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Articles 361 - 390 of 528
Full-Text Articles in Mental and Social Health
Exploring The Professional Development Of Mft Students Enrolled In Equine Assisted Family Therapy Coursework: An Experiential Learning Modality, Natalie Rothman
Exploring The Professional Development Of Mft Students Enrolled In Equine Assisted Family Therapy Coursework: An Experiential Learning Modality, Natalie Rothman
Department of Family Therapy Dissertations and Applied Clinical Projects
Equine assisted activities have been utilized in various manners with multiple populations in therapeutic and educational environments. A graduate level marriage and family therapy program in South Florida is currently offering Equine Assisted Relational Learning (EARL) activities focused on teaching a specific sub-model of Equine Assisted Psychotherapy (EAP), known as Equine Assisted Family Therapy (EAFT). The experiential nature of EAP and EARL transforms abstract concepts such as thoughts and mannerisms into tangible experiences, as well as highlights behavioral patterns. The unique and innovative theoretical foundation of EAFT is being taught, demonstrated, and utilized to assist graduate level therapists with professional …
The Impact Of Grief Work On Hospice Mental Health Providers Through A Bowen Family Systems Lens, Joshua Hernandez
The Impact Of Grief Work On Hospice Mental Health Providers Through A Bowen Family Systems Lens, Joshua Hernandez
Department of Family Therapy Dissertations and Applied Clinical Projects
Marriage and family therapists and other mental health professionals and clients can be thought of as their own, divine emotional unit, generating and distributing the anxiety of one to the other. In fact, Kerr and Bowen (1988) described anxiety as a driving force exchanged by every living organism, and the energy surrounded by every human relationship. Within a hospice setting, anxiety can be heightened due to catering to end-of-life care, which can potentially affect the emotional response and reactivity of the mental health professional, changing the course of treatment for the patient and their family. Emerging research within healthcare has …
Schizophrenia Spectrum Disorders: Linking Motor And Process Skills, Sensory Patterns, And Psychiatric Symptoms, Lola Halperin, Janet Falk-Kessler
Schizophrenia Spectrum Disorders: Linking Motor And Process Skills, Sensory Patterns, And Psychiatric Symptoms, Lola Halperin, Janet Falk-Kessler
Occupational Therapy Faculty Publications
Background: Consistent evidence suggests sensory abnormalities and skill deficits in people with Schizophrenia Spectrum Disorder (SSD). Further exploration of their sensory patterns and performance skills is warranted to promote community participation among these individuals.
Method: This study examined sensory patterns and motor and process skills in relationship to psychiatric symptoms in adult patients with SSD. Participants were evaluated using the Adolescent/Adult Sensory Profile, the Assessment of Motor and Process Skills, and the Brief Psychiatric Rating Scale.
Results: Of the 18 participants, the majority showed sensory differences, deficits in motor and process skills, and the presence of moderate to severe symptoms. …
The Efficacy Of Yoga As An Adjunctive Therapy To Standard Multidisciplinary Care In The Treatment Of Female Patients Presenting With Cognitive Eating Disorder Symptoms, Cassidy Nagle
Capstone Showcase
Introduction: Current treatment of patients exhibiting cognitive eating disorder symptoms is standard multidisciplinary care (SMDC) involving behavioral therapy, medical management and dietetics. Because these symptoms often persist or relapse despite treatment, research has begun to explore adjunctive therapies like yoga for this population. This review will explore seven studies in order to analyze the effect of yoga (I) on cognitive eating disorder symptoms (O) in teenage and adult females (P) when added to SMDC compared to symptom reduction with SMDC alone (C).
