mr. mister: a social robot with aromatherapeutic …...novel diffuser is an easy, healthy option to...

5
Mr. Mister: a social robot with aromatherapeutic solutions for stess and anxiety Ben Fan University of Wisconsin - Madison Thomas Powers University of Wisconsin - Madison Nikhil Trivedi University of Wisconsin - Madison Rayne Xu University of Wisconsin - Madison Bilge Mutlu University of Wisconsin - Madison ACM Reference Format: Ben Fan, Thomas Powers, Nikhil Trivedi, Rayne Xu, and Bilge Mutlu. 2019. Mr. Mister: a social robot with aromatherapeutic solutions for stess and anxiety. In Proceedings of ACM Conference (Conference’17). ACM, New York, NY, USA, 5 pages. https://doi.org/10.1145/nnnnnnn.nnnnnnn ABSTRACT Many who suffer from stress and anxiety use aromatherapy, the diffusing of essential oils, to relax and potentially relieve their negative moods. In this paper, we present Mr. Mister, a robotic diffuser controlled through the Google Assistant platform. This novel diffuser is an easy, healthy option to reduce stress through aromatherapeutic methods. In this paper, we present the blueprint for Mr. Mister and a brief study of its effectiveness. The results show that future iterations of Mr. Mister have potential to be viable, healthy ways to induce relaxation and reduce stress. The results also demonstrated potential features for the next iteration of a similar robot and certain qualities an emotional, aromatherapeutic robot should have. 1 INTRODUCTION Within the last several years, several studies have confirmed the prevalence of mental illness such as stress and anxiety.[1] Unfortu- nately, mental illness is often medicated in unhealthy ways. Further- more, the healthier alternatives to relieving stress, such as physical exercise or meditation, require sufficient practice and discipline for any significant stress relief. In the tense moment, people are least likely to have self-control and instead indulge in the unhealthy stress relievers. The wide range of these unhealthy alternatives, anything from unhealthy eating to television, are addictive in nature and have a general ease of use and availability (a television can be watched with a push of a button), leaving many stumped for healthy solutions.[6] Many healthy stress relief options, from lighting candles to vigorous exercise, fail in that they do not have an easy barrier of entry (easy Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for components of this work owned by others than ACM must be honored. Abstracting with credit is permitted. To copy otherwise, or republish, to post on servers or to redistribute to lists, requires prior specific permission and/or a fee. Request permissions from [email protected]. Conference’17, July 2017, Washington, DC, USA © 2019 Association for Computing Machinery. ACM ISBN 978-x-xxxx-xxxx-x/YY/MM. . . $15.00 https://doi.org/10.1145/nnnnnnn.nnnnnnn for the person to choose when stressed) and engaging (encouraging the individual to continue the healthy option long term). We address this challenge with a system called Mr. Mister, a robotic diffuser that releases aromas in visual patterns to calm a stressed owner. The system consists of casing to hold the liquid aroma, a mister, a motor attached to a disk to create patterns in the propelled mist, a Raspberry Pi and any Google platform. A working prototype can be seen in Figure 1. Figure 1: The Mister Mister Prototype More specifically, Mr. Mister addresses the ease of use issue by using the owner’s existing Google platform (any smartphone, Google Home and most Google products) to receive its order di- rectly. Users don’t have to relearn a new system; instead, they use an already familiar service and though simple steps, activate their healthy diffusing option. The diffuser is also engaging, releasing calming aroma and interesting visual patterns. Being both healthy and easy to use, the system is a unique solution to a challenges faced by millions of people. We tested our product on participants, asking them questions about usability, design and their general thoughts. The results in- dicate successes in the prototype and a few areas of improvement. The overall results suggest Mr. Mister is a promising, early-stage model and that later iterations will be extremely successful.

