Category Archives: Uncategorized

John Sandblom: Improving Quality of Life

John Sandblom is a co-founder, Board member and the Treasurer of Dementia Alliance International (DAI). This is his keynote presentation at the opening Ceremony of the ADI Conference in Chicago. He shares the value of joining DAI, and of self advocacy.

“Improving quality of life for people with dementia” by John Sandblom

If you are watching this now, please consider donating to DAI. If you had been privileged enough to attend this conference and listen to John in persn, it would have cost you much more than the registration fee of more than $800 to attend the conference.

DAI is a 501 (c) 3 registered charity; a non-profit organization of people with dementia from 49 countries seeking to represent, support, and educate others living with the disease, and an organization that will provide a unified voice of strength, advocacy and support in the fight for individual autonomy and improved quality of life. Our activisnm for the human rights for all will continue.

Membership of Dementia Alliance International is free, and open to anyone with a diagnosis of any type of dementia. Join DAI here

Or you can subscribe to our newsletter or weekly blog, by registering your email.

Learnings from patients, by Dr Daniel Potts

In May 2019 DAI was delighted to host one of our “A Meeting Of The Minds”  Webinars, “Learnings from Patients and Families”, presented by Dr Daniel Potts.  We thank Dr Potts sincerely for giving up his time, and sharing his incredible insights, expertise and learnings, as well as his own deeply personal story. It’s an important webinar worth sharing again here.

Jerry Wylie and the Dementia Warriors

Supported by the Oregon University, the Alzheimer’s Association and many others, DAI member Jerry Wylie features in this wonderful video talking about the value of peer to peer support.

In fact, like many others with dementia, he sees it as an ‘essential service’ that everyone should be referred to soon after diagnosis. We are proud of all that Jerry continues to do since stepping down as our Vice Chair last year.

https://youtu.be/qi32xuva2HY

Congratulations Jerry, and thank you for all that you continue to do.

A new Quality of Life measure

ARC Linkage Project – A good life: developing a new quality of life instrument with older Australians for economic evaluation in aged care.

This project sought to develop a suite of quality of life measures or quality of life scale for older personsthat can be used for quality assessment and economic evaluation in aged care across community and residential aged care settings.

In order to be used for economic evaluation, the measures must be preference-based. That means the identified quality of life domains will be weighted according to the importance of those domains to older people.

Unlike other quality of life measures, these measures were developed from their inception with older people.

The project has sought to be inclusive in recruitment, including people with cognitive impairment and dementia if they are able to provide informed consent to participate. Initial eligibility was determined by providers and final eligibility by the research team. Participants were not required to undertake any cognitive testing as part of eligibility determination or for data collection.

In late 2019 the project launched its website which will be updated throughout the project: https://www.qol-acc.org/

Chief Investigator organizations: Flinders University, University of Sydney, Australia National University and Dementia Alliance International, and our Chair Kate Swaffer who is based in Adelaide, has been actively invovled in the project.

Discrimination Campaign – COVID19 #WHA73

The International Disability Alliance and the International Disability and Development Consortium have launched a Covid19 Discrimination campaign to call to raise awareness of examples of the discrimination that persons with disabilities experience in accessing services and call on the global community on the critical and urgent need to deliver disability inclusive COVID-19 responses at global, national and local levels.

The issue:

The one billion persons with disabilities are one of the most excluded groups in our society. The World Health Organisation and various other UN agencies are reporting that people with disabilities are being disproportionately affected by COVID-19.

The issue of discrimination is particularly pressing. Evidence suggests that persons with disabilities are among the hardest hit during the COVID-19 pandemic. Dangerous narratives have been emerging that people with disabilities cannot contribute to the response to COVID-19, make their own decisions and most worryingly, that their lives are not considered as worth saving compared to others ‚Äď in direct contradiction of the UNCRPD and all other human rights instruments.

The Aim:

The campaign will raise awareness of examples of the discrimination that persons with disabilities experience in accessing services (such as health services) during the global pandemic. It will call on the global community on the critical and urgent need to deliver disability inclusive COVID-19 responses at global, national and local levels.

This phase of the campaign will launch to coincide with the World Health Assembly. The public facing elements of the campaign will support the advocacy statement given to the World Health Assembly. The campaign will use the World Health Assembly to highlight the particular barriers persons with disabilities experience accessing health services and why the need to act is so critical and urgent.

