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Full-Text Articles in Medicine and Health Sciences

Correlation Between Gut Biomarkers And Depression, Jianle Gao May 2023

Correlation Between Gut Biomarkers And Depression, Jianle Gao

Rowan-Virtua Research Day

The correlation between the gut-microbiota- brain axis and mental state in the context of mental disorders such as Major Depressive Disorder (MDD), Schizophrenia, etc. has been well studied. Production of inflammatory and non-inflammatory metabolites by the gut- microbiota directly and indirectly affects the brain and mood. Therefore, colonization by maladaptive, pro-inflammatory bacteria may cause mood dysregulation and depressive features. Metabolites from these bacteria can be quantitatively analyzed for use as biomarkers of Major Depressive Disorder. Biomarkers studied include: serotonin, dopamine, butyrate, acetate, and propionate.


Treating Trichotillomania With Olanzapine, Christopher Lee May 2022

Treating Trichotillomania With Olanzapine, Christopher Lee

Rowan-Virtua Research Day

Trichotillomania (TTM) is characterized by repetitive pulling of one’s hair leading to hair loss and problems in social, occupational, or other important areas of functioning. Often individuals with TTM try to decrease or stop hair pulling, however are often unsuccessful without treatment. Community prevalence studies suggest that TTM is a common disorder with point prevalence estimate of 0.5% to 2.0% and with significant psychological comorbidity. Of note, people with TTM are often embarrassed about their condition, so epidemiology data may be underestimated compared to the true prevalence of this condition. The female to male ratio for this condition is 4:1. …


An Interesting Case Of Factitious Disorder Superimposed On Self: Factitious Disorder Vs Somatic Symptom Disorder, Michaela Margolis, Logan Noone, Jessica Baaklini May 2022

An Interesting Case Of Factitious Disorder Superimposed On Self: Factitious Disorder Vs Somatic Symptom Disorder, Michaela Margolis, Logan Noone, Jessica Baaklini

Rowan-Virtua Research Day

Factitious disorder superimposed on self (FDIS) was first described in 1951by Richard Asher, who associated the disorder with Baron Munchhausen, who narrated unrealistic and exaggerated stories about his life.

Suspicion for FDIS should be raised when patients with atypical presentations of medical disorders seek excessive use of healthcare services despite ongoing lack of clinical evidence. Patients with FDIS often demand hospitalization for their symptoms, leading to unnecessary tests and treatments. These patients show signs of pathological lying, deceitfulness, are obstinate with medical staff, and display erratic behavior. When medical investigation does not support their symptoms, patients often develop new “symptoms” …


Physiological Effects Of Activity-Based Anorexia In Female Rats And An Overview Of Eating Disorders, Madelyn Uyemura Jan 2022

Physiological Effects Of Activity-Based Anorexia In Female Rats And An Overview Of Eating Disorders, Madelyn Uyemura

Regis University Student Publications (comprehensive collection)

The aim of this thesis is to bring AN to the foreground of conversation both in a scientific and sociological framework. Nearly 40 million Americans suffer from anxiety disorders, which is characterized by the feeling of a loss of control. In some cases, another disorder called anorexia nervosa (AN) can codevelop. AN is characterized by a refusal, and inability, to maintain a healthy body weight. Some suffering from anxiety may restrict caloric intake and increase exercise to cope with stress. This results in extreme caloric deprivation. AN can be modeled in rats using an activity-based anorexia (ABA) method. In …


Juvenile Justice And The Criminalization Of Mentally Ill Individuals, Michael Collins Jan 2021

Juvenile Justice And The Criminalization Of Mentally Ill Individuals, Michael Collins

Walden Dissertations and Doctoral Studies

Juvenile justice systems in the United States are using incarceration as a solution to the problem of youths with mental health disorders who commit violent crimes. Juvenile justice systems across the United States have a revolving door effect that arrests, adjudicates, and incarcerates youth offenders but fail to address the factors that contribute to recidivism. The purpose of the qualitative case study was to identify which treatment procedures were most appropriate for juvenile offenders who committed violent offenses in an effort to reduce recidivism for this offender population. For this study, an ecological psychology theory was used as a lens …


