Open Access. Powered by Scholars. Published by Universities.®

Digital Commons Network

Open Access. Powered by Scholars. Published by Universities.®

Articles 1 - 30 of 434

Full-Text Articles in Entire DC Network

The Impact Of Sport-Related Concussions On The Vestibular System Utilizing The Vestibular Ocular Motor Screening (Voms) Tool: A Systematic Review For Audiologists, Tina M. Ceriello Jun 2024

The Impact Of Sport-Related Concussions On The Vestibular System Utilizing The Vestibular Ocular Motor Screening (Voms) Tool: A Systematic Review For Audiologists, Tina M. Ceriello

Dissertations, Theses, and Capstone Projects

Objective: This systematic review aims to analyze vestibular side effects of sport-related concussions (SRCs) based on differences such as age, gender, and/or sport when using the VOMS tool, and how audiologists may adapt practice for such individuals who have sustained SRCs.

Methods: A comprehensive search identified relevant articles using Google Scholar, ASHAWire, and other databases through the City University of New York (CUNY) Mina Rees Library website. Studies were included if SRCs were evaluated using the complete seven-item VOMS tool and had 25 or more participants. Studies were excluded if concussions were not sport-related, brain injuries were more severe than …


Development Of The Hearing Emotion/Activity Restrictions On Teenagers (Heart), Robin G. Axelrod Jun 2024

Development Of The Hearing Emotion/Activity Restrictions On Teenagers (Heart), Robin G. Axelrod

Dissertations, Theses, and Capstone Projects

DEVELOPMENT OF THE HEARING EMOTION/ ACTIVITY RESTRICTIONS ON TEENAGERS (HEART)

By: Robin Axelrod

Advisor: Barbara Weinstein

Background:

The Hearing Handicap Inventory for the Elderly is a self-assessment tool used to assess and quantify the impact of hearing loss on emotional and social wellness in the geriatric population. However, there is not an existing version for the teenage population. Hearing loss has the potential to impact social, emotional, and academic domains in the daily lives of teenagers with hearing loss. In this study, a new self-assessment tool called the Hearing Emotion/ Activity Restrictions on Teenagers (HEART) was created and distributed via …


Vestibular Correlates Of Cochlear Implantation, Danielle Lewis Jun 2024

Vestibular Correlates Of Cochlear Implantation, Danielle Lewis

Dissertations, Theses, and Capstone Projects

Previous research has illustrated that vestibular dysfunction is the most prevalent complication of cochlear implant (CI) surgery. There is substantial evidence of both short- and long-term vestibular dysfunction following CI surgery. The objective of this survey was to determine CI recipients’ expectation and satisfaction with their audiologists’ counseling regarding the possible vestibular effects of cochlear implantation. Survey participants included unilateral and bilateral adult CI recipients recruited through the NYC chapter of the Hearing Loss Association of America (HLAA), audiology-related Facebook groups, and Linked-In. The first 25 participants were offered a $20 Amazon gift card upon completion of the survey. The …


Audiological Evaluation Of Persons With Dementia: A Systematic Review, Yehudis Hoch Jun 2024

Audiological Evaluation Of Persons With Dementia: A Systematic Review, Yehudis Hoch

Dissertations, Theses, and Capstone Projects

Background: Dementia and hearing loss are both prevalent, age-related conditions and recent research has established a correlation between the two. Audiological evaluations of persons with dementia are important due to a likely comorbidity of dementia and hearing loss, the detrimental effect that hearing loss has on cognition and cognitive tests, and because the similar presentation of the two conditions can cause hearing loss to be overlooked. Hearing loss intervention is critical for this population due to the positive effects that amplification has on cognition, social engagement, and listening effort. Despite the importance of hearing assessment and intervention, audiological evaluation of …


The Effect Of Personal Listening Devices On Subjective Hearing Status, Esther Feldman Jun 2024

The Effect Of Personal Listening Devices On Subjective Hearing Status, Esther Feldman

Dissertations, Theses, and Capstone Projects

Long term or brief exposure to loud noise can trigger the onset of noise-induced hearing loss which can lead to a temporary (TTS) or permanent (PTS) shift in hearing threshold. Occupational noise, or recreational noise such as music can contribute to shifts in hearing levels. Listening to music in person at a concert or when listening on earphones/earbuds and streaming from a smartphone can produce sound pressure levels (SPL) high enough to lead to PTS, TTS, and associated symptoms. A survey of adults was conducted to gain insight into onset of self-perceived temporary hearing loss and tinnitus after short term …


