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Articles 2791 - 2820 of 8047
Full-Text Articles in Medicine and Health Sciences
For One Child, Zion Bereket, Xin Huang, Yitong Lin, Ruobing Pei, Rachel White, Ziyuan Li
For One Child, Zion Bereket, Xin Huang, Yitong Lin, Ruobing Pei, Rachel White, Ziyuan Li
School of Professional Studies
The entirety of this project was completed on the foundation of the three focus areas, which were identified by our client as areas of high need. The client wanted to prioritize these three areas as they believed that these three areas were the most integral to the successful achievement of their mission, as well as to the overall health and longevity of the organization.
Hiv/Aids In The Latino Community Of San Francisco: Past And Present, Jessica Da Silva
Hiv/Aids In The Latino Community Of San Francisco: Past And Present, Jessica Da Silva
School of Professional Studies
There are approximately 122,000 people of Latino origin in San Francisco, which account for 15% of the total population (Census, 2010). Historically, Latinos have and still face several barriers to access healthcare and improvements in health (Aguirre-Molina, Molina & Zambrana, 2001). When the world was exposed to the spread of a new and unknown virus, the broader population suffered from the epidemic. The Latino community in San Francisco was and still is one of the hardest hit by the virus.
Changing The Current Perception Of Affordable Housing In Worcester, Simone Mcguinness, William Roberts, Vaske Gjino, Tong Zhou, Mengxin Ma, Sarawadee Sonpuak
Changing The Current Perception Of Affordable Housing In Worcester, Simone Mcguinness, William Roberts, Vaske Gjino, Tong Zhou, Mengxin Ma, Sarawadee Sonpuak
School of Professional Studies
One of Worcester Interfaith’s goals is to eradicate the stigma of affordable housing in Worcester. Currently, the perception of affordable housing is of an image of unkept and old residences filled with destitute citizens who cannot afford basic needs to live in a city, let alone housing. This image is perpetuated by media, stigma, and a lack of education of the true reality of affordable housing and who its recipients are. Affordable housing-qualified citizens represent a range of educations, professions, age, race, and income levels. Affordable housing units, too, represent a variety of homes, many of which are extremely well-kept …
Education As Important Predictor For Successful Employment In Adults With Congenital Heart Disease Worldwide., Maayke Sluman, Maayke Sluman, Silke Apers, Judith Sluiter, Karen Nieuwenhuijsen, Philip Moons, Philip Moons, Koen Luyckx, Koen Luyckx, Adrienne Kovacs, Adrienne Kovacs, Corina Thomet, Werner Budts, Junko Enomoto, Hsiao-Ling Yang, Jamie Jackson, Paul Khairy, Stephen Cook, Raghavan Subramanyan, Luis Alday, Katrine Eriksen, Mikael Dellborg, Mikael Dellborg, Malin Berghammer, Malin Berghammer, Eva Mattsson, Andrew Mackie, Samuel Menahem, Maryanne Caruana, Kathy Gosney, Alexandra Soufi, Susan Fernandes, Kamila White, Edward Callus, Shelby Kutty, Berto Bouma, Barbara Mulder
Education As Important Predictor For Successful Employment In Adults With Congenital Heart Disease Worldwide., Maayke Sluman, Maayke Sluman, Silke Apers, Judith Sluiter, Karen Nieuwenhuijsen, Philip Moons, Philip Moons, Koen Luyckx, Koen Luyckx, Adrienne Kovacs, Adrienne Kovacs, Corina Thomet, Werner Budts, Junko Enomoto, Hsiao-Ling Yang, Jamie Jackson, Paul Khairy, Stephen Cook, Raghavan Subramanyan, Luis Alday, Katrine Eriksen, Mikael Dellborg, Mikael Dellborg, Malin Berghammer, Malin Berghammer, Eva Mattsson, Andrew Mackie, Samuel Menahem, Maryanne Caruana, Kathy Gosney, Alexandra Soufi, Susan Fernandes, Kamila White, Edward Callus, Shelby Kutty, Berto Bouma, Barbara Mulder
Psychology Faculty Works
Background: Conflicting results have been reported regarding employment status and work ability in adults with congenital heart disease (CHD). Since this is an impor‐ tant determinant for quality of life, we assessed this in a large international adult CHD cohort. Methods: Data from 4028 adults with CHD (53% women) from 15 different countries were collected by a uniform survey in the cross‐sectional APPROACH International Study. Predictors for employment and work limitations were studied using general linear mixed models. Results: Median age was 32 years (IQR 25‐42) and 94% of patients had at least a high school degree. Overall employment rate …
Investigating Virus Clearance Via Ph Inactivation During Biomanufacturing, Wenbo Xu
