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Articles 3481 - 3510 of 12649
Full-Text Articles in Entire DC Network
Emotional Dissonance And Exhaustion Among Library Professionals During Covid-19, Mubashir Majid Baba
Emotional Dissonance And Exhaustion Among Library Professionals During Covid-19, Mubashir Majid Baba
Library Philosophy and Practice (e-journal)
The COVID-19 pandemic is having a dramatic impact on societies and economies around the world. The virus is affecting millions of lives worldwide, not only physically but also emotionally in the form of panic attacks, obsessional behavior, anxiety, stress and fear. Library professionals are also exposed to coronavirus disease 2019 (COVID-19) and are facing high levels of stress and anxiety. The aim of this exploratory study was to analyze the association between emotional dissonance and emotional exhaustion among library professionals during COVID-19 and to study the impact of demographics on the variables under study. The data collected were analyzed using …
Paying Attention To Water Relations: Poetic Inquiry And Pedagogical Documentation As Curious Practices, Claire O’Callaghan
Paying Attention To Water Relations: Poetic Inquiry And Pedagogical Documentation As Curious Practices, Claire O’Callaghan
Theses: Doctorates and Masters
This project explores climate pedagogies with particular interest in Western Australia’s current water crisis. Human and more-than-human relations are explored with young children and educators from an early learning centre in Perth, Western Australia, with a view to reimagining education in the context of rapid environmental change. The project is grounded in feminist new materialist knowledge and is framed by an attentive focus to amplify the non-binary nature of both human and more-than-human counterparts. The research focuses on challenging colonial ways of knowing water, by decentring the child, unsettling norms, and reinstating reciprocity between human and more-than-human others (Nxumalo & …
Towards An Evidence-Informed Differentiated Learning Consolidation Process To Support Classroom Instruction, Nicola Carr-White
Towards An Evidence-Informed Differentiated Learning Consolidation Process To Support Classroom Instruction, Nicola Carr-White
Theses: Doctorates and Masters
Despite many years of teaching experience, the differentiation and consolidation of classroom learning presented challenges for the researcher. In response, a Differentiated Learning Consolidation Process (DLCP) was developed through informal classroom-based action research over several years. Using low cost and accessible resources, it developed into a manageable supplementary intervention to support individual student needs and the retention of classroom instruction. Increasing interest from colleagues led the researcher to provide professional development on the instructional design and implementation of the DLCP. Through this experience, it became apparent that the DLCP theoretical assumptions were largely unknown. The current study was pursued to …
A Review Of The Effects Of Dietary Restriction, Dehydration, And Caffeine Withdrawal On Cognition: Implications For A Disabled Submarine Scenario, Sarah Chabal
Journal of Human Performance in Extreme Environments
In the event that submariners become trapped aboard a disabled submarine (DISSUB), they must perform a multitude of cognitively demanding tasks in order to maximize their likelihood of survival. During this time, submariners will also be forced to endure poor living conditions, including drastic changes to their nutrition. These nutritional changes have the potential to impair submariners’ cognitive functioning and affect operational performance, which could jeopardize survival; however, the effects of DISSUB nutrition on cognitive performance are not well understood. This review first describes the unique nutritional conditions that submariners will experience in a DISSUB scenario, including the change to …
Exploring The Relationship Between Anger, Aggression, And Perpetrator Substance Use In The Commission Of Sexual Offenses, Dominique Rivera
Exploring The Relationship Between Anger, Aggression, And Perpetrator Substance Use In The Commission Of Sexual Offenses, Dominique Rivera
Student Theses
This study examined the potential association between perpetrator substance use, anger, and aggressive behavior in the commission of sexual crimes. The sample included 246 adult males convicted of rape (n = 54) or child molestation (n = 192). Descriptive statistics revealed that 64.6% of the individuals in this sample (n = 159) were intoxicated at the time of the offense. Results showed that perpetrators who used substances at the time of the offense were more likely to exhibit aggressive behavior toward the victim (e.g., weapon use, verbal abuse) than those who did not. Offenders with higher pervasive anger scores were …
Are Giant Pandas (Ailuropoda Melanoleuca) Averse To Inequity?, Miranda R. Trapani
Are Giant Pandas (Ailuropoda Melanoleuca) Averse To Inequity?, Miranda R. Trapani
Theses and Dissertations
Inequity aversion, a negative response to situations of unequal reward distribution, is a cognitive trait usually seen in social species. This capacity is thought to regulate cooperative relationships in intelligent, cognitively flexible animals. Giant pandas are a unique case in that wild populations are characterized as nonsocial, however captive populations are socially housed until sexual maturity. This allows for the study of a nonsocial species in a social context and thus the assessment of socio-cognitive flexibility across evolutionarily distant taxa. Here, we assessed whether the giant panda (Ailuropoda melanoleuca) displays inequity aversion by testing ten juveniles living at …
Variation In Personality Among Semi-Wild Myanmar Timber Elephants, Sateesh Venkatesh
Variation In Personality Among Semi-Wild Myanmar Timber Elephants, Sateesh Venkatesh
Theses and Dissertations
This study examines two personality traits: exploration and neophobia, which could influence human-elephant conflicts. Thirty-one semi-wild elephants were tested over two trials using a custom novel puzzle tube containing three tasks and three rewards. Our studies show that elephants do vary significantly between individuals in both exploration and neophobia.
