Search results for: parental distress

Authors: Thomas Heffernan, Nick Neave, Colin Hamilton, Gill Case

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Hoarding is the acquisition of and failure to discard possessions, leading to excessive clutter and significant psychological/emotional distress. From a cognitive-behavioural approach, excessive hoarding arises from information-processing deficits, as well as from problems with emotional attachment to possessions and beliefs about the nature of possessions. In terms of information processing, hoarders have shown deficits in executive functions, including working memory, planning, inhibitory control, and cognitive flexibility. However, this previous research is often confounded by co-morbid factors such as anxiety, depression, or obsessive-compulsive disorder. The current study adopted a cognitive-behavioural approach, specifically assessing executive deficits and working memory in a non-clinical sample of hoarders, compared with non-hoarders. In this study, a non-clinical sample of 40 hoarders and 73 non-hoarders (defined by The Savings Inventory-Revised) completed the Adult Executive Functioning Inventory, which measures working memory and inhibition, Dysexecutive Questionnaire-Revised, which measures general executive function and the Hospital Anxiety and Depression Scale, which measures mood. The participant sample was made up of unpaid young adult volunteers who were undergraduate students and who completed the questionnaires on a university campus. The results revealed that, after observing no differences between hoarders and non-hoarders on age, sex, and mood, hoarders reported significantly more deficits in inhibitory control and general executive function when compared with non-hoarders. There was no between-group difference on general working memory. This suggests that non-clinical hoarders have a specific difficulty with inhibition-control, which enables you to resist repeated, unwanted urges. This might explain the hoarder’s inability to resist urges to buy and keep items that are no longer of any practical use. These deficits may be underpinned by general executive function deficiencies.

Keywords: hoarding, memory, executive, deficits

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Authors: Naif A. Haddad

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Greek, Hellenistic and Roman theatre heritage are exposed to multiple risks at varied times or simultaneously. There is no single reason why a theatre building becomes ‘at risk’, as each case has different circumstances which have led to the theatre building decay. There are complicated processes of destruction and distress that show divergence in theatre building materials' decay. Theatre modern use for cultural performances causes much of the risks concerning the physical structure and authenticity of theatre sites. In addition, there are some deterioration and deformations due to previous poor quality restorations and interventions through related excavation and conservation programmes as also risks to authenticity due to new additions. For preventive conservation, theatre natural and anthropogenic risks management can provide a framework for decision making. These risks to ancient theatre heritage may stem from exposure to one or more risk or synergy of many factors. We, therefore, need to link the theatre natural risks to the risks that come from anthropogenic factors associated with social and economic development. However, this requires a holistic approach, and systematic methodology for understanding these risks from various sources while incorporating specific actions, planning and strategies for each specific risk. Elaborating on recent relevant studies, and ERATO and ATHENA EU projects for ancient theaters and odea and general surveys, this paper attempts to discuss the main aspects of the ancient Greek, Hellenistic and Roman theatres risk related issues. Relevant case studies shall also be discussed and investigated to examine frameworks for risk mitigation, and related guidelines and recommendations that provide a systematic approach for sustainable management and planning in relation mainly to ‘compatible use’ of theatre sites.

Keywords: cultural heritage management, European ancient theatres projects, Anthropogenic risks mitigation, sustainable management and planning, preventive conservation, modern use, compatible use

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Authors: Alejandro Arnaldo Barroso Martinez

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Unlike sex, which is constituted by anatomic-physiological differences, gender is a social construction. Our thoughts and behaviors as females and males are not etched in stone by our biology but rather from how society expects us to think and behave based on our sex assignment in the womb. Social expectations, values, and roles are taken on by individuals and shape the ways considered acceptable and linked to our bodies, feelings, and interpersonal relationships. Furthermore, these evolve into dire consequences for those who do not meet these disciplinary, economic, and cultural standards. Then, the social learning of gender identity implies the individual’s psychological sense of being, and it might be highly linked to a sense of life and suicide attempts. As a result, suicide has been considered a gender issue with differences in the rates and means used by men and women worldwide. Nevertheless, there has been a misunderstanding of the meaning of being male or female in a particular context and how it becomes a risk process for suicide attempts. For this reason, the general objective of the current research is to explain how this process occurs in Cuba. From a Critical Sociology and Social Psychology, a qualitative methodology was developed through six case studies and qualitative in-depth interviews. The analysis is focused on the sequence and interplay between two dimensions of meaning: signifiers and voices. Findings show that the risk process of suicide attempts in Cuba means some patriarchal beliefs and practices as part of informal educational models and some positivist practices in mental health attention. Findings also show that community relations create a sense of belonging, and it is a protection against suicide attempts in Cuba. Those frames of signifiers and voices explain in both males and females but differently when and how they are suffering from isolation, violence, the normalization of emotional awareness, and emotional distress expression. Suicide prevention programs should take gender learning into account as a cultural process.

Keywords: social constructions, gender identity, meanings, suicide attempt

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Authors: T. Goldstein, E. Serok, J. D. Kark

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Background and Aim: The prevalence of obesity is increasing worldwide and in Israel. To meet this challenge, our study tests a new educational approach through a controlled school-based trial to achieve an improvement in eating habits, aerobic activity, and reduced obesity in Grades 2-3. Methods and Design: A cluster randomized controlled trial allocated 4 elementary schools (3rd and 2nd-grade classes each) to intervention or control groups. This allocation was switched with the next cohort of children. Recruitment was in first grade, randomization at the beginning of second grade, evaluation of results at the end of second grade and the beginning of third grade — intervention: 5 joint parent-children classroom activities on health topics and 5 educational workshops for parents only. Alfred Adler's concepts were guiding principles. Subjects: Of 743 children in 23-second grade classes, parents provided informed consent for 508 (68%). Information of retention health habits continued for third grade. Additional parental approvals were required. Parents provided informed consent for third-grade follow-up for 432. Results: At the end of 2nd grade, the amount of aerobic activity increased in the intervention group in comparison with the control group, the difference being marginally statistically significant (p=0.061). There is a significant difference between the groups in the percentage of "no activity being done" reported at the end of second grade when in the experimental group, the percentage is lower than the control. There are differences between genders in the percentage of aerobic activity at the end of second grade (p=0.044) and in the third grade (p < 0.0001). Height increased significantly (p=0.030 ), and waist circumference declined significantly (p=0.021) in the intervention compared with the control group. There were no significant between-group differences in BMI and weight. Conclusion: There were encouraging changes in aerobic activity and in anthropometric measurements. To maintain changes over longer periods, refreshing these nutrition and activity themes annually in school using the model is required.

