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Articles 72781 - 72810 of 77012
Full-Text Articles in Entire DC Network
Effects Of Superovulated Heifer Diet Type And Quantity On Relative Mrna Abundances And Pyruvate Metabolism In Recovered Embryos., C Wrenzycki, P De Sousa, E W Overström, R T Duby, D Herrmann, A J Watson, H Niemann, D O'Callaghan, M P Boland
Effects Of Superovulated Heifer Diet Type And Quantity On Relative Mrna Abundances And Pyruvate Metabolism In Recovered Embryos., C Wrenzycki, P De Sousa, E W Overström, R T Duby, D Herrmann, A J Watson, H Niemann, D O'Callaghan, M P Boland
Obstetrics & Gynaecology Publications
This study investigated the effects of quantity and type of diet fed to superovulated donor heifers on molecular and metabolic indices of embryonic development. These effects included the relative abundances of mRNAs for the alpha 1 subunit of Na/K-ATPase and the antioxidant enzyme Cu/Zn-SOD, as well as pyruvate utilization in bovine morulae and blastocysts developed in vivo. Heifers were fed a daily ration of either grass silage and a citrus-beet pulp-based concentrate or grass silage and a barley-based concentrate for 116 days, both at 3 kg per day or ad libitum. In embryos derived from heifers fed the pulp-based diets, …
Sirolimus-Tacrolimus Combination Immunosuppression., Vivian Mcalister, Zu-Hua Gao, Kevork Peltekian, Javier Domingues, Kamran Mahalati, Allan Macdonald
Sirolimus-Tacrolimus Combination Immunosuppression., Vivian Mcalister, Zu-Hua Gao, Kevork Peltekian, Javier Domingues, Kamran Mahalati, Allan Macdonald
Data and Test Instruments
A series of 32 recipients of liver, kidney, or pancreas transplants who were treated with sirolimus and low-dose tacrolimus experienced a low rate of rejection and excellent graft function without drug-related toxic effects.
Canadian Medical Officers In The Royal Navy (Book Review), Vivian Mcalister
Canadian Medical Officers In The Royal Navy (Book Review), Vivian Mcalister
Data and Test Instruments
CANADIAN MEDICAL OFFICERS IN THE ROYAL NAVY -- WORLD WAR II. Harry Stafford Morton. 112 pp. Illust. Canadian Naval Memorial Trust, HMCS Sackville, PO Box 99000, Stn Forces, Halifax NS B3K 5X5. 2000. Can$18.00 At the beginning of the Second World War, the Royal Canadian Navy offered 90 medical officers on loan to the Royal Navy. The author was among that group, which included leaders in Canadian surgery such as Surgeon Lieutenant McLachlin of London, Ont. The history of these medical officers has not been written because it fell between histories of the Royal Canadian Navy and the Royal Navy. …
Children's Mercy Annual Report 1999, Children's Mercy Hospital
Children's Mercy Annual Report 1999, Children's Mercy Hospital
Children's Mercy Annual Reports
Annual report for The Children's Mercy Hospital in Kansas City MO, a pediatric medical center.
Department Of Radiology-Annual Executive Summary Report-July 1, 1999 To June 30, 2000, David Levin, M.D.
Department Of Radiology-Annual Executive Summary Report-July 1, 1999 To June 30, 2000, David Levin, M.D.
Department of Radiology Administrative Documents and Reports
90 page Department of Radiology Annual Executive Summary Report, July 1, 1999 to June 30, 2000, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.
