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Articles 46711 - 46740 of 48817
Full-Text Articles in Entire DC Network
The Impact Of Belonging To Identity-Based Student Organizations On Minority Stress In A Midwestern Predominantly White University, Mallory Millet, Akanksha Das, Christian C. Garcia, Rose Marie Ward
The Impact Of Belonging To Identity-Based Student Organizations On Minority Stress In A Midwestern Predominantly White University, Mallory Millet, Akanksha Das, Christian C. Garcia, Rose Marie Ward
Journal of Higher Education & Student Affairs
Minoritized students are exposed to additional unique stressors due to the systematic devaluation of their identities (i.e., minority stress). Additionally, minoritized students report higher levels of mental health concerns than their peers (e.g., anxiety, depression). Identity-based student organizations can be one avenue that universities could use to support these students. These organizations, designed to build social connections among students with shared experiences, may reduce minority stress through fostering students’ sense of belonging. However, the relationship between sense of belonging, minority stress, and identity-based student organizations has yet to be studied. The present study used quantitative and qualitative methods to understand …
Common Data Set, Georgia Southern University
Common Data Set, Georgia Southern University
Georgia Southern Common Datasets
No abstract provided.
Special Tribute To Fred Sammons, Phd (Hon), Otrl, Faota
Special Tribute To Fred Sammons, Phd (Hon), Otrl, Faota
OJOT Sponsor Profiles
No abstract provided.
Investigating The Effects Of Values Clarification And Self-Compassion On Mental Health Self-Stigma And Willingness To Seek Psychological Help, Sara V. White
Electronic Theses & Dissertations (2024 - present)
Mental health self-stigma, or the harmful beliefs that one holds about his or her mental illness, is associated with psychological distress and acts as a significant barrier to help-seeking. Yet, self-stigma is notoriously resistant to change when targeted directly. To address such concerns, the present study examined the effects of two brief writing interventions, self-compassion and values clarification relative to a control condition, in reducing self-stigma and improving willingness and intentionality to seek psychological help. Additionally, the present study also explored the contributions of two theoretically relevant mechanisms—state self-compassion and psychological (in)flexibility—on self-stigma, and whether resistance to self-compassion negatively impacted …
Systematic Literature Review: Elevating Black Voices Through Universal Social-Emotional Learning Interventions, Natasha J. Hogg
Systematic Literature Review: Elevating Black Voices Through Universal Social-Emotional Learning Interventions, Natasha J. Hogg
Electronic Theses & Dissertations (2024 - present)
This systematic literature review examined the outcomes of culturally responsive universal Social-Emotional Learning (SEL) interventions for Black students in K-12 school settings addressing mental health, racial trauma, and racial disparities. Following the PRISMA protocol, a comprehensive search was conducted across PsycINFO, EBSCO, and five academic journals by April 2025. Results yielded 11 peer-reviewed articles with 2,246 Black participants published between 1994 and 2024. Exclusion criteria included sole focus of Tier 2 or 3 interventions, lacking Black student populations, or lacking outcomes aggregated by race. Seven SEL interventions were identified with risk of bias assessed by a secondary reviewer. Thematic analysis …
Cervical Ligament Systems In Sauropod Dinosaurs: What Support Is There?, Audrey Rose Williams
Cervical Ligament Systems In Sauropod Dinosaurs: What Support Is There?, Audrey Rose Williams
Masters Theses
"Sauropod dinosaurs, such as Diplodocus, have been the subject of numerous hypotheses about what ligamentous structures could have lifted and supported their long necks. Because the supportive tissues rarely fossilize, palaeontologists rely on osteological correlates on the bone to infer their nature. Options for supportive cervical ligaments in sauropods are mammal-style nuchal ligaments, avian-style interlaminar elastic ligaments, reptilian-style supraspinal ligaments, or some combination thereof. This study tested for the presence of a mammal-style nuchal ligament via histological and micro-computed tomography of posterior cervical hemispinous processes of Apatosaurus and Diplodocus, in addition to examining gross morphological features of the cervical vertebrae …
Healthcare Discrimination Under The Canadian Charter Of Rights And Freedoms, Mélisande Charbonneau-Gravel, Sébastien Jodoin, Siobhan O’Connell
Healthcare Discrimination Under The Canadian Charter Of Rights And Freedoms, Mélisande Charbonneau-Gravel, Sébastien Jodoin, Siobhan O’Connell
Dalhousie Law Journal
