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Articles 751 - 780 of 1475
Full-Text Articles in Entire DC Network
The Hemoglobin A1c Of African-Americans/Blacks With Diabetes Mellitus Type Two Using Low-Fat Diabetes Plate Diet, Ednah K. Makori
The Hemoglobin A1c Of African-Americans/Blacks With Diabetes Mellitus Type Two Using Low-Fat Diabetes Plate Diet, Ednah K. Makori
Doctor of Nursing Practice Projects
Diabetes Mellitus type two (DMT2) is a chronic disease that leads to high blood sugar in the body and if not corrected over a period of time, it leads to development of complications. Some of those complications include blindness, kidney failure, and retinopathy, among others. DMT2 continues to affect many people in the USA, especially African-Americans/Black who have the highest prevalence as compared to other races. Proper diet management especially the Low-Fat diabetes diet helps to decrease Hemoglobin A1c, which could result in reduction of risk of developing complications and morbidity related to DMT2. This project was done to educate …
Targeted Advertising Can Increase Healthy Food Choices Among College Students, Stephanie Spera
Targeted Advertising Can Increase Healthy Food Choices Among College Students, Stephanie Spera
Population Health Research Brief Series
Poor nutrition in young adulthood can increase risk of obesity, cancer, cardiovascular disease, and diabetes in mid- and later life. Targeted nutrition programs for young adults are essential to reduce the burden of chronic disease in the U.S. over the next several decades. This research brief describes a successful healthy food marketing strategy that was used at Syracuse University to promote healthy food purchasing among college students.
Medically Tailored Meals As A Prescription For Treatment Of Food-Insecure Type 2 Diabetics, Leslie J. Rabaut
Medically Tailored Meals As A Prescription For Treatment Of Food-Insecure Type 2 Diabetics, Leslie J. Rabaut
Journal of Patient-Centered Research and Reviews
Type 2 diabetes mellitus is an immense burden to the health of our population and to our current health care system, and the weight of this burden is only projected to multiply in coming years. A nutritious diet is an indispensable aspect of diabetes treatment, and the lack of access to food engenders poor disease-state control, which correlates with increased health care utilization. Interventions aimed at improving access to food through medically tailored meals (MTMs) have demonstrated effectiveness in improving the health of food-insecure type 2 diabetic patients and reducing health care costs. Further studies are necessary to increase the …
The Inflammatory Potential Of Diet In Determining Cancer Risk; A Prospective Investigation Of Two Dietary Pattern Scores, Stina Bodén, Robin Myte, Maria Wennberg, Sophia Harlid, Ingegerd Johansson, Nitin Shivappa, James R. Hébert, Bethany Van Guelpen, Lena Maria Nilsson
The Inflammatory Potential Of Diet In Determining Cancer Risk; A Prospective Investigation Of Two Dietary Pattern Scores, Stina Bodén, Robin Myte, Maria Wennberg, Sophia Harlid, Ingegerd Johansson, Nitin Shivappa, James R. Hébert, Bethany Van Guelpen, Lena Maria Nilsson
Faculty Publications
Purpose Inflammation-related mechanisms may contribute to the link between diet and cancer. We sought to investigate the inflammatory impact of diet on cancer risk using the Dietary inflammatory index (DII) and an adapted Mediterranean diet score (MDS).
Methods This population-based, prospective cohort study used self-reported dietary data from the Västerbotten Intervention Programme, including 100,881 participants, of whom 35,393 had repeated measures. Associations between dietary patterns and cancer risk were evaluated using Cox proportional hazards regression. We also used restricted cubic splines to test for potential non-linear associations.
Results A total of 9,250 incident cancer cases were diagnosed during a median …
Lack Of Association Between Dietary Inflammatory Index And Low Impact Fractures In The Brazilian Population: The Brazilian Osteoporosis Study (Brazos), Melissa Morimoto, Nitin Shivappa, Patricia De Souza Genaro, Ligia Araujo Martini, Natielen Jacques Schuch, James R. Hebert, Marcelo Medeiros Pinheiro
Lack Of Association Between Dietary Inflammatory Index And Low Impact Fractures In The Brazilian Population: The Brazilian Osteoporosis Study (Brazos), Melissa Morimoto, Nitin Shivappa, Patricia De Souza Genaro, Ligia Araujo Martini, Natielen Jacques Schuch, James R. Hebert, Marcelo Medeiros Pinheiro
Faculty Publications
Introduction: Adequate nutrition, including intake of dietary calcium and vitamin D, is important to maintain bone health. Evidence suggests that a deficiency in micronutrients may contribute to bone loss during aging and exert generalized effects on chronic inflammation. Recently, the Dietary Inflammatory Index (DII) was developed to assess the inflammatory potential of individual diets. Our aim was to evaluate the DII in a representative sample and verify its association with low-impact fractures.
