Family Visits Research Articles

Understanding the experiences of people with dementia and their family carers participating in healthcare student dementia education: A mixed-methods evaluation from the time for dementia programme.

There is increasing awareness of the potential for positive impacts on student learning from involving people with dementia and family carers within undergraduate teaching. However, research on the experience of people with dementia and their family carers is sparse. This study aimed to evaluate the satisfaction and views of families (people with dementia and their family carers) who volunteered in Time for Dementia (TFD); an educational programme where undergraduate healthcare students visit families at home over a 2-year period. Families taking part in TFD completed a satisfaction survey after taking part in the programme (n = 803). Frequencies of satisfaction survey items were summarised and multiple linear regression models for factors associated with total satisfaction scores were produced. Open text responses were analysed using thematic framework analysis as to the most favourable aspects of the programme and areas requiring improvement. Overall satisfaction was high for taking part in TFD, with a perception of contribution, and being of value. There was strong evidence that families enjoyed the experience and would recommend participation to others. Higher numbers of student visits were significantly associated with greater satisfaction. Families identified aspects of the programme that benefited them, with social interaction rating highly. Improvements suggested by the families included increased visit structure and organisational improvements. This study has sought to evaluate at scale the satisfaction of families taking part in a dementia education programme. It is positive that families report high satisfaction in the programme and identify perceived value for themselves as well as students, suggesting reciprocal benefits. This study contributes to the broader understanding of what Experts by Experience value when taking part in educational interventions.

Nurses' assessment of health literacy requirements for adult inpatients: An integrative review.

This paper reviews current research which examines nurses' assessment of patient's health literacy in the acute hospital setting. Research highlights, that patients with low health literacy have more frequent hospitalisations and are more likely to be re-admitted. Within the healthcare team, nurses are primarily responsible for teaching patients and deciphering health communication, to enhance understanding. Within the acute care setting, there remains a disparity in patient understanding of information, despite nurse-led education. The health literacy assessment and tailoring of information by nurses, is becoming more important with shorter stays, plus limited family visits and the wearing of masks with COVID-19 related changes. An integrative review across four nursing databases, from 2010 and June 2022 was conducted. The integrative framework included problem identification, literature search, data evaluation, data analysis with thematic analysis, and results presentation. Nine studies were included. Common themes were nurses' overestimation of patients' health literacy, the use of universal precautions, and adapting communication techniques to improve education moments. The findings of this review indicate a tendency among nurses to overestimate their patients' health literacy levels, which can result in ineffective health education and inadequate discharge planning. Nurses decipher health communication for their patients. Designing tailored patient communication and education could potentially be a cost saving measure for hospitals by reducing length of stay and reducing readmissions. Health literacy training should be incorporated into nursing practice.

The First Woman in Kefar Ḥasidim: Ḥannah Golda Hopstein’s Memoir

This paper presents an unusual Hasidic figure and sketches her compelling biography in broad outlines. Ḥannah Golda Hopstein (1886–1939), was a unique Hasidic woman, a Zionist pioneer and had a fascinating life story which ended in tragedy. She left Poland in 1924 for Mandatory Palestine, where she was one of the founders of the Hasidic-agricultural settlement Kefar Ḥasidim. She later returned to Europe to visit family and was killed by a German bomb during the invasion of Poland in September 1939. Hopstein’s fourteen-page, Hebrew handwritten diary lies lost in the archives of Kefar Hasidism, Israel. It is entirely translated and published here for the first time with a biographical introduction. This short memoir can be a base for future extensive research, since it teaches us much about several key issues, such as the role of women in Hasidism, Hasidic attitudes towards Zionism, and female leadership among Hasidim.

Impact of COVID-19 on Visitation Policies and Family Dynamics in Long-Term Care Facilities in Taiwan

Impact of COVID-19 on Visitation Policies and Family Dynamics in Long-Term Care Facilities in Taiwan

Psychological distress of inmates at a women's prison in Lima after the first wave of COVID-19 in November 2020.

A descriptive study was carried out to establish the levels of psychological distress amongst female inmates at a high-security prison in Lima in November 2020, after the first wave of COVID-19. The Brief Symptoms Inventory-18 (BSI-18) was applied to a representative sample of 314 female inmates who agreed to participate in the study. Results showed that 34.6% of the inmates could be considered as cases of psychological distress. Moreover, the depression subscale had the highest score, followed by the anxiety and the somatisation subscales. The most prevalent symptom was "feeling blue". The prevalence of distress symptoms was analyzed, taking into account the effects of the first wave of COVID-19, the suspension of family visits, the restriction of treatment and leisure activities, etc. Gender aspects were also taken into consideration.

