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Implementing A Structured Lifestyle Counseling Program To Improve Weight Management In Obese Adults Ages 18–65 Within The Private Primary Care Setting, Ntoge Sone Penda
Implementing A Structured Lifestyle Counseling Program To Improve Weight Management In Obese Adults Ages 18–65 Within The Private Primary Care Setting, Ntoge Sone Penda
Walden Dissertations and Doctoral Studies
Obesity is a major public health concern that affects millions of adults. As a chronic, progressive disease, obesity increases the risk of developing several medical conditions. Although evidence-based clinical practice guidelines recommend comprehensive lifestyle modification as a first-line treatment, implementation of structured lifestyle counseling in primary care remains inconsistent. The practice-focused question guiding this Doctor of Nursing Practice (DNP) quality improvement project was: Among obese adults aged 18–65 years in a private primary care setting, does implementing a structured lifestyle counseling program improve body weight and body mass index (BMI) outcomes over an 11-week period? An organizational change process guided …
Improving Interdisciplinary Healthcare Staff Confidence And Competence In Screening, Brief Intervention, And Referral To Treatment Through Standardized Sbirt Training In A Behavioral Health Facility, Grace Kakie Awo Aidoo
Improving Interdisciplinary Healthcare Staff Confidence And Competence In Screening, Brief Intervention, And Referral To Treatment Through Standardized Sbirt Training In A Behavioral Health Facility, Grace Kakie Awo Aidoo
Walden Dissertations and Doctoral Studies
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach for the early identification and management of substance use concerns. However, inconsistent implementation may occur when healthcare staff lack confidence and competence in applying SBIRT in clinical practice. This Doctor of Nursing Practice staff education project addressed a practice gap related to low confidence and competence among interdisciplinary healthcare staff implementing SBIRT in a behavioral health facility. The purpose of the project was to implement and evaluate a standardized SBIRT education and competency-based training program. Guided by the Johns Hopkins evidence-based practice model, the educational intervention incorporated evidence-based …
Texas Teachers’ Perspectives On Work Experiences That Influenced Their Decision To Leave Their District Or Profession Following The Onset Of The Pandemic, Rose Pham Tran
Walden Dissertations and Doctoral Studies
The problem that was addressed through this study is the over 10% departure of K-12 teachers following the onset of the pandemic, contributing to widespread teacher shortages in the classrooms in Texas. Guided by Bakker and Demerouti’s job demands and resources framework, the purpose of this study was to explore K-12 teachers’ perspectives on the demands and responsibilities as well as their reasons to leave the district or profession following the onset of the pandemic. For this case study, semistructured interviews were conducted with 10 teachers from the same district who voluntarily left between 2020 and 2025. Additional data on …
Southeastern Michigan Firefighters’ Experiences With Their Organization’S Employee Assistance Program, Angela Patricia Johnson
Southeastern Michigan Firefighters’ Experiences With Their Organization’S Employee Assistance Program, Angela Patricia Johnson
Walden Dissertations and Doctoral Studies
Mental health challenges among first responders require coordinated stakeholder efforts. Although employee assistance programs (EAPs) are commonly offered as workplace benefits, little is known about firefighters’ experiences with these programs and how they can be tailored to meet their unique needs. Existing literature suggested that EAP utilization among firefighters is influenced by program awareness, confidentiality concerns, organizational support, stigma, and the extent to which services are tailored to first responders’ needs. Using a generic qualitative design and policy feedback theory, this study explored southeastern Michigan firefighters’ experiences with EAPs. Purposive sampling was used to recruit 11 firefighters for semi structured …
Parents’ Perceptions Of Their Children With Disabilities’ Mental Health During The Rapid Transition To Online Learning At The Time Of The Covid-19 Pandemic, Arnell Rorie Footman
Parents’ Perceptions Of Their Children With Disabilities’ Mental Health During The Rapid Transition To Online Learning At The Time Of The Covid-19 Pandemic, Arnell Rorie Footman
Walden Dissertations and Doctoral Studies
The COVID-19 pandemic prompted an abrupt shift to online learning, raising significant concerns about the mental health of children with disabilities. Existing research highlights increased rates of anxiety, depression, and social isolation during due to the disruptions in structured routines and in-person support systems. This generic qualitative study, guided by Bronfenbrenner’s EST was conducted to explore parents’ perceptions of the mental health challenges experienced by their students with disabilities during the rapid transition to online learning at the time of COVID-19 pandemic. Data was obtained through semi-structured interviews in which parents voiced their perceptions and experiences concerning their children’s mental …
