Search results for: postpartum depression
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 895

Search results for: postpartum depression

355 Stress and Distress among Physician Trainees: A Wellbeing Workshop

Authors: Carmen Axisa, Louise Nash, Patrick Kelly, Simon Willcock

Abstract:

Introduction: Doctors experience high levels of burnout, stress and psychiatric morbidity. This can affect the health of the doctor and impact patient care. Study Aims: To evaluate the effectiveness of a workshop intervention to promote wellbeing for Australian Physician Trainees. Methods: A workshop was developed in consultation with specialist clinicians to promote health and wellbeing for physician trainees. The workshop objectives were to improve participant understanding about factors affecting their health and wellbeing, to outline strategies on how to improve health and wellbeing and to encourage participants to apply these strategies in their own lives. There was a focus on building resilience and developing long term healthy behaviours as part of the physician trainee daily lifestyle. Trainees had the opportunity to learn practical strategies for stress management, gain insight into their behaviour and take steps to improve their health and wellbeing. The workshop also identified resources and support systems available to trainees. The workshop duration was four and a half hours including a thirty- minute meal break where a catered meal was provided for the trainees. Workshop evaluations were conducted at the end of the workshop. Sixty-seven physician trainees from Adult Medicine and Paediatric training programs in Sydney Australia were randomised into intervention and control groups. The intervention group attended a workshop facilitated by specialist clinicians and the control group did not. Baseline and post intervention measurements were taken for both groups to evaluate the impact and effectiveness of the workshop. Forty-six participants completed all three measurements (69%). Demographic, personal and self-reported data regarding work/life patterns was collected. Outcome measures include Depression Anxiety Stress Scale (DASS), Professional Quality of Life Scale (ProQOL) and Alcohol Use Disorders Identification Test (AUDIT). Results: The workshop was well received by the physician trainees and workshop evaluations showed that the majority of trainees strongly agree or agree that the training was relevant to their needs (96%) and met their expectations (92%). All trainees strongly agree or agree that they would recommend the workshop to their medical colleagues. In comparison to the control group we observed a reduction in alcohol use, depression and burnout but an increase in stress, anxiety and secondary traumatic stress in the intervention group, at the primary endpoint measured at 6 months. However, none of these differences reached statistical significance (p > 0.05). Discussion: Although the study did not reach statistical significance, the workshop may be beneficial to physician trainees. Trainees had the opportunity to share ideas, gain insight into their own behaviour, learn practical strategies for stress management and discuss approach to work, life and self-care. The workshop discussions enabled trainees to share their experiences in a supported environment where they learned that other trainees experienced stress and burnout and they were not alone in needing to acquire successful coping mechanisms and stress management strategies. Conclusion: These findings suggest that physician trainees are a vulnerable group who may benefit from initiatives that promote wellbeing and from a more supportive work environment.

Keywords: doctors' health, physician burnout, physician resilience, wellbeing workshop

Procedia PDF Downloads 164
354 Analysis of Patient No-Shows According to Health Conditions

Authors: Sangbok Lee

Abstract:

There has been much effort on process improvement for outpatient clinics to provide quality and acute care to patients. One of the efforts is no-show analysis or prediction. This work analyzes patient no-shows along with patient health conditions. The health conditions refer to clinical symptoms that each patient has, out of the followings; hyperlipidemia, diabetes, metastatic solid tumor, dementia, chronic obstructive pulmonary disease, hypertension, coronary artery disease, myocardial infraction, congestive heart failure, atrial fibrillation, stroke, drug dependence abuse, schizophrenia, major depression, and pain. A dataset from a regional hospital is used to find the relationship between the number of the symptoms and no-show probabilities. Additional analysis reveals how each symptom or combination of symptoms affects no-shows. In the above analyses, cross-classification of patients by age and gender is carried out. The findings from the analysis will be used to take extra care to patients with particular health conditions. They will be forced to visit clinics by being informed about their health conditions and possible consequences more clearly. Moreover, this work will be used in the preparation of making institutional guidelines for patient reminder systems.

Keywords: healthcare system, no show analysis, process improvment, statistical data analysis

Procedia PDF Downloads 211
353 The 5-HT1A Receptor Biased Agonists, NLX-101 and NLX-204, Elicit Rapid-Acting Antidepressant Activity in Rat Similar to Ketamine and via GABAergic Mechanisms

Authors: A. Newman-Tancredi, R. Depoortère, P. Gruca, E. Litwa, M. Lason, M. Papp

Abstract:

The N-methyl-D-aspartic acid (NMDA) receptor antagonist, ketamine, can elicit rapid-acting antidepressant (RAAD) effects in treatment-resistant patients, but it requires parenteral co-administration with a classical antidepressant under medical supervision. In addition, ketamine can also produce serious side effects that limit its long-term use, and there is much interest in identifying RAADs based on ketamine’s mechanism of action but with safer profiles. Ketamine elicits GABAergic interneuron inhibition, glutamatergic neuron stimulation, and, notably, activation of serotonin 5-HT1A receptors in the prefrontal cortex (PFC). Direct activation of the latter receptor subpopulation with selective ‘biased agonists’ may therefore be a promising strategy to identify novel RAADs and, consistent with this hypothesis, the prototypical cortical biased agonist, NLX-101, exhibited robust RAAD-like activity in the chronic mild stress model of depression (CMS). The present study compared the effects of a novel, selective 5-HT1A receptor-biased agonist, NLX-204, with those of ketamine and NLX-101. Materials and methods: CMS procedure was conducted on Wistar rats; drugs were administered either intraperitoneally (i.p.) or by bilateral intracortical microinjection. Ketamine: 10 mg/kg i.p. or 10 µg/side in PFC; NLX-204 and NLX-101: 0.08 and 0.16 mg/kg i.p. or 16 µg/side in PFC. In addition, interaction studies were carried out with systemic NLX-204 or NLX-101 (each at 0.16 mg/kg i.p.) in combination with intracortical WAY-100635 (selective 5-HT1A receptor antagonist; 2 µg/side) or muscimol (GABA-A receptor agonist, 12.5 ng/side). Anhedonia was assessed by CMS-induced decrease in sucrose solution consumption; anxiety-like behavior was assessed using the Elevated Plus Maze (EPM), and cognitive impairment was assessed by the Novel Object Recognition (NOR) test. Results: A single administration of NLX-204 was sufficient to reverse the CMS-induced deficit in sucrose consumption, similarly to ketamine and NLX-101. NLX-204 also reduced CMS-induced anxiety in the EPM and abolished CMS-induced NOR deficits. These effects were maintained (EPM and NOR) or enhanced (sucrose consumption) over a subsequent 2-week period of treatment. The anti-anhedonic response of the drugs was also maintained for several weeks Following treatment discontinuation, suggesting that they had sustained effects on neuronal networks. A single PFC administration of NLX-204 reversed deficient sucrose consumption, similarly to ketamine and NLX-101. Moreover, the anti-anhedonic activities of systemic NLX-204 and NLX 101 were abolished by coadministration with intracortical WAY-100635 or muscimol. Conclusions: (i) The antidepressant-like activity of NLX-204 in the rat CMS model was as rapid as that of ketamine or NLX-101, supporting targeting cortical 5-HT1A receptors with selective, biased agonists to achieve RAAD effects. (ii)The anti-anhedonic activity of systemic NLX-204 was mimicked by local administration of the compound in the PFC, confirming the involvement of cortical circuits in its RAAD-like effects. (iii) Notably, the effects of systemic NLX-204 and NLX-101 were abolished by PFC administration of muscimol, indicating that they act by (indirectly) eliciting a reduction in cortical GABAergic neurotransmission. This is consistent with ketamine’s mechanism of action and suggests that there are converging NMDA and 5-HT1A receptor signaling cascades in PFC underlying the RAAD-like activities of ketamine and NLX-204. Acknowledgements: The study was financially supported by NCN grant no. 2019/35/B/NZ7/00787.

Keywords: depression, ketamine, serotonin, 5-HT1A receptor, chronic mild stress

Procedia PDF Downloads 81
352 Manifestation of Behavioral and Emotional Disturbances in News Reporters Covering Traumatic Events

Authors: Misbah Shahzadi

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The present study was conducted to identify the emotional and behavioral disturbances among the News Reporters covering Traumatic events. In the present study, a sample of 50 News Reporters belonging to the national and the local news agencies were selected from Rawalpindi and Islamabad who had covered any traumatic event in the past one year. Rotter’s Incomplete Sentence Blank (RISB) and Impact of Event Scale interpretations were used to assess a variety of emotional and behavioral patterns of News Reporters. Results showed that some of the frequent emotional and behavioral reactions exhibited by individuals like withdrawal, anxiety\depression, aggression, hyperarousal and avoidance behavior whereas gender-based comparisons indicated that there is no significant gender difference in the News Reporters in manifestations of behavioral and emotional disturbances. It is concluded that significant negative emotional and behavioral reactions are exhibited by the News Reporters who cover traumatic events. The study identifies the negative emotional and behavioral reactions/disturbances after trauma, which can be helpful for identifying problematic areas for counseling and therapeutic interventions for these News Reporters.

Keywords: behavioural disturbance, emotional disturbance, news reporters, traumatic events

Procedia PDF Downloads 403
351 The Significant Effect of Wudu’ and Zikr in the Controlling of Emotional Pressure Using Biofeedback Emwave Technique

Authors: Mohd Anuar Awang Idris, Muhammad Nubli Abdul Wahab, Nora Yusma Mohamed Yusoff

Abstract:

Wudu’ (Ablution) and Zikr are amongst some of the spiritual tools which may help an individual control his mind, emotion and attitude. These tools are deemed to be able to deliver a positive impact on an individual’s psychophysiology. The main objective of this research is to determine the effects of Wudu’ (Ablution) and Zikr therapy using the biofeedback emWave application and technology. For this research, 13 students were selected as samples from the students’ representative body at the University Tenaga National, Malaysia. The DASS (Depression Anxiety Stress Scale) questionnaire was used to help with the assessment and measurement of each student’s ability in controlling his or her emotions before and after the therapies. The biofeedback emWave technology was utilized to monitor the student’s psychophysiology level. In addition, the data obtained from the Heart rate variability (HRV) test have also been used to affirm that Wudu’ and Zikr had had significant impacts on the student’s success in controlling his or her emotional pressure.

Keywords: biofeedback EmWave, emotion, psychophysiology, wudu’, zikr

Procedia PDF Downloads 181
350 An Empirical Examination of the Determinant of the Financial CEOs’ Compensation for the Post-Financial Crisis Period

Authors: Eunsup Daniel Shim, Jooh Lee

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The US financial crisis of 2008 and subsequent Global Financial Crisis were considered by many economists the worst financial crisis since the Great Depression of the 1930s. As a results, Dodd-Frank Act has passed and aims '(1) to promote the financial stability of the United States by improving accountability and transparency in the financial system, to end "too big to fail", (2) to protect the American taxpayer by ending bailouts, (3) to protect consumers from abusive financial services practices, and for other purposes.' The enactment of Dodd-Frank Act, in part, intended to significantly influence accountability on executive compensation especially for the financial institutions. This paper empirically investigates the changes in Financial CEOs’ compensation since the Financial Crisis of 2008. Our findings show that in the post- Financial Crisis period financial leverage is significant factor influencing the CEOs’ total compensation. In addition market based performance such as stock price and market-to-book ratio shows significant positive relationship with CEO compensation. This change can be interpreted an attempt to reduce opportunistic behavior of top executives after the financial crisis and the enactment of the Dodd-Frank Act.