Keywords: aerobic activity, child obesity, Alfred Adler, schoolchildren

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Authors: Jernice S. Y. Tan

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Introduction: Reliability within and between testers is vital to ensure the accuracy of any motor assessment instrument. However, reliability checks of the Movement Assessment Battery for Children-2 (MABC-2) age band 3 using multiple testers assigned to different MABC-2 tasks for the same group of participants are uncommon. Multiple testers were not stated as a choice in the MABC-2 manual. Therefore, the purpose of this study was to determine the inter- and intra-tester reliability for using multiple testers to administer the test protocols of MABC-2 age band 3. Methods: Thirty volunteered adolescents (n = 30; 15 males, 15 females; age range: 13 – 16 years) performed the eight tasks in a randomised sequence at three different test stations for the MABC-2 task components (Manual Dexterity, Aiming and Catching, Balance). Ethics approval and parental consent were obtained. The participants were videotaped while performing the test protocols of MABC-2 age band 3. Five testers were involved in the data collection process. They were Sports Science graduating students doing their final year project and were supervised by experienced motor assessor. Inter- and intra-tester reliability checks using intra-class coefficient (ICC) were carried out using the videotaped data. Results: The inter-tester reliability between the five testers for the eight tasks ranged from rᵢcc = 0.705 to rᵢcc = 0.995. This suggests that the average agreement between them was considered good to excellent. With the exception of one tester who had rᵢcc = 0.687 for one of the eight tasks (i.e. zip-zap hopping), the intra-tester reliability within each tester ranged from rᵢcc = 0.728 to rᵢcc = 1.000, and this also suggested good to excellent consistency within testers. Discussion: The use of multiple testers with good intra-tester reliability for different test stations is feasible. This method allows several participants to be assessed concurrently at different test stations and saves overall data collection time. Therefore, it is recommended that the administering of MABC-2 with multiple testers should be extended to other age bands ensuring the feasibility of such method for other age bands.

Keywords: adolescents, MABC, motor assessment, motor skills, reliability

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Authors: Farzaneh Askari, Jila Ganji, Sedigheh Hasani Moghadam

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Background and Aim: Endometriosis has been reported as one of the most common chronic gynecological conditions characterized by physical and psychological complications. Given that the impact of this disease on marital relationships and quality of life is multidimensional, the present review study aimed to reflect on the effect of psychosomatic aspects of endometriosis on marital relationships and quality of life. Materials and Methods: A narrative review methodology using keywords determined by the Medical Subject Headings (MeSH) thesaurus was adopted in this study. For this purpose, the databases of ScienceDirect, Scientific Information Database (SID), Google Scholar, and PubMed were searched by means of key terms including endometriosis, marital relationships, physical complications, psychological complications, and quality of life in English and Persian from 2005 to 2020. At the end of the search, 38 articles were retrieved, and ultimately a total number of 16 studies were recruited for this review. Results: A review of the selected articles demonstrated that endometriosis could affect marital relationships and quality of life among couples featuring in three different categories, i.e. “category I: physical health dimension” (chronic pelvic pain, dysmenorrhea, cramps but not period, reduction and loss of fertility), “category II: sexual health dimension” (no sexual intercourse, dyspareunia, lack of sexual satisfaction), and “category III: psychosocial health dimension” (negative self-esteem, low energy, sense of loneliness, depression, social isolation, insufficient sleep, marital distress, divorce and marriage breakdown, inability to work and socialize). Conclusion: In general, it is suggested to pay particular attention to psychosomatic aspects of marital problems in patients affected with endometriosis. Accordingly, implementing educational and counseling strategies to minimize the complications of this disease can provide the grounds for improving marital relationships and maintaining the quality of life in these patients.

Keywords: Endometriosis, marital relationships, psychosomatic complications, quality of life

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Authors: Ghazala Yasmeen, Zahid Yousaf

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Frequent social media use has significantly changed people's life and communication styles during the last two decades. Social media use has multiple dimensions, and there are nuanced relationships between it and how it affects different societal subgroups. With the increased popularity and rapid growth of social networking sites, people are experiencing potential social media addiction, which causes severe mental health problems. How social media is dramatically influencing the lives and mental health of its users, and particularly of the students, creating psychological issues, e.g., isolation, depression, and anxiety, will be the primary objective of this study. This research will address the problems confronted by many students who are regular social media users and can undergo mental distress. This study aims to explore how social media use can lead to isolation, depression, and anxiety. This research will also investigate the effects of cyber-bullying on social, emotional, and psychological wellbeing. For this purpose, the researcher will use the survey technique as a method of inquiry. Ryff's theory of Psychological wellbeing will be used as a theoretical framework to explore the association between social media addiction and psychological effects among users. For data collection, the researcher will use the quantitative research method through a survey questionnaire from three universities in Pakistan from the public and private sectors. This study will imply a two-stage random sampling technique. At first, the researcher will select 20% of students from universities. In the second stage, 20% of students using different social networking sites will be chosen, and draw a representative sample from these will be. The intended study will use questionnaires comprising two portions. The first section will consist of social media engagement by the students, following impacts on their mental health and reported attitude towards psychological wellbeing. This study will spotlight the considerations of parents, educationists, and policymakers to take measures against the devastating effects of cyber-crimes on young adults.

Keywords: anxiety, depression, isolation, social media, wellbeing

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Authors: Portia Muehlbauer

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This paper examines the evolving landscape of preventing and countering violent extremism (PCVE) by delving into the growing importance of integrating human rights principles into violence prevention strategies on the local, community level. This study sheds light on the underlying theoretical frameworks of violent extremism and the influence of gender while investigating the intersection between human rights preservation and violent extremism prevention. To gain practical insight, the research focuses on two prominent international non-governmental organizations, Women without Borders (WwB) and Hedayah, and their distinct PCVE initiatives. WwB adopts a gender-sensitive approach, implementing parental education programs that empower mothers in at-risk communities to prevent the spread of violent extremism. In contrast, Hedayah takes an indirect route, employing capacity building programs that enhance the capabilities of educators, social workers, and psychologists in early intervention, rehabilitation and reintegration efforts. Qualitative data for this comparative analysis was collected through an extensive four-month internship at WwB during the fall of 2020, a three-month internship at Hedayah in the spring of 2021, a thought-provoking semi-structured interview with the executive director of WwB, personal field notes, and a comprehensive discourse analysis of the prevailing literature on human rights considerations in PCVE practices. This study examines the merits and challenges of integrating human rights into PCVE programming through the lens of both organizations, WwB and Hedayah. The findings of this study will inform policymakers, practitioners, and researchers on the intricate relationship between human rights protection and effective PCVE strategies.