Responses to Hospital Restrictions on Family Visits during the COVID-19 Epidemic in Mali and France

ABSTRACT Few studies have focused on the presence of families in the hospital in the context of an epidemic. The present study aims to contribute to filling this gap by answering the following question: How did professionals, patients and their families cope with more or less drastic restrictions to family visits and presence during the COVID-19 pandemic in a French and a Malian hospital during the COVID-19 pandemic? Data were collected during the first two waves of the pandemic through 111 semi-structured interviews (France = 55, Mali = 56). Most of the interviews were conducted with staff (n = 103), but also with families in the case of Mali (n = 8). The investigators also conducted 150 days of field observations, 44 in France and 106 in Mali. Thematic analysis was applied using an inductive approach. Interviews were content analyzed to identify passages in the interviews that were relevant to these different themes. The study highlighted the difficulty for the medical-clinical system to provide appropriate responses to the many emotional needs of patients in a pandemic context. Families in France benefited from a support service to reduce stress, while in Mali, no initiative was taken in this sense. In both countries, families often used the telephone as an alternative means of communicating with relatives. The results showed that in the two contexts, the presence and involvement of the families contributed to a better response to the patients’ psycho-affective demands and thus promoted resilience in this field.

"I Ran to Make a Point": Predicting and Preventing Youth Runaway from Foster Care.

Youth who run away from foster care experience danger to health and safety and increased risk of adverse child welfare outcomes. By applying a concurrent mixed-methods approach, this study aimed to develop a deeper understanding of runaway risk that used a person-centered lens and amplified youth voices. Collectively, this approach can inform service innovations to support youth placed in out-of-home care. Working with a foster care agency in Kansas, data sources comprised administrative data for youth ages 12 + in care, and interview data with 20 youth, 12 + in care. Quantitative analyses involved latent class analysis followed by multinomial logistic regression to investigate whether the population of youth in care was comprised of subpopulations with differential runaway risk and whether subpopulations would predict runaway behaviors. Qualitative analyses applied modified analytic inductive thematic analysis to explore critical life experiences that may act as risk or protective factors of running away from care. Results revealed four sub-populations which were characterized by their previous family and system experiences. Additionally, class membership, gender, number of siblings, and age were statistically significant predictors of runway behaviors. Youth interviews revealed five key themes on life experiences that mitigate or exacerbate youths' runaway behaviors. Recommendations resulting from this study were provided in three key areas: (1) improving family visitation and maintaining youth connections with self-identified family and non-relative kin; (2) supporting service approaches for youth that honor and amplify their voices, choices, and family connections; and (3) improving placement quality and individualization of services.

Construction of a Form for Users of the Child Welfare System Based on the Delphi Method.

Professionals in charge of designing individualized plans for children and adolescents in the child welfare system often lack the necessary information, either because it has not been systematically collected or because there are doubts about the reliability of the data obtained. The lack of consensual and validated instruments that gather the necessary information has led to the development of a rigorous and effective form, based on the Delphi methodology, aimed at obtaining an exhaustive knowledge of the characteristics of children and adolescents under the child welfare system. Once a consensus of different specialists approved the hetero-informed form, it was completed by 41 professionals working in residential care facilities for 307 children and adolescents. It consists of 66 items grouped into six dimensions: general information, school/work situation, child welfare system history, family visitation history, biological family information, and experiences of sexual abuse. During its construction and validation, a panel of experts analyzed its format and content during the different phases. Most of the items showed good performance, and professionals highlighted their ease of use and relevance. The method used ensured the content validity of this form. This instrument has proven to be a useful and effective tool for collecting sociodemographic information on children and adolescents in the child welfare system, which may improve their conditions.

Efficacy of COVID-19 control measures on post-vaccination outbreak in Italian Long Term Care Facilities: implications for policies.