Intimate Partner Violence And Cervical Neoplasia, Ann L. Coker, Maureen Sanderson, Mary Kay Fadden, Lucia Pirisi
Intimate Partner Violence And Cervical Neoplasia, Ann L. Coker, Maureen Sanderson, Mary Kay Fadden, Lucia Pirisi
CRVAW Faculty Journal Articles
Intimate partner violence (IPV) is associated with a range of adverse physical health outcomes, including chronic and infectious diseases. An emerging literature suggests that partner violence and specifically sexual violence may be associated with an increased risk of cervical neoplasia. To assess the risk of preinvasive and invasive cervical cancer in a cross-sectional study of women screened for IPV by type, frequency and duration, 1152 women ages 18–65 were recruited from family practice clinics in 1997–1998. They were screened for IPV during a brief in-clinic interview, and health history and current status were assessed in a follow-up interview. Of 1152 …
Role Of KAtp Channels In Reduced Antinociceptive Effect Of Morphine In Streptozotocin-Induced Diabetic Mice, Vivek Sood, Ajay Sharma, Manjeet Singh
Role Of KAtp Channels In Reduced Antinociceptive Effect Of Morphine In Streptozotocin-Induced Diabetic Mice, Vivek Sood, Ajay Sharma, Manjeet Singh
Pharmacy Faculty Articles and Research
The nociceptive effect was measured using withdrawal latency in tail flick test in mice rendered diabetic by administering streptozotocin (200 mg/kg, i.p.). The antinociceptive effect of morphine (4 and 8 mg/kg, s.c.) and cromakalim, a KATP channel opener, (0.3, 1 and 2 micrograms, i.c.v.) was significantly reduced in diabetic mice. Moreover, co-administration of cromakalim(0.3 microgram) did not alter the reduced antinociceptive effect of morphine(4 mg/kg) in diabetic mice. Spleenectomy in diabetic mice restored the decrease in antinociceptive effect of morphine and cromakalim. Multiple dose treatment with insulin to maintain euglycaemia for 3 days in diabetic mice prevented the decrease in …
Identification Of The Transactivation Domain Of The Transcription Factor Sox-2 And An Associated Co-Activator, Tamara K. Nowling, Lance R. Johnson, Matthew S. Wiebe, Angie Rizzino
Identification Of The Transactivation Domain Of The Transcription Factor Sox-2 And An Associated Co-Activator, Tamara K. Nowling, Lance R. Johnson, Matthew S. Wiebe, Angie Rizzino
Nebraska Center for Virology: Faculty Publications
The importance of interactions between Sox and POU transcription factors in the regulation of gene expression is becoming increasingly apparent. Recently, many examples of the involvement of Sox-POU partnerships in transcription have been discovered, including a partnership between Sox-2 and Oct-3. Little is known about the mechanisms by which these factors modulate transcription. To better understand the molecular interactions involved, we mapped the location of the transactivation do-main of Sox-2. This was done in the context of its interaction with Oct-3, as well as its ability to transactivate as a fusion protein linked to the DNA-binding domain of Gal4. Both …
Identification Of Violence In The Home - Pediatric And Parental Reports, Bonnie D. Kerker, Sarah Mccue Horwitz, John M. Leventhal, Stacey Plichta, Phillip J. Leaf
Identification Of Violence In The Home - Pediatric And Parental Reports, Bonnie D. Kerker, Sarah Mccue Horwitz, John M. Leventhal, Stacey Plichta, Phillip J. Leaf
Community & Environmental Health Faculty Publications
Objectives: To compare the rates of domestic violence reported by mothers with those identified by physicians, to compare the rates of harsh discipline practices reported by mothers with the rates of abuse identified by physicians, and to examine the relationship between reported domestic violence and harsh discipline practices.
Design: Interviews with parents and pediatricians to compare pediatric detection of domestic violence and child abuse with parental reports of domestic violence and harsh discipline practices.
Setting: Community-based pediatric practices in the 13-town greater New Haven, Conn, area.