Keywords: preventing and countering violent extremism, human rights, counterterrorism, peacebuilding, capacity building programs, gender studies

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Authors: Laid Fekih

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Background: The purpose of this paper is to examine the psychological stressors caused by urbanization, a field study conducted on a sample range of youth who live in urban areas. Some of them reside in areas with green surroundings while others reside in lack of green areas, which saw the terrible expansion of urban. The study included the impact of urbanization on the mental health of youths; select the psychological problems most commonly caused by urbanization, and the impact of green spaces in alleviating stress. Method: The method used in this research is descriptive, as the data collected from a sample of 160 young men were analyzed. The tool used is the psychological distress test. We proceeded with some statistical techniques, which provided percentages, analysis of variance, and t-tests. Results: The findings of this research were: (i) The psychological stressors caused by urban expansion are mainly in the intensity of stress, incompetence, emotional, and psychosomatic problems. (ii) There was a statistically significant difference at the level of significance 0.02 among young people who live in places in green spaces and without green space in terms of psychological stressors, in favor of young people who live in places free of greenery. (iii) The quality of this primary variable effect of housing (rental or ownership) is statistically significant in favor of young people living in rented accommodation. Conclusion: The green spaces provided by Tlemcen city are inadequate and insufficient to fulfill the population's requirements for contact with nature, leading to such effects that may negatively affect mental health, which makes it a prominent process that should not be neglected. Incorporating green spaces into the design of buildings, homes, and communities to create shared spaces, which facilitate interaction and foster well-being, becomes the main purpose. We think this approach can support the reconstruction of the built environment with green spaces by facilitating the link between psychological stress perception studies and technologies.

Keywords: psychological stressors, urbanization, psychological problems, green spaces

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Authors: M. L. Seretlo-Rangata, T. Sodi, S. Govender

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Despite interventions by various governments to regulate water demand and address water scarcity, literature shows that billions of people across the world continue to struggle with access because not everyone contributes equally to conservation efforts. Behavioral factors such as individual and collective aspects of cognition and commitment have been found to play an important role in water conservation. The aim of the present study was to explore the perceptions of community members in the Lephalale area, Limpopo province, towards water conservation with a view to developing an explanatory psychological model on water conservation. Twenty (20) participants who relied on communal taps to access water in Lephalale Local Municipality, Limpopo province, were selected through purposeful sampling. In-depth, semi-structured, individual face-to-face interviews were used to gather data and were analyzed utilizing thematic content analysis (TCA). The research findings revealed that there are various psychological effects of water scarcity on communities, such as emotional distress, interpersonal conflicts and disruptions of daily activities of living. Additionally, the study results showed that the coping strategies developed by participants to deal with water scarcity included adopting alternative water use behaviors as well as adjusting current behaviors and lifestyles. Derived from the study findings, a psychological model of water conservation was developed. The model incorporates some ideas from the Value-Belief-Norm (VBN) theory and the Afrocentric theory. The model suggests that people’s worldviews, including their values, beliefs and culture, are significant determinants of their pro-environmental behaviors. The study concludes by recommending that authorities and policymakers should consider psychological factors when developing water management programs, strategies and interventions with the consultation of psychology experts.

Keywords: water conservation, psychological model, pro-environmental behaviour, conservation psychology, water-use behaviour

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Authors: Sarah Potter, Michele Laliberte

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As eating disorders are associated with high levels of chronicity, impairment, and distress, it is paramount to evaluate factors that may improve treatment outcomes in this group. Individuals with eating disorders exhibit elevated levels of perfectionism and emotion dysregulation, as well as reduced self-compassion. These variables are related to eating disorder outcomes, including shape/weight concerns and psychosocial impairment. Thus, these factors may be tenable targets for treatment within eating disorder populations. However, the relative contributions of perfectionism, emotion dysregulation, and self-compassion to the severity of shape/weight concerns and psychosocial impairment remain largely unexplored. In the current study, mediation analyses were conducted to clarify how perfectionism, emotion dysregulation, and self-compassion are linked to shape/weight concerns and psychosocial impairment. The sample was comprised of 85 patients from an outpatient eating disorder clinic. The patients completed self-report measures of perfectionism, self-compassion, emotion dysregulation, eating disorder symptoms, and psychosocial impairment. Specifically, emotion dysregulation was assessed as a mediator in the relationships between (1) perfectionism and shape/weight concerns, (2) self-compassion and shape/weight concerns, (3) perfectionism and psychosocial impairment, and (4) self-compassion and psychosocial impairment. It was postulated that emotion dysregulation would significantly mediate relationships in the former two models. An a priori hypothesis was not constructed in reference to the latter models, as these analyses were preliminary and exploratory in nature. The PROCESS macro for SPSS was utilized to perform these analyses. Emotion dysregulation fully mediated the relationships between perfectionism and eating disorder outcomes. In the link between self-compassion and psychosocial impairment, emotion dysregulation partially mediated this relationship. Finally, emotion dysregulation did not significantly mediate the relationship between self-compassion and shape/weight concerns. The results suggest that emotion dysregulation and self-compassion may be suitable targets to decrease the severity of psychosocial impairment and shape/weight concerns in individuals with eating disorders. Further research is required to determine the stability of these models over time, between diagnostic groups, and in nonclinical samples.

Keywords: eating disorders, emotion dysregulation, perfectionism, self-compassion

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Authors: Zewdneh Zana Zate

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The study focuses on the evolutionary and ecological genomics of both wild and cultivated Coffea arabica L. at its center of origin, Ethiopia, aiming to uncover how this vital species may withstand future climate changes. Utilizing bioclimatic models, we project the future distribution of Arabica under varied climate scenarios for 2050 and 2080, identifying potential conservation zones and immediate risk areas. Through whole-genome resequencing of accessions from Ethiopian gene banks, this research assesses genetic diversity and divergence between wild and cultivated populations. It explores relationships, demographic histories, and potential hybridization events among Coffea arabica accessions to better understand the species' origins and its connection to parental species. This genomic analysis also seeks to detect signs of natural or artificial selection across populations. Integrating these genomic discoveries with ecological data, the study evaluates the current and future ecological and genomic vulnerabilities of wild Coffea arabica, emphasizing necessary adaptations for survival. We have identified key genomic regions linked to environmental stress tolerance, which could be crucial for breeding more resilient Arabica varieties. Additionally, our ecological modeling predicted a contraction of suitable habitats, urging immediate conservation actions in identified key areas. This research not only elucidates the evolutionary history and adaptive strategies of Arabica but also informs conservation priorities and breeding strategies to enhance resilience to climate change. By synthesizing genomic and ecological insights, we provide a robust framework for developing effective management strategies aimed at sustaining Coffea arabica, a species of profound global importance, in its native habitat under evolving climatic conditions.