Key Campaign Messages:

  • People with disabilities are being disproportionately impacted by the COVID-19 pandemic.
  • Information is not being made available in accessible formats, so persons with disabilities are denied their right to make informed decisions.
  • Negative attitudes mean persons with disabilities are often considered less of a priority to receive critical health care, or their lives seen as worth less than the lives of persons without disabilities.
  • Social distancing may be particularly challenging for persons with disabilities who require support with personal care.

Persons with disabilities are also more likely to live in institutional settings, which have been shown to be an environment where the COVID-19 virus is exacerbated.

Physical buildings (including health facilities, and testing and quarantine centers) are often inaccessible, and reasonable accommodations like interpreters are often not available.
In many situation, COVID-19 health responses have hindered access to other health services for persons with disabilities. Often, these health services are important and lifesaving, such as rehabilitation services and medicine for people with epilepsy.

Women and girls with disabilities face additional barriers to accessing sexual and reproductive health and rights.

World Health Assembly Statement

The Seventy-third of the World Health Assembly will take place in Geneva, Switzerland from 17 ‚Äď 21 May 2020. The WHA is attended by delegations from all WHO Member States and focuses on a specific health agenda prepared by the Executive Board.
The International Disability Alliance (IDA) and International Disability and Development Consortium (IDDC) members have submitted written statements to be considered under provisional agenda item 3 Address by WHO Director-General devoted to the COVID-19 pandemic response in advance of the opening of the Health Assembly.

Access the official statements here.

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Dementia Alliance International, a an organiszation representing the more than 52 million people with dementia, who are all people with acquited disabilities, thanks IDA and IDDC for their continued advocacy to realise the disability rights for us all.

WHO 73rd World Health Assembly: ADI Statement

WHO 73rd World Health Assembly Statement submitted by Alzheimer’s Disease International

Written statements exceptionally considered under provisional agenda item 3 Address by WHO Director-General devoted to the COVID-19 pandemic response in advance of the opening of the Health Assembly.

Honourable chair and distinguished delegates,

Alzheimer’s Disease International (ADI) is the global umbrella organisation of Alzheimer associations, representing over 100 associations and federations and in official relations with the WHO since 1996.

In light of the global COVID-19 pandemic, we would like to express several concerns on behalf of the 52 million people living with dementia globally, and the millions of others impacted by the condition.

Age is the biggest risk factor for dementia, and we know the elderly are the age group being most seriously affected by COVID-19. With that in mind:

1. In view of the widespread global shortages of medical resources, especially ventilators, it is vital that healthcare professionals have clear guidelines to facilitate extremely difficult decision making Рoften in pressurised triage situations Рabout access to treatment.

2. When available, such guidelines should not be used in a way which is discriminatory on the basis of age or of having a condition like dementia. The rights of people living with dementia and their families must be respected and upheld.

3. Families all over the world are faced with incredibly difficult decisions about whether or not to hospitalise a loved one, risking not acting in their best interest but often having to decide without medical training or knowledge. Governments should help families facing these situations.

4. Elderly people in long-term care, the majority of whom have dementia, have been hit¬†particularly hard by the COVID-19 pandemic ‚Äď with a great number of COVID-19¬†related deaths occurring in long-term care facilities. In many countries, long-term¬†care is seriously under-funded. It is imperative that governments recognise the need¬†to integrate and coordinate health and long-term care and to fund both equally.

5. It is essential that the mental health and wellbeing of our world’s elderly populations is supported, in particular because they are a group already at greater risk of social isolation, and social distancing measures will apply to them for longer. We call on all governments to include dementia in their COVID-19 response plans.

6. We implore all governments to support palliative and end of life care for all individuals, especially those living with dementia who may be distressed and unable to express pain.

7. Social distancing measures during the COVID-19 crisis are necessary to control the spread of the virus but have resulted in increased isolation and great disruption to people’s daily activities that contribute to brain health. As a result, we are concerned that the number of people experiencing cognitive decline may increase. We will continue to follow this nascent area of research, and to support the distribution and awareness of the WHO risk reduction guidelines.

8. People with dementia often have other non-communicable diseases (NCDs) including mental health conditions. The prevalence of these conditions is likely to increase as a result of COVID-19. This crisis has shown that the people living with NCDs are not given commensurate funding or support services.