Keywords: financial CEO compensation, firm performance, financial crisis of 2008, dodd-frank act

Procedia PDF Downloads 496
349 The Conception of the Students about the Presence of Mental Illness at School

Authors: Aline Giardin, Maria Rosa Chitolina, Maria Catarina Zanini

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In this paper, we analyze the conceptions of high school students about mental health issues, and discuss the creation of mental basic health programs in schools. We base our findings in a quantitative survey carried out by us with 156 high school students of CTISM (Colégio Técnico Industrial de Santa Maria) school, located in Santa Maria city, Brazil. We have found that: (a) 28 students relate the subject ‘mental health’ with psychiatric hospitals and lunatic asylums; (b) 28 students have relatives affected by mental diseases; (c) 76 students believe that mental patients, if treated, can live a healthy life; (d) depression, schizophrenia and bipolar disorder are the most cited diseases; (e) 84 students have contact with mental patients, but know nothing about the disease; (f) 123 students have never been instructed about mental diseases while in the school; and (g) 135 students think that a mental health program would be important in the school. We argue that these numbers reflect a vision of mental health that can be related to the reductionist education still present in schools and to the lack of integration between health professionals, sciences teachers, and students. Furthermore, this vision can also be related to a stigmatization process, which interferes with the interactions and with the representations regarding mental disorders and mental patients in society.

Keywords: mental health, schools, mental illness, conception

Procedia PDF Downloads 448
348 Standardization of the Behavior Assessment System for Children-2, Parent Rating Scales - Adolescent Form (K BASC-2, PRS-A) among Korean Sample

Authors: Christine Myunghee Ahn, Sung Eun Baek, Sun Young Park

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The purpose of this study was to evaluate the cross-cultural validity of the Korean version of the Behavioral Assessment System for Children 2nd Edition, Parent Rating Scales - Adolescent Form (K BASC-2, PRS-A). The 150-item K BASC-2, PRS-A questionnaire was administered to a total of 690 Korean parents or caregivers (N=690) of adolescent children in middle school and high school. Results from the confirmatory and exploratory factor analyses indicate that the K BASC-2, PRS-A yielded a 3-factor solution similar to the factor structure found in the original version of the BASC-2. The internal consistencies using the Cronbach’s alpha of the composite scale scores were in the .92~ .98 range. The overall reliability and validity of the K BASC-2, PRS-A seem adequate. Structural equation modeling was used to verify the theoretical relationship among the scales of Adaptability, Withdrawal, Somatization, Depression, and Anxiety, to render additional support for internal validity. Other relevant findings, practical implications regarding the use of the KBASC-2, PRS-A and suggestions for future research are discussed.

Keywords: behavioral assessment system, cross-cultural validity, parent report, screening

Procedia PDF Downloads 467
347 Design and Construction of a Home-Based, Patient-Led, Therapeutic, Post-Stroke Recovery System Using Iterative Learning Control

Authors: Marco Frieslaar, Bing Chu, Eric Rogers

Abstract:

Stroke is a devastating illness that is the second biggest cause of death in the world (after heart disease). Where it does not kill, it leaves survivors with debilitating sensory and physical impairments that not only seriously harm their quality of life, but also cause a high incidence of severe depression. It is widely accepted that early intervention is essential for recovery, but current rehabilitation techniques largely favor hospital-based therapies which have restricted access, expensive and specialist equipment and tend to side-step the emotional challenges. In addition, there is insufficient funding available to provide the long-term assistance that is required. As a consequence, recovery rates are poor. The relatively unexplored solution is to develop therapies that can be harnessed in the home and are formulated from technologies that already exist in everyday life. This would empower individuals to take control of their own improvement and provide choice in terms of when and where they feel best able to undertake their own healing. This research seeks to identify how effective post-stroke, rehabilitation therapy can be applied to upper limb mobility, within the physical context of a home rather than a hospital. This is being achieved through the design and construction of an automation scheme, based on iterative learning control and the Riener muscle model, that has the ability to adapt to the user and react to their level of fatigue and provide tangible physical recovery. It utilizes a SMART Phone and laptop to construct an iterative learning control (ILC) system, that monitors upper arm movement in three dimensions, as a series of exercises are undertaken. The equipment generates functional electrical stimulation to assist in muscle activation and thus improve directional accuracy. In addition, it monitors speed, accuracy, areas of motion weakness and similar parameters to create a performance index that can be compared over time and extrapolated to establish an independent and objective assessment scheme, plus an approximate estimation of predicted final outcome. To further extend its assessment capabilities, nerve conduction velocity readings are taken by the software, between the shoulder and hand muscles. This is utilized to measure the speed of response of neuron signal transfer along the arm and over time, an online indication of regeneration levels can be obtained. This will prove whether or not sufficient training intensity is being achieved even before perceivable movement dexterity is observed. The device also provides the option to connect to other users, via the internet, so that the patient can avoid feelings of isolation and can undertake movement exercises together with others in a similar position. This should create benefits not only for the encouragement of rehabilitation participation, but also an emotional support network potential. It is intended that this approach will extend the availability of stroke recovery options, enable ease of access at a low cost, reduce susceptibility to depression and through these endeavors, enhance the overall recovery success rate.

Keywords: home-based therapy, iterative learning control, Riener muscle model, SMART phone, stroke rehabilitation

Procedia PDF Downloads 245
346 Balanced Ischemia Misleading to a False Negative Myocardial Perfusion Imaging (Stress) Test

Authors: Devam Sheth

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Nuclear imaging with stress myocardial perfusion (stress test) is the preferred first line investigation for noninvasive evaluation of ischaemic heart condition. The sensitivity of this test is close to 90 % making it a very reliable test. However, rarely it gives a false negative result which can be explained by the phenomenon termed as “balanced ischaemia”. We present the case of a 78 year Caucasian female without any significant past cardiac history, who presents with chest pain and shortness of breath since one day. The initial ECG and cardiac enzymes were non-impressive. Few hours later, she had some substernal chest pain along with some ST segment depression in the lateral leads. Stress test comes back negative for any significant perfusion defects. However, given her typical symptoms, she underwent a cardiac catheterization which revealed significant triple vessel disease mandating her to get a bypass surgery. This unusual phenomenon of false nuclear stress test in the setting of positive ECG changes can be explained only by balanced ischemia wherein due to global myocardial ischemia, the stress test fails to reveal relative perfusion defects in the affected segments.