Methods: Individuals from The Brazilian Osteoporosis Study (BRAZOS) database had their DII calculated. BRAZOS is an important cross-sectional epidemiological study carried out with a representative sample of men …
A Randomized, Controlled Trial On The Effects Of Almonds On Lipoprotein Response To A Higher Carbohydrate, Lower Fat Diet In Men And Women With Abdominal Adiposity., Paul T. Williams, Nathalie Bergeron, Sally Chiu, Ronald M. Krauss
A Randomized, Controlled Trial On The Effects Of Almonds On Lipoprotein Response To A Higher Carbohydrate, Lower Fat Diet In Men And Women With Abdominal Adiposity., Paul T. Williams, Nathalie Bergeron, Sally Chiu, Ronald M. Krauss
Faculty Publications & Research of the TUC College of Pharmacy
BACKGROUND: Almonds have been shown to lower LDL cholesterol but there is limited information regarding their effects on the dyslipidemia characterized by increased levels of very low density lipoproteins (VLDL) and small, dense low-density lipoprotein (LDL) particles that is associated with abdominal adiposity and high carbohydrate intake. The objective of the present study was to test whether substitution of almonds for other foods attenuates carbohydrate-induced increases in small, dense LDL in individuals with increased abdominal adiposity.
METHODS: This was a randomized cross-over study of three 3wk diets, separated by 2wk washouts: a higher-carbohydrate (CHO) reference diet (CHO
RESULTS: Relative to …
The Effects Of Exercise On Diabetes Mellitus Ii, Jarrett Thompson, Tyler Marinelli
The Effects Of Exercise On Diabetes Mellitus Ii, Jarrett Thompson, Tyler Marinelli
EXSI 432/532: Research Methods in Exercise Science: Research Proposal Posters
No abstract provided.
Bringing Truth To The Table: An Evidence Review To Dispell Common Dietary Myths, Madison Pierce
Bringing Truth To The Table: An Evidence Review To Dispell Common Dietary Myths, Madison Pierce
Senior Theses
Background/Significance
Nurses are most directly involved with patient care and are in an excellent position to be patient educators. Patients are more likely to actively listen after establishing rapport, especially for loaded topics such as lifestyle choices. While nurses have general nutrition knowledge, they may lack current, scientifically-based information to help patients implement a healthy diet. Nurses can both educate and be an example of health habits that patients should emulate, and therefore need to be adequately informed about topics like dietary misconceptions.
Purpose
The purpose of this project is to provide current evidence-based information regarding dietary misconceptions to nurses …
Health Effects Of A Vegan Diet And Pediatric Cancer Prevention, Lindsay Wisehart
Health Effects Of A Vegan Diet And Pediatric Cancer Prevention, Lindsay Wisehart
Senior Honors Theses
Veganism is a diet which excludes consumption of all animal products. With proper planning and vitamin supplementation to ensure adequate intake of protein, fat, calcium, zinc, iron, and vitamins D and B12, a vegan diet is widely accepted as suitable for growing and developing children. The decreased levels of dairy, red and processed meats, fat, and protein, and increased levels of fruits and vegetables characteristic of a vegan diet have been shown to reduce risk of mortality and a number of diseases including adult and childhood cancer. Childhood cancer is the second leading cause of childhood death in Western society. …
Associations Of Dietary Diversity Score, Obesity, And High-Sensitivity C-Reactive Protein With Hba1c, Irmayanti Irmayanti, Arta Farmawati, Martalena Br Purba
Associations Of Dietary Diversity Score, Obesity, And High-Sensitivity C-Reactive Protein With Hba1c, Irmayanti Irmayanti, Arta Farmawati, Martalena Br Purba
Makara Journal of Health Research
Background: Associations of dietary diversity score (DDS), obesity and high-sensitivity C-reactive protein (hs-CRP) with glucose metabolism have been reported. Furthermore, DDS may not be associated with healthy weight. However, studies on these topics are limited in general Indonesia population. Methods: A total of 3,825 Indonesia Family Life Survey 2014/2015 participants aged 20-59 years old were included in this study. DDS was measured qualitatively in five food groups: carbohydrates, proteins, dairy products, vegetables, and fruits. Obesity was defined by Body Mass Index (BMI) classification for Indonesians. Blood analyses were performed in dried blood spot specimens. hs-CRP were analyzed using enzyme-linked immunosorbent …
Stop The War On Veggies, Une Applied Nutrition Program
Stop The War On Veggies, Une Applied Nutrition Program
All Student-Created Educational Resources
This pamphlet gives parents and caretakers of young children information on creating a food environment for children that promotes vegetable consumption. It further gives some tips on ways to engage children and make eating vegetables fun.
