Implementation of a Physical Activity Group at a Community Mental Health Center: A Pilot Quality Improvement Project to Reduce Depressive Symptoms in Adolescents with Major Depressive Disorder

Major Depressive Disorder is a debilitating illness that affects millions of Americans, including adolescents. The majority of adolescents with Major Depressive Disorder (MDD) do not receive treatment. There may be a variety of reasons for this including stigma, access to care, and potential adverse reactions. People suffering from MDD are known to be at high risk for suicide. Lack of treatments adds the risk of suicide for adolescents with MDD. Identifying and implementing treatment options that are more acceptable and accessible are of the utmost importance. Although there is limited research regarding exercise/physical activity, depressive symptoms, and adolescents with MDD, there are two promising studies by Hughes, Barnes, Barnes, DeFina, Nakonezny, & Graham (2013) and Finazzi, Mesquita, Lopes, Fu, & Oliveira (2009). Currently, there is a physical activity program at Lakes Region Mental Health for adult patients. Unfortunately, adolescents do not have access to a similar group. This Doctorate of Nursing Practice (DNP) Quality Improvement (QI) Project piloted an eight-week physical activity group for adolescents with MDD to determine the impact physical activity had on depressive symptoms. The PHQ-9 for Adolescents Depression Screening Tool was given to participants before joining the physical exercise group and upon completion of the physical activity group. Pre-intervention and post-intervention results of the PHQ-9 for Adolescents Depression Screening were compared and analyzed. In addition, a survey was administered at week four and upon completion of the physical activity group to gather qualitative data. The results of this Pilot DNP QI project indicate there was a decrease in the PHQ-9 for Adolescents for two out of the three participants. The qualitative data demonstrated improvement in depressive symptoms, self-esteem and social interaction for all three participants. These results are promising and support the need for a physical activity group for adolescents with MDD at Lakes Region Mental Health Center

Iranian Attitudes in Advance of the Parliamentary Elections: Economics, Politics, and Foreign Affairs

While views of President Hassan Rouhani and Foreign Minister Javad Zarif have declined from their heights immediately after the nuclear deal, the University of Maryland has found through opinion polls -- among other viewpoints -- that the two leaders continue to enjoy very high levels of popular support in Iran, and their allies have good prospects in the upcoming elections. Views of the nuclear deal continue to be very positive, though some of its less popular aspects have become more apparent. Going forward there is support for growing engagement with the international community, especially in regard to dealing with the problem of Syria and the fight against ISIS. A new University of Maryland survey of the Iranian public finds that that nearly 8 in 10 Iranians say they have a favorable opinion of Rouhani (82 percent) and Zarif (78 percent). With Iran's parliamentary elections about a month away, nearly 6 in 10 Iranians (59 percent) want Rouhani supporters to win. More than 7 in 10 Iranians still approve of the nuclear deal. Rouhani's new efforts to engage with the international community on dealing with the conflict in Syria have received overwhelming support, with 80 percent approving. Of those who know about the Vienna agreement, 7 in 10 (72 percent) approve of it.Rouhani receives high marks for improving Iran's security (86 percent) and deepening its relations with European countries (80 percent). Two thirds (66 percent) say relations with Europe have improved and 54 percent have a favorable view of Germany -- up 10 points from 2014. Nonetheless, views of the U.S. continue to be quite negative. Seventy-one percent have an unfavorable view of the U.S. Only 1 in 3 (34 percent) have confidence that the U.S. will fulfill its obligations under the nuclear deal -- down 11 points from September 2015

A Majestic Presence: A Study of the Development of the Majestic Theater In Gettysburg

In an era of collective entertainment, before private home entertainment systems, people sought amusement within their communities. One aspect of this community entertainment, the theater, offered a social gathering place. Theaters provided an important dual role for the community—both for entertainment and also a certain amount of public service. Theaters in the 1920s and 1930s, in small towns such as Gettysburg, Pennsylvania, served a much different purpose than they do today, with a more prominent and more important role within society. In the 1920s and 1930s, Gettysburg had several theaters. The two most prominent were the Majestic and the Strand (known as the Photoplay before the 1926 renovation). These buildings acted as true centers and hubs for Gettysburg and the surrounding area. These theaters, “served as a showplace and a gathering place for people of all ages from Adams County and the surrounding area of Northern Maryland.” The building’s primary use, as a theater, provided a much needed social environment where people could come, relax, and be entertained, people would come from all over to attend the movies. As the years went on, renovations were made to improve the building. Even more important than the Majestic’s role as a theater were its ties with the community

