Relative Difficulty Research Articles

“Learning to ‘waltz’ rather than ‘wrestle’ … ” : a novel, ultra-brief intervention supporting early child–caregiver relationships

ABSTRACT Introduction The quality of the early child–caregiver relationship plays a crucial role in shaping a child’s development. In response to the lack of early intervention provisions for 2–5 year olds, the Leeds Infant Mental Health Service increased their offer to support children up to their fifth birthday (and their caregivers), where relational difficulties impact upon the child’s emotional wellbeing. Aims This paper aims to evaluate the effectiveness of the direct therapeutic work (named ‘Understanding Your Toddler’; UYT), in promoting the child–caregiver relationship. Method Nineteen families were accepted for UYT, where there was motivation and emotional availability to consider change within the relationship. Thirteen families engaged in the work. The UYT offer adopted a three session, home-visiting model, drawing upon several therapeutic approaches. A two-phased mixed methods design was adopted. Phase I analysed quantitative changes within the relationship. Phase II qualitatively evaluated families and professionals’ experiences of UYT. Results Paired t-tests and Wilcoxon signed rank analyses illustrated significant differences pre and post UYT in caregiver: goals, confidence, perceptions and feelings of irritation. No significant differences were found in caregiver feelings of warmth. Themes from interviews suggested that the strengths-based approach was valued, and that video work supported caregivers to ‘see the world from their (toddlers’) point of view’. Conclusion This evaluation contributes to the limited evidence evaluating the efficacy of child–caregiver interventions in practice. Despite the small sample, the UYT model provides a helpful framework (applicable to clinical contexts) to foster early relationships and emotional development of young children.

Maternal alexithymia and caregiving behavior: the role of executive functioning -A FinnBrain Birth Cohort study.

The growing interest in parental cognition calls for research clarifying how cognition interacts with other parenting determinants to shape caregiving behavior. We studied the interplay between executive functioning (EF; cognitive processes that enable goal-directed thinking and behavior) and alexithymic traits (characterized by emotion processing/regulation difficulties) in relation to emotional availability (EA; the dyad's ability to share an emotionally healthy relationship). As EF has been reported to shape parents' ability to regulate thoughts and emotions during caregiving, we examined whether EF moderated the association between maternal alexithymic traits, and EA. Among 119 mothers with 2.5-year-olds drawn from the FinnBrain Birth Cohort, EF was measured with Cogstate tasks, alexithymic traits with the Toronto Alexithymia Scale (TAS-20), and caregiving with the Emotional Availability Scales (EAS). More alexithymic traits on the TAS-20 subscale Externally Oriented Thinking (EOT) were associated with poorer caregiving in a hierarchical regression analysis (ΔR2 = 0.05, p = .01). A marginally significant moderation effect was found when adding the EOTxEF interaction term to the model (ΔR2 = 0.03, p = .06). These associations weakened slightly when controlling for education level. Estimation of simple slopes and a Johnson-Neyman figure indicated a significant association between higher EOT and lower EAS, that increased in strength as EF decreased from the group mean level. The influence of cognitive alexithymic traits on EA could be especially pronounced among low EF parents, but further studies are needed to support and extend the findings. The potential role of parental reflective functioning in this context is discussed.

A prolonged outbreak of tuberculosis associated with an intellectual disability daycentre in Ireland

Abstract One of the factors impeding tuberculosis elimination in low burden countries is its persistence and concentration in vulnerable populations. This is a complex, prolonged Tuberculosis (TB) outbreak in a daycentre for adults with intellectual disability in Ireland. This is a particularly vulnerable population with special considerations for Public Health (PH) management. There are eight cases of active TB, 46 cases of Latent TB Infection (LTBI) and a cumulative total of 116 contacts associated with this outbreak, with diagnosis spanning 15 years. The last three cases were identical on Whole Genome Sequencing. The index case was an Irish-born, Caucasian, social care worker, with smear positive pulmonary TB, who was symptomatic in the facility for three months prior to diagnosis. Case 2 was a household contact of the index case and the other 6 cases were Service Users (SUs) at the facility. At least five of the subsequent seven cases are secondary cases of the index case. Significant to this outbreak was the change in Irish guidance, 2010, relating to the management of contacts of cases. Following the notification of the most recent case, July 2023, the Outbreak Control Team decided a retrospective review be conducted of all SU contacts of the seven cases associated with the facility. The contacts were stratified according to hierarchical risk. A total of six contacts met the criteria for review and offered screening, re-screening or treatment as appropriate. In this outbreak 21.8% of the total contacts and 16.1% of SU contacts completed treatment for LTBI. The significance of this outbreak lies in its duration, infectivity of the index case and particular vulnerabilities of the SUs. There were issues with overcrowding and difficulties in relation to symptom recognition, diagnosis and treatment. The PH team tailored their approach to meet the SU needs, demonstrating the importance of person-centred contact tracing in the disruption of transmission. Key messages • A factor impeding tuberculosis elimination in low burden countries is it’s persistence and concentration in vulnerable populations. • Adapting a patient-centred approach to contact tracing can lead to higher participation rate and the disruption of infection transmission.