Tools For Thought: Artifacts From The History Of Comparative Psychology, Dylan Kerr
Tools For Thought: Artifacts From The History Of Comparative Psychology, Dylan Kerr
Theses and Dissertations
This project explores the history of comparative psychology through close readings of apparatuses used in seminal experiments on animal behavior, drawing connections between seemingly disparate areas of human culture—including art, architecture, mythology, and economics—and the development of the science, with a particular focus on behaviorist and cognitive approaches.
Communicable Diseases As Occupational Hazards For Agricultural Workers: Using Experience Sampling Methods For Promoting Public Health, Mahima Saxena, Margaret M. Burke
Communicable Diseases As Occupational Hazards For Agricultural Workers: Using Experience Sampling Methods For Promoting Public Health, Mahima Saxena, Margaret M. Burke
Psychology Faculty Publications
Vector-borne communicable diseases cause more than 700,000 deaths annually (World Health Organization, 2019). Despite various efforts, there has been no change in mortality rates due to communicable diseases worldwide (World Health Organization, 2019). Most communicable diseases have no cure and can attain epidemic status quickly. Therefore, prevention is critical in reducing disease transmission. Communicable disease transmission as an occupational health hazard is often ignored in work psychology research and public health policy. Using experience sampling methods, Saxena (2015) found that work and nonwork behaviors associated with rice farming in South Asia increase exposure to Japanese encephalitis. …
Effects Of Chronic Stress On Anxiety-Like Behavior And Fear Learning In The Tgf344-Ad Rat Model Of Alzheimer’S Disease, Samuel James Bouquin
Effects Of Chronic Stress On Anxiety-Like Behavior And Fear Learning In The Tgf344-Ad Rat Model Of Alzheimer’S Disease, Samuel James Bouquin
Psychology ETDs
Alzheimer’s disease (AD) is a progressive neurodegenerative brain disorder that leads to severe cognitive and functional impairments. Many AD patients also exhibit neuropsychiatric symptoms (NPS) such as anxiety and prior to the clinical diagnosis of dementia. The prodromal manifestation of NPS is highly prevalent among patients with mild cognitive impairment (MCI), and the co-occurrence of preclinical NPS and MCI is associated with an increased risk of developing AD. Prolonged or repeated exposure to stress can result in behavioral disturbances (e.g., anxiety) and accelerated global cognitive decline. Importantly, AD patients exhibit altered stress systems and AD-related neuropathology has been linked to …
Corporations And The American Polity, Patrick Labossiere
Corporations And The American Polity, Patrick Labossiere
Student Theses and Dissertations
Research on corporate communications’ effects on politics presents an acknowledgement of a relationship between the two topics, leaving a void in the explanation and examination of this topic. The void presents an opening to introduce a conceptual process for how corporations are able to craft communications to influence the American Polity, the democratic social organization within the United States. This research begins with a historical review of how corporations gain prominence in American society, capturing the ability to participate in the democratic social organization of the polity. A qualitative analysis of several conceptual frameworks serves as data, to establish an …
An Online Resource To Promote Well-Being Among College Students With Social Anxiety Disorder, Valerie Maxine Sanderson, Steven M. Gerardi, Jerilyn Callen
An Online Resource To Promote Well-Being Among College Students With Social Anxiety Disorder, Valerie Maxine Sanderson, Steven M. Gerardi, Jerilyn Callen
Fall 2020 Virtual OTD Capstone Symposium
Transitioning from high school to college can be a challenge for many students, especially those with social anxiety disorder (SAD). SAD can negatively impact a student’s ability to effectively participate in school. Occupational therapy intervention could be useful to students with SAD but many do not seek out treatment due to fear of stigmatization or discrimination. Not seeking services may place students with SAD at risk of developing unhealthy coping strategies (e.g., avoidant behaviors, alcohol use). The availability of an online resource to support participation in school, without the need to disclose their condition, could be helpful to students with …
A Closer Look At The Modern Bond Between Dogs And Humans, Mallory Colwell
A Closer Look At The Modern Bond Between Dogs And Humans, Mallory Colwell
Fall Student Research Symposium 2020
For this project, I wanted to take a closer look at a human's bond with their dog. This bond has been there for centuries, but recently has produced some distinct phenomenon. I believe that dog movies, dog birthdays, and dog social media showcase the modern human to dog relationship. Looking at these occurrences can give a better picture our bonds with our pets. It can also provide insight for ourselves as people.