Investigating Virus Clearance Via Ph Inactivation During Biomanufacturing, Wenbo Xu
Biomedical Engineering Undergraduate Honors Theses
In the processing of biopharmaceuticals, viral clearance and viral safety are important for the development of monoclonal antibodies. Murine xenotropic leukemia virus (XMuLV) is one of the retroviruses, recommended by Food and Drug Administration (FDA) as a model virus for viral clearance via inactivation from therapeutics derived from Chinese hamster ovary cells (CHO). A robust and effective method was investigated to clear or inactivate endogenous viruses by low pH inactivation. The effects of different conductivity and inactivated time on XMuLV clearance was determined. Acetate buffer was prepared with different conductivity, and 2% XMuLV was spiked into acetate buffer. XMuLV virus …
The Effects Of Eicosapentaenoic Acid (Epa) And Docosahexaenoic Acid (Dha) On Brown Adipogenesis In Stem Cell Culture, Darynne Dahlem
The Effects Of Eicosapentaenoic Acid (Epa) And Docosahexaenoic Acid (Dha) On Brown Adipogenesis In Stem Cell Culture, Darynne Dahlem
Animal Science Undergraduate Honors Theses
Polyunsaturated fatty acids (PUFAs), especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are major maternal dietary supplements due to their positive benefits on neurological tissue growth during the first 12 weeks of gestation. Previous studies show that EPA and DHA inhibit muscle formation but promote adipogenesis. However, no research has addressed the question whether high intake of EPA and DHA affects brown fat development during gestation. The objective of this study was to measure the effect of EPA and DHA supplement on brown adipogenesis and potential pathways related to mitochondrial biosynthesis using fibroblasts as in vitro model. Using Oil-Red-O staining …
Addressing Barriers To Preventative Health Care For Transgender Populations: A Systems Approach To Improving Access To Gynecological Care, Meghan N. Flynn
Addressing Barriers To Preventative Health Care For Transgender Populations: A Systems Approach To Improving Access To Gynecological Care, Meghan N. Flynn
Master's Theses
The current study addresses the lack of research exploring the individual and systemic barriers to accessing gynecological care for transgender populations. An integrated mixed-methods needs assessment was designed to explore the individual and systemic barriers to gynecological health care for transgender and gender diverse populations. Participants of the study included established community providers known to serve the transgender community through advocacy or research efforts, as well as clinical psychologists and medical professionals working in gynecological settings. The study includes a brief quantitative survey, which measured “Perceptions of Inclusivity Importance” among key stakeholders. Following the survey, participants were invited to engage …
Career Transitions Caused By Chronic Illness: A Career Construction Perspective, Julie Christine Hill
Career Transitions Caused By Chronic Illness: A Career Construction Perspective, Julie Christine Hill
Graduate Theses and Dissertations
People living with chronic illness face significant challenges when it comes to finding and maintaining employment. There is ample research available that discussed the challenges and barriers to employment for this population. However, there is a lack of research devoted to interventions dedicated to assisting people with chronic illness in career exploration and development. This study attempted to address one possible intervention to assist people with chronic illness identify and pursue possible careers. The purpose of this research study was to explore the impact of participating in the Career Construction Interview on the career exploration of individuals facing a forced …
Increasing Low-Income Residents’ Access To Fresh Produce Through A Local Mobile Pantry, Laura Wasson
Increasing Low-Income Residents’ Access To Fresh Produce Through A Local Mobile Pantry, Laura Wasson
Human Nutrition and Hospitality Management Undergraduate Honors Theses
Seeds that Feed (STF) is a mobile food pantry located in Fayetteville, Arkansas. STF receives produce from local farmers to distribute to residents in low-income housing sites throughout Northwest Arkansas. According to Feeding America, food insecurity affected 14.3% Washington County, Arkansas’ population in 2016. The purpose of this study was to determine if STF’s model is an effective way to increase individuals’ access to fresh fruits and vegetables and increase their potential to meet the United States Department of Agriculture’s Food Patterns (USDA-FP) for to fruit and vegetable consumption. Twenty-three participants from three sites completed the study. A survey was …