Participants: Of the 23 practices invited, 19 agreed to participate. Of the 2006 parents …
Critical Analysis Of Interventions Against Fgc In Egypt, Nahla G. Abdel-Tawab, Sahar Hegazi
Critical Analysis Of Interventions Against Fgc In Egypt, Nahla G. Abdel-Tawab, Sahar Hegazi
Reproductive Health
Community-based programs designed to discourage the practice of female genital cutting (FGC) in Egypt started as early as the 1920s, however, NGOs seldom document the implementation, strengths, and weaknesses of each approach; or difficulties faced in implementation or ways of overcoming those difficulties. The present meta-assessment was designed by the Population Council to address these issues. Recommendations proposed to increase the effectiveness of anti-FGC interventions in Egypt include: conducting formative research to assess the needs of individuals/communities; using more participatory learning techniques in awareness-raising seminars and training workshops; focusing messages not only on the health hazards of FGC, but also …
Oncolog, Volume 45, Number 01, January 2000, Dawn Chalaire, Kerry L. Wright, Rena Sellin Md
Oncolog, Volume 45, Number 01, January 2000, Dawn Chalaire, Kerry L. Wright, Rena Sellin Md
OncoLog MD Anderson's Report to Physicians (All issues) Archives
- Pediatric Brain Tumor Studies Focus on Reducing Side Effects, Locating Biological Targets
- Retinoid Chemoprevention Trial Aims to Reverse Genetic Changes Caused by Smoking
- DiaLog: Surviving Cancer and Staying Healthy, by Rena Sellin, MD, Professor, Department of Internal Medicine Specialties
- House Call: From Biopsy to Diagnosis: Understanding the Process
- Protocols: Pediatric Brain Tumor Clinical Trials
- Protocols: Chemoprevention Studies Feature a Variety of Agents
Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 2000), Philadelphia College Of Osteopathic Medicine
Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 2000), Philadelphia College Of Osteopathic Medicine
Digest
The Winter 2000 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:
- Opening Remarks
- Leonard H. Finkelstein, DO, ’59
- Founders Day 2000
- Student Activity Center Opens
- Special Supplement: PCOM Centennial
- College Board Profile
- Alumni Board Profile
- PCOM Updates
- Convention Highlights
- Class Notes
- In Memoriam
- Coming Events
Vital Signs, Winter 2000, Boonshoft School Of Medicine
Vital Signs, Winter 2000, Boonshoft School Of Medicine
Vital Signs
A twenty four page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.
Chrimcy: A Proposed Institute For Research On Reproduction, Development, And Mother, Child And Youth Health, Harvey Guyda, Robert Armstrong, Ken Milne, Alex Mackenzie, Victor Han, Robert Bortolussi, Elaine Orrbine
Chrimcy: A Proposed Institute For Research On Reproduction, Development, And Mother, Child And Youth Health, Harvey Guyda, Robert Armstrong, Ken Milne, Alex Mackenzie, Victor Han, Robert Bortolussi, Elaine Orrbine
Paediatrics and Child Health, East Africa
The establishment of the Canadian Institutes of Health Research (CIHR) is one of the most significant and far-sighted plans to address the health of Canadians. The success of the CIHR will be determined by the degree to which Canada is able to provide focus and the resources to tackle the critical health issues affecting Canadians.
Perceptions About Female Sexuality Among Young Pakistani Men Presenting To Family Physicians At A Teaching Hospital In Karachi, Waris Qidwai
Perceptions About Female Sexuality Among Young Pakistani Men Presenting To Family Physicians At A Teaching Hospital In Karachi, Waris Qidwai
Department of Family Medicine
Objective: To study the perceptions about female sexuality among young Pakistani men, presenting to family physicians at a teaching hospital in Karachi, Pakistan
Study Design: A questionnaire based prevalence study.
Setting: Questionnaire administered to 188 young Pakistani men, between the ages 18-30 veai-s, who presented to family physicians, at the outpatient department of the Aga Khan University Hospital, Karachi, Pakistan.
Main Outcome Measures: Perception among Pakistani young men about enjoyment of sexual experiences in women, whether women stop to enjoy sexual experiences during stress, menstruation, pregnancy and after menopause. Whether they are aware about “orgasm” in women and their belief …
The Use Of Intra Aortic Baloon Pump In Patients Undergoing Coronary Artery Bypass Grafting At The Aga Khan University Hospital, Karachi, Aamir M. Jafarey, Muneer Amanullah, Sajid A. Khan, Sulaiman B. Hasan
The Use Of Intra Aortic Baloon Pump In Patients Undergoing Coronary Artery Bypass Grafting At The Aga Khan University Hospital, Karachi, Aamir M. Jafarey, Muneer Amanullah, Sajid A. Khan, Sulaiman B. Hasan
Department of Surgery Docs
Objective: To review the experience in the use of Intra Aortic Balloon Pump (IABP) in patietits undergoing Coronary Artery Bypass Grafting (CABG) at a tertiary care hospital with a new Open Heart surgery program. Design: Retrospective study. Setting: The Aga Khan University Hospital, Karachi.
Patients: Medical records of all patients undergoing CABG between November 1994 and July 1997 were reviewed and those in whom IABP device was used, were included in this study.