Examining The Relationships Between Stress, Depressive Symptoms, And The Neighborhood Food Environment On Diet Quality Among Racially-Diverse Pregnant Women In South Carolina, Alycia K. Boutté
Theses and Dissertations
Background
Women’s diet quality during pregnancy often falls short of U.S. Dietary Guidelines and poor mental health and poor access to healthy food may be important barriers to improving diet quality during pregnancy. The purpose of this study was to 1) synthesize existing literature on the relationship between mental health and diet quality during pregnancy, 2) examine the relationship between mental health and diet quality in pregnancy, and 3) examine the relationship between healthy food density and diet quality in pregnancy.
Methods
For Aim 1 (systematic review), articles were obtained from five databases; study characteristics and findings were extracted and …
Anxiety And Depression: Can Diet Help?, Megan Jensen, Mateja R. Savoie-Roskos, Ashley Yaugher, Sandy Sulzer
Anxiety And Depression: Can Diet Help?, Megan Jensen, Mateja R. Savoie-Roskos, Ashley Yaugher, Sandy Sulzer
All Current Publications
This fact sheet explains the role of diet with anxiety and depression.
Hubungan Tingkat Pengetahuan Dan Diabetes Self-Management Dengan Tingkat Stres Pasien Diabetes Melitus Yang Menjalani Diet, Kusnanto Kusnanto, Putri Mei Sundari, Candra Panji Asmoro, Hidayat Arifin
Hubungan Tingkat Pengetahuan Dan Diabetes Self-Management Dengan Tingkat Stres Pasien Diabetes Melitus Yang Menjalani Diet, Kusnanto Kusnanto, Putri Mei Sundari, Candra Panji Asmoro, Hidayat Arifin
Jurnal Keperawatan Indonesia
The correlation between knowledge level and diabetes self-management towards stress level of patients DM with diet. Knowledge is very important in developing diabetes self-management to prevent the risk of long-term complications with a strict diet. The purpose of this study was to determine the relationship between knowledge and diabetes self-management with stress levels of people with diabetes mellitus who went on a diet. This study uses a cross-sectional design. The total samples obtained were106 respondents with multistage sampling, inclusion criteria included patients with DM years, did not use insulin injection, DM patients were still married and lived with their families. …
Is Grassfed Meat And Dairy Better For Human And Environmental Health?, Frederick D. Provenza, Scott L. Kronberg, Pablo Gregorini
Is Grassfed Meat And Dairy Better For Human And Environmental Health?, Frederick D. Provenza, Scott L. Kronberg, Pablo Gregorini
Wildland Resources Faculty Publications
The health of livestock, humans, and environments is tied to plant diversity—and associated phytochemical richness—across landscapes. Health is enhanced when livestock forage on phytochemically rich landscapes, is reduced when livestock forage on simple mixture or monoculture pastures or consume high-grain rations in feedlots, and is greatly reduced for people who eat highly processed diets. Circumstantial evidence supports the hypothesis that phytochemical richness of herbivore diets enhances biochemical richness of meat and dairy, which is linked with human and environmental health. Among many roles they play in health, phytochemicals in herbivore diets protect meat and dairy from protein oxidation and lipid …
Diet For A Changing Climate: Food For Thought, Emilee Bell
Diet For A Changing Climate: Food For Thought, Emilee Bell
Children's Book and Media Review
As the world faces crises of hunger as well as environmental disaster, the authors claim one of the most impactful ways to avert total disaster is to take “eat local” to the extreme. Sidewalk cracks, boat hulls, and abandoned lots are the “foragermarkets” of the future. As incredible as it sounds, Mihaly and Heavenrich stand solidly on science and history: wild food sources, while uncomfortable to the modern eater, are packed with nutrients only whiffed in groceries today. Styled for the middle-grade reader, Mihaly and Heavenrich include legal alerts, safety tips, and even recipes to guide students on the path …
Diet And Addiction: Interview With A Former Food, Pornography, And Alcohol Addict, Tro Kalayjian, Brian Lenzkes
Diet And Addiction: Interview With A Former Food, Pornography, And Alcohol Addict, Tro Kalayjian, Brian Lenzkes
Dignity: A Journal of Analysis of Exploitation and Violence
Drs. Tro Kalayjian (Tapan, New York) and Brian Lenzkes (Santee, California) talk to Matt about his struggles with food, pornography, and alcohol addiction, and how changing his diet contributed to his recovery from his addictions. This report is excerpted from the audio podcast LowCarbMD, Episode 13 (https://itunes.apple.com/us/podcast/low-carb-md-podcast/ ), January 30, 2019). This podcast has filled us with immense hope for those struggling with addiction.