Numerous individual and organizational factors can influence the spread of SARS-CoV-2 infection in Long Term Care Facilities (LTCFs). A range of outbreak control measures are still implemented in most facilities involving administrations, staff, residents and their families. This study aims to evaluate which measure could influence the transmission of SARS-CoV-2 infection among residents during the period March 2021-June 2022. We enrolled 3,272 residents aged ≥60 years. The outbreak control measures adopted to prevent or manage the infection included entry regulations, contact-regulating procedures, and virological surveillance of residents and staff. The association between LTCFs' and participants' characteristics with new cases of COVID-19 infections was analyzed using multilevel logistic regression models. In 33.8% of the facilities 261 cases of SARS-CoV-2 infection were reported. Among participant characteristics, gender and age were not associated with SARS-CoV-2 infection, while having received the vaccine booster dose was protective against infection [Odds Ratio (OR) = 0.34, 95% Confidence Interval (CI) 0.12-0.99, p = 0.048]. In addition, the implementation of protected areas for family visits was associated with a significant reduction of the probability of infections (OR = 0.18, 95% CI 0.03-0.98, p = 0.047). Overall, about 66% of the variability in the probability of SARS-CoV-2 infection during the observational period may be due to facility structure characteristics and 34% to the participant characteristics. These data showed that vaccination booster doses and family visit restriction-control are still needed to make the LTCFs safer against SARS-CoV-2 infection.

The Effectiveness of Implementing Family-Centered Rounds in the PICU on Parental Satisfaction

Family-Centered Care (FCC) is needed in nursing care for children with critical illnesses in the PICU, but the implementation of FCC has yet to be effective. This is due to family visit restrictions, direct care involvement, and decision-making. Family- Centered Rounds (FCR) are a multidisciplinary professional approach to decision-making by facilitating family involvement in medical decision-making. This study aims to analyze the effectiveness of implementing FCR in the PICU on patients' parents' satisfaction. This study used a quantitative experimental design in which Randomized Controlled Trial (RCT) design with a post-test-only control group was used. Sixty-four parents of patients in the PICU unit at RSCM were recruited by consecutive sampling and randomly assigned to two treatments (room standard intervention for the control group and FCR for the intervention group). Treatment in both groups was carried out for two days then the satisfaction level of parent respondents was measured using the Pediatric Family Satisfaction in intensive care Unit 24 (pFS-ICU 24). Bivariate analysis used an independent t-test to analyze differences in family satisfaction scores in both groups. Statistically, there was a significant difference in the mean score of patient family satisfaction between groups with FCR and no FCR with p=0.001 (p<0.05). It was concluded that FCR was effectively carried out, which impacted increasing the satisfaction of the patient's parents. FCR is very effectively implemented in the PICU unit as a development of the application of the FCC concept, which can benefit the patient's family.

Impact of the COVID‐19 pandemic on moral distress of care home staff caring for people with dementia

AbstractBackgroundHealthcare providers caring for people living with dementia may experience moral distress when faced with an ethically challenging situation, such as an inability to provide care that is consistent with their values. The COVID‐19 pandemic both created new and exacerbated pre‐existing factors which contributed to the experience of moral distress amongst healthcare providers in LTCHs.MethodWe conducted an online survey to examine changes in mortal distress during the first wave of the pandemic, its contributing factors and correlates, and its impact on the well‐being of LTCH staff. A total of 227 health care providers from LTCHs across Ontario, Canada completed the online survey. Using a Bayesian approach, we examined the associations between moral distress and staff demographics and roles, and characteristics of the LTCH in which they worked.ResultMore than 80% of LTCH healthcare providers working with people with dementia reported an increase in moral distress since the start of the pandemic. They frequently experienced physical and emotional symptoms related to moral distress more than once a week, with the most common symptoms being physical exhaustion (55%) powerlessness (39%), sadness/anxiety (38%) frustration/anger (31%), and difficulty sleeping (33%). There was no difference in the severity of distress by age, sex, role, or years of experience. The most common situations associated with moral distress were lack of activities and family visits, insufficient staffing and high turnover, and having to follow policies and procedures that were perceived to harm residents with dementia. Respondents working in not‐for‐profit or municipal homes reported less sadness/anxiety and feelings of not wanting to go to work than those in for‐profit homes. Front‐line staff were more likely to report not wanting to work than those in management or administrative positions. In the survey’s free‐text responses, respondents elaborated on the emotional impact of the change in care delivery for LTCH residents.ConclusionMoral distress increased during the pandemic, negatively affecting the well‐being of healthcare providers in LTCHs, with preliminary evidence suggesting that individual and systemic factors may intensify this negative effect.

