (Average WBGT of 26.6°C±1.0°C). About 12.5% of the workers had CBT levels above the usual range, and 24.8% had USG levels above 1.020, both of which suggested mild dehydration. Miscarriages (3%), stillbirths/preterm births (3.5%), and low birth weights (8.8%) were the most common unfavorable outcomes among pregnant employees. In addition, WBGT exposures above TLVs during all trimesters were associated with a 2.3-fold increased risk of adverse fetal/maternal outcomes (95% CI: 1.4-3.8), after adjusting for potential confounding variables including age, education, socioeconomic status, abortion history, stillbirth, preterm, LBW, and BMI. The study determined that WBGTs in the workplace had direct short- and long-term effects on the health of both the mother and the foetus. Despite the study's limited scope, the findings provided valuable insights and highlighted the need for future comprehensive cohort studies and extensive data in order to establish effective policies to protect vulnerable pregnant women from the dangers of heat stress and to promote reproductive health.

Keywords: adverse outcome, heat stress, interventions, physiological strain, pregnant women

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Authors: Ingo Roden, Stefana Lupu, Mara Krone, Jasmin Chantah, Gunter Kreutz, Stephan Bongard, Dietmar Grube

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The present experimental study examined the effects of music and math training on mathematical skills and visuospatial working memory capacity in kindergarten children. For this purpose, N = 54 children (mean age: 5.46 years; SD = .29) were randomly assigned to three groups. Children in the music group (n = 18) received weekly sessions of 60 min music training over a period of eight weeks, whereas children in the math group (n = 18) received the same amount of training focusing on mathematical basic skills, such as numeracy skills, quantity comparison, and counting objectives. The third group of children (n = 18) served as waiting controls. The groups were matched for sex, age, IQ and previous music experiences at baseline. Pre-Post intervention measurements revealed a significant interaction effect of group x time, showing that children in both music and math groups significantly improved their early numeracy skills, whereas children in the control group did not. No significant differences between groups were observed for the visuospatial working memory performances. These results confirm and extend previous findings on transfer effects of music training on mathematical abilities and visuospatial working memory capacity. They show that music and math interventions are similarly effective to enhance children’s mathematical skills. More research is necessary to establish, whether cognitive transfer effects arising from music interventions might facilitate children’s transition from kindergarten to first-grade.

Keywords: music training, mathematical skills, working memory, transfer

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Authors: R. N. Jay A. Ablog, M. N. Dyanne R. Del Carmen, Roma Rose A. Dela Cruz, Joselle Dara M. Estrada, Luke Clifferson M. Gagarin, Florence T. Lang-ay, Ma. Dayanara O. Mariñas, Maria Christina S. Nepa, Jahraine Chyle B. Ocampo, Mark Reynie Renz V. Silva, Jenny Lyn L. Soriano, Loreal Cloe M. Suva, Jackelyn R. Torres

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Background: To date, there is dearth of literature as to the effect of relaxation techniques in lowering the stress level of mothers of children with autism spectrum disorder (ASD). Aim: To investigate the effectiveness of 4-week relaxation techniques in stress level reduction of mothers of children with ASD. Methods: Quasi experimental design. It included 25 mothers (10-experimental, 15-control) who were chosen via purposive sampling. The mothers were recruited in the different SPED centers in Baguio City and La Trinidad and in the community. Statistics used were T-test and Related T-Test. Results: The overall weighted mean score after 4-week training is 2.3, indicating that the relaxation techniques introduced were moderately effective in lowering stress level. Statistical analysis (T-test; CV=4.51>TV=2.26) shown a significant difference in the stress level reduction of mothers in the experimental group pre and post interventions. There is also a significant difference in the stress level reduction in the control and the experimental group (Related T-test; CV=2.08 >TV=2.07). The relaxation techniques introduced were favorable, cost-effective, and easy to perform interventions to decrease stress level.

Keywords: relaxation techniques, mindful eating, progressive muscle relaxation, breathing exercise, autism spectrum disorder

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Authors: Christine Eickhoff, Alyssa Adams, Alaine Duncan