Keywords: balanced, false positive, ischemia, myocardial perfusion imaging

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345 Parenting Stress and Maternal Psychological Statues in Mothers of Dual Diagnosis Children

Authors: Deena Moustafa

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The purpose of this paper is to describe the sources of parenting stress in mothers of Dual Diagnosis children (n =60) and examine the relationship between parenting stress and maternal psychological status (depression and well-being), also examine if there is any difference between the previous variables in different disabilities associated with Autism. A descriptive correlational design was used. Data were collected via online questionnaires. The study finds that there was no significant relationship between Autism Parenting Stress Index (APSI) scores and types of disability which associated with Autism, although Mothers with deaf autistic reported more parenting stress, Similar findings were found regarding Depressive Symptoms, as there was no significant relationship between (CESD-R) scores and types of disability which associated with Autism, also study finds that there was a significant correlation of the (APSI) with the (CESD-R) Mothers with higher overall parenting stress reported more depressive symptoms. Likewise, there was also a significant correlation between the (APSI) and the (RPWB) Mothers reporting more parenting stress also reported lower levels of well-being.

Keywords: parenting stress, maternal psychological statues, mothers of dual diagnosis, autism

Procedia PDF Downloads 436
344 Effects of Heart Rate Variability Biofeedback to Improve Autonomic Nerve Function, Inflammatory Response and Symptom Distress in Patients with Chronic Kidney Disease: A Randomized Control Trial

Authors: Chia-Pei Chen, Yu-Ju Chen, Yu-Juei Hsu

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The prevalence and incidence of end-stage renal disease in Taiwan ranks the highest in the world. According to the statistical survey of the Ministry of Health and Welfare in 2019, kidney disease is the ninth leading cause of death in Taiwan. It leads to autonomic dysfunction, inflammatory response and symptom distress, and further increases the damage to the structure and function of the kidneys, leading to increased demand for renal replacement therapy and risks of cardiovascular disease, which also has medical costs for the society. If we can intervene in a feasible manual to effectively regulate the autonomic nerve function of CKD patients, reduce the inflammatory response and symptom distress. To prolong the progression of the disease, it will be the main goal of caring for CKD patients. This study aims to test the effect of heart rate variability biofeedback (HRVBF) on improving autonomic nerve function (Heart Rate Variability, HRV), inflammatory response (Interleukin-6 [IL-6], C reaction protein [CRP] ), symptom distress (Piper fatigue scale, Pittsburgh Sleep Quality Index [PSQI], and Beck Depression Inventory-II [BDI-II] ) in patients with chronic kidney disease. This study was experimental research, with a convenience sampling. Participants were recruited from the nephrology clinic at a medical center in northern Taiwan. With signed informed consent, participants were randomly assigned to the HRVBF or control group by using the Excel BINOMDIST function. The HRVBF group received four weekly hospital-based HRVBF training, and 8 weeks of home-based self-practice was done with StressEraser. The control group received usual care. We followed all participants for 3 months, in which we repeatedly measured their autonomic nerve function (HRV), inflammatory response (IL-6, CRP), and symptom distress (Piper fatigue scale, PSQI, and BDI-II) on their first day of study participation (baselines), 1 month, and 3 months after the intervention to test the effects of HRVBF. The results were analyzed by SPSS version 23.0 statistical software. The data of demographics, HRV, IL-6, CRP, Piper fatigue scale, PSQI, and BDI-II were analyzed by descriptive statistics. To test for differences between and within groups in all outcome variables, it was used by paired sample t-test, independent sample t-test, Wilcoxon Signed-Rank test and Mann-Whitney U test. Results: Thirty-four patients with chronic kidney disease were enrolled, but three of them were lost to follow-up. The remaining 31 patients completed the study, including 15 in the HRVBF group and 16 in the control group. The characteristics of the two groups were not significantly different. The four-week hospital-based HRVBF training combined with eight-week home-based self-practice can effectively enhance the parasympathetic nerve performance for patients with chronic kidney disease, which may against the disease-related parasympathetic nerve inhibition. In the inflammatory response, IL-6 and CRP in the HRVBF group could not achieve significant improvement when compared with the control group. Self-reported fatigue and depression significantly decreased in the HRVBF group, but they still failed to achieve a significant difference between the two groups. HRVBF has no significant effect on improving the sleep quality for CKD patients.

Keywords: heart rate variability biofeedback, autonomic nerve function, inflammatory response, symptom distress, chronic kidney disease

Procedia PDF Downloads 155
343 Paediatric Motor Difficulties and Internalising Problems: An Integrative Review on the Environmental Stress Hypothesis

Authors: Noah Erskine, Jaime Barratt, John Cairney

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The current study aims to provide an in-depth analysis and extension of the Environmental Stress Hypothesis (ESH) framework, focusing on the complex interplay between poor motor skills and internalising problems like anxiety and depression. Using an integrative research review methodology, this study synthesizes findings from 38 articles, both empirical and theoretical, building upon the foundational work of the model. The hypothesis posits that poor motor skills serve as a primary stressor, leading to internalising problems through various secondary stressors. A rigorous comparison of data was conducted, considering study design, findings, and methodologies - while giving special attention to variables such as age, sex, and comorbidities. The study also enhances the ESH framework by introducing resource buffers, including optimism and familial support, as additional influencing factors. This multi-level approach yields a more nuanced and comprehensive ESH framework, highlighting the need for future studies to consider intersectional variables and how they may vary across various life stages.

Keywords: motor coordination, mental health, developmental coordination disorders, paediatric comorbidities, obesity, peer problems

Procedia PDF Downloads 50
342 The Assessment of Some Biological Parameters With Dynamic Energy Budget of Mussels in Agadir Bay

Authors: Zahra Okba, Hassan El Ouizgani

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Anticipating an individual’s behavior to the environmental factors allows for having relevant ecological forecasts. The Dynamic Energy Budget model facilitates prediction, and it is mechanically dependent on biology to abiotic factors but is generally field verified under relatively stable physical conditions. Dynamic Energy Budget Theory (DEB) is a robust framework that can link the individual state to environmental factors, and in our work, we have tested its ability to account for variability by looking at model predictions in the Agadir Bay, which is characterized by a semi-arid climate and temperature is strongly influenced by the trade winds front and nutritional availability. From previous works in our laboratory, we have collected different biological DEB model parameters of Mytilus galloprovincialis mussel in Agadir Bay. We mathematically formulated the equations that make up the DEB model and then adjusted our analytical functions with the observed biological data of our local species. We also assumed the condition of constant immersion, and then we integrated the details of the tidal cycles to calculate the metabolic depression at low tide. Our results are quite satisfactory concerning the length and shape of the shell in one part and the gonadosomatic index in another part.

