War on the Wards: The collapse of health care infrastructure resulting from violent conflict

Introduction: While utilizing satellite images to verify reports of hospital damage resulting from armed conflict allows for remote assessment, the use of private satellites to gain access to images prohibits widespread use. The questions this study sought to answer were: Is it possible to replicate the findings of previous reports of hospital damage that used the services of private satellite imagery using open source software, such as Google Earth? What variations exist among the different sites where damage to hospitals is visible, and what gradation is possible? Is this methodology applicable to other examples of armed conflict? Methods: Using the map of bombed Syrian hospitals published and maintained by Physicians for Human Rights, hospitals were selected according to their location and the time period of the attack. These coordinates were entered into Google maps and once the attack was verified, a grade of damage was assigned. This methodology was then applied to reports of similar attacks in Iraq. Results: While much information can be gleaned from open source data such as Google Earth, the level of detail in satellite images is lower and coordinates data is less specific. [Further results pending.] Conclusion: There is room for the use of open source satellite technology to track and grade the damage done to health care infrastructure during armed conflict. [More conclusions pending.

Towards an Assessment of Pause Periods on User Habituation in Mitigation of Phishing Attacks

Social engineering is the technique in which the attacker sends messages to build a relationship with the victim and convinces the victim to take some actions that lead to significant damages and losses. Industry and law enforcement reports indicate that social engineering incidents costs organizations billions of dollars. Phishing is the most pervasive social engineering attack. While email filtering and warning messages have been implemented for over three decades, organizations are constantly falling for phishing attacks. Prior research indicated that attackers use phishing emails to create an urgency and fear response in their victims causing them to use quick heuristics, which leads to human errors. Humans use two types of decision-making processes: a heuristic decision, which is a quick, instinctual decision-making process known as ‘System One’, and a second, known as ‘System Two,’ that is a slow, logical process requiring attention. ‘System Two’ is often triggered by a pause in the decision-making process. Additionally, timers were found in other research fields (medicine, transportation, etc.) to affect users’ judgement and reduce human errors. Therefore, the main goal of this work-in-progress research study is to determine through experimental field study whether requiring email users to pause by displaying a phishing email warning with a timer, has any effect on users falling to simulated phishing attacks. This paper will outline the rationale and the process proposed for the validation of the field experiments with Subject Matter Experts (SMEs). Limitations of the proposed study and recommendation for further research are provided

Engaging rural residents in patient-centered health care research

Patient engagement is increasingly recognized as a critical component in improving health care. Yet, there remains a gap in our understanding of the intricacies of rural patient engagement in health-related research. This article describes the process of engaging rural patients, caregivers and broader stakeholders to actively participate in an exploratory effort to understand rural perspectives around the patient-centered medical home model. Highlights of the project’s engagement activities demonstrate how giving voice to rural residents can have a significant impact. Lessons learned point to the importance of six factors for successful engagement of rural residents as partners in health care research: building relationships, defining expectations, establishing communication guidelines, developing shared understanding, facilitating dialogue, and valuing contributions

EXPERIMENTAL STUDY TO ASSESS THE IMPACT OF TIMERS ON USER SUSCEPTIBILITY TO PHISHING ATTACKS

Social engineering costs organizations billions of dollars. It exploits the weakest link of information systems security, the users. It is well-documented in literature that users continue to click on phishing emails costing them and their employers significant monetary resources and data loss. Training does not appear to mitigate the effects of phishing much; other solutions are warranted. Kahneman introduced the concepts of System-One and System-Two thinking. System-One is a quick, instinctual decision-making process, while System-Two is a process by which humans use a slow, logical, and is easily disrupted. The key aim of our experimental field study was to investigate if requiring the user to pause by presenting a countdown or count-up timer when a possible phishing email is opened will influence the user to enter System-Two thinking. In this study, we designed, developed, and empirically tested a Pause-and-Think (PAT) mobile app that presented a user with a warning dialog and a countdown or count-up timer. Our goal was to determine whether requiring users to wait with a colored warning and a timer has any effect on phishing attempts. The study was completed in three phases with 42 subject matter experts and 107 participants. The results indicated that a countdown timer set at 3-seconds accompanied by red warning text was most effective on the user’s ability to avoid clicking on a malicious link or attachment. Recommendations for future research include enhancements to the PAT mobile app and investigating what effect the time of day has on susceptibility to phishing