Emotions and difficulties experienced by parents of children with autism: A qualitative study.

This study was performed to determine the difficulties experienced by the parents of children with autism. A qualitative method was used to determine the difficulties experienced by the parents. The sample of the study consisted of parents with 24 children with autism who met the inclusion criteria. The data were analysed by the MAXQDA qualitative data analysis programme in accordance with Colaizzi's seven-stage method. Total of 5 themes and 29 codes were gathered in line with the data obtained from the interviews. Five main themes of the interviews emerged; emotions experienced by parents; adaptation to family life; difficulty in social relationships; limited opportunity for entertainment/activity and financial difficulty. Parents whose income were less than or equal to their expenses particularly stated that they had economic difficulties in the transportation of their children to places such as hospitals/schools/special education. In accordance with the findings of this study, it was determined that almost all of the parents with a child diagnosed with autism experienced sadness, denial, shock, depression, self-blame in the period when their children were first diagnosed, and later accepted the disease. In addition, it was detected that parents had difficulties in family relations, social relations, entertainment/activity and economic aspects.

Obstáculos para o diagnóstico e tratamento do transtorno do espectro autista

Objective: To understand the obstacles that reduce accessibility to the diagnosis and treatment of autism spectrum disorder (ASD). Literature review: ASD is a disorder characterized by difficulties in social interaction, impairments in communication and restricted patterns of behavior. Its diagnosis is clinical, based on behavioral observations and the patient's history and on criteria defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM – 5). Treatment includes pharmacological and behavioral approaches. However, the difficulties and challenges found in the literature include the symptomatological heterogeneity of ASD, the need for training health professionals and a more accurate assessment through a multidisciplinary team. Late diagnosis or its absence can lead to unfavorable outcomes in adult life, such as: anxiety, depression, and difficulty in interpersonal relationships. Recent studies include the use of specific biomarkers and innovative therapies that are not yet accessible. Final considerations: Early diagnosis and appropriate treatment are ideal for improving the quality of life of individuals with ASD. The importance of the doctor and new studies to improve therapeutic choice in ASD is also highlighted.

Resistance to Cry14A family Bacillus thuringiensis crystal proteins in Caenornabditis elegans operates via the nhr-31 transcription factor and vacuolar-type ATPase pathway.

Bacillus thuringiensis (Bt) has been successfully used commercially for more than 60 years for biocontrol of insect pests. Since 1996, transgenic plants expressing Bt crystal (Cry) proteins have been used commercially to provide protection against insects that predate on corn and cotton. More recently, Bt Cry proteins that target nematodes have been discovered. One of these, Cry14Ab, has been expressed in transgenic soybean plants and found to provide significant protection against the soybean cyst nematode, Heterodera glycines. However, to date there has been no description of high-level resistance to any Cry14A family protein in nematodes. Here, we describe forward genetic screens to identify such mutants using the nematode Caenorhabditis elegans. Although non-conditional screens failed to identify highly resistant C. elegans, a conditional (temperature-sensitive) genetic screen identified one mutant, bre-6(ye123) (for Bt protein resistant), highly resistant to both Cry14Aa and Cry14Ab. The mutant comes at a high fitness cost, showing significant delays in growth and development and reduced fecundity. bre-6(ye123) hermaphrodites are only weakly resistant to copper intoxication, indicating that the mutant is not highly resistant to all insults. Backcrossing-whole genome sequencing was used to identify the gene mutated in ye123 as the nuclear hormone receptor nhr-31. RNAi, DNA rescue, and CRISPR analyses confirm that resistance to Cry14Aa intoxication in bre-6(ye123) is due to mutation of nhr-31 and was renamed nhr-31(ye123). As predicted for a mutation in this gene, nhr-31(ye123) animals showed significantly reduced expression of most of the subunits of the C. elegans vacuolar ATPase (vATPase). Mutants in the vATPase subunits unc-32 and vha-7 also show resistance to Cry14Aa and/or Cry14Ab. These data demonstrate that nhr-31 and the vATPase play a significant role in the intoxication of C. elegans by Cry14A family proteins, that reduction in vATPase levels result in high resistance to Cry14A family proteins, and that such resistance comes at a high fitness cost. Based on the relative difficulty of finding resistant mutants and the fitness cost associated with the vATPase pathway, our data suggest that transgenic Cry14Ab plants may hold up well to resistance by nematode parasites.