Using telehealth to conduct serious illness conversations (SIC) for patients with metastatic lung cancer during the COVID-19 pandemic.

e13687 Background: Engaging patients with advanced cancer in discussions about values and preferences in serious illness allows clinicians to deliver care that is consistent with their patients’ wishes and improves end-of-life outcomes. The COVID-19 pandemic necessitated serious illness conversations to occur via telehealth, yet little is known about how telehealth influences these conversations between patients and their oncology clinicians. Methods: We conducted a retrospective analysis of patients with metastatic lung cancer at a single academic center who had telehealth visits with their oncology clinicians. All outpatient and inpatient clinician notes for these patients were obtained from the electronic medical record during the first surge of COVID-19 in Massachusetts (03/10/2020 - 06/10/2020). Natural Language Processing (NLP) text identification software was used to conduct a semi-automated chart review and to identify documentation of discussion about five SIC domains (goals of care [GOC], limitation of life-sustaining treatment [LLST], prognostic awareness [PA], palliative care [PC] and hospice) and characterize the context of these conversations. We used unadjusted linear regression models to examine the relationship of SIC with (1) type of clinician (MD versus APP) (2) visit type (phone vs video), (3) cancer status, and (4) family involvement during the telehealth visit. Results: The study included 361 unique patients with 634 telehealth notes from 17 oncology clinicians. Most patients had non-small cell lung cancer (92%), and most telehealth notes were completed by physicians (88%). We identified 126 (34%) patients with documentation of discussion of at least one SIC domain. Of the 634 telehealth notes reviewed, 110 (17%) notes had documentation of one SIC domain while 78 notes (12%) documented two or more SIC domains. The most common SIC domain addressed was GOC (21%), followed by PA (16%). The domains of hospice (6%), PC (5%), and LLST (3%) were infrequently discussed. We found no association between clinician or visit type and SIC during telehealth visits. The presence of family at the visit (B=0.179, p=0.002) and progressive or newly diagnosed disease (B=0.58, p<0.001) were associated with an increased number SIC domains addressed during telehealth visits. Conclusions: During the COVID-19 pandemic, oncology clinicians used telehealth to conduct SIC in patients with advanced cancer, but this study demonstrated considerable heterogeneity in the content of these conversations. The presence of family at the visit and progressive or newly diagnosed disease were associated with an increased number SIC domains addressed during telehealth visits. Future efforts should focus on how to optimize telehealth tools to conduct these important conversations between patients and their oncology clinicians.

Open visitation in the NICU: nurses’ perspectives on barriers and facilitators†

Abstract Objective This study aimed to investigate the nurses’ perspectives on open family visitation and its barriers and facilitators in neonatal intensive care units (NICUs). Methods This is a descriptive, cross-sectional study. A total of 113 nurses employed in 3 main NICUs of Tabriz participated in the study through the census sampling method. Nurses’ perspectives on open visitation and its facilitators and barriers were assessed and analyzed using the Beliefs and Attitudes toward Visitation in NICU Questionnaire (BAVNIQ) and descriptive and analytical statistics, respectively. Results Approximately 74% of the nurses who participating in the study had a moderate perspective on open visitation. From the nurses’ viewpoint, “Parents’ low awareness of sensitivity and hygienic principles of the NICU” was the first (90.3%) barrier, and the 2 factors, namely, “physical structure of the ward/lack of sufficient space” and “far distance between family’s residence and the hospital/having another child,” were the second (86.8%) barrier with an equal percentage. Among the facilitating factors, “Supporting employed parents during the neonate’s hospitalization” and “providing facilities for family accommodation in the hospital” were the first (82.3%) and the second (79.6%) facilitators, respectively, for open visitation. Conclusions The majority of NICU nurses had a moderate perspective on the family open visitation. This reluctance seems to be originated mainly from the factors inhibiting open visitation, making its implementation challenging for nurses. The perspective of the frontline staff in caring for vulnerable infants on facilitators and barriers to open visitation may help policymakers, managers, and relevant officials in decision-making and implementing new visiting policies in the NICUs.