Methods: A literature search was conducted in PubMed, Academic Search Ultimate and Google Scholar starting November 2018. Seven …
The Impact Of Yoga On Symptom Management In Adults With Depression, Laura S. Eggen
The Impact Of Yoga On Symptom Management In Adults With Depression, Laura S. Eggen
All Graduate Theses, Dissertations, and Other Capstone Projects
Depression is one of the most prevalent mental health conditions worldwide. Despite continual advances in the fields of psychiatry and psychology, hundreds of millions of individuals continue to suffer due to ineffective treatment, adverse effects, lack of access to care, and the relapsing nature of the disease. Depression extends beyond the affected individual and burdens families, healthcare systems, and societies. Yoga is a mind-body modality, growing in popularity, that has been cited in the literature as a promising treatment for depression. The purpose of this paper is to systematically review recent literature on the impact of yoga on depression management …
Integrating The Natural Healing Process For Post-Traumatic Stress Disorder Treatment In Veterans Through A Healing Garden., Taiwo A. Ajibade
Integrating The Natural Healing Process For Post-Traumatic Stress Disorder Treatment In Veterans Through A Healing Garden., Taiwo A. Ajibade
Graduate Theses, Dissertations, and Problem Reports (ETD)
In 2002, several ex-service personnel brought a court case against the Ministry of Defense for the inability to identify PTSD issues at an early stage and to provide support and effective treatment (Langston et al. 2007). Also in recent times, reports have suggested that US marine and army infantry units returning from duty in Iraq and Afghanistan have a higher level of expected proportions of mental disorders and that about 10% of personnel are returning home are with symptoms of post-traumatic stress disorder (Smith et al., 2008). This discovery made it pertinent to look for natural ways to assist veterans …
Occupational Therapy's Role In Maternal Mental Health Within Transition From Nicu To Home, Victoria Briltz, Becki Cohill, Susan Macdermott
Occupational Therapy's Role In Maternal Mental Health Within Transition From Nicu To Home, Victoria Briltz, Becki Cohill, Susan Macdermott
San Marcos, Fall 2019
The purpose of this capstone project is to identify OT’s role in maternal mental health following the transition home from a NICU setting. This capstone project focused on mothers’ roles, routines, and environment during the transition from the NICU to home. Mothers may feel unprepared for the discharge home when their babies are ready to leave the NICU (Boykova, 2016). Occupational therapists address occupational performance through skilled interventions for women during the perinatal period; however, there is a lack of evidence guiding occupational therapy for providing services for maternal wellness (Slootjes, 2016). This capstone project will help share information, ideas, …
Occupational Therapy's Role In Maternal Mental Health Within Transition From Nicu To Home, Victoria Briltz
Occupational Therapy's Role In Maternal Mental Health Within Transition From Nicu To Home, Victoria Briltz
Student Capstone Papers
The purpose of this capstone project is to identify OT’s role in maternal mental health following the transition home from a NICU setting. This capstone project focused on mothers’ roles, routines, and environment during the transition from the NICU to home. Mothers may feel unprepared for the discharge home when their babies are ready to leave the NICU (Boykova, 2016). Occupational therapists address occupational performance through skilled interventions for women during the perinatal period; however, there is a lack of evidence guiding occupational therapy for providing services for maternal wellness (Slootjes, 2016).
Data analysis for this capstone project consisted of …
Creative Arts-Based Parents Training Program For Parents Of Children With Autism Spectrum Disorder, Jung Eun Park
Creative Arts-Based Parents Training Program For Parents Of Children With Autism Spectrum Disorder, Jung Eun Park
Expressive Therapies Dissertations
This study evaluated the impact of the Creative Arts-based Parents’ Training (CAPT) program. The 6-week long, creative arts therapy-based program and its impact on parental stress and sense of competence for parents of children with Autism Spectrum Disorder (ASD) was examined. Korean Parenting Stress Index Short-Form (K-PSI-SF) and Korean-Parenting Efficacy Test (K-PET) were used as quantitative measurements. Qualitative data were also collected for the experimental group (n = 17) using questionnaires, art journaling, and a 30 min focus group interview. The control group (n = 15) only participated in quantitative measurements. There was no difference in age between …
Preliminary Evaluation Of An Approach To Rehabilitation Aimed At Promoting Return-To-Work In Individuals With Co-Morbid Musculoskeletal Pain And Depression, Michael J. L. Sullivan, Timothy Wideman, Aliki Thomas
Preliminary Evaluation Of An Approach To Rehabilitation Aimed At Promoting Return-To-Work In Individuals With Co-Morbid Musculoskeletal Pain And Depression, Michael J. L. Sullivan, Timothy Wideman, Aliki Thomas
Rapports de recherche scientifique
Nombre de personnes ayant subi une blessure au travail présentent des symptômes de douleur et de dépression. La combinaison de symptômes de douleur et de dépression peut avoir un effet négatif sur le rétablissement de l’individu. La présence de symptômes de dépression peut nuire à la capacité d’accomplir de nombreuses activités importantes de la vie quotidienne, inclusion faite des activités professionnelles. Des études ont démontré que les travailleurs blessés qui présentent des symptômes de dépression demeurent absents du travail deux fois plus longtemps que les travailleurs blessés non dépressifs. Les interventions utilisées pour traiter la douleur et l’incapacité fonctionnelle chez …
An Interprofessional Collaborative Approach To The Development Of A Content Valid Interview Questionnaire For Persons With Hearing Loss And Their Communication Partners, Nancy A. Delich, Stephen D. Roberts
An Interprofessional Collaborative Approach To The Development Of A Content Valid Interview Questionnaire For Persons With Hearing Loss And Their Communication Partners, Nancy A. Delich, Stephen D. Roberts
JADARA
An assessment instrument needs to be valid in order for data to be accurately interpreted and applied. Currently, few rigorous content evaluations have been conducted on hearing-related questionnaires. This study describes a multiphase approach for obtaining content validity evidence in the development of a questionnaire that explores quality of life for persons with hearing loss and their communication partners. A panel of 15 interprofessional experts evaluated 41 questionnaire items for content relevance and content clarity. Findings revealed an overall scale of .99 for content relevance and .85 for content clarity, indicating high content validity for the revised 40-item questionnaire.