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The Washington, DC Veterans Affairs Medical Center (DC VAMC) offers complementary and integrative health (CIH) services such as acupuncture, yoga, meditation, and nutrition education through a coordinated outpatient clinic. The primary population utilizing CIH services are veterans with chronic pain. Acupuncture is one of the most popular of the CIH services available at the DC VAMC. As interest and availability grows, it is important to measure health outcomes associated with CIH service utilization. The purpose of this study was to investigate pain and mental health outcomes for veterans with chronic pain enrolled in individual acupuncture services in the DC VAMC. Veterans at the DC VAMC with self-identified chronic pain and no prior acupuncture experience were recruited for the study (n=70). Veterans were referred for services by a medical provider and completed baseline assessments at the program orientation prior to participating in any CIH services. Veterans received four individual, full-body acupuncture appointments within four weeks of study enrollment. After the first month, participants were scheduled for six appointments that occurred every two weeks and then eight more sessions that were scheduled one month apart. Follow-up assessments were administered at 2, 4, 6, 8, and 12 months. The findings reported will include completed time points at two and four months. Measures include a demographics survey, the Measure Yourself Medical Outcome Profile-2 (MYMOP-2), The Beck Depression Inventory (BDI-II), the Defense Veterans Pain Rating Scale (DVPRS), and the Pain Disability Questionnaire (PDQ). In this sample, 67% identified a pain condition as their primary health concern. Between baseline and two-month follow-up, there were significant improvements in participants’ primary health concern (MYMOP-2 p=0.010), general wellbeing (MYMOP-2 p=0.011), and a significant decrease in the use of medication (MYMOP-2 p<0.000). Between 2 and 4-month follow-up, pain disability (PDQ p=0.035), pain rating (DVPRS p=0.027), and depression (BDI-II p=0.003) significantly improved. Preliminary findings indicate that individual acupuncture therapy can be effective at improving health outcomes, well-being, and decreasing medication use in U.S. military veterans with chronic pain. Findings also suggest that individual acupuncture therapy can improve pain ratings, pain disability, and depression in veterans with chronic pain.

Keywords: acupuncture, chronic pain, depression, integrative health, medication use, military, pain, veterans, wellbeing

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Authors: Viktorya Sargsyan, Arax Hovhannesyan, Karine Abelyan

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Introduction: During the last decade, scientific studies have proven the importance of Early Childhood Development (ECD) interventions. These interventions are shown to create strong foundations for children’s intellectual, emotional and physical well-being, as well as the impact they have on learning and economic outcomes for children as they mature into adulthood. Many children in rural Armenia fail to reach their full development potential due to lack of early brain stimulation (playing, singing, reading, etc.) from their parents, and lack of community tools and services to follow-up children’s neurocognitive development. This is exacerbated by high rates of stunting and anemia among children under 3(CU3). This research study tested the effectiveness of an integrated ECD and Maternal, Newborn and Childhood Health (MNCH) model, called “Go Baby, Go!” (GBG), against the traditional (MNCH) strategy which focuses solely on preventive health and nutrition interventions. The hypothesis of this quasi-experimental study was: Children exposed to GBG will have better neurocognitive and nutrition outcomes compared to those receiving only the MNCH intervention. The secondary objective was to assess the effect of GBG on parental child care and nutrition practices. Methodology: The 14 month long study, targeted all 1,300 children aged 0 to 23 months, living in 43 study communities the in Gavar and Vardenis regions (Gegharkunik province, Armenia). Twenty-three intervention communities, 680 children, received GBG, and 20 control communities, 630 children, received MCHN interventions only. Baseline and evaluation data on child development, nutrition status and parental child care and nutrition practices were collected (caregiver interview, direct child assessment). In the intervention sites, in addition to MNCH (maternity schools, supportive supervision for Health Care Providers (HCP), the trained GBG facilitators conducted six interactive group sessions for mothers (key messages, information, group discussions, role playing, video-watching, toys/books preparation, according to GBG curriculum), and two sessions (condensed GBG) for adult family members (husbands, grandmothers). The trained HCPs received quality supervision for ECD counseling and screening. Findings: The GBG model proved to be effective in improving ECD outcomes. Children in the intervention sites had 83% higher odd of total ECD composite score (cognitive, language, motor) compared to children in the control sites (aOR 1.83; 95 percent CI: 1.08-3.09; p=0.025). Caregivers also demonstrated better child care and nutrition practices (minimum dietary diversity in intervention site is 55 percent higher compared to control (aOR=1.55, 95 percent CI 1.10-2.19, p =0.013); support for learning and disciplining practices (aOR=2.22, 95 percent CI 1.19-4.16, p=0.012)). However, there was no evidence of stunting reduction in either study arm. he effect of the integrated model was more prominent in Vardenis, a community which is characterised by high food insecurity and limited knowledge of positive parenting skills. Conclusion: The GBG model is effective and could be applied in target areas with the greatest economic disadvantages and parenting challenges to improve ECD, care practices and developmental outcomes. Longitudinal studies are needed to view the long-term effects of GBG on learning and school readiness.

Keywords: early childhood development, integrated interventions, parental practices, quasi-experimental study