This paper explores the role that the Canadian Charter of Rights & Freedoms could and should play in addressing and redressing discrimination in the context of healthcare in Canada. Drawing on landmark as well as recent jurisprudence, we analyze how sections 7 and 15 of the Charter apply to three types of healthcare discrimination: (1) lack of access to healthcare and health services; (2) lower quality of services, and attitudes and biases faced in diagnosis and treatment; and (3) physical, verbal, psychological, and sexual abuse experienced by patients. Our analysis highlights the ongoing, problematic nature of the prevailing interpretations of …
Sauce For The Gander: The False Symmetry Of Myths And Stereotypes Against The Accused In Sexual Assault Trials, Janine Benedet
Sauce For The Gander: The False Symmetry Of Myths And Stereotypes Against The Accused In Sexual Assault Trials, Janine Benedet
Dalhousie Law Journal
As sexual assault laws evolved to be expressed in sex-neutral language, so too have arguments relating to myths and stereotypes in the context of sexual offences. This article evaluates the argument that myths and stereotypes, traditionally a reflection of systemic discrimination against female complainants in rape trials, also operate against male accused. Understood correctly, this trend repackages anti-feminist backlash to early equality reform efforts, ultimately working to revive the belief that women’s accusations of sexual assault are often false. The Supreme Court of Canada’s decision in R v Kruk affirms that this historical context matters when it comes to claims …
The Criminalization Of Black Friendship, Kinship And Belonging, Reakash Walters
The Criminalization Of Black Friendship, Kinship And Belonging, Reakash Walters
Dalhousie Law Journal
This paper posits that the Canadian state's attempt to target organized crime through the Criminal Code's criminal organization provisions has led to the criminalization of everyday expressions of Black life, including the criminalization of Black friendship. The statutory architecture of the regime incentivizes criminal legal actors with limited contiguity to Black culture to conflate bids for connection, association, and friendship within Black communities as gang activity.
Before the criminal organization provisions were enacted, Canada had no legacy of directly criminalizing organized crime. Localized violence in Quebec during the mid-1990s led to rushed amendments to the Criminal Code to target biker …
A Front-End Analysis Of Teacher Retention At A High Poverty K-5 Public School, Nicole Gray
A Front-End Analysis Of Teacher Retention At A High Poverty K-5 Public School, Nicole Gray
Theses and Dissertations
This dissertation explored the experiences of educators impacted by teacher retention issues at a high-poverty K-5 public school. Researchers have studied the decline in individuals entering into the education profession as well as the high rates of individuals exiting the profession. With individuals leaving the profession at high rates, and not enough entering to replace those that are leaving, there is now a massive shortage with not enough teachers to meet the needs of students in public schools. The few individuals that are entering into the profession are not being retained, especially at high-poverty schools. This study explored the thoughts …
Implementing Effective Reading Strategies To Improve Reading Comprehension Among Minority Students, Mirlene Georges Moreau
Implementing Effective Reading Strategies To Improve Reading Comprehension Among Minority Students, Mirlene Georges Moreau
Theses and Dissertations
This applied dissertation examined teachers' perceptions of instructional strategies used to support reading comprehension among minority middle school students. The purpose of the quantitative, non-experimental correlational study was to examine relationships among teacher-reported instructional strategies, differentiated instruction, culturally responsive teaching practices, and perceived student reading comprehension outcomes. Because the study relied on survey perception data rather than direct achievement data or experimental intervention, findings were interpreted as associations rather than causal evidence. Data were collected through a researcher-developed survey administered to middle school English Language Arts, ESOL, and reading teachers. Descriptive statistics (frequencies, percentages, means, and standard deviations) summarized demographics …
Teachers’ Perceptions Towards The Impact Of Reading Plus On 10th-Grade Intensive Reading Students, Melvia Williams
Teachers’ Perceptions Towards The Impact Of Reading Plus On 10th-Grade Intensive Reading Students, Melvia Williams
Theses and Dissertations
The purpose of this generic qualitative study was to explore teachers’ experiences and perceptions regarding the impact of the Reading Plus program on 10th-grade students in intensive reading courses. The research was aimed to understand how teachers perceive the program’s effectiveness in enhancing reading fluency, comprehension, and vocabulary, as well as their reports about student engagement and the challenges and successes encountered during implementation. The data was gathered from semi structured interviews with 8 teachers with at least 2 years of experience teaching with Reading Plus in intensive reading programs. Themes for teachers' experiences were generated by inductive analysis.