Assessing the Influence of Economic Factors on the Dynamics of Exports of Russian Oil and Petroleum Products Based on the Use of a Combination of PEST and SWOT Analysis Methods

The presented work is part of a series of articles devoted to assessing the influence of external factors on the dynamics of Russian exports. In this and subsequent related works, the authors proposed to consider the external environment, which had a significant impact on the dynamics of Russian exports and the relative diffi culty of revising its structure, the basis of commodity exports of which in value terms are hydrocarbon energy carriers. This work represents a conceptual basis for the use of instrumental methods for assessing the influence of external factors, in this case, economic ones, on the integral and sectoral indicators of Russian exports and, in particular, on the export of hydrocarbon energy resources. In the second part of this article, it is proposed to use a set of environmental analysis methods, the basis of which was the previously successfully used mechanism for combining the methods of PESTEL and SWOT analysis, which will make it possible, based on the use of scores, to describe the cumulative influence of external factors on the dynamics of the main industries of Russian exports. The novelty of the presented approach lies in the absence of a methodology for a comprehensive assessment of the influence of external factors on the dynamics of Russian exports using the selected tools, which seems useful and timely in light of the emergence of new political and economic factors that have a significant impact on Russian foreign trade in general and on the dynamics of the carbohydrate energy market , in particular. The parameters for assessing external factors proposed by the authors were chosen by the author independently, taking into account the modern realities of the development of the world economy, which can also represent a separate point of novelty of the research conducted or be part of one of the existing points of novelty of the presented work. The merit of the authors of this work lies in the fact that this work proposed their own vision of a comprehensive assessment of the influence of external factors on the dynamics of the country’s exports.

Emotional awareness and expression difficulties in relation to pain experiences in people with brain injury and chronic pain: preliminary investigation

ABSTRACT Objectives Preliminary examination of emotional awareness/expression relationships with pain in people with traumatic brain injury (TBI) and chronic pain (CP) and exploration of psychological factors as mediators or moderators of these relationships. Methods Cross-sectional study in adults (N = 59) with chronic TBI and CP using Toronto Alexithymia Scale-20 Difficulty Identifying and Describing Feelings subscales; Ambivalence over Emotional Expressiveness Questionnaire; Emotional Approach Coping Scale; PROMIS Pain Intensity and Pain Interference scales, Michigan Body Map (pain widespreadness); headache frequency; Pain Catastrophizing Scale; Brief Symptom Inventory-18 (psychological distress), and Post-traumatic Stress Checklist-Civilian. Results Difficulty Identifying Feelings was positively associated with pain intensity, pain interference, and headache frequency. Difficulty Describing Feelings was positively correlated with pain interference and headache frequency. Emotional Approach Coping was inversely correlated with headache frequency. Emotional awareness/expression relationships with pain outcomes were mediated by Pain Catastrophizing; Difficulty Describing Feelings relationships with Pain Interference and headache frequency were mediated by psychological distress; and Difficulty Describing Feelings associations with Pain Interference were mediated by post-traumatic stress. No moderators were identified. Conclusion These preliminary findings suggest that emotional awareness/expression is linked to pain in adults with TBI and CP, which may be connected via pain catastrophizing and psychological distress. If longitudinal studies with larger samples produce similar findings, researchers should explore training emotional awareness/expression for possible pain management after TBI.