Innovation And Equity In Public Health Research : Testing Arts-Based Methods For Trauma-Informed, Culturally-Responsive Inquiry., Tasha Golden
Electronic Theses and Dissertations
As the field of Public Health has shifted from a biomedical paradigm to a social ecological approach, focusing on health equity and social determinants of health, it has increasingly acknowledged the roles of culture and trauma in health outcomes. The field has responded by modifying some research practices, but continues to prioritize conventional methodologies—with few options designed to foreground trauma- and cultural-responsiveness. Unfortunately, to the extent that conventional approaches require health to be defined, communicated, or valued according to dominant norms, they risk perpetuating inequities. Health equity therefore requires the development of research methodologies that increase inclusivity and access, elicit …
The Impact Of Parenting Style On Emerging Adult Sexual Behavior, Xavier Smith
The Impact Of Parenting Style On Emerging Adult Sexual Behavior, Xavier Smith
Health, Human Performance and Recreation Undergraduate Honors Theses
The objective of this study was to examine the impact of parenting style on emerging adult sexual behavior by surveying undergraduate students at the University of Arkansas. A total of 306 participants were evaluated for the study (101 men; 205 women). Methods: For the summer of 2018 through the fall of 2018, the survey was active. University of Arkansas students took the online survey via Qualtrics, and they reflected on topics including familial background, perception of parents, and sexual behavior to describe the relationship between parenting style and personal sexual behavior. Results: It was found that mother autonomy support …
Factors Associated With Food Insecurity Among Individuals, Aged Sixty And Older, In Clark County, Nv, Lisa M. Segler
Factors Associated With Food Insecurity Among Individuals, Aged Sixty And Older, In Clark County, Nv, Lisa M. Segler
UNLV Theses, Dissertations, Professional Papers, and Capstones
Food insecurity is defined as a lack of consistent access to enough food for an active, healthy life. In Nevada, an estimated 80,000 individuals, aged 60 years or older, were food insecure in 2016. The primary aim of this study was to identify factors that are associated with food insecurity in older adults, aged sixty and older, in Clark County, NV. The secondary aim of this study was to identify which factors interact with each other to explain food insecurity among individuals aged sixty and older, in Clark County, NV. A secondary data analysis was conducted using data collected by …
Mental Health On Trial: An In-Depth Look At The Criminalization Of Mental Illness In The United States Criminal Justice System, Addison Elise Shemin
Mental Health On Trial: An In-Depth Look At The Criminalization Of Mental Illness In The United States Criminal Justice System, Addison Elise Shemin
Graduate Theses and Dissertations
The criminal justice system was created to identify, incarcerate, and rehabilitate men and women that have broken the law. However, over two million people with mental illnesses are placed into jails every year. The lack of proper psychological evaluation and diagnosis coupled with misunderstood evidence and economic hardship has produced a system that treats these men and women as criminals rather than someone suffering from an illness. When an individual with mental health issues comes into contact with the criminal justice system they are often improperly evaluated by first responders, wrongfully convicted, and inappropriately sentenced. The lack of proper psychological …
Something’S In The Water: A Look At How Creativity And Innovation Can Prevent Future Water Crises, Tristan Holiday-Nowden
Something’S In The Water: A Look At How Creativity And Innovation Can Prevent Future Water Crises, Tristan Holiday-Nowden
Creativity and Change Leadership Graduate Student Master's Projects
The purpose of this project is to raise awareness and create a level of consciousness about water, unlike anything we have seen in the past. This project presents a synthesis of current writings and ideologies from the fields of Environmental Science and Water Research. As well as think pieces and informative news articles from various publications.