Adaptations And Transformations: Perceptions Of Change In Academic Motivation, Resilience, And Covid-19 Stress, Ella V. Gregorio Jun 2024

Adaptations And Transformations: Perceptions Of Change In Academic Motivation, Resilience, And Covid-19 Stress, Ella V. Gregorio

Dissertations, Theses, and Capstone Projects

Of concern to educators, post-COVID-19 assessments have revealed significant achievement gaps in student performance, as well as significant decreases in adolescent mental health. Less is known about changes in achievement motivation. Here we ask how students perceive their own motivation and whether it changed between “before” the pandemic to the present (Fall 2022 - Spring 2023), about three years after the beginning of the pandemic when many school routines were returning to “normal.” To understand how variance in these perceived changes might be related to pandemic-related stressors, trait resilience, and current mental health, we conducted a large survey study (N …


Flanker Task Performance In Young And Older Adults: A Behavioral And Erp Study, Fatima Medrano Jun 2024

Flanker Task Performance In Young And Older Adults: A Behavioral And Erp Study, Fatima Medrano

Dissertations, Theses, and Capstone Projects

Research suggests that as we get older, executive function abilities decline (Hasher & Zacks, 1988; Salthouse, 1996). One affected ability is that of inhibitory control, which aids in monitoring our responses to non-target stimuli or information. Current research on inhibition reveals inconsistencies across studies. Monitoring brain responses during the Flanker (used to measure inhibitory control) task may add valuable insight into the processes underlying group differences behaviorally, by studying the N200 and P300 event-related potentials which have been associated with inhibitory control processes. This study investigated whether there are differences between older and younger adults in inhibitory control and whether …


Best Practices For Healthcare Providers When Communicating With Individuals With Hearing Loss: A Systematic Review, Ashley Mccaig Jun 2024

Best Practices For Healthcare Providers When Communicating With Individuals With Hearing Loss: A Systematic Review, Ashley Mccaig

Dissertations, Theses, and Capstone Projects

Objectives: The purpose of this study is to conduct a systematic review of the literature to gather information about strategies to use when communicating with people with hearing loss, specifically in healthcare settings or environments where face masks are frequently used. The compiled literature was used to establish the best practices for healthcare providers to use when communicating with their patients with hearing loss, especially when utilizing face masks.

Methods: A comprehensive search of the literature was conducted using the Google Scholar, PubMed, and MEDLINE Complete databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to …


Knowledge And Attitudes Towards Usage Of Hearing Protection In Volunteer Firefighters, Rachel S. Combs Jun 2024

Knowledge And Attitudes Towards Usage Of Hearing Protection In Volunteer Firefighters, Rachel S. Combs

Dissertations, Theses, and Capstone Projects

Background: Occupational noise-induced hearing loss (NIHL) represents a substantial global public health concern. Regulatory agencies such as the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupation Safety and Health (NIOSH) aim to establish noise exposure limits in occupational settings, yet certain professions, such as firefighting, remain at a heightened risk. Although research has been conducted on noise exposure and hearing protection in career firefighters, a lack of research exists on volunteer firefighters. The purpose of this study was to 1) establish the extent that volunteer firefighters are currently educated on hearing conservation and hearing protection 2) …


A Comparison Of Temporary Threshold Shifts In Dentists, Hygienists, And Dental Assistants, Sabina E. Ciaccio Jun 2024

A Comparison Of Temporary Threshold Shifts In Dentists, Hygienists, And Dental Assistants, Sabina E. Ciaccio

Dissertations, Theses, and Capstone Projects

Objective: The purpose of this study is to compare the temporary threshold shifts (TTS) in dentists, hygienists, and dental assistants. The specific aim of this study is to compare the differences in temporary shifts caused by the different dental equipment and the proximity to the equipment. The current literature does not compare the change in hearing thresholds of dental personnel.