Objective Coding Of Content And Techniques In Workplace-Based Supervision Of An Ebt In Public Mental Health, Shannon Dorsey, Suzanne E U Kerns, Leah Lucid, Michael D Pullmann, Julie P Harrison, Lucy Berliner, Kelly Thompson, Esther Deblinger Jan 2018

Objective Coding Of Content And Techniques In Workplace-Based Supervision Of An Ebt In Public Mental Health, Shannon Dorsey, Suzanne E U Kerns, Leah Lucid, Michael D Pullmann, Julie P Harrison, Lucy Berliner, Kelly Thompson, Esther Deblinger

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

BACKGROUND: Workplace-based clinical supervision as an implementation strategy to support evidence-based treatment (EBT) in public mental health has received limited research attention. A commonly provided infrastructure support, it may offer a relatively cost-neutral implementation strategy for organizations. However, research has not objectively examined workplace-based supervision of EBT and specifically how it might differ from EBT supervision provided in efficacy and effectiveness trials.

METHODS: Data come from a descriptive study of supervision in the context of a state-funded EBT implementation effort. Verbal interactions from audio recordings of 438 supervision sessions between 28 supervisors and 70 clinicians from 17 public mental health …


Predicting Mental Conditions Based On "History Of Present Illness" In Psychiatric Notes With Deep Neural Networks, Tung Tran, Ramakanth Kavuluru Nov 2017

Predicting Mental Conditions Based On "History Of Present Illness" In Psychiatric Notes With Deep Neural Networks, Tung Tran, Ramakanth Kavuluru

Computer Science Faculty Publications

Background—Applications of natural language processing to mental health notes are not common given the sensitive nature of the associated narratives. The CEGS N-GRID 2016 Shared Task in Clinical Natural Language Processing (NLP) changed this scenario by providing the first set of neuropsychiatric notes to participants. This study summarizes our efforts and results in proposing a novel data use case for this dataset as part of the third track in this shared task.

Objective—We explore the feasibility and effectiveness of predicting a set of common mental conditions a patient has based on the short textual description of patient’s history …


Factors Differentiating Successful Versus Unsuccessful Malingerers, John Edens, Laura Guy, Randy Otto, Jacqueline Buffington, Tara Tomicic, Norman Poythress Dec 2015

Factors Differentiating Successful Versus Unsuccessful Malingerers, John Edens, Laura Guy, Randy Otto, Jacqueline Buffington, Tara Tomicic, Norman Poythress

Norman Poythress

Relatively little is known about the processes in which "successful" malingerers engage to avoid detection. This study summarizes the response strategies used by participants (N = 540) instructed to feign a specific mental disorder while completing various self-report instruments designed to detect faking. Postexperiment questionnaires indicated that those who were able to appear symptomatic while avoiding being detected as feigning (n = 60) were more likely to endorse a lower rate of legitimate symptoms, to avoid overly unusual or bizarre items, and to base their responses on their own personal experiences.


Self-Reported Lifetime Psychiatric Hospitalization Histories Of Jail Detainees With Mental Disorders: Comparison With A Non-Incarcerated National Sample, William Fisher, Ira Packer, Steven Banks, David Smith, Lorna Simon, Kristen Roy-Bujnowski Oct 2014

Self-Reported Lifetime Psychiatric Hospitalization Histories Of Jail Detainees With Mental Disorders: Comparison With A Non-Incarcerated National Sample, William Fisher, Ira Packer, Steven Banks, David Smith, Lorna Simon, Kristen Roy-Bujnowski

Ira K Packer

Lack of access to hospitalization is an often-cited risk factor for incarceration among persons with severe mental illness. This proposition is examined by comparing self-reports of lifetime psychiatric hospitalization histories of mentally ill jail inmates with data from a national sample of non-incarcerated mentally ill. Roughly 52% of mentally ill jail detainees reported at least one psychiatric hospitalization, a rate nearly three times that of the comparison group. The data call into question the notion that mentally ill jail inmates have reduced access to psychiatric inpatient treatment, without addressing the adequacy of the treatment received. Longitudinal studies are needed to …


Diversity And Homelessness: Minorities And Psychiatric Survivors, Cheryl Forchuk, Elsabeth Jensen, Rick Csiernik, Carolyn Gorlick, Susan Ray, Helene Berman, Pamela Mckane, Libbey Joplin Aug 2012

Diversity And Homelessness: Minorities And Psychiatric Survivors, Cheryl Forchuk, Elsabeth Jensen, Rick Csiernik, Carolyn Gorlick, Susan Ray, Helene Berman, Pamela Mckane, Libbey Joplin

Rick Csiernik

No abstract provided.