Rethinking U.S.-China Security Cooperation

This paper argues that traditional arms control approaches no longer work well for even traditional security problems on the U.S.-Chinese security agenda for three reasons: Firstly, even when both states reason for arms control from the superpowers’ experience during the Cold War, they do so in different ways; secondly, a growing number of experts and policy elite in both countries do not think the benefits of formal arms control outweigh the costs and risks; and thirdly, those who think formal arms control has an important role to play lack a clear and compelling logic for why arms control is durable and achievable among highly interdependent states with unequal power, mixed interests, and dissimilar values. Past attempts find a new basis for U.S.-China security cooperation—e.g., by using voluntary measures or by relying on the economic interdependence of the two states—have proved insufficient. The second half of this paper suggests the basic elements of a cooperative security logic that could be a more appropriate and effective basis for cooperation. Instead of narrowly defining the objective of arms control as increasing deterrence stability at lower cost and risk, this logic aims more broadly to prevent threats from developing, provide reassurance, and promote consensual political order among states. Rather than trying primarily to set equal technical limitations on military capabilities, dialogue and negotiations should seek to ensure that whatever capabilities states have, including asymmetrical and dual-use ones, are used for mutually acceptable purposes and according to equitable behavioral rules. Issues related to transparency, verification, and compliance management would also be handled in ways that promote cooperation rather than competition. The paper concludes by examining how U.S.-Chinese cooperation in space, on nuclear weapons issues (including the Comprehensive Test Ban Treaty), and on missile defense all stand to benefit from reliance on this new logic

International Security on the Road to Nuclear Zero

The disappointingly slow pace of progress on efforts to prevent proliferation, reduce nuclear weapons, and eliminate nuclear risks has many causes. The factor that might be easiest for individuals in the arms control and nonproliferation community to change stems from their own ambivalence about major questions that must be addressed on the road to reducing the number of nuclear weapons in the world to zero. This essay explores how ambivalence about four key issues—strategic stability, alliance relations, institution-building, and nuclear energy—often leads community members to take positions that play well at home and within their like-minded group but raise unintended impediments to achieving their own long-term goals. The author suggests alternative ways to handle these questions to improve the prospects for domestic and international agreement on practical measures that would eliminate, not perpetuate, nuclear risks

Categorizing and Assessing the Severity of Disruptive Cyber Incidents

Faced with a rapidly growing volume and range of cyber attacks, policymakers and organizational leaders have had difficulty setting priorities, allocating resources, and responding effectively without a standard way to categorize cyber events and estimate their consequences. Presidential Policy Directive 41 laid out the Obama administration’s principles for executive branch responses to significant cyber incidents in the public or private sector. But it neither drew important distinctions between different types of cyber incidents, nor gave a standard way to determine where a particular incident falls on its 0-5 point severity scale. This policy brief demonstrates how an analytical framework developed at the Center for International and Security Studies at the University of Maryland (CISSM) can help address these problems. It first differentiates between low-level incidents and more significant cyber events that result in either exploitation of information and/or disruption of operations. It categorizes five types of disruptive events and analyzes 2,030 cyber events in a dataset developed from media sources, showing that cyber exploitation remains more common than disruption, and that most disruptive activity fits into two categories: message manipulation and external denial of service attacks. Finally, the brief offers a standard method to assess the severity of different categories of disruptive attacks against different kinds of organizations based on the scope, magnitude, and duration of the event. This Cyber Disruption Index (CDI) is then applied to survey data on Distributed Denial of Service (DDoS) attacks in the private sector to assess severity within a common category of disruptive events. Of 3,900 cases reported, only 5 events (less than 1% of the DDoS cases) had a combined scope, magnitude, and duration severe enough to be a priority for prevention and potentially warrant government involvement

Building Confidence in the Cybersphere: A Path to Multilateral Progress

As use of the Internet has become critical to global economic development and international security, there is near-unanimous agreement on the need for more international cooperation to increase stability and security in cyberspace. Several multilateral initiatives over the last five years have begun to spell out cooperative measures, norms of behavior, and transparency and confidence-building measures (TCBMs) that could help improve mutual cybersecurity. These efforts have been painstakingly slow, and some have stalled due to competing interests. Nonetheless, a United Nations (UN) Group of Governmental Experts (GGE) and the Organization for Cooperation and Security in Europe (OSCE) have achieved some high-level agreement on principles, norms, and “rules of the road” for national Internet activities and transnational cyber interactions. Their agreements include commitments to share more information, improve national protective capacities, cooperate on incident response, and restrain certain destabilizing state practices. Voluntary international agreements are worth little, unless states implement their commitments. So far, implementation has been crippled by vague language, national security considerations, complex relations between public and private actors in cyberspace, and privacy concerns. This is particularly true regarding the upfront sharing of information on threats and the willingness of participants to cooperate on incident investigations, including identifying perpetrators. With multilateral forums struggling to find a way forward with norm-setting and implementation, alternate pathways are needed to protect and build on what has been accomplished so far. Different strategies can help advance implementation of measures in the UN and OSCE agreements. Some commitments, such as establishing and sharing information about national points of contact, are best handled unilaterally or through bilateral or regional inter-governmental cooperation. Other objectives, such as protecting the core architecture and functions of the Internet that support trans-border critical infrastructure and underpin the global financial system, require a multi-stakeholder approach that includes not only governments but also private sector service providers, academic experts, and nongovernmental organizations. This paper compares what the GGE and OSCE norm-building processes have achieved so far and what disagreements have impeded these efforts. It identifies several priorities for cooperation identified by participants in both forums. It also proposes three practical projects related to these priorities that members of regional or global organizations might be able to work on together despite political tensions and philosophical disputes. The first would help state and non-state actors share information and communicate about various types of cybersecurity threats using a flexible and intuitive effects-based taxonomy to categorize cyber activity. The second would develop a more sophisticated way for state and non-state actors to assess the risks of different types of cyber incidents and the potential benefits of cooperation. The third would identify aspects of the Internet that might be considered the core of a public utility, worthy of special protection in their own right and for their support of trans-border critical infrastructure