Maturity And Well-Being: Consistent Associations Across Samples And Measures, Stephen Reysen, Courtney N. Plante, Truong Quang Lam, Shanmukh V. Kamble, Iva Katzarska-Miller, Natalia Assis, Grace Packard, Eduardo Gregolin Moretti
Maturity And Well-Being: Consistent Associations Across Samples And Measures, Stephen Reysen, Courtney N. Plante, Truong Quang Lam, Shanmukh V. Kamble, Iva Katzarska-Miller, Natalia Assis, Grace Packard, Eduardo Gregolin Moretti
Journal of Wellness
Introduction: Researchers have noted an association between maturity and well-being. However, this body of research uses different measures and conceptualizations of maturity (e.g., ego development, psychosocial maturity) and often only a few indicators of well-being. In the present research, we examined associations between a single self-rated measure of maturity and a variety of different indicators of well-being. Furthermore, we examined this association across a variety of samples. We hypothesized that maturity will show a positive relationship with measures related to well-being.
Methods: Samples of college students (Studies 1, 3, 4), Star Wars fans (Study 2), and individuals in the U.S., …
Use Of Behaviour Change Techniques By Direct Support Professionals To Support Healthy Lifestyle Behaviour For People With Moderate To Profound Intellectual Disabilities, Annelies Overwijk, Annette A.J. Van Der Putten, Cees P. Van Der Schans, Mariël Willems, Thessa I.M. Hilgenkamp, Aly Waninge
Use Of Behaviour Change Techniques By Direct Support Professionals To Support Healthy Lifestyle Behaviour For People With Moderate To Profound Intellectual Disabilities, Annelies Overwijk, Annette A.J. Van Der Putten, Cees P. Van Der Schans, Mariël Willems, Thessa I.M. Hilgenkamp, Aly Waninge
Physical Therapy Faculty Research
Background: Behaviour change techniques (BCTs) can be employed to support a healthy lifestyle for people with intellectual disabilities. The aim of this study is to determine whether and which BCTs are used by direct support professionals (DSPs) for supporting healthy lifestyle behaviour of people with moderate to profound intellectual disabilities. Method: Direct support professionals (n = 18) were observed in their daily work using audio-visual recordings. To code BCTs, the Coventry Aberdeen London Refined (CALO-RE-NL) taxonomy was employed. Results: Direct support professionals used 33 BCTs out of 42. The most used BCTs were as follows: ‘feedback on performance’, ‘instructions on …
Does Inhibitory Control Training Reduce Weight And Caloric Intake In Adults With Overweight And Obesity? A Pre-Registered, Randomized Controlled Event-Related Potential (Erp) Study, Kaylie A. Carbine, Alexandra M. Muir, Whitney D. Allen, James D. Lecheminant, Scott A. Baldwin, Chad D. Jensen, C. Brock Kirwan, Michael Larson
Does Inhibitory Control Training Reduce Weight And Caloric Intake In Adults With Overweight And Obesity? A Pre-Registered, Randomized Controlled Event-Related Potential (Erp) Study, Kaylie A. Carbine, Alexandra M. Muir, Whitney D. Allen, James D. Lecheminant, Scott A. Baldwin, Chad D. Jensen, C. Brock Kirwan, Michael Larson
Faculty Publications
A cognitive intervention that may reduce weight and caloric intake is inhibitory control training (ICT; having individuals repeatedly withhold dominant responses to unhealthy food images). We conducted a randomized controlled trial where 100 individuals with overweight or obesity were assigned to complete a generic (n = 48) or food-specific ICT (n = 52) training four times per week for four weeks. Weight and caloric intake were ob- tained at baseline, four-weeks, and 12-weeks. Participants also completed high-calorie and neutral go/no-go tasks while N2 event-related potential (ERP) data, a neural indicator of inhibitory control, was measured at all visits. Results from …
"Moral Of The Story": How Children’S Books Regulated Race Relations Starting Before The Civil War To Today, Faleya Scales
"Moral Of The Story": How Children’S Books Regulated Race Relations Starting Before The Civil War To Today, Faleya Scales
History: Student Scholarship & Creative Works
