Mental health and wellbeing implications of the COVID-19 quarantine for disabled and disadvantaged children and young people: evidence from a cross-cultural study in Zambia and Sierra Leone

BACKGROUND

The mental health impact of the COVID-19 pandemic and quarantining on children and young people (CYP) living in low- and middle-income countries (LMICs) has yet to be fully comprehended. CYP in LMICs are at utmost risk, given the COVID-19-related restrictions and social distancing measures, resulting in reduced access to school-based services for nutritional and mental health needs. This study examined mental health of CYP during the first COVID-19 lockdown in Zambia and Sierra Leone.

METHOD

A total of 468 disabled and disadvantaged CYP aged 12 to 25 completed a planning tool that comprised the short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), as well as open-ended questions covering social connectedness, physical distancing and educational challenges during the lockdown. The community coaches screened individuals and families who could be eligible to receive emergency aid, and based on a convenience sample following distribution of aid, recipients were invited to complete the planning tool.

RESULTS

The data showed that participants in the global south have increasing anxieties and fears centred on accessing offline educational resources and income loss in the family effecting food security and their ability to return to education. Mean (SD) SWEMWBS scores for all participants in Zambia and Sierra Leone, were 19.61 (3.45) and 21.65 (2.84), respectively. Mental well-being scores were lower in females, children aged 12-14 and participants with two or more disabilities. Factors significantly associated with poor mental wellbeing in the sample were: type of disability, nationality, peer relationships, connection to others during the pandemic, knowledge about COVID-19, worry about the long-term impact of COVID-19, and the types of self-isolating.

CONCLUSION

The study shows that participants who self-reported low levels of COVID-19 health literacy also scored low on the mental wellbeing self-assessment. Yet, despite undoubted limited resources, these CYP are doing well in identifying their needs and maintaining hope in the face of the problems associated with COVID-19 in countries where stigma persists around mental ill-health.

Desert wanderings: pathways for whole, broken and shattered psyches

This paper challenges an implicit assumption of analytical psychology that centred, mandalic images express psychical wholeness in an optimal fashion across cultures and eras. I suggest that liminal, bardo-like eras, such as our 'post-modern' one, constellate complex, antithetical and ec-centric images, which are process-oriented and which encompass wholeness and fragmentation, conjunction and disjunction, thus holding and expressing actual individual and collective experience. In our era, we inhabit unfolding states of wholeness, brokenness and fragmentation. Images of wholeness, emerging spontaneously from the unconscious, may reflect part or all of these contradictory realities. Examples of such antithetical Self-images are developed from the ancient midrashic traditions of the rabbis; from Jung's contemporary exposition of Pauli's 'world-clock' dream; from Kepler's discovery, at the dawn of modernity, that the planets circled the sun in ellipses rather than circles; and from a clinical illustration.

Subjective evaluation of four low-complexity audio coding schemes

In this study the subjective performance of four low-complexity audio data compression methods are compared, operating at nominal bit rates of 2, 3, 4, and 5 bits per sample, applied to four 20-kHz bandwidth, 16-bits per sample digitized musical signals. The simple compression schemes compared were elementary differential pulse-code modulation (DPCM), noise feedback coding DPCM (NFC-DPCM), adaptive quantizer DPCM (DPCM-AQB), and a recently proposed method known as recursively indexed quantizer DPCM (RIQ-DPCM). Pairs consisting of a reconstructed signal and a reference signal were presented in a two-interval preference experiment. The reference signals were processed for specified levels of modulated noise reference unit (MNRU) in order to estimate the equality threshold rating (ETR) of the reconstructed audio stimuli. The subjective MNRU values were found to increase by 2-5 dB for each increment in bits per sample. The DPCM-AQB scores were found to be 8-10 dB higher than for DPCM and NFC-DPCM. RIQ-DPCM was rated highest, exceeding the DPCM-AQB results by 2-5 dB in all tests. Objective measurements of segmental signal-to-noise ratio (SNRSEG) for the reconstructed signals predicted a performance level 2-5 dB lower than was actually found in the subjective results, particularly for SNRSEG values below 25 dB.

Preliminary evaluation of a new curriculum--incorporation of problem based learning (PBL) into the traditional format

An account of the establishment of a Problem Based Learning (PBL) curriculum at the Eric Williams Medical Science Complex Republic of Trinidad and Tobago provides the forum for a critical analysis of this process and for dialogue with current relevant literature on similar attempts elsewhere. Initial resistance to change and the assessment of the new system is discussed in the light of the fact that this is the first Caribbean territory to adopt Problem Based Learning as the major instrument to be employed in tertiary level medical education. The analysis uncovers a model of practitioner/researcher which provides a useful conceptual and operational framework for the articulation of the role of those engaged in effecting and studying the management of change.