Upload: others

Post on 24-Jul-2020

0 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Mr. Mister: a social robot with aromatherapeutic …...novel diffuser is an easy, healthy option to reduce stress through aromatherapeutic methods. In this paper, we present the blueprint

Mr. Mister: a social robot with aromatherapeutic solutions forstess and anxiety

Ben FanUniversity of Wisconsin - Madison

Thomas PowersUniversity of Wisconsin - Madison

Nikhil TrivediUniversity of Wisconsin - Madison

Rayne XuUniversity of Wisconsin - Madison

Bilge MutluUniversity of Wisconsin - Madison

ACM Reference Format:Ben Fan, Thomas Powers, Nikhil Trivedi, Rayne Xu, and Bilge Mutlu. 2019.Mr. Mister: a social robot with aromatherapeutic solutions for stess andanxiety. In Proceedings of ACM Conference (Conference’17). ACM, New York,NY, USA, 5 pages. https://doi.org/10.1145/nnnnnnn.nnnnnnn

ABSTRACTMany who suffer from stress and anxiety use aromatherapy, thediffusing of essential oils, to relax and potentially relieve theirnegative moods. In this paper, we present Mr. Mister, a roboticdiffuser controlled through the Google Assistant platform. Thisnovel diffuser is an easy, healthy option to reduce stress througharomatherapeutic methods. In this paper, we present the blueprintfor Mr. Mister and a brief study of its effectiveness. The resultsshow that future iterations of Mr. Mister have potential to be viable,healthy ways to induce relaxation and reduce stress. The resultsalso demonstrated potential features for the next iteration of asimilar robot and certain qualities an emotional, aromatherapeuticrobot should have.

1 INTRODUCTIONWithin the last several years, several studies have confirmed theprevalence of mental illness such as stress and anxiety.[1] Unfortu-nately, mental illness is often medicated in unhealthy ways. Further-more, the healthier alternatives to relieving stress, such as physicalexercise or meditation, require sufficient practice and discipline forany significant stress relief. In the tense moment, people are leastlikely to have self-control and instead indulge in the unhealthystress relievers.

The wide range of these unhealthy alternatives, anything fromunhealthy eating to television, are addictive in nature and have ageneral ease of use and availability (a television can bewatchedwitha push of a button), leaving many stumped for healthy solutions.[6]Many healthy stress relief options, from lighting candles to vigorousexercise, fail in that they do not have an easy barrier of entry (easy

Permission to make digital or hard copies of all or part of this work for personal orclassroom use is granted without fee provided that copies are not made or distributedfor profit or commercial advantage and that copies bear this notice and the full citationon the first page. Copyrights for components of this work owned by others than ACMmust be honored. Abstracting with credit is permitted. To copy otherwise, or republish,to post on servers or to redistribute to lists, requires prior specific permission and/or afee. Request permissions from [email protected]’17, July 2017, Washington, DC, USA© 2019 Association for Computing Machinery.ACM ISBN 978-x-xxxx-xxxx-x/YY/MM. . . $15.00https://doi.org/10.1145/nnnnnnn.nnnnnnn

for the person to choose when stressed) and engaging (encouragingthe individual to continue the healthy option long term).

We address this challenge with a system called Mr. Mister, arobotic diffuser that releases aromas in visual patterns to calm astressed owner. The system consists of casing to hold the liquidaroma, a mister, a motor attached to a disk to create patterns in thepropelled mist, a Raspberry Pi and any Google platform. A workingprototype can be seen in Figure 1.

Figure 1: The Mister Mister Prototype

More specifically, Mr. Mister addresses the ease of use issueby using the owner’s existing Google platform (any smartphone,Google Home and most Google products) to receive its order di-rectly. Users don’t have to relearn a new system; instead, they usean already familiar service and though simple steps, activate theirhealthy diffusing option. The diffuser is also engaging, releasingcalming aroma and interesting visual patterns. Being both healthyand easy to use, the system is a unique solution to a challengesfaced by millions of people.

We tested our product on participants, asking them questionsabout usability, design and their general thoughts. The results in-dicate successes in the prototype and a few areas of improvement.The overall results suggest Mr. Mister is a promising, early-stagemodel and that later iterations will be extremely successful.

Page 2: Mr. Mister: a social robot with aromatherapeutic …...novel diffuser is an easy, healthy option to reduce stress through aromatherapeutic methods. In this paper, we present the blueprint

Conference’17, July 2017, Washington, DC, USA Appleton et al.

This paper makes the following contributions: (1) an easy touse, engaging and healthy stress-relief robot, Mr. Mister; (2) theprototype blueprint to build the Mr. Mister; (3) an evaluation inwhich participants gave their feedback on the implementation andgeneral thoughts on the idea; (4) the idea that modern technol-ogy and robotic interaction can solve age-old problem of stress inproductive and novel ways.