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Authors: Rahat Zaman

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The present study was conducted to investigate psychological well-being and positive and negative affect among adults. The sample comprised 221 adults; the sample was collected from all over Pakistan. Psychological well-being was measured with the help of the psychological well-being scale developed by Ryff and Keyes (1995). Lifestyle was measured with the help of the Health Promoting Lifestyle Profile Scale developed by Walker et al. (1995). Positive and negative effects were measured by PANAS, developed by Watson, Clark, and Tellegen (1998). To check the properties of scale, the alpha reliability coefficient was calculated. To test the hypotheses of the research, correlation, independent sample t-rest, and ANOVA were computed. It was hypothesized that there would be a positive relationship between psychological well-being and lifestyles and positive affect. The results show that psychological well-being, lifestyle, and positive affect are positively related. This also supports our hypothesis. The research also searched for relationships in the study variables according to the demographics of the sample. The respondents varied according to their dominant affect levels with respect to their psychological well-being and lifestyles. The research found significant differences for the genders in life appreciation, nutrition, and negative affect. Single and married individuals differed significantly on autonomy, environmental mastery, life appreciation, nutrition, and stress management. Individuals showed significant differences with respect to their living situation, joint and nuclear family members showed significant differences in personal growth, autonomy, health responsibilities, social support, physical activities, and stress management. The sample showed significant differences in environmental mastery, personal growth, purpose in life, life appreciation, health responsibilities, physical activities, stress management, and negative affect when divided in socioeconomic status. Age-wise analysis showed significant differences in autonomy, personal growth, purpose in life, life appreciation, nutrition, and stress management. Provincially significant differences were found in life appreciation, nutrition, social support, physical activities, and stress management, and both positive and negative effects were experienced. Implications of the results are discussed.

Keywords: wellbeing, healthy lifestyle, self acceptance, positive

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Authors: Leen Al Kassab, Sarah Johns, Helen Noble, Nawal Nour, Elizabeth Janiak, Sarrah Shahawy

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Introduction: Immigrant and refugee women experience disparities in sexual and reproductive health (SRH) outcomes, partially as a result of barriers to SRH literacy and to regular healthcare access and engagement. Despite the existing data highlighting growing needs for culturally relevant and structurally competent care, interventions are scarce and not well-documented. Methods: In this IRB-approved study, we used a community-based participatory research approach, with the assistance of a community advisory board, to conduct a qualitative needs assessment of SRH knowledge and service engagement with immigrant and refugee women from Africa or the Middle East and currently residing in Boston. We conducted a total of nine focus group discussions (FGDs) in partnership with medical, community, and religious centers, in six languages: Arabic, English, French, Somali, Pashtu, and Dari. A total of 44 individuals participated. We explored migrant and refugee women’s current and evolving SRH care needs and gaps, specifically related to the development of interventions and clinical best practices targeting SRH literacy, healthcare engagement, and informed decision-making. Recordings of the FGDs were transcribed verbatim and translated by interpreter services. We used open coding with multiple coders who resolved discrepancies through consensus and iteratively refined our codebook while coding data in batches using Dedoose software. Results: Participants reported immigrant adaptation experiences, discrimination, and feelings of trust, autonomy, privacy, and connectedness to family, community, and the healthcare system as factors surrounding SRH knowledge and needs. The context of previously learned SRH knowledge was commonly noted to be in schools, at menstruation, before marriage, from family members, partners, friends, and online search engines. Common themes included empowering strength drawn from religious and cultural communities, difficulties bridging educational gaps with their US- born daughters, and a desire for more SRH education from multiple sources, including family, health care providers, and religious experts & communities. Regarding further SRH education, participants’ preferences varied regarding ideal platform (virtual vs. in-person), location (in religious and community centers or not), smaller group sizes, and the involvement of men. Conclusions: Based on these results, empowering SRH initiatives should include both community and religious center-based, as well as clinic-based, interventions. Interventions should be composed of frequent educational workshops in small groups involving age-grouped women, daughters, and (sometimes) men, tailored SRH messaging, and the promotion of culturally, religiously, and linguistically competent care.

Keywords: community, immigrant, religion, sexual & reproductive health, women's health

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Authors: Sukjai Charoensuk, Penphan Pitaksongkram, Michael Christopher

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Preliminary evidences supported the effectiveness of mindfulness-based interventions in reducing symptoms associated with a variety of medical and psychological conditions. However, the measurements of mindfulness are questionable since they have not been developed based-on Buddhist experiences. The purpose of this qualitative study was to describe meaning and cultivating factors of mindfulness as experienced by Thai females who practice Dhamma. Participants were purposively selected to include 2 groups of Thai females who practice Dhamma. The first group consisted of 6 female Buddhist monks, and the second group consisted of 7 female who practice Dhamma without ordaining. Data were collected using in-depth interview. The instruments used were demographic data questionnaire and guideline for in-depth interview developed by researchers. Content analysis was employed to analyze the data. The results revealed that Thai women who practice Dhamma described their experience in 2 themes, which were meaning and cultivating factors of mindfulness. The meaning composed of 4 categories; 1) Being Present, 2) Self-awareness, 3) Contemplation, and 4) Neutral. The cultivating factors of mindfulness composed of 2 categories; In-personal factors and Ex-personal factors. The In-personal cultivating factors included 4 sub-categories; Faith and Love, the Five Precepts, Sound body, and Practice. The Ex-personal cultivating factors included 2 sub-categories; Serenity, and Learning. These findings increase understanding about meaning of mindfulness and its cultivating factors. These could be used as a guideline to promote mental health and develop nursing interventions using mindfulness based, as well as, develop the instrument for assessing mindfulness in Thai context.

Keywords: cultivating factor, meaning of mindfulness, practice Dhamma, Thai women

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