Small Finds, Space, and Social Context: Exploring Agency in Historical Archaeology

The George Washington Foundation Department of Archaeology has combined a number of excavation and artifact-recovery techniques with a deliberate approach to artifact research and analysis in the laboratory to enhance interpretations of past behaviors. This article describes the elements of this approach and provides a case study involving the numerous 18th-century wig hair curler fragments found at the boyhood home of George Washington. The historical record together with the material culture assemblage allow us to demonstrate that the Washington family engaged in a home-based system of wig maintenance, allowing the economically struggling Washington boys to don wigs, an essential element of male gentry attire. This approach illustrates that conscientious recovery and analysis of small finds, such as wig curlers, can provide data used to reveal a great deal about the agency and consumer motivations of their owners

Design and evolution of enzymes for the Morita-Baylis-Hillman reaction

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Delivering the Strengthening Families Program to Native American Families During COVID-19: Lessons & Next Steps

The COVID-19 pandemic (COVID) of 2020 has forced adaptation for all Americans. Programs that serve Native American children and families are particularly critical during this time due to the disproportionate risks and disparities faced by this population. The objective of this qualitative evaluation is to gather adult participant feedback on strengths and needed changes with a telehealth adaptation of the Strengthening Families Program. This evaluation builds on previous knowledge of SFP group leadership which suggests that supportive helping relationships paired with dynamic flexibility are facilitators of effective family engagement. Participant feedback suggests that caregiver’s felt comfort, care, and genuine concern. In addition all participants noticed a difference in their families’ communication and relationships. Although tragic and challenging, the COVID-19 pandemic, forced a spotlight on barriers (limited internet access, social services, and food resources) that were needed to sustain participation and increase resilience among Native American residents in this mid-western state.  The individualized planning and checking in on every level which started out as a “how do we replicated this service” became about building resilience strategies for Native American families in this critical time in history

Implementation of a Pediatric Behavioral Health Medication Safety Initiative in a State Medicaid Program

The poster will address concerns about an increase in the use of behavioral medications in children and the need to manage prescribing practices to ensure appropriate use of the drugs. Presented at the American Drug Utilization Review Society 2015 Conference

Childhood ADHD and Risk for Substance Dependence in Adulthood: A Longitudinal, Population-Based Study

Background: Adolescents with attention-deficit/hyperactivity disorder (ADHD) are known to be at significantly greater risk for the development of substance use disorders (SUD) compared to peers. Impulsivity, which could lead to higher levels of drug use, is a known symptom of ADHD and likely accounts, in part, for this relationship. Other factors, such as a biologically increased susceptibility to substance dependence (addiction), may also play a role. Objective: This report further examines the relationships between childhood ADHD, adolescent- onset SUD, and substance abuse and substance dependence in adulthood. Method Individuals with childhood ADHD and non-ADHD controls from the same population-based birth cohort were invited to participate in a prospective outcome study. Participants completed a structured neuropsychiatric interview with modules for SUD and a psychosocial questionnaire. Information on adolescent SUD was obtained retrospectively, in a previous study, from medical and school records. Associations were summarized using odds ratios (OR) and 95% CIs estimated from logistic regression models adjusted for age and gender. Results: A total of 232 ADHD cases and 335 non-ADHD controls participated (mean age, 27.0 and 28.6 years, respectively). ADHD cases were more likely than controls to have a SUD diagnosed in adolescence and were more likely to have alcohol (adjusted OR 14.38, 95% CI 1.49–138.88) and drug (adjusted OR 3.48, 95% CI 1.38–8.79) dependence in adulthood. The subgroup of participating ADHD cases who did not have SUD during adolescence were no more likely than controls to develop new onset alcohol dependence as adults, although they were significantly more likely to develop new onset drug dependence. Conclusions: Our study found preliminary evidence that adults with childhood ADHD are more susceptible than peers to developing drug dependence, a disorder associated with neurological changes in the brain. The relationship between ADHD and alcohol dependence appears to be more complex