Denial of Service in Voice Over IP Networks

In this paper we investigate denial of service (DoS) vulnerabilities in Voice over IP (VoIP) systems, focusing on the ITU-T H.323 family of protocols. We provide a simple characterisation of DoS attacks that allows us to readily identify DoS issues in H.323 protocols. We also discuss network layer DoS vulnerabilities that affect VoIP systems. A number of improvements and further research directions are proposed

A qualitative study of the contribution of pharmacists to heart failure management in Scotland

Study objectives: (1) To identify the medication management needs of chronic heart failure (CHF) patients and their caregivers; (2) To examine the perceived support for medication management available to these people from health professionals; (3) To identify the actual and potential perceived contribution of pharmacists to medication management. Setting: A mixed urban/ rural region in the west of Scotland. Design: Semi-structured qualitative research interviews. Participants: A total of 50 people with CHF (NYHA Class II and III) due to left ventricular systolic dysfunction (33 males; mean age 67 years, 17 females; mean age 68 years) and 30 nominated caregivers recruited from the outpatient departments of two hospitals in the West of Scotland. Sampling was purposive to include patients from a range of CHF severity, ages and sexes. Main results: Managing medications was a responsibility shared by both the patients with CHF and caregivers. Treatment regimens were reported to be difficult to comply with. Health professionals were seen to provide little support for medication management. Pharmacists were viewed as being a good and accessible source of practical assistance who were also knowledgeable about the individual’s heart health history. Participants reported valuing advice from pharmacists about the side effects of medications and for their assistance in reducing the complex logistics of medication management and in having medications delivered. Conclusions: Patients with CHF and caregivers voiced a willingness to try to manage their medication regimen accurately but had a limited capacity to do so. Pharmacists were viewed as providing valuable support to patients with CHF and their caregivers, in terms of medication management. The extended role of pharmacists in medication management of CHF should be encouraged

The distance and neutral environment of the massive stellar cluster Westerlund 1

The goal of this study is to determine a distance to Westerlund 1 independent of the characteristics of the stellar population and to study its neutral environment, using observations of atomic hydrogen. The HI observations are taken from the Southern Galactic Plane Survey to study HI absorption in the direction of the HII region created by the members of Westerlund 1 and to investigate its environment as observed in the HI line emission. A Galactic rotation curve was derived using the recently revised values for the Galactic centre distance of $R_\odot = 7.6$ kpc, and the velocity of the Sun around the Galactic centre of $\Theta_\odot = 214$ km s$^{-1}$. The newly determined rotation model leads us to derive a distance of $3.9\pm 0.7$ kpc to Westerlund 1, consistent with a location in the Scutum-Crux Arm. Included in this estimate is a very careful investigation of possible sources of error for the Galactic rotation curve. We also report on small expanding HI features around the cluster with a maximum dynamic age of 600,000 years and a larger bubble which has a minimum dynamic age of 2.5 million years. Additionally we re-calculated the kinematic distances to nearby HII regions and supernova remnants based on our new Galaxic rotation curve. We propose that in the early stages of the development of Wd 1 a large interstellar bubble of diameter about 50 pc was created by the cluster members. This bubble has a dynamic age similar to the age of the cluster. Small expanding bubbles, with dynamical ages $\sim 0.6$ Myr are found around Wd 1, which we suggest consist of recombined material lost by cluster members through their winds.Comment: 8 pages, accepted for publication in A&

Contamination of short GRBs by giant magnetar flares: significance of downwards revision in distance to SGR 1806-20

We highlight how the downward revision in the distance to the star cluster associated with SGR1806-20 by Bibby et al. reconciles the apparent low contamination of BATSE short GRBs by intense flares from extragalactic magnetars without recourse to modifying the frequency of one such flare per 30 years per Milky Way galaxy. We also discuss the variety in progenitor initial masses of magnetars based upon cluster ages, ranging from ~50 Msun for SGR 1806-20 and 1E 1647-455 in Westerlund 1 to ~15 Msun for SGR 1900+14 and presumably 1E 1841-045 if it originated from one of the massive RSG clusters #2 or #3

