Journal articles: 'Center for Mental Health Services (U.S.)' – Grafiati (2024)

Abstract:

<p><strong>List of abstracts and authors:</strong></p><p><strong>1. Antipsychotics in anxiety disorders</strong></p><p>Christer Allgulander</p><p><strong>2. Anxiety in somatic disorders</strong></p><p>Christer Allgulander</p><p><strong>3. Community rehabilitation of the schizophrenic patient</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera</p><p><strong>4. Dual diagnosis: A theory-driven multidisciplinary approach for integrative care</strong></p><p>David Blackbeard</p><p><strong>5. The emotional language of the gut - when 'psyche' meets 'soma'</strong></p><p>Helen Clark</p><p><strong>6. The Psychotherapy of bipolar disorder</strong></p><p>Franco Colin</p><p><strong>7. The Psychotherapy of bipolar disorder</strong></p><p>Franco Colin</p><p><strong>8. Developing and adopting mental health policies and plans in Africa: Lessons from South Africa, Uganda and Zambia</strong></p><p>Sara Cooper, Sharon Kleintjes, Cynthia Isaacs, Fred Kigozi, Sheila Ndyanabangi, Augustus Kapungwe, John Mayeya, Michelle Funk, Natalie Drew, Crick Lund</p><p><strong>9. The importance of relapse prevention in schizophrenia</strong></p><p>Robin Emsley</p><p><strong>10. Mental Health care act: Fact or fiction?</strong></p><p>Helmut Erlacher, M Nagdee</p><p><strong>11. Does a dedicated 72-hour observation facility in a district hospital reduce the need for involuntary admissions to a psychiatric hospital?</strong></p><p>Lennart Eriksson</p><p><strong>12. The incidence and risk factors for dementia in the Ibadan study of ageing</strong></p><p>Oye Gureje, Lola Kola, Adesola Ogunniyi, Taiwo Abiona</p><p><strong>13. Is depression a disease of inflammation?</strong></p><p><strong></strong>Angelos Halaris</p><p><strong>14. Paediatric bipolar disorder: More heat than light?</strong></p><p>Sue Hawkridge</p><p><strong>15. EBM: Anova Conundrum</strong></p><p>Elizabeth L (Hoepie) Howell</p><p><strong>16. Tracking the legal status of a cohort of inpatients on discharge from a 72-hour assessment unit</strong></p><p>Bernard Janse van Rensburg</p><p><strong>17. Dual diagnosis units in psychiatric facilities: Opportunities and challenges</strong></p><p>Yasmien Jeenah</p><p><strong>18. Alcohol-induced psychotic disorder: A comparative study on the clinical characteristics of patients with alcohol dependence and schizophrenia</strong></p><p>Gerhard Jordaan, D G Nel, R Hewlett, R Emsley</p><p><strong>19. Anxiety disorders: the first evidence for a role in preventive psychiatry</strong></p><p>Andre F Joubert</p><p><strong>20. The end of risk assessment and the beginning of start</strong></p><p>Sean Kaliski</p><p><strong>21. Psychiatric disorders abd psychosocial correlates of high HIV risk sexual behaviour in war-effected Eatern Uganda</strong></p><p>E Kinyada, H A Weiss, M Mungherera, P Onyango Mangen, E Ngabirano, R Kajungu, J Kagugube, W Muhwezi, J Muron, V Patel</p><p><strong>22. One year of Forensic Psychiatric assessment in the Northern Cape: A comparison with an established assessment service in the Eastern Cape</strong></p><p>N K Kirimi, C Visser</p><p><strong>23. Mental Health service user priorities for service delivery in South Africa</strong></p><p>Sharon Kleintjes, Crick Lund, Leslie Swartz, Alan Flisher and MHaPP Research Programme Consortium</p><p><strong>24. The nature and extent of over-the-counter and prescription drug abuse in cape town</strong></p><p>Liezl Kramer</p><p><strong>25. Physical health issues in long-term psychiatric inpatients: An audit of nursing statistics and clinical files at Weskoppies Hospital</strong></p><p>Christa Kruger</p><p><strong>26. Suicide risk in Schizophrenia - 20 Years later, a cohort study</strong></p><p>Gian Lippi, Ean Smit, Joyce Jordaan, Louw Roos</p><p><strong>27.Developing mental health information systems in South Africa: Lessons from pilot projects in Northern Cape and KwaZulu-Natal</strong></p><p>Crick Lund, S Skeen, N Mapena, C Isaacs, T Mirozev and the Mental Health and Poverty Research Programme Consortium Institution</p><p><strong>28. Mental health aspects of South African emigration</strong></p><p>Maria Marchetti-Mercer</p><p><strong>29. What services SADAG can offer your patients</strong></p><p>Elizabeth Matare</p><p><strong>30. Culture and language in psychiatry</strong></p><p>Dan Mkize</p><p><strong>31. Latest psychotic episode</strong></p><p>Povl Munk-Jorgensen</p><p><strong>32. The Forensic profile of female offenders</strong></p><p>Mo Nagdee, Helmut Fletcher</p><p><strong>33. The intra-personal emotional impact of practising psychiatry</strong></p><p>Margaret Nair</p><p><strong>34. Highly sensitive persons (HSPs) and implications for treatment</strong></p><p>Margaret Nair</p><p><strong>35. Task shifting in mental health - The Kenyan experience</strong></p><p>David M Ndetei</p><p><strong>36. Bridging the gap between traditional healers and mental health in todya's modern psychiatry</strong></p><p>David M Ndetei</p><p><strong>37. Integrating to achieve modern psychiatry</strong></p><p>David M Ndetei</p><p><strong>38. Non-medical prescribing: Outcomes from a pharmacist-led post-traumatic stress disorder clinic</strong></p><p>A Parkinson</p><p><strong>39. Is there a causal relationship between alcohol and HIV? Implications for policy, practice and future research</strong></p><p>Charles Parry</p><p><strong>40. Global mental health - A new global health discipline comes of age</strong></p><p>Vikram Patel</p><p><strong>41. Integrating mental health into primary health care: Lessons from pilot District demonstration sites in Uganda and South Africa</strong></p><p>Inge Petersen, Arvin Bhana, K Baillie and MhaPP Research Programme Consortium</p><p><strong>42. Personality disorders -The orphan child in axis I - Axis II Dichotomy</strong></p><p><strong></strong>Willie Pienaar</p><p><strong>43. Case Studies in Psychiatric Ethics</strong></p><p>Willie Pienaar</p><p><strong>44. Coronary artery disease and depression: Insights into pathogenesis and clinical implications</strong></p><p>Janus Pretorius</p><p><strong>45. Impact of the Mental Health Care Act No. 17 of 2002 on designated hospitals in KwaZulu-Natal: Triumphs and trials</strong></p><p>Suvira Ramlall, Jennifer Chipps</p><p><strong>46. Biological basis of addication</strong></p><p>Solomon Rataemane</p><p><strong>47. Genetics of Schizophrenia</strong></p><p>Louw Roos</p><p><strong>48. Management of delirium - Recent advances</strong></p><p>Shaquir Salduker</p><p><strong>49. Social neuroscience: Brain research on social issues</strong></p><p>Manfred Spitzer</p><p><strong>50. Experiments on the unconscious</strong></p><p>Manfred Spitzer</p><p><strong>51. The Psychology and neuroscience of music</strong></p><p>Manfred Spitzer</p><p><strong>52. Mental disorders in DSM-V</strong></p><p>Dan Stein</p><p><strong>53. Personality, trauma exposure, PTSD and depression in a cohort of SA Metro policemen: A longitudinal study</strong></p><p>Ugashvaree Subramaney</p><p><strong>54. Eating disorders: An African perspective</strong></p><p>Christopher Szabo</p><p><strong>55. An evaluation of the WHO African Regional strategy for mental health 2001-2010</strong></p><p>Thandi van Heyningen, M Majavu, C Lund</p><p><strong>56. A unitary model for the motor origin of bipolar mood disorders and schizophrenia</strong></p><p>Jacques J M van Hoof</p><p><strong>57. The origin of mentalisation and the treatment of personality disorders</strong></p><p>Jacques J M Hoof</p><p><strong>58. How to account practically for 'The Cause' in psychiatric diagnostic classification</strong></p><p>C W (Werdie) van Staden</p><p><strong>POSTER PRESENTATIONS</strong></p><p><strong>59. Problem drinking and physical and sexual abuse at WSU Faculty of Health Sciences, Mthatha, 2009</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz</p><p><strong>60. Prevalence of alcohol drinking problems and other substances at WSU Faculty of Health Sciences, Mthatha, 2009</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz</p><p><strong>61. Lessons learnt from a modified assertive community-based treatment programme in a developing country</strong></p><p>Ulla Botha, Liezl Koen, John Joska, Linda Hering, Piet Ooosthuizen</p><p><strong>62. Perceptions of psychologists regarding the use of religion and spirituality in therapy</strong></p><p>Ottilia Brown, Diane Elkonin</p><p><strong>63. Resilience in families where a member is living with schizophreni</strong></p><p>Ottilia Brown, Jason Haddad, Greg Howcroft</p><p><strong>64. Fusion and grandiosity - The mastersonian approach to the narcissistic disorder of the self</strong></p><p>William Griffiths, D Macklin, Loray Daws</p><p><strong>65. Not being allowed to exist - The mastersonian approach to the Schizoid disorder of the self</strong></p><p>William Griffiths, D Macklin, Loray Daws</p><p><strong>66. Risky drug-injecting behaviours in Cape Town and the need for a needle exchange programme</strong></p><p>Volker Hitzeroth</p><p><strong>67. Neuroleptic malignant syndrome in adolescents in the Western Cape: A case series</strong></p><p>Terri Henderson</p><p><strong>68. Experience and view of local academic psychiatrists on the role of spirituality in South African specialist psychiatry, compared with a qualitative analysis of the medical literature</strong></p><p>Bernard Janse van Rensburg</p><p><strong>69. The role of defined spirituality in local specialist psychiatric practice and training: A model and operational guidelines for South African clinical care scenarios</strong></p><p>Bernard Janse van Rensburg</p><p><strong>70. Handedness in schizophrenia and schizoaffective disorder in an Afrikaner founder population</strong></p><p>Marinda Joubert, J L Roos, J Jordaan</p><p><strong>71. A role for structural equation modelling in subtyping schizophrenia in an African population</strong></p><p>Liezl Koen, Dana Niehaus, Esme Jordaan, Robin Emsley</p><p><strong>72. Caregivers of disabled elderly persons in Nigeria</strong></p><p>Lola Kola, Oye Gureje, Adesola Ogunniyi, Dapo Olley</p><p><strong>73. HIV Seropositivity in recently admitted and long-term psychiatric inpatients: Prevalence and diagnostic profile</strong></p><p>Christina Kruger, M P Henning, L Fletcher</p><p><strong>74. Syphilis seropisitivity in recently admitted longterm psychiatry inpatients: Prevalence and diagnostic profile</strong></p><p>Christina Kruger, M P Henning, L Fletcher</p><p><strong>75. 'The Great Suppression'</strong></p><p>Sarah Lamont, Joel Shapiro, Thandi Groves, Lindsey Bowes</p><p><strong>76. Not being allowed to grow up - The Mastersonian approach to the borderline personality</strong></p><p>Daleen Macklin, W Griffiths</p><p><strong>77. Exploring the internal confirguration of the cycloid personality: A Rorschach comprehensive system study</strong></p><p>Daleen Macklin, Loray Daws, M Aronstam</p><p><strong>78. A survey to determine the level of HIV related knowledge among adult psychiatric patients admitted to Weskoppies Hospital</strong></p><p><strong></strong> T G Magagula, M M Mamabolo, C Kruger, L Fletcher</p><p><strong>79. A survey of risk behaviour for contracting HIV among adult psychiatric patients admitted to Weskoppies Hospital</strong></p><p>M M Mamabolo, T G Magagula, C Kruger, L Fletcher</p><p><strong>80. A retrospective review of state sector outpatients (Tara Hospital) prescribed Olanzapine: Adherence to metabolic and cardiovascular screening and monitoring guidelines</strong></p><p>Carina Marsay, C P Szabo</p><p><strong>81. Reported rapes at a hospital rape centre: Demographic and clinical profiles</strong></p><p>Lindi Martin, Kees Lammers, Donavan Andrews, Soraya Seedat</p><p><strong>82. Exit examination in Final-Year medical students: Measurement validity of oral examinations in psychiatry</strong></p><p>Mpogisheng Mashile, D J H Niehaus, L Koen, E Jordaan</p><p><strong>83. Trends of suicide in the Transkei region of South Africa</strong></p><p>Banwari Meel</p><p><strong>84. Functional neuro-imaging in survivors of torture</strong></p><p>Thriya Ramasar, U Subramaney, M D T H W Vangu, N S Perumal</p><p><strong>85. Newly diagnosed HIV+ in South Africa: Do men and women enroll in care?</strong></p><p>Dinesh Singh, S Hoffman, E A Kelvin, K Blanchard, N Lince, J E Mantell, G Ramjee, T M Exner</p><p><strong>86. Diagnostic utitlity of the International HIC Dementia scale for Asymptomatic HIV-Associated neurocognitive impairment and HIV-Associated neurocognitive disorder in South Africa</strong></p><p>Dinesh Singh, K Goodkin, D J Hardy, E Lopez, G Morales</p><p><strong>87. The Psychological sequelae of first trimester termination of pregnancy (TOP): The impact of resilience</strong></p><p>Ugashvaree Subramaney</p><p><strong>88. Drugs and other therapies under investigation for PTSD: An international database</strong></p><p>Sharain Suliman, Soraya Seedat</p><p><strong>89. Frequency and correlates of HIV Testing in patients with severe mental illness</strong></p><p>Hendrik Temmingh, Leanne Parasram, John Joska, Tania Timmermans, Pete Milligan, Helen van der Plas, Henk Temmingh</p><p><strong>90. A proposed mental health service and personnel organogram for the Elizabeth Donkin psychiatric Hospital</strong></p><p>Stephan van Wyk, Zukiswa Zingela</p><p><strong>91. A brief report on the current state of mental health care services in the Eastern Cape</strong></p><p>Stephan van Wyk, Zukiswa Zingela, Kiran Sukeri, Heloise Uys, Mo Nagdee, Maricela Morales, Helmut Erlacher, Orlando Alonso</p><p><strong>92. An integrated mental health care service model for the Nelson Mandela Bay Metro</strong></p><p>Stephan van Wyk, Zukiswa Zingela, Kiran Sukeri</p><p><strong>93. Traditional and alternative healers: Prevalence of use in psychiatric patients</strong></p><p>Zukiswa Zingela, S van Wyk, W Esterhuysen, E Carr, L Gaauche</p>

Abstract:

The Mental Health Project in BiH (PMZ BiH), Phase II, is a continuation of Phase I of the Mental Health Project. Direct results are: strengthened competencies and skills of multidisciplinary teams to provide better mental health services. In co-operation with sister associations from BiH, Swiss experts have supported the further strengthening of nursing staff in mental health through: support for the development of sister documentation, support in updating clinical guides with a focus on sister practice and providing training and / or direct support to selected members of sister associations in regarding the application of sister documentation and instructions for acting in their work.Assessment of the capacity of professional associations and specific needs of mental health professionals, realized within the BiH Mental Health Project, resulted in the signing of the Memorandum of Understanding and Cooperation between the above mentioned associations:1. Association of nurses and technicians in FBiH “UMSTFBiH”2. Association of nurses and technicians of the Republic of Srpska (Section nurses and technicians in the field of mental health of Republika Srpska)3. Udruženje “Medicinar” District Brčkowho implemented the Project: “Strengthening Nursing Competencies within the Center for the Protection of Mental Health”.Targeted sisterhood interventions will improve the orientation of the mental health system to the patient, provide health care with respect and understanding, and effectively treat patients. Interventions will contribute to better health outcomes, a better quality of life for mental health users and the general well-being of people with mental disorders, as well as those at risk of having a mental disorder.The project encompasses 40 centers for the protection of mental health in BiH with one representative - a medical nurse / technician. The acquired knowledge and skills, trained nurses / technicians, were passed on to other employees in the centers.The users with whom the sister documentation is applied are more satisfied with the speed and method of obtaining professional help. In 55.51% of respondents, the time of establishing the final diagnosis and condition is shortened. In 44.49% of users who are already in treatment in the centers, the deterioration of the disease is prevented by the introduction of a faster and better quality service.

Abstract:

College and university counseling centers have dual loyalties to both individuals and institutions that can create difficult conflicts of interest. Skillful juggling of conflicting loyalties is one of the variables that define college counseling as a mental health specialty. Conflicts typically involve pressures either to breach confidentiality or, more problematically, to involve the agency in administrative functions and decisions. The professional literature and the professional association ethical codes offer little guidance on how to respond to these pressures. A number of variables such as institutional size and stability, administrative location, agency history, degree of external pressure, degree of consensus on the counseling center s role, philosophy of psychological services, and the current ethical and legal climate influence how difficult the juggling act may be. The International Association of Counseling Services recommendation of "administrative neutrality" provides a conceptual tool usefull in formulating counseling center policy and selling boundaries.

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This is a study showcasing the utilization and knowledge of Counselling Services by Graduate Students at KNUST. The counselling Center of KNUST has been in existence over a decade and most of the clients that patronize its services are undergraduate students with few being Graduate Students. This paper was basically aimed at examining the level of awareness the KNUST Counselling Center, the services provided for members of the university community including graduate students and patronage of the services among Graduate students. There is minimal literature about studies done on Graduate students and counselling and there has not been such study to examine the impact of counselling among Graduate students in a university in Ghana. Therefore, it is hopedthat this study will lead to further studies among graduate students towards better ways of resolving their issues to improve their mental health. From the study, most Graduate students attest to the fact that Counselling is very important and some confirmed that they would recommend the KNUST-Counselling Center to other students. The services and benefits of the KNUST Counselling Center are described in this paper. Alternative ways for effective utilization of the services of the counselling center are explained to support graduate students to improve their mental heal while in school. Citation:De-Graft Adjei, V., Nuako, R. and Peasah, B. O. S. (2021). Relevance of Counselling Services among Graduate Students at Kwame Nkrumah University of Science and Technology, (KNUST), Kumasi, Ghana. International Journal of Technology and Management Research (IJTMR), Vol. 6 (2): Pp.81-86. Received: April 19, 2020Accepted: September 1, 2021

Abstract:

Racial and ethnic minorities in the United States are less likely to receive treatment for psychiatric disorders than are White Americans. For two decades, clinicians and researchers have worked to reduce health and health care disparities, with at best minimal success. In 2001 the Surgeon General issued a seminal report that described the magnitude of the problem (U. S. Department of Health and Human Services, 2001). Nevertheless, the vexing problem of unequal treatment persists. This review provides preliminary evidence for reducing racial and ethnic disparities in mental health treatment in primary care settings by giving priority to culturally competent practices and cultural tailoring in assessment, diagnosis, and treatment.

Abstract:

Summary Background: Immigrants have increased risk of a poor recovery from first episode psychosis (FEP). Early treatment can improve prognosis, but having an immigrant background may influence pathways to care. Method: We present research of service use and factors influencing treatment outcome in immigrants with FEP. Service use was assessed in in-patients at an early intervention center in Berlin, Germany. Duration of untreated psychosis and beliefs about illness was assessed in a FEP study in Oslo, Norway and cognitive functioning in patients with FEP schizophrenia from the regular mental health services in The Hague, the Netherlands. The proportion of immigrants in Berlin and Oslo was at level with the local populations, while the proportion in The Hague appeared to be higher. Result: There were clear indications that mental health literacy, probably based in different cultural expectations, were lower in first generation immigrants (FGI). Findings regarding clinical insight were ambiguous. There were also indications that FGI had more cognitive problems, based in higher stress levels or in cognitive styles. Early psychosis services must take issues of immigration and ethnicity into consideration.

Abstract:

As New York City became an international epicenter of the novel coronavirus disease 2019 (COVID-19) pandemic, telehealth was rapidly integrated into prenatal care at Columbia University Irving Medical Center, an academic hospital system in Manhattan. Goals of implementation were to consolidate in-person prenatal screening, surveillance, and examinations into fewer in-person visits while maintaining patient access to ongoing antenatal care and subspecialty consultations via telehealth virtual visits. The rationale for this change was to minimize patient travel and thus risk for COVID-19 exposure. Because a large portion of obstetric patients had underlying medical or fetal conditions placing them at increased risk for adverse outcomes, prenatal care telehealth regimens were tailored for increased surveillance and/or counseling. Based on the incorporation of telehealth into prenatal care for high-risk patients, specific recommendations are made for the following conditions, clinical scenarios, and services: (1) hypertensive disorders of pregnancy including preeclampsia, gestational hypertension, and chronic hypertension; (2) pregestational and gestational diabetes mellitus; (3) maternal cardiovascular disease; (4) maternal neurologic conditions; (5) history of preterm birth and poor obstetrical history including prior stillbirth; (6) fetal conditions such as intrauterine growth restriction, congenital anomalies, and multiple gestations including monochorionic placentation; (7) genetic counseling; (8) mental health services; (9) obstetric anesthesia consultations; and (10) postpartum care. While telehealth virtual visits do not fully replace in-person encounters during prenatal care, they do offer a means of reducing potential patient and provider exposure to COVID-19 while providing consolidated in-person testing and services. Key Points

Abstract:

Abstract Background There is a growing body of evidence suggesting that specialized early intervention (EI) programs deliver superior outcomes for individuals with early phase psychosis. Coordinated Specialty Care (CSC) is a recovery-oriented EI treatment program that employs multi-disciplinary team based care with high provider to patient staffing ratios and promotes shared decision making. CSC services are primarily provided in health care clinics. An alternative to “in clinic” service models is tele-health (TH) where clinical care and team interactions occur remotely through TH platforms. The advantages of this model may include reduced costs, bridging geographical distances, decreased stigma and increased flexibility for when and where therapeutic sessions occur. The purpose of this study is to compare the effectiveness of CSC delivered through TH (CSC-TH) versus the standard, clinic-based CSC model (CSC-Clinic). Methods A TH network was established in Indiana, USA to provide statewide CSC services. A “hub” team, comprised of a psychiatrist, therapist, team leader, nurse and data manger, was located in Indianapolis, IN and four “spoke” sites (Ft. Wayne, Anderson, Gary and Bloomington IN), were established across the State. All hub team services were delivered remotely through VIDYO, a leading, HIPPA compliant TH platform which was used on hand-held devices for care deliver in the subjects’ homes, as well as in local CMHCs. The standard clinical CSC program (CSC-Clinic), termed Prevention and Recovery Center (PARC), was located in Indianapolis, IN and all services were obtained through in-person clinic visits. Both the CSC-TH and CSC-Clinic programs employed identical inclusion criteria (16 – 30 years; within 3 years of psychosis onset; and non-substance induced psychotic disorder), assessment instruments, OnTrackNY training for all treatment staff, and outcome measures. Both programs conducted weekly team meetings where all patients were reviewed. Both programs were assessed for fidelity to the CSC model. All CSC patients were newly enrolled over the same treatment period. Data was collected at baseline, 3 months and 6 months. The outcome measures included engagement (drop outs), use of acute services (ER, hospitalization), illness severity (CGI-S), and MIRECC GAF symptoms, occupation/school function and social function. Ratings were independently determined through consensus of the respective treatment teams. Results Thirty-one early phase subjects were enrolled in the CSC-TH and 89 in the CSC-Clinic programs. Analyses demonstrates that CSC-TH was associated with significant and trend level superiority compared to CSC-Clinic for better engagement (3-month: X2=2.89, p=0.09; 6-month: X2=3.12, p=0.05); less use of acute services (3-month: X2= 6.62, p=0.01; 6-month: X2 =7.17, p=0.07); lower MIRECC GAF symptoms (3-month: t=3.2, p=0.002), improved occupation/school function (3-month: t=3.02, p=0.003) and social function (t=3.18, p=0.002). No group differences were found for CGI-S ratings. Discussion These results suggest that CSC-TH was associated with better outcomes compared to CSC-Clinic on key variables. Important caveats, including lack of randomization and blinded ratings, will be discussed. Future studies needed to further evaluate the role of TH in EI programs will be proposed.

Abstract:

The patient registration service is the starting gate for the health center services. In implementing BPJS, the community expects to get satisfactory health services. Patients will feel or not depends on the quality of registration services provided. If the patient feels satisfied the he will come back to get health care. However, if the patient is not satisfied, there will be many complaints that will not only be delivered face-to-face but more than that it can occur the complaint is submitted thorugh print media, visual media, and even social media. The purpose of study was to determine the comparative satisfaction of BPJS and non BPJS patients on the quality of registration services at the Johar Baru Health Center in Central Jakarta.riptive method with a Cross Sectional Comparative approach in the registration section at Johar Baru Health Center, Central Jakarta Research methods. This research was conducted with a descriptive method with a Cross Sectional Comparative approach in the registration section at Johar Baru Health Center, Central Jakarta. The population in this study were BPJS and Non BPJS patients who registered at the outpatient Registration in October-December 2019. The method of selecting samples was used with probability sampling whie to take samples using the proportionate stratified random sampling technique. The tool used for research with Questionnaire/Questionnaire. With a Likert scale measurement scale. For data analysis techniques using the Vality Test used is the product moment correlation which results in that the whoe question items are valid, which decision considerations are based on the r table for N = 30 at a significance of 5%, amounting to 0.361.Realibility Tests are used to show the extent to which a measurement result is relatively consistent if our measuring instrument repeatedly. Based on the reliability test, for the item questionnaire, the decision consideration is based on Cronbach’salfa value>0.60, the questionnaire is declared reliable or consistent. In this study the Cronvachs’s Alfa Value of 0.699 ‘s was rounded to 0.70, the cronbanch Alfa Value of 0.70>0.60, the questionnaire was declared reliable or consistent. With cross sectional time approach. The Mann Whitney U test was used to prove the hypothesis with the SPSS For Windows 25 software version, the significance value or Symp was obtained. Sig, (2 tailed) of 0.001. Therefore the value of Symp. Sig, (2 tailed) of 0.001>from the probability of 0.0f, the hypothesis “Ha is a accepted” or there is a difference. Based on the average value in the level of BPJS patient satisfaction obtained an average of 79.96 for Non BPJS patients obtained an average of 76.13 while the difference between the two amounted to 3.83. Targeted Output. Is a scientific publication in the National Journal of ISSN submitted, speakers in scientific meetings are registered, teaching material (ISBN) draft newspapaer articles are published. The proposed TKT research is TKT 1 The patient registration service is the starting gate for the health center services. In implementing BPJS, the community expects to get satisfactory health services. Patients will feel or not depends on the quality of registration services provided. If the patient feels satisfied the he will come back to get health care. However, if the patient is not satisfied, there will be many complaints that will not only be delivered face-to-face but more than that it can occur the complaint is submitted thorugh print media, visual media, and even social media. The purpose of study was to determine the comparative satisfaction of BPJS and non BPJS patients on the quality of registration services at the Johar Baru Health Center in Central Jakarta.riptive method with a Cross Sectional Comparative approach in the registration section at Johar Baru Health Center, Central JakartaResearch methods. This research was conducted with a descriptive method with a Cross Sectional Comparative approach in the registration section at Johar Baru Health Center, Central Jakarta. The population in this study were BPJS and Non BPJS patients who registered at the outpatient Registration in October-December 2019. The method of selecting samples was used with probability sampling whie to take samples using the proportionate stratified random sampling technique. The tool used for research with Questionnaire/Questionnaire. With a Likert scale measurement scale. For data analysis techniques using the Vality Test used is the product moment correlation which results in that the whoe question items are valid, which decision considerations are based on the r table for N = 30 at a significance of 5%, amounting to 0.361.Realibility Tests are used to show the extent to which a measurement result is relatively consistent if our measuring instrument repeatedly. Based on the reliability test, for the item questionnaire, the decision consideration is based on Cronbach’salfa value>0.60, the questionnaire is declared reliable or consistent. In this study the Cronvachs’s Alfa Value of 0.699 ‘s was rounded to 0.70, the cronbanch Alfa Value of 0.70>0.60, the questionnaire was declared reliable or consistent. With cross sectional time approach. The Mann Whitney U test was used to prove the hypothesis with the SPSS For Windows 25 software version, the significance value or Symp was obtained. Sig, (2 tailed) of 0.001. Therefore the value of Symp. Sig, (2 tailed) of 0.001>from the probability of 0.0f, the hypothesis “Ha is a accepted” or there is a difference. Based on the average value in the level of BPJS patient satisfaction obtained an average of 79.96 for Non BPJS patients obtained an average of 76.13 while the difference between the two amounted to 3.83.Targeted Output. Is a scientific publication in the National Journal of ISSN submitted, speakers in scientific meetings are registered, teaching material (ISBN) draft newspapaer articles are published. The proposed TKT research is TKT 1

Abstract:

Abstract Background Mild-traumatic brain injury (mTBI) and concussions cause significant morbidity. To date, synthesis of specific health care disparities and gaps in care for rural mTBI/concussion patients remains needed. Methods A comprehensive literature search was performed using PubMed database for English articles with keywords “rural” and (“concussion” or “mild traumatic brain injury”) from 1991 to 2019. Eighteen articles focusing on rural epidemiology (n = 5), management/cost (n = 5), military (n = 2), and concussion prevention/return to play (n = 6) were included. Results mTBI/concussion incidence was higher in rural compared with urban areas. Compared with urban patients, rural patients were at increased risk for vehicular injuries, lifetime number of concussions, admissions for observation without neuroimaging, and injury-related costs. Rural patients were less likely to utilize ambulatory and mental health services following mTBI/concussion. Rural secondary schools had decreased access to certified personnel for concussion evaluation, and decreased use of standardized assessment instruments/neurocognitive testing. While school coaches were aware of return-to-play laws, mTBI/concussion education rates for athletes and parents were suboptimal in both settings. Rural veterans were at increased risk for postconcussive symptoms and posttraumatic stress. Telemedicine in rural/low-resource areas is an emerging tool for rapid evaluation, triage, and follow-up. Conclusions Rural patients are at unique risk for mTBI/concussions and health care costs. Barriers to care include lower socioeconomic status, longer distances to regional medical center, and decreased availability of neuroimaging and consultants. Due to socioeconomic and distance barriers, rural schools are less able to recruit personnel certified for concussion evaluation. Telemedicine is an emerging tool for remote triage and evaluation.

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Abstract With a growing need for specialized training for direct caregivers and support staff of persons with intellectual and developmental disabilities (IDD) affected by dementia, the National Task Group on Developmental Disabilities and Dementia Practices (NTG) developed a comprehensive evidence-informed Dementia Capable Care Training (DCCT). To overcome the challenge of the training length and cost, and to extend its dissemination, the Sonoran Center developed a shorter version of the NTG-DCCT while retaining its core components, and implemented it in seven cities in the U. S. Southwest (N = 368). The pre- and post-training evaluation (n =260) demonstrated that the short version of the NTG-DCCT is effective in significantly improving participants' knowledge and/or confidence in dementia capable care. The follow-up semi-structured interviews of participants (n = 7) provide some insights.

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The Confinenment action to the mental disordes suffer is the action done by the society to limited the suffer’s mobilitas or activities its done based on the hopeless of the family which the medical effort can not made the suffer better than before. The economic burden is not small, additional with stigma from the society and the less optimal of mental health services base on family. Society and medical”s crew.The result of this researchplore the family experience towar the confinement and re confinement of the disorder’s family members in job area of Bantur Community health service of Malang Regency, East Java Province.The research methodology of this thesis use qualitative research (purposive sampling)about 6 sample. The process of data taking used the deep interview with semi structure helping by interview guide and fieldmemorize, its found 7 theme; 1) The cause of mental disorder, 2) The attitude change, 3) The Family’s comment on this situation, 4) The society stigma, 5) Confinement re confinement, 6) The confinement release, 7) The suffer family and society recovery.According the family conclusion the cause of disorder mental are pfisic condition and social pressure , and the moment of confinement –free-reconfinement happened of the society coment toward the situation stigma of the society and unoptimally the medical service. The free of confinement happened because of the family readiness,society and medical service and government involment. The rehabilition of the suffer after free from the confinement need the support from the family, society, community health service and related government.

Abstract:

Background Transgender women of color (TWC) are a medically underserved population who often experience substantial barriers to care. TWC experience high rates of stigma, violence, and entrenched barriers to receiving routine or specialty health services. Novel ways to improve access for TWC are urgently needed. Telehealth is one way to support TWC in overcoming barriers, yet this approach has been largely unexamined. The purpose of this study was to develop a TWC-specific telehealth intervention to increase access to primary and specialty care and then pilot test this intervention in a sample of TWC with at least one structural barrier to care. Methods Eligible participants were 18 years or older, identified as male sex at birth with a current gender identity of either female or transgender, a member of a racial/ethnic minority, and had experienced at least one study-defined structural barrier to primary or specialty care in the past 6 months. Following a 3-month preintervention phase, participants began a 3-month telehealth intervention which provided secure, remote access to trained, culturally appropriate, peer health consultants (PHCs) via video chat, e-mail, text, or phone. Health care utilization was assessed monthly via computer-assisted self-interview. Outcomes of intention to seek care in the next month and receipt of care in the past month were modeled using generalized estimating equations (GEE). Results Twenty-five eligible participants were enrolled in the study; a majority were black (96%), older than 25 years (69%), living with human immunodeficiency virus (HIV) (52%), and reported depressive symptomatology (67%). Of the 16 who had at least one pre- and one intervention data collection point, 13 downloaded the mobile video chat application and 7 participated in a qualitative exit interview. The intervention was associated with significantly (p < 0.05) increased odds of intention to seek transgender-specific care (adjusted odds ratio, aOR: 1.76 [95% confidence interval, CI: 1.001–3.08]); participants with depression defined by an elevated Center for Epidemiologic Studies 8-item depression scale (CES-D-8) score were significantly more likely to have intention to seek specialty care (aOR: 10.53 [95% CI: 1.42–77.97]), HIV-specific care (aOR: 2.56 [95% CI: 1.27–5.17]), and mental health care (aOR: 2.56 [95% CI: 1.27–5.17]) during the intervention period. Participants with elevated CES-D-8 scores had significantly greater odds of having sought HIV-specific care (aOR: 2.31 [95% CI: 1.31–4.06]) during the intervention period relative to those with lower scores. Conclusion These pilot data suggest that telehealth with remote access to PHCs who can provide immediate, culturally competent, nonclinical, education, and referral guidance may be effective in overcoming multiple barriers and improving care utilization outcomes for TWC. Telehealth may be an innovative, low-cost solution to improve health outcomes for populations with multiple barriers to health care services.