Building The Foundation For The Family Options Project, Joanne Nicholson, Kathleen Biebel, Valerie Williams, Karen Albert Mar 2012

Building The Foundation For The Family Options Project, Joanne Nicholson, Kathleen Biebel, Valerie Williams, Karen Albert

Joanne Nicholson

This article describes how the long-standing partnership between Employment Options, Inc., a psychosocial rehabilitation agency in Marlborough, MA, and the University of Massachusetts Medical School's (UMMS) Center for Mental Health Services Research led to the development of the Family Options program.


Mothers With Mental Health Disorders: Mental Health Promotion In The Context Of Parenting, Joanne Nicholson, Elizabeth Aaker, Michael Agar, Karen Albert, Steven Banks, Kathleen Biebel, Bernice Gershenson, Antonia Seligowski, Valerie Williams, Brenda Warren, Sierra Williams, Katherine Woolsey Mar 2012

Mothers With Mental Health Disorders: Mental Health Promotion In The Context Of Parenting, Joanne Nicholson, Elizabeth Aaker, Michael Agar, Karen Albert, Steven Banks, Kathleen Biebel, Bernice Gershenson, Antonia Seligowski, Valerie Williams, Brenda Warren, Sierra Williams, Katherine Woolsey

Joanne Nicholson

Parenting is a meaningful role for the majority of American women, including those with mental health disorders. Success in this role, particularly for women with mental health disorders, would seem to be intimately related to mental health promotion, the recovery process, and successful functioning in other major life domains (e.g., employment, community living, and personal health and well-being). The achievement of maximum social participation for women with mental health disorders may hinge on addressing the challenges they face as parents. Presented at Margins to Mainstream: World Congress on Mental Health Promotion and Prevention. Melbourne, Victoria, Australia, September 2008.


Critical Issues For Parents With Mental Illness And Their Families, Joanne Nicholson, Kathleen Biebel, Beth Hinden, Alexis Henry, Lawrence Stier Mar 2012

Critical Issues For Parents With Mental Illness And Their Families, Joanne Nicholson, Kathleen Biebel, Beth Hinden, Alexis Henry, Lawrence Stier

Joanne Nicholson

This report discusses the outcomes of a study that investigated the impact of parents who have mental illness on children and families. The report discusses the scope of the issue and the experiences of parents with mental illness, federal and State policies impacting policies and practices relating to parents with mental illness, current programs for parents with mental illness and their families, and recommended steps for improving and expanding services. Prepared for the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Rockville, MD.


Exploring The Concept Of “Young Carer” In Families Living With Parental Mental Illness, Antonia Seligowski, Peter Mcnamee, Karen Albert, Valerie Williams, Joanne Nicholson Mar 2012

Exploring The Concept Of “Young Carer” In Families Living With Parental Mental Illness, Antonia Seligowski, Peter Mcnamee, Karen Albert, Valerie Williams, Joanne Nicholson

Joanne Nicholson

Background Information: The concept of “young carers” has been framed in the literature as children providing care and assuming household responsibilities when parents have physical and/or mental disabilities (Aldridge & Becker, 2003). In the United Kingdom, young carers have been studied extensively, leading to increased access to services and supports (Dearden & Becker, 2004). Our goal is to explore the concept of young carers in the U.S.

Aims: 1) To describe the care giving and household responsibilities of children and youth living with parents with mental illnesses, how often they are performed, and the feelings of children and youth about …


Programs For Families With Parental Mental Illness: Results Of A Us National Survey, Joanne Nicholson, Beth Hinden, Kathleen Biebel, Alexis Henry, Lawrence Stier Mar 2012

Programs For Families With Parental Mental Illness: Results Of A Us National Survey, Joanne Nicholson, Beth Hinden, Kathleen Biebel, Alexis Henry, Lawrence Stier

Joanne Nicholson

Citation: Nicholson, J., Hinden, B., Biebel, K., Henry, A., & Stier, L. (2004). Programs for families with parental mental illness. Visions: British Columbia Mental Health and Addictions Journal, 2(2), 27-29. Available at: http://www.heretohelp.bc.ca/publications/visions/parenting. Summary: Survey of programs in the U.S. for parents with mental illness.