Results: A total of 15 patients had IABP suppOrt during the study period. Four surgeries were done urgently while two were emergencies. There were three mortalities. Ejection …
Ultrasonographic Renal Size In Individuals Without Known Renal Disease, Niels-Peter Buchholz, Farhat Abbas, Syed Raziuddin Biyabani, Qaiser Javed, Jamsheer Jehangir Talati, Masood Afzal, Imtiaz Rizvi
Ultrasonographic Renal Size In Individuals Without Known Renal Disease, Niels-Peter Buchholz, Farhat Abbas, Syed Raziuddin Biyabani, Qaiser Javed, Jamsheer Jehangir Talati, Masood Afzal, Imtiaz Rizvi
Section of Urology
Objective: In order to establish some preliminary data of our population, we determined the ultrasonographic kidney dimensions in individuals withoud known renal disease. We assessed whether age, sex, side, body mass index (BMI) and presence or absence of diabetes mellitus and hypertension affect the renal size.
Methods: Ultrasonographic kidney measurements were performed on 194 adult patients without known kidney lesions. Measurements included length, width, cortical thickness and estimation of renal size which was obtained by multiplying the first three variables. The effect of age, gender, side, height, weight, BNll, hypertension and diabetes mellitus was statistically analyzed.
Results: The mean kidney …
Effect Of Actinomycin D And Cycloheximide On Ischemic Preconditioning-Induced Delayed Cardioprotective Effect In Rats, Devinder Singh, Ajay Sharma, Manjeet Singh
Effect Of Actinomycin D And Cycloheximide On Ischemic Preconditioning-Induced Delayed Cardioprotective Effect In Rats, Devinder Singh, Ajay Sharma, Manjeet Singh
Pharmacy Faculty Articles and Research
The present study was designed to investigate the effect of actinomycin D, a transcription inhibitor, and cycloheximide, a translation inhibitor, on the delayed cardioprotective effect of ischemic preconditioning. Left thoracotomy was performed in anaesthetized rats at 4th/5th intercostal space and polypropylene suture (5-0) was employed to occlude left common coronary artery. Ischemic preconditioning was produced by four episodes of 5 min of coronary artery occlusion followed by 5 min of reperfusion and thoracic cavity was sutured. Left thoracotomy was performed again after 24 hr of ischemic preconditioning and left coronary artery was occluded for 30 min followed by reperfusion for …
Health Promotion For Older Adults: What Is The Potential?, Linda P. Fried
Health Promotion For Older Adults: What Is The Potential?, Linda P. Fried
Center for Policy Research
As a greater number of people reach old age, medicine is challenged to develop new approaches to this population. Health promotion, not just treatment of disease but improving the quality of life for older persons, must play a role. What happens to individuals in terms of health status as they get older, and what are the implications for health care needs? Where should we focus to get the biggest benefits in terms of health promotion? Overall, we have learned a tremendous amount over the last 25 years about the components of health as people get older, and what modifies their …
Pharmaceuticals And The Elderly: A Comparative Analysis, Deborah A. Freund, Don Wilson, Grant D. Reeher, Bernie O'Brien
Pharmaceuticals And The Elderly: A Comparative Analysis, Deborah A. Freund, Don Wilson, Grant D. Reeher, Bernie O'Brien
Center for Policy Research
This paper compares and contrasts outpatient pharmaceutical policies for the elderly in seven OECD nations: Australia, Canada, Germany, Japan, New Zealand, the United Kingdom, and the United States. Each country is facing an increasing financial burden due to rapidly growing numbers of elderly citizens, in number and as a percentage of population, and rising drug costs. As a result, they are struggling to balance varying levels of commitment to providing drugs for the elderly with the need to contain costs. Although each country's healthcare system is unique, the methods that each country is using to control rising pharmaceutical costs are …
A Qualitative Study Of The Impact Of Hip Fracture In The Elderly Population, Stephanie Anne Price
A Qualitative Study Of The Impact Of Hip Fracture In The Elderly Population, Stephanie Anne Price