Dietary Intake Reporting Accuracy Of The Bridge2u Mobile Application Food Log Compared To Control Meal And Dietary Recall Methods, Jennifer Lemacks, Kristen Adams, Ashley Lovetere
Dietary Intake Reporting Accuracy Of The Bridge2u Mobile Application Food Log Compared To Control Meal And Dietary Recall Methods, Jennifer Lemacks, Kristen Adams, Ashley Lovetere
Faculty Publications
Mobile technology introduces opportunity for new methods of dietary assessment. The purpose of this study was to compare the reporting accuracy of a mobile food log application and 24 h recall method to a controlled meal among a convenience sample of adults (18 years of age or older). Participants were recruited from a community/university convenience sample. Participants consumed a pre-portioned control meal, completed mobile food log entry (mfood log), and participated in a dietary recall administered by a registered dietitian (24R). Height, weight, and application use survey data were collected. Sign test, Pearson’s correlation, and descriptive analyses were conducted to …
Is A Whole Food, Plant-Based Diet The Most Effective Treatment Of Arthritis?, Elisheva Liberman
Is A Whole Food, Plant-Based Diet The Most Effective Treatment Of Arthritis?, Elisheva Liberman
The Science Journal of the Lander College of Arts and Sciences
Arthritis is a debilitating disease where joint inflammation occurs. There are different types of arthritis, such as Osteoarthritis and Rheumatoid Arthritis. Osteoarthritis is the destruction of the articular cartilage that usually comes with age, whereas Rheumatoid Arthritis is a chronic autoimmune disease. They both have symptoms which include reduced range of motion, pain and swelling. There are various treatments to alleviate the pain and reduce the inflammation of arthritis. Among them are medication, physical therapy, surgery and a whole food, plant-based diet. The whole food, plant-based diet yields the best results and is the most effective and practical.