9. Diagnosis rates for dementia have decreased during the outbreak as people are afraid to attend clinics. This will greatly impact on people’s prognosis due to later diagnoses and cognitive decline occurring due to lack of support or access to medication. In addition, more families will be unable to access timely information on the condition and receive adequate psychosocial support. As a consequence, stigma may increase.

10. The possible disruption to clinical trials could be particularly devastating for those living with dementia, given that there is currently no disease modifying treatment and disease progression will exclude participation.

11. The mortality associated with the pandemic will also impact dementia prevalence. The data on dementia-COVID-19 mortality is sparse, and we are concerned that the data around the number of people with dementia, who are dying in their homes, is not being recorded accurately.

We are concerned that the factors outlined above will undermine progress being made¬†towards achieving the targets of the WHO‚Äôs Global action plan on dementia. We will¬†continue to work with our member Alzheimer and dementia associations and the WHO to¬†maintain progress, but it is essential that every Member State includes dementia in their¬†responses to COVID-19.¬†Otherwise, people living with dementia ‚Äď who‚Äôs concerns are so¬†often side-lined at the best of times ‚Äď will be left behind.

 

 

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Reminder to register now for our second May “Meeting Of The Minds” Webinar, Safe and Just Futures in Residential Aged Care; Lessons Learned.

 

International Nurses Day 2020

We celebrate¬†International Nurses Day¬†around the world every year on May 12, which is the anniversary of Florence Nightingale’s birth.¬†DAI also commemorates this important day each year to ensure nurses are honoured and recognised for their work.

Many of our members are retired nurses, and without nurses, many of the services we end up needing would not be available.

The World Health Organisation has also designated 2020 as the International Year of the Nurse and the Midwife, to recognise the important work they do, and the vital role they play in providing health services.

They also celebrated them on International Nurses Day, and DAI also celebrated and honoured nurses on World Health Day.

Today, Dementia Alliance International (DAI) is asking you to make a donation to support our important work, in honour of the many nurses in our organisation, and the work they have continued to do in supporting other so many other people also diagnosed with dementia.

Once a nurse, always a nurse!

Due to the Coronavirus pandemic, our sponsors may not be in a position to commit¬†to further funding this year and beyond… We therefore need your help.

Please donate generously.

World Health Day 2020: DAI Honours all nurses

It was World Health Day on 7 April 2020, and we celebrated the work of our nurses and midwives by reminding everyone of the critical role they play in keeping the world healthy. Nurses and other health care professionals (HCPs) are at the forefront of the COVID-19 response.

Frankly, without nurses, there would be no response to the COVID pandemic; without them, our lives would not be as safe.

Many DAI members were also qualified nurses or health care professionals, and although they cannot contribute to the current health crisis as nurses, due to having retired, their work has continued on through DAI.

Determination, service to others, empathy and compassion are the trademarks of all nurses. DAI salutes and thanks you.

Below we have shared some of the stories of a number of retired nurses wo are also members of DAI, not only to help raise awareness of the work done by nurses and midwives, but to raise awareness of the important work done by members of Dementia Alliance International (DAI).

Please support our work at this important time.

Listen to DAI Chair, CEO and co founder Kate Swaffer, on being a nurse, volunteering for DAI, and why we need your support.

Image source: Kate Swaffer © 1987

By Kate Swaffer: As a proud retired nurse, who has worked in aged and dementia care, and then operating theatres, it is heartbreaking to see just how hard our nurses are working globally to support the whole world through the COVID-19 pandemic, and this is too often without adequate infection control measures available to keep THEM safe.

Many people with dementia who take on leadership roles in DAI were also nurses or other health care professionals. It seems to be innately who ‘we’ are: helping others. In my life as a nurse and also a volunteer, which I have been doing since my early teens, DAI is the most important volunteer role I have ever undertaken.

Although I work at least as many hours every week as most other CEO’s, very often more, but without the same funding or respect as them, it is truly worthwhile leading an organisation that is so proactively working to support others with dementia to live more positively, and to advocate for human rights and disability rights.

But DAI needs your help. Without donations or partnerships, DAI could not continue, as we are not a well funded organisation; on top of that, we  still have no paid staff.