Findings …
“Soccer Before Sex, Always” - Popular On-Screen Depictions Of Irish Masculinty During The Recession (2008 – 2020), Michael Sweeney
“Soccer Before Sex, Always” - Popular On-Screen Depictions Of Irish Masculinty During The Recession (2008 – 2020), Michael Sweeney
Masters
This thesis examines how on-screen masculinity changed from the fallout of the Celtic Tiger to Ireland's years of austerity, and why popular productions deploy “Mancession” narratives. This popularises tropes such as ‘Craic Merchant’ from key popular shows such as Hardy Bucks (2008), Love Hate (2010) and Young Offenders (2016). The term ‘Mancession’ (Perry, 2008) was coined following the global 2008 recession, which led to assumptions that men were more economically affected than women. Domestically, this was relayed in popular on-screen media through the ‘Celtic Bromance’ genre, which developed the trope of male friendships as a coping mechanism amid austerity and …
High Temperature Diffraction From Aerodynamically Levitated Materials, Chris J. Benmore, Stephen K. Wilke, David Lipke, Richard Weber
High Temperature Diffraction From Aerodynamically Levitated Materials, Chris J. Benmore, Stephen K. Wilke, David Lipke, Richard Weber
Materials Science and Engineering Faculty Research & Creative Works
Aerodynamic levitation combined with laser beam heating has become an established technique for studying the structure of materials at ultra-high temperatures and under non-equilibrium conditions. This article briefly highlights some recent technical and scientific advancements in understanding the relationships between a material's behavior and its structure, investigated using diffraction methods. It focuses on three evolving frontiers: sophisticated sample environments for accessing metastable states and reactive chemistries, high-flux photon and neutron probes to reveal atomic structure, and advanced computational modeling frameworks. Free from contamination, containerless processing (levitation) can minimize heterogeneous nucleation at the interface, enabling access to deeply supercooled melts or …
Analytical And Empirical Data-Driven Risk-Governance Design Across The Different Phases: Creating Informed Policy Adjustments For The Transportation Project Lifecycle, Mariam A. Elazhary
Analytical And Empirical Data-Driven Risk-Governance Design Across The Different Phases: Creating Informed Policy Adjustments For The Transportation Project Lifecycle, Mariam A. Elazhary
Doctoral Dissertations
"Transportation infrastructure is a critical foundation for economic productivity, yet agencies still face challenges in translating the expanding transportation datasets into defensible, phase-specific risk-governance tools. This dissertation addresses this gap by developing analytical and empirical, data-driven approaches to support risk governance across the transportation project lifecycle. Module 1 uses a panel model with bid-letting data to examine how out-of-state contractor participation affects pre-award competition and to derive entry-governance rules. Module 2 analyzes nonfatal injury data through iterative multiple linear regression and fatality data through association-rule change mining to identify multi-factor safety-risk configurations and develop adaptive safety-governance provisions. Module 3 develops …
Re-Crosslinkable Hyper-Branched Polymer Gels Based On A Transamidation Reaction, Tao Song, Baojun Bai, Thomas P. Schuman
Re-Crosslinkable Hyper-Branched Polymer Gels Based On A Transamidation Reaction, Tao Song, Baojun Bai, Thomas P. Schuman
Patents
The present invention generally relates to the field of conformance control in oil fields, particularly to a re-crosslinkable preformed particle gel system, and composition thereof. The composition of the re-crosslinkable preformed particle gel system contains monomers, crosslinkers, a polymer matrix, and additives. Components in the composition for re-crosslinkable preformed particle gel in the present invention have excellent compatibility with each other, and the obtained gel has excellent long term high-temperature resistance property. Different from prior products, in the recrosslinkable preformed particle gel compositions according to embodiments of the present invention, the components that are used to re-crosslink the particle gels …
Healthy Diet For Every Child, Every Ability: Inclusive Nutrition For Healthier Futures, Ayesha Zahid Khan, Mehwish Farooq, Kausar Waqar
Healthy Diet For Every Child, Every Ability: Inclusive Nutrition For Healthier Futures, Ayesha Zahid Khan, Mehwish Farooq, Kausar Waqar
Books