COVID-19 vaccination intention among people who use drugs in France in 2021: results from the international community-based research program EPIC

BackgroundCOVID-19 vaccination is crucial to reduce the incidence of severe forms of the disease in the population. However, people who use drugs (PWUD) face structural and individual barriers to vaccination, and little is known about vaccination intention and factors associated with that intention among PWUD. This study aimed to estimate vaccination intention in PWUD and associated factors in the early stage of vaccination campaigns.MethodsWe conducted cross-sectional study in France among PWUD, as part of the international EPIC program, a community-based research study coordinated by Coalition PLUS. It included 166 unvaccinated PWUD attending harm reduction centers. A questionnaire collected data on sociodemographic characteristics, COVID-19 related difficulties, and mental health, among other things. Multivariate logistic regression was used to identify factors associated with low vaccination intention.ResultsOnly 19% of participants reported strong intention to get vaccinated against COVID-19. Factors independently associated with low vaccination intention were younger age (aOR = 0.90, 95%CI = 0.85–0.95), lower education level (aOR = 2.67, 95% CI = 0.95–7.55), and unstable housing (aOR = 6.44, 95% CI = 1.59–40.34). The most-cited reasons for low intention were mistrust in COVID-19 vaccines (66.1%), fear of side effects (48.7%), and non-belief in vaccinations in general (25.2%).ConclusionsThis study highlights the need for targeted COVID-19 information and interventions to increase vaccine uptake in PWUD, especially those living in precarity. Community-based interventions and targeted government assistance could play a crucial role in addressing vaccine hesitancy in this population, not only for COVID-19 but for future epidemics.

Promoting Health for a vulnerable Family with Relationship Challenges. Exploring the Community Nurse's Role

Background: In today's dynamic social landscape, families often encounter a myriad of challenges that can impact their overall health and well-being. Among these challenges, relationship difficulties within the family unit stand out as a significant concern, with potential repercussions for the physical, emotional, and psychological health of its members. Aim: This case study article delves into the intricate dynamics of promoting health within a vulnerable family facing significant relationship challenges. The focus of this study is to explore the pivotal role of the community nurse in addressing the unique needs of such families. Materials and Methods: A qualitative research approach was employed to comprehensively investigate the experiences of a vulnerable family navigating relationship challenges. Data collection involved in-depth interviews, direct observations, and document analysis. Thematic analysis was used to extract meaningful patterns and insights from the collected data. Results: The findings underscored the crucial influence of the community nurse in fostering the health and well-being of the vulnerable family. Through tailored interventions, collaborative support, and sensitive communication, the community nurse played a pivotal role in addressing the family's relationship challenges and promoting their overall health. Conclusions: This study sheds light on the significance of the community nurse's involvement in enhancing the health outcomes of families facing relationship challenges. The role of the community nurse emerges as an essential component in fostering resilience and facilitating positive changes within the family unit.

Early Socio-Emotional Difficulty as a Childhood Barrier to the Expected Benefits of Active Play: Associated Risks for School Engagement in Adolescence.

Active play allows children to develop social and cognitive skills, which could lead to higher school engagement. Little is known about the role of child socioemotional difficulty in these associations. This study aims to examine the interaction between active play and socioemotional difficulty in childhood and their prospective association with academic engagement in adolescence. The participants were 4537 children (51.1% boys) who were longitudinally followed, between ages 6 and 14 years, from the National Longitudinal Study on Children and Youth (NLSCY), Canada. Active play (weekly organized sport and unstructured physical activity outside of school hours) and child behavior (hyperactivity, anxiety, and relational difficulties) were reported by mothers for their children at age 6 years. Academic engagement was self-reported at age 14 years. Unstructured physical activity predicted lower subsequent school engagement for boys (β = -0.057, p < 0.05). Boys with high anxiety symptoms and high relational aggression who participated in more unstructured physical activity in childhood were subsequently less engaged in school (respectively, β = -0.066, p < 0.05 and β = -0.062, p < 0.05). Girls who partook in more organized sports showed lower school engagement in adolescence when they had high anxiety symptoms (β = -0.067, p < 0.05). Although past studies have highlighted the contribution of active play to school engagement, certain socioemotional difficulties could impede the child's ability to reap its benefits.