Exploring Elite Athletes’ Perceptions Of The Practice Of Mindfulness For Mental Health And Optimal Performance, Omar A. Sesay
Exploring Elite Athletes’ Perceptions Of The Practice Of Mindfulness For Mental Health And Optimal Performance, Omar A. Sesay
Walden Dissertations and Doctoral Studies
Elite athletes experience physical, cognitive, and emotional demands that affect athletic performance and personal well-being, increasing the risk for anxiety, depression, burnout, attentional difficulties, and maladaptive coping strategies. Mindfulness-based stress reduction (MBSR) has been examined for its effect on attentional control, emotional regulation, cognitive flexibility, and stress resilience, but limited qualitative research has examined how elite athletes experience the practice of mindfulness. The purpose of this generic qualitative study was to explore elite athletes’ perceptions of the practice of mindfulness for mental health and optimal performance. The theoretical framework draws from mindfulness theory and MBSR principles. Semistructured interviews were conducted …
Staff Education To Improve Central Line Maintenance Documentation Compliance, Martha Danette Oglesby
Staff Education To Improve Central Line Maintenance Documentation Compliance, Martha Danette Oglesby
Walden Dissertations and Doctoral Studies
This was a staff education quality improvement project aimed at improving compliance with central line maintenance documentation among nurses on a busy transitional care unit (TCU). The practice problem was inconsistent documentation of central line bundle documentation. Documentation is an important part of nursing care and is the most effective way to communicate the care provided. Effective documentation is a pivotal way of identifying evidence-based care to prevent central line-associated bloodstream infections (CLABSIs). The practice-focused question was, In nursing staff working on an inpatient TCU, what is the impact of targeted education on evidence-based central venous catheter bundle care documentation, …
Mexican Women Caregivers’ Support For Family Members With Type 2 Diabetes, Andrea Mesa
Mexican Women Caregivers’ Support For Family Members With Type 2 Diabetes, Andrea Mesa
Walden Dissertations and Doctoral Studies
Type 2 diabetes (T2D) is a persistent public health challenge in the United States, disproportionately affecting Hispanic populations. Mexican-origin women often serve as primary caregivers for relatives living with diabetes, yet their voices and lived experiences remain underrepresented in research. This study addressed the limited understanding of how cultural values and caregiving roles influence diabetes management within Hispanic families. The purpose of this qualitative phenomenological study was to explore the lived experiences of Mexican-origin women aged 40 to 60 who care for a family member with T2D. Guided by the theory of planned behavior and social cognitive theory, the study …
Lived Experiences And Competencies Of Mental Health Professionals Supporting Postpartum Mothers’ Mental Health And Well-Being, Shaynie Wolski
Lived Experiences And Competencies Of Mental Health Professionals Supporting Postpartum Mothers’ Mental Health And Well-Being, Shaynie Wolski
Walden Dissertations and Doctoral Studies
Perinatal mood and anxiety disorders (PMADs), including depression, anxiety, obsessive-compulsive disorder, posttraumatic stress disorder, and postpartum psychosis, affect postpartum individuals and their families. Limited research has examined the lived experiences and competencies of licensed mental health professionals who address PMADs, potentially limiting counselor educators’ ability to prepare counselors for postpartum mental health needs. Guided by hermeneutic phenomenology and informed by Ecological Systems Theory, the purpose of this qualitative study was to answer the guiding question: What are the lived experiences of licensed mental health professionals in recognizing, assessing, and treating PMADs among postpartum clients? Semi-structured interviews were conducted with eight …
Retaining Teaching Hospital Nonacademic Nurse Educators: Addressing Burnout And Building Workforce Resilience, Walter Guevara
Retaining Teaching Hospital Nonacademic Nurse Educators: Addressing Burnout And Building Workforce Resilience, Walter Guevara
Walden Dissertations and Doctoral Studies