VdBH 222: a starburst cluster in the inner Milky Way

Context. It has been suggested that the compact open cluster VdBH 222 is a young massive distant object.Aims. We set out to characterise VdBH 222 using a comprehensive set of multi-wavelength observations.Methods.We obtained multi-band optical (UBVR) and near-infrared (JHKS) photometry of the cluster field, as well as multi-object and long-slit optical spectroscopy for a large sample of stars in the field. We applied classical photometric analysis, as well as more sophisticated methods using the CHORIZOS code, to determine the reddening to the cluster. We then plotted dereddened HR diagrams and determined cluster parameters via isochrone fitting.Results. We have identified a large population of luminous supergiants confirmed as cluster members via radial velocity measurements. We find nine red supergiants (plus one other candidate) and two yellow supergiants. We also identify a large population of OB stars. Ten of them are bright enough to be blue supergiants. The cluster lies behind ≈7.5 mag of extinction for the preferred value of RV = 2.9. Isochrone fitting allows for a narrow range of ages between 12 and 16 Ma. The cluster radial velocity is compatible with distances of ~6 and ~10 kpc. The shorter distance is inconsistent with the age range and Galactic structure. The longer distance implies an age ≈ 12 Ma and a location not far from the position where some Galactic models place the far end of the Galactic bar.Conclusions. VdBH 222 is a young massive cluster with a likely mass >20 000 M⊙. Its population of massive evolved stars is comparable to that of large associations, such as Per OB1. Its location in the inner Galaxy, presumably close to the end of the Galactic bar, adds to the increasing evidence for vigorous star formation in the inner regions of the Milky Way

Perceived enablers and barriers to optimal health among music students: a qualitative study in the music conservatoire setting

Student health and wellbeing within higher education has been documented as poor in relation to the general population. This is a particular problem among students at music conservatoires, who are studying within a unique educational context that is known to generate both physical and psychological challenges. This article examines how conservatoire students experience health and wellbeing within their institutional context, using a framework from health promotion to focus attention on perceived enablers and barriers to optimal health in relation to three levels: lifestyle, support services, and conservatoire environment. In order to respond to the individuality of students’ experiences, a qualitative approach was taken based on semi-structured interviews with 20 current or recent conservatoire students in the United Kingdom. Thematic analysis revealed a complex set of enablers and barriers: (i) lifestyle enablers included value placed on the importance of optimal health and wellbeing for musicians and daily practices to enable this; lifestyle barriers included struggling to maintain healthy lifestyles within the context of musical practice and learning; (ii) support enablers included accessible support sources within and beyond the conservatoire; support barriers included a perceived lack of availability or awareness of appropriate support; (iii) environmental enablers included positive and enjoyable experiences of performance as well as strong relationships and communities; environmental barriers included experiences of comparison and competition, pressure and stress, challenges with negative performance feedback, psychological distress, and perceived overwork. The findings reveal a need for health promotion to focus not only on individuals but also on the daily practices and routines of conservatoires. Additionally, they suggest that continued work is required to embed health and wellbeing support as an integral component of conservatoire education, raising awareness so that all students are fully informed of where, and how, to seek the information or help that they may need. Finally, they indicate a need for more radical scrutiny of the cultures of conservatoires and an assessment of how these can be modified to best optimize students’ health and wellbeing