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BackgroundCurrent dosage regimen of aminophylline is similar in both Appropriate for Gestational Age (AGA) and Small for Gestational Age (SGA) preterm neonates.1 In contrast with AGA babies, SGA babies handle drugs in different way. However, developing countries like India has significant proportion of Growth Restricted/SGA babies. Hence, there is a need to develop appropriate dosage regimen in this population. Objective of the current study was set to develop and qualify the Population-Pharmaco*kinetic (PPK) model for aminophylline in premature neonates in Indian population.2MethodsAminophylline-treated neonates with IV loading dose of 5 mg/kg followed by maintenance dose of 1.5 or 2 mg/kg 8th hourly for Apnoea of Prematurity (AOP) were included. Any other conditions for secondary causes were excluded. Blood samples were collected by adopting sparse sample scheme and estimated by LCMS-MS. PPK model was developed with appropriate covariates.3 Data was analysed by NONMEM vesion 7.3. Non-parametric bootstrap procedure and Visual Predictive Check (VPC) was used to qualify the developed model.ResultsOne compartment, first-order structured model was fitted to the dataset containing 454 observations from 107 neonates. PPK parameters were represented as model estimated values and variability was depicted as% Co-efficient of variation (%CV). Typical population value of CL was 0.011 L/hour with inter-individual variability (IIV) of 59% and V was 0.332 (L/kg) with 31% IIV. Residual error was found to be 19%. Only postnatal age (PNA) had significant effect on V which was assessed by forward addition and backword elimination regression model.ConclusionAGA and SGA had no influence on PK parameters. However, PNA showed to have significant influence on V. Developed nomogram based on the qualified model may be effective and safe for aminophylline therapy in preterm neonates with apnoea.ReferencesShivakumar M, Jayashree P, Najih M, Lewis LES, Bhat Y R, Kamath A, et al. Comparative Efficacy and Safety of Caffeine and Aminophylline for Apnea of Prematurity in Preterm (≤34 weeks) Neonates: A Randomized Controlled Trial. Indian Pediatr 2017 Apr 15;54(4):279–83.U S Department of Health and Human Services, FDA, Center for Drug Evaluation and Research (CDER), Center for Biologics Evaluation and Research (CBER): Guidance for Industry Population pharmaco*kinetics; 1991; Feb CP1, 35 pages.Ette EI, Sun H, Ludden TM, Balanced designs in longitudinal Population Pharmaco*kinetic studies. Journal of Clinical Pharmacology 1998 May; 38(5):417–423.Disclosure(s)Nothing to disclose

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1. In the Case report titled ?A fatal case of fulminant myocarditis caused by influenza A virus? by Mila Kovacevic, Ilija Srdanovic, Milana Jarakovic, Dragana Bogdanovic, Milenko Cankovic, published in the Vojnosanitetski Pregled 2019; 76(12): 1290-6. (https://doi.org/10.2298/VSP170928017K), there was an error in the byline. The correct byline is: Mila Kovacevic*?, Ilija Srdanovic*?, Milana Jarakovic*, Dragana Bogdanovic*, Golub Samardzija*?, Milenko Cankovic*? *Institute of Cardiovascular Diserases of Vojvodina, Sremska Kamenica, Serbia; ?University of Novi Sad, ?Faculty of Medicine, Novi Sad, Serbia. The correction has been made to the online version of that issue of the Journal which is available at: http://www.vma.mod.gov.rs/vsp12-2019.pdf 2. In the Case report titled ?Psychogenic diabetes insipidus - A case report of behavioral psychotherapy? by Miodrag M. Stankovic, Jelena Stevanovic, Aleksandra Stojanovic, Sandra Stankovic, published in the Vojnosanitetski Pregled 2020; 77(12): 1332-5. (https://doi.org/10.2298/VSP180527188S), there was an error in the byline. The correct byline is: Miodrag M. Stankovic*?, Jelena Stevanovic?, Aleksandra Stojanovic*, Jelena Kostic*?, Sandra Stankovic? University of Nis, *Faculty of Medicine, Nis, Serbia; Clinical Centre Nis, ?Center for Mental Health Protection, ?Clinic for Children?s Internal Diseases, Nis, Serbia; ?General Hospital, Leskovac, Serbia The correction has been made to the online version of that issue of the Journal which is available at: http://www.vma.mod.gov.rs/vsp-12-2020.pdf <br><br><font color="red"><b> Link to the corrected article <u><a href="http://dx.doi.org/10.2298/VSP170928017K">10.2298/VSP170928017K</a></b></u> <br><br><font color="red"><b> Link to the corrected article <u><a href="http://dx.doi.org/10.2298/VSP180527188S">10.2298/VSP180527188S</a></b></u>

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Mental disorders are common [1] and they are associated with high levels of distress, morbidity, disability, and mortality. We know today that psychiatric treatments work and there is extensive evidence and agreement on effective mental health practices for persons with these disorders. Unfortunately, at a time when treatment for psychiatric illness has never been more effective, many people with these disorders do not have access to psychiatric services due to the shortage, and maldistribution of providers, especially psychiatrists. This has resulted in patients going to hospital emergency departments to seek services resulting in long lengths of stay and boarding of psychiatric patients in hospital emergency departments. A growing body of literature now suggests that the use of telepsychiatry to provide mental health care has the potential to mitigate the workforce shortage that directly affects access to care, especially in remote and underserved areas [2,3].The North Carolina Statewide Telepsychiatry Program (NC-STeP) was developed in response to NC Session Law 2013-360. The vision of NC-STeP is to assure that if an individual experiencing an acute behavioral health crisis enters an emergency department of a hospital anywhere in the state of North Carolina, s/he receives timely, evidence-based psychiatric treatment through this program. Aside from helping address the problems associated with access to mental health care, NC-STeP is helping North Carolina face a pressing and difficult challenge in the healthcare delivery system today: the integration of science-based treatment practices into routine clinical care. East Carolina University's Center for Telepsychiatry is the home for this statewide program, which is connecting 80-85 hospital emergency departments across the state of North Carolina. The plan for NC-STeP was developed in collaboration with a workgroup of key stakeholders including representatives from Universities in NC, hospitals/healthcare systems, NC Hospital Association, NC Psychiatric Association, LME-MCOs, NC-Department of HHS, and many others. The NC General Assembly has appropriated $4 million over two years to fund the program. The program is also partially funded by the Duke Endowment.The program has already connected 56 of the projected 85 hospitals in the first 18 months since its inception and over 12,000 encounters have been successfully completed during this time. A web portal has been designed and implemented that combines scheduling, EMR, HIE functions, and data management systems. This presentation will provide current program data on the length of stay, dispositions, IVC status, and other parameters for all ED patients who received telepsychiatry services. NC-STeP is now positioned well to create collaborative linkages and develop innovative models for the mental health care delivery by connecting psychiatric providers with EDs and Hospitals, Community-based mental health providers, Primary Care Providers, FQHCs and Public Health Clinics, and others. NC-STeP is positioned well to build capacity by taking care of patients in community-based settings and by creating collaborative linkages across continuums of care. By doing so, the program implements evidence-based practice to make recovery possible for patients that it serves.Disclosure of interestThe author has not supplied his declaration of competing interest.

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Background COVID-19 has thrust video consulting into the limelight, as health care practitioners worldwide shift to delivering care remotely. Evidence suggests that video consulting is acceptable, safe, and effective in selected conditions and settings. However, research to date has mostly focused on initial adoption, with limited consideration of how video consulting can be mainstreamed and sustained. Objective This study sought to do the following: (1) review and synthesize reported opportunities, challenges, and lessons learned in the scale-up, spread, and sustainability of video consultations, and (2) identify transferable insights that can inform policy and practice. Methods We identified papers through systematic searches in PubMed, CINAHL, and Web of Science. Included articles reported on synchronous, video-based consultations that had spread to more than one setting beyond an initial pilot or feasibility stage, and were published since 2010. We used the Nonadoption, Abandonment, and challenges to the Scale-up, Spread, and Sustainability (NASSS) framework to synthesize findings relating to 7 domains: an understanding of the health condition(s) for which video consultations were being used, the material properties of the technological platform and relevant peripherals, the value proposition for patients and developers, the role of the adopter system, organizational factors, wider macro-level considerations, and emergence over time. Results We identified 13 papers describing 10 different video consultation services in 6 regions, covering the following: (1) video-to-home services, connecting providers directly to the patient; (2) hub-and-spoke models, connecting a provider at a central hub to a patient at a rural center; and (3) large-scale top-down evaluations scaled up or spread across a national health administration. Services covered rehabilitation, geriatrics, cancer surgery, diabetes, and mental health, as well as general specialist care and primary care. Potential enablers of spread and scale-up included embedded leadership and the presence of a telehealth champion, appropriate reimbursem*nt mechanisms, user-friendly technology, pre-existing staff relationships, and adaptation (of technology and services) over time. Challenges tended to be related to service development, such as the absence of a long-term strategic plan, resistance to change, cost and reimbursem*nt issues, and the technical experience of staff. There was limited articulation of the challenges to scale-up and spread of video consultations. This was combined with a lack of theorization, with papers tending to view spread and scale-up as the sum of multiple technical implementations, rather than theorizing the distinct processes required to achieve widespread adoption. Conclusions There remains a significant lack of evidence that can support the spread and scale-up of video consulting. Given the recent pace of change due to COVID-19, a more definitive evidence base is urgently needed to support global efforts and match enthusiasm for extending use.

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The euphoria greeting the election of Barack Hussein Obama as the forty-fourth president of the United States seized the popular imagination in Africa, much as it did in the U. S. There was hope and enormous goodwill on the continent, derived from President Obama's special tie to Africa—the dreams from his father that he has translated so eloquently. There was hope that the Obama administration would initiate new policies based on mutual respect, multilateral collaboration, and an awareness that there will be no security unless there is common security—and also that security must be broadly defined, extending beyond the military to include the environment, the economy, and health, as well as political and social rights. Yet as many anticipated, given the enormous and wide-ranging problems confronting the new administration, Africa has not been front and center on its agenda. Although President Obama visited Egypt in June and Ghana in July 2009, only a few months into his presidency, Africa has not become a centerpiece of his foreign policy.In his much-publicized speech in Accra, President Obama lauded Ghana for its “repeated peaceful transfers of power,” declared that “development depends on good governance,” and urged Africans to take responsibility for their continent: “to hold [their] leaders accountable, and to build institutions that serve the people.” He pledged that the United States would support their efforts and committed his administration to opening the doors to African goods and services in ways that previous administrations have not. He pledged $63 billion to a new, comprehensive global health strategy that would promote public health systems and combat HIV/AIDS, malaria, tuberculosis, polio, and other devastating diseases. In the months that followed, he pledged to double American foreign aid to $50 billion a year and to develop a multilateral program to combat hunger.

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Background: Shishu Bikash Kendra (SBK or Child Development Center) of the Dhaka Shishu (Children’s) Hospital (DSH) has been using a multidisciplinary approach for assessment and management of children with various neurodevelopmental disorders since its establishment in 1991. In the past decade, a major proportion have presented with a range of emotional and behavioural problems. This paper aims to describe the types of child psychiatric disorders and the multidisciplinary team approach used in this centre for diagnosis and management of these children.Patients and Methods: Clinical records of 300 children who were assessed by the Child Mental Health Clinic of SBK during April 2004 to December 2006 were analyzed. These children were among the 1648 children who were referred for behavioural problems after having a General Developmental assessment (GDA). Children received services by a team comprising of child health physicians, child neurologists, child psychologists, developmental therapists and psychosocial counselors and a social worker. Psychiatric conditions were diagnosed using the multi-axial diagnostic guidelines of the Diagnostic and Statistical Manual (DSM-IV) and the International Classification of Diseases (ICD-10). The role of various clinics of the SBK to address specific aspects of a child’s mental health condition is described.Results: Of the 300 children seen 55% were of primary school age (ie, between 5-10 years), boys comprising 71%. The majority (94%) could be categorized into a psychiatric condition. Sixty three percent had a developmental problem. In addition, with 44% children having some intellectual deficit. Sixty one percent had an associated neurological or general medical condition. It was important to note also that 54% had some form of psychosocial adversity which needed immediate help. Commonest psychiatric diagnosis was Hyperkinetic Disorders (33%) followed by Autism Spectrum Disorders (ASD) and other Pervasive Developmental Disorders (PDD) (27%).Conclusion: Psychiatric morbidity is a common presentation among children who come to the child development and neurodisability service. If Child Mental Health professionals work with a multidisciplinary team within a child development service such as SBK, it may best utilize the multiaxial diagnosis system.DOI: http://dx.doi.org/10.3329/bjch.v35i3.10385 Bangladesh J Child Health 2011; Vol 35 (3): 84-89

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One in six senior citizens (age 65 years and older) living alone in the United States faces physical, cultural, and/or geographical barriers that isolate them from their peers and communities. This isolation can prevent them from receiving benefits and services that can improve their economic security and ability to live healthy, independent lives. Although it is generally known that depression is not directly related to the aging process, adults 65 years and older are more likely to experience depression due the onset of physical limitations, living alone, decreases in mobility, feelings of purposeless, cognitive decline, and fear of dying (Neff 2020). Prior to COVID-19, older adults attending senior activities centers (SAC) were instrumental in decreasing episodes of depression. This is largely based on socialization with peers, getting out of the home and, and listening to the life experiences of the much older adults. Since COVID-19, social distancing has been encouraged and the elimination of social gathering has been emphasized, which was, heretofore, expected in senior activities center settings. In the authors’ combined experience, the primary goal of successfully transitioning senior citizens returning to senior activities centers can best be accomplished by mental health care workers use of the EASE method. EASE stands for E: educate: Mental health care workers must educate older adults on the importance of social distancing in decreasing the spread of COVID-19 to the most vulnerable population (based on age and pre morbid conditions). By training staff to educate older adults on CDC guidelines relative to COVID-19 on proper handwashing, the wearing of facemasks to cover the mouth and nose, and to seek medical attention if Covid-19 symptoms are present, is essential. A: avoid: mental health care workers must constantly remind older adults to avoid the touching of the face and eyes. From picking up objects to turning doorknobs, people are constantly touching surfaces contaminated with pathogens. These pathogens can be picked up by our hands and get into the body through mucous membranes on the face — eyes, nose, and mouth — that act as pathways to the throat and lungs (Elder NC, Sawyer W, Pallerla H, Khaja S, Blacker M, 2014). S: support: Mental health care workers who work in senior activities centers. Senior should strive to support and provide an environment for older adults engaging them in opportunities for socialization, exercise, and education. The more active a senior citizen is, the healthier they will be. Recent research suggests when older adults consistently engage in social activities, they experience significant improvements in their physical, mental, and emotional health. Much of this improvement results from the ability to maintain healthy relationships and a continued sense of being part of society. E: Eliminate: mental health care workers should convey to older adults the need to eliminate activities that may contribute to contracting Covid-19, such as smoking and decreasing contact with those that smoke. Educating mental health workers on the benefits of transitioning the (EASE) of senior citizens back to attending the senior activities center will better assist this population to return to and overcome their fears to participate in the “new normal” beyond convid-19. Senior activities centers have been and will continue to be valuable community assets providing significant benefit to older adults and their families. Change in these programs will have to be significant enough to make a difference for this large demographic group. Using the EASE Method will assist with meeting the scale of change with the scale of the demand for Seniors to feel safe to return to Senior activities Centers.

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Executive Summary 1 This report analyzes the US Refugee Admissions Program (USRAP), leveraging data from a national survey of resettlement stakeholders conducted in 2020. 2 The survey examined USRAP from the time that refugees arrive in the United States. Its design and questionnaire were informed by three community gatherings organized by Refugee Council USA in the fall and winter of 2019, extensive input from an expert advisory group, and a literature review. This study finds that USRAP serves important purposes, enjoys extensive community support, and offers a variety of effective services. Overall, the survey finds a high degree of consensus on the US resettlement program’s strengths and objectives, and close alignment between its services and the needs of refugees at different stages of their settlement and integration. Because its infrastructure and community-based resettlement networks have been decimated in recent years, the main challenges of subsequent administrations, Congresses, and USRAP stakeholders will be to rebuild, revitalize, and regain broad and bipartisan support for the program. This article also recommends specific ways that USRAP’s programs and services can be strengthened. Among the study’s findings: 3 Most refugee respondents identified USRAP’s main purpose(s) as giving refugees new opportunities, helping them to integrate, offering hope to refugees living in difficult circ*mstances abroad, and saving lives. High percentages of refugees reported that the program allowed them to support themselves soon after arrival (92 percent), helped them to integrate (77 percent), and has a positive economic impact on local communities (71 percent). Refugee respondents also reported that the program encourages them to work in jobs that do not match their skills and credentials (56 percent), does not provide enough integration support after three months (54 percent), does not offer sufficient financial help during their first three months (49 percent), and reunites families too slowly (47 percent). Respondents identified the following main false ideas about the program: refugees pose a security risk (84 percent), use too many benefits and drain public finances (83 percent), and take the jobs of the native-born (74 percent). Refugee respondents reported using public benefits to meet basic needs, such as medical care, food, and housing. Non-refugee survey respondents believed at high rates that former refugees (69 percent) and refugee community advocate groups (64 percent) should be afforded a voice in the resettlement process. Non-refugee respondents indicated at high rates that the program’s employment requirements limit the time needed for refugees to learn English (65 percent) and limit their ability to pursue higher education (59 percent). Eighty-six percent of non-refugee respondents indicated that the Reception and Placement program is much too short (56 percent) or a little too short (30 percent). Respondents identified a wide range of persons and institutions as being very helpful to refugees in settling into their new communities: these included resettlement staff, friends, and acquaintances from refugees’ country of origin, members of places of worship, community organizations led by refugees or former refugees, and family members. Refugee respondents identified finding medical care (61 percent), housing (52 percent), and a job (49 percent) as the most helpful services in their first three months in the country. Refugees reported that the biggest challenge in their first year was to find employment that matched their educational or skill levels or backgrounds. The needs of refugees and the main obstacles to their successful integration differ by gender, reflecting at least in part the greater childcare responsibilities borne by refugee women. Refugee men reported needing assistance during their first three months in finding employment (68 percent), English Language Learning (ELL) courses (59 percent), and orientation services (56 percent), while refugee women reported needing orientation services (81 percent) and assistance in securing childcare (64 percent), finding ELL courses (53 percent), and enrolling children in school (49 percent). To open-response questions, non-refugee respondents identified as obstacles to the integration of men: digital literacy, (lack of) anti–domestic violence training, the need for more training to improve their jobs, the new public benefit rule, transportation to work, low wages, the need for more mental health services, cultural role adjustment, and lack of motivation. Non-refugee respondents identified as obstacles to the integration of women: lack of childcare and affordable housing, the different cultural roles of women in the United States, lack of affordable driver’s education classes, a shortage of ELL classes for those with low literacy or the illiterate, digital literacy challenges, difficulty navigating their children’s education and school systems, transportation problems, poorly paying jobs, and lack of friendships with US residents. Non-refugee respondents report that refugee children also face unique obstacles to integration, including limited funding or capacity to engage refugee parents in their children’s education, difficulties communicating with refugee families, and the unfamiliarity of teachers and school staff with the cultures and backgrounds of refugee children and families. LGBTQ refugees have many of the same basic needs as other refugees — education, housing, employment, transportation, psychosocial, and others — but face unique challenges in meeting these needs due to possible rejection by refugees and immigrants from their own countries and by other residents of their new communities. Since 2017, the number of resettlement agencies has fallen sharply, and large numbers of staff at the remaining agencies have been laid off. As a result, the program has suffered a loss in expertise, institutional knowledge, language diversity, and resettlement capacity. Resettlement agencies and community-based organizations (CBOs) reported at high rates that to accommodate pre-2017 numbers of refugees, they would need higher staffing levels in employment services (66 percent), general integration and adjustment services (62 percent), mental health care (44 percent) and medical case management (44 percent). Resettlement agencies indicated that they face immense operational and financial challenges, some of them longstanding (like per capita funding and secondary migration), and some related to the Trump administration’s hostility to the program. Section I introduces the article and provides historic context on the US refugee program. Section II outlines the resettlement process and its constituent programs. Section III describes the CMS Refugee Resettlement Survey: 2020. Section IV sets forth the study’s main findings, with subsections covering USRAP’s purpose and overall strengths and weaknesses; critiques of the program; the importance of receiving communities to resettlement and integration; the effectiveness of select USRAP programs and services; integration metrics; and obstacles to integration. The article ends with a series of recommendations to rebuild and strengthen this program.

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<p><strong>1. How can we maintain a sustainable private practice in the current political and economic climate?</strong></p><p>Eugene Allers</p><p><strong>2. SASOP Clinical guidelines, protocols and algorithms: Development of treatment guidelines for bipolar mood disorder and major depression</strong></p><p> Eugene Allers, Margaret Nair, Gerhard Grobler</p><p><strong>3. The revolving door phenomenon in psychiatry: Comparing low-frequency and high-frequency users of psychiatric inpatient services in a developing country</strong></p><p>U A Botha, P Oosthuien, L Koen, J A Joska, J Parker, N Horn</p><p><strong>4. Neurophysiology of emotion and senses - The interface between psyche and soma</strong></p><p>Eugene Allers</p><p><strong>5. Suicide prevention: From and beyond the psychiatrist's hands</strong></p><p>O Alonso Betanourt, M Morales Herrera</p><p><strong>6. Treatment of first-episod psychosis: Efficacy and toleabilty of a long-acting typical antipsychotic </strong></p><p>B Chiliza, R Schoeman, R Emsey, P Oosthuizen, L KOen, D Niehaus, S Hawkridge</p><p><strong>7. Treatment of attention deficit hyperactivity disorder in the young child</strong></p><p>Helen Clark</p><p><strong>8. Holistic/ Alternative treatment in psychiatry: The value of indigenous knowledge systems in cllaboration with moral, ethical and religious approaches in the military services</strong></p><p>J Dill</p><p><strong>9. Treating Schizophrenia: Have we got it wrong?</strong></p><p>Robin Emsley</p><p><strong>10.Terminal questions in the elderly</strong></p><p>Mike Ewart Smith</p><p><strong>11. Mental Health Policy development and implementation in Ghana, South Africa, Uganda and Zambia</strong></p><p>Alan J Flisher, Crick Lund, Michelle Frank, Arvin Bhana, Victor Doku, Natalie Drew, Fred N Kigozi, Martin Knapp, Mayeh Omar, Inge Petersen, Andrew Green andthe MHaPP Research Programme Consortium</p><p><strong>12. What indicators should be used to monitor progress in scaling uo services for people with mental disorders?</strong></p><p>Lancet Global Mental Health Group (Alan J Flisher, Dan Chisholm, Crick Lund, Vikram Patel, Shokhar Saxena, Graham Thornicroft, Mark Tomlinson)</p><p><strong>13. Does unipolar mania merit research in South Africa? A look at the literature</strong></p><p>Christoffel Grobler</p><p><strong>14. Revisiting the Cartesian duality of mind and body</strong></p><p>Oye Gureje</p><p><strong>15. Child and adolescent psychopharmacology: Current trends and complexities</strong></p><p>S M Hawkridge</p><p><strong>16. Integrating mental illness, suicide and religion</strong></p><p>Volker Hitzeroth</p><p><strong>17. Cost of acute inpatient mental health care in a 72-hour assessment uniy</strong></p><p>A B R Janse van Rensburg, W Jassat</p><p><strong>18. Management of Schizophrenia according to South African standard treatment guidelines</strong></p><p>A B R Janse van Rensburg</p><p><strong>19. Structural brain imaging in the clinical management of psychiatric illness</strong></p><p>F Y Jeenah</p><p><strong>20. ADHD: Change in symptoms from child to adulthood</strong></p><p>S A Jeeva, A Turgay</p><p><strong>21. HIV-Positive psychiatric patients in antiretrovirals</strong></p><p>G Jonsson, F Y Jeenah, M Y H Moosa</p><p><strong>22. A one year review of patients admitted to tertiary HIV/Neuropsychiatry beds in the Western Cape</strong></p><p>John Joska, Paul Carey, Ian Lewis, Paul Magni, Don Wilson, Dan J Stein</p><p><strong>23. Star'd - Critical review and treatment implications</strong></p><p>Andre Joubert</p><p><strong>24. Options for treatment-resistent depression: Lessons from Star'd; an interactive session</strong></p><p>Andre Joubert</p><p><strong>25. My brain made me do it: How Neuroscience may change the insanity defence</strong></p><p>Sean Kaliski</p><p><strong>26. Child andadolescent mental health services in four African countries</strong></p><p>Sharon Kleintjies, Alan Flisher, Victoruia Campbell-Hall, Arvin Bhana, Phillippa Bird, Victor Doku, Natalie, Drew, Michelle Funk, Andrew Green, Fred Kigozi, Crick Lund, Angela Ofori-Atta, Mayeh Omar, Inge Petersen, Mental Health and Poverty Research Programme Consortium</p><p><strong>27. Individualistic theories of risk behaviour</strong></p><p>Liezl Kramer, Volker Hitzeroth</p><p><strong>28. Development and implementation of mental health poliy and law in South Africa: What is the impact of stigma?</strong></p><p>Ritsuko Kakuma, Sharon Kleintjes, Crick Lund, Alan J Flisher, Paula Goering, MHaPP Research Programme Consortium</p><p><strong>29. Factors contributing to community reintegration of long-term mental health crae users of Weskoppies Hospital</strong></p><p>Carri Lewis, Christa Kruger</p><p><strong>30. Mental health and poverty: A systematic review of the research in low- and middle-income countries</strong></p><p>Crick Lund, Allison Breen, Allan J Flisher, Ritsuko Kakuma, Leslie Swartz, John Joska, Joanne Corrigall, Vikram Patel, MHaPP Research Programe Consortium</p><p><strong>31. The cost of scaling up mental health care in low- and middle-income countries</strong></p><p>Crick Lund, Dan Chishlom, Shekhar Saxena</p><p><strong>32. 'Tikking'Clock: The impact of a methamphetamine epidemic at a psychiatric hospital in the Western Cape</strong></p><p>P Milligan, J S Parker</p><p><strong>33. Durban youth healh-sk behaviour: Prevalence f Violence-related behaviour</strong></p><p>D L Mkize</p><p><strong>34. Profile of morality of patients amitted Weskoppies Psychiatric Hospital in Sout frican over a 5-Year period (2001-2005)</strong></p><p>N M Moola, N Khamker, J L Roos, P Rheeder</p><p><strong>35. One flew over Psychiatry nest</strong></p><p>Leverne Mountany</p><p><strong>36. The ethical relationship betwe psychiatrists and the pharmaceutical indutry</strong></p><p>Margaret G Nair</p><p><strong>37. Developing the frameor of a postgraduate da programme in mental health</strong></p><p>R J Nichol, B de Klerk, M M Nel, G van Zyl, J Hay</p><p><strong>38. An unfolding story: The experience with HIV-ve patients at a Psychiatric Hospital</strong></p><p>J S Parker, P Milligan</p><p><strong>39. Task shifting: A practical strategy for scalingup mental health care in developing countries</strong></p><p>Vikram Patel</p><p><strong>40. Ethics: Informed consent and competency in the elderly</strong></p><p>Willie Pienaar</p><p><strong>41. Confronting ommonmoral dilemmas. Celebrating uncertainty, while in search patient good</strong></p><p>Willie Pienaar</p><p><strong>42. Moral dilemmas in the treatment and repatriation of patients with psychtorders while visiting our country</strong></p><p>Duncan Ian Rodseth</p><p><strong>43. Geriatrics workshop (Psegal symposium): Medico-legal issuess in geriatric psyhiatry</strong></p><p>Felix Potocnik</p><p><strong>44. Brain stimulation techniques - update on recent research</strong></p><p>P J Pretorius</p><p><strong>45. Holistic/Alternative treatments in psychiatry</strong></p><p>T Rangaka, J Dill</p><p><strong>46. Cognitive behaviour therapy and other brief interventions for management of substances</strong></p><p>Solomon Rataemane</p><p><strong>47. A Transtheoretical view of change</strong></p><p>Nathan P Rogerson</p><p><strong>48. Profile of security breaches in longerm mental health care users at Weskoppies Hospital over a 6-month period</strong></p><p>Deleyn Rema, Lindiwe Mthethwa, Christa Kruger</p><p><strong>49. Management of psychogenic and chronic pain - A novel approach</strong></p><p>M S Salduker</p><p><strong>50. Childhood ADHD and bipolar mood disorders: Differences and similarities</strong></p><p>L Scribante</p><p><strong>51. The choice of antipsychotic in HIV-infected patients and psychopharmacocal responses to antipsychotic medication</strong></p><p>Dinesh Singh, Karl Goodkin</p><p><strong>52. Pearls in clinical neuroscience: A teaching column in CNS Spectrums</strong></p><p><strong></strong>Dan J Stein</p><p><strong>53. Urinary Cortisol secretion and traumatics in a cohort of SA Metro policemen A longitudinal study</strong></p><p>Ugash Subramaney</p><p><strong>54. Canabis use in Psychiatric inpatients</strong></p><p><strong></strong>M Talatala, G M Nair, D L Mkize</p><p><strong>55. Pathways to care and treatmt in first and multi-episodepsychosis: Findings fm a developing country</strong></p><p>H S Teh, P P Oosthuizen</p><p><strong>56. Mental disorders in HIV-infected indivat various HIV Treatment sites in South Africa</strong></p><p>Rita Thom</p><p><strong>57. Attendanc ile of long-term mental health care users at ocupational therapy group sessions at Weskoppies Hospital</strong></p><p>Ronel van der Westhuizen, Christa Kruger</p><p><strong>58. Epidemiological patterns of extra-medical drug use in South Africa: Results from the South African stress and health study</strong></p><p>Margaretha S van Heerden, Anna Grimsrud, David Williams, Dan Stein</p><p><strong>59. Persocentred diagnosis: Where d ps and mental disorders fit in the International classificaton of diseases (ICD)?</strong></p><p>Werdie van Staden</p><p><strong>60. What every psychiatrist needs to know about scans</strong></p><p>Herman van Vuuren</p><p><strong>61. Psychiatric morbidity in health care workers withle drug-resistant erulosis (MDR-TB) A case series</strong></p><p>Urvashi Vasant, Dinesh Singh</p><p><strong>62. Association between uetrine artery pulsatility index and antenatal maternal psychological stress</strong></p><p>Bavanisha Vythilingum, Lut Geerts, Annerine Roos, Sheila Faure, Dan J Stein</p><p><strong>63. Approaching the dual diagnosis dilemma</strong></p><p>Lize Weich</p><p><strong>64. Women's mental health: Onset of mood disturbance in midlife - Fact or fiction</strong></p><p>Denise White</p><p><strong>65. Failing or faking: Isses in the fiagnosis and treatment of adult ADHD</strong></p><p>Dora Wynchank</p>

Abstract:

In the COVID-19 pandemic scenario, parents need to be familiar with health literacy by applying clean and healthy living habits to their family members, especially those with early childhood. This study aims to explain parents' perceptions of health literacy for a clean and healthy behavior in their children during the COVID-19 pandemic. The method used in this study is a cross-sectional study involving 22 men and 62 female respondents. Respondent requirements were used in data analysis to determine parents' perceptions of health literacy and the efforts they have made to practice clean and healthy lifestyle in their children. The research findings show that knowing the health awareness of parents has an impact on a child's balanced lifestyle. Based on six measures of clean and healthy behavior for children, three indicators were determined in the category of discipline and high discipline: using clean water, using the toilet, and doing physical activity. The act of washing children's hands with soap indicators has a high discipline score and the use of masks in children has low discipline. If the use of masks is not disciplined by parents, exposure to COVID-19 in early childhood can be disrupted. Keywords: Early Childhood, Parental health literacy, Clean and healthy behaviors References: Abuhammad, S. (2021). Parents’ knowledge and attitude towards COVID‐19 in children: A Jordanian Study. International Journal of Clinical Practice, 75(2). https://doi.org/10.1111/ijcp.13671 Bauza, V., Sclar, G. D., Bisoyi, A., Majorin, F., Ghugey, A., & Clasen, T. (2021). Water, sanitation, and hygiene practices and challenges during the COVID-19 pandemic: A cross-sectional study in rural Odisha, India [Preprint]. Epidemiology. https://doi.org/10.1101/2021.01.26.21250274 Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J., & Crotty, K. (2011). Low Health Literacy and Health Outcomes: An Updated Systematic Review. Annals of Internal Medicine, 155(2), 97. https://doi.org/10.7326/0003-4819-155-2-201107190-00005 Bröder, J., Okan, O., Bauer, U., Schlupp, S., & Pinheiro, P. (2020). Advancing perspectives on health literacy in childhood and youth. Health Promotion International, 35(3), 575–585. https://doi.org/10.1093/heapro/daz041 Center for Disease ontrol and Prevention (CDC). (2019). How to Protect Yourself and Others. https://www.cdc.gov/ Chanchlani, N., Buchanan, F., & Gill, P. J. (2020). Addressing the indirect effects of COVID-19 on the health of children and young people. Canadian Medical Association Journal, 192(32), E921–E927. https://doi.org/10.1503/cmaj.201008 Clouston, S. A. P., Manganello, J. A., & Richards, M. (2016). A life course approach to health literacy: The role of gender, educational attainment and lifetime cognitive capability. Age and Ageing, ageing; afw229v1. https://doi.org/10.1093/ageing/afw229 Cooper, A. (2019). Health in the eyes of young people. The Lancet Child & Adolescent Health, 3(5), 299. https://doi.org/10.1016/S2352-4642(19)30085-9 Duplaga, M. (2020). Determinants and Consequences of Limited Health Literacy in Polish Society. International Journal of Environmental Research and Public Health, 17(2), 642. https://doi.org/10.3390/ijerph17020642 Duplaga, M., & Grysztar, M. (2021). The Association between Future Anxiety, Health Literacy and the Perception of the COVID-19 Pandemic: A Cross-Sectional Study. Healthcare, 9(1), 43. https://doi.org/10.3390/healthcare9010043 Gagliardi, A. R., Berta, W., Kothari, A., Boyko, J., & Urquhart, R. (2015). Integrated knowledge translation (IKT) in health care: A scoping review. Implementation Science, 11(1), 38. https://doi.org/10.1186/s13012-016-0399-1 Humphrys, E., Burt, J., Rubin, G., Emery, J. D., & Walter, F. M. (2019). The influence of health literacy on the timely diagnosis of symptomatic cancer: A systematic review. European Journal of Cancer Care, 28(1), e12920. https://doi.org/10.1111/ecc.12920 Kementerian Kesehatan RI. (2011). Pedoman Pembinaan Perilaku Hidup Bersih dan Sehat (PHBS). Kementerian Kesehatan RI. Lee, P.-I., Hu, Y.-L., Chen, P.-Y., Huang, Y.-C., & Hsueh, P.-R. (2020). Are children less susceptible to COVID-19? Journal of Microbiology, Immunology and Infection, 53(3), 371–372. https://doi.org/10.1016/j.jmii.2020.02.011 Nutbeam, D. (1998). Health promotion glossary. 13(4), 16. https://doi.org/10.1093/heapro/13.4.349 O’Conor, R., Muellers, K., Arvanitis, M., Vicencio, D. P., Wolf, M. S., Wisnivesky, J. P., & Federman, A. D. (2019). Effects of health literacy and cognitive abilities on COPD self-management behaviors: A prospective cohort study. Respiratory Medicine, 160, 105630. https://doi.org/10.1016/j.rmed.2019.02.006 Okan, O. (2019). The importance of early childhood in addressing equity and health literacy development in the life-course. 5(2), 8. Sentell, T., Vamos, S., & Okan, O. (2020). Interdisciplinary Perspectives on Health Literacy Research Around the World: More Important Than Ever in a Time of COVID-19. International Journal of Environmental Research and Public Health, 17(9), 3010. https://doi.org/10.3390/ijerph17093010 Sørensen, K., Pelikan, J. M., Röthlin, F., Ganahl, K., Slonska, Z., Doyle, G., Fullam, J., Kondilis, B., Agrafiotis, D., Uiters, E., Falcon, M., Mensing, M., Tchamov, K., Broucke, S. van den, & Brand, H. (2015). Health literacy in Europe: Comparative results of the European health literacy survey (HLS-EU). The European Journal of Public Health, 25(6), 1053–1058. https://doi.org/10.1093/eurpub/ckv043 Sørensen, K., Van den Broucke, S., Pelikan, J. M., Fullam, J., Doyle, G., Slonska, Z., Kondilis, B., Stoffels, V., Osborne, R. H., & Brand, H. (2013). Measuring health literacy in populations: Illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health, 13(1), 948. https://doi.org/10.1186/1471-2458-13-948 Toussaint, L. L., Cheadle, A. D., Fox, J., & Williams, D. R. (2020). Clean and Contain: Initial Development of a Measure of Infection Prevention Behaviors During the COVID-19 Pandemic. Annals of Behavioral Medicine, 54(9), 619–625. https://doi.org/10.1093/abm/kaaa064 Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., Choo, F. N., Tran, B., Ho, R., Sharma, V. K., & Ho, C. (2020). A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Behavior, and Immunity, 87, 40–48. https://doi.org/10.1016/j.bbi.2020.04.028 Weston, D., Hauck, K., & Amlôt, R. (2018). Infection prevention behaviour and infectious disease modelling: A review of the literature and recommendations for the future. BMC Public Health, 18(1), 336. https://doi.org/10.1186/s12889-018-5223-1 Zaben, K., & Khalil, A. (2019). Health Literacy, Self-Care Behavior and Quality of Life in Acute Coronary Syndrome Patients: An Integrative Review. Open Journal of Nursing, 09(04), 383–395. https://doi.org/10.4236/ojn.2019.94035