2 RELATEDWORKBefore starting our design, we researched the effects of aromather-apy on people’s stress levels and anxiety. We wanted to confirm thata potential robot could relax people’s mood through aromatherapyand subtle movement.

Research and clinical trials have shown that aromatherapy helpsin regulating mood, especially when people are experiencing neg-ative feelings. For example, in the academic article The effect ofaromatherapy upon salivary cortisol, academic stress, academic self-efficacy and suicidal ideation in middle school students, a group ofmedical students proved that aromatherapy is effective in reducingsuicidal thoughts when students are experiencing pressure andstress.[9] Also, another article noted that the use of lavender andhumidified water subtly increased vital signs and well-being amonghospice care patients, allowing some to relax more than withouttreatment. among This supports our idea that an aromatherapyrobot can assist in reducing stress.[5]

Additional research has also shown that essential oils have im-portant effects when aromatherapy works to reduce stress levels.According to Lavender Fragrance Cleansing Gel Effects on Relax-ation, lavender has been verified to have relaxing effects. Puttingcertain scents into the diffuser is an important factor that we con-sidered when we are designing the robot.[3] According to Influenceof Fragrances on Human Psychophysiological Activity: With Spe-cial Reference to Human Electroencephalographic Response, differentfragrances can create different moods. Lavender oil has also beenproved to increase sleep qualities, which can be part of our robot’sfunction.[7]

We also found that there are existing pet robots which helpcomfort people through their engaging motion. Japan invented aseal shaped pet robot named Paro, an emotional robot, that cancorrespond to people’s touch. Those robots have shown to reduceloneliness and anxiety levels. We decided to include motion in themist patterns and motor movement of our aromatherapy robot. Therobot might not be a pet shape, but it will have physical responsesto connect with the user. Similarly, the Paro robot demonstratedthe impact a social robot could have, especially among the elderly.Paro, a robotic seal, was shown to help relax elderly participantsby engaging with them. We aim to follow this model of emotionalrobot in order to avoid simply constructing a smart diffuser.[4, 8]

The research we did inspired our idea that a robot can reducestress levels by choosing the correct essential oil for aromather-apy and through engaging, but relaxing motion. These are thetwo important factors we primarily took into consideration whendesigning and constructing our robot.

Figure 2: System Diagram of the Mister Mister

3 SYSTEM DESCRIPTION3.1 User InterfaceThe user interface of Mr. Mister consists of the hardware and anyexisting Google platforms (see Figure 3). More specifically, theprototype is built with a 3D printed encasing, which contains asmall spherical indentation to hold any liquid aroma, a mister, amotor to turn a disk that cuts though the rising vapor and anyassociated wiring. The encasing itself has eight holes for the mistto escape and the entire product requires a power source. Severalimages and diagrams can be seen below in Figures 1 and 5. Inaddition, any existing Google platform (mobile phone, AIY kit andGoogle Home) controls Mr. Mister. Portability is another importantaspect; the robot can be stationed at any convenient location suchas desks, coffee tables or kitchen counters.

Users are required to open the body, put in a liquid aroma anduse their Google device to turn Mr. Mister on with either voiceactivation or typing. This will turn on the mister and the motor,diffusing the rising aroma in patterns. Both components are con-trolled by a Raspberry Pi with Python and Arduino code that loopsinfinitely until the user shuts the system down, allowing for asmuch aroma and visual stimulus as needed to calm the owner. TheGoogle system communicates directly with the robot’s Pi, thusensuring the user never has to write code or encounter technicaldifficulty.

Two example dialogues with our prototype follow. If they sensethemselves becoming stressed, individuals can load the Google AIYkit app on their phone and say, âĂIJTurn on Mr. Mister âĂę" towhich it will respond âĂIJOkay. Turning on Mr. Mister now!" andwill activate the robot. A more complicated and working dialogflow involves setting specific times the robot will start diffusing.For example, if the user had a study session at 3pm, he could sayâĂIJHey Mr. Mister, start diffusing at 3pm today!" and the responsewill confirm his request, log the time on the Raspberry Pi and startthe requested time. This function could be extended to assist inany event, such waking up, arriving home from work and evenpredetermined romantic dates. Over-functionality needlessly com-plicates a system and we left the number of options of interactionlow to ensure an easy to use stress reliever.