A Multi-Disciplinary, Whole-Of-Family Approach To Supporting Parents With Mental Illness, Joanne Nicholson Mar 2012

A Multi-Disciplinary, Whole-Of-Family Approach To Supporting Parents With Mental Illness, Joanne Nicholson

Joanne Nicholson

Summary: Family members are likely to have multiple and overlapping needs & roles – individuals with mental illness, carers & siblings. There are many opportunities & strategies for intervention. The best care requires the engagement of multiple stakeholders working in partnership. Citation: Nicholson, J. (2010, November). A multi-disciplinary, whole-of-family approach to supporting parents with mental illness. Presented as a plenary at the Developing Strength and Resilience in Children conference of Voksne for Barn, Oslo, Norway.


Mental Illness: Understanding The Impact On Families And How To Help, Joanne Nicholson Mar 2012

Mental Illness: Understanding The Impact On Families And How To Help, Joanne Nicholson

Joanne Nicholson

Abstract: Family is the context where mental health recovery takes place. Mental health services need to take a whole-of-family approach when working with people with a mental illness. Supporting people with a mental illness in their family roles actually improved the mental health outcomes of people participating in their programs. Citation: Nicholson, J. (2010, May). Mental illness: Understanding the impact on families and how to help. Presented as the 12th Annual Bruce Woodcock Memorial Lecture, Mental Illness Fellowship Victoria, Melbourne, Victoria, Australia.


Family Members With Overlapping Mental Health Needs Require The Transformation Of Systems And Services, Joanne Nicholson, Kathleen Biebel, Beth Hinden, Valerie Williams, Bernice Gershenson, Judith Katz-Leavy Mar 2012

Family Members With Overlapping Mental Health Needs Require The Transformation Of Systems And Services, Joanne Nicholson, Kathleen Biebel, Beth Hinden, Valerie Williams, Bernice Gershenson, Judith Katz-Leavy

Joanne Nicholson

Women and men with a lifetime prevalence of psychiatric disorder are at least as likely to be parents as are adults without psychiatric disorder. The majority of adults in all diagnostic categories are parents, including those meeting criteria for affective and anxiety disorders, PTSD, and non-affective psychosis. Children with Serious Emotional Disturbance (SED) receiving services in Systems of Care (SOCs) programs may have multiple family risk factors. Family-centered, strengths-based practices require a paradigm shift in the way administrators and providers view and intervene with children and adults. Presented at The Santa Fe Summit on Behavioral Health, the American College of …


Family Options For Parents With Mental Illnesses: A Developmental, Mixed Methods Pilot Study, Joanne Nicholson, Karen Albert, Bernice Gershenson, Valerie Williams, Kathleen Biebel Mar 2012

Family Options For Parents With Mental Illnesses: A Developmental, Mixed Methods Pilot Study, Joanne Nicholson, Karen Albert, Bernice Gershenson, Valerie Williams, Kathleen Biebel

Joanne Nicholson

OBJECTIVE: The objective of this paper is to provide a description of Family Options, a rehabilitation intervention for parents with serious mental illnesses and their children focusing on recovery and resilience, and to report the findings from a pilot study at 6-months post-enrollment for participating mothers. METHODS: A developmental design, and mixed quantitative and qualitative methods facilitate an in-depth understanding of Family Options and its impact on parents early in the implementation process. RESULTS: Participating families faced significant challenges, including long-term mental health conditions in adults, and emotional and behavioral difficulties in children. Data from mothers (n = 22) demonstrate …


Supporting Parents: Multi-Needs And The Need For Multi-Institutions’ Coordination Of Supports, Joanne Nicholson Mar 2012

Supporting Parents: Multi-Needs And The Need For Multi-Institutions’ Coordination Of Supports, Joanne Nicholson

Joanne Nicholson

Summary: Family members are likely to have multiple and overlapping needs & roles – individuals with mental illness, carers & siblings. There are many opportunities & strategies for intervention. The best care requires the engagement of multiple stakeholders working in partnership.

Citation: Nicholson, J. (2010, May). Supporting parents: multi-needs and the need for multi-institutions coordination of supports. Presented as a keynote at the Conference on Ondersteuning Ouders met Psychiasche Problemen,The Hague, The Netherlands.