Children Are Not Miniature Adults: Child-Friendly Healthcare in Practice

Although, as eloquently stated by Swiss developmental psychologist Jean Piaget, "Children are not miniature adults" (Piaget, 2001), it remains common in pediatric clinical nursing practice to encounter viewpoints such as "Be patient and it will pass!" and "Is it really that bad?" as well as insensitive comments such as "Cry again, and I'll…" Dealing with children and their families during invasive treatments is a daily challenge as well as source of fulfillment for pediatric nurses. The concept of child-friendly care centers on providing support and care that addresses the needs of both the child and family to help them adapt to various situations within the healthcare environment (Lookabaugh & Ballard, 2018). Child-friendly healthcare must be grounded in the recognition of children's rights, which includes the right to health and the right to healthcare (Lenton & Ehrich, 2015). Strategies, policies, and environmental transformations are necessary to translate this concept into practice. One related strategy commonly used in pediatric nursing practice is therapeutic play, which encompasses instructional, cathartic, and physical health promotion categories (Hockenberry et al., 2023). By engaging in therapeutic play, hospitalized children can better comprehend the tests or treatments they are about to undergo, alleviate their fear and pain, and develop healthier behaviors. It is also crucial to approach long-debated issues such as whether children and adolescents should visit family members in intensive care units from a child-friendly perspective. German scholars Brauchle et al. (2023) proposed recommendations for child-friendly visitation policies that consider the prerequisites and responsibilities of medical staff, parents, and children. In recent years, Taiwan has made great strides in integrating child life specialists and art and music therapists into hospital medical teams. This inclusion is helping families better adapt to the medical environment and better cope with medical and treatment situations, fostering more-positive medical and nursing experiences (Fang et al., 2020). Furthermore, reconstructing the medical environment for children; designing safe and healing spaces (Chang, 2021); and providing overall-friendly physical, psychological, social, and spiritual care to children and their families are essential. Each of the three topics in this column reflect the relationships between pediatric emergency nurses and, respectively, patients, and the healing functions of music therapy and art therapy, and provide important insights into the world of children through the lens of child-friendly care.

When Interdependence Backfires: The Coronavirus Infected Three Times More People in Rice-Farming Areas During Chinese New Year.

Interdependent cultures around the world have generally controlled COVID-19 better. We tested this pattern in China based on the rice theory, which argues that historically rice-farming regions of China are more interdependent than wheat-farming areas. Unlike earlier findings, rice-farming areas suffered more COVID-19 cases in the early days of the outbreak. We suspected this happened because the outbreak fell on Chinese New Year, and people in rice areas felt more pressure to visit family and friends. We found historical evidence that people in rice areas visit more family and friends for Chinese New Year than people in wheat areas. In 2020, rice areas also saw more New Year travel. Regional differences in social visits were correlated with COVID-19 spread. These results reveal an exception to the general idea that interdependent culture helps cultures contain COVID-19. When relational duties conflict with public health, interdependence can lead to more spread of disease.

Towards systematic measurement of travel problems: A pilot study in the greater Tel Aviv area

There is rich evidence of the various problems people may experience in accessing destinations due to a poorly functioning transport system. Since providing access to destinations is a key purpose of transport systems, it should be important to systematically measure to what extent people experience travel problems. Yet, while some travel problems, such as travel time delays, are measured regularly, data collection on other problems is patchy at best. Against this backdrop, this paper presents a survey instrument to systematically determine the prevalence and severity of a broad range of travel problems among a population. The survey distinguishes between three problem types: difficulties related to actual trip-making (e.g., high travel costs), reliance on others for trip-making (e.g., being dropped off for lack of another option), and forgoing trips (e.g., forgoing a family visit for lack of suitable transport). The instrument is tested in a large-scale survey (n = 1430 valid responses) in four areas in the Tel Aviv region. Confirmatory factor analysis largely corroborates the importance of distinguishing between the three types of travel problems. The resulting latent constructions are then used for cluster analysis. Results show that travel problems are concentrated among a small portion of the population (6% of respondents), who regularly relied on others for trip making and frequently forwent trips. Further analysis showed this group to have low car ownership, below-average income, and a low educational level. The paper ends with suggestions for further improvement of the developed questionnaire and its relevance for transport planning and policy.