- ASD: Autism Spectrum Disorder
- BCC: Behavior Change Communication
- CP: Cerebral Palsy DS: Down Syndrome
- NDD: Neurodevelopmental Disorder
- OT: Occupational Therapist
- PDGN: Pakistan Dietary Guidelines for Better Nutrition
- SLT: Speech and Language Therapist TGC
- Typically Growing Children
- WHO: World Health Organization
Improving Continuity Of Care In A Psychiatric Outpatient Clinic: A Quality Improvement Initiative., Irene Maranga
Improving Continuity Of Care In A Psychiatric Outpatient Clinic: A Quality Improvement Initiative., Irene Maranga
DNP Scholarly Projects
Abstract
Missed appointments, also known as ‘no-shows,’ disrupt continuity of care in psychiatric outpatient settings, leading to treatment delays, symptom exacerbation, and increased risk of hospitalization. This project was implemented at an outpatient psychiatric clinic where approximately 4 of 14 patients missed scheduled appointments daily, with no systematic follow-up protocol. A quality improvement initiative designed to re-engage patients after missed appointments through follow-up phone calls was implemented using the Plan-Do-Study-Act (PDSA) framework over two cycles from August through September 2026. Patients who missed appointments received a follow-up phone call within 24 hours. Cycle 1 included one call attempt per …
Hs 6000 Food Systems And Health, Shannon Caravello
Hs 6000 Food Systems And Health, Shannon Caravello
Open Educational Resources
Within the context of the US food system, students will examine the role of urban agriculture and its impact on local communities. Students will gain the ability to critically analyze current trends in urban agriculture and apply them to societal; cultural and health issues associated with the US food system as well as develop strategies to implement healthy eating in their own lives. Issues of food justice and insecurity will be addressed. Demonstrations and workshops on the KCC Community Farm and Garden may be included.
Thermal Requirements And Phenology Modelling Of A Drosophila Suzukii Population: Implications For Pest Risk Under A Changing Climate, Shepard Ndlela, Abdelmutalab G.A. Azrag, Esther Owino Awuor, Ibrahim Maholidy Farid, Samira Abuelgasim Mohamed
Thermal Requirements And Phenology Modelling Of A Drosophila Suzukii Population: Implications For Pest Risk Under A Changing Climate, Shepard Ndlela, Abdelmutalab G.A. Azrag, Esther Owino Awuor, Ibrahim Maholidy Farid, Samira Abuelgasim Mohamed
All Peer-Reviewed Publications
Drosophila suzukii (spotted-wing drosophila) is an invasive pest causing significant economic losses in soft-skinned fruit crops globally. This study presents comprehensive temperature-dependent life table data and phenology models for an African D. suzukii population collected in Kenya. Developmental time, mortality, fecundity, and adult longevity were assessed under constant temperatures from 12 to 30 °C. Using Insect Life Cycle Modelling (ILCYM) software, linear and nonlinear models were applied to characterise the effects of temperature on life history traits. Additionally, spatial risk indices including Establishment Risk Index (ERI), Generation Index (GI), and Activity Index (AI) were mapped globally for current and future …
Intensified Push-Pull Technology Enhances Above-Ground Arthropod Assemblages And Ecological Balance, Evanson R. Omuse, Honest Machekano, Daniel M. Mutyambai, Bonoukpoe M. Sokame, Chrysantus M. Tanga, Johnson O. Nyasani, Sevgan Subramanian, Frank Chidawanyika
Intensified Push-Pull Technology Enhances Above-Ground Arthropod Assemblages And Ecological Balance, Evanson R. Omuse, Honest Machekano, Daniel M. Mutyambai, Bonoukpoe M. Sokame, Chrysantus M. Tanga, Johnson O. Nyasani, Sevgan Subramanian, Frank Chidawanyika
All Peer-Reviewed Publications
Agroecological intensification aims to increase farm productivity, reduce dependency on external inputs, and enhance biodiversity conservation. However, the contribution of recent sustainable agricultural practices to arthropod assemblages and their ecosystem services remains underexplored. Through a 2-year multilocation trial, we investigated the response of above-ground arthropod assemblages and their ecological functions in cowpea and maize grown under monocropping systems and diversified systems (pure and intensified push-pull technologies). Using three sampling methods (visual observations, pitfall traps, sticky traps), a total of 65, 307 arthropod specimens were collected. The most dominant arthropod taxa were Hemiptera (true bugs; 47%), followed by Thysanoptera (thrips; 17%), …