Abstract:

During COVID-19, early-childhood school closings led to higher levels of stress in parents when compared to childless adults. In addition, lack of time to prepare, as well as mental-health problems, worry, and stress in parenting, may have hampered parents' ability to support their children's educational needs. The research aims to solve the problem of early childhood parenting during learning from home and improve the quality of early childhood parenting. The research method uses the research and development stage of the Borg & Gall model. Participants are mothers who have children aged 5-6 years. The data collection technique was done through expert validation and effectiveness testing with a quasi-experimental design. The data analysis used paired t-test statistical analysis. The findings show that the validity of the results of the material expert's test is 96%, and the media expert's test is 94% in the very good category. The effectiveness test based on the pre-test and post-test results showed that Sig. (2-tailed) <0,05 (α), which means that the parenting e-book media significantly increases mothers' understanding of parenting well-being practices in early childhood. The implications of this multimedia-based anyflip e-book can be downloaded via gadgets, android, laptop, practical, easy to read and repeated to accompany childcare activities from home. Keywords: Anyflip E-book, Early Childhood, Parenting References Banerjee, A., Hanna, R., Kyle, J., Olken, B. A., & Sumarto, S. (2019). Private Outsourcing and Competition: Subsidized Food Distribution in Indonesia. Journal of Political Economy, 127(1), 101–137. https://doi.org/10.1086/700734 Borg, W. R., & Gall, M. D. (2007). Educational Research an Introduction. Fourth Edition. Bacon Publishing. Bruni, O., Sette, S., Fontanesi, L., Baiocco, R., Laghi, F., & Baumgartner, E. (2015). Technology Use and Sleep Quality in Preadolescence and Adolescence. Journal of Clinical Sleep Medicine, 11(12), 1433–1441. https://doi.org/10.5664/jcsm.5282 de Jong, E., Visscher, T., HiraSing, R., Heymans, M., Seidell, J., & Renders, C. (2013). Association between TV viewing, computer use and overweight, determinants and competing activities of screen time in 4- to 13-year-old children. International Journal of Obesity, 7. Dong, C., Cao, S., & Li, H. (2020). Young children’s online learning during COVID-19 pandemic: Chinese parents’ beliefs and attitudes. Children and Youth Services Review, 118, 105440. https://doi.org/10.1016/j.childyouth.2020.105440 Ebert, S. (2020). Theory of mind, language, and reading: Developmental relations from early childhood to early adolescence. Journal of Experimental Child Psychology, 191, 104739. https://doi.org/10.1016/j.jecp.2019.104739 Evans, M. A., Nowak, S., Burek, B., & Willoughby, D. (2017). The effect of alphabet eBooks and paper books on preschoolers’ behavior: An analysis over repeated readings. Early Childhood Research Quarterly, 40, 1–12. https://doi.org/10.1016/j.ecresq.2017.02.002 Fry, A. (2020). Use patterns for ebooks: The effects of subject, age and availability on rate of use. The Journal of Academic Librarianship, 46(3), 102150. https://doi.org/10.1016/j.acalib.2020.102150 Gerber, L. A., Guggenheim, M., Pang, Y. C., Ross, T., Mayevskaya, Y., Jacobs, S., & Pecora, P. J. (2020). Understanding the effects of an interdisciplinary approach to parental representation in child welfare. Children and Youth Services Review, 116, 105163. https://doi.org/10.1016/j.childyouth.2020.105163 Lau, E. Y. H., & Lee, K. (2020). Parents’ Views on Young Children’s Distance Learning and Screen Time During COVID-19 Class Suspensio. Early Education and Development, 19. https://doi.org/10.1080/10409289.2020.1843925 Lee, S. J., Ward, K. P., Chang, O. D., & Downing, K. M. (2021). Parenting activities and the transition to home-based education during the COVID-19 pandemic. Children and Youth Services Review, 122, 105585. https://doi.org/10.1016/j.childyouth.2020.105585 Morawska, A., Dittman, C. K., & Rusby, J. C. (2019). Promoting Self-Regulation in Young Children: The Role of Parenting Interventions. Clinical Child and Family Psychology Review, 22(1), 43–51. https://doi.org/10.1007/s10567-019-00281-5 Mourlam, D. J., DeCino, D. A., Newland, L. A., & Strouse, G. A. (2020). “It’s fun!” using students’ voices to understand the impact of school digital technology integration on their well-being. Computers & Education, 159, 104003. https://doi.org/10.1016/j.compedu.2020.104003 Nuñez, B., Stuart-Cassel, V., & Temkin, D. (2020). As COVID-19 spreads, most states have laws that address how schools should respond to pandemics. 66. Paredes, E., Hernandez, E., Herrera, A., & Tonyan, H. (2020). Putting the “family” in family childcare: The alignment between familismo (familism) and family childcare providers’ descriptions of their work. Early Childhood Research Quarterly, 52, 74–85. https://doi.org/10.1016/j.ecresq.2018.04.007 Rosen, L. D., Felice, K. T., & Walsh, T. (2020). Whole health learning: The revolutionary child of integrative health and education. EXPLORE, 16(4), 271–273. https://doi.org/10.1016/j.explore.2020.05.003 Thomas, V., De Backer, F., Peeters, J., & Lombaerts, K. (2019). Parental involvement and adolescent school achievement: The mediational role of self-regulated learning. Learning Environments Research, 22(3), 345–363. https://doi.org/10.1007/s10984-019-09278-x Tran, T., Hoang, A.-D., Nguyen, Y.-C., Nguyen, L.-C., Ta, N.-T., Pham, Q.-H., Pham, C.-X., Le, Q.-A., Dinh, V.-H., & Nguyen, T.-T. (2020). Toward Sustainable Learning during School Suspension: Socioeconomic, Occupational Aspirations, and Learning Behavior of Vietnamese Students during COVID-19. Sustainability, 12(10), 4195. https://doi.org/10.3390/su12104195 Troseth, G. L., & Strouse, G. A. (2017). Designing and using digital books for learning: The informative case of young children and video. International Journal of Child-Computer Interaction, 12, 3–7. https://doi.org/10.1016/j.ijcci.2016.12.002 UNESCO, U. (2020). COVID-19 impact on education. United Nations Educational Scientific and Cultural Organization. https://en. unesco.org/covid19/educationresponse Webster, E. K., Martin, C. K., & Staiano, A. E. (2019). Fundamental motor skills, screen-time, and physical activity in preschoolers. Journal of Sport and Health Science, 8(2), 114–121. https://doi.org/10.1016/j.jshs.2018.11.006

Abstract:

CME/CNE Information Activity Available Online: To access the article, post-test, and evaluation online, go to https://www.highmarksce.com/mscare. Target Audience: The target audience for this activity is physicians, physician assistants, nursing professionals, mental health practitioners, rehabilitation therapists, and other health care providers involved in the management of patients with multiple sclerosis (MS). Learning Objectives: 1) Identify several specific barriers and facilitators encountered by people with MS when attempting to access health care services, which the learner should consider in their clinical practice. Accreditation Statement: In support of improving patient care, this activity has been planned and implemented by the Consortium of Multiple Sclerosis Centers (CMSC) and Delaware Media Group. The CMSC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Physician Credit: The CMSC designates this journal-based activity for a maximum of 0.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nurse Credit: The CMSC designates this enduring material for 0.75 contact hour (0.0 in the area of pharmacology). Disclosures: Francois Bethoux, MD, Editor in Chief of the International Journal of MS Care (IJMSC), has served as Physician Planner for this activity. He has disclosed relationships with Springer Publishing (royalty), Qr8 (receipt of intellectual property rights/patent holder), Biogen (receipt of intellectual property rights/patent holder, speakers’ bureau), GW Pharma (consulting fee), MedRhythms (consulting fee, contracted research), Genentech (consulting fee), Helius (consulting fee), and Adamas Pharmaceuticals (contracted research). Laurie Scudder, DNP, NP, has served as Reviewer for this activity. She has disclosed no relevant financial relationships. Chantel D. Mayo, MSc, has disclosed no relevant financial relationships. Negar Farzam-kia, BSc, has disclosed no relevant financial relationships. Setareh Ghahari, PhD, OT Reg (Ont), has disclosed no relevant financial relationships. The peer reviewer for IJMSC has disclosed no relevant financial relationships. The staff at IJMSC, CMSC, and Delaware Media Group who are in a position to influence content have disclosed no relevant financial relationships. Note: Financial relationships may have changed in the interval between listing these disclosures and publication of the article. Method of Participation: Release Date: February 1, 2021 Valid for Credit Through: February 1, 2022 In order to receive CME/CNE credit, participants must: 1) Review the continuing education information, including learning objectives and author disclosures.2) Study the educational content.3) Complete the post-test and evaluation, which are available at https://www.highmarksce.com/mscare. Statements of Credit are awarded upon successful completion of the evaluation and the post-test with a passing score of &gt;70%. The post-test may be retaken if necessary. There is no fee to participate in this activity. Disclosure of Unlabeled Use: This educational activity may contain discussion of published and/or investigational uses of agents that are not approved by the FDA. The CMSC and Delaware Media Group do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the CMSC or Delaware Media Group. Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any medications, diagnostic procedures, or treatments discussed in this publication should not be used by clinicians or other health care professionals without first evaluating their patients’ conditions, considering possible contraindications or risks, reviewing any applicable manufacturer’s product information, and comparing any therapeutic approach with the recommendations of other authorities.

Abstract:

The Covid-19 pandemic had a dangerous impact on early-childhood education, lost learning in almost all aspects of child development. The house-to-house learning, with the name Moving Home Learning Program (MHLP), is an attractive offer as an emergency remote teaching solution. This study aims to describe the application of MHLP designed by early-childhood education institutions during the learning process at home. This study used a qualitative approach with data collection using interviews, observation, and documentation. The respondents involved in the interview were a kindergarten principal and four teachers. The research data were analyzed using the data content analysis. The Findings show that the MHLP has proven to be sufficiently in line with the learning needs of early childhood during the Covid-19 pandemic. Although, the application of the MHLP learning model has limitations such as the distance from the house that is far away, the number of meetings that are only once a week, the number of food and toy sellers passing by, disturbing children's concentration, and the risk of damage to goods at home. The implication of this research can be the basis for evaluating MHLP as an adaptive strategy that requires the attention of related parties, including policy makers, school principals, and teachers for the development of new, more effective online learning models. Keywords: Moving Home Learning Program (MHLP), Children Remote Teaching References:Abdollahi, E., Haworth-Brockman, M., Keynan, Y., Langley, M. J., & Oghadas, S. M. (2020). Simulating the effect of school closure during COVID-19 outbreaks in Ontario , Canada. BMC Medicine, 1–8. https://doi.org/https://doi.org/10.1186/s12916-020-01705-8 Arends, R. I., & Kilcher, A. (2010). Teaching for Student Learning: Becoming an Accomplished Teacher (1st ed.). Routledge. Arysandhi, K. N., & Meitriana, M. A. (2014). Studi Komparatif Motivasi Belajar Siswa pada Mata Pelajaran IPS antara Moving Class dengan Kelas Menetap di SMPN 1 Kerambitan dan SMPN 2 Tabanan Tahun Pelajaran 2013/2014. Ekuitas-Jurnal Pendidikan Ekonomi, 2(1), 30–39. Bawa, P. (2020). Learning in the age of SARS-COV-2 : A quantitative study of learners ’ performance in the age of emergency remote teaching. Computers and Education Open, 1(October), 100016. https://doi.org/10.1016/j.caeo.2020.100016 Bialek, S., Gierke, R., Hughes, M., McNamara, L., Pilishvili, T., & Skoff, T. (2020). Morbidity and mortality weekly report (mmwr) - Coronavirus Disease 2019 in Children — United States, February 12–April 2, 2020. Morbidity and Mortality Weekly Report, 69, 2–6. https://www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdf. Boardman, M. (2003). Changing Times: Changing Challenges for Early Childhood Leaders. Australasian Journal of Early Childhood, 28(2), 20–26. https://doi.org/10.1177/183693910302800205 Bronfenbrenner, U. (1979). The ecology of human development (1st ed.). Harvard University Press. Chen, Y. T. (2020). An investigation of young children’s science and aesthetic learning through a science aesthetic thematic curriculum: A mixed-methods study. Australasian Journal of Early Childhood, 45(2), 127–141. https://doi.org/10.1177/1836939120918503 Choi, N., & Jung, H. (2020). Temperament and Home Environment Characteristics as Predictors of Young Children ’ s Learning Motivation. Early Childhood Education Journal, 1994. https://doi.org/10.1007/s10643-020-01019-7 Counselman, K. P., & Jones, E. (2001). Distance learning in early childhood teacher education: The experience of Pacific Oaks College. Journal of Early Childhood Teacher Education, 22(4), 225–230. https://doi.org/10.1080/1090102010220402 Daniel, S. J. (2020). Education and the COVID-19 pandemic. PROSPECTS, 6. https://doi.org/10.1007/s11125-020-09464-3 Dick, W., Carey, L., & Carey, J. O. (2015). The Systematic Design of Instruction (8th ed.). Pearson. Diningrat, S. W. M., Nindya, M. A., & Salwa. (2020). Cakrawala Pendidikan ,. Cakrawala Pendidikan, 39(3), 705–719. https://doi.org/10.21831/cp.v39i3.32304 Dong, C., Cao, S., & Li, H. (2020). Young children’s online learning during COVID-19 pandemic: Chinese parents’ beliefs and attitudes. Children and Youth Services Review, 118(June), 105440. https://doi.org/10.1016/j.childyouth.2020.105440 Dong, Y., Dong, Y., Mo, X., Hu, Y., Qi, X., Jiang, F., Jiang, Z., Jiang, Z., Tong, S., Tong, S., & Tong, S. (2020). Epidemiology of COVID-19 among children in China. Pediatrics, 145(6). https://doi.org/10.1542/peds.2020-0702 Eliza, D. (2013). Penerapan Model Pembelajaran Kontekstual Learning (CTL) Berbasis Centra di Taman Kanak-Kanak. Pedagogi: Jurnal Ilmiah Ilmu Pendidikan, XIII(2), 93–106. Fadlilah, azizah nurul. (2021). Jurnal Obsesi : Jurnal Pendidikan Anak Usia Dini Strategi Menghidupkan Motivasi Belajar Anak Usia Dini Selama Pandemi COVID-19 melalui Publikasi Abstrak. Jurnal Obsesi : Jurnal Pendidikan Anak Usia Dini, 5(1), 373–384. https://doi.org/10.31004/obsesi.v5i1.548 Fenech, M. (2013). Quality early childhood education for my child or for all children?: Parents as activists for equitable, high-quality early childhood education in Australia. Australian Journal of Early Childhood, 38(4), 92–98. https://doi.org/10.1177/183693911303800413 Gibson, M. (2013). “I want to educate school-age children”: Producing early childhood teacher professional identities. Contemporary Issues in Early Childhood, 14(2), 127–137. https://doi.org/10.2304/ciec.2013.14.2.127 Hamzah, N. (2016). Pelaksanaan Pembelajaran BCCT Bagi Anak Usia Dini ; Study Pelaksanaan BCCT Di Tk Islam Mujahidin Pontianak. At-Turats: Jurnal Pemikiran Pendidikan Islama, 10(2), 119–131. Hasan, M. S., & Saputri, D. E. (2020). Pembelajaran PAI Berbasis Moving Class di SMP Negeri 1 Gudo Jombang. Attaqwa: Jurnal Ilmu Pendidikan Islam, 16(September), 113–125. Hew, K. F., Jia, C., Gonda, D. E., & Bai, S. (2020). Transitioning to the “new normal” of learning in unpredictable times: pedagogical practices and learning performance in fully online flipped classrooms. International Journal of Educational Technology in Higher Education, 17(1). https://doi.org/10.1186/s41239-020-00234-x Hodges, C. B., Moore, S., Lockee, B., Trust, T., & Bond, A. (2020). The Difference Between Emergency Remote Teaching and Online Learning. Educase Review. Hussein, E., Daoud, S., Alrabaiah, H., & Badawi, R. (2020). Children and Youth Services Review Exploring undergraduate students ’ attitudes towards emergency online learning during COVID-19 : A case from the UAE. Children and Youth Services Review, 1–7. https://doi.org/10.1016/j.childyouth.2020.105699 Işıkoğlu, N., Ero, A., Atan, A., & Aytekin, S. (2021). A qualitative case study about overuse of digital play at home. Current Psychology. https://doi.org/https://doi.org/10.1007/s12144-021-01442-y A Kilgallon, P., Maloney, C., & Lock, G. (2008). Early childhood teachers coping with educational change. Australian Journal of Early Childhood, 33(1), 23–29. https://doi.org/10.1177/183693910803300105 Kim, J. (2020). Learning and Teaching Online During Covid ‑ 19 : Experiences of Student Teachers in an Early Childhood Education Practicum. International Journal of Early Childhood, 52(2), 145–158. https://doi.org/10.1007/s13158-020-00272-6 Kurniati, E., Kusumanita, D., Alfaeni, N., & Andriani, F. (2021). Analisis Peran Orang Tua dalam Mendampingi Anak di Masa Abstrak. Jurnal Obsesi : Jurnal Pendidikan Anak Usia Dini, 5(1), 241–256. https://doi.org/10.31004/obsesi.v5i1.541 Lopes, H., & Mckay, V. (2020). pandemics : The COVID ‑ 19 experience. International Review of Education, 0123456789. https://doi.org/10.1007/s11159-020-09843-0 Macartney, K., Quinn, H. E., Pillsbury, A. J., Koirala, A., Deng, L., Winkler, N., Katelaris, A. L., & Sullivan, M. V. N. O. (2020). Articles Transmission of SARS-CoV-2 in Australian educational settings : a prospective cohort study. Lancet Child Adolesc Health 2020, 4642(20), 1–10. https://doi.org/10.1016/S2352-4642(20)30251-0 Marina, Indrawati, H., & Suarman. (2019). Application of Moving Class Learning Models and Teacher Pedagogical Competence on Learning Motivation and Student Learning Discipline. Journal of Educational Sciences, 3(1), 72–83. https://doi.org/doi.org/10.31258/jes.3.1.p.72-83 McLean, K., Edwards, S., & Mantilla, A. (2020). A review of community playgroup participation. Australasian Journal of Early Childhood, 45(2), 155–169. https://doi.org/10.1177/1836939120918484 Muhdi, Nurkolis, & Yuliejantiningsih, Y. (2020). The Implementation of Online Learning in Early Childhood Education During the Covid-19 Pandemic. Jurnal Pendidikan Usia Dini, 14(2), 248–261. https://doi.org/https://doi.org/10.21009/JPUD.142.04 Panovska-griffiths, J., Kerr, C. C., Stuart, R. M., Mistry, D., Klein, D. J., Viner, R. M., & Bonell, C. (2020). Articles Determining the optimal strategy for reopening schools , the impact of test and trace interventions , and the risk of occurrence of a second COVID-19 epidemic wave in the UK : a modelling study. The Lancet Child and Adolescent Health, 4642(20), 1–11. https://doi.org/10.1016/S2352-4642(20)30250-9 Piquero, A. R., Riddell, J. R., Bishopp, S. A., Narvey, C., Reid, J. A., & Piquero, N. L. (2020). Staying Home , Staying Safe ? A Short-Term Analysis of COVID-19 on Dallas Domestic Violence. American Journal of Criminal Justice, 601–635. https://doi.org/https://doi.org/10.1007/s12103-020-09531-7 Pramling, I., Judith, S., Elin, T. W., & Ødegaard, E. (2020). The Coronavirus Pandemic and Lessons Learned in Preschools in Norway , Sweden and the United States : OMEP Policy Forum. International Journal of Early Childhood, 0123456789. https://doi.org/10.1007/s13158-020-00267-3 Pribadi, H., & Harjati, P. (2013). Analisis Pembelajaran Fisika dalam Sistem Moving Class di SMP Negeri 1 Pekalongan Lampung Timur Tahun Pelajaran 2012/2013. JPF, 32–41. Project Tommorow & Blackboard. (2017). Trends in Digital Learning: Building teachers’ capacity and competency to create new learning experiences for students. https://tomorrow.org/speakup/speak-up-2016-trends-digital-learning-june-2017.html Rahiem, M. D. H. (2020). The Emergency Remote Learning Experience of University Students in Indonesia amidst the COVID-19 Crisis. International Journal of Learning, Teaching and Educational Research, 19(6), 1–26. http://orcid.org/0000-0002-5618-2486%0AAbstract. Ramdhani, M. T. (2016). Model Pelaksanaan Pembelajaran Pendidikan Agama Islam dengan Sistem Moving Class dalam Meningkatkan Motivasi dan Prestasi Belajar Siswa SMP IT Sahabat Alam. Anterior Jurnal, 15(2), 212–221. Reigeluth, C. M., Beatty, B. J., & Myers, R. D. (2017). Instructional-Design Theories and Models (R. D. Myers (Ed.); IV). Routledge. Sangsawang, T. (2020). Indonesian Journal of Science & Technology An Instructional Design for Online Learning in Vocational Education according to a Self-Regulated Learning Framework for Problem Solving during the CoViD-19 Crisis. 5. Schmerse, D., Anders, Y., Wieduwilt, N., & Tietze, W. (2018). Differential effects of home and preschool learning environments on early language development. British Educational Research Journal, 44(2), 338–357. https://doi.org/10.1002/berj.3332 Schreier, M. (2013). Qualitative Content Analysis (First Edit). SAGE Publications. Shisley, S. (2020). Emergency Remote Learning Compared to Online Learning. Learning Solution. https://learningsolutionsmag.com/articles/emergency-remote-learning-compared-to-online-learning Son, S., & Morrison, F. J. (2010). The Nature and Impact of Changes in Home Learning Environment on Development of Language and Academic Skills in Preschool Children. 46(5), 1103–1118. https://doi.org/10.1037/a0020065 Stephen, C., Ellis, J., & Martlew, J. (2010). Taking active learning into the primary school: A matter of new practices? International Journal of Early Years Education, 18(4), 315–329. https://doi.org/10.1080/09669760.2010.531916 Sudrajat, C. J., Agustin, M., Kurniati, L., & Karsa, D. (2021). Strategi Kepala TK dalam Meningkatkan Mutu Pendidikan pada Masa Pandemi Covid 19 Abstrak. Jurnal Obsesi : Jurnal Pendidikan Anak Usia Dini, 5(1), 508–520. https://doi.org/10.31004/obsesi.v5i1.582 Sumindar, A., & Wahyu, L. (2012). Model Pembelajaran Moving Class Mata Pelajaran Seni Budaya dan Implikasinya terhadap Kemandirian Siswa (Kajian Kasus) di SMA Karangturi Semarang. Catharsis: Journal of Arts Education, 1(2), 21. Supriatna, R., Hafidhuddin, D., & Syafri, U. A. (2018). Model Pembelajaran Beyond Center and Circle Time (BCCT) Berbasis Q.S Lukman Ayat 12-19. Tawazun: Jurnal Pendidikan Islam, 11(2), 1–11. Syarah, E. S. (2020). Understanding Teacher ’ s Perspectives in Media Literacy Education as an Empowerment Instrument of Blended Learning in Early Childhood Classroom. Jurnal Pendidikan Usia Dini, 14(2), 202–214. https://doi.org/https://doi.org/10.21009/JPUD.142.01 Tang, Y., & Hew, K. F. (2020). Does mobile instant messaging facilitate social presence in online communication? A two-stage study of higher education students. International Journal of Educational Technology in Higher Education, 17(1). https://doi.org/10.1186/s41239-020-00188-0 Thompson, M. (2019). Early Childhood Pedagogy in a Socio ‑ cultural Medley in Ghana : Case Studies in Kindergarten. International Journal of Early Childhood, 51(2), 177–192. https://doi.org/10.1007/s13158-019-00242-7 Togher, M., & Fenech, M. (2020). Ongoing quality improvement in the context of the National Quality Framework: Exploring the perspectives of educators in ‘Working Towards’ services. Australasian Journal of Early Childhood, 45(3), 241–253. https://doi.org/10.1177/1836939120936003 UNESCO. (2020). UNESCO’s support: Educational response to COVID-19. Unesco. https://en.unesco.org/covid19/educationresponse/support Vygotsky, L. S. (1978). Mind in Society: The Development of Higher Psychological Processes. Harvard University Press. Wiresti, R. D. (2021). Analisis Dampak Work From Home pada Anak Usia Dini di Masa Pandemi Covid-19. Jurnal Obsesi : Jurnal Pendidikan Anak Usia Dini, 5(1), 641–653. https://doi.org/10.31004/obsesi.v5i1.563 Wiwatowski, M., Page, J., & Young, S. (2020). Examining early childhood teachers’ attitudes and responses to superhero play. Australasian Journal of Early Childhood, 45(2), 170–182. https://doi.org/10.1177/1836939120918486 Yin, R. K. (2018). Case Study Research and Applications Design and Methods (Eliza Wells (Ed.); Sixth Edit). SAGE Publications. Yoshikawa, H., Wuermli, A. J., Britto, P. R., Dreyer, B., Leckman, J. F., Lye, S. J., Ponguta, L. A., Richter, L. M., & Stein, A. (2020). Effects of the Global Coronavirus Disease-2019 Pandemic on Early Childhood Development: Short- and Long-Term Risks and Mitigating Program and Policy Actions. The Journal of Pediatrics, 223(1), 188–193. https://doi.org/10.1016/j.jpeds.2020.05.020 Zhu, X., & Liu, J. (2020). Education in and After Covid-19 : Immediate Responses and Long-Term Visions. Postdigital Science and Education. https://doi.org/https://doi.org/10.1007/s42438-020-00126-3

Abstract:

The pandemic of COVID-19 has afflicted every individual and has initiated a cascade of directly or indirectly involved events in precipitating mental health issues. The human species is a wanderer and hunter-gatherer by nature, and physical social distancing and nationwide lockdown have confined an individual to physical isolation. The present review article was conceived to address psychosocial and other issues and their aetiology related to the current pandemic of COVID-19. The elderly age group has most suffered the wrath of SARS-CoV-2, and social isolation as a preventive measure may further induce mental health issues. Animal model studies have demonstrated an inappropriate interacting endogenous neurotransmitter milieu of dopamine, serotonin, glutamate, and opioids, induced by social isolation that could probably lead to observable phenomena of deviant psychosocial behavior. Conflicting and manipulated information related to COVID-19 on social media has also been recognized as a global threat. Psychological stress during the current pandemic in frontline health care workers, migrant workers, children, and adolescents is also a serious concern. Mental health issues in the current situation could also be induced by being quarantined, uncertainty in business, jobs, economy, hampered academic activities, increased screen time on social media, and domestic violence incidences. The gravity of mental health issues associated with the pandemic of COVID-19 should be identified at the earliest. Mental health organization dedicated to current and future pandemics should be established along with Government policies addressing psychological issues to prevent and treat mental health issues need to be developed. References World Health Organization (WHO) Coronavirus Disease (COVID-19) Dashboard. Available at: https://covid19.who.int/ [Accessed on 23 August 2020] Sim K, Chua HC. The psychological impact of SARS: a matter of heart and mind. CMAJ. 2004; 170:811e2. https://doi.org/10.1503/cmaj.1032003. Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatr. 2009; 54:302e11. https://doi.org/10.1177/070674370905400504. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020; 395:912e20. https://doi.org/10.1016/S0140-6736(20)30460-8. Robertson E, Hershenfield K, Grace SL, Stewart DE. The psychosocial effects of being quarantined following exposure to SARS: a qualitative study of Toronto health care workers. Can J Psychiatr. 2004; 49:403e7. https://doi.org/10.1177/070674370404900612. Barbisch D, Koenig KL, Shih FY. Is there a case for quarantine? Perspectives from SARS to Ebola. Disaster Med Public Health Prep. 2015; 9:547e53. https://doi.org/10.1017/dmp.2015.38. Jeong H, Yim HW, Song YJ, Ki M, Min JA, Cho J, et al. Mental health status of people isolated due to Middle East Respiratory Syndrome. Epidemiol Health. 2016;38: e2016048. https://doi.org/10.4178/epih.e2016048. Liu X, Kakade M, Fuller CJ, Fan B, Fang Y, Kong J, et al. Depression after exposure to stressful events: lessons learned from the severe acute respiratory syndrome epidemic. Compr Psychiatr. 2012; 53:15e23. https://doi.org/10.1016/j.comppsych.2011.02.003 Chadda RK, Deb KS. Indian family systems, collectivistic society and psychotherapy. Indian J Psychiatry. 2013;55: S299‑ https://dx.doi.org/10.4103%2F0019-5545.105555. Grover S, Sahoo S, Mehra A, Avasthi A, Tripathi A, Subramanyan A, et al. Psychological impact of COVID‑19 lockdown: An online survey from India. Indian J Psychiatry. 2020; 62:354-62. https://doi.org/ 10.4103/psychiatry.IndianJPsychiatry _427_20. Hawkley LC, Cacioppo JT. Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med. 2010; 40: 218–27. https://dx.doi.org/10.1007%2Fs12160-010-9210-8. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. https://doi.org/10.1016/S0140-6736(20)30211-7. Bhandari S, Sharma R, Singh Shaktawat A, Banerjee S, Patel B, Tak A, et al. COVID-19 related mortality profile at a tertiary care centre: a descriptive study. Scr Med. 2020;51(2):69-73. https://doi.org/10.5937/scriptamed51-27126. Baumeister RF, Leary MR. The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychol Bull. 1995; 117: 497–529. https://doi.org/10.1037/0033-2909.117.3.497. Caspi A, Harrington H, Moffitt TE, Milne BJ, Poulton R. Socially isolated children 20 years later: risk of cardiovascular disease. Arch Pediatr Adolesc Med. 2006; 160(8):805-11. https://doi.org/10.1001/archpedi.160.8.805. Eaker ED, Pinsky J, Castelli WP. Myocardial infarction and coronary death among women: psychosocial predictors from a 20-year follow-up of women in the Framingham Study. Am J Epidemiol. 1992; 135(8):854-64. https://doi.org/10.1093/oxfordjournals.aje.a116381. Luo Y, Hawkley LC, Waite LJ, Cacioppo JT. Loneliness, health, and mortality in old age: a national longitudinal study. Soc Sci Med. 2012 Mar; 74(6):907-14. https://dx.doi.org/10.1016%2Fj.socscimed.2011.11.028. Olsen RB, Olsen J, Gunner-Svensson F, Waldstrøm B. Social networks and longevity. A 14-year follow-up study among elderly in Denmark. Soc Sci Med. 1991; 33(10):1189-95. https://doi.org/10.1016/0277-9536(91)90235-5. Patterson AC, Veenstra G. Loneliness and risk of mortality: a longitudinal investigation in Alameda County, California. Soc Sci Med. 2010; 71(1):181-6. https://doi.org/10.1016/j.socscimed.2010.03.024. Savikko N, Routassalo P, Tilvis RS, Strandberg TE, Pitkalla KH. Predictors and subjective causes of loneliness in an aged population. Arch Gerontol Geriatrics. 2005; 41:3;223-33. https://doi.org/10.1016/j.archger.2005.03.002. Health Advisory for Elderly Population of India during COVID19. Available at: https://www.mohfw.gov.in/pdf/AdvisoryforElderlyPopulation.pdf [Accessed on 13 August 2020]. Dicks D, Myers R, Kling A. Uncus and amygdala lesions: effects on social behavior in the free-ranging rhesus monkey. Science. 1969; 165:69–71. https://doi.org/10.1126/science.165.3888.69. Kanai R, Bahrami B, Duchaine B, Janik A, Banissy MJ, Rees G. Brain structure links loneliness to social perception. Curr Biol. 2012; 22(20):1975-9. https://dx.doi.org/10.1016%2Fj.cub.2012.08.045. Bender AR, Daugherty A, Raz N. Vascular risk moderates associations between hippocampal subfield volumes and memory. J Cogn Neurosci. 2013; 25:1851–62. https://doi.org/10.1162/jocn_a_00435. Raz N. Diabetes: brain, mind, insulin–what is normal and do we need to know? Nat Rev Endocrinol. 2011; 7:636–7. https://doi.org/10.1038/nrendo.2011.149. Colcombe SJ, Erickson KI, Naftali R, Andrew GW, Cohen NJ, McAuley E, et al. Aerobic fitness reduces brain tissue loss in aging humans. J Gerontol A Biol Sci Med Sci. 2003; 58:176–80. https://doi.org/10.1093/gerona/58.2.m176. Maass A, Düzel S, Goerke M, Becke A, Sobieray U, Neumann K, et al. Vascular hippocampal plasticity after aerobic exercise in older adults. Mol Psychiatry. 2015; 20, 585–93. https://doi.org/10.1038/mp.2014.114. Wilson RS, Krueger KR, Arnold SE, Schneider JA, Kelly JF, Barnes LL, et al. Loneliness and Risk of Alzheimer Disease. Arch Gen Psychiatry. 2007;64(2):234–240. https://doi.org/10.1001/archpsyc.64.2.234. Kogan JH, Frankland PW, Silva AJ. Long-term memory underlying hippocampus-dependent social recognition in mice. Hippocampus. 2000;10(1):47-56. https://doi.org/10.1002/(sici)1098-1063(2000)10:1%3C47::aid-hipo5%3E3.0.co;2-6. Yorgason JT, España RA, Konstantopoulos JK, Weiner JL, Jones SR. Enduring increases in anxiety-like behavior and rapid nucleus accumbens dopamine signaling in socially isolated rats. Eur J Neurosci. 2013;37(6):1022-31. https://doi.org/10.1111/ejn.12113. Bledsoe AC, Oliver KM, Scholl JL, Forster GL. Anxiety states induced by post-weaning social isolation are mediated by CRF receptors in the dorsal raphe nucleus. Brain Res Bull. 2011;85(3-4):117-22. https://dx.doi.org/10.1016%2Fj.brainresbull.2011.03.003. Lukkes JL, Engelman GH, Zelin NS, Hale MW, Lowry CA. Post-weaning social isolation of female rats, anxiety-related behavior, and serotonergic systems. Brain Res. 2012; 1443:1-17. https://dx.doi.org/10.1016%2Fj.brainres.2012.01.005. Ago Y, Araki R, Tanaka T, Sasaga A, Nishiyama S, Takuma K, et al. Role of social encounter-induced activation of prefrontal serotonergic systems in the abnormal behaviors of isolation-reared mice. Neuropsychopharmacology. 2013; 38(8):1535-47. https://doi.org/10.1038/npp.2013.52. Veenema AH. Early life stress, the development of aggression and neuroendocrine and neurobiological correlates: what can we learn from animal models? Front Neuroendocrinol. 2009;30(4):497-518. https://doi.org/10.1016/j.yfrne.2009.03.003. Zhao X, Sun L, Jia H, Meng Q, Wu S, Li N, et al. Isolation rearing induces social and emotional function abnormalities and alters glutamate and neurodevelopment-related gene expression in rats. Prog Neuropsychopharmacol Biol Psychiatry. 2009;33(7):1173-1177. https://doi.org/10.1016/j.pnpbp.2009.06.016. Sciolino NR, Bortolato M, Eisenstein SA, Fu J, Oveisi F, Hohmann AG, et al. Social isolation and chronic handling alter endocannabinoid signaling and behavioral reactivity to context in adult rats. Neuroscience. 2010;168(2):371-86. https://dx.doi.org/10.1016%2Fj.neuroscience.2010.04.007. Ghasemi M, Phillips C, Trillo L, De Miguel Z, Das D, Salehi A. The role of NMDA receptors in the pathophysiology and treatment of mood disorders. Neurosci Biobehav Rev. 2014; 47:336-358. https://doi.org/10.1016/j.neubiorev.2014.08.017. Olivenza R, Moro MA, Lizasoain I, Lorenzo P, Fernández AP, Rodrigo J, et al. Chronic stress induces the expression of inducible nitric oxide synthase in rat brain cortex. J Neurochem. 2000;74(2):785-791. https://doi.org/10.1046/j.1471-4159.2000.740785.x. Maeng S, Zarate CA Jr, Du J, Schloesser RJ, McCammon J, Chen G, et al. Cellular mechanisms underlying the antidepressant effects of ketamine: role of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptors. Biol Psychiatry. 2008;63(4):349-352. https://doi.org/10.1016/j.biopsych.2007.05.028. Kalia LV, Kalia SK, Salter MW. NMDA receptors in clinical neurology: excitatory times ahead. Lancet Neurol. 2008;7(8):742-755. https://dx.doi.org/10.1016%2FS1474-4422(08)70165-0. Waxman EA, Lynch DR. N-methyl-D-aspartate Receptor Subtypes: Multiple Roles in Excitotoxicity and Neurological Disease. The Neuroscientist. 2005; 11(1), 37–49. https://doi.org/10.1177/1073858404269012. Hermes G, Li N, Duman C, Duman R. Post-weaning chronic social isolation produces profound behavioral dysregulation with decreases in prefrontal cortex synaptic-associated protein expression in female rats. Physiol Behav. 2011;104(2):354-9. https://dx.doi.org/10.1016%2Fj.physbeh.2010.12.019. Sestito RS, Trindade LB, de Souza RG, Kerbauy LN, Iyomasa MM, Rosa ML. Effect of isolation rearing on the expression of AMPA glutamate receptors in the hippocampal formation. J Psychopharmacol. 2011;25(12):1720-1729. https://doi.org/10.1177/0269881110385595. Toua C, Brand L, Möller M, Emsley RA, Harvey BH. The effects of sub-chronic clozapine and haloperidol administration on isolation rearing induced changes in frontal cortical N-methyl-D-aspartate and D1 receptor binding in rats. Neuroscience. 2010;165(2):492-499. https://doi.org/10.1016/j.neuroscience.2009.10.039. Alò R, Avolio E, Mele M, Storino F, Canonaco A, Carelli A et al. Excitatory/inhibitory equilibrium of the central amygdala nucleus gates anti-depressive and anxiolytic states in the hamster. Pharmacol Biochem Behav. 2014; 118:79-86. https://doi.org/10.1016/j.pbb.2014.01.007. St JP, Petkov VV. Changes in 5-HT1 receptors in different brain structures of rats with isolation syndrome. General pharmacology. 1990;21(2):223-5. https://doi.org/10.1016/0306-3623(90)90905-2. Miachon S, Rochet T, Mathian B, Barbagli B, Claustrat B. Long-term isolation of Wistar rats alters brain monoamine turnover, blood corticosterone, and ACTH. Brain Res Bull. 1993;32(6):611-614. https://doi.org/10.1016/0361-9230(93)90162-5. Van den Berg CL, Van Ree JM, Spruijt BM, Kitchen I. Effects of juvenile isolation and morphine treatment on social interactions and opioid receptors in adult rats: behavioural and autoradiographic studies. Eur J Neurosci. 1999;11(9):3023-3032. https://doi.org/10.1046/j.1460-9568.1999.00717.x. Vanderschuren LJ, Stein EA, Wiegant VM, Van Ree JM. Social play alters regional brain opioid receptor binding in juvenile rats. Brain Res. 1995;680(1-2):148-156. https://doi.org/10.1016/0006-8993(95)00256-p. Moles A, Kieffer BL, D'Amato FR. Deficit in attachment behavior in mice lacking the mu-opioid receptor gene. Science. 2004;304(5679):1983-1986. https://doi.org/10.1126/science.1095943. Panksepp J, Herman BH, Vilberg T, Bishop P, DeEskinazi FG. Endogenous opioids and social behavior. Neurosci Biobehav Rev. 1980;4(4):473-487. https://doi.org/10.1016/0149-7634(80)90036-6. Gong JP, Onaivi ES, Ishiguro H, Liu Q, Tagliaferro PA, Brusco A, et al. Cannabinoid CB2 receptors: immunohistochemical localization in rat brain. Brain Res. 2006;1071(1):10-23. https://doi.org/10.1016/j.brainres.2005.11.035. Breivogel CS, Sim-Selley LJ. Basic neuroanatomy and neuropharmacology of cannabinoids. Int Rev Psychiatry 2009; 21:2:113-121. https://doi.org/10.1080/09540260902782760. Haj-Mirzaian A, Amini-Khoei H, Haj-Mirzaian A, Amiri S, Ghesmati M, Zahir M, et al. Activation of cannabinoid receptors elicits antidepressant-like effects in a mouse model of social isolation stress. Brain Res Bull. 2017; 130:200-210. https://doi.org/10.1016/j.brainresbull.2017.01.018. Banach M, Piskorska B, Czuczwar SJ, Borowicz KK. Nitric Oxide, Epileptic Seizures, and Action of Antiepileptic Drugs. CNS & Neurological Disorders - Drug Targets 2011;10: 808. https://doi.org/10.2174/187152711798072347. Förstermann U, Sessa WC. Nitric oxide synthases: regulation and function. Eur Heart J. 2012;33(7):829-37, 837a-837d. https://dx.doi.org/10.1093%2Feurheartj%2Fehr304. Hu Y, Wu D, Luo C, Zhu L, Zhang J, Wu H, et al. Hippocampal nitric oxide contributes to sex difference in affective behaviors. PNAS. 2012, 109 (35) 14224-14229. https://doi.org/10.1073/pnas.1207461109. Khan MI, Ostadhadi S, Zolfa*ghari S, Mehr SE, Hassanzadeh G, Dehpour, A et al. The involvement of NMDA receptor/NO/cGMP pathway in the antidepressant like effects of baclofen in mouse force swimming test. Neuroscience Letters. 2016; 612:52-61. https://doi.org/10.1016/j.neulet.2015.12.006. Matsumoto K, Puia G, Dong E, Pinna G. GABAA receptor neurotransmission dysfunction in a mouse model of social isolation-induced stress: Possible insights into a non-serotonergic mechanism of action of SSRIs in mood and anxiety disorders. Stress. 2007; 10:1:3-12. https://doi.org/10.1080/10253890701200997. Zlatković J, Filipović D. Chronic social isolation induces NF-κB activation and upregulation of iNOS protein expression in rat prefrontal cortex. Neurochem Int. 2013;63(3):172-179. https://doi.org/10.1016/j.neuint.2013.06.002. Haj-Mirzaian A, Amiri S, Kordjazy N, Momeny M, Razmi A, Balaei MR, et al. Lithium attenuated the depressant and anxiogenic effect of juvenile social stress through mitigating the negative impact of interlukin-1β and nitric oxide on hypothalamic-pituitary-adrenal axis function. Neuroscience. 2016; 315:271-285. https://doi.org/10.1016/j.neuroscience.2015.12.024. Larson HJ. The biggest pandemic risk? Viral misinformation. Nature 2018; 562:309. https://doi.org/10.1038/d41586-018-07034-4. Zarocostas J. How to fight an infodemic. Lancet 2020; 395:676. https://doi.org/10.1016/S0140-6736(20)30461-X. World Health Organization, 2019. Ebola Virus Disease – Democratic Republic of the Congo. Geneva, Switzerland: WHO. Available at: https://www.who.int/csr/don/28-november-2019-ebola-drc/en/ [Accessed on August 8, 2020] Times of India. Covid-19: doctors gone to collect samples attacked in Indore. Available at: https://timesofindia.indiatimes.com/videos/news/covid-19-doctors-goneto- collect-samples-attacked-in-indore/videoshow/74942153.cms; 2020 [Accessed on August 8, 2020]. Withnall A. Coronavirus: why India has had to pass new law against attacks on healthcare workers. The Independent. April 23, 2020. Semple K. “Afraid to be a nurse”: health workers under attack. The New York Times. 2020 Apr 27. The Economist. Health workers become unexpected targets during COVID-19. The Economist. May 11, 2020. Turan B, Budhwani H, Fazeli PL, Browning WR, Raper JL, Mugavero MJ, et al. How does stigma affect people living with HIV? The mediating roles of internalized and anticipated HIV stigma in the effects of perceived community stigma on health and psychosocial outcomes. AIDS Behav. 2017; 21: 283–291. https://doi.org/10.1007/s10461-016-1451-5. James PB, Wardle J, Steel A, Adams J. An assessment of Ebola-related stigma and its association with informal healthcare utilisation among Ebola survivors in Sierra Leone: a cross sectional study. BMC Public Health. 2020; 20: 182. https://doi.org/10.1186/s12889-020-8279-7. Aljazeera, 2020. Iran: Over 700 Dead after Drinking Alcohol to Cure Coronavirus. Aljazeera. Available at: https://www.aljazeera.com/ news/2020/04/iran-700-dead-drinking-alcohol-cure-coronavirus200427163529629.html. (Accessed June 4, 2020) Delirrad M, Mohammadi AB, 2020. New methanol poisoning outbreaks in Iran following COVID-19 pandemic. Alcohol Alcohol. 55: 347–348. https://doi.org/10.1093/alcalc/agaa036. Hassanian-Moghaddam H, Zamani N, Kolahi A-A, McDonald R, Hovda KE. Double trouble: methanol outbreak in the wake of the COVID-19 pandemic in Iran-a cross-sectional assessment. Crit Care. 2020; 24: 402. https://doi.org/10.1186/s13054-020-03140-w. Soltaninejad K. Methanol Mass Poisoning Outbreak: A Consequence of COVID-19 Pandemic and Misleading Messages on Social Media. Int J Occup Environ Med. 2020;11(3):148-150. https://dx.doi.org/10.34172%2Fijoem.2020.1983. Islam MS, Sarkar T, Khan SH, Kamal AM, Hasan SMM, Kabir A, et al. COVID-19–Related Infodemic and Its Impact on Public Health: A Global Social Media Analysis. Am J Trop Med Hyg. 2020; 00(0):1–9. https://doi.org/10.4269/ajtmh.20-0812. Hawryluck L, Gold W, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004;10(7):1206–1212. https://dx.doi.org/10.3201%2Feid1007.030703. Lee S, Chan LYY, Chau AAM, Kwok KPS, Kleinman A. The experience of SARS-related stigma at Amoy Gardens. Soc Sci Med. 2005; 61(9): 2038-2046. https://doi.org/10.1016/j.socscimed.2005.04.010. Yoon MK Kim SY Ko HS Lee MS. System effectiveness of detection, brief intervention and refer to treatment for the people with post-traumatic emotional distress by MERS: a case report of community-based proactive intervention in South Korea. Int J Ment Health Syst. 2016; 10: 51. https://doi.org/10.1186/s13033-016-0083-5. Reynolds DL, Garay JR, Deamond SL, Moran MK, Gold W, Styra R. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect. 2008; 136: 997-1007. https://dx.doi.org/10.1017%2FS0950268807009156. Marjanovic Z, Greenglass ER, Coffey S. The relevance of psychosocial variables and working conditions in predicting nurses' coping strategies during the SARS crisis: an online questionnaire survey. Int J Nurs Stud. 2007; 44(6): 991-998. https://doi.org/10.1016/j.ijnurstu.2006.02.012. Bai Y, Lin C-C, Lin C-Y, Chen J-Y, Chue C-M, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr Serv. 2004; 55: 1055-1057. https://doi.org/10.1176/appi.ps.55.9.1055. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/Guidelinesforhomequarantine.pdf [Accessed on 25 August 2020]. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/RevisedguidelinesforHomeIsolationofverymildpresymptomaticCOVID19cases10May2020.pdf [Accessed on 25 August 2020]. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/AdvisoryformanagingHealthcareworkersworkinginCOVIDandNonCOVIDareasofthehospital.pdf (Accessed on 25 August 2020). Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/RevisedguidelinesforInternationalArrivals02082020.pdf [Accessed on 25 August 2020]. Cost of the lockdown? Over 10% of GDP loss for 18 states. Available at: https://timesofindia.indiatimes.com/india/cost-of-the-lockdown-over-10-of-gdp-loss-for-18-states/articleshow/76028826.cms [Accessed on 21 August 2020]. Jorda O, Singh SR, Taylor AM. Longer-Run Economic Consequences of Pandemics. Federal Reserve Bank of San Francisco Working Paper. 2020-09. https://doi.org/10.24148/wp2020-09. Firdaus G. Mental well‑being of migrants in urban center of India: Analyzing the role of social environment. Indian J Psychiatry. 2017; 59:164‑ https://doi.org/10.4103/psychiatry.indianjpsychiatry_272_15. National Crime Record Bureau. Annual Crime in India Report. New Delhi, India: Ministry of Home Affairs; 2018. 198 migrant workers killed in road accidents during lockdown: Report. Available at: https://www.hindustantimes.com/india-news/198-migrant-workers-killed-in-road-accidents-during-lockdown-report/story-hTWzAWMYn0kyycKw1dyKqL.html [Accessed on 25 August 2020]. Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020; 20:689-96. https://doi.org/10.1016/S1473-3099(20)30198-5. Dalton L, Rapa E, Stein A. Protecting the psychological health of through effective communication about COVID-19. Lancet Child Adolesc Health. 2020;4(5):346-347. https://doi.org/10.1016/S2352-4642(20)30097-3. Centre for Disease Control. Helping Children Cope with Emergencies. Available at: https://www.cdc.gov/childrenindisasters/helping-children-cope.html [Accessed on 25 August 2020]. Liu JJ, Bao Y, Huang X, Shi J, Lu L. Mental health considerations for children quarantined because of COVID-19. Lancet Child & Adolesc Health. 2020; 4(5):347-349. https://doi.org/10.1016/S2352-4642(20)30096-1. Sprang G, Silman M. Posttraumatic Stress Disorder in Parents and Youth After Health-Related Disasters. Disaster Med Public Health Prep. 2013;7(1):105-110. https://doi.org/10.1017/dmp.2013.22. Rehman U, Shahnawaz MG, Khan NH, Kharshiing KD, Khursheed M, Gupta K, et al. Depression, Anxiety and Stress Among Indians in Times of Covid-19 Lockdown. Community Ment Health J. 2020:1-7. https://doi.org/10.1007/s10597-020-00664-x. Cao W, Fang Z, Hou, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research. 2020; 287:112934. https://doi.org/10.1016/j.psychres.2020.112934. Wang C, Zhao H. The Impact of COVID-19 on Anxiety in Chinese University Students. Front Psychol. 2020; 11:1168. https://dx.doi.org/10.3389%2Ffpsyg.2020.01168. Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry 2020;7(3): e14. https://doi.org/10.1016/s2215-0366(20)30047-x. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020;3(3): e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976. Lancee WJ, Maunder RG, Goldbloom DS, Coauthors for the Impact of SARS Study. Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak. Psychiatr Serv. 2008;59(1):91-95. https://dx.doi.org/10.1176%2Fps.2008.59.1.91. Tam CWC, Pang EPF, Lam LCW, Chiu HFK. Severe acute respiratory syndrome (SARS) in Hongkong in 2003: Stress and psychological impact among frontline healthcare workers. Psychol Med. 2004;34 (7):1197-1204. https://doi.org/10.1017/s0033291704002247. Lee SM, Kang WS, Cho A-R, Kim T, Park JK. Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients. Compr Psychiatry. 2018; 87:123-127. https://dx.doi.org/10.1016%2Fj.comppsych.2018.10.003. Koh D, Meng KL, Chia SE, Ko SM, Qian F, Ng V, et al. Risk perception and impact of severe acute respiratory syndrome (SARS) on work and personal lives of healthcare workers in Singapore: What can we learn? Med Care. 2005;43(7):676-682. https://doi.org/10.1097/01.mlr.0000167181.36730.cc. Verma S, Mythily S, Chan YH, Deslypere JP, Teo EK, Chong SA. Post-SARS psychological morbidity and stigma among general practitioners and traditional Chinese medicine practitioners in Singapore. Ann Acad Med Singap. 2004; 33(6):743e8. Yeung J, Gupta S. Doctors evicted from their homes in India as fear spreads amid coronavirus lockdown. CNN World. 2020. Available at: https://edition.cnn.com/2020/03/25/asia/india-coronavirus-doctors-discrimination-intl-hnk/index.html. [Accessed on 24 August 2020] Violence Against Women and Girls: the Shadow Pandemic. UN Women. 2020. May 3, 2020. Available at: https://www.unwomen.org/en/news/stories/2020/4/statement-ed-phumzile-violence-against-women-during-pandemic. [Accessed on 24 August 2020]. Gearhart S, Patron MP, Hammond TA, Goldberg DW, Klein A, Horney JA. The impact of natural disasters on domestic violence: an analysis of reports of simple assault in Florida (1999–2007). Violence Gend. 2018;5(2):87–92. https://doi.org/10.1089/vio.2017.0077. Sahoo S, Rani S, Parveen S, Pal Singh A, Mehra A, Chakrabarti S, et al. Self-harm and COVID-19 pandemic: An emerging concern – A report of 2 cases from India. Asian J Psychiatr 2020; 51:102104. https://dx.doi.org/10.1016%2Fj.ajp.2020.102104. Ghosh A, Khitiz MT, Pandiyan S, Roub F, Grover S. Multiple suicide attempts in an individual with opioid dependence: Unintended harm of lockdown during the COVID-19 outbreak? Indian J Psychiatry 2020; [In Press]. The Economic Times. 11 Coronavirus suspects flee from a hospital in Maharashtra. March 16 2020. Available at: https://economictimes.indiatimes.com/news/politics-and-nation/11-coronavirus-suspects-flee-from-a-hospital-in-maharashtra/videoshow/74644936.cms?from=mdr. [Accessed on 23 August 2020]. Xiang Y, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. The Lancet Psychiatry 2020;(3):228–229. https://doi.org/10.1016/S2215-0366(20)30046-8. Van Bortel T, Basnayake A, Wurie F, Jambai M, Koroma A, Muana A, et al. Psychosocial effects of an Ebola outbreak at individual, community and international levels. Bull World Health Organ. 2016;94(3):210–214. https://dx.doi.org/10.2471%2FBLT.15.158543. Kumar A, Nayar KR. COVID 19 and its mental health consequences. Journal of Mental Health. 2020; ahead of print:1-2. https://doi.org/10.1080/09638237.2020.1757052. Gupta R, Grover S, Basu A, Krishnan V, Tripathi A, Subramanyam A, et al. Changes in sleep pattern and sleep quality during COVID-19 lockdown. Indian J Psychiatry. 2020; 62(4):370-8. https://doi.org/10.4103/psychiatry.indianjpsychiatry_523_20. Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4): P300-302. https://doi.org/10.1016/S2215-0366(20)30073-0. Dubey S, Biswas P, Ghosh R, Chatterjee S, Dubey MJ, Chatterjee S et al. Psychosocial impact of COVID-19. Diabetes Metab Syndr. 2020; 14(5): 779–788. https://dx.doi.org/10.1016%2Fj.dsx.2020.05.035. Wright R. The world's largest coronavirus lockdown is having a dramatic impact on pollution in India. CNN World; 2020. Available at: https://edition.cnn.com/2020/03/31/asia/coronavirus-lockdown-impact-pollution-india-intl-hnk/index.html. [Accessed on 23 August 2020] Foster O. ‘Lockdown made me Realise What’s Important’: Meet the Families Reconnecting Remotely. The Guardian; 2020. Available at: https://www.theguardian.com/keep-connected/2020/apr/23/lockdown-made-me-realise-whats-important-meet-the-families-reconnecting-remotely. (Accessed on 23 August 2020) Bilefsky D, Yeginsu C. Of ‘Covidivorces’ and ‘Coronababies’: Life During a Lockdown. N. Y. Times; 2020. Available at: https://www.nytimes.com/2020/03/27/world/coronavirus-lockdown-relationships.html [Accessed on 23 August 2020]

Abstract:

The prevalence of ADHD children increases every year. Some researchers have shown that psychosocial behavior therapy (antecedents-consequences modification) was effective to decrease hyperactivity and increase attention to ADHD children. This study aims to find out the effectiveness of antecedents-consequences modification by parents and teachers to decrease hyperactivity and increase attention to a 6 years old boy with ADHD. The study was a single case experimental design. Psychosocial behavior therapy has been used with antecedents-consequences modification. The antecedents-consequences modification was applied by teacher at school and parents at home. Data were analyzed using Wilcoxon Signed Rank Test. Results showed that there’s a significant decrease of hyperactivity behavior and significant increase of doing his assignment both at school and also at home. Not only about the content of behavior therapy itself, but how to give the therapy is important. Parents and teacher should do the therapy consistently, immediately, specifically and saliency to reach the target of intervention. Keywords: ADHD Children, Antecedents, Consequences, Modification Reference: (APA), A. A. P. (2013). Diagnostic and Manual of Mental Disorder (5th ed.). Arlington: American Psychiatric Association. Amalia, R. (2018). Intervensi terhadap Anak Usia Dini yang Mengalami Gangguan ADHD Melalui Pendekatan Kognitif Perilaku dan Alderian Play Therapy. Jurnal Obsesi : Jurnal Pendidikan Anak Usia Dini, 2(1), 27. https://doi.org/10.31004/obsesi.v2i1.4 Anastopoulos, A.D; Farley, S. . (2003). A Cognitive Behavioural Training Program for Parents of Children with Attention-Deficit/Hyperactivity Disorder. In W. J. Kazdin, Alan E (Ed.), Evidence-based psychotherapies for children and adolescents (pp. 187–203). New York: Guildford Press. Barkley, Russell A; DuPaul, G.L ; McMurray, M. . (1990). A comprehensive evaluation of attention deficit disorder with and without hyperactivity. Journal of Consulting and Clinical Psychology, 58, 775–789. Barkley, R. A. (2006). Attention-deficit hyperactivity disorder : A handbook for diagnosis and treatment (3rd ed.). New York City: Guildford Press. Barlow, D.H ; Hersen, M. (1984). Single case experimental design : Strategies for studying behavior change (2nd ed.). New York: Pergamon Press. Baumeister, S., Wolf, I., Holz, N., Boecker-Schlier, R., Adamo, N., Holtmann, M., … Brandeis, D. (2018). Neurofeedback Training Effects on Inhibitory Brain Activation in ADHD: A Matter of Learning? Neuroscience, 378, 89–99. https://doi.org/10.1016/j.neuroscience.2016.09.025 Cantwell, D. P., & Baker, L. (1991). Association between attention deficit-hyperactivity disorder and learning disorders. Journal of Learning Disabilities, 24(2), 88–95. https://doi.org/10.1177/002221949102400205 Center for Children and Families. (2019). Evidence-based Psychosocial Treatment for ADHD Children and Adolescents. Retrieved from http://ccf.fiu.edu Davidson, G. C. (2010). Abnormal Psychology. New Jersey: Wiley. DuPaul, George; Stoner, G. (2003). ADHD in the schools. New York: Guildford Press. DuPaul, G., & Weyandt, L. (2006). School-based intervention for children with attention deficit hyperactivity disorder: Effects on academic, social, and behavioural functioning. International Journal of Disability, Development and Education, 53(2), 161–176. https://doi.org/10.1080/10349120600716141 Erinta, D. B. M. S. (2012). Efektivitas penerapan terapi permainan sosialisasi untuk menurunkan perilaku impulsif pada anak dengan attention deficit hyperactive disorder (ADHD). Jurnal Psikologi : Teori & Terapan, 3(1). Evans, Steven W; Owens, Julie; Bunford, M. N. (2014). Evidence-Based Psychosocial Treatments for Children and Adolescents with Attention-Deficit/Hyperactivity Disorder. Journal Clinical Child Adolescence Psychology, 43(4), 527–551. https://doi.org/10.1038/jid.2014.371 Fabiano, G. A., Pelham, W. E., Coles, E. K., Gnagy, E. M., Chronis-Tuscano, A., & O’Connor, B. C. (2009). A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clinical Psychology Review, 29(2), 129–140. https://doi.org/10.1016/j.cpr.2008.11.001 Gerdes, A. C., Hoza, B., & Pelham, W. E. (2003). Attention-deficit/hyperactivity disordered boys’ relationships with their mothers and fathers: Child, mother, and father perceptions. Development and Psychopathology, 15(2), 363–382. https://doi.org/10.1017/S0954579403000208 Haas, S. M., Waschbusch, D. A., Pelham, W. E., King, S., Andrade, B. F., & Carrey, N. J. (2011). Treatment response in CP/ADHD children with callous/unemotional traits. Journal of Abnormal Child Psychology, 39(4), 541–552. https://doi.org/10.1007/s10802-010-9480-4 Helseth, S. A., Waschbusch, D. A., Gnagy, E. M., Onyango, A. N., Burrows-MacLean, L., Fabiano, G. A., … Pelham, W. E. (2015). Effects of behavioral and pharmacological therapies on peer reinforcement of deviancy in children with ADHD-Only, ADHD and conduct problems, and controls. Journal of Consulting and Clinical Psychology, 83(2), 280–292. https://doi.org/10.1037/a0038505 Hidayati, DM Ria ; Purwandari, E. (2010). Time Out : Alternatif Modifikasi Perilaku Anak ADHD (Attention Deficit/ Hyperacitivity Disorder). Indigenous, Jurnal Ilmiah Berkala Psikologi, 12(2), 101–114. Hinshaw, S. P., Owens, E. B., Wells, K. C., Kraemer, H. C., Abikoff, H. B., Arnold, L. E., … Wigal, T. (2000). Family processes and treatment outcome in the MTA: Negative/ineffective parenting practices in relation to multimodal treatment. Journal of Abnormal Child Psychology, 28(6), 555–568. https://doi.org/10.1023/A:1005183115230 Hinshaw, Stephen P., Owens, E. B., Zalecki, C., Huggins, S. P., Montenegro-Nevado, A. J., Schrodek, E., & Swanson, E. N. (2012). Prospective follow-up of girls with attention-deficit/hyperactivity disorder into early adulthood: Continuing impairment includes elevated risk for suicide attempts and self-injury. Journal of Consulting and Clinical Psychology,80(6), 1041–1051. https://doi.org/10.1037/a0029451 Jackson, N. A. (2003). A Survey of Music Therapy Methods and Their Role in the Treatment of Early Elementary School Children with ADHD. Journal of Music Therapy, 40(4), 302–323. https://doi.org/10.1093/jmt/40.4.302 Johnston, Charlotte; Mash, E. J. (2001). Families of Children With Attention-Deficit/Hyperactivity Disorder : Review and Recommendations for Future Research. Clinical Child and Family Psychology Review, 4(3), 183–207. Jr, W. E. P., Fabiano, G. A., & Pelham, W. E. (2008). Evidence-Based Psychosocial Treatments for Attention- Deficit / Hyperactivity Disorder (Vol. 4416). https://doi.org/10.1080/15374410701818681 Kaiser, N. M., McBurnett, K., & Pfiffner, L. J. (2011). Child ADHD severity and positive and negative parenting as predictors of child social functioning: Evaluation of three theoretical models. Journal of Attention Disorders, 15(3), 193–203. https://doi.org/10.1177/1087054709356171 Kazdin, A. E. (1984). Behavior Modification in Applied Settings. New York: Dorsey Press. Krasny-Pacini, A., & Evans, J. (2018). Single-case experimental designs to assess intervention effectiveness in rehabilitation: A practical guide. Annals of Physical and Rehabilitation Medicine, 61(3), 164–179. https://doi.org/10.1016/j.rehab.2017.12.002 Langberg, J. M., Molina, B. S. G., Arnold, L. E., Epstein, J. N., Altaye, M., Hinshaw, S. P., … Hechtman, L. (2011). Patterns and predictors of adolescent academic achievement and performance in a sample of children with attention-deficit/hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 40(4), 519–531. https://doi.org/10.1080/15374416.2011.581620 Nigg, J.T ; Barkley, R. . (2014). (Attention-deficit Hyperactivity Disorder). In R. A. Barkley (Ed.), E-book Pediatric เรื่องPsychiatry (Third Edit, Vol. 54, pp. 1–17). Retrieved from http://www.thaipediatrics.org/pages/Doctor/Download/48aedb8880cab8c45637abc7493ecddd:e0a186938dc3b74657fd46d32fac5fe6 Pastor, P., Reuben, C., Duran, C., & Hawkins, L. J. (2015). Association between diagnosed ADHD and selected characteristics among children aged 4-17 years: United States, 2011-2013. NCHS Data Brief, (201), 201. Patterson, G. . (1982). Coercive Family Process. Eugene: Castalia. Pfiffner, L. J ; Barkley, R. . (1990). Educational Placement and Classroom Management. In R. A. Barkley (Ed.), Attention Deficit Hyperactivity Disorder : A Handbook for Diagnosis and Treatment. New York: Guildford Press. Pfiffner, Linda J; Barkley, R; DuPaul, G. (2006). Treatment of ADHD in school settings. In R. A. Barkley (Ed.), Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (3th ed., pp. 547–589). New York: Guildford Press. Pfiffner, L. J., Calzada, E., & McBurnett, K. (2000). Interventions to enhance social competence. Child and Adolescent Psychiatric Clinics of North America, 9(3), 689–709. https://doi.org/10.1016/s1056-4993(18)30113-5 Pfiffner, Linda J., Hinshaw, S. P., Owens, E., Zalecki, C., Kaiser, N. M., Villodas, M., & McBurnett, K. (2014). A two-site randomized clinical trial of integrated psychosocial treatment for ADHD-inattentive type. Journal of Consulting and Clinical Psychology, 82(6), 1115–1127. https://doi.org/10.1037/a0036887 Pfiffner, Linda J, & Haack, L. M. (2014). Behavior Management for School - Aged Children with ADHD. 23, 731–746. Pfiffner, Linda J, Hinshaw, S. P., Owens, E., Zalecki, C., Kaiser, N. M., Villodas, M., & Mcburnett, K. (2015). A two-site randomized clinical trial of Integrated Psychosocial Treatment for ADHD-Inattentive Type. Journal of Consulting and Clinical Psychology, 82(6), 1115–1127. https://doi.org/10.1037/a0036887.A Riddle, M. A., Yershova, K., Lazzaretto, D., Paykina, N., Yenokyan, G., Greenhill, L., … Posner, K. (2013). The preschool attention-deficit/hyperactivity disorder treatment study (PATS) 6-year follow-up. Journal of the American Academy of Child and Adolescent Psychiatry, 52(3). https://doi.org/10.1016/j.jaac.2012.12.007 Saputro, D. (2009). ADHD (Attention Deficit/ Hyperactivity Disorder). Jakarta: Sagung Seto. Schunk, D. H. (2012). Learning Theories : An Educational Perspective (6th ed.; Pearson Education, Ed.). Boston. Shriver, M. D., Segool, N., & Gortmaker, V. (2011). Behavior observations for linking assessment to treatment for selective mutism. Education and Treatment of Children, 34(3), 389–411. https://doi.org/10.1353/etc.2011.0023 Suyanto, B. N., & Wimbarti, S. (2019). Program Intervensi Musik terhadap Hiperaktivitas Anak Attention Deficit Hyperactivity Disorder (ADHD). Gadjah Mada Journal of Professional Psychology (GamaJPP), 5(1), 15. https://doi.org/10.22146/gamajpp.48584 Taylor, E. (2009). Developing ADHD. Journal of Child Psychology and Psychiatry, 50, 126–132. Thomas, R., Sanders, S., Doust, J., Beller, E., & Glasziou, P. (2015). Prevalence of attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. Pediatrics, 135(4), e994–e1001. https://doi.org/10.1542/peds.2014-3482 Tran, J. L. A., Sheng, R., Beaulieu, A., Villodas, M., McBurnett, K., Pfiffner, L. J., & Wilson, L. (2018). Cost-Effectiveness of a Behavioral Psychosocial Treatment Integrated Across Home and School for Pediatric ADHD-Inattentive Type. Administration and Policy in Mental Health and Mental Health Services Research, 45(5), 741–750. https://doi.org/10.1007/s10488-018-0857-y Tresco, K. E., Lefler, E. K., & Power, T. J. (2010). Psychosocial Interventions to Improve the School Performance of Students with Attention-Deficit/Hyperactivity Disorder. Mind & Brain : The Journal of Psychiatry, 1(2), 69–74. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21152355%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC2998237 U.S. Department of Health and Human Services. (2014). US Department of Health and Human Services. The Health and Well-Being of Children: A Portrait of States and the Nation, 2011-2012. (June), 1–109. Weiss, Gabrielle ; Hechtman, L. T. (1993). Hyperactive Children Grown Up. New York: Guildford Press.