Page 3: Mr. Mister: a social robot with aromatherapeutic …...novel diffuser is an easy, healthy option to reduce stress through aromatherapeutic methods. In this paper, we present the blueprint

Mr. Mister: a social robot with aromatherapeutic solutions for stess and anxiety Conference’17, July 2017, Washington, DC, USA

Figure 3: Google Assistant Interface on an Android Phone

3.2 Design of Robot BodyAs with any project, there were several technical challenges, mostnotably software and hardware issues. Configuring the RaspberryPi and Arduino (see Figure 6) and writing code to control themister and motor took the entire three month development cycle.In addition, we had to fit these large components within compactcasing, ensuring no wires overlapped and the hardware did notinteract with the rising vaporized aroma. The mister does not workunless laid perfectly across the surface of the aroma, forcing us tocreate a platform of tape for it to rest upon (See Figure 5). Finally,for visual patterns to be created, the mist must rise from all holesequally, requiring the mister be placed equidistant from all sides ofthe body in the liquid aroma.

The Mr. Mister system evolved in several ways throughout ourdevelopment period. In early prototype testing, for example, wewere using an existing diffuser base that created weak and infre-quent intervals of vapor. Channeling the aroma into patterns wasimpossible, and we transitioned to a stronger mister controlleddirectly from the Raspberry Pi and created our own base. We alsoexperimented hole sizes in the body’s top. Small holes do not allowfor the vapor to be seen while larger ones do not form interestingpatterns. We settled on medium sized holes of approximately aquarter inch diameter (See Figure 5).

The contributions of this unique design further allow ease ofuse by the access of the personal robot anywhere in the world. Forexample, after a stressful day at work, the overworked owner maybe in a taxi heading home and can turn on the diffuser while still

Figure 4: The diffuser mechanism

Figure 5: Top of the Mister Mister

in his cab with a simple conversation on his phone. The spinningtop, meanwhile, creates calming visual patterns in the vapor. Thiscombined aromatherapy and visual approach ensures the owneris relaxed though two senses. Perhaps most importantly, is that allinteraction with Mr. Mister is through existing Google products, sothe owner does not have to relearn a new system when stressed.This further breeds familiarity and ease of use. To build the proto-type, we used drills, saws and three-dimensional printing for thebody and casing.

3.3 Software DesignThe robot has four major software components, consisting of aDialogflow agent, a Google FireBase Firestore database, a pythonlistening node and Arduino code for the hardware.

The Dialogflow agent was designed to encapsulate the personaof Mister Mister. Through Google Assistant, a user would ask forMr. Mister, and the Dialogflow agent would commence. In the agent,there were three âĂIJintents", each of which translate user inputinto action through Google’s voice recognition software. The fourintents included setting a time for the user to wake up, go to sleep,

Page 4: Mr. Mister: a social robot with aromatherapeutic …...novel diffuser is an easy, healthy option to reduce stress through aromatherapeutic methods. In this paper, we present the blueprint

Conference’17, July 2017, Washington, DC, USA Appleton et al.

Figure 6: Inter-workings of the Mister Mister

or plan a special event. These intents would trigger JavaScript codewhich updated the times for the events into the Firestore database.

The Firestore database, updated through Dialogflow fulfilment,would serve as the temporary storage needed for each of the user’srequested events like going to sleep. Through this database, theMister Mister could be updated by any Google Assistant accessibledevice on the Internet, instead of requiring the user to be near therobot itself.

In order to trigger the hardware at the needed event times spec-ified in the Firestore database, a python script on a Raspberry Piwould poll the database every second to determine if the userchanged any of their event times, started the diffuser outright,or if one of the event times had been reached.

Once the diffuser needs to be turned off or on, the Python scriptsends information over Serial connection to the Arduino Uno mi-croprocessor, triggering code existing there to turn on or off thehardware components such as the motor or diffuser.

4 STUDY, EXPERIMENT AND DEPLOYMENT4.1 Deployment and Study DesignOur experiment will test the claim of our hypothesis, that Mr. Misterwill reduce stress in a healthy, an easy to use and engaging way. Itwill ascertain what works well or otherwise needs improvementin our prototype. Our participants were college students who arelikely are a subset of our target audience of stressed individuals.