Keywords: dynamic energy budget, mussels, mytilus galloprovincialis, agadir bay, DEB model

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341 A Look into Surgical Site Infections: Impact of Collective Interventions

Authors: Lisa Bennett, Cynthia Walters, Cynthia Argani, Andy Satin, Geeta Sood, Kerri Huber, Lisa Grubb, Woodrow Noble, Melissa Eichelberger, Darlene Zinalabedini, Eric Ausby, Jeffrey Snyder, Kevin Kirchoff

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Background: Surgical site infections (SSIs) within the obstetric population pose a variety of complications, creating clinical and personal challenges for the new mother and her neonate during the postpartum period. Our journey to achieve compliance with the SSI core measure for cesarean sections revealed many opportunities to improve these outcomes. Objective: Achieve and sustain core measure compliance keeping surgical site infection rates below the national benchmark pooled mean of 1.8% in post-operative patients, who delivered via cesarean section at the Johns Hopkins Bayview Medical Center. Methods: A root cause analysis was performed and revealed several environmental, pharmacologic, and clinical practice opportunities for improvement. A multidisciplinary approach led by the OB Safety Nurse, OB Medical Director, and Infectious Disease Department resulted in the implementation of fourteen interventions over a twenty-month period. Interventions included: post-operative dressing changes, standardizing operating room attire, broadening pre-operative antibiotics, initiating vaginal preps, improving operating room terminal cleaning, testing air quality, and re-educating scrub technicians on technique. Results: Prior to the implementation of our interventions, the SSI quarterly rate in Obstetrics peaked at 6.10%. Although no single intervention resulted in dramatic improvement, after implementation of all fourteen interventions, the quarterly SSI rate has subsequently ranged from to 0.0% to 2.70%. Significance: Taking an introspective look at current practices can reveal opportunities for improvement which previously were not considered. Collectively the benefit of these interventions has shown a significant decrease in surgical site infection rates. The impact of this quality improvement project highlights the synergy created when members of the multidisciplinary team work in collaboration to improve patient safety, and achieve a high quality of care.

Keywords: cesarean section, surgical site infection, collaboration and teamwork, patient safety, quality improvement

Procedia PDF Downloads 455
340 Horticulture Therapy: A Healing Tool for Combating Depression

Authors: Eric Spruth, Lindsey Herbert, Danielle DiCristofano, Isis Violet Spruth, Drake Von Spruth

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Turning dreams into reality, the lifelong passion of Mr. Spruth and the company is to transform garbage-filled courtyards into flourishing flower and vegetable gardens, bringing light, hope, and wellness to not just the space but to the populations served within these public and private spaces. As an Expressive Art Therapist at Cook County Jail, Eric Spruth has implemented gardening projects, mobile radish carts, plant fostering systems, and large-scale murals. Lindsey Herbert, the Manager of Operations and Events at the International Museum of Surgical Science, supports gardening projects with Mr. Spruth along the front lawn of the museum, which will eventually accumulate into a community wellness garden. Mr. Spruth and Ms. Herbert both have dedicated efforts towards fostering awareness of hope and help and accountability for physical and mental wellbeing. Medicinal plants can rightfully be called one of nature’s wonderful healing tools with therapeutic powers. They can inhibit and kill bacteria, lower blood pressure, blood cholesterol, and blood sugar, prevent blood clotting, boost the immune system, and serve as a digestive aid. Some plants have the ability to stimulate the lymphatic system, which expedites the removal of waste products from the body to fight off evil toxins. Many plants are considered effective antioxidants to protect cells against free radical damage, serving to prevent some forms of cancer, heart disease, strokes, and viral infections. Garlic alone can provide us with over two hundred unusual chemicals that have the capability of protecting the human body from a wide variety of diseases. Besides the medicinal qualities of plants, plant and vegetable gardens also have an echoing effect on non-participants to look at something beautiful rather than a concrete courtyard or an unkempt lawn in front of a beautiful building. Plants also purify spaces and affect mood with color therapy. Collective gardening can foster a sense of community and purpose. Additionally, by recognizing the ever-evolving planet with global warming, horticulture therapy teaches important lessons in responsibility, accountability, and sustainability. Growing local food provides an opportunity to be involved in your own mental and physical health and gives you a chance for your own self-resilience, combating depression and a lack of nutrition. In adolescents, the process of watering and caring for plants can teach important life lessons that transcend beyond the garden by providing knowledge on how to care for yourself and how to be an active member of society. It also gives a sense of purpose and pride in transforming a small seed into a plant that can be consumed or enjoyed by others. Mr. Spruth and Ms. Herbert recognize the importance of bringing more green spaces to urban areas, both to serve a nutritional benefit and provide a beautiful transformation to underutilized areas. Gardens can bring beauty, wellness, and hope to dark spaces and provide immeasurable benefits for all.

Keywords: growth, hope, mental health, sustainability, transformation, wellness

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339 Investigation of Stress and Its Effects on Health Workers in Federal Medical Centres in Nigeria

Authors: Chisom N. Nwaigwe, Blessing N. Egbulefu, Angela Uwakwem

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A study on Stress and its’ effect on the health of workers in Federal Medical Centres in Nigeria is presented. The aim is to evaluate how much stress related hazards health workers in our tertiary health institutions are exposed to and to create awareness and reduce the rate at which stress affect the health of the working population in Nigeria, using workers in Federal Medical Centre, Umuahia as a case study. The descriptive survey design was adopted with the aid of 100 questionnaires delivered to the respondents in order to obtain first-hand information. From the findings, the major causes of stress were identified as inadequate staffing, unresolved family problems and psychological/cultural factors like the return of a lactating mother to work after three months post-delivery. The effects of stress on the workers were identified as hypertension, poor job performances, depression, asthma, and peptic ulcers. The study recommended instituting counseling units for stress management, holding seminars on stress management and increasing the salary scale (remuneration) and proper roster planning as solutions to stress reduction in our hospitals. This study is important to management in planning staffing, roaster, and a rehabilitation programme for her staff.