Burnout and high turnover intentions among nonacademic nurse educators (NANEs) in academic teaching hospitals pose a critical challenge for healthcare administration, threatening workforce stability, nursing education capacity, and healthcare outcomes. The purpose of the integrative review was to examine evidence-based strategies to reduce burnout and enhance resilience among NANEs, thereby improving retention, well-being, and workforce sustainability. An integrative literature review was conducted using the Johns Hopkins Evidence-Based Practice appraisal tools and 49 sources published between 2020 and 2025 were found to match criteria and quality for thematic analysis. Guided by Herzberg’s two-factor theory, a thematic analysis was used to synthesize …
Staff Education To Improve Consistent Phq-9 Administration In An Outpatient Psychiatric Practice, Ngozi Eboru
Staff Education To Improve Consistent Phq-9 Administration In An Outpatient Psychiatric Practice, Ngozi Eboru
Walden Dissertations and Doctoral Studies
Depression is a leading cause of disability and is associated with functional impairment, reduced quality of life, and increased healthcare utilization. Consistent administration of the Patient Health Questionnaire-9 (PHQ-9) is an essential component of measurement-based care, supporting the identification, monitoring, and treatment of depressive symptoms. A retrospective chart review at a private outpatient psychiatric practice identified inconsistent PHQ-9 administration and documentation, with a baseline completion rate of 62%. The purpose of this Doctor of Nursing Practice staff education project was to evaluate the impact of a structured educational intervention on the consistency of PHQ-9 administration among staff involved in the …
Strategies For Managing Change In Home Health Care Businesses, Halbert Brown
Strategies For Managing Change In Home Health Care Businesses, Halbert Brown
Walden Dissertations and Doctoral Studies
Home health care agencies may experience financial hardship when regulatory inspections result in deficiencies and administrative penalties. Home health company (HHC) leaders are concerned because ineffective change management strategies may contribute to ongoing regulatory deficiencies, penalties, and reduced business performance. Grounded in Lewin’s change management theory, the purpose of this qualitative pragmatic inquiry project was to explore change management strategies some HHC owners successfully implemented to reduce administrative deficiencies and penalties to augment business performance and profitability. The participants were six leaders from HHC firms in the southwestern region of the United States who had developed effective strategies to improve …
Staff Education To Implementation Of Fall Prevention Education To Improve Fall Prevention Knowledge Among Nurses And Cnas In A Nursing Home, Margret Nkechi Anabaronye
Staff Education To Implementation Of Fall Prevention Education To Improve Fall Prevention Knowledge Among Nurses And Cnas In A Nursing Home, Margret Nkechi Anabaronye
Walden Dissertations and Doctoral Studies
This project was a staff education initiative designed to enhance fall-prevention knowledge among nurses and certified nursing assistants (CNAs) in a nursing home setting. The practice problem addressed was the high incidence of patient falls among older adults, which is a persistent safety concern in caregiving facilities since it leads to injury, decreased quality of life, and heightened healthcare costs. The project aimed to determine whether implementing a fall-prevention educational initiative would enhance staff knowledge and confidence levels on fall prevention. Analytical strategies used in this project included quantitative pre- and posttests and descriptive statistics to measure changes in participants’ …
Staff Education To Improve Knowledge Of Standardized Scheduling In A Certified Home Health Agency, Roger Nounamo Kamkoumeu
Staff Education To Improve Knowledge Of Standardized Scheduling In A Certified Home Health Agency, Roger Nounamo Kamkoumeu
Walden Dissertations and Doctoral Studies
In this staff education project, I addressed the concerning rate of missed patient visits in home healthcare settings. At the practicum site, there has been no education program addressing scheduling and communication best practices for staff. The practice-focused question guiding this project was: Among nursing staff in a home health agency, does implementation of a staff education program on a standardized scheduling and reminder protocol, improve staff knowledge of missed visit reduction practices? The purpose of the project was to evaluate the effectiveness of the staff training on staff knowledge of scheduling, communication, and reminder protocols for the reduction of …
Lived Experiences Of Clinical Psychologists: Personal Coping Strategies To Address Emotional Exhaustion, Ayushi Shrestha
Lived Experiences Of Clinical Psychologists: Personal Coping Strategies To Address Emotional Exhaustion, Ayushi Shrestha
Walden Dissertations and Doctoral Studies