Keywords: coffea arabica, climate change adaptation, conservation strategies, genomic resilience

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Authors: Eli Buchbinder

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Introduction. Language is the basis to our experience as human being. We use language in describing our experiences and construct meaning and narratives from experiences. Metaphors are a valuable linguistic tool commonly use. Metaphors link two domains that are ordinarily not related. Metaphors achieve simultaneously multi-level integration: abstract and concrete, rational and imaginative, familiar and the unfamiliar, conscious and preconscious/unconscious. As such, metaphors epistemological and ontological tool that are important in social work in every field and domain. Goals and Methods The presentation’s aim is to validate the value of metaphors through the first psychiatric breakdown is a traumatic for families. The presentation is based on two pooled qualitative studies. The first study focused on 12 spouses: 7 women and 5 men, between the ages of 22 and 57, regarding their experiences and meanings of the first psychiatric hospitalization of their partners diagnosed with affective disorders. The second study focused on 10 parents, between the ages of 47 and 62, regarding their experiences and meanings following their child's first psychotic breakdown during young adulthood. Results Two types of major metaphors evolved from the interviews in farming the trauma of the first mental breakdown. The first mode - orientation (spatial) metaphors, reflect symbolic expression of the loss of a secure base, represented in the physical environment, e.g., describing hospitalization as "falling into an abyss." The second mode- ontological metaphors, reflect how parents and spouses present their traumatic experiences of hospitalization in terms of discrete, powerful and coherent entities, e.g., describing the first hospitalization as "swimming against the tide." The two metaphors modes reflect the embodiment of the unpredictability, being mired in distress, shock, intense pain and the experience the collapse of continuity on the life course and cuts off the experience of control. Conclusions Metaphors are important and powerful guide in assessing individuals and families’ phenomenological reality. As such, metaphors are useful for understanding and orientated therapeutic intervening, in the studies above, with the first psychiatric hospitalization experienced, as well as in others social workers’ interventions.

Keywords: first mental breakdown, metaphors, family perspective, qualitative research

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Authors: Ezat Vahidian, Babak Eshrati

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Introduction: Elder abuse, a very complex issue with diverse definitions and names, has been very slow to capture the public eye and public policy since it is manifested at many levels. It requires the involvement of different types of professionals. While elder abuse is not a new phenomenon, the speed of population ageing world-wide is likely to lead to an increase in its incidence and prevalence. Elder abuse has devastating consequences for older persons such as poor quality of life, psychological distress, and loss of property and security. It is also associated with increased mortality and morbidity. Elder abuse is a problem that manifests itself in both rich and poor countries and at all levels of society. Purpose: The purpose of this study is to determine the prevalence of elder abuse and effects of social factor on it in Markazi Province. Materials and methods: The society of the study was all of the elders in Markazi Province that were available by geographical address in the table of rural and urban household societies. The study was cross sectional and multi phases in sampling the first one was classification according rural and urban area and the second one was cluster sampling with equal cluster. Estimation of samples were 472 persons and increased by design effect to 1110 persons. Collection data was done by questionnaire and analyzed by SPSS and chi 2 exam. Results: This study showed 70 persons were abused (42/8% male and 57/2% female) mean of ages was 74/7 years. 64% were marred and 31% were widows. There were not any significant meaningful association between elder abuse and area of living (pv=0.299),occupation (p.v=0.104), education (pv=0.358) and age (P.value=0.104) there were significant meaningful association between physical impairment (pv=0.08), and movement impairment (P.value=0.008). Conclusion: Results verify that maltreatment occurred in the aged persons. Analysis of data indicated that elder abuse exist in every socioeconomic group with any context of education in urban area and rural area and in men and women. Prevalence of elder abuse was 6.3% (70 persons) that verify the data of developed countries with limited sample.

Keywords: elder abuse, education, occupation, area of living

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Authors: Victorine Mbong Shu

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Very little research exists on family sex and sexuality communication and identity formation and how communication is helping adolescents in forming their sexual identities in South Africa. This study is designed to explore the impact of sexual communication in African families and the dynamics that influence the openness or closedness of adolescent sexual identities. The primary objectives of this study are threefold; to understand how sexuality communication in African families impacts the closedness and/or openness of adolescent African identities; to explore the nature of African children's sexuality given the status of their families’ communications on sex; to describe how parental or adult sexual knowledge, attitudes, values of sex, etc. are translated to children in African families, if at all. This study seeks answers to challenges faced by African parents and caregivers of adolescent children in South Africa regarding sex-sexuality communication and their shifting identities in different spaces. Its outcome seeks to empower these families on how to continue to effectively communicate sex and sexuality at different stages and circumstances. Two sets of people are interviewed separately in order to explore issues of familial communication and how to understand how together with religion and culture, adolescents are socialised to form the social and gender identities that they take to adulthood. They were parents of adolescents and young adult children who spoke in retrospect on when they were adolescents. The results of this study will fill knowledge gaps considering the chosen theory of communication that gives clarity to the topic of sex and sexuality communication in African families in South Africa and the dynamics of privacy that influence identity formation. A subset of the 40 conversations, 5 female parents, 5 male parents, 5 young female adults, and 5 male young adults, was used for this analysis. The preliminary results revealed five emergent themes informed by research questions and the theoretical framework of this study: Open communication, Discomfort discussing sex and sexuality, The importance of sex communication to African parents, Factors influencing African families’ communication about sex and sexuality and Privacy and boundaries.