Creative Methods for Improving Health Literacy in Underserved Communities

In 2003, Recovery Café was founded with the goal of providing long-term recovery support to those in the margins, including those experiencing homelessness, addiction, and mental health challenges (Recovery Café, 2022). Recovery Café provides members with the support needed to gain and maintain access to housing, social and health services, healthy relationships, education, and employment (Recovery Café, 2022). Recovery Café provides this support by offering a safe space, with nutritious meals, fostering a loving community, and providing resources such as educational opportunities, 12-step meetings, and referral services (Recovery Café, 2022). In 2022, the Seattle Pacific University Lydia Green Nursing Program partnered with Recovery Café to determine and fulfill an unmet need of the organization and its members. After visiting Recovery Café and completing a windshield survey, the undergraduate nursing students determined a need for health information, presented in an appealing and accessible way. To address this need, a collection of double-sided educational sheets, with a word search puzzle on the front and information on the back, were created on the following topics: COVID-19, drug overdose prevention, sexual health, Type 2 Diabetes, vaccinations, and Hepatitis. These sheets were designed to provide an educational resource about relevant health topics that is creative, fun, and utilizes easy readability and inclusive language. Background Health literacy refers to the ability of people to access, understand, and use information to make decisions related to their health (Castro-Sanchez et al., 2016). It has been estimated that a third of adults in the United States are considered low level in terms of health literacy, with prevalence in the populations of older adults, those with low income, and those with low education level (Netemeyer et al., 2019). Consequently, low health literacy levels are associated with poorer health outcomes, including increased use of emergency services, lower adherence to health protocols, and inaccurate assessments of disease risk (Netemeyer et al., 2019). Unfortunately, public health entities do not always take health literacy levels into consideration when developing and dispersing complex public health information to communities. In the process of determining community health needs at Recovery Café, it was found that 69% of members at the café were experiencing homelessness in 2020, while 87% of members had experienced homelessness sometime in the past (“2019-20 Annual Report”, 2021). A vast majority of members also possessed education and reading levels lower than the high-school level. These demographic statistics speak to the income and education level of members at Recovery Café, demonstrating how health literacy levels may be low as well. Considering the health literacy level of this community and the subsequent need for improved accessibility to appropriate public health information, the nursing students created digestible health education fact sheets with activities to increase understanding. Activities Studies have shown that crossword and word search puzzles are effective self-learning tools that can reinforce previously acquired knowledge (Nirmal et al., 2020). Utilizing this study, the team developed six educational fact sheets focused on community health needs with corresponding word search puzzles. The primary goal of the word search puzzles was to increase engagement with health material and increase information retention. Community health needs were determined through interviewing Recovery Café members and staff, leading students to focus on COVID-19, drug overdose prevention, sexual health, Type 2 Diabetes, vaccinations, and Hepatitis. Each fact sheet provides essential health information and resources for the Recovery Café members, while the corresponding word search reinforces the material. The primary nursing diagnosis associated with the Recovery Café population was deficient knowledge of health topics. The team utilized up-to-date and peer-reviewed information to create our health sheets to increase health literacy in this population. The educational level of Recovery Café members also led to the decision to refine health information and present it so that any member, regardless of literacy level, could comprehend the information. The health education word searches were placed alongside the coloring sheets and community resources on the main activity table of Recovery Café. This puzzle-based learning engages the members of Recovery Café in the fact sheet\u27s material, thereby increasing their competence with the topic and their ability to retain the material (Nirmal et al., 2020). Outcomes The project’s first outcome goal was to educate the members of Recovery Café about different health concerns (e.g., COVID-19, drug overdose prevention, sexual health, Type 2 Diabetes, vaccinations, and Hepatitis). A limitation was that there are many health concerns at Recovery Café that need to be addressed. To address this limitation, each group member focused on a specific health problem so that education could be provided on as many topics as possible. The next outcome goal was to create fact sheets that improve the health literacy among the members. A limitation to this goal was that most members at the Recovery Café read between 5th to 8th grade levels. To avoid these limitations, everyone took medical terms and simplified them as much as possible, and gave definitions within the word searches on words that might be harder to understand. The last outcome goal was to provide an incentive or an activity to keep the members engaged and want to learn more about these health concerns. A limitation was finding an activity that will encourage members to pick up the fact sheets and keep their interest. Avoiding this limitation was quite difficult, but since the Recovery Café has coloring nights, karaoke nights, and other engaging activities available, the team decided that a word search with the fact sheets might be the best way to keep the members engaged. However, due to time constraints, these are the desired outcomes, and the team will not be able to evaluate whether they have been met. Conclusion In conclusion, the student\u27s mission was to meet with the individuals at Recovery Café and discover what nursing students could do to provide the organization with the help that they might need. Learning about the history of this community center encouraged students to become more engaged in terms of figuring out some new methods to further provide for this community. The population at Recovery Café described a need for health education in a way that members can easily understand. This includes topics such as COVID-19, drug overdose prevention, sexual health, Type 2 Diabetes, vaccinations, and Hepatitis. The idea of creating word search puzzles and fact sheets adequately demonstrates the main information these individuals need to know. Taking into consideration their education level and condition, the team made sure to create pieces of information that would make sense to them, are appealing to the eye, and would encourage them to become more engaged in learning more about these health topics. This method will further improve their knowledge deficit regarding topics that are important for them to be wary about and improve overall health literacy. References American Diabetes Association. (n.d.). Help with insulin is a phone call away. https://insulinhelp.org/ Banta-Green, C., Kuszler, P., Coffin, P., & Schoeppe, J. (2011). Washington’s 911 Good Samaritan Drug Overdose Law - Initial Evaluation Results. Alcohol & Drug Abuse Institute, University of Washington. http://adai.uw.edu/pubs/infobriefs/ADAI-IB-2011-05.pdf Carusone, S. C., Guta, A., Robinson, S., Tan, D. H., Cooper, C., O’Leary, B., Prinse, K. D., Cobb, G., Upshur, R., & Strike, C. (2019). 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