Keywords: stress, causes, effects, workers

Procedia PDF Downloads 445
338 Survey of Potential Adverse Health Effects of Mobile Phones, and Wireless Base Stations in Nigeria

Authors: Nureni A. Yekini, Isaac T. Babalola, Edwin E. Aighokhan, Agnes K. Akinwole, N. Stephen Igwe

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Survey was conducted to gather information on potential adverse health effects of Mobile Phones, and Telecommunication Tower Base Stations in Nigeria. Data was sourced from two sampled populations. Firstly from the people living in close proximity to base stations, and secondly from cell phone users. Questionnaire was used to gathered information from 574 people on thirteen non-specific health symptoms. Data obtained was presented and analyzed. The analysis shows that people living close to the based stations over a long period of time with or without cell phone, and also the heavy phone users with close proximity to the base stations are liable to have some potential health hazards, such as fatigue, sleep disturbances, headaches, feeling of discomfort, difficulty in concentrating, depression, memory loss, visual disruptions, irritability, hearing disruptions, skin problems, cardiovascular disorders, and dizziness.

Keywords: health hazards, wireless base stations, phone users, mobile phones, Nigeria

Procedia PDF Downloads 293
337 Emotional Disclosure as Mediator Between Marital Satisfaction and Mental Health Problems in Women with Infertility

Authors: Sadia Saleem

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Infertility is a global health concern that may have a long-lasting effect on the psychosocial functioning of an individual. Rich research evidence has shown that women with infertility are at greater risk of adverse psychological experiences than men. The culture plays a risk factor when it comes to infertility. Family is considered as a central focus of a collectivistic culture like Pakistan and having children is the key factor that determines the quality of a marital relationship, individual well-being and overall standing in the society. In this collectivistic cultural context, women usually get the blame and experience more psychological distress and social isolation. A total sample of 121 (M 28.17, SD 4.73) women with primary infertility selected through purposive sampling were tested using Emotional Disclosure Questionnaire, Couple Satisfaction Index and Depression Anxiety Stress Scale. The results indicate that negative emotional disclosure positively mediates the relationship between marital satisfaction and mental health problems (p < .001) in women with primary infertility. The results are discussed in terms of psychosocial counseling and family psychoeducation in Pakistani collectivistic cultural context.

Keywords: infertility, couple satisfaction, emotional disclosure, mental health

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336 Occupational Heat Stress Related Adverse Pregnancy Outcome: A Pilot Study in South India Workplaces

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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335 Adapting to College: Exploration of Psychological Well-Being, Coping, and Identity as Markers of Readiness

Authors: Marit D. Murry, Amy K. Marks

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The transition to college is a critical period that affords abundant opportunities for growth in conjunction with novel challenges for emerging adults. During this time, emerging adults are garnering experiences and acquiring hosts of new information that they are required to synthesize and use to inform life-shaping decisions. This stage is characterized by instability and exploration, which necessitates a diverse set of coping skills to successfully navigate and positively adapt to their evolving environment. However, important sociocultural factors result in differences that occur developmentally for minority emerging adults (i.e., emerging adults with an identity that has been or is marginalized). While the transition to college holds vast potential, not all are afforded the same chances, and many individuals enter into this stage at varying degrees of readiness. Understanding the nuance and diversity of student preparedness for college and contextualizing these factors will better equip systems to support incoming students. Emerging adulthood for ethnic, racial minority students presents itself as an opportunity for growth and resiliency in the face of systemic adversity. Ethnic, racial identity (ERI) is defined as an identity that develops as a function of one’s ethnic-racial group membership. Research continues to demonstrate ERI as a resilience factor that promotes positive adjustment in young adulthood. Adaptive coping responses (e.g., engaging in help-seeking behavior, drawing on personal and community resources) have been identified as possible mechanisms through which ERI buffers youth against stressful life events, including discrimination. Additionally, trait mindfulness has been identified as a significant predictor of general psychological health, and mindfulness practice has been shown to be a self-regulatory strategy that promotes healthy stress responses and adaptive coping strategy selection. The current study employed a person-centered approach to explore emerging patterns across ethnic identity development and psychological well-being criterion variables among college freshmen. Data from 283 incoming college freshmen at Northeastern University were analyzed. The Brief COPE Acceptance and Emotional Support scales, the Five Factor Mindfulness Questionnaire, and MIEM Exploration and Affirmation measures were used to inform the cluster profiles. The TwoStep auto-clustering algorithm revealed an optimal three-cluster solution (BIC = 848.49), which classified 92.6% (n = 262) of participants in the sample into one of the three clusters. The clusters were characterized as ‘Mixed Adjustment’, ‘Lowest Adjustment’, and ‘Moderate Adjustment.’ Cluster composition varied significantly by ethnicity X² (2, N = 262) = 7.74 (p = .021) and gender X² (2, N = 259) = 10.40 (p = .034). The ‘Lowest Adjustment’ cluster contained the highest proportion of students of color, 41% (n = 32), and male-identifying students, 44.2% (n = 34). Follow-up analyses showed higher ERI exploration in ‘Moderate Adjustment’ cluster members, also reported higher levels of psychological distress, with significantly elevated depression scores (p = .011), psychological diagnoses of depression (p = .013), anxiety (p = .005) and psychiatric disorders (p = .025). Supporting prior research, students engaging with identity exploration processes often endure more psychological distress. These results indicate that students undergoing identity development may require more socialization and different services beyond normal strategies.