Methods: Dentists, dental assistants, and hygienists from Hermann Dental Associates will be given a case history form to determine inclusion status for this study. Exclusion criteria will include known hearing loss and significant noise exposure the day prior. …


Articulatory Activity Of The Tongue, Jaw, And Lips During The Second Passaggio Transition Of The Soprano Voice, Richard C. Lissemore Jun 2024

Articulatory Activity Of The Tongue, Jaw, And Lips During The Second Passaggio Transition Of The Soprano Voice, Richard C. Lissemore

Dissertations, Theses, and Capstone Projects

This dissertation describes three experiments designed to explore the acoustic and articulatory activity of a perceptible change in the soprano voice known as the secondo passaggio, or second transition, which typically occurs for the [ɑ] vowel between D♮5 (587 Hz) and F♮5 (698 Hz). Acoustically, the transition involves a shift in resonance strategy from second resonance tracking of the second harmonic (fR2/2fo) to first resonance tracking of the fundamental frequency (fR1/fo). To quantify the acoustics of the transition, we employed the measure L1-L2, the …


Positron Emission Tomography In Oncology And Environmental Science, Samantha Delaney Jun 2024

Positron Emission Tomography In Oncology And Environmental Science, Samantha Delaney

Dissertations, Theses, and Capstone Projects

The last half century has played witness to the onset of molecular imaging for the clinical assessment of physiological targets. While several medical imaging modalities allow for the visualization of the functional and anatomical properties of humans and living systems, few offer accurate quantitation and the ability to detect biochemical processes with low-administered drug mass doses. This limits how physicians and scientists may diagnose and treat medical issues, such as cancer, disease, and foreign agents.

A promising alternative to extant invasive procedures and suboptimal imaging modalities to assess the nature of a biological environment is the use of positron emission …


Toolkit For Users Of Over-The-Counter Hearing Aids, Sabrina Malasarte Jun 2024

Toolkit For Users Of Over-The-Counter Hearing Aids, Sabrina Malasarte

Dissertations, Theses, and Capstone Projects

Untreated hearing loss oftentimes has significant adverse effects on the quality of life of older adults. The associations include, but are not limited to loneliness, isolation, anxiety, and a decrease in cognitive function. Hearing aids significantly improve audibility, social interactions, and decrease feelings of loneliness or isolation. However, despite technological advances, and evidence of positive outcomes associated with hearing aid use, uptake and continued use of hearing aids remain low. Accessibility and affordability are considered barriers to uptake. Purchasing a prescription hearing aid from an audiologist is the traditional approach to receiving an amplification device, but the advent of over …


Ethnic Minorities And Family Health History: An Autoethnography Of Guyanese Americans And Kidney Disease, Dhaneesha R. Bahadur Feb 2024

Ethnic Minorities And Family Health History: An Autoethnography Of Guyanese Americans And Kidney Disease, Dhaneesha R. Bahadur

Dissertations, Theses, and Capstone Projects

Exploring family health histories (FHHs) has emerged in recent years as an inexpensive genomic tool in public health. Families and clinicians can also use them to uncover family histories and experiences, which could inform better lifestyle choices to prevent or delay the onset of diseases. Exploring family health histories focuses on an individual’s genetic makeup and considers differences in lifestyle and environment. Despite national campaigns, it is an underutilized tool that could lead to engagement in effective strategies and better health outcomes. One important and serious condition that families should be more aware of is chronic kidney disease (CKD). One …


Modeling Of Covid-19 Clinical Outcomes In Mexico: An Analysis Of Demographic, Clinical, And Chronic Disease Factors, Livia Clarete Feb 2024

Modeling Of Covid-19 Clinical Outcomes In Mexico: An Analysis Of Demographic, Clinical, And Chronic Disease Factors, Livia Clarete

Dissertations, Theses, and Capstone Projects

This study explores COVID-19 clinical outcomes in Mexico, focusing on demographic, clinical, and chronic disease variables to develop predictive models. In the binary classification task, the Ada Boost Classifier distinguishes survivors from non-survivors, with age, sex, ethnicity, and chronic medical conditions influencing outcomes. In multiclass classification, the Gradient Boosting Classifier categorizes patients into outcome groups.