Coaggregation Patterns And Surface Characteristics Of Lactobacillus Rhamnosus Gg Under Varying Nutrient Conditions, Amanda Rielinger
Coaggregation Patterns And Surface Characteristics Of Lactobacillus Rhamnosus Gg Under Varying Nutrient Conditions, Amanda Rielinger
Senior Honors Theses and Projects
Lactobacillus rhamnosus GG (LGG) is one of the best studied probiotic organisms. The ability of probiotics to adhere to other microorganisms and the intestinal epithelium is thought to play a major role in their protective functions. Coaggregation is an important mechanism for biofilm formation by microorganisms. The goals of this study were to examine the ways in which nutrient variation affects intercellular interactions between LGG and other gut microbes and the hydrophobic character of LGG. We hypothesized that nutritional variation may affect the ability of LGG to coaggregate and form biofilms and thus affect its probiotic characteristics and ability to …
Comparing Gut Microbiome And Virome In The Breast Milk- And Formula-Fed Late Preterm Infants, Zyi Wang
Comparing Gut Microbiome And Virome In The Breast Milk- And Formula-Fed Late Preterm Infants, Zyi Wang
Electronic Theses and Dissertations
The neonatal intestinal microbiome consists of all microorganisms in the gut. Although the microbiome is critical to human health and disease, its colonization remains incompletely understood, particularly in the preterm infant. We aimed to characterize the intestinal bacteria microbiome and virome in moderate-to-late preterm infants. We hypothesized that the bacteria microbiome and virome differs between breast milk and formula-fed infants. We collected stool samples from twenty infants born between 32 0/7 and 36 6/7 weeks gestation. Samples were collected after infants reached full volume enteral feedings. Ten infants were breast milk fed and ten received infant formula. DNA and RNA …
Improving Quality Of Life In Menopausal Women Through Lifestyle Management : A Web-Based Health Promotion Project, Dana Essner
Improving Quality Of Life In Menopausal Women Through Lifestyle Management : A Web-Based Health Promotion Project, Dana Essner
Doctor of Nursing Practice (DNP)
Introduction: The symptoms of menopause affect 2 million women per year. Patient education and health promotion are key components of the primary care well visit. Lifestyle medicine focuses on behavioral changes to improve health and quality of life. One can use lifestyle medicine to promote wellness in menopausal women, thus improving their mental and physical health. Current data suggests that behavioral counseling enhances the patient education experience. A series of behavioral changes in diet, exercise, and mindfulness can be used. Social media is an effective tool to engage the population at large, while small group or individual counseling works on …
Sugar-Sweetened Beverages: A Survey To Assess Adults Knowledge, Attitudes, And Consumption Patterns Of Sugar-Sweetened Beverages, Jeff Schafer
All Graduate Theses, Dissertations, and Other Capstone Projects
Sugar-sweetened beverages (SSBs) have a direct impact on the general health of the country when looking at the rising obesity levels (CDC, 2017a). The USDA’s dietary guidelines suggest that the daily intake of added sugar should be limited to 6 teaspoons for women and 9 teaspoons for men (Hughes, 2017). However, the average American consumes 20 teaspoons of sugar daily (Hughes, 2017). These extra calories are converted into fat and stored in the body. Data collected throughout the years indicates a rise in the number of Americans living with a weight above healthy recommendations, which is termed, obese. Obesity is …
Nutrition Interventions Integrated Into An Existing Maternal, Neonatal, And Child Health Program Reduce Food Insecurity Among Recently Delivered And Pregnant Women In Bangladesh, Edward A. Frongillo Jr., Phuong H. Nguyen, Tina Sanghvi, Zeba Mahmud, Bachera Aktar, Silvia Alayon, Purnima Menon
Nutrition Interventions Integrated Into An Existing Maternal, Neonatal, And Child Health Program Reduce Food Insecurity Among Recently Delivered And Pregnant Women In Bangladesh, Edward A. Frongillo Jr., Phuong H. Nguyen, Tina Sanghvi, Zeba Mahmud, Bachera Aktar, Silvia Alayon, Purnima Menon
Faculty Publications
Background
Antenatal care may be a means to reduce food insecurity in pregnancy and postpartum periods.
Objective
With the use of a cluster-randomized design, we tested whether participation in nutrition-focused antenatal care intending to improve household knowledge about the importance of nutrition for pregnant and lactating women and encourage allocation of household resources to ensure sufficient quality and quantity of foods, without providing food assistance, would reduce household food insecurity.