NON-PHARMACOLOGICAL TREATMENT STRATEGIES FOR ATTENTION-DEFICIT HYPERACTIVITY DISORDER (ADHD): THE CURRENT STATE OF THE ART

Attention deficit hyperactivity disorder (ADHD) consists of a set of symptoms, such as impulsivity, restlessness, difficulties in relationships with family and colleagues, which disrupt the individual's social, personal and academic life. The aim of this study was to analyze the state of the art on non-pharmacological treatment and its effectiveness as a first-line treatment and as an adjunct to medication. The research consisted of a synthesis of the literature, presenting different types of non-pharmacological methods and their effects on the manifestations of the disease, consequently improving the social and personal lives of these patients. In this sense, it was possible to observe the importance of non-pharmacological treatment in isolation and in association with pharmacological treatment as an important coping strategy for the symptoms of individuals with ADHD.

Risk of Revictimization within Intimate Relationships among Women Survivors of Childhood Sexual Abuse: The Role of Cumulative Trauma and Self-Capacities Disturbances

Childhood sexual abuse, especially in the context of cumulative childhood interpersonal trauma (CCIT), is associated with an increased risk of revictimization by an intimate partner among women. The aim of the present study is to examine the role of self-capacities disturbances in the association between CCIT and revictimization by an intimate partner. The sample comprised of 247 adult women survivors consulting in sex therapy. Path analyses showed an indirect effect of self-capacities disturbances in the association between CCIT and revictimization (ORs = 1.49 and 1.62), demonstrating the importance of intervening in relational and affective difficulties among women survivors to prevent the risk of revictimization.

A systematic review examining outcomes of children following permanency placements

Children in care have experienced adversities, including maltreatment prior to contact with the system, negatively impacting on their mental health outcomes. The type of placement and length of time in care are thought to be important and the child welfare system aim is to achieve a permanent decision for children that best supports their needs by establishing a stable familial network. Permanency decisions can include reunification, foster care, kinship care, adoption, and residential placements. This review aims to establish to what extent permanent placement type, maltreatment experienced, length of time in care and age at which permanency is achieved impacts child mental health outcomes. Following PRISMA guidelines, five databases (ASSIA, CINAHL, PsycINFO, Scopus and SocINDEX) and two registers (CENTRAL and TRoPHI) were systematically searched yielding six articles for inclusion in the study. Data were extracted and articles critically appraised utilising the Crowe Critical Appraisal Tool (CCAT). Papers reported mixed findings for permanent placement type and child mental health outcomes with little or no significant overall differences reported. Type of maltreatment experienced moderated the type of mental health symptomology reported. Difficulties in attachment and social relationships were reported for children placed older than two years, although confounding factors such as type of maltreatment likely reduce the strength of the association. Typically, children in permanent placements had better outcomes compared with peers in short-term or unstable placements. A lack of suitable validated and age-appropriate outcome measures and the existence of confounding factors impair our understanding of the interaction between pre-care adversities, the child welfare system itself and permanent placement outcomes.

Lived experiences of working-age polytrauma patients in Germany - A qualitative Analysis

BackgroundSurvivors of a major trauma experience a range of difficulties in relation to the reduction in physical, psychosocial, and cognitive functions, which can result in a reduced health-related quality of life. This study aims to explore lived experiences of major trauma survivors in the German healthcare system. MethodsSemi-structured exploratory interviews were performed with nine major trauma survivors (18–55 years; Injury Severity Score ≥16). For exploratory analyses, an artificial intelligence-based coding software was used. Further, results were clustered by using the International Classification of Functioning, Disability and Health framework (ICF). ResultsCommunication was one of the major topics concerning amongst others diverting opinions between different healthcare disciplines and a general lack of information. The participants showed a high demand for a contact person. Furthermore, social support was essential during recovery for those interviewed. Social network was not only important as emotional and physical support but also for overcoming of gaps in the healthcare system. The support by employers and colleagues seemed to be beneficial for our participants in relation to returning to work. Further, psychological consequences of trauma, and that mobility is a key factor for quality of life, self-efficacy and return to work were discussed. DiscussionThe qualitative analyses highlight several topics such as communication, burden of sickness, support systems that the participants mentioned as important along their journey through the German healthcare system during recovery. Through the ICF model the interplay of certain components that influenced the outcome of the major trauma survivors was visualized. ImplicationsThese results might offer a deepened understanding of modifiable components of a patient pathway in recovery process such as improvements of patient communication, provision of a contact person and others.

Psychosocial Assessment Tool 2.0 and Long-term Mental Health Outcomes in Childhood Cancer.