To illustrate the damaging effects of water contamination, water pollution, and water scarcity; Flint, Michigan will serve as a case study. After diagnosing and defining the problem using the Creative Problem Solving (CPS) framework. This project will explore the challenge and look at the …
Female Genital Mutilation In The United States: Estimating The Number Of Girls At Risk, Phyllis Chesler
Female Genital Mutilation In The United States: Estimating The Number Of Girls At Risk, Phyllis Chesler
Dignity: A Journal of Analysis of Exploitation and Violence
Female genital mutilation (FGM) destroys the capacity of women to experience sexual pleasure. It causes serious medical complications such as bleeding, painful urination, cysts, dangerous and recurrent bladder and urinary tract infections, the growth of scar tissue that make marital intercourse a nightmare and that turns childbirth into an experience of danger and torture. Due to immigration, FGM now poses a potential health crisis in the West, both in Europe and in the United States. To estimate how many girls who live in the West are at risk, one can measure the prevalence of FGM in the non-Western countries where …
Exploring The Homeless Persons Perception Of Living In A Long-Term Care Facility, Janice Woods
Exploring The Homeless Persons Perception Of Living In A Long-Term Care Facility, Janice Woods
Dissertations
Objective:The purpose of this study was to explore the lived experiences of homeless persons admitted to a nursing home facility. Originally, the study was to explore their understanding of and their experience with advance health care planning; coincidently, the participants were more open to their experience of living in a long-term care facility.
Method:A convenience sample of 13 participants (12 male, 1 female) at four long-term care facilities in Southern California were interviewed about their perception of advanced health care planning, including the physician’s orders for life sustaining treatment (POLST); a consent form required in all nursing homes. …
The Influence Of Interpersonal Dyadic Differences On Condom Use Among Men Who Have Sex With Men, Andrew M. O'Neil
The Influence Of Interpersonal Dyadic Differences On Condom Use Among Men Who Have Sex With Men, Andrew M. O'Neil
Health, Human Performance and Recreation Undergraduate Honors Theses
Background: Men who have sex with men (MSM) continue to be disproportionately affected by HIV/AIDS and other STIs. Condom use is one of the most effective methods of prevention, but rates of condom use have been steadily declining among MSM. Therefore, determining what factors influence condom use decision-making among MSM is important. Interpersonal factors such as physical attractiveness, race, and age have been explored in relation to condom use. However, there is a dearth of research exploring the influence of discrepancies between casual partners in these social categories and its influence on condom use directly.
Purpose: The purpose of this …
Dusty Shoes: Appalachia Wisdom Fertilizing The Future Of Religious Leadership, Jill Crainshaw
Dusty Shoes: Appalachia Wisdom Fertilizing The Future Of Religious Leadership, Jill Crainshaw
Journal of Appalachian Health
Dust from their journeys through the hills and hollows of Appalachia clings to their shoes and has forever shaped their vocational journeys. This is a refrain I have distilled from the reflections of students who have participated in Wake Forest University School of Divinity’s multicultural contexts course that includes a 10-day sojourn in the mountains of North Carolina.
Identifying Priority And “Bright-Spot” Counties For Diabetes Preventive Care In Appalachia: An Exploratory Analysis, Peter J. Mallow, Michael Topmiller, Jennifer Rankin, Jene Grandmont, David Grolling, Jessica L. Mccann, Mark Carrozza
Identifying Priority And “Bright-Spot” Counties For Diabetes Preventive Care In Appalachia: An Exploratory Analysis, Peter J. Mallow, Michael Topmiller, Jennifer Rankin, Jene Grandmont, David Grolling, Jessica L. Mccann, Mark Carrozza
Journal of Appalachian Health
Introduction: Type 2 diabetes mellitus (T2DM) prevalence and mortality in Appalachian counties is substantially higher when compared to non-Appalachian counties, although there is significant variation within Appalachia.
Purpose: The objectives of this research were to identify low-performing (priority) and high-performing (bright spot) counties with respect to improving T2DM preventive care.
Methods: Using data from the Centers for Medicare and Medicaid (CMS), the Dartmouth Atlas of Health Care, and the Appalachia Regional Commission, conditional maps were created using county-level estimates for T2DM prevalence, mortality, and annual hemoglobin A1c (HbA1c) testing rates. Priority counties were identified using the following criteria: top 33rd …
Serum Cotinine Versus Parent Reported Measures Of Secondhand Smoke Exposure In Rural Appalachian Children, Samrat Yeramaneni, Kimberly Yolton, Kurunthachalam Kannan, Kim N. Dietrich, Erin N. Haynes
Serum Cotinine Versus Parent Reported Measures Of Secondhand Smoke Exposure In Rural Appalachian Children, Samrat Yeramaneni, Kimberly Yolton, Kurunthachalam Kannan, Kim N. Dietrich, Erin N. Haynes
Journal of Appalachian Health
Background: Secondhand smoke (SHS) exposure in Appalachian children and associated adverse effects is understudied and not well documented. This study assessed the prevalence of SHS exposure in Appalachian children by parental self-report and internal biological measure.