Keywords: adjustment, coping, college, emerging adulthood, ethnic-racial identity, psychological well-being, resilience

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334 Multivariate Analysis of the Relationship between Professional Burnout, Emotional Intelligence and Health Level in Teachers University of Guayaquil

Authors: Viloria Marin Hermes, Paredes Santiago Maritza, Viloria Paredes Jonathan

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The aim of this study is to assess the prevalence of Burnout syndrome in a sample of 600 professors at the University of Guayaquil (Ecuador) using the Maslach Burnout Inventory (M.B.I.). In addition, assessment was made of the effects on health from professional burnout using the General Health Questionnaire (G.H.Q.-28), and the influence of Emotional Intelligence on prevention of its symptoms using the Spanish version of the Trait Meta-Mood Scale (T.M.M.S.-24). After confirmation of the underlying factor structure, the three measurement tools showed high levels of internal consistency, and specific cut-off points were proposed for the group of Latin American academics in the M.B.I. Statistical analysis showed the syndrome is present extensively, particularly on medium levels, with notably low scores given for Professional Self-Esteem. The application of Canonical Correspondence Analysis revealed that low levels of self-esteem are related to depression, with a lack of personal resources related to anxiety and insomnia, whereas the ability to perceive and control emotions and feelings improves perceptions of professional effectiveness and performance.

Keywords: burnout, academics, emotional intelligence, general health, canonical correspondence analysis

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333 State of the Science: Digital Therapies in Pediatric Mental Health

Authors: Billy Zou

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Statement of the Problem: The burden of mental illness and problem behaviors in adolescence has risen worldwide. While less than 50% of teens have access to traditional mental health care, more than 73% have smartphones. Internet-based interventions offer advantages such as cost-effectiveness, availability, and flexibility. Methodology & Theoretical Orientation: A literature review was done using a PubMed search with the words mental health app yielding 2113 results. 103 articles that met inclusion criteria were reviewed, and findings were then described and synthesized. Findings: 1. Computer-based CBT was found to be effective for OCD, depression, social phobia, and panic disorder. 2. Web-based psychoeducation reduced problem behavior and improved parental well-being. 3. There is limited evidence for mobile-phone-based apps, but preliminary results suggest computer-based interventions are transferrable to mobile apps. 4. Adherence to app-based treatment was correlated with impressions about the user interface Conclusion & Significance: There is evidence for the effectiveness of computer-based programs in filling the significant gaps that currently exist in mental health delivery in the United States and internationally. There is also potential and theoretical validity for mobile-based apps to do the same, though more data is needed.

Keywords: children's mental health, mental health app, child and adolecent psychiatry, digital therapy

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332 Macroinvertebrate Variation of Endorheic Depression Wetlands within North West and Mpumalanga Provinces, South Africa

Authors: Lee-Ann Foster, Wynand Malherbe, Martin Ferriera, Johan Van Vuren

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Aquatic macroinvertebrates are rarely used in wetland assessments due to their variability. However, in terms of biodiversity, these invertebrates form an important component of wetlands. The objective of this study was to compare the spatial and temporal variation of macroinvertebrate assemblages within endorheic depressions in Mpumalanga and North West Provinces of South Africa. Sampling was conducted over a period of two seasons during 2012 and 2013 at all sampling points to account for a wet and dry season. The identification of macroinvertebrate community samples resulted in 24 taxa for both provinces. Results showed similarities in the structure of communities in perennial endorheic depressions in both provinces with the exception of one or two species. Macroinvertebrates sampled in Mpumalanga depressions (locally called pans) were similar to those reported in previous studies completed in the area and most of the macroinvertebrates sampled in Mpumalanga and the North West are known to be commonly found in temporary habitats. The knowledge acquired can now be utilised to enhance the available literature on these systems. Long-term studies have to be implemented to better understand the ecological functioning of the pans in the North West Province.

Keywords: aquatic, macroinvertebrate assemblages, pans, spatial variation

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331 Efficacy of Ergonomics Ankle Support on Squatting Pushing Skills during the Second Stage of Labor

Authors: Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee

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Objective: To compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor. The three positions were: semi-recumbent, squatting, and squatting with the aid of ergonomically designed ankle supports. Methods: A randomized controlled trial was conducted at a regional teaching hospital in northern Taiwan. Data were collected from 168 primiparous women in their 38th to 42nd gestational week. None of the participants received epidural analgesia during labor and all were free of pregnancy and labor-related complications. Intervention: During labor, after full cervical dilation and when the fetal head had descended to at least the +1 station and had turned to the occiput anterior position, the experimental group was asked to push in the squatting position while wearing the ergonomically designed ankle supports; comparison group A was asked to push in the squatting position without the use of these supports; and comparison group B was asked to push in a standard semi-recumbent position. Measures: The participants completed a demographic and obstetrics datasheet, the Short Form McGill Pain Questionnaire (MPQ-SF), and the Labor Pushing Experience scale within 4-hours postpartum. Conclusion: In terms of delivery time, the duration between the start of pushing to crowning for the experimental group (squatting with ankle supports) averaged 25.52 minutes less (F =6.02, p< .05) than the time for comparison group B (semi-recumbent). Furthermore, the duration between the start of pushing to infant birth averaged 25.21 minutes less for the experimental group than for comparison group B (F =6.14, p< .05). Moreover, the experimental group had a lower average VAS pain score (5.05±3.22) than comparison group B and the average McGill pain score for the experimental group was lower than both comparison groups (F=18.12, p< .001). In summary, the participants in the group that delivered from a squatting position with ankle supports had better labor pushing experiences than their peers in the comparison groups. Results: In comparison to both unsupported squatting and semi-recumbent pushing, squatting with the aid of ergonomically designed ankle supports reduced pushing times, ameliorated labor pain, and improved the pushing experience. Clinical application and suggestion: The squatting with ankle-support intervention introduced in the present study may significantly reduce tiredness and difficulties in maintaining balance as well as increase pushing efficiency. Thus, this intervention may reduce the caring needs of women during the second stage of labor. This intervention may be introduced in midwifery education programs and in clinical practice as a method to improve the care of women during the second stage of labor.