Abstract:

<p><strong>List of abstracts and authors:</strong></p><p><strong>1. Bipolar disorder not otherwise specified -overdiagnosed or underdiagnosed?</strong></p><p>E Allers</p><p><strong>2. The prognosis of major depression untreated and treated: Does the data reflect the true picture of the prognosis of this very common disorder?</strong></p><p>E Allers</p><p><strong>3. Can we prolong our patients' life expectancy? Providing a better quality of life for patients with severe mental illness</strong></p><p>O A Betencourt</p><p><strong>4. The scope of ECT practice in South Africa</strong></p><p>J Benson-Martin, P Milligan</p><p><strong>5. Biomarkers for schizophrenia: Can we evolve like cancer therapeutics?</strong></p><p>P Buckley<strong></strong></p><p><strong>6. Relapse in schizophrenis: Major challenges in prediction and prevention</strong></p><p>P Buckley</p><p><strong>7. Informed consent in biological treatments: The right to know the duty to inform</strong></p><p><strong></strong>I Chetty</p><p><strong>8. Effectiveness of a long-acting injectable antipsychotic plus an assertive monitoring programme in first-episode schizophrenia</strong></p><p><strong></strong>B Chiliza, L Asmal, O Esan, A Ojagbemi, O Gureje, R Emsley</p><p><strong>9. Name, shame, fame</strong></p><p>P Cilliers</p><p><strong>10. Can we manage the increasing incidence of violent raging children? We have to!</strong></p><p>H Clark</p><p><strong>11. Serotonin, depression and antidepressant action</strong></p><p>P Cowen</p><p><strong>12. Prevalence and correlates of comorbid psychiatris illness in patients with heroin use disorder admitted to Stikland Opioid Detoxification Unit</strong></p><p>L Dannatt, K J Cloete, M Kidd, L Weich</p><p><strong>13. Investigating the association between diabetes mellitus, depression and psychological distress in a cohort of South African teachers</strong></p><p>A K Domingo, S Seedat, T M Esterhuizen, C Laurence, J Volmink, L Asmal</p><p><strong>14. Neuropeptide S -emerging evidence for a role in anxiety</strong></p><p>K Domschke</p><p><strong>15. Pathogenetics of anxiety</strong></p><p>K Domschke</p><p><strong>16. The effects of HIV on the fronto-striatal system</strong></p><p>S du Plessis, M Vink, J Joska, E Koutsilieri, C Scheller, B Spottiswoode, D Stein, R Emsley</p><p><strong>17. Effects of acute antipsychotic treatment on brain morphology in schizophrenia</strong></p><p>R Emsley, L Asmal, B Chiliza, S du Plessis, J Carr, A Goosen, M Kidd, M Vink, R Kahn</p><p><strong>18. Development of a genetic database resource for monitoring of breast cancer patients at risk of physical and psychological complications</strong></p><p>K Grant, F J Cronje, K Botha, J P Apffelstaedt, M J Kotze</p><p><strong>19. Unipolar mania reconsidered: Evidence from a South African study</strong></p><p><strong></strong>C Grobler</p><p><strong>20. Antipsychotic-induced movement disorders: Occurence and management</strong></p><p>P Haddad</p><p><strong>21. The place of observational studies in assessing the effectiveness of long-acting injectable antipsychotics</strong></p><p>P Haddad</p><p><strong>22. Molecular mechanisms of d-cycloserine in fear extinction: Insights from RNS sequencing</strong></p><p>S Hemmings, S Malan-Muller, L Fairbairn, M Jalali, E J Oakeley, J Gamieldien, M Kidd, S Seedat</p><p><strong>23. Schizophrenia: The role of inflammation</strong></p><p>DC Henderson</p><p><strong>24. Addictions: Emergent trends and innovations</strong></p><p>V Hitzeroth</p><p><strong>25. The socio-cultural-religious context of biological psychiatric practice</strong></p><p>B Janse van Rensburg</p><p><strong>26. Biochemical markers for identifying risk factors for disability progression in multiple sclerosis</strong></p><p><strong></strong>S Janse van Rensburg, M J Kotze, F J Cronje, W Davis, K Moremi, M Jalali Sefid Dashti, J Gamieldien, D Geiger, M Rensburg, R van Toorn, M J de Klerk, G M Hon, T Matsha, S Hassan, R T Erasmus</p><p><strong>27. Alcohol-induced psychotic disorder: Brain perfusion and psychopathology - before and after antipsychotic treatment</strong></p><p>G Jordaan, J M Warwick, D G Nel, R Hewlett, R Emsley</p><p><strong>28.'Pump and dump': Harm reduction strategies for breastfeeding while using substances</strong></p><p>L Kramer</p><p><strong>29. Adolescent neuropsychiatry - an emerging field in South African adolescent psychiatric services</strong></p><p>A Lachman</p><p><strong>30. Recovery versus remission, or what it means to be healthy for a psychiatric patient?</strong></p><p>B Latecki</p><p><strong>31. Holistic methods utilised to normalise behaviours in youth diagnosed with neuro-biochemical disorders</strong></p><p>P Macqueen</p><p><strong>32. Candidate genes and novel polymorphisms for anxiety disorder in a South African cohort</strong></p><p>N McGregor, J Dimatelis, S M J Hemmings, C J Kinnear, D Stein, V Russel, C Lochner</p><p><strong>33. Higher visual functioning</strong></p><p>A Moodley</p><p><strong>34. The effects of prenatal methylmercury exposure on trace element and antioxidant levels in rat offspring following 6-hydroxydopamine-induced neuronal insult</strong></p><p>Z M Moosa, W M U Daniels, M V Mabandla</p><p><strong>35. Paediatric neuropsychiatric movement disorders</strong></p><p>L Mubaiwa</p><p><strong>36. The South African national female offenders study</strong></p><p>M Nagdee, L Artz, C de Clercq, P de Wet, H Erlacher, S Kaliski, C Kotze, L Kowalski, J Naidoo, S Naidoo, J Pretorius, M Roffey, F Sokudela, U Subramaney</p><p><strong>37. Neurobiological consequences of child abuse</strong></p><p>C Nemeroff</p><p><strong>38. What do Stellenbosch Unviversity medical students think about psychiatry - and why should we care?</strong></p><p>G Nortje, S Suliman, K Seed, G Lydall, S Seedat</p><p><strong>39. Neurological soft skins in Nigerian Africans with first episode schizophrenia: Factor structure and clinical correlates</strong></p><p><strong></strong>A Ojagbemi, O Esan, O Gureje, R Emsley</p><p><strong>40. Should psychiatric patients know their MTHFR status?</strong></p><p>E Peter</p><p><strong>41. Clinical and functional outcome of treatment refractory first-episode schizophrenia</strong></p><p>L Phahladira, R Emsley, L Asmal, B Chiliza</p><p><strong>42. Bioethics by case discussion</strong></p><p>W Pienaar</p><p><strong>43. Reviewing our social contract pertaining to psychiatric research in children, research in developing countries and distributive justice in pharmacy</strong></p><p>W Pienaar</p><p><strong>44. The performance of the MMSE in a heterogenous elderly South African population</strong></p><p>S Ramlall, J Chipps, A I Bhigjee, B J Pillay</p><p><strong>45. Biological basis addiction (alocohol and drug addiction)</strong></p><p>S Rataemane</p><p><strong>46. Volumetric brain changes in prenatal methamphetamine-exposed children compared with healthy unexposed controls</strong></p><p><strong></strong>A Roos, K Donald, G Jones, D J Stein</p><p><strong>47. Single voxel proton magnetic resonance spectroscopy of the amygdala in social anxiety disorder in the context of early developmental trauma</strong></p><p>D Rosenstein, A Hess, S Seedat, E Meintjies</p><p><strong>48. Discussion of HDAC inhibitors, with specific reference to supliride and its use during breastfeeding</strong></p><p>J Roux</p><p><strong>49. Prevalence and clinical correlates of police contact prior to a first diagnosis of schizophrenia</strong></p><p>C Schumann, L Asmal, K Cloete, B Chiliza, R Emsley</p><p><strong>50. Are dreams meaningless?</strong></p><p>M Solms</p><p><strong>51. The conscious id</strong></p><p>M Solms<strong></strong></p><p><strong>52. Depression and resilience in HIV-infected women with early life stress: Does trauma play a mediating role?</strong></p><p>G Spies, S Seedat</p><p><strong>53. State of affairs analysis for forensic psychiatry in SA</strong></p><p>U Subramaney</p><p><strong>54. Escitalopram in the prevention of post-traumatic stress disorder: A pilot randomised controlled trial</strong></p><p>S Suliman, S Seedat, J Pingo, T Sutherland, J Zohar, D J Stein</p><p><strong>55. Epigenetic consequences of adverse early social experiences in primates</strong></p><p>S Suomi</p><p><strong>56. Risk, resilience, and gene x environment interactions in primates</strong></p><p>S Suomi</p><p><strong>57. Biological aspects of anorexia nervosa</strong></p><p>C Szabo</p><p><strong>58. Agents used and profiles of non-fatal suicidal behaviour in East London</strong></p><p>H Uys</p><p><strong>59. The contributions of G-protein coupled receptor signalling to opioid dependence</strong></p><p>J van Tonder</p><p><strong>60. Emerging trend and innovation in PTSD and OCD</strong></p><p>J Zohar</p><p><strong>61. Making the SASOP treatment guidelines operational</strong></p><p>E Allers</p><p><strong>Poster Presentations</strong></p><p><strong>62. Neuropsychological deficits in social anxiety disorder in the context of early developmental trauma</strong></p><p><strong></strong>S Bakelaar, D Rosenstein, S Seedat</p><p><strong>63.Social anxiety disorder in patients with or without early childhood trauma: Relationship to behavioral inhibition and activation and quality of life</strong></p><p><strong></strong>S Bakelaar, C Bruijnen, A Sambeth, S Seedat</p><p><strong>64. Exploring altered affective processing in obssessive compulsive disorder symptom subtypes</strong></p><p>E Breet, J Ipser, D Stein, C Lochner<strong><br /></strong></p><p><strong>65. To investigate the bias toward recognising the facial expression of disgust in obsessive compulsive disorder as well as the effect of escitalopram</strong></p><p>E Breet, J Ipser, D Stein, C Lochner</p><p><strong>66. A fatal-case of nevirapine-induced Stevens-Johnson's syndrome in HIV mania</strong></p><p>A Bronkhorst, Z Zingela, W M Qwesha, B P Magigaba<strong></strong></p><p><strong>67. Association of the COMT G472A (met/met) genotype with lower disability in people diagnosed with multiple sclerosis</strong></p><p>W Davis, S J van Rensburg, L Fisher, F J Cronje, D Geiger, M J Kotze</p><p><strong>68. hom*ocycsteine levels are associated with the fat mass and obesity associated gene FTO(intron 1 T&gt;A) polymorphism in MS patients</strong></p><p>W Davis, S J Van Rensburg, M J Kotze, L Fisher, M Jalali, F J Cronje, K Moremi, J Gamieldien, D Geiger, M Rensburg, R van Toorn, M J de Klerk, G M Hon, T Matsha, S Hassan, R T Erasmus</p><p><strong>69. Analysis of the COMT 472 G&gt;A (rs4680) polymorphism in relation to environmental influences as contributing factors in patients with schizophrenia</strong></p><p>D de Klerk, S J van Rensburg, R A Emsley, D Geiger, M Rensburg, R T Erasmus, M J Kotze</p><p><strong>70. Dietary folate intake, hom*ocysteine levels and MTHFR mutation detection in South African patients with depression: Test development for clinical application </strong></p><p>D Delport, N vand der Merwe, R Schoeman, M J Kotze</p><p><strong>71. The use ofexome sequencing for antipsychotic pharmacogenomic applications in South African schizophrenia patients</strong></p><p>B Drogmoller, D Niehaus, G Wright, B Chiliza, L Asmal, R Emsley, L Warnich</p><p><strong>72. The effects of HIV on the ventral-striatal reward system</strong></p><p>S du Plessis, M Vink, J Joska, E Koutsilieri, C Scheller, B Spottiswoode, D Stein, R Emsley</p><p><strong>73. Xenomelia relates to asymmetrical insular activity: A case study of fMRI</strong></p><p>S du Plessis, M Vink, L Asmal</p><p><strong>74. Maternal mental helath: A prospective naturalistic study of the outcome of pregancy in women with major psychiatric disorders in an African country</strong></p><p>E du Toit, L Koen, D Niehaus, B Vythilingum, E Jordaan, J Leppanen</p><p><strong>75. Prefrontal cortical thinning and subcortical volume decrease in HIV-positive children with encephalopathy</strong></p><p>J P Fouche, B Spottiswoode, K Donald, D Stein, J Hoare</p><p><strong>76. H-magnetic resonance spectroscopy metabolites in schizophrenia</strong></p><p>F Howells, J Hsieh, H Temmingh, D J Stein</p><p><strong>77. Hypothesis for the development of persistent methamphetamine-induced psychosis</strong></p><p><strong></strong> J Hsieh, D J Stein, F M Howells</p><p><strong>78. Culture, religion, spirituality and psychiatric practice: The SASOP Spirituality and Psychiatry Special Interest Group Action Plan for 2012-2014</strong></p><p>B Janse van Rensburg</p><p><strong>79. Cocaine reduces the efficiency of dopamine uptake in a rodent model of attention-deficit/hyperactivity disorder: An <em>in vivo</em> electrochemical study</strong></p><p><strong></strong>L Kellaway, J S Womersley, D J Stein, G A Gerhardt, V A Russell</p><p><strong>80. Kleine-Levin syndrome: Case in an adolescent psychiatric unit</strong></p><p>A Lachman</p><p><strong>81. Increased inflammatory stress specific clinical, lifestyle and therapeutic variables in patients receiving treatment for stress, anxiety or depressive symptoms</strong></p><p>H Luckhoff, M Kotze, S Janse van Rensburg, D Geiger</p><p><strong>82. Catatonia: An eight-case series report</strong></p><p>M Mabenge, Z Zingela, S van Wyk</p><p><strong>83. Relationship between anxiety sensitivity and childhood trauma in a random sample of adolescents from secondary schools in Cape Town</strong></p><p>L Martin, M Viljoen, S Seedat</p><p><strong>84. 'Making ethics real'. An overview of an ethics course presented by Fraser Health Ethics Services, BC, Canada</strong></p><p>JJ McCallaghan</p><p><strong>85. Clozapine discontinuation rates in a public healthcare setting</strong></p><p>M Moolman, W Esterhuysen, R Joubert, J C Lamprecht, M S Lubbe</p><p><strong>86. Retrospective review of clozapine monitoring in a publica sector psychiatric hospital and associated clinics</strong></p><p>M Moolman, W Esterhuysen, R Joubert, J C Lamprecht, M S Lubbe</p><p><strong>87. Association of an iron-related TMPRSS6 genetic variant c.2007 C&gt;7 (rs855791) with functional iron deficiency and its effect on multiple sclerosis risk in the South African population</strong></p><p>K Moremi, S J van Rensburg, L R Fisher, W Davis, F J Cronje, M Jalali Sefid Dashti, J Gamieldien, D Geiger, M Rensburg, R van Toorn, M J de Klerk, G M Hon, T Matsha, S Hassan, R T Erasmus, M Kidd, M J Kotze</p><p><strong>88. Identifying molecular mechanisms of apormophine-induced addictive behaviours</strong></p><p>Z Ndlazi, W Daniels, M Mabandla</p><p><strong>89. Effects of lifestyle factors and biochemistry on the major neck blood vessels in patients with mutiple sclerosis</strong></p><p>M Nelson, S J van Rensburg, M J Kotze, F Isaacs, S Hassan</p><p><strong>90. Nicotine protects against dopamine neurodegenration and improves motor deficits in a Parkinsonian rat model</strong></p><p>N Ngema, P Ngema, M Mabandla, W Daniels</p><p><strong>91. Cognition: Probing anatomical substrates</strong></p><p>H Nowbath</p><p><strong>92. Chronic exposure to light reverses the effects of maternal separation on the rat prefrontal cortex</strong></p><p>V Russel, J Dimatelis</p><p><strong>93. Evaluating a new drug to combat Alzheimer's disease</strong></p><p>S Sibiya, W M U Daniels, M V Mabandla</p><p><strong>94. Structural brain changes in HIV-infected women with and without childhood trauma</strong></p><p>G Spies, F Ahmed, C Fennema-Notestine, S Archibald, S Seedat</p><p><strong>95. Nicotine-stimulated release of hippocampal norepinephrine is reduced in an animal model of attention-deficit/ hyperactivity disorder: the spontaneously hypertensive rat</strong></p><p>T Sterley</p><p><strong>96. Brain-derive neurotrophic factor (BDNF) protein levels in anxiety disorders: Systematic review and meta-regression analysis</strong></p><p>S Suliman, S M J Hemmings, S Seedat</p><p><strong>97. A 12-month retrospective audit of the demographic and clinical profile of mental healthcare users admitted to a district level hospital in the Western Cape, South Africa</strong></p><p>E Thomas, K J Cloete, M Kidd, H Lategan</p><p><strong>98. Magnesium recurarization: A comparison between reversal of neuromuscular block with sugammadex v. neostigmine/ glycopyrrolate in an <em>in vivo</em> rat model</strong></p><p><strong></strong>M van den Berg, M F M James, L A Kellaway</p><p><strong>99. Identification of breast cancer patients at increased risk of 'chemobrain': Case study and review of the literature</strong></p><p>N van der Merwe, R Pienaar, S J van Rensburg, J Bezuidenhout, M J Kotze</p><p><strong>100. The protective role of HAART and NAZA in HIV Tat protein-induced hippocampal cell death</strong></p><p>S Zulu, W M U Daniels, M V Mabandla</p>

Abstract:

The UP Manila Health Policy Development Hub recognizes the invaluable contribution of the participants in theseries of roundtable discussions listed below: RTD: Beyond Hospital Beds: Equity,quality, and service1. Ma. Esmeralda C. Silva, MPAf, MSPPM, PhD,Faculty, College of Public Health, UP Manila2. Leonardo R. Estacio, Jr., MCD, MPH, PhD, Dean,College of Arts and Sciences, UP Manila3. Michael Antonio F. Mendoza, DDM, MM, Faculty,College of Dentistry, UP Manila4. Hilton Y. Lam, MHA, PhD, Chair, UP Manila HealthPolicy Development Hub; Director, Institute of HealthPolicy and Development Studies, University of thePhilippines Manila5. Irma L. Asuncion, MHA, CESO III, Director IV,Bureau of Local Health Systems Development,Department of Health6. Renely Pangilinan-Tungol, MD, CFP, MPM-HSD,Municipal Health Officer, San Fernando, Pampanga7. Salome F. Arinduque, MD, Galing-Pook AwardeeRepresentative, Municipal Health Officer, San Felipe,Zambales8. Carmelita C. Canila, MD, MPH, Faculty, College ofPublic Health, University of the Philippines Manila9. Lester M. Tan, MD, MPH, Division Chief, Bureau ofLocal Health System Development, Department ofHealth10. Anthony Rosendo G. Faraon, MD, Vice President,Zuellig Family Foundation (ZFF)11. Albert Francis E. Domingo, MD, Consultant, HealthSystem strengthening through Public Policy andRegulation, World Health Organization12. Jesus Randy O. Cañal, MD, FPSO-HNS, AssociateDirector, Medical and Regulatory Affairs, AsianHospital and Medical Center13. Christian Edward L. Nuevo, Health Policy and SystemsResearch Fellow, Health Policy Development andPlanning Bureau, Department of Health14. Paolo Victor N. Medina, MD, Assistant Professor 4,College of Medicine, University of the PhilippinesManila15. Jose Rafael A. Marfori, MD, Special Assistant to theDirector, Philippine General Hospital16. Maria Teresa U. Bagaman, Committee Chair, PhilippineSociety for Quality, Inc.17. Maria Theresa G. Vera, MSc, MHA, CESO III, DirectorIV, Health Facility Development Bureau, Departmentof Health18. Ana Melissa F. Hilvano-Cabungcal, MD, AssistantAssociate Dean for Planning & Development, Collegeof Medicine, University of the Philippines Manila19. Fevi Rose C. Paro, Faculty, Department of Communityand Environmental Resource Planning, University ofthe Philippines Los Baños20. Maria Rosa C. Abad, MD, Medical Specialist III,Standard Development Division, Health Facilities andServices Regulation21. Yolanda R. Robles, RPh, PhD, Faculty, College ofPharmacy, University of the Philippines Manila22. Jaya P. Ebuen, RN, Development Manager Officer,CHDMM, Department of Health23. Josephine E. Cariaso, MA, RN, Assistant Professor,College of Nursing, University of the Philippines Manila24. Diana Van Daele, Programme Manager, CooperationSection, European Union25. Maria Paz de Sagun, Project Management Specialist,USAID26. Christopher Muñoz, Member, Yellow Warriors SocietyPhilippinesRTD: Health services and financingroles: Population based- andindividual-based1. Hilton Y. Lam, MHA, PhD, Chair, University of thePhilippines Manila Health Policy Development Hub;Director, Institute of Health Policy and DevelopmentStudies, University of the Philippines Manila2. Ma. Esmeralda C. Silva, MPAf, MSPPM, PhD,Faculty, College of Public Health, University of thePhilippines Manila3. Leonardo R. Estacio, Jr., MCD, MPH, PhD, Dean,College of Arts and Sciences, University of thePhilippines Manila4. Michael Antonio F. Mendoza, DDM, MM, Faculty,College of Dentistry, University of the PhilippinesManila5. Mario C. Villaverde, Undersecretary, Health Policyand Development Systems and Development Team,Department of Health6. Jaime Z. Galvez Tan, MD, Former Secretary, Department of Health7. Marvin C. Galvez, MD, OIC Division Chief, BenefitsDevelopment and Research Department, PhilippineHealth Insurance Corporation8. Alvin B. Caballes, MD, MPE, MPP, Faculty, Collegeof Medicine, University of the Philippines Manila9. Carlos D. Da Silva, Executive Director, Association ofMunicipal Health Maintenance Organization of thePhilippines, Inc.10. Anthony Rosendo G. Faraon, MD, Vice President,Zuellig Family Foundation (ZFF) 11. Albert Francis E. Domingo, MD, Consultant, HealthSystem strengthening through Public Policy andRegulation, World Health Organization12. Salome F. Arinduque, MD, Galing-Pook AwardeeRepresentative, Municipal Health Officer, San Felipe,Zambales13. Michael Ralph M. Abrigo, PhD, Research Fellow,Philippine Institute for Developmental Studies14. Oscar D. Tinio, MD, Committee Chair, Legislation,Philippine Medical Association15. Rogelio V. Dazo, Jr., MD, FPCOM, Legislation,Philippine Medical Association16. Ligaya V. Catadman, MM, Officer-in-charge, HealthPolicy Development and Planning Bureau, Department of Health17. Maria Fatima Garcia-Lorenzo, President, PhilippineAlliance of Patients Organization18. Tomasito P. Javate, Jr, Supervising Economic DevelopmentSpecialist, Health Nutrition and Population Division,National Economic and Development Authority19. Josefina Isidro-Lapena, MD, National Board ofDirector, Philippine Academy of Family Physicians20. Maria Eliza Ruiz-Aguila, MPhty, PhD, Dean, Collegeof Allied Medical Professions, University of thePhilippines Manila21. Ana Melissa F. Hilvano-Cabungcal, MD, AssistantAssociate Dean for Planning & Development, College ofMedicine, University of the Philippines Manila22. Maria Paz P. Corrales, MD, MHA, MPA, Director III,Department of Health-National Capital Region23. Karin Estepa Garcia, MD, Executive Secretary, PhilippineAcademy of Family Physicians24. Adeline A. Mesina, MD, Medical Specialist III,Philippine Health Insurance Corporation25. Glorey Ann P. Alde, RN, MPH, Research Fellow,Department of HealthRTD: Moving towards provincelevel integration throughUniversal Health Care Act1. Hilton Y. Lam, MHA, PhD, Chair, University of thePhilippines Manila Health Policy Development Hub;Director, Institute of Health Policy and DevelopmentStudies, University of the Philippines Manila2. Ma. Esmeralda C. Silva, MPAf, MSPPM, PhD,Faculty, College of Public Health, University of thePhilippines Manila3. Leonardo R. Estacio, Jr., MCD, MPH, PhD, Dean,College of Arts and Sciences, University of thePhilippines Manila4. Michael Antonio F. Mendoza, DDM, MM, Faculty,College of Dentistry, University of the PhilippinesManila5. Mario C. Villaverde, Undersecretary of Health, HealthPolicy and Development Systems and DevelopmentTeam, Department of Health6. Ferdinand A. Pecson, Undersecretary and ExecutiveDirector, Public Private Partnership Center7. Rosanna M. Buccahan, MD, Provincial Health Officer,Bataan Provincial Office8. Lester M. Tan, MD, Division Chief, Bureau of LocalHealth System Development, Department of Health9. Ernesto O. Domingo, MD, FPCP, FPSF, FormerChancellor, University of the Philippines Manila10. Albert Francis E. Domingo, MD, Consultant, HealthSystem strengthening through Public Policy andRegulation, World Health Organization11. Leslie Ann L. Luces, MD, Provincial Health Officer,Aklan12. Rene C. Catan, MD, Provincial Health Officer, Cebu13. Anthony Rosendo G. Faraon, MD, Vice President,Zuellig Family Foundation14. Jose Rafael A. Marfori, MD, Special Assistant to theDirector, Philippine General Hospital15. Jesus Randy O. Cañal, MD, FPSO-HNS, Consultant,Asian Hospital and Medical Center16. Ramon Paterno, MD, Member, Universal Health CareStudy Group, University of the Philippines Manila17. Mayor Eunice U. Babalcon, Mayor, Paranas, Samar18. Zorayda E. Leopando, MD, Former President,Philippine Academy of Family Physicians19. Madeleine de Rosas-Valera, MD, MScIH, SeniorTechnical Consultant, World Bank20. Arlene C. Sebastian, MD, Municipal Health Officer,Sta. Monica, Siargao Island, Mindanao21. Rizza Majella L. Herrera, MD, Acting Senior Manager,Accreditation Department, Philippine Health InsuranceCorporation22. Alvin B. Caballes, MD, MPE, MPP, Faculty, Collegeof Medicine, University of the Philippines Manila23. Pres. Policarpio B. Joves, MD, MPH, MOH, FPAFP,President, Philippine Academy of Family Physicians24. Leilanie A. Nicodemus, MD, Board of Director,Philippine Academy of Family Physicians25. Maria Paz P. Corrales, MD, MHA, MPA, Director III,National Capital Region Office, Department of Health26. Dir. Irma L. Asuncion, MD, MHA, CESO III, DirectorIV, Bureau of Local Health Systems Development,Department of Health27. Bernard B. Argamosa, MD, Mental Health Representative, National Center for Mental Health28. Flerida Chan, Chief, Poverty Reduction Section, JapanInternational Cooperation Agency29. Raul R. Alamis, Chief Health Program Officer, ServiceDelivery Network, Department of Health30. Mary Anne Milliscent B. Castro, Supervising HealthProgram Officer, Department of Health 31. Marikris Florenz N. Garcia, Project Manager, PublicPrivate Partnership Center32. Mary Grace G. Darunday, Supervising Budget andManagement Specialist, Budget and Management Bureaufor the Human Development Sector, Department ofBudget and Management33. Belinda Cater, Senior Budget and Management Specialist,Department of Budget and Management34. Sheryl N. Macalipay, LGU Officer IV, Bureau of LocalGovernment and Development, Department of Interiorand Local Government35. Kristel Faye M. Roderos, OTRP, Representative,College of Allied Medical Professions, University ofthe Philippines Manila36. Jeffrey I. Manalo, Director III, Policy Formulation,Project Evaluation and Monitoring Service, PublicPrivate Partnership Center37. Atty. Phebean Belle A. Ramos-Lacuna, Division Chief,Policy Formulation Division, Public Private PartnershipCenter38. Ricardo Benjamin D. Osorio, Planning Officer, PolicyFormulation, Project Evaluation and MonitoringService, Public Private Partnership Center39. Gladys Rabacal, Program Officer, Japan InternationalCooperation Agency40. Michael Angelo Baluyot, Nurse, Bataan Provincial Office41. Jonna Jane Javier Austria, Nurse, Bataan Provincial Office42. Heidee Buenaventura, MD, Associate Director, ZuelligFamily Foundation43. Dominique L. Monido, Policy Associate, Zuellig FamilyFoundation44. Rosa Nene De Lima-Estellana, RN, MD, Medical OfficerIII, Department of Interior and Local Government45. Ma Lourdes Sangalang-Yap, MD, FPCR, Medical OfficerIV, Department of Interior and Local Government46. Ana Melissa F. Hilvano-Cabungcal, MD, AssistantAssociate Dean for Planning & Development, College ofMedicine, University of the Philippines Manila47. Colleen T. Francisco, Representative, Department ofBudget and Management48. Kristine Galamgam, Representative, Department ofHealth49. Fides S. Basco, Officer-in-charge, Chief Budget andManagement Specialist, Development of Budget andManagementRTD: Health financing: Co-paymentsand Personnel1. Hilton Y. Lam, MHA, PhD, Chair, University of thePhilippines Manila Health Policy Development Hub;Director, Institute of Health Policy and DevelopmentStudies, University of the Philippines Manila2. Ma. Esmeralda C. Silva, MPAf, MSPPM, PhD,Faculty, College of Public Health, University of thePhilippines Manila3. Leonardo R. Estacio, Jr., MCD, MPH, PhD, Dean,College of Arts and Sciences, University of thePhilippines Manila4. Michael Antonio F. Mendoza, DDM, MM, Faculty,College of Dentistry, University of the Philippines Manila5. Ernesto O. Domingo, MD, Professor Emeritus,University of the Philippines Manila6. Irma L. Asuncion, MHA, CESO III, Director IV,Bureau of Local Health Systems Development,Department of Health7. Lester M. Tan, MD, MPH, Division Chief, Bureau ofLocal Health System Development, Department ofHealth8. Marvin C. Galvez, MD, OIC Division Chief, BenefitsDevelopment and Research Department, PhilippineHealth Insurance Corporation9. Adeline A. Mesina, MD, Medical Specialist III, BenefitsDepartment and Research Department, PhilippineHealth Insurance Corporation10. Carlos D. Da Silva, Executive Director, Association ofHealth Maintenance Organization of the Philippines,Inc.11. Ma. Margarita Lat-Luna, MD, Deputy Director, FiscalServices, Philippine General Hospital12. Waldemar V. Galindo, MD, Chief of Clinics, Ospital ngMaynila13. Albert Francis E. Domingo, MD, Consultant, HealthSystem strengthening through Public Policy andRegulation, World Health Organization14. Rogelio V. Dazo, Jr., MD, Member, Commission onLegislation, Philippine Medical Association15. Aileen R. Espina, MD, Board Member, PhilippineAcademy of Family Physicians16. Anthony R. Faraon, MD, Vice President, Zuellig FamilyFoundation17. Jesus Randy O. Cañal, Associate Director, Medical andRegulatory Affairs, Asian Hospital and Medical Center18. Jared Martin Clarianes, Technical Officer, Union of LocalAuthorities of the Philippines19. Leslie Ann L. Luces, MD, Provincial Health Officer,Aklan20. Rosa Nene De Lima-Estellana, MD, Medical OfficerIII, Department of the Interior and Local Government21. Ma. Lourdes Sangalang-Yap, MD, Medical Officer V,Department of the Interior and Local Government 22. Dominique L. Monido, Policy Associate, Zuellig FamilyFoundation23. Krisch Trine D. Ramos, MD, Medical Officer, PhilippineCharity Sweepstakes Office24. Larry R. Cedro, MD, Assistant General Manager, CharitySector, Philippine Charity Sweepstakes Office25. Margarita V. Hing, Officer in Charge, ManagementDivision, Financial Management Service Sector,Department of Health26. Dr. Carlo Irwin Panelo, Associate Professor, College ofMedicine, University of the Philippines Manila27. Dr. Angelita V. Larin, Faculty, College of Public Health,University of the Philippines Manila28. Dr. Abdel Jeffri A. Abdulla, Chair, RegionalizationProgram, University of the Philippines Manila29. Christopher S. Muñoz, Member, Philippine Alliance ofPatients Organization30. Gemma R. Macatangay, LGOO V, Department ofInterior and Local Government – Bureau of LocalGovernment Development31. Dr. Narisa Portia J. Sugay, Acting Vice President, QualityAssurance Group, Philippine Health InsuranceCorporation32. Maria Eliza R. Aguila, Dean, College of Allied MedicalProfessions, University of the Philippines Manila33. Angeli A. Comia, Manager, Zuellig Family Foundation34. Leo Alcantara, Union of Local Authorities of thePhilippines35. Dr. Zorayda E. Leopando, Former President, PhilippineAcademy of Family Physicians36. Dr. Emerito Jose Faraon, Faculty, College of PublicHealth, University of the Philippines Manila37. Dr. Carmelita C. Canila, Faculty, College of PublicHealth, University of the Philippines ManilaRTD: Moving towards third partyaccreditation for health facilities1. Hilton Y. Lam, MHA, PhD, Chair, University of thePhilippines Manila Health Policy Development Hub;Director, Institute of Health Policy and DevelopmentStudies, University of the Philippines Manila2. Ma. Esmeralda C. Silva, MPAf, MSPPM, PhD,Faculty, College of Public Health, University of thePhilippines Manila3. Leonardo R. Estacio, Jr., MCD, MPH, PhD, Dean,College of Arts and Sciences, University of thePhilippines Manila4. Michael Antonio F. Mendoza, DDM, MM, Faculty,College of Dentistry, University of the PhilippinesManila5. Rizza Majella L. Herrera, MD, Acting SeniorManager, Accreditation Department, Philippine HealthInsurance Corporation6. Bernadette C. Hogar-Manlapat, MD, FPBA, FPSA,FPSQua, MMPA, President and Board of Trustee,Philippine Society for Quality in Healthcare, Inc.7. Waldemar V. Galindo, MD, Chief of Clinics, Ospital ngMaynila8. Amor. F. Lahoz, Division Chief, Promotion andDocumentation Division, Department of Trade andIndustry – Philippine Accreditation Bureau9. Jenebert P. Opinion, Development Specialist, Department of Trade and Industry – Philippine AccreditationBureau10. Maria Linda G. Buhat, President, Association ofNursing Service Administrators of the Philippines, Inc.11. Bernardino A. Vicente, MD, FPPA, MHA, CESOIV, President, Philippine Tripartite Accreditation forHealth Facilities, Inc.12. Atty. Bu C. Castro, MD, Board Member, PhilippineHospital Association13. Cristina Lagao-Caalim, RN, MAN, MHA, ImmediatePast President and Board of Trustee, Philippine Societyfor Quality in Healthcare, Inc.14. Manuel E. Villegas Jr., MD, Vice Treasurer and Board ofTrustee, Philippine Society for Quality in Healthcare,Inc.15. Michelle A. Arban, Treasurer and Board of Trustee,Philippine Society for Quality in Healthcare, Inc.16. Joselito R. Chavez, MD, FPCP, FPCCP, FACCP,CESE, Deputy Executive Director, Medical Services,National Kidney and Transplant Institute17. Blesilda A. Gutierrez, CPA, MBA, Deputy ExecutiveDirector, Administrative Services, National Kidney andTransplant Institute18. Eulalia C. Magpusao, MD, Associate Director, Qualityand Patient Safety, St. Luke’s Medical Centre GlobalCity19. Clemencia D. Bondoc, MD, Auditor, Association ofMunicipal Health Officers of the Philippines20. Jesus Randy O. Cañal, MD, FPSO-HNS, AssociateDirector, Medical and Regulatory Affairs, Asian Hospitaland Medical Center21. Maria Fatima Garcia-Lorenzo, President, PhilippineAlliance of Patient Organizations22. Leilanie A. Nicodemus, MD, Board of Directors,Philippine Academy of Family Physicians23. Policarpio B. Joves Jr., MD, President, PhilippineAcademy of Family Physicians24. Kristel Faye Roderos, Faculty, College of Allied MedicalProfessions, University of the Philippines Manila25. Ana Melissa Hilvano-Cabungcal, MD, AssistantAssociate Dean, College of Medicine, University of thePhilippines Manila26. Christopher Malorre Calaquian, MD, Faculty, Collegeof Medicine, University of the Philippines Manila27. Emerito Jose C. Faraon, MD, Faculty, College ofPublic Health, University of the Philippines Manila 28. Carmelita Canila, Faculty, College of Public Health,University of the Philippines Manila29. Oscar D. Tinio, MD, Representative, Philippine MedicalAssociation30. Farrah Rocamora, Member, Philippine Society forQuality in Healthcare, IncRTD: RA 11036 (Mental Health Act):Addressing Mental Health Needs ofOverseas Filipino Workers1. Hilton Y. Lam, MHA, PhD, Chair, University of thePhilippines Manila Health Policy Development Hub;Director, Institute of Health Policy and DevelopmentStudies, University of the Philippines Manila2. Leonardo R. Estacio, Jr., MCD, MPH, PhD, UPManila Health Policy Development Hub; College ofArts and Sciences, UP Manila3. Ma. Esmeralda C. Silva, MPAf, MSPPM, PhD, UPManila Health Policy Development Hub; College ofPublic Health, UP Manila4. Michael Antonio F. Mendoza, DDM, UP ManilaHealth Policy Development Hub; College of Dentistry,UP Manila5. Frances Prescilla L. Cuevas, RN, MAN, Director,Essential Non-Communicable Diseases Division,Department of Health6. Maria Teresa D. De los Santos, Workers Education andMonitoring Division, Philippine Overseas EmploymentAdministration7. Andrelyn R. Gregorio, Policy Program and Development Office,Overseas Workers Welfare Administration8. Sally D. Bongalonta, MA, Institute of Family Life &Children Studies, Philippine Women’s University9. Consul Ferdinand P. Flores, Department of ForeignAffairs10. Jerome Alcantara, BLAS OPLE Policy Center andTraining Institute11. Andrea Luisa C. Anolin, Commission on FilipinoOverseas12. Bernard B. Argamosa, MD, DSBPP, National Centerfor Mental Health13. Agnes Joy L. Casino, MD, DSBPP, National Centerfor Mental Health14. Ryan Roberto E. Delos Reyes, Employment Promotionand Workers Welfare Division, Department of Laborand Employment15. Sheralee Bondad, Legal and International AffairsCluster, Department of Labor and Employment16. Rhodora A. Abano, Center for Migrant Advocacy17. Nina Evita Q. Guzman, Ugnayan at Tulong para saMaralitang Pamilya (UGAT) Foundation, Inc.18. Katrina S. Ching, Ugnayan at Tulong para sa MaralitangPamilya (UGAT) Foundation, Inc.RTD: (Bitter) Sweet Smile of Filipinos1. Dr. Hilton Y. Lam, Institute of Health Policy andDevelopment Studies, NIH2. Dr. Leonardo R. Estacio, Jr., College of Arts andSciences, UP Manila3. Dr. Ma. Esmeralda C. Silva, College of Public Health,UP Manila4. Dr. Michael Antonio F. Mendoza, College of Dentistry,UP Manila5. Dr. Ma. Susan T. Yanga-Mabunga, Department ofHealth Policy & Administration, UP Manila6. Dr. Danilo L. Magtanong, College of Dentistry, UPManila7. Dr. Alvin Munoz Laxamana, Philippine DentalAssociation8. Dr. Fina Lopez, Philippine Pediatric Dental Society, Inc9. Dr. Artemio Licos, Jr.,Department of Health NationalAssociation of Dentists10. Dr. Maria Jona D. Godoy, Professional RegulationCommission11. Ms. Anna Liza De Leon, Philippine Health InsuranceCorporation12. Ms. Nicole Sigmuend, GIZ Fit for School13. Ms. Lita Orbillo, Disease Prevention and Control Bureau14. Mr. Raymond Oxcena Akap sa Bata Philippines15. Dr. Jessica Rebueno-Santos, Department of CommunityDentistry, UP Manila16. Ms. Maria Olivine M. Contreras, Bureau of LocalGovernment Supervision, DILG17. Ms. Janel Christine Mendoza, Philippine DentalStudents Association18. Mr. Eric Raymund Yu, UP College of DentistryStudent Council19. Dr. Joy Memorando, Philippine Pediatric Society20. Dr. Sharon Alvarez, Philippine Association of DentalColleges