To identify childhood cancer patients and their families at the greatest risk for psychosocial difficulties, this study examined the predictive validity of the Psychosocial Assessment Tool 2.0 (PAT2.0) on caregiver and patient-reported mental health outcomes at 1-year follow-up. The PAT2.0 was administered to caregivers a median of 0.08 years after cancer diagnosis. A brief psychosocial screening battery (Family Symptom Inventory and PROMIS v1.0 Pediatric Profile-25) was administered to patient-caregiver dyads (n=53) ∼1-year later. Linear regressions support the longitudinal predictive validity of the PAT2.0 for caregiver-reported child and caregiver mental health symptoms and child-reported peer relationships difficulties.

Letter identity and position coding in the parafovea.

Letter position coding has been extensively examined in studies of isolated word identification, spurring the development of computational models. However, these models are largely restricted to explaining word identification in foveal vision, despite the fact that early lexical processing during reading occurs in the parafovea. We report four experiments that examined the flexibility of parafoveal letter identity and position coding using a variant of the same-different match task. Participants matched transposed- and substituted-letter strings to reference words, with the former being displayed at various retinal eccentricities for 100 ms versus 300 ms to respectively preclude or allow eye movements. The first pair of experiments demonstrated the relative difficulty of coding parafoveal letter positions as compared to their identities, as well as the standard benefit in identifying words displayed in the right visual field. The second pair of experiments further demonstrated that the location of letter-position uncertainty (i.e., transposed letters) interacts with both eccentricity and visual field. Initial letter transpositions were more easily detected in the left visual field, whereas transpositions of the final letters were more accurately detected in the right visual field. As discussed, these results are challenging for existing models of reading, which can individually account for some of our findings but not the results in their entirety. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

아동양육시설 보호종료 아동의 삶에 관한 내러티브 탐구: 타인과의 관계를 중심으로

This study attempted to explore their lives, focusing on the relationship of children who have terminated protection in child care facilities. To this end, it was analyzed through a narrative research method among qualitative research methods for 3 children who had terminated protection who lived in child care facilities for more than 10 years. As a result of the study, first, it was confirmed that it was difficult to establish a stable relationship with a life instructor instead of parents because of the lack of positive relationship experiences that made living in the facility more difficult. Second, the experience of being abandoned by parents and not being protected in the facility distorted the meaning of relationships with others. The distorted family concept that even violence must be understood and the stigma of coming from a facility have led to greater difficulties in relationships. For them, termination of protection means feeling alone and loneliness, and while relationships are no longer important to those who do not have intimate relationships other than family members and friends in the facility, relationships are found to be very insufficient. Recently, support for children who have terminated protection is increasing, but most of them are supportive of basic life, and there is not much support for them to acquire interpersonal skills to build relationships in society. Based on the results of this study, implications and suggestions for establishing positive relationships for children who have terminated protection were presented.

Optimisation of Sentiment Analysis for E-Commerce

Sentiment analysis is widely used today to make data-driven decisions in different industries, starting from marketing and including brand management, reputation monitoring, and customer satisfaction analysis. Its growing importance is closely linked with so-called ‘word-of-mouth’ communication, from reading online reviews to writing comments on social networks. Effective separation of sentiments ensures that companies' responses are timely and critical patterns are seen in big data sets. Statistical measures, information gain, correlation-based approaches, etc, have been employed for the feature selection. Still, the problem associated with text data mining is that they don’t convey the text's relative difficulty and additional features. To fill this gap, our research proposes a new feature selection technique through Ant Colony Optimization (ACO) and K Nearest Neighbour (KNN) performed on 28,000 customer reviews in different product categories. The results, therefore, showed an overall accuracy of 80.1%, with the Support Vector Machine (SVM) set at 80.5% on each selected feature, which was slightly higher than the Convolutional Neural Network (CNN), which scored a 78.41% accuracy. SVM remains on the mark of 83%, and for CNN, the rate achieved on the same was 80.8% when both were applied to the entire dataset. These facts rejected the infallibility of the simple and complex algorithms used singly in the sentiment classification, indicating that more sophisticated algorithms like ACO and KNN can provide business solutions to improve their service delivery based on customers’ feedback.

A Case Study of Gestalt Art Therapy for Children with Peer Relationship Conflict and Difficulty in Self-Expression

A Case Study of Gestalt Art Therapy for Children with Peer Relationship Conflict and Difficulty in Self-Expression