Mothers With Mental Illness: I. The Competing Demands Of Parenting And Living With Mental Illness, Joanne Nicholson, Elaine Sweeney, Jeffrey Geller Mar 2012

Mothers With Mental Illness: I. The Competing Demands Of Parenting And Living With Mental Illness, Joanne Nicholson, Elaine Sweeney, Jeffrey Geller

Joanne Nicholson

OBJECTIVE: The purpose of this study is to understand the parenting experiences of women with mental illness from the perspectives of mothers and case managers employed by the state department of mental health. METHODS: Six focus groups of mothers and five focus groups of case managers met to discuss the problems facing mothers with mental illness and to recommend solutions. Focus-group transcripts were coded and items grouped by themes in qualitative analyses to explore the conflicts mothers face in meeting the dual challenges of parenting and living with mental illness. RESULTS: Mothers and case managers identified sources of conflict in …


Parenting With A Mental Illness. A Radio Interview For Abc Radio National, Australia Public Radio (Audio File), Joanne Nicholson Mar 2012

Parenting With A Mental Illness. A Radio Interview For Abc Radio National, Australia Public Radio (Audio File), Joanne Nicholson

Joanne Nicholson

Interview (mp3 audio file, 9.8 MB) by Dr. Joanne Nicholson with Richard Aedy, host and producer, “Parenting with a Mental Illness” on Life Matters, ABC Radio National, Australia public radio, May 25, 2010. Nicholson says that keeping families intact benefits both the family as a whole, and the ill parent's recovery. She argues too many health professionals make treatment plans without considering the family context. Citation: Nicholson, J. Interview with Richard Aedy, host and producer, “Parenting with a Mental Illness” on Life Matters, ABC Radio National, Australia public radio. May 25, 2010. Available from: http://www.abc.net.au/rn/lifematters/stories/2010/2906312.htm.


Helping Families— Shifting The Emphasis, Joanne Nicholson Mar 2012

Helping Families— Shifting The Emphasis, Joanne Nicholson

Joanne Nicholson

Abstract: Family members are likely to have multiple and overlapping needs & roles – individuals with mental illness and carers. There are many opportunities & strategies for intervention. The best care requires the engagement of multiple stakeholders. Citation: Nicholson, J. (2010, May). Helping families – Shifting the emphasis. Presented as a keynote address at the Annual Corporate Breakfast with the Lord Mayor, Mental Illness Fellowship Victoria, Melbourne, Victoria, Australia.


Supporting Parents With Mental Health Needs In Systems Of Care, Barbara Friesen, Judith Katz-Leavy, Joanne Nicholson Mar 2012

Supporting Parents With Mental Health Needs In Systems Of Care, Barbara Friesen, Judith Katz-Leavy, Joanne Nicholson

Joanne Nicholson

Summary: Community-based systems of care (SOCs) must address both the needs of parents with mental illness and the needs of their children. Learning more about the challenges faced by SOCs in this area, and the strategies they implement to overcome them, provides insights with implications for the broader field. This project was intended to learn more about efforts to assess parents’ mental health needs, effectively engage and support them, and improve system coordination and access to services to inform service delivery and system reform, especially for those involved in both child welfare and mental health. This report presents information gathered …


Supporting Parents With Psychiatric Disabilities And Promoting Recovery: An International Challenge, Peter Van Der Ende, Joanne Nicholson Mar 2012

Supporting Parents With Psychiatric Disabilities And Promoting Recovery: An International Challenge, Peter Van Der Ende, Joanne Nicholson

Joanne Nicholson

Introduction: Parenting is a significant life role for adults with psychiatric disabilities. Not only is success in this role a normal life goal for many, but functioning as well as possible as parents would seem to be intimately related to the recovery process and successful functioning in other major life domains. Research on the prevalence and needs of parents with psychiatric disabilities in two countries, the U.S. and The Netherlands, provides the framework for developing and testing interventions. Essential program components include supports for parents in meeting their children’s needs as well as managing their own. Research Question: What are …


Mothers With Mental Illness: Ii. Family Relationships And The Context Of Parenting, Joanne Nicholson, Elaine Sweeney, Jeffrey Geller Mar 2012

Mothers With Mental Illness: Ii. Family Relationships And The Context Of Parenting, Joanne Nicholson, Elaine Sweeney, Jeffrey Geller

Joanne Nicholson

OBJECTIVE: This study explores the experiences of mothers with mental illness regarding their family relationships.