Keywords: sex, sexuality, communication, African families, adolescents

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Authors: Beaudoin Marie-Joelle, Poirier Nathalie

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Introduction: Children with autism spectrum disorder (ASD) tend to lack socio-emotional skills (e.g., emotional regulation and theory of mind). Eisenberg’s theoretical model on emotion-related socialization behaviors suggests that mothers of children with ASD could play a central role in fostering the acquisition of socio-emotional skills by engaging in frequent educational conversations about emotions. Although, mothers’ perceptions of their own emotional skills and their child’s personality traits and social deficits could mitigate the benefit of their educative role. Objective: Our study aims to explore the association between mother-child conversations about emotions and the socio-emotional skills of their children when accounting for the moderating role of the mothers’ perceptions. Forty-nine mothers completed five questionnaires about emotionally related conversations, self-openness to emotions, and perceptions of personality and socio-emotional skills of their children with ASD. Results: Regression analyses showed that frequent mother-child conversations about emotions predicted better emotional regulation and theory of mind skills in children with ASD (p < 0.01). The children’s theory of mind was moderated by mothers’ perceptions of their own emotional openness (p < 0.05) and their perceptions of their children’s openness to experience (p < 0.01) and conscientiousness (p < 0.05). Conclusion: Mothers likely play an important role in the socio-emotional education of children with ASD. Further, mothers may be most helpful when they perceive that their interventions improve their child’s behaviors. Our findings corroborate those of the Eisenberg model, which claims that mother-child conversations about emotions predict socio-emotional development skills in children with ASD. Our results also help clarify the moderating role of mothers’ perceptions, which could mitigate their willingness to engage in educational conversations about emotions with their children. Therefore, in special needs' children education, school professionals could collaborate with mothers to increase the frequency of emotion-related conversations in ASD's students with emotion dysregulation or theory of mind problems.

Keywords: autism, parental socialization of emotion, emotional regulation, theory of mind

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Authors: Patrick Nurse, Professor Neil Sebire, Polly Livermore

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The use of digital systems in healthcare is now highly prevalent. With further advancement of technology, these systems will become increasingly utilised within the healthcare sector. Therefore understanding how clinicians (for example, doctors, nurses) interact with technology and digital systems is critical to making care safer. Seven members from the Parent/Carers’ Research Advisory Group and the Young-Persons’ Research Group at a healthcare Trust in London and three staff members contributed to an engagement workshop to assess the impact of digital systems on the practice of nurses. The group also advised on the viability of a research study to investigate this further. A wide range of issues within digital system implementation in healthcare were raised, such as ‘workarounds’, system’s training, and upkeep and regulation of usage, which all emerged as early themes during the discussion. Further discussion focused on the subject of escalation of issues, ‘workarounds’, and problem solving. While challenging to implement, digital systems are hugely beneficial to healthcare providers. The workshop indicated that there is scope for investigation of the prevalence, nature, and escalation of ‘workarounds’, this was of key interest to the advisory group. An interesting concern of the group was their worry from a patient and parental perspective regarding how nurses might feel when needing to complete a ‘workaround’ during a busy shift. This is especially relevant if the reasons to complete the ‘workaround’ were outside the nurse’s control, driven by clinical need and urgency of care. This showed the level of insight that those using healthcare services have into the reality of workflows of those providing care. Additionally, it reflects the desire for patients and families to understand more about the administration and methodology of their care. Future study should be dedicated to understanding why nurses deploy ‘workarounds’, as well as their perspective and experience of them and subsequent escalation through leadership hierarchies

Keywords: patient engagement/involvement, workarounds, medication-administration, digital systems

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Authors: McKenna Halverson, Allison Karpyn

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Introduction: The COVID-19 pandemic posed unprecedented challenges for families with young children in the United States. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federal nutrition assistance program that provides low-income mothers and young children with access to healthy foods (e.g., infant formula, milk, and peanut butter), mitigated some financial challenges for families. However, the U.S. experienced a national infant formula shortage and rising inflation rates during the pandemic, which likely impacted WIC participants’ shopping experiences and well-being. As such, this study aimed to characterize how the COVID-19 pandemic and related events impacted Delaware WIC participants’ in-store benefit redemption experiences and overall well-being. Method: The authors conducted semi-structured interviews with 51 WIC participants in Wilmington, Delaware. Survey measures included demographic questions and open-ended questions regarding participants’ experiences with WIC benefit redemption during the COVID-19 pandemic. Data were analyzed using a hybrid inductive and deductive coding approach. Findings: The COVID-19 pandemic significantly impacted WIC participants’ shopping experiences and well-being. Specifically, participants were forced to alter their shopping behaviors to account for rising food prices (e.g., used coupons, bought less food, used food banks). Additionally, WIC participants experienced significant distress during the national infant formula shortage resulting from difficulty finding formula to feed their children. Participants also struggled with in-store benefit redemption due to inconsistencies in shelf labelling, the WIC app, and low stock of WIC foods. These findings highlight the need to reexamine WIC operations and emergency food response policy in the United States during times of crisis to optimize public health and ensure federal nutrition assistance programs meeting the needs of low-income families with young children.

Keywords: benefit redemption, COVID-19 pandemic, infant formula shortage, inflation, shopping, WIC

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Authors: Prathama Guha Chaudhuri, Arunima Datta, Ashis Mukhopadhyay

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Background: Visualization (guided imagery) is a set of techniques which induce relaxation and help people create positive mental images in order to reduce stress.It is relatively inexpensive and can even be practised by bed bound people. Studies have shown visualization to be an effective tool to improve cancer patients’ anxiety, depression and quality of life. The common images used with cancer patients in the developed world are those involving the individual’s body and its strengths. Since breast cancer patients in India are more family oriented and often their main concerns are the stigma of having cancer and subsequent isolation of their families, including their children, we figured that positive images involving acceptance and integration within family and society would be more effective for them. Method: Data was collected from 119 breast cancer patients on chemotherapy willing to undergo psychotherapy, with no history of past psychiatric illness. Their baseline stress, anxiety, depression and quality of life were assessed using validated tools. The participants were then randomly divided into three groups: a) those who received visualization therapy with standard imageries involving the body and its strengths (sVT), b) those who received visualization therapy using indigenous family oriented imageries (mVT) and c) a control group who received supportive therapy. There were six sessions spread over two months for each group. The psychological outcome variables were measured post intervention. Appropriate statistical analyses were done. Results:Both forms of visualization therapy were more effective than supportive therapy alone in reducing patients’ depression, anxiety and quality of life.Modified VT proved to be significantly more effective in improving patients’ anxiety and quality of life. Conclusion: Visualization is a valuable therapeutic option for reduction of psychological distress and improving quality of life of breast cancer patients.In order to be more effective, the images used need to be modified according to the sociocultural background and individual needs of the patients.