Keywords: second stage of labor, pushing, squatting with ankle supports, squatting

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330 Decision Making, Reward Processing and Response Selection

Authors: Benmansour Nassima, Benmansour Souheyla

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The appropriate integration of reward processing and decision making provided by the environment is vital for behavioural success and individuals’ well being in everyday life. Functional neurological investigation has already provided an inclusive image on affective and emotional (motivational) processing in the healthy human brain and has recently focused its interest also on the assessment of brain function in anxious and depressed individuals. This article offers an overview on the theoretical approaches that relate emotion and decision-making, and spotlights investigation with anxious or depressed individuals to reveal how emotions can interfere with decision-making. This research aims at incorporating the emotional structure based on response and stimulation with a Bayesian approach to decision-making in terms of probability and value processing. It seeks to show how studies of individuals with emotional dysfunctions bear out that alterations of decision-making can be considered in terms of altered probability and value subtraction. The utmost objective is to critically determine if the probabilistic representation of belief affords could be a critical approach to scrutinize alterations in probability and value representation in subjective with anxiety and depression, and draw round the general implications of this approach.

Keywords: decision-making, motivation, alteration, reward processing, response selection

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329 Representation of How Patriarchy Affects Mental Health in Qala and Black Swan

Authors: Mokshida Bhat

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This paper examines the representation of patriarchy in the movies 'Qala' and 'Black Swan' and how it affects the mental health of women. Both movies portray female characters who are subject to patriarchal attitudes and structures that limit their choices and opportunities and contribute to negative mental health outcomes. In 'Qala' the central character Qala confronts the patriarchal attitudes of her family and community, which contribute to feelings of frustration and despair. In 'Black Swan' the main character Nina is subject to the demands and expectations of a patriarchal system that leads to anxiety, paranoia, and disconnection from her own body and emotions. Both movies highlight the harmful impact of patriarchal attitudes on women's mental health, including feelings of disempowerment, objectification, and self-doubt. The paper suggests that these negative outcomes can be addressed through a rejection of patriarchal norms and an assertion of one's own agency and identity. Overall, this paper demonstrates the importance of recognizing the role of patriarchy in contributing to mental health struggles for women and the need for more diverse and empowering representations of women in media.

Keywords: patriarchy, mental health, depression, PTSD, mental health in Indian cinema, patriarchy in Indian cinema, feminism and patriarchy, sexism

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328 Meditation-Based Interventions in the Workplace

Authors: Louise Fitzgerald, John Allman

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Introduction: Having previously engaged in a meditation-based programme (MBP) for staff in general practice, we explore the evidence and extent to which MBPs are employed in the workplace. Aim of the study: We aim to understand the current workplace MBP intervention literature, which will help inform the suitability of these interventions within the workplace domain. Objectives: Uptake of MBPs in the workplace has grown as organizations look to support employee health, wellbeing, and performance. We will discuss the current MBP literature, including the large variability across MBPs and the associated difficulties in evaluating their efficacy. Learning points: 1) MBPs have a positive impact on cognitive function including concentration and memory and as such job performance. MBPs appear to have a positive impact on objective and subjective job satisfaction, productivity, motivation and work engagement. Meditation in the workplace may have positive impacts on mental health issues - including stress reduction and depression. 2) From our review MBPs appear to be implementable in a wide range of professions and work contexts - regardless of individual factors. Given many companies are focusing on health and wellbeing of employees, this could be included in employee wellbeing programmes. 3) Despite the benefits of mindfulness and meditation interventions in psychosocial workplace health and work performance the long-term efficacy has yet to be fully determined.

Keywords: meditation-based programmes, mindfulness, meditation, well-being

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327 Identify the Factors Affecting Employment and Prioritize in the Economic Sector Jobs of Increased Employment MADM approach of using SAW and TOPSIS and POSET: Ministry of Cooperatives, Do Varamin City Social Welfare

Authors: Mina Rahmani Pour

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Negative consequences of unemployment are: increasing age at marriage, addiction, depression, drug trafficking, divorce, immigration, elite, frustration, delinquency, theft, murder, etc., has led to addressing the issue of employment by economic planners, public authorities, chief executive economic conditions in different countries and different time is important. All countries are faced with the problem of unemployment. By identifying the influential factors of occupational employment and employing strengths in the basic steps can be taken to reduce unemployment. In this study, the most significant factors affecting employment has identified 12 variables based on interviews conducted Choose Vtasyrafzaysh engaged in three main business is discussed. DRGAM next question the 8 expert ministry to respond to it is distributed and for weight Horns AZFN Shannon entropy and the ranking criteria of the (SAW, TOPSIS) used. According to the results of the above methods are not compatible with each other, to reach a general consensus on the rating criteria of the technique of integrating (POSET) involving average, Borda, copeland is used. Ultimately, there is no difference between the employments in the economic sector jobs of increased employment.

Keywords: employment, effective techniques, SAW, TOPSIS

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326 Fear of Covid-19 a Major Contributing Factor to Insomnia in General Iranian Population

Authors: Amin Nakhostin-Ansari, Samaneh Akbarour, Khosro Sadeghniiat Haghighi, Zahra Banafsheh Alemohammad, Farnaz Etesam, Arezu Najafi, Mahnaz Khalafehnilsaz

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Introduction: The outbreak of coronavirus disease has considerably burdened the healthcare system in Iran. This study aimed to evaluate the characteristics of insomnia experienced by the general Iranian population during the COVID-19 pandemic. Method: A scale(FCV-19) was used for Fear of COVID-19, Insomnia Severity Index (ISI), Patient Health Questionnaire-2 (PHQ-2), and Generalized Anxiety Disorder Scale-2 (GAD-2) for detailed characterization of insomnia and its patterns Results: In total, 675 people with insomnia with the mean age of 40.28 years (SD=11.15) participated in this study. Prevalence of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA) were 91.4%, 86.7%, and 77%, respectively. DIS, DMS, and EMA were more common in people with depression and anxiety. FCV-19 score was higher in those with more severe types of DIS, DMS, and EMA (P<0.001). FCV-19 was a risk factor for all patterns of insomnia (OR=1.19, 1.12, 1.02 for DIS, DMS, and EMA, respectively). Conclusion: fear of COVID-19 is a major factor to insomnia patterns. Investigation of COVID-19 fear in people with insomnia and the addition of attributed relieving or management strategies to conventional management of insomnia are reasonable approaches to improve the sleep condition of people in the pandemic.

Keywords: insomnia, difficulty maintaining sleep, COVID-19, Coronavirus

Procedia PDF Downloads 146