The Effectiveness Of 3d Printing Project-Based Learning In Developing Future Skills And Academic Passion Among 10th Grade Students In Physics, Asma Abdullah Alshabnuti, Salim Khamis Al Harmali, Sulaiman Mohammed Al-Balushi
The Effectiveness Of 3d Printing Project-Based Learning In Developing Future Skills And Academic Passion Among 10th Grade Students In Physics, Asma Abdullah Alshabnuti, Salim Khamis Al Harmali, Sulaiman Mohammed Al-Balushi
Journal of Educational and Psychological Studies
The study aimed to explore the effectiveness of 3D Printing Project-based Learning in developing future skills, according to the Omani Future Skills Framework, and academic passion among 10th-grade students in physics in the Sultanate of Oman. A quasi-experimental research design was used, with a control and experimental group. The sample consisted of (114) male and female students. The Study instruments were the Future Skills Classroom Observation and the Academic Passion Scale, to gather data. Findings showed statistically significant differences in favor of the experimental group in most of future skills, except in flexibility and adaptation skill. The effect size of …
Evaluating The Impact Of Telemedicine-Based Medication Education On Glycemic Control In Adult Male Veterans With Type 2 Diabetes Mellitus, Megan N. Calter
Evaluating The Impact Of Telemedicine-Based Medication Education On Glycemic Control In Adult Male Veterans With Type 2 Diabetes Mellitus, Megan N. Calter
West Chester University Graduate Theses, Dissertations, and Final Projects
Veterans experience disproportionately high rates of type 2 diabetes mellitus (20.5% vs 11.6% nationally), driven by military-related factors such as PTSD, deployment-related obesity, and service-connected disabilities. At a large urban primary care clinic, 28% (40/141) of veterans with type 2 diabetes mellitus had persistently elevated HbA1c levels of ≥8%, indicating a high risk for diabetes-related complications. This quality improvement project aimed to reduce the proportion of veterans with HbA1c of ≥8% by implementing tailored telemedicine-based medication education, leveraging underutilized virtual care infrastructure to address access barriers and improve diabetes self-management. Participants received two 30-minute telemedicine medication and disease management education …
Culture Of Betrayal: Exploring Organizational Antecedents Of Institutional Betrayal And Military Sexual Trauma, Natalie Kline
Culture Of Betrayal: Exploring Organizational Antecedents Of Institutional Betrayal And Military Sexual Trauma, Natalie Kline
West Chester University Graduate Theses, Dissertations, and Final Projects
Female service members experience disproportionately higher rates of military sexual trauma (MST) compared to their male counterparts. MST significantly increases risk for many mental health, physical health, and occupational concerns. In addition to the negative effects of MST itself, many service members also experience institutional betrayal (IB), which refers to failures of the organization to prevent or appropriately respond to traumatic events such as MST. High rates of MST and its negative consequences are well documented, but the organizational factors fostering IB are under-studied in the military population. The current study examined environmental antecedents of MST and IB guided by …
Impact Of Sepsis Order Set Optimization On Sep-1 Compliance And Clinical Outcomes: A Retrospective Data Analysis, Janelle Harding
Impact Of Sepsis Order Set Optimization On Sep-1 Compliance And Clinical Outcomes: A Retrospective Data Analysis, Janelle Harding
West Chester University Graduate Theses, Dissertations, and Final Projects
Sepsis remains a leading cause of mortality, morbidity, and healthcare expenditure in the United States, with national SEP-1 compliance rates persistently near 60%. This quality improvement project evaluated whether optimizing sepsis order sets within a large, urban, Magnet-designated hospital improved adherence to the CMS SEP-1 quality measure and associated patient outcomes. Guided by the Donabedian Model, a multidisciplinary sepsis workgroup redesigned emergency department and inpatient sepsis order sets to streamline evidence-based care, enhance workflow alignment, and reduce variation in treatment. A retrospective analysis of 158 adult SEP-1 cases, with 67 cases in the preintervention group and 91 cases in the …
A Pull Toward Independence: Improving Pessary Removal Ease And Patient Independence Using Dental Floss, Stephanie Haly
A Pull Toward Independence: Improving Pessary Removal Ease And Patient Independence Using Dental Floss, Stephanie Haly