Image source: Maria Turner © 2020

By Maria Turner: “Apart from my family, my nursing career was everything to me, and I was devastated having to give it up. I had to retire from my work as a registered nurse after 30 years, and although I had spent my life taking care of others, mostly in a critical care environment, and I am determined to not let my diagnosis change that. I have always been passionate about volunteering ever since I was 8 years old, and am still actively volunteering for the American Red Cross and for Dementia Alliance International.

Although I was diagnosed with FTD in 2016 at the age of 48 and with ALS shortly thereafter, I do live a full and positive life. I host weekly peer-to-peer support groups all over the world for DAI, and I am determined to help those who currently may not have as many resources as those of us who are attending this conference this week.

DAI and I want to see a stronger and more inclusive community by reaching out to those who are recently diagnosed so that we can emphasize the fact that we must plan for and be excited about our own futures even after a diagnosis.

If I can just walk alongside one person and prevent them from having to walk this path alone, I will know that I had a part in breaking down barriers and helping end the stigma a dementia diagnosis can and will bring.

  • Do not ever let dementia define you.
  • Life doesn’t end with a dementia diagnosis, a new life begins.

Maria’s son Rhys also said: ‘Through DAI, mum has been able to fulfill her goal of helping others by giving her a platform to talk to the newly diagnosed. Her responsibilities as a board member keep her sharp and focused. Peers have taken the place of her patients, and through the support groups, she is still helping so many other people.

This is in fact, why it is so important for people with dementia who were nurses to consider volunteering; whether it is at their local Red Cross or Church, or an organisation such as DAI.

It‚Äôs not just important it‚Äôs the fibre of our very beings.”

(includes excerpts from a speech given by Maria and Rhys at the ADI conference Chicago: Mother and Son)

Image source: Phyllis Fehr © 2020

By Phyllis Fehr: “As a person living with Alzhiemers and a former Intensive Care Unite (I.C.U.)  Nurse, I have always felt that this was a hidden and never talked about disease. When I was diagnosed I felt it was my new lease on life to change this so that other people living with dementia didn‚Äôt have to hide that they could have a voice and that we have support in each other.

During this time of COVID-19 it is never been more apparent to me that we need extra support. We all know what isolation feels like and to have this added burden of having to be isolated and not leave the house it’s very difficult, it’s a different kind of isolation. So I felt it highly important that we try and help people Living with Alzheimer’s and dementia to not feel so isolated, not feel so alone and to feel supported.

In my years of being a D.A.I. member the camaraderie and learning experiences that we have amongst us is absolutely phenomenal it helps me to get through my day-to-day life.

D.A.I. offers online peer to peer support groups. We learn from each other, we learn how to cope with the day-to-day challenges of living with dementia. We help each other to stay uplifted, we support each other in times of need and there‚Äôs no bigger need them at the present. So D.A.I. chose to add extra support groups during this time.  I think it‚Äôs been wonderful rather than having a once a week meeting we get together twice a week.

We help each other by saying what we‚Äôre doing to cope, so that others see that there still are ways to see your grandchildren even though they‚Äôre not in front of you. We discussed ways of helping us deal with our stress and anxiety over all of what‚Äôs happening and without these groups I don‚Äôt know if I personally  would be able to cope.

With my nursing background I know what is going on, I know how sick people are and I fear for other people who may get this disease. I also know that people with any type of dementia including Alzheimer’s are more vulnerable at this time and worry about getting this disease, so if we get any form of illness we all decline a little bit more and we‚Äôre all worried that if we get this where would we be.”

Image souce: Agnes Houston

By Agnes Houston: “I feel I was given a diagnosis and could either sink into the corner and be ‚Äėdone to‚Äô or take control of my life. I feel like I am leaving a legacy for others so they can stand up and be a citizen, not a victim.” (extract from an interview for Elder Magazine, Seizing control of dementia)

Image source: Tracey Shorthouse

By Tracey Shorthouse: “Tracey, a retired nurse, was diagnosed with early-onset dementia and posterior cortical atrophy (PCA) when she was in her mid-forties. Tracey is determined to keep her mind and her body active during the coronavirus pandemic with a variety of activities and hobbies at home…. In the old days, when I was a nurse, I used to use Davina McCall‚Äôs workout DVDs in a way to keep fit. She really inspired me. And I have started to do that again as it‚Äôs so important to keep my body moving.” (extract from the Alzheimers Society UK blog, ‘Life during lockdown’)

It is indeed important to keep moving at this time, and we recommend you contact your local gymnasiums, exercise physiologists, pilates or yoga instructors or other providers including physiotherapists, and ask if they have online group. Many are currently providing online telehealth visits like this for free.