Keywords: breast cancer, visualization therapy, quality of life, anxiety, depression

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Authors: Tong Mei Yan

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Introduction: The experience of infertility could be excruciating but has not received much attention in Hong Kong. The strong Confucian culture pressures couples to continue their family lineage resulting in women facing more stress than men in the social-cultural milieu. In Vitro Fertilization (IVF) treatment is one of the common ways to deal with the problem. Abundant literature exists the psychological trajectories of people receiving IVF treatment in Europe, the USA and other east Asian societies but not in Hong Kong. Aim: This study aims to highlight the circumstances and needs of the women before, during and after IVF treatment through examining their lived experiences. It is hoped that the public, once informed of regarding their tribulations and needs , would support the adequate provision of the required psychological support . Methods: Qualitative analysis was adopted in this study. In-depth interviews were conducted with six women who have undergone at least one complete cycle of IVF treatment within the past five years. Data was analyzed through thematic analysis and narrative analysis. Results: 4 broad themes were found, including (i) emotional responses; (ii) experiences in medical consultation; (iii) impacts of the treatment; and (iv) their coping strategies. Additionally, specific events in three cases were chosen for narrative analysis to further examine their unresolved emotional distress and the ethical issues. Conclusion: IVF treatment distressed the interviewees immensely, both physically and psychologically, with the negative emotions outweighing their physical strains, a result unexpected by all of the interviewees. The pressure for lineage continuation, the demanding treatment process and the dearth of support from health professionals all contribute to their emotional pain which could linger for both successful and unsuccessful cases. Although a number of coping strategies were attempted, most of them completely failed to ease their psychological tension. The findings of this study therefore evidence the need for psychological support for this population. A service model to cater their needs of IVF treatment before, during and after treatment is therefore proposed.

Keywords: coping strategies, emotional experiences, impacts of IVF, infertility, IVF treatment, medical experiences

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Authors: Beatrice Wamuyu Muchiri, Monika M. L. Dos Santos

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An increasingly recognised prevention approach for substance use entails reduction in risk factors and enhancement of promotive or protective factors in individuals and the environment surrounding them during their growth and development. However, in order to enhance the effectiveness of this approach, continuous study of risk aspects targeting different cultures, social groups and mixture of society has been recommended. This study evaluated the impact of potential risk and protective factors associated with family management and relations on adolescent substance abuse in South Africa. Exploratory analysis and cumulative odds ordinal logistic regression modelling was performed on the data while controlling for demographic and socio-economic characteristics on adolescent substance use. The most intensely used substances were tobacco, cannabis, cocaine, heroin and alcohol in decreasing order of use intensity. The specific protective or risk impact of family management or relations factors varied from substance to substance. Risk factors associated with demographic and socio-economic factors included being male, younger age, being in lower education grades, coloured ethnicity, adolescents from divorced parents and unemployed or fully employed mothers. Significant family relations risk and protective factors against substance use were classified as either family functioning and conflict or family bonding and support. Several family management factors, categorised as parental monitoring, discipline, behavioural control and rewards, demonstrated either risk or protective effect on adolescent substance use. Some factors had either interactive risk or protective impact on substance use or lost significance when analysed jointly with other factors such as controlled variables. Interaction amongst risk or protective factors as well as the type of substance should be considered when further considering interventions based on these risk or protective factors. Studies in other geographical regions, institutions and with better gender balance are recommended to improve upon the representativeness of the results. Several other considerations to be made when formulating interventions, the shortcomings of this study and possible improvements as well as future studies are also suggested.

Keywords: risk factors, protective factors, substance use, adolescents

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Authors: C. S. Subhashini, H. L. Premaratne

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Landslides are the most recurrent and prominent disaster in Sri Lanka. Sri Lanka has been subjected to a number of extreme landslide disasters that resulted in a significant loss of life, material damage, and distress. It is required to explore a solution towards preparedness and mitigation to reduce recurrent losses associated with landslides. Artificial Neural Networks (ANNs) and Hidden Markov Model (HMMs) are now widely used in many computer applications spanning multiple domains. This research examines the effectiveness of using Artificial Neural Networks and Hidden Markov Model in landslides predictions and the possibility of applying the modern technology to predict landslides in a prominent geographical area in Sri Lanka. A thorough survey was conducted with the participation of resource persons from several national universities in Sri Lanka to identify and rank the influencing factors for landslides. A landslide database was created using existing topographic; soil, drainage, land cover maps and historical data. The landslide related factors which include external factors (Rainfall and Number of Previous Occurrences) and internal factors (Soil Material, Geology, Land Use, Curvature, Soil Texture, Slope, Aspect, Soil Drainage, and Soil Effective Thickness) are extracted from the landslide database. These factors are used to recognize the possibility to occur landslides by using an ANN and HMM. The model acquires the relationship between the factors of landslide and its hazard index during the training session. These models with landslide related factors as the inputs will be trained to predict three classes namely, ‘landslide occurs’, ‘landslide does not occur’ and ‘landslide likely to occur’. Once trained, the models will be able to predict the most likely class for the prevailing data. Finally compared two models with regards to prediction accuracy, False Acceptance Rates and False Rejection rates and This research indicates that the Artificial Neural Network could be used as a strong decision support system to predict landslides efficiently and effectively than Hidden Markov Model.

Keywords: landslides, influencing factors, neural network model, hidden markov model

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Authors: Anna Siegler

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Bullying among peers is not uncommon; however, adults can notice only a fragment of the cases of harassment during everyday life. The systemic approaches of bullying investigation put the whole school community in the focus of attention and propose that the solution should emerge from the culture of the school. Bystanders are essential in the prevention and intervention processes as an active agent rather than passive. For combating exclusion, stigmatization and harassment, it is important that the bystanders have to realize they have the power to take action. To prevent the escalation of violence, victims must believe that students and teachers will help them and their environment is able to provide safety. The study based on scientific narrative psychological approach, and focuses on the examination of the different perspectives of students, how peers are mentalizing with each other in case of bullying. The data collection contained responses of students (N = 138) from three schools in Hungary, and from three different area of the country (Budapest, Martfű and Barcs). The test battery include Bullying Prevalence Questionnaire, Interpersonal Reactivity Index and an instruction to get narratives about bullying, which effectiveness was tested during a pilot test. The obtained results are in line with the findings of previous bullying research: the victims are mentalizing less with their peers and experience greater personal distress when they are in identity threatening situations, thus focusing on their own difficulties rather than social signals. This isolation is an adaptive response in short-term although it seems to lead to a deficit in social skills later in life and makes it difficult for students to become socially integrated to society. In addition the results also show that students use more mental state attribution when they report verbal bullying than in case of physical abuse. Those who witness physical harassment also witness concrete answers to the problem from teachers, in contrast verbal abuse often stays without consequences. According to the results students mentalizing more in these stories because they have less normative explanation to what happened. To expanding bullying literature, this research helps to find ways to reduce school violence through community development.