Investigating Whether Consuming Meals In A Dining Room Impacts Patients’ Mood, Level Of Interaction, And Subsequent Nutrient Intake In A Stroke Rehabilitation Ward., Sali Abouhajar, Grace Bennett, Linda Dooley Ms., Tracy Waldron Ms., Katie Walsh Ms., Sile Murphy Ms., Aoibheann Mcmorrow Dr., Joseph Harbison Prof., Suzanne L Doyle
Investigating Whether Consuming Meals In A Dining Room Impacts Patients’ Mood, Level Of Interaction, And Subsequent Nutrient Intake In A Stroke Rehabilitation Ward., Sali Abouhajar, Grace Bennett, Linda Dooley Ms., Tracy Waldron Ms., Katie Walsh Ms., Sile Murphy Ms., Aoibheann Mcmorrow Dr., Joseph Harbison Prof., Suzanne L Doyle
SURE Journal: Science Undergraduate Research Experience Journal
Background/objectives
Malnutrition is evident in hospitals and stroke patients are at increased risk. Protected mealtimes may help increase nutrient intake especially when patients interact and enjoy the dining room atmosphere. The aim of this research is to investigate if eating in a communal dining room increases nutritional intake compared to eating at the bedside and to investigate whether patient interaction and mood affects patient nutrient intake.
Population/methods:
A randomised cross-sectional study of 20 patients, assessing a comparison of patient’s mealtime consumption at lunchtime in the dining room and at the beside. Patients’ meals were weighed before and after consumption as …
Assessing Workplace Wellness For The Occupation Of Hairdressing, Alex Kim
Assessing Workplace Wellness For The Occupation Of Hairdressing, Alex Kim
Student Capstone Papers
There is presently a lack of occupational therapy interventions that holistically treat work-related musculoskeletal disorders (WRMSDs) commonly found in the hairdressing population. Current studies found in the literature solely focus on the hairdressers’ symptoms, which leads to a more limited understanding of their situation. Furthermore, this focus on symptoms could lead to the possibility of overlooking confounding variables that could play a role in impacting these workers. This capstone project aims to examine the hairdressing occupation as a whole, assessing the health-related needs of hairdressers and create a holistic program that would address current needs and future preventative treatments for …
Recent Trends, Current Research In Cyberpsychology: A Literature Review, Amarjit Kumar Singh, Pawan Kumar Singh
Recent Trends, Current Research In Cyberpsychology: A Literature Review, Amarjit Kumar Singh, Pawan Kumar Singh
Library Philosophy and Practice (e-journal)
Cyberpsychology refers to the study of the mind and behavior in the context of interactions with technology. It is an emerging branch, which has focused on the psychological aspects connected to the increasing presence and usages of technology in modern lives. This paper traces recent advancement and trends of Cyberpsychology is an emerging domain of knowledge and goes on the give a literature review of the same. An analysis of the recent research and literature covering 300 most relevant research papers from the period of 2012 to 15, August 2019 was conducted to determine and shape the research pattern based …
Transforming Trauma: Resilience And Healing Through Our Connections With Animals, Philip Teseschi, Molly Anne Jenkins
Transforming Trauma: Resilience And Healing Through Our Connections With Animals, Philip Teseschi, Molly Anne Jenkins
Purdue University Press Book Previews
Have you ever looked deep into the eyes of an animal and felt entirely known? Often, the connections we share with non-human animals represent our safest and most reliable relationships, offering unique and profound opportunities for healing in periods of hardship. This book focuses on research developments, models, and practical applications of human-animal connection and animal-assisted intervention for diverse populations who have experienced trauma. Physiological and psychological trauma are explored across three broad and interconnected domains: 1) child maltreatment and family violence; 2) acute and post-traumatic stress, including military service, war, and developmental trauma; and 3) times of crisis, such …
Implementing School-Based Education Programs To Combat Lack Of Access To Psychiatric Facilities In The United States, Marisa L. Sparbanie
Implementing School-Based Education Programs To Combat Lack Of Access To Psychiatric Facilities In The United States, Marisa L. Sparbanie
Kentucky Journal of Undergraduate Scholarship
One in five Americans are diagnosed with a mental illness, yet only 41% of adults received healthcare services in the past year. Due to barriers in accessing care, services are costly, wait times are long, and appointment times are inconvenient. Lack of access to quality, affordable care disproportionately affects those in rural areas and individuals with low socioeconomic status. School-based mental health education programs should be developed as a beginning step to combat increasing mental health conditions and limited access to healthcare facilities. Lack of access to care may lead to occupational injustices such as: occupational alienation, deprivation, and imbalance. …
Promoting Resilience In Economically Disadvantaged Adolescents Through School-Based Expressive Arts Groups, Bailey Knox