The relationship between the racial content displayed in children's books and the development of relationships between blacks and whites has consistently been one that has been overlooked. The purpose of this article is to address the correlation between the two topics while also explaining how racial propaganda in children's books has affected the psychology of those in the relationship. Children's books are key components of everyone's childhood and understanding how they have impacted how we think and behave in relationships with the other race is the key topic highlighted in this article. Not only do you get a perspective into …
Negative Emotions In Fieldwork: A Narrative Inquiry Of Three Efl Researchers’ Lived Experiences, Adilur Rahaman, Shuvo Saha
Negative Emotions In Fieldwork: A Narrative Inquiry Of Three Efl Researchers’ Lived Experiences, Adilur Rahaman, Shuvo Saha
The Qualitative Report
Through narrative inquiry this research depicts and interprets the negative emotions that three English as Foreign Language (EFL) researchers experienced in different research sites during their fieldwork. Narrative inquiry informs the design of this investigation as the approach is particularly useful for understanding lived experiences. The study draws on autobiographical as well as narrative data to report the negative emotions that evolve during English language education fieldwork, an aspect absent in the existing literature. Findings suggest that the researchers experienced a wide range of negative emotions namely ethical dilemma, anger, anxiety, guilt, and shame. These results carry implications for language …
The Fear Of Reptiles And How To Change It, Maxwell Lyman
The Fear Of Reptiles And How To Change It, Maxwell Lyman
Honors Projects
Reptile fear is prominent across many cultures. Anti-reptilian attitudes can lead to anti-conservation attitudes towards reptiles. Person-animal interaction has been shown to decrease fear desensitization and increase positive attitudes towards "unpopular" animals. My project demonstrates the effectiveness of live animal presentation in dispelling negative attitudes of reptiles. However, due to the sample size of the project, further research is highly suggested.
The Role Of Citizen Science In Science Perception, Meaning, And Environmental Values: An Evaluation Of The Living Snow Project, Rachel L. Severson, Phoebe S. Bean, Cali Caughie, Robin Kodner
The Role Of Citizen Science In Science Perception, Meaning, And Environmental Values: An Evaluation Of The Living Snow Project, Rachel L. Severson, Phoebe S. Bean, Cali Caughie, Robin Kodner
Psychology Faculty Publications
Citizen science programs provide a means for outdoor enthusiasts to combine their recreational pursuits with engagement in science. This research evaluated the role of citizen science in peoples’ perceptions of science, meaningfulness of their outdoor experiences, and environmental attitudes, identity, and connection. The Living Snow Project (LSP), a community-enabled (citizen science) program, engages the outdoor recreation community in research characterizing alpine snow microbiomes through volunteer sample collections in alpine environments. Citizen scientists (N=41) volunteering with LSP participated in this study at two time points before and after the 2019 snow sampling season. At both time points, participants completed five well-established …
Coexistence Of Perseveration And Apathy In The Tdp-43Q331k Knock-In Mouse Model Of Als–Ftd, Eosu Kim, Matthew A. White, Benjamin U. Phillips, Laura Lopez-Cruz, Hyunjeong Kim, Christopher J. Heath, Jong Eun Lee, Lisa M. Saksida, Jemeen Sreedharan, Timothy J. Bussey
Coexistence Of Perseveration And Apathy In The Tdp-43Q331k Knock-In Mouse Model Of Als–Ftd, Eosu Kim, Matthew A. White, Benjamin U. Phillips, Laura Lopez-Cruz, Hyunjeong Kim, Christopher J. Heath, Jong Eun Lee, Lisa M. Saksida, Jemeen Sreedharan, Timothy J. Bussey
Brain and Mind Institute Researchers' Publications
© 2020, The Author(s). Perseveration and apathy are two of the most common behavioural and psychological symptoms of dementia (BPSDs) in amyotrophic lateral sclerosis–frontotemporal dementia (ALS–FTD). Availability of a validated and behaviourally characterised animal model is crucial for translational research into BPSD in the FTD context. We behaviourally evaluated the male TDP-43Q331K mouse, an ALS–FTD model with a human-equivalent mutation (TDP-43Q331K) knocked into the endogenous Tardbp gene. We utilised a panel of behavioural tasks delivered using the rodent touchscreen apparatus, including progressive ratio (PR), extinction and visual discrimination/reversal learning (VDR) assays to examine motivation, response inhibition and cognitive flexibility, respectively. …