Keywords: bullying, mentalization, narrative, school culture

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Authors: Sungho Kim, Jaechoul Shin, Yujin Baek, Nakseok Kim, Kyungnam Kim, Shinhaeng Jo

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The climate change and increase in heavy traffic have been accelerating damages that cause the problems such as pothole on asphalt pavement. Pothole causes traffic accidents, vehicle damages, road casualties and traffic congestion. A quick and efficient maintenance method is needed because pothole is caused by stripping and accelerates pavement distress. In this study, we propose a rapid and systematic pothole management by developing a pothole automated repairing equipment including a volume measurement system of pothole. Three kinds of cold mix asphalt mixture were investigated to select repair materials. The materials were evaluated for satisfaction with quality standard and applicability to automated equipment. The volume measurement system of potholes was composed of multi-sensor that are combined with laser sensor and ultrasonic sensor and installed in front and side of the automated repair equipment. An algorithm was proposed to calculate the amount of repair material according to the measured pothole volume, and the system for releasing the correct amount of material was developed. Field test results showed that the loss of repair material amount could be reduced from approximately 20% to 6% per one point of pothole. Pothole rapid automated repair equipment will contribute to improvement on quality and efficient and economical maintenance by not only reducing materials and resources but also calculating appropriate materials. Through field application, it is possible to improve the accuracy of pothole volume measurement, to correct the calculation of material amount, and to manage the pothole data of roads, thereby enabling more efficient pavement maintenance management. Acknowledgment: The author would like to thank the MOLIT(Ministry of Land, Infrastructure, and Transport). This work was carried out through the project funded by the MOLIT. The project name is 'development of 20mm grade for road surface detecting roadway condition and rapid detection automation system for removal of pothole'.

Keywords: automated equipment, management, multi-beam sensor, pothole

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Authors: C. A. Bradley, D. Patsios, D. Berridge

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This paper presents evidence to better understand the risk and protective factors related to sibling conflict and the patterns of association between sibling conflict and negative adjustment outcomes by incorporating additional familial and societal factors within statistical models of risk and adjustment. It was conducted through the secondary analysis of a large representative cross-sectional dataset of children in the UK. The original study includes proxy interviews for young children and self-report interviews for adolescents. The study applies an ecological systems framework for the analyses. Hierarchical regression models assess risk and protective factors and adjustment outcomes associated with sibling conflict. Interactions reveal differential effect between contextual risk factors and the social context of influence. The general pattern of findings suggested that, although factors affecting likelihood of experiencing sibling conflict were often determined by child age, some remained consistent across childhood. These factors were often conditional on each other, reinforcing the importance of an ecological framework. Across both age-groups, sibling conflict was associated with siblings closer in age; male sibling groups; most advantaged socio-economic group; and exposure to community violence, such as witnessing violent assault or robbery. The study develops the evidence base on the influence of ethnicity and socio-economic group on sibling conflict by exploring interactions between social context. It also identifies key new areas of influence – such as family structure, disability, and community violence in exacerbating or reducing risk of conflict. The study found negative associations between sibling conflict and young children’s mental well-being and adolescents' mental well-being and anti-social behaviour, but also more context specific associations – such as sibling conflict moderating the negative impact of adversity and high risk experiences for young children such as parental violence toward the child.

Keywords: adjustment, conflict, ecological systems, family systems, risk and protective factors, sibling

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Authors: Ali Fuad Ashour

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Introduction: Multiple sclerosis (MS) is a chronic, progressive and degenerative disease that affects the central nervous system (CNS). MS has been described to result in the debilitating symptom of the disease. It is reported to have a negative impact on the patient’s mental activities, brings a lower quality of life, leads to unemployment, causes distress and psychological disorders, generates low levels of motivation and self-esteem, and result in disability and neurological impairment. The aim of this study was to compare the effects of MS on patients from Britain and Kuwait. Methodology: A questionnaire was distributed to 200 individuals with MS (100 Kuwaiti and 100 British). The questionnaire consists of three parts; 1. General demographics, 2. Disease-specific data (symptoms, severity levels, relapse frequency, and support system), and 3. Attitudes towards physical exercise. Results: A response rate of 62% from the British sample and 50% from the Kuwaiti sample was achieved. 84% of the sample (n=52) were 41 years old or over. The duration of the disease was less than 10 years in 43.4% of British and 68% of Kuwaiti respondents. The majority of British respondents (56.5%) reported the disease severity to be moderate, while the majority of Kuwaitis was mild (72%). The annual relapse rates in Kuwait were relatively low, with 82% of the Kuwaiti sample had one relapse per year, compared to the 64.5% of British. The most common symptoms reported by British respondents were balance (75.8%), fatigue (74.2%), and weakness (71%), and by Kuwaiti respondents were fatigue (86%), balance (76%), and weakness (66%). The help and support for MS were by far more diverse for the British than Kuwaiti respondents. Discussion: The results unveiled marked differences between two groups of British and Kuwaiti MS patients in terms of patients’ age and disease duration, and severity. The overwhelming majority of Kuwaiti patients are young individuals who have been with the disease for a relatively short period of time, and their MS in most cases was mild. On the other hand, British patients were relatively older, many have been with the disease for a long period of time, and their average MS condition was more serious than that of their Kuwaiti counterparts. The main support in Kuwait comes from the neurologist, who primarily prescribe medications and advise patients to try to be active. The Kuwaiti respondents thought that lack of encouragement was the main reason for them not to engage in social activities.