Demographic variables, especially age, are crucial for predicting COVID-19 outcomes for both the binary and multiclass classification tasks. Clinical information about previous conditions, including chronic diseases, also holds relevance, especially diabetes, immunocompromise, and cardiovascular diseases. These insights inform public health measures and healthcare strategies, emphasizing …


The Effect Of Alpha Binaural Beats On Virtual Reality Experiences, Andronikki C. Gerohristodoulos Feb 2024

The Effect Of Alpha Binaural Beats On Virtual Reality Experiences, Andronikki C. Gerohristodoulos

Dissertations, Theses, and Capstone Projects

Visually induced motion sickness (VIMS), a subset of motion sickness, has been a long-term obstacle preventing comfortable experiences in virtual reality (VR). There is a growing body of research showing that binaural beats (BBs) have been effective to influence aspects of cognition. The goal of this experiment was to investigate the possible effects of attending to BBs and any changes to the severity of VIMS symptoms following immersion in a virtual reality environment (VRE). To validate our hypothesis a repeated-measures, between-subjects experiment was designed (n=16) and an alpha (10Hz) frequency BB and a control audio were created. Participants were split …


Methamphetamine-Induced Dna Double-Stranded Breaks: The Impact Of The Dopamine Transporter And Insights Into The Mechanisms Of Dna Damage In Mouse Neuro 2a Cells, Lizette Couto Feb 2024

Methamphetamine-Induced Dna Double-Stranded Breaks: The Impact Of The Dopamine Transporter And Insights Into The Mechanisms Of Dna Damage In Mouse Neuro 2a Cells, Lizette Couto

Dissertations, Theses, and Capstone Projects

Methamphetamine (METH) abuse remains a global health concern, with emerging evidence highlighting its genotoxic potential. In the central nervous system METH enters dopaminergic cells primarily through the dopamine transporter (DAT), which controls the dynamics of dopamine (DA) neurotransmission by driving the reuptake of extracellular DA into the presynaptic neuronal cell. Additional effects of METH on the storage of DA in synaptic vesicles lead to the dysregulated cytosolic accumulation of DA. Previous studies have shown that after METH disrupts intracellular vesicular stores of DA, the excess DA in the cytosol is rapidly oxidized. This generates an abundance of reactive oxygen species …


Clustering Of Patients With Heart Disease, Mukadder Cinar Feb 2024

Clustering Of Patients With Heart Disease, Mukadder Cinar

Dissertations, Theses, and Capstone Projects

Heart disease, a leading cause of mortality worldwide, presents complex challenges in public health due to its varied manifestations. Accurate diagnosis and patient stratification are essential for effective management and improved outcomes. In response, this study employed machine learning techniques to analyze heart disease data obtained from UCI Machine Learning Repository, aiming to enhance patient care through advanced data analysis.

The study began with the application of K-Nearest Neighbors (KNN) classification, which categorized patients into 'Disease' and 'No Disease' groups. This preliminary step provided initial insights into the structure of the dataset. Subsequently, K-means clustering was applied in two rounds, …


Targeting Strategies To Optimize The Therapeutic Potential Of Gold Compounds Against Her2-Positive Breast Cancers, Afruja Ahad Feb 2024

Targeting Strategies To Optimize The Therapeutic Potential Of Gold Compounds Against Her2-Positive Breast Cancers, Afruja Ahad

Dissertations, Theses, and Capstone Projects

The overexpression of HER2 accounts for 20-30% of breast cancer tumors and not only serves as a marker for poor predictive clinical outcomes but also as a target for treatment. Antibody-drug conjugates (ADCs) combine the selectivity of monoclonal antibodies (mAbs) with the efficacy of chemotherapeutic drugs to provide targeted treatment without toxicity to normal tissue. Most of the ADCs currently in the clinic for cancer chemotherapy are based on complex organic molecules. In contrast, the conjugation of metallodrugs to mAbs has been overlooked when there is enormous potential in this area with the resurgence of metal-based drugs as prospective cancer …


Knowing The Patient As A Person: Social Media Listening And Gadamerian Analysis Of Nurses’ Expressions Shared During The Covid-19 Global Health Pandemic, Janusz A. Kaleta Feb 2024

Knowing The Patient As A Person: Social Media Listening And Gadamerian Analysis Of Nurses’ Expressions Shared During The Covid-19 Global Health Pandemic, Janusz A. Kaleta

Dissertations, Theses, and Capstone Projects

Background: COVID-19 has dramatically changed human-to-human interactions from in-person to the nonhuman domain of virtual space. In January 2021, every 28 seconds one person died of COVID-19 in the United States. An average of 3,100 Americans died each day during the deadliest month of the pandemic. As of January 2023, the number of COVID-19 deaths in the USA surpassed 1.000.000 people. In hospitals, human-to-human interactions were often limited to seeing one’s eyes behind the face shields, and respirator masks, and hearing a muffled voice, or sounds of the ventilators. In New York State 452 nurses died during the pandemic.