Prevalence and factors associated with sexual and reproductive health services use among reproductive age women with disabilities: a community based cross-sectional study

BackgroundAccording to International Convention on the Right of Person with Disabilities (CRPD), all nations should discern Sexual and Reproductive Health (SRH) as human rights and needs of all people living with disabilities. Women and girls with disabilities are highly vulnerable to SRH disparities including unintended pregnancy, acquiring sexual transmitted infections and unsafe abortion. Little has known about SRH service uptake and influencing factors among reproductive aged women living with disabilities.MethodsA community-based cross-sectional study was conducted from January 1–30, 2021, the central Gondar zone selected districts. A total of 535 reproductive-age (18–49 years) women with disabilities had been interviewed through face-to-face using structured questionnaire. Multistage cluster sampling method was applied. A binary logistic regression model was computed to look the relationship between independent variables and uptake of SRH, and p-value < 0.05 was a cut-off point to declare statistical significance.ResultsA total of 33.27% (178/535) women with disabilities used at least one SRH service in the last twelve months preceding the survey. Those who had three or more children [AOR = 4.85; 95% CI (1.24–9.71)], autonomy to visit health care facilities [AOR = 3.30; 95% CI (1.45–6.92)], lived with sexual partner [AOR = 9.2; 95% CI (2.84–13.60)], subjected to radio/television in daily bases [AOR = 5.9; 95% CI (1.26–13.04)], autonomy to visit friends and relatives [AOR = 3.95; 95% CI (1.28–12.17)], had a discussion with family members about sexual and reproductive health [AOR = 9.36; 95% CI (3.44–17.47)], and engaged in sexual activity after the age of 18 years [AOR = 7.2; 95% CI (2.51–14.45)] were important predictors for service uptake.ConclusionsOnly one in three reproductive age women with disabilities used at least one SRH service. These findings suggest that accessing information through mainstream media exposure, having full autonomous to visit friends and families, open discussion with family members, live with sexual partner, having optimal family size and starting sexual act at the recommended age improve the uptake of SRH services. Therefore, the stakeholders (both governmental and non-governmental) need to make efforts to increase the uptake of SRH services.

Understanding Why Many People Experiencing Homelessness Reported Migrating to a Small Canadian City: Machine Learning Approach With Augmented Data

Over the past years, homelessness has become a substantial issue around the globe. The largest social services organization in Thunder Bay, Ontario, Canada, has observed that a majority of the people experiencing homelessness in the city were from outside of the city or province. Thus, to improve programming and resource allocation for people experiencing homelessness in the city, including shelter use, it was important to investigate the trends associated with homelessness and migration. This study aimed to address 3 research questions related to homelessness and migration in Thunder Bay: What factors predict whether a person who migrated to the city and is experiencing homelessness stays or leaves shelters? If an individual stays, how long are they likely to stay? What factors predict stay duration? We collected the required data from 2 sources: a survey conducted with people experiencing homelessness at 3 homeless shelters in Thunder Bay and the database of a homeless information management system. The records of 110 migrants were used for the analysis. Two feature selection techniques were used to address the first and third research questions, and 8 machine learning models were used to address the second research question. In addition, data augmentation was performed to improve the size of the data set and to resolve the class imbalance problem. The area under the receiver operating characteristic curve value and cross-validation accuracy were used to measure the models' performances while avoiding possible model overfitting. Factors predicting an individual's stay duration included home or previous district, highest educational qualification, recent receipt of mental health support, migrating to visit family or friends, and finding employment upon arrival. For research question 2, among the classification models developed for predicting the stay duration of migrants, the random forest and gradient boosting tree models presented better results with area under the receiver operating characteristic curve values of 0.91 and 0.93, respectively. Finally, home district, band membership, status card, previous district, and recent support for drug and/or alcohol use were recognized as the factors predicting stay duration. Applying machine learning enables researchers to make predictions related to migrants' homelessness and investigate how various factors become determinants of the predictions. We hope that the findings of this study will aid future policy making and resource allocation to better serve people experiencing homelessness. However, further improvements in the data set size and interpretation of the identified factors in decision-making are required.