Survival Analysis Of Colorectal Cancer Patients With Liver Metastasis, Brandon O’Grady
Survival Analysis Of Colorectal Cancer Patients With Liver Metastasis, Brandon O’Grady
Dissertations and Theses (Open Access)
Background- Colorectal cancer is the third most common cancer in the world. I investigated the survival rates among colorectal cancer patients diagnosed with hepatic metastasis to see if any variables are associated colorectal risk and survival. Methods- Patients were diagnosed from 2000-2019 and collected through MD Anderson’s database. A descriptive analysis, univariate analysis, Kaplan-Meier with Mantel log-rank test, Cox proportion hazard regression and a Stratified Cox Model was performed to investigate death. A competing risk regression was implemented to investigate liver recurrence. Results- There was a clear difference in the survival outcome between liver surgery patients and non-liver surgery patients …
Applications Of Statistical Methods Studying The Impact Of Mobilization Regimes On The Total Collection Yield Of Hematologic Stem Cell, Mengchen Ding
Applications Of Statistical Methods Studying The Impact Of Mobilization Regimes On The Total Collection Yield Of Hematologic Stem Cell, Mengchen Ding
Dissertations and Theses (Open Access)
Hematologic malignancies are cancers that develop in the blood, bone marrow, and lymph nodes. Hematopoietic stem cell transplantation (HSCT) is a critical therapeutic approach that contributes to offer a potential cure for hematologic cancers and other hematologic disorders by replacing abnormal bone marrow with healthy bone marrow components to help bone marrow function recovery. Peripheral blood is the primary resource for collecting hematopoietic stem cells (HSCs). The collection yield of HSCs is critical for successful transplantation. Few articles have discussed this topic that the collection of stem cells not only from healthy donors but also from donors with a hematologic …
Determining The Molecular Events Underlying The Role Of Estradiol In Mediating Sex Differences In Cocaine Reward., Saurabh Sanjeev Kokane
Determining The Molecular Events Underlying The Role Of Estradiol In Mediating Sex Differences In Cocaine Reward., Saurabh Sanjeev Kokane
Psychology Dissertations - Archive
Research has demonstrated that women rapidly progress from recreational cocaine use to dependence, consume greater quantities of cocaine, experience more positive subjective effects of cocaine and have higher incidences of relapse during abstinence. These effects have been well replicated in animal models of cocaine addiction and indicate an enhanced sensitivity and therefore, vulnerability of females to cocaine addiction. This increased vulnerability of women and female animals to cocaine addiction has been attributed to enhanced cocaine reward. Furthermore, it has been demonstrated that the female hormone estradiol (E2) is a key mediator of the aforementioned effects of cocaine in women and …
The Pain In The Pleasure: Electrophysiological Analysis Of The Tail Region Of The Ventral Tegmental Area (Tvta), Akshay Parchure
The Pain In The Pleasure: Electrophysiological Analysis Of The Tail Region Of The Ventral Tegmental Area (Tvta), Akshay Parchure
Psychology Dissertations - Archive
The mesolimbic (midbrain) reward system is well documented to be involved with the analgesic effects of opioids, which involves the ventral tegmental area (VTA) causing release of dopamine (DA). The dopamine neurons from the ventral tegmental area (VTA) directly innervate the nucleus accumbens (NAc) and the prefrontal cortex via D1 DA Receptors. GABAergic inhibition of VTA DA system occurs regularly, but in 1990s Johnson and North showed the administration of opioids led to hyperpolarization of GABA interneurons in the VTA removing this inhibition, further leading to the “disinhibition model”. However, more recent studies have defined a new structure heavily influencing …
The Relationship Between Group Identification And Perceived Control Under Stressful Conditions, Fanshu Jin
The Relationship Between Group Identification And Perceived Control Under Stressful Conditions, Fanshu Jin
Legacy Theses & Dissertations (2009 - 2024)