Methods: SHS exposure was determined in children residing in rural Appalachian communities during their participation in the Communities Actively Researching Exposure Study between 2009 and 2013. Parents reported the number of smokers in the household and number of cigarettes smoked/day. Children ages 7-9 provided a serum sample for cotinine analysis. Parent reported measures and child serum cotinine measures of SHS exposure were compared with …
The Social Determinants Of Health And The Decline In U.S. Life Expectancy: Implications For Appalachia, Steven H. Woolf, Heidi Schoomaker, Latoya Hill, Christine M. Orndahl
The Social Determinants Of Health And The Decline In U.S. Life Expectancy: Implications For Appalachia, Steven H. Woolf, Heidi Schoomaker, Latoya Hill, Christine M. Orndahl
Journal of Appalachian Health
For the past century, life expectancy in industrialized countries has increased, and the U.S. has shared in that progress. However, beginning in the 1980s, advances in U.S. life expectancy began to lose pace with peer countries. By 1998, U.S. life expectancy had fallen below the average for Organisation for Economic Cooperation and Development nations. U.S. life expectancy peaked in 2014 and has been decreasing for three consecutive years, a trend not been seen since the influenza pandemic a century ago. Put simply, U.S. health is in decline.
Delivering Health Knowledge And Wisdom From The Hills And Hollows Of Appalachia, F. Douglas Scutchfield Md, Erin N. Haynes, Robert M. Shapiro Ii, Charlotte S. Seidman
Delivering Health Knowledge And Wisdom From The Hills And Hollows Of Appalachia, F. Douglas Scutchfield Md, Erin N. Haynes, Robert M. Shapiro Ii, Charlotte S. Seidman
Journal of Appalachian Health
There is knowledge in the pages of Appalachia’s hills. This journal is positioned to find and publish those translations. It grows from a need to provide an outlet for scholarship about Appalachia’s health so that knowledge, and occasionally wisdom, is shared with those who care about and are committed to improving the region’s health.
Health And Social Disparities Influence Opioid Misuse Among Adult Females Living In Rural Areas, Tequila Porter
Health And Social Disparities Influence Opioid Misuse Among Adult Females Living In Rural Areas, Tequila Porter
Master of Science in Integrative Biology Theses
Since the early 1800s scientists have been working to create the best non-addictive pain medication derived from opium. In the early 1800s morphine was distilled from opium extracted from opium poppy plants (Quinones, 2015). Soon after a chemist invents a synthetic derivative of opium and names it diacetylmorphine (heroin) (Quinones, 2015, (Drugs and Morphine Text, 2018). Heroin originally was a safe cure for morphine addiction. Once this was proven to be false, and as having addictive properties, the government intervened and began initiatives to address the issue. This public crisis quickly grew to what modern scientists and healthcare professionals know …
The Effect Of Perceived Level Of Social Support On The Fear Of Falling, Kali A. Todd
The Effect Of Perceived Level Of Social Support On The Fear Of Falling, Kali A. Todd
Honors College Theses
Background: Perhaps the most prevalent cause of anxiety among the elderly is the fear of falling (FOF), considering that a fall can lead to serious complications and the decline of health. Kumar et al. found that subjects with a FOF usually have less social support. Therefore, increased social support could possibly decrease the FOF, thus decreasing the likelihood of a fall overall. The purpose of this study is to examine the relationship between the amount of perceived social support one receives and the FOF among people ages 60 and up. Methods: In order to measure FOF and social support among …
Case Study - The Organization And Promotion Of Health Services, Cindy Ramos Rico, Sarah Freschi
Case Study - The Organization And Promotion Of Health Services, Cindy Ramos Rico, Sarah Freschi
The International Undergraduate Journal For Service-Learning, Leadership, and Social Change
Our eight-week partnership took place in Cochabamba, Bolivia. Cochabamba is the third largest city in Bolivia with a population of 630,587. Our group partnered with Pro Mujer, an international microfinance organization founded in El Alto, Bolivia in 1990. Pro Mujer’s vision, as detailed on their website, is “a Latin America where all women thrive” and their mission is “to empower underserved women to achieve their full potential”. Pro Mujer empowers the women they serve through providing access to microfinance loans and communal banks, capacity-building workshops, and health services.