AWWA Water Science Author Spotlight

Having recently published an article in AWWA Water Science, Victoria Nystrom answered questions from the publication's editor-in-chief, Kenneth L. Mercer, about the research. Seasonal Impacts on Biofiltration Acclimation Dynamics and Performance Victoria E. Nystrom, Ashley N. Evans, Jason T. Carter, and Ben Kuhnel Victoria Nystrom collects water samples from a biofilter as part of an ozone and biofilter pilot study that was conducted for the US Army Corps of Engineers in Washington, D.C. Victoria and Arcadis coworker Nissim Gore-Datar explore the parks and downtown Austin, Texas. I am thankful to have had many mentors in my life between undergraduate school, graduate school, and my current company, Arcadis. One mentor who stands out is Dr. Kelsey Pieper. I got connected with her when I began undergraduate research in the Department of Biological Systems Engineering at Virginia Tech. Through the years, I worked under her and then alongside her. She transitioned from being my superior in the field; to getting me connected with my advisor and being a member on my advisory committee; and to being a friend, colleague, and continuous mentor. Without her support, technical expertise, and humor, I would not be where I am in my career today. At the time this study was conducted, there were two broad objectives of the research: (1) understand the importance of monitoring biofilter acclimation and (2) fill the larger knowledge gap in the industry around the use of biofiltration and the benefits and challenges associated with this type of treatment. There was a unique opportunity with the City of Denton [Texas] to monitor the acclimation of biofilters and understand the duration of this process as their approach was to bring half the biofilters on line in the winter and the remaining half on line in the summer. With this research and other studies that have been completed to date, we've been able to recognize the influence of seasonal changes on biofilter performance for removal of water quality parameters of interest such as total organic carbon and manganese. As many utilities consider the use of biofiltration, we need to understand how to optimize this treatment during the acclimation phase to ensure regulatory compliance and also to meet internal targets set by utilities. Scuba diving with her sister in the south Pacific Ocean. Victoria (far right) and ski friends at the top of a mountain in Wyoming. The findings of this research highlight the use of a sustainable water treatment solution that can help address an array of contaminants but could also act as a buffer for other emerging contaminants in the future. As we learn more about the health effects of various contaminants, drinking water regulations becoming stricter (e.g., California proposed revisions to notification and response levels for manganese in drinking water) and utilities proactively pursue lower targets in their finished water. Effective treatment processes need to be in place. I grew up in the suburbs of Philadelphia, drinking well water. While I had very little knowledge of water treatment, the progression of my childhood and career naturally influenced my drinking water research. Private wells are not regulated by EPA; thus, homeowners are responsible for maintaining their wells and quality of their drinking water. Understanding how my parents were responsible for maintaining their own mini-distribution system at home led me to want to better understand how other people receive their drinking water and how to have treatment processes in place to ensure it is safe and clean. I love traveling and enjoying the outdoors like many of my colleagues in the drinking water and environmental engineering industry. I've been an avid skier since I was five years old and annually travel with 30-plus friends to the Teton Mountains for the best skiing in the United States. On the opposite end of the spectrum, I enjoy scuba diving and taking underwater photos; swimming with a whale shark is on my bucket list! I am also a dog lover, and while I don't have my own dog, I am an aunt to many and thoroughly spoil them when I visit friends and family. To learn more about Victoria's research, visit the article, available online at https://doi.org/10.1002/aws2.1225.

Resiko Bunuh Diri pada Warga Binaan Pemasyarakatan Dewasa dengan Masa Hukuman ≥ 5 Tahun di Lembaga Pemasyarakatan Kelas IIA Palangka Raya

Correctional Institutions (Lapas), namely institutions that foster convicts so that they are ready to return to being citizens who comply with the values ​​and legal norms of society. The large number of suicide risk cases is due to the government's lack of attention to the psychological conditions of prisoners or correctional inmates. The causes of suicide are depression, encouragement from the heart, social problems, bad experiences that trigger trauma, and heredity. The purpose of this study was to determine and analyze the risk of suicide as well as the inhibiting and supporting factors for suicide risk in adult prisoners with a sentence of ≥5 years in Palangka Raya Class IIA Penitentiary. This research is case research using qualitative research methods or research based on phenomena that occur intensively in an institution. There is a risk of suicide among prisoners in the Palangka Raya Class IIA Penitentiary, while the supporting factors are the lack of human resources in the field of mental health (psychologists) in the Palangka Raya Class IIA Penitentiary, lack of family trust support, feelings of not accepting the condition and sentence sentences that have been given, the environment of the Class IIA Penitentiary in Palangka Raya which exceeds capacity (overload). Inhibiting factors that affect the risk of suicide in prisoners of correctional services, namely, the existence of facilities for worship in accordance with the beliefs held by each prisoner, the availability of educational facilities, facilities for developing handicrafts, sports facilities such as volly ball, futsal, table tennis, social facilities consisting of from family visits, meeting rooms and family support such as regular visits, giving love, understanding and attention.