Emotional exhaustion is a key element of burnout among clinical psychologists. However, there are limited qualitative studies that examine how psychologists experience and cope with it. This study explored how licensed clinical psychologists experience and cope with emotional exhaustion. The study used Orem’s Self-Care Deficit Theory to explore how clinicians perceive, interpret, and respond to emotional demands. Semi structured interviews with licensed clinical psychologists experiencing emotional exhaustion were used to collect data. Data were analyzed using an interpretative phenomenological analysis approach, including descriptive and pattern coding to identify themes. Five themes were identified: workplace and organizational stressors; emotional experience of …
Relationship Between Sociodemographic Factors And Opioid Overdose Mortality In Milwaukee County, 2020-2021, Elizabeth David
Relationship Between Sociodemographic Factors And Opioid Overdose Mortality In Milwaukee County, 2020-2021, Elizabeth David
Walden Dissertations and Doctoral Studies
Opioid overdose deaths increased significantly from 2020 to 2021, with Milwaukee County experiencing higher rates than the national and state averages. African American and Hispanic residents faced disproportionately high fatal overdose rates. The purpose of this quantitative retrospective cross-sectional study was to examine the associations among socioeconomic status, race, age, access to treatment (measured by emergency medical services [EMS] naloxone administration), and opioid overdose mortality among underserved minority populations in Milwaukee County. Guided by the social-ecological model, the study analyzed data from the Milwaukee Health Department and the Milwaukee County Medical Examiner's Office across 34 ZIP codes. Inclusion criteria for …
Sbirt Staff Education To Registered Nurses In The Emergency Department, Rosemary Thuet
Sbirt Staff Education To Registered Nurses In The Emergency Department, Rosemary Thuet
Walden Dissertations and Doctoral Studies
Summary The project hospitals have, on average, 2,400 emergency department (ED) visits a month. Although patients receive a social screening, there are no specific assessments to determine if the person is at risk for alcohol use disorder (AUD). The lack of screening is a missed opportunity to provide a Screening, Brief Intervention and Referral to Treatment (SBIRT) assessment of over 2,400 patients a month or 48,000 people annually. Although several screening tools could be used for an SBIRT assessment, the recommendation of ED nursing leadership is to implement the tool known as the CAGE Questionnaire (Cut down, Annoyed, Guilty, and …
African American Experiences Accessing Mental Health Services In Rural Communities, Danielle O. Keith-Alexandre
African American Experiences Accessing Mental Health Services In Rural Communities, Danielle O. Keith-Alexandre
Walden Dissertations and Doctoral Studies
African American communities have exhibited greater vulnerability in psychological functioning and well-being, and usage of mental health services for evaluation and treatment are lower than for other groups, due to a range of barriers, including geographic location and lack of access. There is a lack of research on the difficulties African Americans face in accessing mental health services in U.S. rural communities. The purpose of this qualitative study was to explore, from a phenomenological approach, the lived experiences of African American adults residing in rural Pennsylvania mid-U.S. Eastern Coastal communities in regard to accessing mental health services. The social-ecological model …
Staff Education To Improve Behavioral Health Integration In Primary Care, Nelly Endah Atu
Staff Education To Improve Behavioral Health Integration In Primary Care, Nelly Endah Atu
Walden Dissertations and Doctoral Studies
This staff education project addressed a persistent gap in the delivery of integrated physical and mental healthcare for patients with co-occurring conditions. Fragmented care in primary care contributes to untreated mental health needs, increased patient distress, higher costs, and poor outcomes. The aim of this project was to develop, deliver, and evaluate a staff education program equipping nurses, nurse practitioners, and interdisciplinary team members with the knowledge, skills, and practical strategies needed to improve behavioral health integration in primary care. The practice question was, among interdisciplinary staff in a community health setting, did the implementation of an evidence-based, ADDIE-designed staff …
Self-Care Behavior And Diabetes Knowledge In African American Women With Type 2 Diabetes, Rena Renee Barron
Self-Care Behavior And Diabetes Knowledge In African American Women With Type 2 Diabetes, Rena Renee Barron
Walden Dissertations and Doctoral Studies
African American women experience a disproportionate burden of Type 2 diabetes, and limited evidence exists regarding the relationship between diabetes knowledge and self-care behaviors, particularly among African American female veterans. The purpose of this quantitative, cross-sectional study was to examine the relationship between diabetes knowledge and diabetes self-care among African American women with Type 2 diabetes, including a subsample of African American female veterans, and to evaluate whether the COVID-19 pandemic (2017–2019 vs. 2021–2023) moderated this relationship. Additional variables included age, marital status, physical health, and mental health. Guided by the social-ecological model, de-identified data from the Behavioral Risk Factor …