Methods
Alive & Thrive integrated nutrition interventions into an existing Maternal, Neonatal, and Child Health (MNCH) program in Bangladesh. The nutrition-focused MNCH package was delivered in 10 subdistricts through antenatal …
Preventing Obesity And Type 2 Diabetes In Immigrant Populations, Maxwell K. Chikuta
Preventing Obesity And Type 2 Diabetes In Immigrant Populations, Maxwell K. Chikuta
Walden Dissertations and Doctoral Studies
Obesity-related diseases have been increasing in African immigrants throughout the United States. Although research has been done to identify risk factors associated with many ethnic groups in the United States, only a few studies exist that explore obesity and type 2 diabetes diseases among Central African immigrants. The conceptual framework for this qualitative case study was social constructivism and the health belief model. The primary research question addressed the potential underlying causes for an increase in obesity and type 2 diabetes among Central African Immigrants. The secondary research questions explored how culture, illiteracy, and religion contribute to the problem of …
The Role Of Diet In Inflammatory Bowel Diseases, Aviva Smilow
The Role Of Diet In Inflammatory Bowel Diseases, Aviva Smilow
The Science Journal of the Lander College of Arts and Sciences
Inflammatory Bowel Disease encompasses two diseases, Crohn’s Disease and Ulcerative Colitis. During the last 70 years the evolving of diet in the industrialized countries has led to the utilization of foods that have been processed rather than those in their more natural original state. This increase in the processing of foods has been correlated with the more recent occurrence of metabolic diseases such as Inflammatory Bowel Disease. Patients suffering from this problem exhibit lesser amounts of anti-inflammatory bacteria such as Roseburia and Faecalibacterium and increased amounts of pro-inflammatory bacteria Escheria and Fusobacterium. Since diet directly alters the composition of the …
Associations Between Low-Carbohydrate Diet Score And Prognostic Factors Among Adults With Diabetes Mellitus: An Analysis Of The Nhanes 2005-2016, Elta N. Charles
Associations Between Low-Carbohydrate Diet Score And Prognostic Factors Among Adults With Diabetes Mellitus: An Analysis Of The Nhanes 2005-2016, Elta N. Charles
Honors Undergraduate Theses
Background: Type 2 diabetes mellitus is one of the leading chronic diseases affecting Americans. There is a lack of literature discussing the link between diet and prognosis of those already diagnosed with DM. Objective: To provide insight into which diet is better for the outlook of diabetes mellitus by examining the associations between the low-carbohydrate diet (LCD) score and three diabetes-related health indicators: blood hemoglobin (HbA1c), triglycerides, and retinopathy. Methods: A total of 3,313 U.S. adults with DM were selected from the National Health and Nutrition Examination Survey 2005-2016. Presence of retinopathy was ascertained through self-reporting. Dietary intake was measured …
The Impact Of Maternal Nutrition During Pregnancy On Inflammation And Birth Outcomes, Lori Ogden
The Impact Of Maternal Nutrition During Pregnancy On Inflammation And Birth Outcomes, Lori Ogden
Theses and Dissertations--Nursing
More than 85% of American adults do not consume recommended amounts of fruits or vegetables. Preterm birth and hypertensive disorders of pregnancy are common adverse conditions affecting pregnancy and are leading causes of maternal and fetal morbidity and mortality. Preterm birth affects nearly 10% of all births in the United States and is on the rise, as are hypertensive disorders, which have increased by 25% over the last two decades. Pregnancy is a state of controlled inflammation, and dysregulation has been linked to preterm birth and other adverse gestational outcomes. A healthy diet is recommended in pregnancy, but little is …
Associations Between Income, Acculturation, Country Of Origin, And Type Ii Diabetes Among African Immigrants To Ontario, Canada, Girma Aman Goshe
Associations Between Income, Acculturation, Country Of Origin, And Type Ii Diabetes Among African Immigrants To Ontario, Canada, Girma Aman Goshe
Walden Dissertations and Doctoral Studies
Diabetes has become a longstanding public health challenge around the world. Over the last 3 decades, the number of people with Type II diabetes (T2DM) has grown to an epidemic level in Canada. Prior research indicated African immigrants residing in Ontario, Canada experienced a 2-4 times higher prevalence of T2DM than Canadian-born individuals. The social determinants of health theoretical framework guided this study assessing the relationship of the risk factors with T2DM. A quantitative, cross-sectional design was employed using the 2007-2014 Canadian Community Health Survey data. The random sample included 1,526 African immigrants residing in Ontario, Canada. Descriptive, bivariate, and …
Sleep, Communicative Ability, And Diet As Predictors Of Aggression In Autism Spectrum Disorder, Rafat Omar
Sleep, Communicative Ability, And Diet As Predictors Of Aggression In Autism Spectrum Disorder, Rafat Omar
PCOM Psychology Dissertations
Aggression is a common behavioral issue in children with autism spectrum disorder (ASD). Aggression is often treated with evidence-based behavioral treatments, such as applied behavioral analysis and functional communication training. Another form of intervention that has grown in popularity is to alter the child’s diet. The most popular dietary intervention, the autism diet, has been used as a form of behavior management by parents and guardians for children diagnosed with ASD to address aggressive behavior; however, its use has not been strongly supported by research. The authors proposed that a more beneficial way of understanding aggression in ASD is to …