Thank you for honouring nurses and midwives with us, and for your support.

We sincerely hope you will support DAI by donating or partnering with us. Thank you.

Supporting people with dementia through COVID-19

This DAI infographic provides an easy reference to support for people with dementia globally.

During the current COVID-19 pandemic, members of DAI and almost all others are rightfully extremely worried about the impact on their day to day lives of this outbreak, including being able to shop in their communities for the most basic of supplies.

In most countries cinemas, almost all essential services such as restaurants, conference venues, hairdressers, beauty therapists and nail salons have been ordered to close. Physical distancing measures are in place (commonly referred to as social distancing), In some countries, no more than two people can meet in any one group, and they must be 1.5 metres apart.

DAI is providing additional support to DAI members at this difficult time by hosting a number of extra support groups, reported on recently.

If you have demenetia, or know someone who does, please refer them to DAI, or to their local or national Alzheimer’s organisation, as many are also now providing online support.

These are extraordinary and extremely stressful and upsetting times for most people, perhaps especially older persons and marginalised groups such as people with dementia, and the information  below may be of interest.

It is a challenging time for everyone, and enhances why access to clear, accurate, and up-to-date information is essential.

Alzheimer’ Disease International (ADI)

ADI has recently published a¬†position¬†paper on COVID-19 with members of their Medical and Scientific Panel, which as their strategic partner,¬†our Chair Kate Swaffer was asked to contribute as an author, and provide a quote. The global impact of¬†COVID-19¬†is unprecedented, particularly on vulnerable groups such as people living with¬†dementia¬†and their families and caregivers.¬†We hope that by sharing such information, we can¬†assist persons and families in making informed decisions about how, when and where to seek help at this difficult time. You can read the full article here…

Within the article, several important topics are addressed:

  • Is¬†COVID19¬†different for people with¬†dementia?
  • Different countries’ guidance on¬†how and when to seek further treatment
  • Difficult decisions around hospital admission and triage
  • Other information on¬†COVID¬†prevention and treatment and additional challenges to consider for people living withdementia
The World Health Organisaton (WHO):

The WHO provides daily updates and many other resources Рhttps://www.who.int/emergencies/diseases/novel-coronavirus-2019 and including a very recently released publication for children Рhttps://www.who.int/news-room/detail/09-04-2020-children-s-story-book-released-to-help-children-and-young-people-cope-with-covid-19

The following is a précis of recently received information from the WHO Working Group webinar on COVID-19 and Non Communicable Diseases (NCDs) webinar:

The United Nations three strategic priorities:
  1. Contain the spread of the COVID-19 pandemic and decrease morbidity and mortality (WHO SPRP/2)
  2. Decrease the deterioration of human assets and rights, social cohesion and livelihoods
  3. Protect, assistant and advocate for refugees, internally displaced people, migrants and host communities particularly vulnerable to the pandemic.
The WHOs three strategic priorities:
  1. Rapidly establishing international coordination and operational support
  2. Scaling up country readiness and response operations
  3. Accelerating priority research and innovation.

Links between COVID-19 and other Non-Communicable Diseases What we know so far:

  • People of all ages can be infected by COVID-19.
  • The risk of becoming severely ill with the virus appears to increase for people who are 60+.
  • People living with NCDs also appear to be more vulnerable to becoming severely ill with the virus, in particular people living with:
  • Cardiovascular disease (e.g. hypertension, persons who have had, or are at risk for, a heart attack or stroke)
  • Chronic respiratory disease (e.g. COPD)
  • Diabetes
  • Cancer
  • Smokers are likely to be more vulnerable to COVID-19

The International Disability Alliance (IDA) is providing many updates to the disability community, as well as hosting webinars and live Facebook chats. DAI has regular opportunities through the IDA to contribute to policy and publications about disability to ensure people with dementia are included.

Many other orgnaisations are hosting webinars and live Facebook chats; listing them here is difficult as there are simpy too many, and new opportunitiues from different organisations and individuals are emerign every day.

Please contact us if we can assist in any way.

What we can’t do alone, we can do together.