Relationship Between Hospital Case Management Leadership Style And Employee Engagement, Malinda Ellis
Relationship Between Hospital Case Management Leadership Style And Employee Engagement, Malinda Ellis
Walden Dissertations and Doctoral Studies
Employee engagement among hospital-based nurse case managers is important because these nurses support discharge planning, utilization management, care coordination, and safe patient transitions. Although leadership style has been studied in nursing, limited research has examined its relationship to engagement among nurse case managers. The purpose of this quantitative, nonexperimental, correlational study, using House’s path-goal theory, was to examine the relationship between transformational, transactional, and laissez-faire leadership styles and employee engagement among hospital-based nurse case managers. Data were collected from 89 registered nurse case managers in acute care settings in the United States, who completed the Multifactor Leadership Questionnaire, Short Form, …
Social Workers’ Perceptions Of Pediatric Hiv Disclosure Process, Colleen Myrie
Social Workers’ Perceptions Of Pediatric Hiv Disclosure Process, Colleen Myrie
Walden Dissertations and Doctoral Studies
Although the social problem of pediatric HIV disclosure has been studied by researchers internationally, there remains a gap in the experiences of social workers in facilitating this process. The purpose of this generic qualitative study was to explore the experiences and perceptions of social workers in the United States regarding the disclosure process for HIV positive children. This study was grounded in Rosenstock’s health belief model, which posits that an individual will take necessary action to prevent or manage a disease based on their perceptions of health. This model was effective in helping to identify what social workers think about …
Staff Education On Frailty And Senior Surgical Safety, Kimberly Buhay Gibu
Staff Education On Frailty And Senior Surgical Safety, Kimberly Buhay Gibu
Walden Dissertations and Doctoral Studies
This staff education doctoral project addressed a practice gap involving limited education on frailty assessment and senior surgical safety within the general surgery department of a large, integrated healthcare system. Frailty is associated with increased postoperative complications, hospitalizations, readmissions, and mortality among older adults, making early recognition essential to improving surgical outcomes. The practice-focused question project was: Does education on frailty screening and senior surgical safety improve the knowledge, confidence, and intent of general surgery staff in a large, integrated health system? The purpose was to develop, implement, and evaluate an evidence-based educational intervention. The project was guided by the …
Improving Hypertension Control Through Increased Follow-Up Frequency In Rural Adult Patients, Clarissa Renea King
Improving Hypertension Control Through Increased Follow-Up Frequency In Rural Adult Patients, Clarissa Renea King
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project centered on the implementation of an organizational change initiative to improve hypertension control among adults aged 18 years and older in a rural primary care setting, where barriers to healthcare contribute to poorer outcomes. The practice-focused question asked whether more frequent follow-up visits improve hypertension control rates in rural adults. Interventions included increased follow-up visits for uncontrolled hypertension, patient education, home blood pressure monitoring, and staff education on accurate blood pressure measurement techniques. The project involved a pre-/post- evaluation design and analysis of deidentified organizational quality data. Findings show that the baseline hypertension …
Staff Education To Improve Blood Pressure Reassessment And Referral Practices In An Urgent Care Setting, Carolyn Denise Kluttz
Staff Education To Improve Blood Pressure Reassessment And Referral Practices In An Urgent Care Setting, Carolyn Denise Kluttz
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project was a staff education and quality improvement initiative designed to improve blood pressure (BP) reassessment and referral compliance among adult patients presenting with elevated BP readings in an urgent care setting. Elevated blood pressure is frequently identified during urgent care visits; however, provider responses and follow-up recommendations are often inconsistent, creating missed opportunities for early identification and intervention. The practice-focused question guiding this project was: In adult patients presenting to urgent care settings, how does implementing a standardized nurse-led hypertension screening and referral protocol, compared with usual care, affect the identification and follow-up …