Iranian Public Opinion, One Year After the Nuclear Deal

On July 14, 2015, the United States, Iran, and five other world powers announced that they had agreed on a Joint Comprehensive Plan of Action (JCPOA) to resolve international concerns about Iran’s nuclear program. In return for Iran strengthening its commitments never to pursue nuclear weapons, sharply limiting its dual-use capabilities, and allowing greater international scrutiny of its nuclear program, the United Nations Security Council, the European Union, and the United States agreed to lift nuclear-related sanctions on Iran. Both the nuclear deal and Iranian President Hassan Rouhani were immensely popular in Iran right after the JCPOA was announced, in part because the public thought that the terms were more generous toward Iran than they actually were, and because people had high expectations about economic and political benefits. Reactions in the United States were much more mixed. A smaller majority of the American public supported the deal, but critics in Congress came close to blocking its implementation because they worried about what Iran would do if it received a windfall from sanctions relief and hoped that tightening sanctions further could convince Iran to give up all dual-use nuclear capabilities. It’s appropriate to assess how Iranian public opinion has changed in the year since the deal was signed and the six months since sanctions relief began to be implemented, given that U.S. and European leaders frequently assert that Rouhani was elected with a mandate to improve Iran’s economy by using nuclear diplomacy to get sanctions relief. Comparing shifts in Iranian public opinion over time also offers a way to test some of the predictions made by congressional critics, including that there would be a crack-down on human rights in Iran to appease the opponents of increased engagement with the West, or that giving the Iranian public only a small taste of the economic and political benefits that could flow from becoming a “normal” country would increase pressure for more sweeping changes to Iran’s domestic and foreign policies. This survey of Iranian public opinion is the sixth in a series conducted during and after the negotiations that produced the JCPOA by the Center for International and Security Studies at Maryland in collaboration with the Program on Public Consultation and Iranpoll.com. Some of the same questions have been asked consistently since July 2014, when negotiations had been underway for many months, but the two sides remained far apart on some important issues. Some were reworded to reflect important contextual changes, such as public understanding about the main elements of the JCPOA and the Iranian parliamentary elections earlier this year. Some new questions have been added to find out what the Iranian public thinks about issues that have become particularly salient in recent months, such as the extent to which those who have not yet seen any economic benefits from the JCPOA hold Rouhani responsible or blame factors beyond his control. The previous reports in this series, a set of assessments about American attitudes towards nuclear diplomacy with Iran, and a collection of related articles are available at: http://www.cissm.umd.edu/projects/security-cooperation-iran-challenges-and-opportunities

Leveraging Google Earth Engine to Couple Landsat and MODIS for Detecting Phenological Changes in Semi-Arid Ecosystems

High spatial and temporal imagery are necessary to monitor phenological changes in semi-arid regions, but it is challenging to obtain this coverage using public satellites. Moderate Resolution Imaging Spectroradiometer (MODIS) has a repeat interval of one to two days, but coarse spatial resolutions up to 1000 m. Landsat has a higher spatial resolution of 30 m, but a 16-day period. StarFM algorithm combines multi-resolution satellite systems to interpolate data with MODIS temporal and Landsat spatial scales. We use Google Earth Engine (GEE) to preprocess the data. This improved imagery can be leveraged to classify vegetation species with short phenological cycles

Comprehensive Nuclear Material Accounting

Existing national and international standards for accounting for nuclear materials, including those designated for military use, are insufficient to meet current and future nuclear security, nonproliferation, and weapons reduction demands. Improved accounting practices are needed to provide reliable assurance that nuclear materials designated for peaceful use have not been diverted to state-level nuclear weapons programs or stolen by non-state actors, as well as to deter or detect diversion or the, were it to occur. Implementing an effective and efficient comprehensive, global nuclear accounting system is also a critical element of creating the conditions for future nuclear security if global nuclear energy use increases as part of the effort to mitigate climate change and countries make deep cuts to, or potentially eliminate, their stockpiles of nuclear weapons and nuclear materials designated for military use. Policy makers from around the globe have recognized the importance of ensuring that all countries with nuclear materials or weapons practice high standards of material control and accounting (MC&A), but the emphasis of current initiatives to improve MC&A has been on national laws and regulations—and primarily in states without nuclear weapons. States have yet to develop comprehensive requirements that address the full scope of nuclear risks and that are meant to be adopted by all states—including nuclear weapons states. This study examines a range of current material accounting practices and requirements and argues that in order for MC&A to fully perform the functions necessary to reduce global nuclear risks to an acceptably low level, its emphasis needs to transition from ensuring the non-diversion of nuclear materials to military uses to providing positive inventory control of nuclear materials, whereby national and international authorities can actively account for the location and form of all designated nuclear materials on a continuous and detailed basis.Center for International & Security Studies at Marylan