Abstract:

AbstractIntroductionPerinatal mood and anxiety disorders (PMADs) are the most common complication of pregnancy and have been found to have long-term implications for both mother and child. In vulnerable patient populations such as those served at Denver Health, a federally qualified health center the prevalence of PMADs is nearly double the nationally reported rate of 15–20%. Nearly 17% of women will be diagnosed with major depression at some point in their lives and those numbers are twice as high in women who live in poverty. Women also appear to be at higher risk for depression in the child-bearing years. In order to better address these issues, an Integrated Perinatal Mental Health program was created to screen, assess, and treat PMADs in alignment with national recommendations to improve maternal–child health and wellness. This program was built upon a national model of Integrated Behavioral Health already in place at Denver Health.MethodsA multidisciplinary team of physicians, behavioral health providers, public health, and administrators was assembled at Denver Health, an integrated hospital and community health care system that serves as the safety net hospital to the city and county of Denver, CO. This team was brought together to create a universal screen-to-treat process for PMAD’s in perinatal clinics and to adapt the existing Integrated Behavioral Health (IBH) model into a program better suited to the health system’s obstetric population. Universal prenatal and postnatal depression screening was implemented at the obstetric intake visit, a third trimester prenatal care visit, and at the postpartum visit across the clinical system. At the same time, IBH services were implemented across our health system’s perinatal care system in a stepwise fashion. This included our women’s care clinics as well as the family medicine and pediatric clinics. These efforts occurred in tandem to support all patients and staff enabling a specially trained behavioral health provider (psychologists and L.C.S.W.’s) to respond immediately to any positive screen during or after pregnancy.ResultsIn August 2014 behavioral health providers were integrated into the women’s care clinics. In January 2015 universal screening for PMADs was implemented throughout the perinatal care system. Screening has improved from 0% of women screened at the obstetric care intake visit in August 2014 to >75% of women screened in August 2016. IBH coverage by a licensed psychologist or licensed clinical social worker exists in 100% of perinatal clinics as of January 2016. As well, in order to gain sustainability, the ability to bill same day visits as well as to bill, and be reimbursed for screening and assessment visits, continues to improve and provide for a model that is self-sustaining for the future.ConclusionImplementation of a universal screening process for PMADs alongside the development of an IBH model in perinatal care has led to the creation of a program that is feasible and has the capacity to serve as a national model for improving perinatal mental health in vulnerable populations.

Abstract:

Abstract Background Youth violence is a major public health concern in the United States. Hospital-based Violence Intervention Programs (HVIPs) are integral in connecting youth sustaining interpersonal violence-related injuries to medical, mental health, and social services. At our pediatric emergency department, our baseline referral rate to the established HVIP was 32.5%. From November 2018–2019, we aimed to increase the percent of eligible patients referred to our HVIP from 32.5 to 70% for patients aged 7–18 years who present to our Level 1 emergency department/trauma center with a violent injury. Methods For this quality improvement project, we recorded key aspects of the referral process, such as patient eligibility, who placed referrals, and when referrals were placed in relation to the ED admission. Key stakeholders were interviewed to identify specific interventions. Our key interventions were: 1. Educating providers on eligibility requirements. 2. Encouraging nurses to enter consults at the time of admission. 3. Publishing information about program referrals in the weekly nursing newsletter. 4. Updating social workers on eligibility requirements for the HVIP. We used PDSA cycles to inform our project. Our primary outcome measure was the number of eligible patients referred to our HVIP and measures were analyzed using statistical process control charts. Results The HVIP-eligible population had the following demographics: 31.1% female and a mean age 14.3 ± 2.7, 82.6% assaults and 17.4% gunshot wounds. From 11/2018 to 11/2019, there were 78 referrals to the HVIP, out of 167 eligible patients. The referral rate improved from 32.5% pre-interventions to 61.1% post-interventions, showing an 88% increase. Conclusion(s) We noted an increase in referrals to our HVIP following our interventions that centered on educating, advertising, and encouraging. Future studies will focus on analyzing other aspects of the enrollment process, such as obtaining patient consent.

Abstract:

In the last months of his life, 86-year-old Albert Facey became a best-selling author and revered cultural figure following the publication of his autobiography, A Fortunate Life. Released on Anzac Day 1981, it was praised for its “plain, unembellished, utterly sincere and un-self-pitying account of the privations of childhood and youth” (Semmler) and “extremely powerful description of Gallipoli” (Dutton 16). Within weeks, critic Nancy Keesing declared it an “Enduring Classic.” Within six months, it was announced as the winner of two prestigious non-fiction awards, with judges acknowledging Facey’s “extraordinary memory” and “ability to describe scenes and characters with great precision” (“NBC” 4). A Fortunate Life also transformed the fortunes of its publisher. Founded in 1976 as an independent, not-for-profit publishing house, Fremantle Arts Centre Press (FACP) might have been expected, given the Australian average, to survive for just a few years. Former managing editor Ray Coffey attributes the Press’s ongoing viability, in no small measure, to Facey’s success (King 29). Along with Wendy Jenkins, Coffey edited Facey’s manuscript through to publication; only five months after its release, with demand outstripping the capabilities, FACP licensed Penguin to take over the book’s production and distribution. Adaptations soon followed. In 1984, Kerry Packer’s PBL launched a prospectus for a mini-series, which raised a record $6.3 million (PBL 7–8). Aired in 1986 with a high-rating documentary called The Facey Phenomenon, the series became the most watched television event of the year (Lucas). Syndication of chapters to national and regional newspapers, stage and radio productions, audio- and e-books, abridged editions for young readers, and inclusion on secondary school curricula extended the range and influence of Facey’s life writing. Recently, an option was taken out for a new television series (Fraser).A hundred reprints and two million readers on from initial publication, A Fortunate Life continues to rate among the most appreciated Australian books of all time. Commenting on a reader survey in 2012, writer and critic Marieke Hardy enthused, “I really loved it [. . .] I felt like I was seeing a part of my country and my country’s history through a very human voice . . .” (First Tuesday Book Club). Registering a transformed reading, Hardy’s reference to Australian “history” is unproblematically juxtaposed with amused delight in an autobiography that invents and embellishes: not believing “half” of what Facey wrote, she insists he was foremost a yarn spinner. While the work’s status as a witness account has become less authoritative over time, it seems appreciation of the author’s imagination and literary skill has increased (Williamson). A Fortunate Life has been read more commonly as an uncomplicated, first-hand account, such that editor Wendy Jenkins felt it necessary to refute as an “utter mirage” that memoir is “transferred to the page by an act of perfect dictation.” Sidonie Smith and Julia Watson argue of life narratives that some “autobiographical claims [. . .] can be verified or discounted by recourse to documentation outside the text. But autobiographical truth is a different matter” (16). With increased access to archives, especially digitised personnel records, historians have asserted that key elements of Facey’s autobiography are incorrect or “fabricated” (Roberts), including his enlistment in 1914 and participation in the Gallipoli Landing on 25 April 1915. We have researched various sources relevant to Facey’s early years and war service, including hard-copy medical and repatriation records released in 2012, and find A Fortunate Life in a range of ways deviates from “documentation outside of the text,” revealing intriguing, layered storytelling. We agree with Smith and Watson that “autobiographical acts” are “anything but simple or transparent” (63). As “symbolic interactions in the world,” they are “culturally and historically specific” and “engaged in an argument about identity” (63). Inevitably, they are also “fractured by the play of meaning” (63). Our approach, therefore, includes textual analysis of Facey’s drafts alongside the published narrative and his medical records. We do not privilege institutional records as impartial but rather interpret them in terms of their hierarchies and organisation of knowledge. This leads us to speculate on alternative readings of A Fortunate Life as an illness narrative that variously resists and subscribes to dominant cultural plots, tropes, and attitudes. Facey set about writing in earnest in the 1970s and generated (at least) three handwritten drafts, along with a typescript based on the third draft. FACP produced its own working copy from the typescript. Our comparison of the drafts offers insights into the production of Facey’s final text and the otherwise “hidden” roles of editors as transformers and enablers (Munro 1). The notion that a working man with basic literacy could produce a highly readable book in part explains Facey’s enduring appeal. His grandson and literary executor, John Rose, observed in early interviews that Facey was a “natural storyteller” who had related details of his life at every opportunity over a period of more than six decades (McLeod). Jenkins points out that Facey belonged to a vivid oral culture within which he “told and retold stories to himself and others,” so that they eventually “rubbed down into the lines and shapes that would so memorably underpin the extended memoir that became A Fortunate Life.” A mystique was thereby established that “time” was Albert Facey’s “first editor” (Jenkins). The publisher expressly aimed to retain Facey’s voice, content, and meaning, though editing included much correcting of grammar and punctuation, eradication of internal inconsistencies and anomalies, and structural reorganisation into six sections and 68 chapters. We find across Facey’s drafts a broadly similar chronology detailing childhood abandonment, life-threatening incidents, youthful resourcefulness, physical prowess, and participation in the Gallipoli Landing. However, there are also shifts and changed details, including varying descriptions of childhood abuse at a place called Cave Rock; the introduction of (incompatible accounts of) interstate boxing tours in drafts two and three which replace shearing activities in Draft One; divergent tales of Facey as a world-standard athlete, league footballer, expert marksman, and powerful swimmer; and changing stories of enlistment and war service (see Murphy and Nile, “Wounded”; “Naked”).Jenkins edited those sections concerned with childhood and youth, while Coffey attended to Facey’s war and post-war life. Drawing on C.E.W. Bean’s official war history, Coffey introduced specificity to the draft’s otherwise vague descriptions of battle and amended errors, such as Facey’s claim to have witnessed Lord Kitchener on the beach at Gallipoli. Importantly, Coffey suggested the now famous title, “A Fortunate Life,” and encouraged the author to alter the ending. When asked to suggest a title, Facey offered “Cave Rock” (Interview)—the site of his violent abuse and humiliation as a boy. Draft One concluded with Facey’s repatriation from the war and marriage in 1916 (106); Draft Two with a brief account of continuing post-war illness and ultimate defeat: “My war injuries caught up with me again” (107). The submitted typescript concludes: “I have often thought that going to War has caused my life to be wasted” (Typescript 206). This ending differs dramatically from the redemptive vision of the published narrative: “I have lived a very good life, it has been very rich and full. I have been very fortunate and I am thrilled by it when I look back” (412).In The Wounded Storyteller, Arthur Frank argues that literary markets exist for stories of “narrative wreckage” (196) that are redeemed by reconciliation, resistance, recovery, or rehabilitation, which is precisely the shape of Facey’s published life story and a source of its popularity. Musing on his post-war experiences in A Fortunate Life, Facey focuses on his ability to transform the material world around him: “I liked the challenge of building up a place from nothing and making a success where another fellow had failed” (409). If Facey’s challenge was building up something from nothing, something he could set to work on and improve, his life-writing might reasonably be regarded as a part of this broader project and desire for transformation, so that editorial interventions helped him realise this purpose. Facey’s narrative was produced within a specific zeitgeist, which historian Joy Damousi notes was signalled by publication in 1974 of Bill Gammage’s influential, multiply-reprinted study of front-line soldiers, The Broken Years, which drew on the letters and diaries of a thousand Great War veterans, and also the release in 1981 of Peter Weir’s film Gallipoli, for which Gammage was the historical advisor. The story of Australia’s war now conceptualised fallen soldiers as “innocent victims” (Damousi 101), while survivors were left to “compose” memories consistent with their sacrifice (Thomson 237–54). Viewing Facey’s drafts reminds us that life narratives are works of imagination, that the past is not fixed and memory is created in the present. Facey’s autobiographical efforts and those of his publisher to improve the work’s intelligibility and relevance together constitute an attempt to “objectify the self—to present it as a knowable object—through a narrative that re-structures [. . .] the self as history and conclusions” (Foster 10). Yet, such histories almost invariably leave “a crucial gap” or “censored chapter.” Dennis Foster argues that conceiving of narration as confession, rather than expression, “allows us to see the pathos of the simultaneous pursuit and evasion of meaning” (10); we believe a significant lacuna in Facey’s life writing is intimated by its various transformations.In a defining episode, A Fortunate Life proposes that Facey was taken from Gallipoli on 19 August 1915 due to wounding that day from a shell blast that caused sandbags to fall on him, crush his leg, and hurt him “badly inside,” and a bullet to the shoulder (348). The typescript, however, includes an additional but narratively irreconcilable date of 28 June for the same wounding. The later date, 19 August, was settled on for publication despite the author’s compelling claim for the earlier one: “I had been blown up by a shell and some 7 or 8 sandbags had fallen on top of me, the day was the 28th of June 1915, how I remembered this date, it was the day my brother Roy had been killed by a shell burst.” He adds: “I was very ill for about six weeks after the incident but never reported it to our Battalion doctor because I was afraid he would send me away” (Typescript 205). This account accords with Facey’s first draft and his medical records but is inconsistent with other parts of the typescript that depict an uninjured Facey taking a leading role in fierce fighting throughout July and August. It appears, furthermore, that Facey was not badly wounded at any time. His war service record indicates that he was removed from Gallipoli due to “heart troubles” (Repatriation), which he also claims in his first draft. Facey’s editors did not have ready access to military files in Canberra, while medical files were not released until 2012. There existed, therefore, virtually no opportunity to corroborate the author’s version of events, while the official war history and the records of the State Library of Western Australia, which were consulted, contain no reference to Facey or his war service (Interview). As a consequence, the editors were almost entirely dependent on narrative logic and clarifications by an author whose eyesight and memory had deteriorated to such an extent he was unable to read his amended text. A Fortunate Life depicts men with “nerve sickness” who were not permitted to “stay at the Front because they would be upsetting to the others, especially those who were inclined that way themselves” (350). By cross referencing the draft manuscripts against medical records, we can now perceive that Facey was regarded as one of those nerve cases. According to Facey’s published account, his wounds “baffled” doctors in Egypt and Fremantle (353). His medical records reveal that in September 1915, while hospitalised in Egypt, his “palpitations” were diagnosed as “Tachycardia” triggered by war-induced neuroses that began on 28 June. This suggests that Facey endured seven weeks in the field in this condition, with the implication being that his debility worsened, resulting in his hospitalisation. A diagnosis of “debility,” “nerves,” and “strain” placed Facey in a medical category of “Special Invalids” (Butler 541). Major A.W. Campbell noted in the Medical Journal of Australia in 1916 that the war was creating “many cases of little understood nervous and mental affections, not only where a definite wound has been received, but in many cases where nothing of the sort appears” (323). Enlisted doctors were either physicians or surgeons and sometimes both. None had any experience of trauma on the scale of the First World War. In 1915, Campbell was one of only two Australian doctors with any pre-war experience of “mental diseases” (Lindstrom 30). On staff at the Australian Base Hospital at Heliopolis throughout the Gallipoli campaign, he claimed that at times nerve cases “almost monopolised” the wards under his charge (319). Bearing out Facey’s description, Campbell also reported that affected men “received no sympathy” and, as “carriers of psychic contagion,” were treated as a “source of danger” to themselves and others (323). Credentialed by royal colleges in London and coming under British command, Australian medical teams followed the practice of classifying men presenting “nervous or mental symptoms” as “battle casualties” only if they had also been wounded by “enemy action” (Loughran 106). By contrast, functional disability, with no accompanying physical wounds, was treated as unmanly and a “hysterical” reaction to the pressures of war. Mental debility was something to be feared in the trenches and diagnosis almost invariably invoked charges of predisposition or malingering (Tyquin 148–49). This shifted responsibility (and blame) from the war to the individual. Even as late as the 1950s, medical notes referred to Facey’s condition as being “constitutional” (Repatriation).Facey’s narrative demonstrates awareness of how harshly sufferers were treated. We believe that he defended himself against this with stories of physical injury that his doctors never fully accepted and that he may have experienced conversion disorder, where irreconcilable experience finds somatic expression. His medical diagnosis in 1915 and later life writing establish a causal link with the explosion and his partial burial on 28 June, consistent with opinion at the time that linked concussive blasts with destabilisation of the nervous system (Eager 422). Facey was also badly shaken by exposure to the violence and abjection of war, including hand-to-hand combat and retrieving for burial shattered and often decomposed bodies, and, in particular, by the death of his brother Roy, whose body was blown to pieces on 28 June. (A second brother, Joseph, was killed by multiple bayonet wounds while Facey was convalescing in Egypt.) Such experiences cast a different light on Facey’s observation of men suffering nerves on board the hospital ship: “I have seen men doze off into a light sleep and suddenly jump up shouting, ‘Here they come! Quick! Thousands of them. We’re doomed!’” (350). Facey had escaped the danger of death by explosion or bayonet but at a cost, and the war haunted him for the rest of his days. On disembarkation at Fremantle on 20 November 1915, he was admitted to hospital where he remained on and off for several months. Forty-one other sick and wounded disembarked with him (HMAT). Around one third, experiencing nerve-related illness, had been sent home for rest; while none returned to the war, some of the physically wounded did (War Service Records). During this time, Facey continued to present with “frequent attacks of palpitation and giddiness,” was often “short winded,” and had “heart trouble” (Repatriation). He was discharged from the army in June 1916 but, his drafts suggest, his war never really ended. He began a new life as a wounded Anzac. His dependent and often fractious relationship with the Repatriation Department ended only with his death 66 years later. Historian Marina Larsson persuasively argues that repatriated sick and wounded servicemen from the First World War represented a displaced presence at home. Many led liminal lives of “disenfranchised grief” (80). Stephen Garton observes a distinctive Australian use of repatriation to describe “all policies involved in returning, discharging, pensioning, assisting and training returned men and women, and continuing to assist them throughout their lives” (74). Its primary definition invokes coming home but to repatriate also implies banishment from a place that is not home, so that Facey was in this sense expelled from Gallipoli and, by extension, excluded from the myth of Anzac. Unlike his two brothers, he would not join history as one of the glorious dead; his name would appear on no roll of honour. Return home is not equivalent to restoration of his prior state and identity, for baggage from the other place perpetually weighs. Furthermore, failure to regain health and independence strains hospitality and gratitude for the soldier’s service to King and country. This might be exacerbated where there is no evident or visible injury, creating suspicion of resistance, cowardice, or malingering. Over 26 assessments between 1916 and 1958, when Facey was granted a full war pension, the Repatriation Department observed him as a “neuropathic personality” exhibiting “paroxysmal tachycardia” and “neurocirculatory asthenia.” In 1954, doctors wrote, “We consider the condition is a real handicap and hindrance to his getting employment.” They noted that after “attacks,” Facey had a “busted depressed feeling,” but continued to find “no underlying myocardial disease” (Repatriation) and no validity in Facey’s claims that he had been seriously physically wounded in the war (though A Fortunate Life suggests a happier outcome, where an independent medical panel finally locates the cause of his ongoing illness—rupture of his spleen in the war—which results in an increased war pension). Facey’s condition was, at times, a source of frustration for the doctors and, we suspect, disappointment and shame to him, though this appeared to reduce on both sides when the Repatriation Department began easing proof of disability from the 1950s (Thomson 287), and the Department of Veteran’s Affairs was created in 1976. This had the effect of shifting public and media scrutiny back onto a system that had until then deprived some “innocent victims of the compensation that was their due” (Garton 249). Such changes anticipated the introduction of Post-Traumatic Shock Disorder (PTSD) to the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980. Revisions to the DSM established a “genealogy of trauma” and “panic disorders” (100, 33), so that diagnoses such as “neuropathic personality” (Echterling, Field, and Stewart 192) and “soldier’s heart,” that is, disorders considered “neurotic,” were “retrospectively reinterpreted” as a form of PTSD. However, Alberti points out that, despite such developments, war-related trauma continues to be contested (80). We propose that Albert Facey spent his adult life troubled by a sense of regret and failure because of his removal from Gallipoli and that he attempted to compensate through storytelling, which included his being an original Anzac and seriously wounded in action. By writing, Facey could shore up his rectitude, work ethic, and sense of loyalty to other servicemen, which became necessary, we believe, because repatriation doctors (and probably others) had doubted him. In 1927 and again in 1933, an examining doctor concluded: “The existence of a disability depends entirely on his own unsupported statements” (Repatriation). We argue that Facey’s Gallipoli experiences transformed his life. By his own account, he enlisted for war as a physically robust and supremely athletic young man and returned nine months later to life-long anxiety and ill-health. Publication transformed him into a national sage, earning him, in his final months, the credibility, empathy, and affirmation he had long sought. Exploring different accounts of Facey, in the shape of his drafts and institutional records, gives rise to new interpretations. In this context, we believe it is time for a new edition of A Fortunate Life that recognises it as a complex testimonial narrative and theorises Facey’s deployment of national legends and motifs in relation to his “wounded storytelling” as well as to shifting cultural and medical conceptualisations and treatments of shame and trauma. ReferencesAlberti, Fay Bound. Matters of the Heart: History, Medicine, and Emotions. Oxford: Oxford UP, 2010. Butler, A.G. Official History of the Australian Medical Services 1814-1918: Vol I Gallipoli, Palestine and New Guinea. Canberra: Australian War Memorial, 1930.Campbell, A.W. “Remarks on Some Neuroses and Psychoses in War.” Medical Journal of Australia 15 April (1916): 319–23.Damousi, Joy. “Why Do We Get So Emotional about Anzac.” What’s Wrong with Anzac. Ed. Marilyn Lake and Henry Reynolds. Sydney: UNSWP, 2015. 94–109.Dutton, Geoffrey. “Fremantle Arts Centre Press Publicity.” Australian Book Review May (1981): 16.Eager, R. “War Neuroses Occurring in Cases with a Definitive History of Shell Shock.” British Medical Journal 13 Apr. 1918): 422–25.Echterling, L.G., Thomas A. Field, and Anne L. Stewart. “Evolution of PTSD in the DSM.” Future Directions in Post-Traumatic Stress Disorder: Prevention, Diagnosis, and Treatment. Ed. Marilyn P. Safir and Helene S. Wallach. New York: Springer, 2015. 189–212.Facey, A.B. A Fortunate Life. 1981. Ringwood: Penguin, 2005.———. Drafts 1–3. University of Western Australia, Special Collections.———. Transcript. University of Western Australia, Special Collections.First Tuesday Book Club. ABC Splash. 4 Dec. 2012. <http://splash.abc.net.au/home#!/media/1454096/http&>.Foster, Dennis. Confession and Complicity in Narrative. Cambridge: Cambridge UP, 1987.Frank, Arthur. The Wounded Storyteller. London: U of Chicago P, 1995.Fraser, Jane. “CEO Says.” Fremantle Press. 7 July 2015. <https://www.fremantlepress.com.au/c/news/3747-ceo-says-9>.Garton, Stephen. The Cost of War: Australians Return. Melbourne: Oxford UP, 1994.HMAT Aeneas. “Report of Passengers for the Port of Fremantle from Ports Beyond the Commonwealth.” 20 Nov. 1915. <http://recordsearch.naa.gov.au/SearchNRetrieve/Interface/ViewImage.aspx?B=9870708&S=1>.“Interview with Ray Coffey.” Personal interview. 6 May 2016. Follow-up correspondence. 12 May 2016.Jenkins, Wendy. “Tales from the Backlist: A Fortunate Life Turns 30.” Fremantle Press, 14 April 2011. <https://www.fremantlepress.com.au/c/bookclubs/574-tales-from-the-backlist-a-fortunate-life-turns-30>.Keesing, Nancy. ‘An Enduring Classic.’ Australian Book Review (May 1981). FACP Press Clippings. Fremantle. n. pag.King, Noel. “‘I Can’t Go On … I’ll Go On’: Interview with Ray Coffey, Fremantle Arts Centre Press, 22 Dec. 2004; 24 May 2006.” Westerly 51 (2006): 31–54.Larsson, Marina. “A Disenfranchised Grief: Post War Death and Memorialisation in Australia after the First World War.” Australian Historical Studies 40.1 (2009): 79–95.Lindstrom, Richard. “The Australian Experience of Psychological Casualties in War: 1915-1939.” PhD dissertation. Victoria University, Feb. 1997.Loughran, Tracey. “Shell Shock, Trauma, and the First World War: The Making of a Diagnosis and its Histories.” Journal of the History of Medical and Allied Sciences 67.1 (2012): 99–119.Lucas, Anne. “Curator’s Notes.” A Fortunate Life. Australian Screen. <http://aso.gov.au/titles/tv/a-fortunate-life/notes/>.McLeod, Steve. “My Fortunate Life with Grandad.” Western Magazine Dec. (1983): 8.Munro, Craig. Under Cover: Adventures in the Art of Editing. Brunswick: Scribe, 2015.Murphy, Ffion, and Richard Nile. “The Naked Anzac: Exposure and Concealment in A.B. Facey’s A Fortunate Life.” Southerly 75.3 (2015): 219–37.———. “Wounded Storyteller: Revisiting Albert Facey’s Fortunate Life.” Westerly 60.2 (2015): 87–100.“NBC Book Awards.” Australian Book Review Oct. (1981): 1–4.PBL. Prospectus: A Fortunate Life, the Extraordinary Life of an Ordinary Bloke. 1–8.Repatriation Records. Albert Facey. National Archives of Australia.Roberts, Chris. “Turkish Machine Guns at the Landing.” Wartime: Official Magazine of the Australian War Memorial 50 (2010). <https://www.awm.gov.au/wartime/50/roberts_machinegun/>.Semmler, Clement. “The Way We Were before the Good Life.” Courier Mail 10 Oct. 1981. FACP Press Clippings. Fremantle. n. pag.Smith, Sidonie, and Julia Watson. Reading Autobiography: A Guide for Interpreting Life Narratives. 2001. 2nd ed. U of Minnesota P, 2010.Thomson, Alistair. Anzac Memories: Living with the Legend. 1994. 2nd ed. Melbourne: Monash UP, 2013. Tyquin, Michael. Gallipoli, the Medical War: The Australian Army Services in the Dardanelles Campaign of 1915. Kensington: UNSWP, 1993.War Service Records. National Archives of Australia. <http://recordsearch.naa.gov.au/NameSearch/Interface/NameSearchForm.aspx>.Williamson, Geordie. “A Fortunate Life.” Copyright Agency. <http://readingaustralia.com.au/essays/a-fortunate-life/>.

Abstract:

In the last decades, many studies have shown ample evidence that the existence of trees and vegetation around buildings can contribute to reduce the demand for energy by cooling and heating. The use of green areas in the urban environment as an effective strategy in reducing the cooling load of buildings has attracted much attention, though there is a lack of quantitative actions to apply the general idea to a specific building or location. Due to the large-scale construction of high buildings, large amounts of solar radiation are reflected and stored in the canyons of the streets. This causes higher air temperature and surface temperature in city areas compared to the rural environment and, consequently, deteriorates the urban heat island effect. The constant high temperatures lead to more air conditioning demand time, which results in a significant increase in building energy consumption. In general, the shade of the trees reduces the building energy demand for air conditioning, reducing solar radiation on the walls and roofs. The increase of urban green spaces has been extensively accepted as effective in mitigating the effects of heat island and reducing energy use in buildings. However, by influencing temperatures, especially extreme, it is likely that trees also affect human health, an important economic variable of interest. Since human behavior has a major influence on maintaining environmental quality, today's urban problems such as air and water pollution, floods, excessive noise, cause serious damage to the physical and mental health of the population. By minimizing these problems, vegetation (especially trees) is generally known to provide a range of ecosystem services such as rainwater reduction, air pollution mitigation, noise reduction, etc. This study focuses on the functions of temperature regulation, improvement of external thermal comfort and cooling energy reduction, so it aims to evaluate the influence of trees on the energy consumption of a house in the mid-western Brazil, located at latitude 15 ° S, in the center of South America. The methodology adopted was computer simulation, analyzing two scenarios that deal with issues such as the influence of vegetation and tree shade on the energy consumption of a building. In this way, the methodological procedures were divided into three stages: climatic contextualization of the study region; definition of a basic dwelling, of the thermophysical properties; computational simulation for quantification of energy consumption for the four facade orientations. The results show that the façades orientated to north, east and south, without the insertion of arboreal shading, obtained higher values of annual energy consumption. With the adoption of shading, the facades obtained a consumption reduction of around 7,4%. It is concluded that shading vegetation can bring significant climatic contribution to the interior of built environments and, consequently, reduction in energy consumption, promoting improvements in the thermal comfort conditions of users.