Staff Education On Improving Medication Adherence, Oneil Dobgima Galega
Staff Education On Improving Medication Adherence, Oneil Dobgima Galega
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project addressed a practice gap in an outpatient behavioral health setting involving inconsistent use of structured communication strategies to support medication adherence among psychiatric patients. Although nurses routinely provided medication instructions, approaches such as motivational interviewing and psychoeducation were underutilized, limiting patient engagement, understanding, and adherence, and ultimately affecting care continuity and outcomes. The purpose of the project was to improve psychiatric nurses’ knowledge and intent to use motivational interviewing and psychoeducation to enhance medication adherence. The guiding practice-focused question examined whether a structured educational intervention could strengthen nurses’ competencies in these communication strategies. …
Staff Education To Improve Nursing Knowledge On Pressure Injury Prevention, Kheeda Kimberly Gopaul
Staff Education To Improve Nursing Knowledge On Pressure Injury Prevention, Kheeda Kimberly Gopaul
Walden Dissertations and Doctoral Studies
Staff education in this project was focused on improving nursing staff’s knowledge on pressure injury prevention, inspired by the persistent care quality gap. The gap in practice as of 2024 related to hospital-acquired pressure injury (HAPI) at the host health organization was reported to be approximately 0.2 per 1,000 discharges. It was apparent that education could benefit the nursing staff to improve their knowledge in pressure injury prevention. The education in service focused on continuous nursing skin assessments, to ensure over prolonged hospitalization, patients’ skin does not deteriorate with the development of pressure injuries or advancing of pre-existing pressure ulcers. …
Exploring The Experiences And Support Needs Of African Immigrant Families Raising Children With Autism Spectrum Disorder In Ohio, Linda Nkoumba Eteki
Exploring The Experiences And Support Needs Of African Immigrant Families Raising Children With Autism Spectrum Disorder In Ohio, Linda Nkoumba Eteki
Walden Dissertations and Doctoral Studies
Autism spectrum disorder (ASD) presents unique challenges for families; however, African immigrant parents raising children with ASD in Ohio experience additional difficulties related to cultural stigma, systemic inequities, and limited access to culturally responsive services. This social work practice problem is important because it reflects disparities in diagnosis, intervention, service access, and family support that align with social work’s commitment to equity, advocacy, and social justice. The purpose of this qualitative study was to explore the experiences of African immigrant families raising children with ASD in Ohio and to examine how they describe autism-related stigma, caregiving challenges, and interactions with …
Openness To Experience And Creative Capacity Among Active First Responders, William Reagan
Openness To Experience And Creative Capacity Among Active First Responders, William Reagan
Walden Dissertations and Doctoral Studies
Because emergency services demand adaptive, creative problem-solving within procedurally rigid cultures, this study examined whether Openness to Experience predicted creative capacity among active first responders and whether age or tenure moderated that relationship. A cross-sectional design used N = 117 first responders from eight agencies. Openness was measured with the Big Five Inventory-2 (percentile ranks); creativity was assessed with the Divergent Association Task (DAT; n = 116) and the Consensual Assessment Technique (CAT; n = 111). Covariates were age, tenure, rank, gender, and, for 46 participants at one agency, a dispatch-derived operational exposure score. In the full sample, Openness did …
Addressing Implicit Bias Toward Patients With Substance Use Disorders Through A Staff Education Quality Improvement Initiative, Jeanne Baleng Okuwobi
Addressing Implicit Bias Toward Patients With Substance Use Disorders Through A Staff Education Quality Improvement Initiative, Jeanne Baleng Okuwobi
Walden Dissertations and Doctoral Studies
This doctoral project was a staff education quality improvement (QI) initiative designed to reduce implicit bias among healthcare providers toward patients with substance use disorder (SUD) at a community mental health center. Provider implicit bias toward patients with SUD contributes to stigma, inequitable care, reduced treatment engagement, and poorer health outcomes; addressing this bias is essential to advancing patient safety, health equity, and quality nursing care. The practice-focused question guiding this project asked whether a 9-week evidence-based staff education program incorporating didactic instruction and reflective practice would reduce provider implicit bias toward patients with SUD compared with current practice, which …