How Professional Physical Therapist Education Programs Develop Cultural Competence Within Their Students: An Exploratory Concurrent Mixed Methods Study, Dustin E. Domingo
How Professional Physical Therapist Education Programs Develop Cultural Competence Within Their Students: An Exploratory Concurrent Mixed Methods Study, Dustin E. Domingo
Dissertations
Purpose: The purpose of this exploratory concurrent mixed methods study was to describe experiences that shape the factors of cultural intelligence (CQ) as perceived by students of professional physical therapist education programs. In addition, it was the purpose of this study to determine whether any particular factor of cultural intelligence influenced one’s overall cultural competence according to the cultural competence continuum by Cross et al. (1989).
Methodology: Students in a professional physical therapist education program completed a questionnaire, which included Likert scale questions, open ended questions, and a 37-item self-assessment based on the expanded cultural intelligence scale by Van Dyne …
A Study Of Music: Music Psychology, Music Therapy, And Worship Music, Jessica Whittemore
A Study Of Music: Music Psychology, Music Therapy, And Worship Music, Jessica Whittemore
Senior Honors Theses
There are three specific fields related to music: the psychology of Music and how it affects human brain and functions, the methodology of Music Therapy and how it affects individuals undergoing treatment, and the psychological effects of Worship Music and how it can be used in music therapy. Music therapy is a growing field in which the therapeutic outcomes greatly benefit the patients. The overall purpose is to create a greater understanding of music and music therapy in order to a provide a system for introducing group worship services into music therapy to ultimately bring spiritual healing to individuals.
Nutrient And Food Group Intakes Of Low-Income Pregnant Women By Race/Ethnicity, Alla M. Hill, Danielle L. Nunnery Phd, Rdn, Ldn, Alice Ammerman Drph, Jigna M. Dharod Phd
Nutrient And Food Group Intakes Of Low-Income Pregnant Women By Race/Ethnicity, Alla M. Hill, Danielle L. Nunnery Phd, Rdn, Ldn, Alice Ammerman Drph, Jigna M. Dharod Phd
Journal of Health Disparities Research and Practice
In an exploratory study, a convenience sample of 148 pregnant women was recruited from a WIC clinic in the southeast region of the U.S. to: 1) Examine and compare daily nutrient and food group intakes of WIC pregnant women to national guidelines, and; 2) Determine racial/ethnic differences in nutrient and food group intakes among WIC pregnant women. Women were selected for the study if they were: ≥ 18 y, in 2nd trimester of pregnancy, and if they spoke English or Spanish as a first language. Upon recruitment, participants were interviewed to collect information on their socio-demographics, including race/ethnicity. Additionally, …
More Kindergarteners Are Exempted From Required School Vaccinations Than In The Past, Kent Jason G. Cheng
More Kindergarteners Are Exempted From Required School Vaccinations Than In The Past, Kent Jason G. Cheng
Population Health Research Brief Series
The percentage of kindergarteners being granted exemption from vaccination is growing across the U.S. as parents increasingly request exemptions for philosophical reasons. During the 2017-18 school year, 2.2% of kindergartners were exempted from vaccination. This is up from 1.6% during the 2011-12 school year.
Increasing Mental Health Literacy In The African American Community: Collaborations Between Mental Health Professionals And The Black Church, Brianna Simmons
Increasing Mental Health Literacy In The African American Community: Collaborations Between Mental Health Professionals And The Black Church, Brianna Simmons
Virginias Collegiate Honors Council Conference
African Americans tend to underutilize mental health services due to historical and present institutionalized racism, misdiagnoses, and misunderstandings, and to the lack of representation in the mental health field (Dempsey, Butler, and Gaither, 2016). African Americans thus turn to the Black Church for help. Clergy members of the Black Church use biblical counseling, which consists of seeking God’s wisdom (Dempsey et al., 2016). This differs from traditional psychological counseling where formalized diagnostic criteria are followed, and medication is often prescribed. Despite these differences between the Black Church and professional mental health agencies, there are a number of commonalities, such as …