Research …


Recursive Functional Learning In Nonfluent Aphasia, Gerald C. Imaezue Sep 2023

Recursive Functional Learning In Nonfluent Aphasia, Gerald C. Imaezue

Dissertations, Theses, and Capstone Projects

People with nonfluent aphasia (PWNA) require feedback from an external agent as well self-feedback to facilitate performance of language production tasks. The extent to which PWNA can use self-feedback alone to improve their task performance is unknown. In addition, it is argued that self-feedback may reinforce or minimize performance errors over time. To test whether either is the case, we introduce an original learning mechanism, recursive functional learning, which uses self-feedback loops to optimize recursively multiple subsystems (cognitive and linguistic subsystems) that PWNA engage during task performance. We used this mechanism to underpin a novel automated procedure we developed, recursive …


Nursing Perspectives On Intimate Partner Violence Screening In The Emergency Department, Justin Cabrera Sep 2023

Nursing Perspectives On Intimate Partner Violence Screening In The Emergency Department, Justin Cabrera

Dissertations, Theses, and Capstone Projects

Using descriptive and quality descriptive (QD) analysis, emergency department nurses from around the country completed a modified version of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool to gain insight on their attitudes, knowledge, and preparedness about working with patient survivors of intimate partner violence (IPV) regarding their willingness to and comfort in engaging in IPV screening practices. In total, 1,523 responses were received from emergency department nurses currently or formerly in practice.

Findings show that there was no correlation between emergency department nurses’ education and training on IPV and willingness and comfort with IPV screening with …


Social And Cultural Processes That Impact Physical Activity Among South Asian Americans Managing Hypertension: A Mixed Methods Study, Sugandha Gupta Sep 2023

Social And Cultural Processes That Impact Physical Activity Among South Asian Americans Managing Hypertension: A Mixed Methods Study, Sugandha Gupta

Dissertations, Theses, and Capstone Projects

Cardiovascular disease (CVD), the number one cause of death in the U.S., disproportionately affects South Asian Americans (SAAs). Physical activity is a modifiable health behavior that can reduce cardiovascular risk. Health behaviors, such as physical activity, occur within specific social and cultural contexts and are influenced by multiple factors at multiple levels of the social ecological model. This dissertation aimed to provide a rich, culturally-informed understanding of the factors at multiple levels – individual, interpersonal, and cultural –associated with physical activity among SAAs at risk for CVD. A sequential exploratory mixed methods approach was employed to examine social and cultural …


Examining The Effect Of Training Using Natural And Noise-Vocoded Sentences On Noise-Vocoded Speech Perception In Normal-Hearing Listeners, Alexis Leiderman Jun 2023

Examining The Effect Of Training Using Natural And Noise-Vocoded Sentences On Noise-Vocoded Speech Perception In Normal-Hearing Listeners, Alexis Leiderman

Dissertations, Theses, and Capstone Projects

Auditory training has been shown to be an intervention strategy that may improve speech perception abilities in individuals with and without hearing loss. Within the cohort of individuals with hearing loss, auditory training has also been shown to have an improvement on speech perception in cochlear implant users. In several training studies, normal-hearing listeners have been exposed to noise-vocoded speech using auditory training paradigms to mimic how cochlear implant users may in turn be affected by these paradigms. These studies have highlighted certain areas for improvement in speech perception abilities based off of the training paradigms put in place. Several …


The Lived Experience Of Using Opiates Among Young Adults, Catherine Mbewe Jun 2023

The Lived Experience Of Using Opiates Among Young Adults, Catherine Mbewe

Dissertations, Theses, and Capstone Projects

The purpose of this research study is to explore the lived experience of using opiates, as described by young adults aged 18 to 25 years. Over the last 2 decades, opioid use disorders (OUDs) and opiate overdose deaths have increased dramatically in the United States. What used to be a problem primarily contained to minority groups in poor inner-city areas is now increasingly common in all races, genders, ages, and classes. There has also been an alarming increase in opiate use—including fentanyl, both legal and illegal—among young adults. While much of the literature has been focused on the opiate use …