Abstract:

<p align="center"><strong>Theoretical and methodological approaches to the evaluation of the quality </strong><strong>of </strong><strong>higher education WITHIN THE CONTEXT OF the world's higher education institutions rating</strong><strong>S</strong></p><p align="center">А. V. Kaydalovа, О. V. Posylkina</p><p align="center">National pharmaceutical University,Kharkov</p><p class="a0"><strong>Summary</strong>: In the article we have reviewed the world rankings of the higher education institutions; principles and methodology of ratings, their key indicators, the indices of ranking the higher education institutions and their role in assessing the quality of education.</p><p class="a0"><strong>Keywords</strong>: quality of education, world rankings of the higher education institutions, indicating indices in determining ratings, criteria for evaluation of the quality level.</p><pre><strong>Іntroduction.</strong></pre><p>The question of the participation of local educational institutions, including medical and pharmaceutical ones, in the world rankings is regarded as a serious problem during the recent years, which is widely discussed inUkraine.</p><p>At the present stage of development of the higher education the ratings of HEI turn to be seen not only as a means of competitiveness, but also as instruments of assurance of the higher educational quality.</p><p>To form the national system of ranking of the universities, including medical and pharmaceutical profile, it is important to analyze the international experience of building different ratings.</p><p>In the system of providing and evaluating the quality of education, the internal and external monitoring of the university plays an important role. If the internal monitoring - is an assessment by the university of its own activity, the external monitoring - is an assessment of the quality of education by the state, society and the educational environment.</p><p>The aim of this publication is to analyze the methodology of forming global university rankings of the universities, formulation of guidelines and indicators of ranking, the study of the specificity of the external evaluation of the quality of education to strengthen the international domestic medical and pharmaceutical universities that train future specialists in the pharmaceutical field.</p><p><strong>Results and discussion.</strong></p><p>Analysis of foreign experience has highlighted that the processes of formation, development and improvement of the world educational systems have been developing in different ways at the international level.</p><p>In scientific sources it is noted that the European system of the quality of education is based on the standards and recommendations, the principles of which are: the interest of students and employers in the quality of education, autonomy of institutions, internal and external quality of assurance of educational services [3, 5, 11].</p><p>It should be noted that the history of the world university ranking was absent up to the eighties. This was due to the lack of competition, both in domestic and foreign educational space. The first step in conducting the external evaluation of the university was the publication by the magazine US News &amp; World Report in 1983 the first in the world ranking of universities, which launched the process of globalization of the higher education. The main purpose of this rating was to provide applicants with information.</p><p>In aspects of the studing problem it has been found out that for the time being there are more than 50 national and over 10 international ratings for the evaluation of universities [1, 8]. The aim of international ratings is to determine the best universities in the world and evaluation of their activities, but each rating involves the use of its own indices to determine the competitive potential in the universities.</p><p>During our research we have analyzed the most famous and internationally recognized the global systems of monitoring and ranking of universities and compiled a chronology of the world rankings and summarized their main quantitative characteristics.</p><p>According to the analysis of the official sources [12-25] it has been found out that the world university rankings have both general trends and significant differences. Common principles of ratings are the following ones: consideration of different indicators with their further grouping due to the validity coefficients, which are determined in each rating individually and also principles of ranking of universities without taking into account their scientific and educational activities.</p><p><strong>Сonclusions</strong></p><p>The results of the research methodology and the formation of the international ratings of higher educational institutions showed, first of all, the multiplicity of approaches to assessing the quality of education, variety of criteria for assessing the quality of education, lack of scientifically validated studies of indicators ranking.</p><p>To ensure quality at the national level and the University level, including pharmaceutical and medical profile, the formation of certain ratings to assess the activities of domestic universities, which requires further research methodology of domestic and national rankings of various countries based on the experience of the world rankings and the use of the most important indicators in the construction of the system of internal monitoring of the activities of the university.</p><p><strong>References</strong></p><p>1. Valenkevych L. P. Analysis of current rankings of higher education institutions as a tool for quality assessment in higher education / L. P. Valenkevych, A. V. Finkelstein // State regulation of processes of economic and social development. № 3. (42). 2013. – С. 36-42.</p><p>2. Dubinsky A. G. international Webometrics ranking of universities: how to increase the value of the factor of superiority // Scientific Bulletin of NLTU Ukraine. – 2012. – Вип. 22 .15 – С. 377-384.</p><p>3. Zgurovsky M. the World experience of evaluation of University rankings / [Electronic resource] – access Mode: www.kampus.com.ua/index.php.</p><p>4. Zimenkovsky, Would. C. component Rating of the quality management system of preparation of doctors and pharmacists / B. S. Zimenkovsky, M. G. Gregorini, I. I. Solonenko // Medical education. – 2012. – № 2. – С. 49-51.</p><p>5. Kovalev A.V. Assessment of efficiency of quality of educational process in higher school / A. V. Kovalev // Theoretical and practical aspects of Economics and intellectual property : collection of scientific works : in 2 vol. / PSTU. – Mariupol, 2013. – Вип. 1, Т. 1. – С. 18-21.</p><p>6. Kolesnik Yu. M. System of quality management of education is a necessary component of competitiveness of domestic experts / Yu. M. Kolesnik, Y. M. Neronov, M. V. kompaniec // Higher education of Ukraine.– 2011.– № 3,</p><p>Т. ІІ(27).– С.240–247.</p><p>7. G. Lesyk. The role of Internet resources as an indicator of performance in the rating / Year. Lesik, A. If. Zimenkovsky, A. I. Lopatinsky // Medical and pharmaceutical education. –2008. –№ 1. – С. 66-70.</p><p>8. Mykhaylychenko N. V. Rating as a mechanism for evaluating the quality of educational services/ N. V. Mikhailichenko / / [chasopys NPU ei. M. P. Dragomanov.– Випуск 27, 2011. – Серія 5. Педагогічні науки: реалії та перспективи. – С. 180-184.</p><p>9. Ranking universities as a key tool to improve the quality of medical education / V. F. Moskalenko, O. P. yavorovskyy, L. I. ostapyuk, etc. / / Health education. – 2012. – № 2. – С.23-25.</p><p>10. World ranking of universities (Academic Ranking of World Universities) in 2012 [Electronic resource]. – 2012. – Access mode: http://euroosvita.net/index.php/ ?category=1&amp;id=2102.</p><p>11. Trishkina N. I. quality management System – European component of education // Vestnik Humantiy. Annex 1 to Vol. 5, Vol. II (53): The. Vol. "Higher education of*ckrainein the context of integration to European educational space". – K.: Gnosis.2014. –С. 244-252.</p><p>12. Academic Ranking of World Universities: Metodology [Electronic resource]. – Access mode: http://www.shanghairanking.com.</p><p>13. AguilloI.F., Bar-Ilan J., Levene M., Ortega J. L.(2010): Comparing University Rankings // Scientometrics. Vol. 85. February.</p><p>14. CWTS [Electronic resource]. – Access mode: http://www.leidenranking.com.</p><p>15. CWUR [Electronic resource]. – Access mode: http:// www.kikstats.com.</p><p>16. Global World Communicator [Electronic resource]. – Access mode : http://www.cicerobook.com.</p><p>17. International professional ranking of higher education institutions: [Electronic resource]. Access mode: http://www.ensmp.fr.</p><p>18. Performance Ranking of Scientific Papers for World Universities : [Electronic resource] Access mode: http://ranking.heeact.edu.tw/en-us.</p><p>19. QS [Electronic resource]. – Access mode: http://www.topuniversities.com</p><p>20. RUR [Electronic resource]. – Access mode: http://www.roundranking.com.</p><p>21. SCImago Institutions Rankings: [Electronic resource]. – Access mode: http://www.scimagoir.com.</p><p>22. Times Higher Education [Electronic resource]. – Access mode: http://www.timeshighereducation.co.uk. </p><p>23. UI Green Metric Ranking of World Universities [Electronic resource]. – Access mode: http:// www.greenmetric.ui.ac.id. </p><p>24. U-Multirank: [Electronic resource]. – Access mode: <a href="http://www.umultirank.org/">http://www.umultirank.org</a>.</p>25. Webometrics Ranking of World Universities: [Electronic resource]. – Access mode: http://www.webometrics.info.

Abstract:

This article is about refugees’ and migrants’ dreams of home and family and stems from an Australian Research Council Linkage Grant, “A Hand Up: Disrupting the Communication of Intergenerational Welfare Dependency” (LP140100935), with Partner Organisation St Vincent de Paul Society (WA) Inc. (Vinnies). A Vinnies-supported refugee and migrant support centre was chosen as one of the hubs for interviewee recruitment, given that many refugee families experience persistent and chronic economic disadvantage. The de-identified name for the drop-in language-teaching and learning social facility is the Migrant and Refugee Homebase (MARH). At the time of the research, in 2018, refugee and forced migrant families from Syria, Iraq, and Afghanistan constituted MARH’s primary membership base. MARH provided English language classes alongside other educational and financial support. It could also organise provision of emergency food and was a conduit for furniture donated by Australian families. Crucially, MARH operated as a space in which members could come together to build shared community.As part of her role, the researcher was introduced to Sara (de-identified), a mother-tongue Arabic speaker and the centre’s coordinator. Sara had personal experience of being a refugee, as well as being MARH’s manager, and she became both a point of contact for the researcher team, an interpreter/translator, and an empathetic listener as refugees shared their stories. Dreams of home and family emerged throughout the interviews as a vital part of participants’ everyday lives. These dreams and hopes were developed in the face of what was, for some, a nightmare of adversity. Underpinning participants’ sense of agency, subjectivity and resilience, Badiou argues (93, as noted in Jackson, 241) that hope can appear as a basic form of patience or perseverance rather than a dream for justice. Instead of imagining an improvement in personal circ*mstances, the dream is one of simply moving forward rather than backward. While dreams of being reunited with family are rooted in the past and project a vision of a family which no longer exists, these dreams help fashion a future which once again contains a range of possibilities.Although Sara volunteered her time on the research project as part of her commitment to Vinnies, she was well-known to interviewees as a MARH staff member and, in many cases, a friend and confidante. While Sara’s manager role implies an imbalance of power, with Sara powerful and participants comparatively less so, the majority of the information explored in the interviews pertained to refugees’ experiences of life outside the sphere in which MARH is engaged, so there was limited risk of the data being sanitised to reflect positively upon MARH. The specialist information and understandings that the interviewees shared positions them as experts, and as co-creators of knowledge.Recruitment and Methodological ApproachThe project researcher (Jaunzems) met potential contributors at MARH when its members gathered for a coffee morning. With Sara’s assistance, the researcher invited MARH members to take part in the research project, giving those present the opportunity to ask and have answered any questions they deemed important. Coffee morning attendees were under no obligation to take part, and about half chose not to do so, while the remainder volunteered to participate. Sara scheduled the interviews at times to suit the families participating. A parent and child from each volunteer family was interviewed, separately. In all cases it was the mother who volunteered to take part, and all interviewees chose to be interviewed in their homes. Each set of interviews was digitally recorded and lasted no longer than 90 minutes. This article includes extracts from interviews with three mothers from refugee families who escaped war-torn homelands for a new life in Australia, sometimes via interim refugee camps.The project researcher conducted the in-depth interviews with Sara’s crucial interpreting/translating assistance. The interviews followed a traditional approach, except that the researcher deferred to Sara as being more important in the interview exchange than she was. This reflects the premise that meaning is socially constructed, and that what people do and say makes visible the meanings that underpin their actions and statements within a wider social context (Burr). Conceptualising knowledge as socially constructed privileges the role of the decoder in receiving, understanding and communicating such knowledge (Crotty). Respecting the role of the interpreter/translator signified to the participants that their views, opinions and their overall cultural context were valued.Once complete, the interviews were sent for translation and transcription by a trusted bi-lingual transcriber, where both the English and Arabic exchanges were transcribed. This was deemed essential by the researchers, to ensure both the authenticity of the data collected and to demonstrate “trust, understanding, respect, and a caring connection” (Valibhoy, Kaplan, and Szwarc, 23) with the participants. Upon completion of the interviews with volunteer members of the MARH community, and at the beginning of the analysis phase, researchers recognised the need for the adoption of an interpretive framework. The interpretive approach seeks to understand an individual’s view of the world through the contexts of time, place and culture. The knowledge produced is contextualised and differs from one person to another as a result of individual subjectivities such as age, race and ethnicity, even within a shared social context (Guba and Lincoln). Accordingly, a mother-tongue Arabic speaker, who identifies as a refugee (Al-Hameed), was added to the project. All authors were involved in writing up the article while authors two, three and four took responsibility for transcript coding and analysis. In the transcripts that follow, words originally spoken in Arabic are in intalics, with non-italcised words originally spoken in English.Discrimination and BelongingAya initially fled from her home in Syria into neighbouring Jordan. She didn’t feel welcomed or supported there.[00:55:06] Aya: …in Jordan, refugees didn’t have rights, and the Jordanian schools refused to teach them [the children…] We were put aside.[00:55:49] Interpreter, Sara (to Researcher): And then she said they push us aside like you’re a zero on the left, yeah this is unfortunately the reality of our countries, I want to cry now.[00:56:10] Aya: You’re not allowed to cry because we’ll all cry.Some refugees and migrant communities suffer discrimination based on their ethnicity and perceived legitimacy as members of the host society. Although Australian refugees may have had searing experiences prior to their acceptance by Australia, migrant community members in Australia can also feel themselves “constructed in the public and political spheres as less legitimately Australian than others” (Green and Aly). Jackson argues that both refugees and migrants experiencethe impossibility of ever bridging the gap between one’s natal ties to the place one left because life was insupportable there, and the demands of the nation to which one has travelled, legally or illegally, in search of a better life. And this tension between belonging and not belonging, between a place where one has rights and a place where one does not, implies an unresolved relationship between one’s natural identity as a human being and one’s social identity as ‘undocumented migrant,’ a ‘resident alien,’ an ‘ethnic minority,’ or ‘the wretched of the earth,’ whose plight remains a stigma of radical alterity even though it inspires our compassion and moves us to political action. (223)The tension Jackson refers to, where the migrant is haunted by belonging and not belonging, is an area of much research focus. Moreover, the label of “asylum seeker” can contribute to systemic “exclusion of a marginalised and abject group of people, precisely by employing a term that emphasises the suspended recognition of a community” (Nyers). Unsurprisingly, many refugees in Australia long for the connectedness of the lives they left behind relocated in the safe spaces where they live now.Eades focuses on an emic approach to understanding refugee/migrant distress, or trauma, which seeks to incorporate the worldview of the people in distress: essentially replicating the interpretive perspective taken in the research. This emic framing is adopted in place of the etic approach that seeks to understand the distress through a Western biomedical lens that is positioned outside the social/cultural system in which the distress is taking place. Eades argues: “developing an emic approach is to engage in intercultural dialogue, raise dilemmas, test assumptions, document hopes and beliefs and explore their implications”. Furthermore, Eades sees the challenge for service providers working with refugee/migrants in distress as being able to move beyond “harm minimisation” models of care “to recognition of a facilitative, productive community of people who are in a transitional phase between homelands”. This opens the door for studies concerning the notions of attachment to place and its links to resilience and a refugee’s ability to “settle in” (for example, Myers’s ground-breaking place-making work in Plymouth).Resilient PrecariousnessChaima: We feel […] good here, we’re safe, but when we sit together, we remember what we went through how my kids screamed when the bombs came, and we went out in the car. My son was 12 and I was pregnant, every time I remember it, I go back.Alongside the dreams that migrants have possible futures are the nightmares that threaten to destabilise their daily lives. As per the work of Xavier and Rosaldo, post-migration social life is recreated in two ways: the first through participation and presence in localised events; the second by developing relationships with absent others (family and friends) across the globe through media. These relationships, both distanced and at a distance, are dispersed through time and space. In light of this, Campays and Said suggest that places of past experiences and rituals for meaning are commonly recreated or reproduced as new places of attachment abroad; similarly, other recollections and experience can trigger a sense of fragility when “we remember what we went through”. Gupta and Ferguson suggest that resilience is defined by the migrant/refugee capacity to “reimagine and re-materialise” their lost heritage in their new home. This involves a sense of connection to the good things in the past, while leaving the bad things behind.Resilience has also been linked to the migrant’s/refugee’s capacity “to manage their responses to adverse circ*mstances in an interpersonal community through the networks of relationships” (Eades). Resilience in this case is seen through an intersubjective lens. Joseph reminds us that there is danger in romanticising community. Local communities may not only be hostile toward different national and ethnic groups, they may actively display a level of hostility toward them (Boswell). However, Gill maintains that “the reciprocal relations found in communities are crucially important to their [migrant/refugee] well-being”. This is because inclusion in a given community allows migrants/refugees to shrug off the outsider label, and the feeling of being at risk, and provides the opportunity for them to become known as families and friends. One of MAHR’s central aims was to help bridge the cultural divide between MARH users and the broader Australian community.Hope[01:06: 10] Sara (to interviewee, Aya): What’s the key to your success here in Australia?[01:06:12] Aya: The people, and how they treat us.[01:06:15] Sara (to Researcher): People and how they deal with us.[01:06:21] Aya: It’s the best thing when you look around, and see people who don’t understand your language but they help you.[01:06:28] Sara (to Researcher): She said – this is nice. I want to cry also. She said the best thing when I see people, they don’t understand your language, and I don’t understand theirs but they still smile in your face.[01:06:43] Aya: It’s the best.[01:06:45] Sara (to Aya): yes, yes, people here are angels. This is the best thing about Australia.Here, Sara is possibly shown to be taking liberties with the translation offered to the researcher, talking about how Australians “smile in your face”, when (according to the translator) Aya talked about how Australians “help”. Even so, the capacity for social connection and other aspects of sociality have been linked to a person’s ability to turn a negative experience into a positive cultural resource (Wilson). Resilience is understood in these cases as a strength-based practice where families, communities and individuals are viewed in terms of their capabilities and possibilities, instead of their deficiencies or disorders (Graybeal and Saleeby in Eades). According to Fozdar and Torezani, there is an “apparent paradox between high-levels of discrimination experienced by humanitarian migrants to Australia in the labour market and everyday life” (30) on the one hand, and their reporting of positive well-being on the other. That disparity includes accounts such as the one offered by Aya.As Wilson and Arvanitakis suggest,the interaction between negative experiences of discrimination and reports of wellbeing suggested a counter-intuitive propensity among refugees to adapt to and make sense of their migration experiences in unique, resourceful and life-affirming ways. Such response patterns among refugees and trauma survivors indicate a similar resilience-related capacity to positively interpret and derive meaning from negative migration experiences and associated emotions. … However, resilience is not expressed or employed uniformly among individuals or communities. Some respond in a resilient manner, while others collapse. On this point, an argument could be made that collapse and breakdown is a built-in aspect of resilience, and necessary for renewal and ongoing growth.Using this approach, Wilson and Arvanitakis have linked resilience to hope, as a “present- and future-oriented mode of situated defence against adversity”. They argue that the term “hope” is often utilised in a tokenistic way “as a strategic instrument in increasingly empty domestic and international political vocabularies”. Nonetheless, Wilson and Arvanitakis believe hope to be of vital academic interest due to the prevalence of war and suffering throughout the world. In the research reported here, the authors found that participants’ hopes were interwoven with dreams of being reunited with their families in a place of safety. This is a common longing. As Jackson states,so it is that migrants travel abroad in pursuit of utopia, but having found that place, which is also no-place (ou-topos), they are haunted by the thought that utopia actually lies in the past. It is the family they left behind. That is where they properly belong. Though the family broke up long ago and is now scattered to the four winds, they imagine a reunion in which they are together again. (223)There is a sense here that with their hopes and dreams lying in the past, refugees/migrants are living forward while looking backwards (a Kierkegaardian concept). If hope is thought to be key to resilience (Wilson and Arvanitakis), and key to an individual’s ability to live with a sense of well-being, then perhaps a refugee’s past relations (familial) impact both their present relations (social/community), and their ability to transform negative experiences into positive experiences. And yet, there is no readily accessible way in which migrants and refugees can recreate the connections that sustained them in the past. As Jackson suggests,the irreversibility of time is intimately connected with the irreversibility of one’s place of origin, and this entwined movement through time and across space proves perplexing to many migrants, who, in imagining themselves one day returning to the place from where they started out, forget that there is no transport which will convey them back into the past. … Often it is only by going home that is becomes starkly and disconcertingly clear that one’s natal village is no longer the same and that one has also changed. (221)The dream of home and family, therefore and the hope that this might somehow be recreated in the safety of the here and now, becomes a paradoxical loss and longing even as it is a constant companion for many on their refugee journey.Esma’s DreamAccording to author three, personal dreams are not generally discussed in Arab culture, even though dreams themselves may form part of the rich tradition of Arabic folklore and storytelling. Alongside issues of mental wellbeing, dreams are constructed as something private, and it generally breaks social taboos to describe them publicly. However, in personal discussions with other refugee women and men, and echoing Jackson’s finding, a recurring dream is “to meet my family in a safe place and not be worried about my safety or theirs”. As a refugee, the third author shares this dream. This is also the perspective articulated by Esma, who had recently had a fifth child and was very much missing her extended family who had died, been scattered as refugees, or were still living in a conflict zone. The researcher asked Sara to ask Esma about the best aspect of her current life:[01:17:03] Esma: The thing that comforts me here is nature, it’s beautiful.[01:17:15] Sara (to the Researcher): The nature.[01:17:16] Esma: And feeling safe.[01:17:19] Sara (to the Researcher): The safety. ...[01:17:45] Esma: Life’s beautiful here.[01:17:47] Sara (to the Researcher): Life is beautiful here.[01:17:49] Esma: But I want to know people, speak the language, have friends, life is beautiful here even if I don’t have my family here.[01:17:56] Sara (to the Researcher): Life is so pretty you only need to improve the language and have friends, she said I love my life here even though I don’t have any family or community here. (To Esma:) I am your family.[01:18:12] Esma: Bring me my siblings here.[01:18:14] Sara (to Esma): I just want my brothers here and my sisters.[01:18:17] Esma: It’s a dream.[01:18:18] Sara (to Esma): it’s a dream, one day it will become true.Here Esma uses the term dream metaphorically, to describe an imagined utopia: a dream world. In supporting Esma, who is mourning the absence of her family, Sara finds herself reacting and emoting around their shared experience of leaving siblings behind. In doing so, she affirms the younger woman, but also offers a hope for the future. Esma had previously made a suggestion, absorbed into her larger dream, but more achievable in the short term, “to know people, speak the language, have friends”. The implication here is that Esma is keen to find a way to connect with Australians. She sees this as a means of compensating for the loss of family, a realistic hope rather than an impossible dream.ConclusionInterviews with refugee families in a Perth-based migrant support centre reveals both the nightmare pasts and the dreamed-of futures of people whose lives have experienced a radical disruption due to war, conflict and other life-threatening events. Jackson’s work with migrants provides a context for understanding the power of the dream in helping to resolve issues around the irreversibility of time and circ*mstance, while Wilson and Arvanitakis point to the importance of hope and resilience in supporting the building of a positive future. Within this mix of the longed for and the impossible, both the refugee informants and the academic literature suggest that participation in local events, and authentic engagement with the broader community, help make a difference in supporting a migrant’s transition from dreaming to reality.AcknowledgmentsThis article arises from an ARC Linkage Project, ‘A Hand Up: Disrupting the Communication of Intergenerational Welfare Dependency’ (LP140100935), supported by the Australian Research Council, Partner Organisation St Vincent de Paul Society (WA) Inc., and Edith Cowan University. The authors are grateful to the anonymous staff and member of Vinnies’ Migrant and Refugee Homebase for their trust in and support of this project, and for their contributions to it.ReferencesBadiou, Alan. Saint Paul: The Foundation of Universalism. Trans. Ray Brassier. Stanford, CA: Stanford UP, 2003.Boswell, Christina. “Burden-Sharing in the European Union: Lessons from the German and UK Experience.” Journal of Refugee Studies 16.3 (2003): 316–35.Burr, Vivien. Social Constructionism. 2nd ed. Hove, UK & New York, NY: Routledge, 2003.Campays, Philippe, and Vioula Said. “Re-Imagine.” M/C Journal 20.4 (2017). Aug. 2017 <http://journal.media-culture.org.au/index.php/mcjournal/article/view/1250>.Crotty, Michael. The Foundations of Social Research: Meaning and Perspective in the Research Process. St Leonards: Allen & Unwin, 1998.Eades, David. “Resilience and Refugees: From Individualised Trauma to Post Traumatic Growth.” M/C Journal 16.5 (2013). Aug. 2013 <http://journal.media-culture.org.au/index.php/mcjournal/article/view/700>.Fozdar, Farida, and Silvia Torezani. “Discrimination and Well-Being: Perceptions of Refugees in Western Australia.” The International Migration Review 42.1 (2008): 1–34.Gill, Nicholas. “Longing for Stillness: The Forced Movement of Asylum Seekers.” M/C Journal 12.1 (2009). Mar. 2009 <http://journal.media-culture.org.au/index.php/mcjournal/article/view/123>.Graybeal, Clay. “Strengths-Based Social Work Assessment: Transforming the Dominant Paradigm.” Families in Society 82.3 (2001): 233–42.Green, Lelia, and Anne Aly. “Bastard Immigrants: Asylum Seekers Who Arrive by Boat and the Illegitimate Fear of the Other.” M/C Journal 17.5 (2014). Oct. 2014 <http://journal.media-culture.org.au/index.php/mcjournal/article/view/896>.Guba, Egon G., and Yvonna S. Lincoln. "Competing Paradigms in Qualitative Research." Handbook of Qualitative Research 2 (1994): 163-194.Gupta, Akhil, and James Ferguson. “Beyond ‘Culture’: Space, Identity, and the Politics of Difference.” Religion and Social Justice for Immigrants. Ed. Pierrette Hondagneu-Sotelo. New Jersey: Rutgers UP, 2006. 72-79.Jackson, Michael. The Wherewithal of Life: Ethics, Migration, and the Question of Well-Being. California: U of California P, 2013.Joseph, Miranda. Against the Romance of Community. Minnesota: University of Minnesota Press, 2002.Myers, Misha. “Situations for Living: Performing Emplacement." Research in Drama Education 13.2 (2008): 171-180. DOI: 10.1080/13569780802054828.Nyers, Peter. “Abject Cosmopolitanism: The Politics of Protection in the Anti-Deportation Movement.” Third World Quarterly 24.6 (2003): 1069–93.Saleeby, Dennis. “The Strengths Perspective in Social Work Practice: Extensions and Cautions.” Social Work 41.3 (1996): 296–305.Valibhoy, Madeleine C., Ida Kaplan, and Josef Szwarc. “‘It Comes Down to Just How Human Someone Can Be’: A Qualitative Study with Young People from Refugee Backgrounds about Their Experiences of Australian Mental Health Services.” Transcultural Psychiatry 54.1 (2017): 23-45.Wilson, Michael. Accumulating Resilience: An Investigation of the Migration and Resettlement Experiences of Young Sudanese People in the Western Sydney Area. Sydney: University of Western Sydney, 2012.Wilson, Michael John, and James Arvanitakis. “The Resilience Complex.” M/C Journal 16.5 (2013). <http://journal.media-culture.org.au/index.php/mcjournal/article/view/741>.Xavier, Johnathon, and Renato Rosaldo. “Thinking the Global.” The Anthropology of Globalisation. Eds. Johnathon Xavier and Renato Rosaldo. New Jersey: Wiley-Blackwell Publishers, 2002.

Abstract:

Introduction Burning Man (BM) is a festival of art and music that materialises for one week each year in the Nevada desert. It is considered by many to be the world’s largest countercultural event. But what is BM, really? With record attendance of 69,613 in 2013 (Griffith) (the original event in 1986 had twenty), and recent event themes that have engaged with mainstream political themes such as “Green Man” (2007) and “American Dream” (2008), can BM still be considered countercultural? Was it ever? In the first part of this article, we define counterculture as a subculture that originates in the hippie movement of 1960s America and the rejection of “mainstream” values associated with post-WWII industrial culture, that aligns itself with environmentalism and ecological consciousness, and that is distinctly anti-consumer (Roszak, Making). Second, we identify BM as an art and music festival that transcends the event to travel with its desert denizens out into the “real world.” In this way, it is also a festival that has countercultural connections. Third, though BM bears some resemblance to counterculture, given that it is founded upon “Radical Self-Reliance”, BM is actually anything but countercultural because it interlocks with the current socioeconomic zeitgeist of neoliberalism, and that reflects a “new individualism” (Elliot & Lemert). BM’s ambition to be a commercial-free zone runs aground against its entanglement with market relations, and BM is also arguably a consumer space. Finally, neoliberal ideology and “new individualism” are encoded in the space of BM at the level of the spectacle (Debord). The Uchronian’s structure from BM 2006 (a cavernous wooden construction nicknamed the “Belgian Waffle”) could be read as one example. However, opportunities for personal transformation and transcendent experience may persist as counterculture moves into a global age. Defining Counterculture To talk about BM as a counterculture, we must first define counterculture. Hebdige provided a useful distinction between subculture and counterculture in an endnote to a discussion of Teds versus Rockers (148). According to Hebdige, what distinguishes counterculture from mere subculture and related styles is its association with a specific era (1967–70), that its adherents tended to hail from educated, middle-class families, and that it is “explicitly political and ideological” and thus more easily “read” by the dominant powers. Finally, it opposes the dominant culture. Counterculture has its roots in “the hippies, the flower children, the yippies” of the 60s. However, perhaps Hebdige’s definition is too narrow; it is more of an instance of counterculture than a definition. A more general definition of counterculture might be a subculture that rejects “mainstream” values, and examples of this have existed throughout time. For example, we might include the 19th century Romantics with their rejection of the Enlightenment and distrust of capitalism (Roszak 1972), or the Beat generation and post-War America (Miller). Perhaps counterculture even requires one to be a criminal: the prominent Beat writer William S. Burroughs shot guns and heroin, was a hom*osexual, and accidentally shot and killed his wife in a drug haze (Severo). All of these are examples of subcultures that rejected or opposed the mainstream values of the time. But it was Roszak (Making) who originally defined counterculture as the hippie movement of 1960s era college-aged middle-class American youth who revolted against the values and society inherited not only from their parents, but from the “military-industrial complex” itself, which “quite simply was the American political system” (3). Indeed, the 1960s counterculture—what the term “counterculture” has more generally come to mean—was perhaps the most radical expression of humanity ever in its ontological overthrow of industrial culture and all that it implied (and also, Roszak speculates, in so much that it may have been an experiment gone wrong on the part of the American establishment): The Communist and Socialist Left had always been as committed to industrialism as their capitalist foes, never questioning it as an inevitable historical stage. From this viewpoint, all that needed to be debated was the ownership and control of the system. But here was a dissenting movement that yearned for an entirely different quality of life. It was not simply calling the political superstructure into question; with precocious ecological insight, it was challenging the culture of industrial cities on which that superstructure stood. And more troubling still, there were those among the dissenters who questioned the very sanity of that culture. These psychic disaffiliates took off in search of altered states of consciousness that might generate altered states of society. (8) For the purposes of this paper, then, counterculture refers specifically to those cultures that find their roots in the hippie movement of the late 1960s. I embrace both Roszak’s and Hebdige’s definitions of counterculture because they define it as a unique reaction of post-WWII American youth against industrial culture and a rejection of the accompanying values of home, marriage and career. Instead, counterculture embraced ecological awareness, rejected consumption, and even directed itself toward mystical altered states. In the case of the espoused ecological consciousness, that blossomed into the contemporary (increasingly mainstream) environmental movement toward “green” energy. In the case of counterculture, the specific instance really is the definition in this case because the response of postwar youth was so strong and idiosyncratic, and there is overlap between counterculture and the BM community. So what is Burning Man? Defining Burning Man According to the event’s website: Burning Man is an annual event and a thriving year-round culture. The event takes place the week leading up to and including Labor Day, in Nevada’s Black Rock Desert. The Burning Man organization […] creates the infrastructure of Black Rock City, wherein attendees (or “participants”) dedicate themselves to the spirit of community, art, self-expression, and self-reliance. They depart one week later, leaving no trace […] Outside the event, Burning Man’s vibrant year-round culture is growing through the non-profit Burning Man Project, including worldwide Regional Groups and associated non-profits who embody Burning Man’s ethos out in the world. (“What is Burning Man?”) I interpret BM as a massive art festival and party that materialises in the desert once a year to produce one of the largest cities in Nevada, but one with increasingly global reach in which the participants feel compelled to carry the ethos forward into their everyday lives. It is also an event with an increasing number of “regional burns” (Taylor) that have emerged as offshoots of the original. Creator Larry Harvey originally conceived of burning the effigy of a man on San Francisco’s Baker Beach in 1986 in honor of the solstice (“Burning Man Timeline”). Twenty people attended the first BM. That figure rapidly rose to 800 by 1990 when for legal reasons it became necessary to relocate to the remote Black Rock desert in Nevada, the largest expanse of flat land in the United States. In the early 90s, when BM had newly relocated and attendees numbered in the low thousands, it was not uncommon for participants to mix drugs, booze, speeding cars and firearms (Bonin) (reminiscent of the outlaw associations of counterculture). As the Internet became popular in the mid-1990s word spread quickly, leading to a surge in the population. By the early 2000s attendance regularly numbered in the tens of thousands and BM had become a global phenomenon. In 2014 the festival turned 28, but it had already been a corporation for nearly two decades before transitioning to a non-profit (“Burning Man Transitions”). Burning Man as Countercultural Event BM has connections to the counterculture, though the organisation is quick to dispel these connections as myths (“Media Myths”). For example, in response to the notion that BM is a “90s Woodstock”, the organisers point out that BM is for all ages and not a concert. Rather, it is a “noncommercial environment” where the participants come to entertain each other, and thus it is “not limited by the conventions of any subculture.” The idea that BM is a “hippie” festival is also a myth, but one with some truth to it: Hippies helped create environmental ethics, founded communes, wore colorful clothing, courted mysticism, and distrusted the modern industrial economy. In some ways, this counterculture bears a resemblance to aspects of Burning Man. Hippie society was also a youth movement that often revolved around drugs, music, and checks from home. Burning Man is about “radical self-reliance”–it is not a youth movement, and it is definitely not a subculture (“Media Myths”). There are some familiar aspects of counterculture here, particularly environmental consciousness, anti-consumer tendencies and mysticism. Yet, looking at the high attendance numbers and the progression of themes in recent years one might speculate that BM is no longer as countercultural as it once was. For instance, psychedelic themes such as “Vault of Heaven” (2004) and “Psyche” (2005) gave way to “The Green Man” (2007) and “American Dream” (2008). Although “Green Man” was an environmental theme it debuted the year after Vice President Al Gore’s “An Inconvenient Truth” (2006) brought the issue of climate change to a mainstream audience. Indeed, as a global, leaderless event with a strong participatory ethos in many respects BM followed suit with the business world, particularly given it was a Limited Liability Corporation (LLC) for many years (though it was ahead of the curve): “Capitalism has learned from the counter culture. But this is not news” (Rojek 355). Similarly, just in time for the 2008 U.S. Presidential election the organisational committee decided to juxtapose “the Man” with the American flag. Therefore, there has been an arguable shift toward engagement with mainstream issues and politics in recent years (and away from mysticism). Recent themes are really re-appropriations of mainstream discourses; hence they are “agonistic” readings (Mouffe). Take for example the VoterDrive Bus, an early example of political talk at BM that engaged with mainstream politics. The driver was seven-time BM veteran Corey Mervis (also known as “Misty Mocracy”) (“Jack Rabbit Speaks”). Beginning on 22 July 2004, the VoterDrive Bus wrote the word VOTE in script across the continental United States in the months before the election, stopping in the Black Rock City (BRC) for one week during the BM festival. Four years later the theme “American Dream” would reflect this countercultural re-appropriation of mainstream political themes in the final months leading up to the 2008 Presidential election. In that year, “the Man,” a massive wooden effigy that burns on the last night of the event, stood atop a platform of windows, each inscribed with the flag of a different country. “American Dream” was as politically as it was poetically inspired. Note the agonistic appeal: “This year's art theme is about patriotism—not that kind which freights the nation state with the collective weight of ego, but a patriotism that is based upon a love of country and culture. Leave ideology at home…Ask yourself, instead…What can postmodern America, this stumbling, roused, half-conscious giant, yet give to the world?” (“2008 Art Theme: American Dream”). BM has arguably retained its countercultural authenticity despite engagement with mainstream political themes by virtue of such agonistic appeals to “American Dream”, and to “Green Man” which promoted environmental awareness, and which after all started out in the counterculture. I attended BM twice in 2006 and 2007 with “The Zombie Hotel”, one among a thousand camps in the BRC, Nevada (oddly, there were numerous zombie-themed camps). The last year I attended, the festival seemed to have come of age, and 2007 was the first in its history that BM invited corporate presence in the form of green energy companies (and informational kiosks, courtesy of Google) (Taylor). Midway through the week, as I stumbled through the haphazard common area that was The Zombie Hotel hiding from the infernal heat of the desert sun, two twin fighter jets, their paths intertwining, disturbed the sanctity of the clear, blue afternoon sky followed by a collective roar from the city. One can imagine my dismay at rumours that the fighter jets—which I had initially assumed to be some sort of military reconnaissance—were in fact hired by the BM Organizational Committee to trace the event’s symbol in the sky. Speculation would later abound on Tribe.net (“What was up with the fighter jets?”). What had BM become after all? Figure 1: Misty Mocracy & the VoterDrive Bus. Photo: Erick Leskinen (2004). Reproduced with permission. “Radical Self-Reliance”, Neoliberalism and the “New Individualism” Despite overlap with elements of counterculture, there is something quite normative about BM from the standpoint of ideology, and thus “mainstream” in the sense of favouring values associated with what Roszak calls “industrial society”, namely consumption and capitalist labor relations. To understand this, let us examine “The Ten Principles of BM”. These include: Radical Inclusion, Gifting, Decommodification, Radical Self-Reliance, Radical Self-Expression, Communal Effort, Civic Responsibility, Leaving No Trace, Participation and Immediacy (“Ten Principles of Burning Man”). These categories speak to BM’s strong connection to the counterculture. For example, “Decommodification” is a rejection of consumerism in favour of a culture of giving; “Immediacy” rejects mediation, and “Participation” stresses transformative change. Many of these categories also evoke political agonism, for example “Radical Inclusion” requires that “anyone may be a part of Burning Man”, and “Radical Self-Expression”, which suggests that no one other than the gift-giver can determine the content of the message. Finally, there are categories that also engage with concepts associated with traditional civil society and democracy, such as “Civic Responsibility”, which refers to the “public welfare”, “Participation”, and “Communal Effort.” Though at first it may seem to connect with countercultural values, upon closer inspection “Radical Self-Reliance” aligns BM with the larger socioeconomic zeitgeist under late-capitalism, subverting its message of “Decommodification.” Here is what it says: “Burning Man encourages the individual to discover, exercise and rely on his or her inner resources.” That message is transformative, even mystical, but it aligns well with a neoliberal ideology and uncertain labor relations under late capitalism. Indeed, Elliot and Lemert explore the psychological impact of a “new individualism”, setting the self in opposition to the incoming forces of globalisation. They address the question of how individuals respond to globalisation, perhaps pathologically. Elliot and Lemert clarify the socio-psychological ramifications of economic fragmentation. They envision this as inextricably caught up with the erosion of personal identity and the necessity to please “self-absorbed others” in a multiplicity of incommensurate realities (20, 21). Individuals are not merely atomised socially but fragmented psychologically, while at the macroscopic level privatisation of the economy spawns this colonisation of the personal Lifeworld, as social things move into the realm of individualised dilemmas (42). It is interesting to note how BM’s principles (in particular “Radical Self-Reliance”) evoke this fracturing of identity as identities and realities multiply in the BRC. Furthermore, the spectre of neoliberal labour conditions on “the Playa” kicks down the door for consumer culture’s entrée. Consumer society “technicises” the project of the self as a series of problems having consumer solutions with reference to expert advice (Slater 86), BM provides that solution in the form of a transformative experience through “Participation”, and acolytes of the BM festival can be said to be deeply invested in the “experience economy” (Pine & Gilmore): “We believe that transformative change, whether in the individual or in society, can occur only through the medium of deeply personal participation” (“Ten Principles”). Yet, while BM rejects consumption as part of “Decommodification”, the event has become something of a playground for new technological elites (with a taste for pink fur and glow tape rather than wine and cheese) with some camps charging as much as US $25,000 in fees per person for the week (most charge $300) (Bilton). BM is gentrifying, or as veteran attendee Tyler Hanson put it, “Burning Man is no longer a counterculture revolution. It’s now become a mirror of society” (quoted in Bilton). Neoliberalism and “new individualism” are all around at BM, and a reading of space and spectacle in the Uchronian structure reveals this encoding. Figure 2: “Message Out of the Future by Night” (also known as “the Belgian Waffle). Photo: Laurent Chavanne (2006). Reproduced with permission. “Long Gone Hippies” Republican tax reformist Grover Norquist made his way to BM for the first time this year, joining the tech elites. He subsequently proclaimed that America had a lot to learn from BM: “The story of Burning Man is one of radical self-reliance” (Norquist). As the population of the BRC surges toward seventy thousand, it may be difficult to call BM a countercultural event any longer. Given parallels between the BM ethos and neoliberal market relations and a “new individualism”, it is hard to deny that BM is deeply intertwined with counterposing forces of globalisation. However, if you ask the participants (and Norquist) they will have a different story: After you buy your ticket to Burning Man to help pay for the infrastructure, and after you pay for your own transportation, food and water, and if you optionally decide to pay to join a camp that provides some services THEN you never have to take your wallet out while at Burning Man. Folks share food, massages, alcohol, swimming pools, trampolines, many experiences. The expenses that occur prior to the festival are very reasonable and it is wonderful to walk around free from shopping or purchasing. Pockets are unnecessary. So are clothes. (Alex & Allyson Grey) Consumerism is a means to an end in an environment where the meanings of civic participation and “giving back” to the counterculture take many forms. Moreover, Thornton argued that the varied definitions of what is “mainstream” among subcultures point more to a complex and multifaceted landscape of subculture than to any coherent agreement as to what “mainstream” actually means (101), and so perhaps our entire discussion of the counterculture/mainstream binary is moot. Perhaps there is something yet to be salvaged in the spaces of participation at BM, some agonistic activity to be harnessed. The fluid spaces of the desert are the loci of community action. Jan Kriekels, founder of the Uchronia Community, holds out some hope. The Belgian based art collective hauled 150 kilometres of lumber to the BRC in the summer of 2006 to construct a freestanding, cavernous structure with a floor space of 60 by 30 metres at its center and a height of 15 metres (they promised a reforestation of the equivalent amount of trees) (Figure 1). “Don’t mistake us for long gone hippies in the desert”, wrote Kriekels in Message Out of the Future: Uchronia Community, “we are trying to build a bridge between materialism and spiritualism” (102). The Uchronians announced themselves as not only desert nomads but nomads in time (“U” signifying “nothing” and “chronos” or “time”), their time-traveller personas designed to subvert commodification, their mysterious structure (nicknamed the “Belgian Waffle” by the burners, a painful misnomer in the eyes of the Uchronians) evoking a sense of timelessness. I remember standing within that “cathedral-like” (60) structure and feeling exhilarated and lonely and cold all at once for the chill of the desert at night, and later, much later, away from the Playa in conversations with a friend we recalled Guy Debord’s “Thesis 30”: “The spectator feels at home nowhere, for the spectacle is everywhere.” The message of the Uchronians provokes a comparison with Virilio’s conceptualisations of “world time” and “simultaneity” that emerge from globalisation and digital technologies (13), part of the rise of a “globalitarianism” (15)—“world time (‘live’) takes over from the ancient, immemorial supremacy of the local time of regions” (113). A fragmented sense of time, after all, accompanies unstable labour conditions in the 21st century. Still, I hold out hope for the “resistance” inherent in counterculture as it fosters humanity’s “bothersomely unfulfilled potentialities” (Roszak, Making 16). I wonder in closing if I have damaged the trust of burners in attempting to write about what is a transcendent experience for many. It may be argued that the space of the BRC is not merely a spectacle—rather, it contains the urban “forests of gestures” (de Certeau 102). These are the secret perambulations—physical and mental—at risk of betrayal. References An Inconvenient Truth. Dir. Davis Guggenheim. Perf. Al Gore. Paramount Pictures, 2006. Bilton, Nick. “At Burning Man, the Tech Elite One-Up One Another.” The New York Times: Fashion & Style, 20 Aug. 2014. 10 Oct. 2014 ‹http://www.nytimes.com/2014/08/21/fashion/at-burning-man-the-tech-elite-one-up-one-another.html› “Burning Man Timeline.” Burningman. 10 Oct. 2014 ‹http://burningman.org/timeline/›. “Burning Man Transitions to Non-Profit Organization.” Burningman 3 Mar. 2014. 10 Oct. 2014 ‹http://blog.burningman.com/2014/03/news/burning-man-transitions-to-non-profit-organization/›. De Bord, Guy. The Society of the Spectacle. New York: Zone, 1994. De Certeau, Michel. The Practice of Everyday Life. Berkeley, Calif.: U of California P, 1984. Dust & Illusions: 30 Years of History of Burning Man. Dir. Oliver Bonin. Perf. Jerry James, Larry Harvey, John Law. Imagine, 2009. Elliot, Anthony, and Charles Lemert. The New Individualism. New York: Routledge, 2006. Grey, Alex, and Alyson Grey. “Ticket 4066, Burning Man Study.” Message to the author. 30 Nov. 2007. E-mail. Griffith, Martin. “Burning Man Draws 66,000 People to the Nevada Desert.” The Huffington Post 2 Sep. 2014. 10 Oct. 2014 ‹http://www.huffingtonpost.com/2014/09/02/burning-man-2014_n_5751648.html›. Hebdige, Dick. Subculture: The Meaning of Style. New York: Methuen, 1979. “Jack Rabbit Speaks.” JRS 8.32 (2004). 10 Oct. 2014 ‹http://www.burningman.com/blackrockcity_yearround/jrs/vol08/jrs_v08_i32.html›. Kriekels, Jan. Message Out of the Future: Uchronia Community. 2006. 10 Oct. 2014 ‹http://issuu.com/harmenvdw/docs/uchronia-book-low#›. “Media Myths.” Burningman. 6 Nov. 2014 ‹http://www.burningman.com/press/myths.html›. Miller, Timothy. The Hippies and American Values. Knoxville: U of Tennessee P, 1999. Mouffe, Chantal. On the Political. London: Routledge, 2005. Norquist, Grover. “My First Burning Man: Confessions of a Conservative from Washington.” The Guardian 2 Sep. 2014. 10 Oct. 2014 ‹http://www.theguardian.com/commentisfree/2014/sep/02/my-first-burning-man-grover-norquist›. Pine, B. Joseph, and James H. Gilmore. The Experience Economy. Boston: Harvard Business School P, 1999. Rojek, Chris. "Leaderless Organization, World Historical Events and Their Contradictions: The ‘Burning Man’ City Case.” Cultural Sociology 8.3 (2014): 351–364. Roszak, Theodore. The Making of a Counter Culture. Oakiland, Calif.: U of California P, 1995 [1968]. Roszak, Theodore. Where the Wasteland Ends. Charlottesville, Va.: U of Virginia P, 1972. Severo, Richard. “William S. Burroughs Dies at 83.” New York Times 3 Aug. 1997. 6 Nov. 2014 ‹http://www.nytimes.com/1997/08/03/nyregion/william-s-burroughs-dies-at-83-member-of-the-beat-generation-wrote-naked-lunch.html›. Slater, Don. Consumer Culture and Modernity. Cambridge, U.K.: Polity, 1997. Taylor, Chris. “Burning Man Grows Up.” CNN: Money. 10 Oct. 2014 ‹http://money.cnn.com/magazines/business2/business2_archive/2007/07/01/100117064›. “Ten Principles of Burning Man.” Burningman. 10 Oct. 2014 ‹http://burningman.org/culture/philosophical-center/10-principles/›. Thornton, Sarah. Club Cultures: Music, Media and Subcultural Capital. Hanover, NH: Wesleyan UP, 1996. Virilio, Paul. The Information Bomb. London: Verso, 2000. “What Was Up with the Fighter Jets?” Tribe 7 Sep. 2007. 10 Oct. 2014 ‹http://bm.tribe.net/thread/84f762e0-2160-4e6e-b5af-1e35ce81a1b7›. “2008 Art Theme: American Dream.” Tribe 3 Sep. 2007. 10 Oct. 2014 ‹http://bm.tribe.net/thread/60b9b69c-001a-401f-b69f-25e9bdef95ce›.