Theses: Doctorates and Masters
The social, emotional and economic impact of falling in the elderly population is significant. Falls are the leading cause of injury related deaths and hospitalisation amongst people aged 65 years and older, a major factor in their morbidity and mortality rates. Post fall sequelae can have major ramifications that include reduction or avoidance of activities, attributable to an enduring fear of future falls. Twenty-three older people who had fallen in the community were located via hospital records and invited to participate in the study. Subjective accounts of the impact of falling and sustaining a hip fracture were obtained by means …
The Use Of The Cognitive Status Examination In Detecting Cognitive Impairment In Elderly People, Geoff Mccann
The Use Of The Cognitive Status Examination In Detecting Cognitive Impairment In Elderly People, Geoff Mccann
Theses: Doctorates and Masters
Dementia is a growing social problem in Australia because as the population ages, the incidence of dementia increases. While the prevalence rates are only about I% at age 65, they double every five years until by 85 years of age the rate is over 24%. It is expected that by the year 2030, the number of elderly people with dementia will increase by 200%. Dementia is easily recognized in its advanced stages but can be overlooked in the early phase. Family members, care-givers and even the treating medical practitioner may mistakenly attribute the early decline in mental function to the …
Factors Associated With Healthy Eating: Attitudes, Cultural Adherence, And Snacking Behavior Among Korean-American Adolescents, Kyoung Eun Oh
Factors Associated With Healthy Eating: Attitudes, Cultural Adherence, And Snacking Behavior Among Korean-American Adolescents, Kyoung Eun Oh
Loma Linda University Electronic Theses, Dissertations & Projects
Adolescents have increased nutrition needs and report frequent meal skipping and snacking, but there are few studies that examine the determinants of unhealthy eating, especially among ethnic minority groups. This study investigated dietary intake and snacking behavior among Korean-American adolescents in the Los Angeles area. We determined the relationship between dietary fat intake and overall quality of the diet as assessed by two healthy eating indices: the Healthy Eating Index (HEl) and Mean Nutrient Adequacy Ratio (MNAR). HEl assessed degree of compliance to Food Guide Pyramid and Dietary Guidelines for Americans while MNAR assessed nutrient consumption compared to Recommended Dietary …
Client-Centered Versus Traditional-Directive Educational Approach: A Randomized Study Of Exercises And Perceived Control Among Patients With Type 2 Diabetes, Melissa D. Olfert
Client-Centered Versus Traditional-Directive Educational Approach: A Randomized Study Of Exercises And Perceived Control Among Patients With Type 2 Diabetes, Melissa D. Olfert
Loma Linda University Electronic Theses, Dissertations & Projects
A patient’s adherence to self-management therapies in diabetes strongly influences health outcomes, health care utilization, and ultimately health care costs. Engaging in regular exercise therapy reduces risk factors associated with type 2 diabetes. The purpose of this randomized prospective study was to determine if a client-centered approach (CCA) toward diabetes education, verses a traditional-directive approach (TDA), would improve exercise participation, perceived control, intention to exercise, and glycemic control in patients with type 2 diabetes.
Fifty-nine type 2 patients were randomized into two groups: CCA and TDA. Diabetes education in the CCA group provided empowerment toward acquiring knowledge, skills, and responsibility …
Effect Of Dietary Garlic (Allium Sativum) On The Blood Pressure In Humans - A Pilot Study, Waris Qidwai, Riaz Qureshi, Iqba Azam, Syed Najmul Hasan
Effect Of Dietary Garlic (Allium Sativum) On The Blood Pressure In Humans - A Pilot Study, Waris Qidwai, Riaz Qureshi, Iqba Azam, Syed Najmul Hasan
Department of Family Medicine
Objective: To find out whether individuals with blood pressures on the lower side consume more garlic in their diets. A pilot study to make grounds for more elaborate future trials.