We tested our study at the University of Wisconsin-Madison. Weset up our robot in the lobby of the Computer Sciences buildingand flagged down six random participants. We briefly explainedthe product, allowed them to interact with it using a phone andanswered questions. The users were able to give commands, suchas âĂIJStart the diffuser!" or âĂIJStart the diffuser at five today!"After playing around with the product, they filled out a surveydetailing their thoughts on. The questions are designed to improveour product and test our hypothesis if it reduces stress.

4.2 Results and Data AnalysisAs already stated, we had a total of six participants and asked thema series of questions with questionnaire. We asked them questionthrough the testing process and had several open-ended questionat the end of our survey. We ask a set of nine questions that canbe roughly broken down into two categories, assessing the posi-tives and any areas of improvement. This was in accordance to the

SUS score, however we did not adhere entirely to its structure.[2]Nonetheless, our evaluation was still derived from a weighted com-bination of the positive and negative halves.

Questions to Understanding Areas of Strength:• I would use this product frequently (1);• I thought the product was easy to use (3);• I found the motor motions to be engaging (4);• I found the various functions in the product were well inte-grated (5);

• I found that the mist helped reduce stress (7);• I like the overall design of this product (9);

Questions to Understand Flaws:• I found this product unnecessarily complex (2);• I thought there was too much inconsistency in this product(6);

• I found this product very awkward to use (8);Free Response Questions:• What suggestions do you have? (functions, features, motion)(10);

• What did you like about this product? (11);• Other Comments (12);

Each participant graded a statement on a integer scale of 1 to 5,with 1 being âĂIJstrongly disagree" and 5 âĂIJstrongly agree" witha statement. Statements 1 through 9 received overall scores of 3.83,2.5, 4.5, 3.83, 4.16, 2.33, 4, 2.66 and 4.16 respectively. Thus, on certainquestions, such as ease of use and stress relief, participants werein general agreement and favored our product. Future iterations ofMr. Mister will incorporate the participants’ constructive criticismswhile building on current strengths.

5 DISCUSSIONOur system provides an healthy, easy way for stressed individualsto calm themselves through visual stimuli and aromatherapy. Beloware the bar charts for the and opened ended question for the surveydata. Generally, our test participants believed they would use theproduct frequently and that would successfully help them reducestress. Others positives include that it links to existing GoogleSystem (illustrating the ease of use point part of our hypothesis).There were some mixed responses, however, relating to questionâĂIJI found this product very awkward to use" and a some generalvariability in other questions. In our final sus score, we achieved arating of 69.7 which is above the average of 68. Since the SUS didnot adhere to the standard structure, we had six positive questionsweighted to three negative ones so the three negatives carried agreater contribution in the 50-50 part end score. Though our SUSscore is weighted due to containing only nine questions total, itstill represents the overall quality of this project.

In the free response questions, the participants gave valuableadvice on benefits and possible improvements. One repeated sug-gestion was using a quieter motor, which would be more calmingand less intrusive. On the same relation to sound, since others rec-ommended adding music to our device. This may have detractedsomewhat from our end goal, although it is an easy fix for subse-quent iterations of our product. Most agreed that the design waseasy to follow, which was noted in both the free response and the

Page 5: Mr. Mister: a social robot with aromatherapeutic …...novel diffuser is an easy, healthy option to reduce stress through aromatherapeutic methods. In this paper, we present the blueprint

Mr. Mister: a social robot with aromatherapeutic solutions for stess and anxiety Conference’17, July 2017, Washington, DC, USA

questionnaire. Participants also agreed that the integration withexisting Google products made the experience better, likely due toGoogle being a platform that is adaptable and familiar.

5.1 LimitationsThere are certain non-compromising limitations to our study. Wewould liked to have asked questions when the participant was in astressed state, which would have involved creating multiple prod-ucts and having participants use them over a period of time when innegative moods. This, however, was infeasible and our current datais therefore non-comprehensive. There are a few potential biasesas well; foremost, we only surveyed individuals in the Universityof Wisconsin-Madison’s Computer Science building. To get a moreaccurate representation of stressed individuals, our study may needto include more subjects to reach a more diverse set. This, again,was not practical with time and budget constraints and our studyobjectively captures feedback on our product. Additionally, ourtesting location was shared by another robotics research group.This may have influenced the users in unintended ways, like whenthe other group was playing music our participants also desired toincorporate a audio experience into our own system.