West Chester University Graduate Theses, Dissertations, and Final Projects
Pelvic Organ Prolapse and Stress Urinary Incontinence are the most common medical conditions for prescribing a vaginal pessary. Treating these conditions is vital to improve patient outcomes and quality of life. Treatment options vary from surgical options to less invasive alternatives. Due to various reasons, a patient might opt to avoid surgical management which leaves a vaginal pessary as the next best treatment option. Barriers to pessary self-management are seen frequently and can reduce patient independence and compliance. This quality improvement project sought to answer the following research question: In women using vaginal pessaries for pelvic organ prolapse or stress …
Poct Hgb A1c And Patient Satisfaction In Adult Patients With Diabetes, Kelly Galvin
Poct Hgb A1c And Patient Satisfaction In Adult Patients With Diabetes, Kelly Galvin
West Chester University Graduate Theses, Dissertations, and Final Projects
Point-of-care testing (POCT) is used to measure a variety of healthcare data rapidly at the bedside. It can be particularly useful when laboratory data is not available at the time a patient sees their healthcare provider (HCP). Patients living with diabetes frequently do not obtain laboratory data prior to their visit with their HCP. This quality improvement projected aim to assess if use of POCT to measure an Hgb A1c level in patients with diabetes affected patient satisfaction in an endocrinology clinic. Eligible participants were asked to complete an anonymous survey, with three questions asking if having their Hgb A1c …
Social Dirt Or Fertile Soil: A Phenomenological Study Of Contingent Faculty, Ann M. Hiloski-Fowler
Social Dirt Or Fertile Soil: A Phenomenological Study Of Contingent Faculty, Ann M. Hiloski-Fowler
West Chester University Graduate Theses, Dissertations, and Final Projects
The experiences of contingent or adjunct faculty affect their professional identity development. Contingent faculty use has increased since the 1970s. By 2013, two-thirds of U.S. higher education faculty were contingent (Finkelstein et al., 2016). While institutions use contingent faculty to fulfill their educational missions (Haviland et al., 2017; Kezar & Sam, 2011; Kimmel & Fairchild, 2017), their status as academic laborers stigmatizes them in academia, developing what Levin and Shaker (2011) term a “hybrid identity” (p. 1479), as both professionals and laborers, professors and temporary employees. Historically, the professional status of the professoriate has been defined on the tenure track …
Factors That Impact K-6th Grade Teachers’ Sense Of Self-Efficacy: A Mixed Methods Study, Becky A. Eckburg
Factors That Impact K-6th Grade Teachers’ Sense Of Self-Efficacy: A Mixed Methods Study, Becky A. Eckburg
West Chester University Graduate Theses, Dissertations, and Final Projects
Although there have been efforts to narrow the "achievement gap," research shows that the academic achievement levels of students in low socioeconomic school settings are likely to be significantly lower than the academic achievement levels of students in higher socioeconomic school settings (Babayiğit et al., 2021; Rahman et al., 2024). Studies also show that teachers have a significant impact on their students' growth, no matter what their academic setting may be (Petek & Pope, 2023), and that collective teacher self-efficacy is a significant factor in positive student achievement (Hattie, 2008). If targeted professional development could support teachers' self-efficacy, student achievement …
Retrospective Analysis Of Calcium Administration In Patients Undergoing Massive Transfusion Protocol (Mtp), Chrissy Unton
Retrospective Analysis Of Calcium Administration In Patients Undergoing Massive Transfusion Protocol (Mtp), Chrissy Unton
West Chester University Graduate Theses, Dissertations, and Final Projects
Unintentional injuries have remained the third leading cause of death in the United States since 2015, with the exception of 2020. Of those deaths resulting from traumatic injury, 40% result from hemorrhage and uncontrolled blood loss. Current treatment efforts focus on early, balanced transfusion of blood products and aim to correct metabolic derangements/coagulopathies, while minimizing crystalloid administration. As such, the role hypocalcemia plays in the injury process and the importance of calcium administration in resuscitation efforts has gained traction over recent years. The aim of this retrospective analysis was to assess calcium supplementation in relation to current facility protocol for …