METHODS: Six focus groups of mothers with mental illness and five focus groups of case managers met to discuss problems facing mothers with mental illness and to recommend solutions. Focus groups were audiotaped, and transcripts were coded and analyzed qualitatively to describe ways in which husbands and partners, grandparents, and other family members contribute to the context of parenting for mothers with mental illness.

RESULTS: Mothers with mental illness and case managers described a range of relationships and attitudes of family members and provided examples …


Creating The Organizational Capacity To Serve Families With Parental Mental Illness: The Implementation Of Family Options, Kathleen Biebel, Katherine Woolsey Feb 2011

Creating The Organizational Capacity To Serve Families With Parental Mental Illness: The Implementation Of Family Options, Kathleen Biebel, Katherine Woolsey

Kathleen Biebel

Summary: The purpose of this presentation is to present preliminary findings describing the organizational context of a traditionally adult-serving community mental health program, Employment Options, Inc., as they implement a family-centered, strengths-based intervention for families living with parental mental illness.


The Future (Or Lack Of Future) Of Personalized Prescription In Psychiatry, Jose De Leon Feb 2009

The Future (Or Lack Of Future) Of Personalized Prescription In Psychiatry, Jose De Leon

Psychiatry Faculty Publications

Rapid technological advances in genetics have created conceptual chaos regarding the genetics of drug response. Terms for differing concepts are used interchangeably: pharmacogenetics with pharmacogenomics, personalized medicine with personalized prescription. Biomarker has many definitions. The author prefers the concept of personalized prescription and uses it with implications beyond pharmacogenetics by considering all scientific information valid for prescribing medication. Genetics may not be crucial for all drugs. In this comprehensive view, clinicians must consider genetic, environmental and personal variables when prescribing medication and incorporate some basic pharmacological principles: (1) safety and efficacy, (2) pharmacokinetics and pharmacodynamics, (3) therapeutic window and prescriber's …


Caffeine Use: Association With Nicotine Use, Aggression, And Other Psychopathology In Psychiatric And Pediatric Outpatient Adolescents, Catherine A. Martin, Circe Cook, John H. Woodring, Gretchen Burkhardt, Greg Guenthner, Hatim A. Omar, Tom H. Kelly May 2008

Caffeine Use: Association With Nicotine Use, Aggression, And Other Psychopathology In Psychiatric And Pediatric Outpatient Adolescents, Catherine A. Martin, Circe Cook, John H. Woodring, Gretchen Burkhardt, Greg Guenthner, Hatim A. Omar, Tom H. Kelly

Psychiatry Faculty Publications

The objective of this study was to evaluate the relationship between caffeine use, other drug use, and psychopathology in adolescents, using self-report measures. The study group consisted of 132 adolescents (average age 14.01 ± 2.06 years, 52% female, 19% African American, 5% other categories, 76% Caucasian). Most (47%) were recruited from a child psychiatry clinic with emphasis on youth with disruptive disorders, with 35% from an adolescent pediatric clinic with emphasis on prevention of risk-taking behavior and 18% from a pediatric clinic for families with limited resources. Subjects were consecutively recruited before or after regular clinic visits. Consent was obtained …


Combinations Of Dsm-Iv-Tr Criteria Sets For Bipolar Disorders., Daniel Z Lieberman, Roger Peele, Maryam Razavi Jan 2008

Combinations Of Dsm-Iv-Tr Criteria Sets For Bipolar Disorders., Daniel Z Lieberman, Roger Peele, Maryam Razavi

Psychiatry and Behavioral Sciences Faculty Publications

BACKGROUND: DSM-IV-TR is the standard for making psychiatric diagnoses in many countries. The diagnostic categorization of DSM-IV-TR is valued for its reliability, however it is well accepted that patients with the same diagnosis demonstrate substantial heterogeneity. In order to quantitatively characterize the degree of possible heterogeneity that can exist, combinatorial mathematics was used to calculate the number of possible ways to satisfy symptom criteria for the diagnosis of bipolar disorder as an example of this problem.

SAMPLING AND METHODS: The formula n!/(r!(n - r)!), which calculates the number of different ways of choosing an unordered number of items without repetition …