Reviews Of Applications For Smartphone-Connected Hearing Aids And Implications On Counseling, Rebecca Strong Jun 2023

Reviews Of Applications For Smartphone-Connected Hearing Aids And Implications On Counseling, Rebecca Strong

Dissertations, Theses, and Capstone Projects

With the recent rise of smartphone ownership, more applications have been created that connect user’s hearing aids to their smartphone. One type of application that has become popular is one that allows the user to control hearing aids using a smartphone. While these applications have many benefits for the user, there has been very little research on the experiences of individuals using these applications. In order for audiologists to best help their patients troubleshoot and prepare reasonable expectations for using smartphone-connected hearing aids, they need to understand the patient experience to create effective solutions. One technique that can be used …


Practices And Attitudes Towards Infant Hearing Protection At Orthodox Jewish Weddings, Rebecca Weiss Jun 2023

Practices And Attitudes Towards Infant Hearing Protection At Orthodox Jewish Weddings, Rebecca Weiss

Dissertations, Theses, and Capstone Projects

Previous research has shown that prolonged exposure to noise can cause permanent hearing loss no matter what age, including infants. The impact of noise at orthodox Jewish weddings, where infants are frequently in attendance, can reach extremely high and damaging levels of sound intensity. Because the hearing conservation behaviors and attitudes towards child hearing protection in this population are unknown, the objective of this study is to identify the attitudes and behaviors of orthodox Jewish wedding attendees toward child hearing conservation. A survey was developed and administered electronically to congregants of orthodox Jewish synagogues in the New York City area. …


Barriers To Optimal Audiological Care For Members Of The Deaf Community, Joyce Orenshein Jun 2023

Barriers To Optimal Audiological Care For Members Of The Deaf Community, Joyce Orenshein

Dissertations, Theses, and Capstone Projects

Background:

The purpose of this study was to identify the barriers to optimal audiological care for members of the Deaf community from the perspectives of Deaf individuals compared to audiologists. The goal is to help bridge the clinical communication barriers that lie between audiologists and the Deaf community by identifying the perceived gaps in care specifically and by gathering suggestions for improvement. A survey was administered to both audiologists and members of the Deaf community, making the present study unique and essential in that responses from both communities are compared and suggestions for bridging the gap are made.

Methods …


The Impact Of Semantics And Syntax On Lexical Retrieval In Individuals With Aphasia, Marta M. Korytkowska Jun 2023

The Impact Of Semantics And Syntax On Lexical Retrieval In Individuals With Aphasia, Marta M. Korytkowska

Dissertations, Theses, and Capstone Projects

Nearly all people with aphasia (PWA) report difficulty with lexical retrieval (i.e., anomia). While there are several tasks used to measure lexical retrieval, each poses different degrees and types of challenges. For example, some studies have found that PWA performance varies depending on the type of lexical retrieval task. The tasks that have been used include lexical retrieval in isolation tasks (such as picture-naming), lexical retrieval in sentence level tasks (such as narration tasks), and lexical retrieval in sentence-completion tasks. Some studies have found no differences between the accuracy of lexical retrieval in isolation and at the sentence level (e.g., …


Caring For Individuals Who Are Experiencing Homelessness: An Audiologist’S Toolkit, Jenna Marie Sparacio Jun 2023

Caring For Individuals Who Are Experiencing Homelessness: An Audiologist’S Toolkit, Jenna Marie Sparacio

Dissertations, Theses, and Capstone Projects

National-level counts for individuals experiencing homelessness have been steadily on the rise. People experiencing homelessness face extraordinary barriers and challenges in accessing health care services, including hearing healthcare. Additionally, there is a high prevalence of self- reported hearing difficulties and hearing handicap among people experiencing homelessness. Hearing loss status and management is often not prioritized in healthcare settings, and treatment plans are not typically modified to best address the hearing needs of individuals who are homeless. This evidence-based toolbox for audiologists was developed to help understand and mediate healthcare barriers that people experiencing homelessness face, as well as to help …