5.2 Future WorkFuture work on Mr. Mister and robotic aroma therapy has manypotential paths. Our participants suggested several ideas, such aquieter motor and adding more features. In future iterations, theowner may be able control the length and frequency of the robot’sfragrance diffusions and the speed of the motor to create differentpatterns. For this particular iteration, our motor also spun too fastthereby dispersing much of the vapor and neutralizing our intended"puff" effects. Perhaps one would be able to select an mood, suchas energetic or calm, and the robot releases specific aromas andpatterns to recreate the emotion. Furthermore, different fragrancescould be employed to enhance various mental states in accordanceto the user’s wishes. Our intended scent was restricted to lavenderdue to it having the most scientific backing, but implementationof a multi-cartridge system for scents could prove beneficial. Thiscould be paired with existing alarm functionality to create a morevigorous motion during wakeup or a calming one when the userwishes to go to bed.

Additionally, creating a more interactive device could lend thediffuser to becoming a better robot and device. For example, thediffuser could greet the stressed owner or tell jokes to humanizeitself. This would create a more calming or humorous tone for thosein the room to achieve an overall less stressful atmosphere. Addingmore movement with alternating scent cycles or dispersion patternswould create a more engaging experience and contribute to thegoal too. Other paths include audio or visual stimuli to join withthe existing a olfactory pathways, as suggested by several of ourparticipants. Aromatherapy and chromatherapy have long beenmarried to address stress.

CONCLUSIONOur product shows promise in alleviating user stress levels in itscurrent form. It was shown to be quite user friendly and easy to useby our participants, making it a simple solution for our problem

domain. Integration with existing home devices via Google defi-nitely contributed to a positive experience and a seamless adoptionof our system by users. However, there were several features thatneeded tuning before being able to comprehensively address stresslevels. Sound was the most notable concern participants had forour system, evidenced through our motor feedback. User’s alsoseemed to suggest incorporating more customization features likemusic and vapor control in ways to effect the mood. Adding thesesuggestions to our system would likely make for a less stressfulenvironment altogether, the main goal of this project.

REFERENCES[1] R Beiter, R Nash, MMcCrady, D Rhoades, M Linscomb, M Clarahan, and S Sammut.

2015. The prevalence and correlates of depression, anxiety, and stress in a sampleof college students. Journal of affective disorders 173 (2015), 90–96.

[2] John Brooke et al. 1996. SUS-A quick and dirty usability scale. Usability evaluationin industry 189, 194 (1996), 4–7.

[3] Tiffany Field, Miguel Diego, Maria Hernandez-Reif, Wendy Cisneros, Larissa Feijo,Yanexy Vera, Karla Gil, Diana Grina, and Qing Claire He. 2005. Lavender fragrancecleansing gel effects on relaxation. International Journal of Neuroscience 115, 2(2005), 207–222.

[4] Barbara Klein, Lone Gaedt, and Glenda Cook. 2013. Emotional robots. GeroPsych(2013).

[5] Margaret Louis and Susan D Kowalski. 2002. Use of aromatherapy with hospicepatients to decrease pain, anxiety, and depression and to promote an increasedsense of well-being. American Journal of Hospice and Palliative Medicine® 19, 6(2002), 381–386.

[6] David Scott and Brenda Happell. 2011. The high prevalence of poor physicalhealth and unhealthy lifestyle behaviours in individuals with severe mental illness.Issues in mental health nursing 32, 9 (2011), 589–597.

[7] Kandhasamy Sowndhararajan and Songmun Kim. 2016. Influence of fragranceson human psychophysiological activity: With special reference to human elec-troencephalographic response. Scientia pharmaceutica 84, 4 (2016), 724–751.

[8] Kazuyoshi Wada and Takanori Shibata. 2007. Living with seal robotsâĂŤitssociopsychological and physiological influences on the elderly at a care house.IEEE Transactions on Robotics 23, 5 (2007), 972–980.

[9] Su-Jin Won and Young-Soon Choi. 2017. The effect of aromatherapy upon salivarycortisol, academic stress, academic self-efficacy and suicidal ideation in middleschool students. Biomedical Research 28, 16 (2017), 7005–7011.