Method: A questionnaire was developed in order to estimate the dietary intake of garlic per person per month and to record three blood pressure readings on each individual. It was administered to 101 adult subjects, presenting to the Family Practice Centre of a hospital in the city of Karachi, Pakistan. The various demographic parameters including age, sex, marital status and education were recorded. Those subjects found to be overweight, with …
Teleradiology As A Foundation For An Enterprise-Wide Health Care Delivery System, John David N. Dionisio, Ricky K. Taira, Usha Sinha, David B. Johnson, Benjamin Y. Dai, Gregory H. Tashima, Stephen Blythe, Richard Johnson, Hooshang Kangarloo
Teleradiology As A Foundation For An Enterprise-Wide Health Care Delivery System, John David N. Dionisio, Ricky K. Taira, Usha Sinha, David B. Johnson, Benjamin Y. Dai, Gregory H. Tashima, Stephen Blythe, Richard Johnson, Hooshang Kangarloo
Computer Science Faculty Works
An effective, integrated telemedicine system has been developed that allows (a) teleconsultation between local primary health care providers (primary care physicians and general radiologists) and remote imaging subspecialists and (b) active patient participation related to his or her medical condition and patient education. The initial stage of system development was a traditional teleradiology consultation service between general radiologists and specialists; this established system was expanded to include primary care physicians and patients. The system was developed by using a well-defined process model, resulting in three integrated modules: a patient module, a primary health care provider module, and a specialist module. …
Micronutrient And Iron Supplementation And Effective Anti-Malarial Treatment Synergistically Improve Childhood Anaemia, H. Ekvall, Zul Premji, A. Bjorkman
Micronutrient And Iron Supplementation And Effective Anti-Malarial Treatment Synergistically Improve Childhood Anaemia, H. Ekvall, Zul Premji, A. Bjorkman
Pathology, East Africa
The control of childhood anaemia in malaria holoendemic areas is a major public health challenge for which an optimal strategy remains to be determined. Malaria prevention may compromise the development of partial immunity. Regular micronutrient supplementation has been suggested as an alternative but its effectiveness remains unsettled. We therefore conducted a randomised placebo-controlled intervention trial with 207 Tanzanian children aged 5 months to 3 years on the efficacy of supervised supplementation of low-dose micronutrients including iron (Poly Vi-Sol with iron) three times per week, with an average attendance of ≥ 90%. The mean haemoglobin (Hb) level increased by 8 g/l …
Generational Conflict, Human Capital Accumulation, And Economic Growth, Douglas Holtz-Eakin, Mary E. Lovely, Mehmet Serkan Tosun
Generational Conflict, Human Capital Accumulation, And Economic Growth, Douglas Holtz-Eakin, Mary E. Lovely, Mehmet Serkan Tosun
Center for Policy Research
Worldwide, dependency ratios are forecast to increase dramatically in the next 50 years. A great deal of attention has been devoted to understanding the changes in fiscal policies that "must" take place to accommodate these changes. In contrast, less effort has been concentrated on studying the fiscal shifts that will endogenously result from demographic pressures. An example of particular interest is the degree to which a more elderly population will support public spending for education. We use an overlapping-generations model to investigate the effect of this demographic transition on the endogenous determination of public spending for education. A demographic transition …
Relationship Between Intestinal Parasitosis With The Basic Services, And The Nutritional State Of Children Under The Age Of Five Of Black, Native, And Mestizo Ethnicities In The Rural Area Of The Province Of Imbabura 1998-1999, Carlos Rosero
Theses and Dissertations
The parasitosis in the tropical countries like Ecuador, are found in the different population groups of all ages, sexes, social conditions, ethnic groups, especially in those without hygienic conditions, pertaining to different geographic zones and the prevalence varies in agreement with the ecology, the human factors and the social economic characteristics. The fecal contamination on land and water where an adequate disposition of excretes, the surrounding conditions, the deficient living conditions, the rural life, the absence of bathrooms, the custom to not use shoes and to have contact with the water. The deficiency of hygienic education, contamination of foods and …
Attitudes, Practices And Knowledge Regarding Cervical Cancer Screening Among Greek Women In The Area Of Perth, Panagiota Karnaki
Attitudes, Practices And Knowledge Regarding Cervical Cancer Screening Among Greek Women In The Area Of Perth, Panagiota Karnaki
Theses: Doctorates and Masters
The purpose of this thesis is to study the attitudes, practices and knowledge of Greek women in Perth, Western Australia, regarding cervical cancer screening. This is important because no study has yet examined the cervical screening pattern of this group, despite their low participation rate in screening programs. Qualitative semi-structured interviews among 15 Greek women in Perth were used for data collection. Interviews were conducted both in English and Greek. Eight out of the 15 women interviewed did not participate in frequent screening and many had had only one Pap test in their life. Culture and religion influenced negative attitudes …