Extra support during COVID-19

 

 

 

In these extraordinary times as we are all facing the collective global challenges of the COVID-19 pandemic, we are united in the sense that no matter where we are in the world, we are being asked to minimise physical contact with everyone, and to support each other.

Thankfully technology is on our side, and people with dementia have been using it for many years to maintain or develop new friendships.  DAI has existed entirely due to zoom, for all communications and meetings, so most of our members are used to it.

DAI is delighted to be able to share with you a number of additional peer to peer support groups which have been set up to support our members during COVID-19.

Although isolation and distancing is something many people with dementia experience once they share the news of their diagnosis, it has increased, and the basics of living have been made more difficult. Things such as shoppng, visiting family,  attending a local advocacy or support group, all have been impacted by the restrictions that have been imposed on all members of the community.

An updated list of the DAI peer to peer support groups

Note: If you are not already in a DAI support group and wish to join one, please contact us at [email protected]

Weekly peer to peer support groups:

  • Mondays 1:30 PM CSTNEW GROUP¬†– co hosts Christine Thelker, Phyllis Fehr and Kate Swaffer, US/CA
  • Mondays 10:00 AM ACST ‚Äď co-hosts Eileen Taylor & Kate Swaffer, AU/NZ/SG
  • Mondays 9:00 AM GMC ‚Äď co-hosts James McKillop & Dennis Frost,¬†UK/EU/SA/AU
  • Wednesdays 1:30 PM ACST ‚Äď co-hosts Bobby Redman and Kate Swaffer (Back up hosts: Alister Robertson, Cheryl Day & Eileen Taylor),¬†AU/NZ/SG
  • Thursdays 1:00 PM CDT ‚Äď co-hosts John Sandblom & Wally Cox, USA/CA
  • Thursdays 3:00 PM CDT ‚Äď co-hosts Sid Yidowitch, Dallas Dixon & Kate Swaffer, USA/CA/AU
  • Fridays 2pm ACST – NEW GROUP – co hosts Kate Swaffer and Eileen Taylor, AU/NZ/SG
  • Fridays 2:30 PM CDT ‚Äď co-hosts Christine Thelker & Diane Blackwelder, USA/CA

Living Alone Social Support Groups

  • Sundays 5 PM GMC, co-hosts David Paulson & Julie Hayden, USA/CA/UK,¬†weekly
  • Sundays 5 PM AEST, co hosts Bobby Redman & Jo Browne, AU/NZ, ¬†NEW – now being hosted weekly

If you are not already in a DAI support group and wish to join, please contact us at [email protected]

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Tackling COVID-19: New Platforms and Resources

The World Health Organisation

The World Health Organisation provides daily updates on COVID-19, information on protectign yourself, data, technical advice and much more for us all to stay informed.

They also provide guidance on mental health and psychosocial support for health workers, managers of health facilities, people who are looking after children, older adults, people in isolation and members of the public more generally.

Please find below a list of materials already published.

Please send any feedback on these materials and suggestions for other materials that would be helpful to you during this outbreak to [email protected]

The Organisation for Economic Co-operation and Development (OECD)

As part of the OECD’s response to this crisis, they have launched a platform that provides timely and comprehensive information on policy responses in countries around the world, together with OECD advice, in some cases.

Alzheimer’s Disease International (ADI)

Alzheimer’s Disease International (ADI)¬†is bringing together news, resources, stories, advice and support for anyone affected by dementia around the world, dedicated to resources relating to the COVID-19 pandemic. If you have information or resources you would like them to share, please contact them.

Dementia Australia (DA)

In a coronavirus (COVID-19) update from Dementia Australia, they reported that Dementia Australia will be modifying the way they approach their service delivery and activity . They have however produced a number of very useful resources to spport us all during COVID-19:

Tips for people living with dementia
Tips for carers, families and friends of people living with dementia
Tips for residential care providers
Tips for home care providers

LTC Responses to COVID-19: International Long Term Care Policy Network

Resources to support community and institutional Long-Term Care responses to COVID-19. This website has been assembled by a hopefully growing team of volunteers working on Long-Term Care research, to provide a space to bring together all those really useful resources we were spotting on Twitter. Please join if you can. Adelina Comas-Herrera (@adelinacohe).

Please feel free to contact us if you have other information or sites for us to consider sharing.