Group identification provides important psychological resources. One potential benefit is that it may relieve individuals’ strain in stressful situation by increasing their perceived personal control. The current research explores the different roles that group identification plays in reaction to stressful performance situations. In particular, it investigates the extent to which group identification impacts perceived control in performance contexts. It was hypothesized that activating group identification prior to performing a challenging task will bolster perceptions of personal control, thereby sustaining or improving performance. An experimental study was conducted that manipulated salience of group identification, either before or after exposure to a …
Neural Correlates Of Social Pain In Psychological Disorders: Implications For Educational Settings, Skye E. Johnson
Neural Correlates Of Social Pain In Psychological Disorders: Implications For Educational Settings, Skye E. Johnson
Honors Projects
Pain has long been defined as a multidimensional construct; in past research, not only have the physical and sensory aspects of pain been investigated, but also the cognitive and emotional aspects, which include the experience of social pain. This experience is generally accepted to be very distressing and can have adverse effects on one's mental health, especially for those with neurological disorders. In my paper, I examine the effects of social pain on brain activity in individuals with autism spectrum disorder (ASD) and borderline personality disorder (BPD) as compared to those who are neurotypical. This research finds that while neurotypical …
Effects Of Alcohol Intoxication On Hostile Attribution Bias And Relational Aggression In Women, Alita M. Mobley
Effects Of Alcohol Intoxication On Hostile Attribution Bias And Relational Aggression In Women, Alita M. Mobley
Graduate Theses and Dissertations
Alcohol intoxication is consistently linked to physical and sexual aggression in men, but not women. The lack of evidence supporting the relationship between alcohol and aggression for women could be due to a failure to measure relational aggression (i.e., harmful social manipulation), the form of aggression more commonly employed by women. Further, alcohol intoxication may interfere with the interpretation of social cues, resulting in greater perceived provocation in ambiguous social interactions and increased aggression. The current study examined the relationship between alcohol intoxication and relational aggression in women and the extent to which interpretation of social cues (i.e., hostile attribution …
The Influence Of Proximal And Distal Familial Factors On Preschool Children's Inhibitory Control And Social Emotional Skills, Amy Encinger
The Influence Of Proximal And Distal Familial Factors On Preschool Children's Inhibitory Control And Social Emotional Skills, Amy Encinger
College of Education and Human Sciences: Dissertations, Theses, and Student Research
Children in the United States experience higher rates of poverty than any other age group, including elderly adults and the poverty rate of young children (0-5 years) is considerably higher than that of older children (Proctor et al., 2016). There is an extensive body of research examining familial socioeconomic status (SES) and the influence on the skills and behaviors of young children; however, common key indicators of family SES may not fully depict the ways in which children living in poverty/low-income homes are influenced by economic disadvantage. The focus of the current study is to explore the ways in which …
Breastfeeding Duration And Reasons Given For Early Cessation Of Breastfeeding Among Wic Mothers, Amy Willa
Breastfeeding Duration And Reasons Given For Early Cessation Of Breastfeeding Among Wic Mothers, Amy Willa
Dissertations and Theses (Open Access)
The Breastfeeding Duration and Reasons for Early Cessation of Breastfeeding Among WIC Mothers study was conducted to describe the duration of and factors associated with early breastfeeding cessation among the Women, Infants, and Children (WIC) population. We collected data from a random sample of WIC medical records, sampling medical records belonging to mothers who initiated breastfeeding an infant but did not breastfeed to 52 weeks. Data were analyzed to answer the questions: How long do WIC mothers breastfeed? What reasons are given during counseling sessions at WIC for early cessation of breastfeeding? Do socio-economic, demographic, or medical factors influence the …