Keywords: multiple sclerosis, Kuwait, exercise, demographic

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Authors: Marinelle El-Khoury, Lina Bouhaya, Nivine Abbas, Hassan Sleiman

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The road network in the north of Lebanon is a prime example of the lack of pavement design and execution in Lebanon.  These roads show major distresses and hence, should be tested and evaluated. The aim of this research is to investigate and determine the deficiencies in road surface design in Lebanon, and to propose an environmentally friendly asphalt mix design. This paper consists of several parts: (i) evaluating pavement performance and structural behavior, (ii) identifying the distresses using visual examination followed by laboratory tests, (iii) deciding the optimal solution where rehabilitation or reconstruction is required and finally, (iv) identifying a sustainable method, which uses recycled material in the proposed mix. The asphalt formula contains Reclaimed Asphalt Pavement (RAP) in the base course layer and in the asphalt layer. Visual inspection of the roads in Tripoli shows that these roads face a high level of distress severity. Consequently, the pavement should be reconstructed rather than simply rehabilitated. Coring was done to determine the pavement layer thickness. The results were compared to the American Association of State Highway and Transportation Officials (AASHTO) design methodology and showed that the existing asphalt thickness is lower than the required asphalt thickness. Prior to the pavement reconstruction, the road materials were tested according to the American Society for Testing and Materials (ASTM) specification to identify whether the materials are suitable. Accordingly, the ASTM tests that were performed on the base course are Sieve analysis, Atterberg limits, modified proctor, Los Angeles, and California Bearing Ratio (CBR) tests. Results show a CBR value higher than 70%. Hence, these aggregates could be used as a base course layer. The asphalt layer was also tested and the results of the Marshall flow and stability tests meet the ASTM specifications. In the last section, an environmentally friendly mix was proposed. An optimal RAP percentage of 30%, which produced a well graded base course and asphalt mix, was determined through a series of trials.

Keywords: asphalt mix, reclaimed asphalt pavement, California bearing ratio, sustainability

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Authors: Yelba Maria Carrillo

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The focus of this research study was to explore barriers, if any, faced by parents or legal guardians who are of Latinx background and speak Spanish as a primary language or are bilingual speakers of Spanish and English; barriers that limit their understanding of and involvement in their gifted child’s academic life. This study was guided by a qualitative case study design. The primary investigator hosted focus group interviews at a Magnet Middle School in Southern California. The groups consisted of 25 parents, or legal guardians of bilingual (English/Spanish) or former English learner students enrolled in a school serving 6th-8th grades. The primary investigator interviewed Latinx Spanish-speaking parents or legal guardians of gifted students regarding their perception of their child’s giftedness, parental involvement in schools, and fostering their child’s exceptional abilities. Parents and legal guardians described children as creative, intellectual, and highly intelligent. Key themes such as student performance, language proficiency, socio-emotional, and general intellectual ability were strong indicators of giftedness. Barriers such as language and education inhibited parent and legal guardian ability to understand their child’s giftedness, which resulted in their inability to adequately contribute to the development of their children’s talents and advocate for the appropriate services for their children. However, they recognized the importance of being involved in their child’s academic life and the importance of nurturing their ‘dón’ or ‘gift.’ La Familia is the foundation and core of Latinx culture; and, without a strong foundation, children lack guidance, confidence, and awareness to tap into their gifted abilities. Providing Latinx parents with the proper tools and resources to appropriately identify gifted characteristics and traits could lead to early identification and intervention for students in schools and at home.

Keywords: gifted education, gifted Latino students, Latino parent involvement, high ability students

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Authors: Chueh Chang, Chia-jung Hsieh, Fu-yu Yu, Yu-Hwa Lin

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Background:The majority of women diagnosed with breast cancer undergo treatment involving surgery and radiotherapy or chemotherapy, or both. With these major advances in breast cancer management, many patients still have to deal with short or long-term side effects and psychological distress related to the disease and treatment, which have a substantial impact on their quality of life. The Laughing Qigong Program (LQP) is an interactive laughter program that combines the physical and physiological benefits of laughter with the mental benefits of Chinese qigong. Purpose: In order to improve the quality of life for breast cancer women in the community as well as echoing the WHO 2004 “Promoting Mental Health” for every one. This study focused on how to promote the positive mental health for women of breast cancer through the “laughter program” in Taiwan. During the presentation, how to practice Laughing Qigong will be demonstrated. Method: Using nonequivalent pretest-posttest design, ix-one breast cancer patients were volunteered to enroll in this study from the Taiwan Breast Cancer Alliance (TBCA). Thirty patients were assigned to the experimental group and the other 31 patients were assigned to the control group. The women who were assigned to the experimental group received laughter program one hour per session, once a week, totally 12 sessions. All subjects were tested before and after the intervention on the following: Self-Esteem scale (RSE), Face Scale (FS), Anxiety and pain experience were measured as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR),and heart rate variability (HRV) as physiological markers of the body’s response to stress. Results: After comparing the experimental and control groups, the results revealed that those breast cancer women with “laughing program” their sense of humor were improved, less uncomfortable on self report physical conditions, more positive attitudes toward stress management by using laughter, and had emotional improvement according to the face scale.

Keywords: mental health promotion, breast cancer, laughing Qigong, women

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Authors: Nazish Badar

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Background: To investigate the epidemic resurgent wave of influenza A (H1N1) pdm09 infections during 2015-16 Influenza season(Nov,15 –Feb,16) we compared epidemiological features of influenza A (H1N1) pdm09 associated hospitalizations and deaths during this period in Pakistan. Methods: Respiratory samples were tested using CDC Real-Time RT-PCR protocols. Demographic and epidemiological data was analyzed using SPSS. Risk ratio was calculated between age groups to compare patients that were hospitalized and died due to influenza A (H1N1) pdm09 during this period. Results: A total of 1970 specimens were analyzed; influenza virus was detected in 494(25%) samples, including 458(93%) Influenza type A and 36(7%) influenza type B viruses. Amongst influenza A viruses, 351(77%) A(H1N1) pdm09 and 107(23%) were A/H3N2. Influenza A(H1N1)pdm09 peaked in January 2016 when 250(54%) of tested patients were positive. The resurgent waves increased hospitalizations due to pdmH1N1 as compared to the rest part of the year. Overall 267(76%) A(H1N1) pdm09 cases were hospitalized. Adults ≥18 years showed the highest relative risk of hospitalization (1.2). Median interval of hospitalization and symptom onset was five days for all age groups. During this period, a total of 34 laboratory-confirmed deaths associated with pandemic influenza A (H1N1) were reported out of 1970 cases, the case fatality rate was 1.72%. the male to female ratio was 2:1in reported deaths. The majority of the deaths during that period occurred in adults ≥18 years of age. Overall median age of the death cases was 42.8 years with underlying medical conditions. The median number of days between symptom onset was two days. The diagnosis upon admission in influenza-associated fatal cases was pneumonia (53%). Acute Respiratory Distress Syndrome 9 (26%), eight out of which (88%) required mechanical ventilation. Conclusions: The present resurgence of pandemic virus cannot be attributed to a single factor. The prolong cold and dry weather, possibility of drift in virus and absence of annual flu vaccination may have played an integrated role in resurfacing of pandemic virus.

Keywords: influenza A (H1N1)pdm 09, resurgence, epidemiology, Pakistan

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