Abstract:

Introduction The highly contagious COVID-19 virus has presented particularly difficult public policy challenges. The relatively late emergence of an effective treatments and vaccines, the structural stresses on health care systems, the lockdowns and the economic dislocations, the evident structural inequalities in effected societies, as well as the difficulty of prevention have tested social and political cohesion. Moreover, the intrusive nature of many prophylactic measures have led to individual liberty and human rights concerns. As noted by the Victorian (Australia) Ombudsman Report on the COVID-19 lockdown in Melbourne, we may be tempted, during a crisis, to view human rights as expendable in the pursuit of saving human lives. This thinking can lead to dangerous territory. It is not unlawful to curtail fundamental rights and freedoms when there are compelling reasons for doing so; human rights are inherently and inseparably a consideration of human lives. (5) These difficulties have raised issues about the importance of social or community capital in fighting the pandemic. This article discusses the impacts of social and community capital and other factors on the governmental efforts to combat the spread of infectious disease through the maintenance of social distancing and household ‘bubbles’. It argues that the beneficial effects of social and community capital towards fighting the pandemic, such as mutual respect and empathy, which underpins such public health measures as social distancing, the use of personal protective equipment, and lockdowns in the USA, have been undermined as preventive measures because they have been transmogrified to become a salient aspect of the “culture wars” (Peters). In contrast, states that have relatively lower social capital such a China have been able to more effectively arrest transmission of the disease because the government was been able to generate and personify a nationalist response to the virus and thus generate a more robust social consensus regarding the efforts to combat the disease. Social Capital and Culture Wars The response to COVID-19 required individuals, families, communities, and other types of groups to refrain from extensive interaction – to stay in their bubble. In these situations, especially given the asymptomatic nature of many COVID-19 infections and the serious imposition lockdowns and social distancing and isolation, the temptation for individuals to breach public health rules in high. From the perspective of policymakers, the response to fighting COVID-19 is a collective action problem. In studying collective action problems, scholars have paid much attention on the role of social and community capital (Ostrom and Ahn 17-35). Ostrom and Ahn comment that social capital “provides a synthesizing approach to how cultural, social, and institutional aspects of communities of various sizes jointly affect their capacity of dealing with collective-action problems” (24). Social capital is regarded as an evolving social type of cultural trait (f*ckuyama; Guiso et al.). Adger argues that social capital “captures the nature of social relations” and “provides an explanation for how individuals use their relationships to other actors in societies for their own and for the collective good” (387). The most frequently used definition of social capital is the one proffered by Putnam who regards it as “features of social organization, such as networks, norms and social trust that facilitate coordination and cooperation for mutual benefit” (Putnam, “Bowling Alone” 65). All these studies suggest that social and community capital has at least two elements: “objective associations” and subjective ties among individuals. Objective associations, or social networks, refer to both formal and informal associations that are formed and engaged in on a voluntary basis by individuals and social groups. Subjective ties or norms, on the other hand, primarily stand for trust and reciprocity (Paxton). High levels of social capital have generally been associated with democratic politics and civil societies whose institutional performance benefits from the coordinated actions and civic culture that has been facilitated by high levels of social capital (Putnam, Democracy 167-9). Alternatively, a “good and fair” state and impartial institutions are important factors in generating and preserving high levels of social capital (Offe 42-87). Yet social capital is not limited to democratic civil societies and research is mixed on whether rising social capital manifests itself in a more vigorous civil society that in turn leads to democratising impulses. Castillo argues that various trust levels for institutions that reinforce submission, hierarchy, and cultural conservatism can be high in authoritarian governments, indicating that high levels of social capital do not necessarily lead to democratic civic societies (Castillo et al.). Roßteutscher concludes after a survey of social capita indicators in authoritarian states that social capital has little effect of democratisation and may in fact reinforce authoritarian rule: in nondemocratic contexts, however, it appears to throw a spanner in the works of democratization. Trust increases the stability of nondemocratic leaderships by generating popular support, by suppressing regime threatening forms of protest activity, and by nourishing undemocratic ideals concerning governance (752). In China, there has been ongoing debate concerning the presence of civil society and the level of social capital found across Chinese society. If one defines civil society as an intermediate associational realm between the state and the family, populated by autonomous organisations which are separate from the state that are formed voluntarily by members of society to protect or extend their interests or values, it is arguable that the PRC had a significant civil society or social capital in the first few decades after its establishment (White). However, most scholars agree that nascent civil society as well as a more salient social and community capital has emerged in China’s reform era. This was evident after the 2008 Sichuan earthquake, where the government welcomed community organising and community-driven donation campaigns for a limited period of time, giving the NGO sector and bottom-up social activism a boost, as evidenced in various policy areas such as disaster relief and rural community development (F. Wu 126; Xu 9). Nevertheless, the CCP and the Chinese state have been effective in maintaining significant control over civil society and autonomous groups without attempting to completely eliminate their autonomy or existence. The dramatic economic and social changes that have occurred since the 1978 Opening have unsurprisingly engendered numerous conflicts across the society. In response, the CCP and State have adjusted political economic policies to meet the changing demands of workers, migrants, the unemployed, minorities, farmers, local artisans, entrepreneurs, and the growing middle class. Often the demands arising from these groups have resulted in policy changes, including compensation. In other circ*mstances, where these groups remain dissatisfied, the government will tolerate them (ignore them but allow them to continue in the advocacy), or, when the need arises, supress the disaffected groups (F. Wu 2). At the same time, social organisations and other groups in civil society have often “refrained from open and broad contestation against the regime”, thereby gaining the space and autonomy to achieve the objectives (F. Wu 2). Studies of Chinese social or community capital suggest that a form of modern social capital has gradually emerged as Chinese society has become increasingly modernised and liberalised (despite being non-democratic), and that this social capital has begun to play an important role in shaping social and economic lives at the local level. However, this more modern form of social capital, arising from developmental and social changes, competes with traditional social values and social capital, which stresses parochial and particularistic feelings among known individuals while modern social capital emphasises general trust and reciprocal feelings among both known and unknown individuals. The objective element of these traditional values are those government-sanctioned, formal mass organisations such as Communist Youth and the All-China Federation of Women's Associations, where members are obliged to obey the organisation leadership. The predominant subjective values are parochial and particularistic feelings among individuals who know one another, such as guanxi and zongzu (Chen and Lu, 426). The concept of social capital emphasises that the underlying cooperative values found in individuals and groups within a culture are an important factor in solving collective problems. In contrast, the notion of “culture war” focusses on those values and differences that divide social and cultural groups. Barry defines culture wars as increases in volatility, expansion of polarisation, and conflict between those who are passionate about religiously motivated politics, traditional morality, and anti-intellectualism, and…those who embrace progressive politics, cultural openness, and scientific and modernist orientations. (90) The contemporary culture wars across the world manifest opposition by various groups in society who hold divergent worldviews and ideological positions. Proponents of culture war understand various issues as part of a broader set of religious, political, and moral/normative positions invoked in opposition to “elite”, “liberal”, or “left” ideologies. Within this Manichean universe opposition to such issues as climate change, Black Lives Matter, same sex rights, prison reform, gun control, and immigration becomes framed in binary terms, and infused with a moral sensibility (Chapman 8-10). In many disputes, the culture war often devolves into an epistemological dispute about the efficacy of scientific knowledge and authority, or a dispute between “practical” and theoretical knowledge. In this environment, even facts can become partisan narratives. For these “cultural” disputes are often how electoral prospects (generally right-wing) are advanced; “not through policies or promises of a better life, but by fostering a sense of threat, a fantasy that something profoundly pure … is constantly at risk of extinction” (Malik). This “zero-sum” social and policy environment that makes it difficult to compromise and has serious consequences for social stability or government policy, especially in a liberal democratic society. Of course, from the perspective of cultural materialism such a reductionist approach to culture and political and social values is not unexpected. “Culture” is one of the many arenas in which dominant social groups seek to express and reproduce their interests and preferences. “Culture” from this sense is “material” and is ultimately connected to the distribution of power, wealth, and resources in society. As such, the various policy areas that are understood as part of the “culture wars” are another domain where various dominant and subordinate groups and interests engaged in conflict express their values and goals. Yet it is unexpected that despite the pervasiveness of information available to individuals the pool of information consumed by individuals who view the “culture wars” as a touchstone for political behaviour and a narrative to categorise events and facts is relatively closed. This lack of balance has been magnified by social media algorithms, conspiracy-laced talk radio, and a media ecosystem that frames and discusses issues in a manner that elides into an easily understood “culture war” narrative. From this perspective, the groups (generally right-wing or traditionalist) exist within an information bubble that reinforces political, social, and cultural predilections. American and Chinese Reponses to COVID-19 The COVID-19 pandemic first broke out in Wuhan in December 2019. Initially unprepared and unwilling to accept the seriousness of the infection, the Chinese government regrouped from early mistakes and essentially controlled transmission in about three months. This positive outcome has been messaged as an exposition of the superiority of the Chinese governmental system and society both domestically and internationally; a positive, even heroic performance that evidences the populist credentials of the Chinese political leadership and demonstrates national excellence. The recently published White Paper entitled “Fighting COVID-19: China in Action” also summarises China’s “strategic achievement” in the simple language of numbers: in a month, the rising spread was contained; in two months, the daily case increase fell to single digits; and in three months, a “decisive victory” was secured in Wuhan City and Hubei Province (Xinhua). This clear articulation of the positive results has rallied political support. Indeed, a recent survey shows that 89 percent of citizens are satisfied with the government’s information dissemination during the pandemic (C Wu). As part of the effort, the government extensively promoted the provision of “political goods”, such as law and order, national unity and pride, and shared values. For example, severe publishments were introduced for violence against medical professionals and police, producing and selling counterfeit medications, raising commodity prices, spreading ‘rumours’, and being uncooperative with quarantine measures (Xu). Additionally, as an extension the popular anti-corruption campaign, many local political leaders were disciplined or received criminal charges for inappropriate behaviour, abuse of power, and corruption during the pandemic (People.cn, 2 Feb. 2020). Chinese state media also described fighting the virus as a global “competition”. In this competition a nation’s “material power” as well as “mental strength”, that calls for the highest level of nation unity and patriotism, is put to the test. This discourse recalled the global competition in light of the national mythology related to the formation of Chinese nation, the historical “hardship”, and the “heroic Chinese people” (People.cn, 7 Apr. 2020). Moreover, as the threat of infection receded, it was emphasised that China “won this competition” and the Chinese people have demonstrated the “great spirit of China” to the world: a result built upon the “heroism of the whole Party, Army, and Chinese people from all ethnic groups” (People.cn, 7 Apr. 2020). In contrast to the Chinese approach of emphasising national public goods as a justification for fighting the virus, the U.S. Trump Administration used nationalism, deflection, and “culture war” discourse to undermine health responses — an unprecedented response in American public health policy. The seriousness of the disease as well as the statistical evidence of its course through the American population was disputed. The President and various supporters raged against the COVID-19 “hoax”, social distancing, and lockdowns, disparaged public health institutions and advice, and encouraged protesters to “liberate” locked-down states (Russonello). “Our federal overlords say ‘no singing’ and ‘no shouting’ on Thanksgiving”, Representative Paul Gosar, a Republican of Arizona, wrote as he retweeted a Centers for Disease Control list of Thanksgiving safety tips (Weiner). People were encouraged, by way of the White House and Republican leadership, to ignore health regulations and not to comply with social distancing measures and the wearing of masks (Tracy). This encouragement led to threats against proponents of face masks such as Dr Anthony Fauci, one of the nation’s foremost experts on infectious diseases, who required bodyguards because of the many threats on his life. Fauci’s critics — including President Trump — countered Fauci’s promotion of mask wearing by stating accusingly that he once said mask-wearing was not necessary for ordinary people (Kelly). Conspiracy theories as to the safety of vaccinations also grew across the course of the year. As the 2020 election approached, the Administration ramped up efforts to downplay the serious of the virus by identifying it with “the media” and illegitimate “partisan” efforts to undermine the Trump presidency. It also ramped up its criticism of China as the source of the infection. This political self-centeredness undermined state and federal efforts to slow transmission (Shear et al.). At the same time, Trump chided health officials for moving too slowly on vaccine approvals, repeated charges that high infection rates were due to increased testing, and argued that COVID-19 deaths were exaggerated by medical providers for political and financial reasons. These claims were amplified by various conservative media personalities such as Rush Limbaugh, and Sean Hannity and Laura Ingraham of Fox News. The result of this “COVID-19 Denialism” and the alternative narrative of COVID-19 policy told through the lens of culture war has resulted in the United States having the highest number of COVID-19 cases, and the highest number of COVID-19 deaths. At the same time, the underlying social consensus and social capital that have historically assisted in generating positive public health outcomes has been significantly eroded. According to the Pew Research Center, the share of U.S. adults who say public health officials such as those at the Centers for Disease Control and Prevention are doing an excellent or good job responding to the outbreak decreased from 79% in March to 63% in August, with an especially sharp decrease among Republicans (Pew Research Center 2020). Social Capital and COVID-19 From the perspective of social or community capital, it could be expected that the American response to the Pandemic would be more effective than the Chinese response. Historically, the United States has had high levels of social capital, a highly developed public health system, and strong governmental capacity. In contrast, China has a relatively high level of governmental and public health capacity, but the level of social capital has been lower and there is a significant presence of traditional values which emphasise parochial and particularistic values. Moreover, the antecedent institutions of social capital, such as weak and inefficient formal institutions (Batjargal et al.), environmental turbulence and resource scarcity along with the transactional nature of guanxi (gift-giving and information exchange and relationship dependence) militate against finding a more effective social and community response to the public health emergency. Yet China’s response has been significantly more successful than the Unites States’. Paradoxically, the American response under the Trump Administration and the Chinese response both relied on an externalisation of the both the threat and the justifications for their particular response. In the American case, President Trump, while downplaying the seriousness of the virus, consistently called it the “China virus” in an effort to deflect responsibly as well as a means to avert attention away from the public health impacts. As recently as 3 January 2021, Trump tweeted that the number of “China Virus” cases and deaths in the U.S. were “far exaggerated”, while critically citing the Centers for Disease Control and Prevention's methodology: “When in doubt, call it COVID-19. Fake News!” (Bacon). The Chinese Government, meanwhile, has pursued a more aggressive foreign policy across the South China Sea, on the frontier in the Indian sub-continent, and against states such as Australia who have criticised the initial Chinese response to COVID-19. To this international criticism, the government reiterated its sovereign rights and emphasised its “victimhood” in the face of “anti-China” foreign forces. Chinese state media also highlighted China as “victim” of the coronavirus, but also as a target of Western “political manoeuvres” when investigating the beginning stages of the pandemic. The major difference, however, is that public health policy in the United States was superimposed on other more fundamental political and cultural cleavages, and part of this externalisation process included the assignation of “otherness” and demonisation of internal political opponents or characterising political opponents as bent on destroying the United States. This assignation of “otherness” to various internal groups is a crucial element in the culture wars. While this may have been inevitable given the increasingly frayed nature of American society post-2008, such a characterisation has been activity pushed by local, state, and national leadership in the Republican Party and the Trump Administration (Vogel et al.). In such circ*mstances, minimising health risks and highlighting civil rights concerns due to public health measures, along with assigning blame to the democratic opposition and foreign states such as China, can have a major impact of public health responses. The result has been that social trust beyond the bubble of one’s immediate circle or those who share similar beliefs is seriously compromised — and the collective action problem presented by COVID-19 remains unsolved. Daniel Aldrich’s study of disasters in Japan, India, and US demonstrates that pre-existing high levels of social capital would lead to stronger resilience and better recovery (Aldrich). Social capital helps coordinate resources and facilitate the reconstruction collectively and therefore would lead to better recovery (Alesch et al.). Yet there has not been much research on how the pool of social capital first came about and how a disaster may affect the creation and store of social capital. Rebecca Solnit has examined five major disasters and describes that after these events, survivors would reach out and work together to confront the challenges they face, therefore increasing the social capital in the community (Solnit). However, there are studies that have concluded that major disasters can damage the social fabric in local communities (Peaco*ck et al.). The COVID-19 epidemic does not have the intensity and suddenness of other disasters but has had significant knock-on effects in increasing or decreasing social capital, depending on the institutional and social responses to the pandemic. In China, it appears that the positive social capital effects have been partially subsumed into a more generalised patriotic or nationalist affirmation of the government’s policy response. Unlike civil society responses to earlier crises, such as the 2008 Sichuan earthquake, there is less evidence of widespread community organisation and response to combat the epidemic at its initial stages. This suggests better institutional responses to the crisis by the government, but also a high degree of porosity between civil society and a national “imagined community” represented by the national state. The result has been an increased legitimacy for the Chinese government. Alternatively, in the United States the transformation of COVID-19 public health policy into a culture war issue has seriously impeded efforts to combat the epidemic in the short term by undermining the social consensus and social capital necessary to fight such a pandemic. Trust in American institutions is historically low, and President Trump’s untrue contention that President Biden’s election was due to “fraud” has further undermined the legitimacy of the American government, as evidenced by the attacks directed at Congress in the U.S. capital on 6 January 2021. As such, the lingering effects the pandemic will have on social, economic, and political institutions will likely reinforce the deep cultural and political cleavages and weaken interpersonal networks in American society. Conclusion The COVID-19 pandemic has devastated global public health and impacted deeply on the world economy. Unsurprisingly, given the serious economic, social, and political consequences, different government responses have been highly politicised. Various quarantine and infection case tracking methods have caused concern over state power intruding into private spheres. The usage of face masks, social distancing rules, and intra-state travel restrictions have aroused passionate debate over public health restrictions, individual liberty, and human rights. Yet underlying public health responses grounded in higher levels of social capital enhance the effectiveness of public health measures. In China, a country that has generally been associated with lower social capital, it is likely that the relatively strong policy response to COVID-19 will both enhance feelings of nationalism and Chinese exceptionalism and help create and increase the store of social capital. In the United States, the attribution of COVID-19 public health policy as part of the culture wars will continue to impede efforts to control the pandemic while further damaging the store of American community social capital that has assisted public health efforts over the past decades. References Adger, W. Neil. “Social Capital, Collective Action, and Adaptation to Climate Change.” Economic Geography 79.4 (2003): 387-404. Bacon, John. “Coronavirus Updates: Donald Trump Says US 'China Virus' Data Exaggerated; Dr. Anthony Fauci Protests, Draws President's Wrath.” USA Today 3 Jan. 2021. 4 Jan. 2021 <https://www.usatoday.com/story/news/health/2021/01/03/COVID-19-update-larry-king-ill-4-million-december-vaccinations-us/4114363001/>. Berry, Kate A. “Beyond the American Culture Wars.” Regions & Cohesion / Regiones y Cohesión / Régions et Cohésion 7.2 (Summer 2017): 90-95. Castillo, Juan C., Daniel Miranda, and Pablo Torres. “Authoritarianism, Social Dominance and Trust in Public Institutions.” Annual Scientific Meeting of the International Society of Political Psychology, Istanbul, 9-12 July 2011. 2 Jan. 2021 <https://pdfs.semanticscholar.org/>. Chapman, Roger. “Introduction, Culture Wars: Rhetoric and Reality.” Culture Wars: An Encyclopedia of Issues, Viewpoints, and Voices. Eds. Roger Chapman and M.E. Sharpe. 2010. 8-10. Chen, Jie, and Chunlong Lu. “Social Capital in Urban China: Attitudinal and Behavioral Effects on Grassroots Self-Government.” Social Science Quarterly 88.2 (June 2007): 422-442. China's State Council Information Office. “Fighting COVID-19: China in Action.” Xinhuanet 7 June 2020. 2 Sep. 2020 <http://www.xinhuanet.com/english/2020-06/07/c_139120424.htm?bsh_bid=551709954>. f*ckuyama, Francis. Trust: The Social Virtues and the Creation of Prosperity. Hamish Hamilton, 1995. Kelly, Mike. “Welcome to the COVID-19 Culture Wars. Why Are We Fighting about Masks?’ Yahoo News 4 Dec. 2020 <https://www.msn.com/en-us/news/us/welcome-to-the-COVID-19-culture-wars-why-are-we-fighting-about-masks-mike-kelly/ar-BB1bCOHN>. Luigi Guiso, Paola Sapienza, and Luigi Zingales, “Social Capital as Good Culture.” National Bureau of Economic Research Working Paper No. 13712. 2007. 18 ct. 2017 <http://www.nber.org/papers/w13712.pdf>. Malik, Nesrine. “The Right's Culture War Is No Longer a Sideshow to Our Politics – It Is Our Politics.” The Guardian 31 Aug. 2020. 6 Jan. 2021 <https://www.theguardian.com/commentisfree/2020/aug/31/the-rights-culture-war-politics-rightwing-fantasy-elections>. Offe, Carl. “How Can We Trust Our Fellow Citizens?” Democracy and Trust. Ed. M.E. Warren. Cambridge University Press, 1999. 42-87. Ostrom, Elinor, and T.K. Ahn. “The Meaning of Social Capital and Its Link to Collective Action.” Handbook of Social Capital: The Troika of Sociology, Political Science and Economics. Eds. Gert Tinggaard Svendsen and Gunnar Lind Haase Svendsen. Edward Elgar, 2009. 17–35. Paxton, Pamela. “Is Social Capital Declining in the United States? A Multiple Indicator Assessment.” American Journal of Sociology 105.1 (1999): 88-127. People.cn. “Hubeisheng Huanggangshi chufen dangyuan ganbu 337 ren.” [“337 Party Cadres Were Disciplined in Huanggang, Hubei Province.”] 2 Feb. 2020. 10 Sep. 2020 <http://fanfu.people.com.cn/n1/2020/0130/c64371-31565382.html>. ———. “Zai yiqing fangkong douzheng zhong zhangxian weida zhongguo jingshen.” [“Demonstrating the Great Spirit of China in Fighting the Pandemic.”] 7 Apr. 2020. 9 Sep. 2020 <http://opinion.people.com.cn/n1/2020/0407/c1003-31663076.html>. Peters, Jeremy W. “How Abortion, Guns and Church Closings Made Coronavirus a Culture War.” New York Times 20 Apr. 2020. 6 Jan. 2021 <http://www.nytimes.com/2020/04/20/us/politics/coronavirus-protests-democrats-republicans.html>. Pew Research Center. “Americans Give the U.S. Low Marks for Its Handling of COVID-19, and So Do People in Other Countries.” 21 Sep. 2020. 15 Jan. 2021 <https://www.pewresearch.org/fact-tank/2020/09/21/americans-give-the-u-s-low-marks-for-its-handling-of-covid-19-and-so-do-people-in-other-countries/>. Putnam, Robert D. “Bowling Alone: America’s Declining Social Capital.” Journal of Democracy 6.1 (1995): 65-78. ———. Making Democracy Work: Civic Traditions in Modern Italy. Princeton University Press, 1993. Roßteutscher, Sigrid. “Social Capital Worldwide: Potential for Democratization or Stabilizer of Authoritarian Rule?” American Behavioural Scientist 53.5 (2010): 737–757. Russonello, G. “What’s Driving the Right-Wing Protesters Fighting the Quarantine?” New York Times 17 Apr. 2020. 2 Jan. 2021 <http://www.nytimes.com/2020/04/17/us/politics/poll-watch-quarantine-protesters.html>. Shear, Michael D., Maggie Haberman, Noah Weiland, Sharon LaFraniere, and Mark Mazzetti. “Trump’s Focus as the Pandemic Raged: What Would It Mean for Him?” New York Times 31 Dec. 2020. 2 Jan. 2021 <https://www.nytimes.com/2020/12/31/us/politics/trump-coronavirus.html>. Tracy, Marc. “Anti-Lockdown Protesters Get in Reporters’ (Masked) Faces.” New York Times 13 May 2020. 5 Jan. 2021 <https://www.nytimes.com/2020/05/13/business/media/lockdown-protests-reporters.html>. Victoria Ombudsman. “Investigation into the Detention and Treatment of Public Housing Residents Arising from a COVID-19 ‘Hard Lockdown’ in July 2020.” Dec. 2020. 8 Jan. 2021 <https://assets.ombudsman.vic.gov.au/>. Vogel, Kenneth P., Jim Rutenberg, and Lisa Lerer. “The Quiet Hand of Conservative Groups in the Anti-Lockdown Protests.” New York Times 21 Apr. 2020. 2 Jan. 2021 <http://www.nytimes.com/2020/04/21/us/politics/coronavirus-protests-trump.html>. Weiner, Jennifer. “Fake ‘War on Christmas’ and the Real Battle against COVID-19.” New York Times 7 Dec. 2020. 6 Jan. 2021 <https://www.nytimes.com/2020/12/07/opinion/christmas-religion-COVID-19.html>. White, Gordon. “Civil Society, Democratization and Development: Clearing the Analytical Ground.” Civil Society in Democratization. Eds. Peter Burnell and Peter Calvert. Taylor & Francis, 2004. 375-390. Wu, Cary. “How Chinese Citizens View Their Government’s Coronavirus Response.” The Conversation 5 June 2020. 2 Sep. 2020 <https://theconversation.com/how-chinese-citizens-view-their-governments-coronavirus-response-139176>. Wu, Fengshi. “An Emerging Group Name ‘Gongyi’: Ideational Collectivity in China's Civil Society.” China Review 17.2 (2017): 123-150. ———. “Evolving State-Society Relations in China: Introduction.” China Review 17.2 (2017): 1-6. Xu, Bin. “Consensus Crisis and Civil Society: The Sichuan Earthquake Response and State-Society Relations.” The China Journal 71 (2014): 91-108. Xu, Juan. “Wei yiqing fangkong zhulao fazhi diba.” [“Build a Strong Legal ‘Dam’ for Disease Control.”] People.cn 24 Feb. 2020. 10 Sep. 2020 <http://opinion.people.com.cn/n1/2020/0224/c1003-31600409.html>.