Promoting Resilience In Economically Disadvantaged Adolescents Through School-Based Expressive Arts Groups, Bailey Knox
Expressive Therapies Capstone Theses
Since 2013, the majority of students served by the public school system in the United States have been considered “low-income” by the federal government. The stressors associated with low socioeconomic status significantly increase risk for social, emotional and behavioral challenges at all age levels, but can be particularly damaging to adolescents coping with heightened stress levels related to the intense multi-dimensional changes that define this developmental period. As the correlation between economic disadvantage and negative socio-emotional and academic outcomes is increasingly evidenced, schools have begun to recognize their responsibility for providing preventative mental health care to high-risk students. Over the …
Moving Blind Spots: Cultural Bias In The Movement Repertoire Of Dance/Movement Therapists, Ebony Nichols
Moving Blind Spots: Cultural Bias In The Movement Repertoire Of Dance/Movement Therapists, Ebony Nichols
Expressive Therapies Capstone Theses
This thesis explores the need for cultural diversity in the field of dance/movement therapy and the impact of unconscious bias as it relates to cultural rhythmic patterns, movement styles, and music choices in therapeutic practice. This literature review examines the historical context that has contributed to the field of dance/movement therapy while outlining cultural competency and ethical considerations in practice as it relates to cultural and/or race identity. Common themes are summarized notating the effects of oppression, bias, and trauma on populations of statistically marginalized communities with specific emphases on African American cultural identity. With consideration toward action steps, culturally …
Beyond Regression: An Investigation Of Art Material Choice For Children With Trauma, Natalie Lane
Beyond Regression: An Investigation Of Art Material Choice For Children With Trauma, Natalie Lane
Expressive Therapies Capstone Theses
Choice in art materials and the artistic process are arguably two of the primary facets of how art making can be therapeutic. The purpose of the present inquiry was to investigate the impacts of art material choice in children who have experienced trauma. Using the expressive therapies continuum (ETC) as a foundation for choosing art materials in a therapeutic context, this inquiry sought to introduce art materials in the kinesthetic/sensory component of the ETC (e.g., clay, paint, large paint brushes, etc.). As a mediating consideration, this inquiry articulated the responsibilities and obligations that the art therapist possesses in working with …
Expressive Mindfulness: A Trauma-Sensitive Expressive Arts Therapy Group Method, Meghan Daly
Expressive Mindfulness: A Trauma-Sensitive Expressive Arts Therapy Group Method, Meghan Daly
Expressive Therapies Capstone Theses
Mindfulness and expressive arts therapy are both supportive of directing attention in a manner that promotes integration and function of a person. In this paper, a trauma-sensitive method was created for use in a day treatment setting for adults with severe and persistent mental illness (SPMI). This method utilized expressive movement, visual art making with three different materials, and creative writing to encourage mindful, non-judgmental acceptance of the present moment; a sense of relaxation; and an overall increase in quality of life. During development of the method arts-based research informed the choice of materials, music, and structure of the group. …
Watering Black Roots: Exploring Black Ecological Identity Development Within Nature-Based Expressive Arts Therapy, Stormy Saint-Val
Watering Black Roots: Exploring Black Ecological Identity Development Within Nature-Based Expressive Arts Therapy, Stormy Saint-Val
Expressive Therapies Capstone Theses
Nature-based expressive arts therapy promotes the holistic healing and recovery of individuals by interweaving the practices of ecopsychology, ecotherapy, and expressive arts therapy. These interventions have been proven to mediate ranges of symptomologies, such as anxiety disorders and PTSD. Research conducted by the U.S. National Park Services indicates that African- Americans are less likely to have a positive relationship to nature than all other racial groups. The amplification of this report without introspection of its context perpetuates racialized generalizations. This can limit a black individual’s ability to embrace their ecological identity and be receptive of nature-based expressive arts therapy interventions. …
God, I Hope This Part Of My Life Is Over: A Focused Ethnography Of A Correctional Youth Facility’S Therapeutic Climate, Eric Meyer
Theses & Dissertations
Although all prisons have the same goal of isolating offenders from society, the precise strategies used vary from one jurisdiction to the next. Some prisons use means of punishment to gain inmate compliance. Other prisons concentrate their limited resources on rehabilitation. Contained within the following pages are details of a focused ethnography that was completed in a state correctional youth facility that housed males between the ages of 15 and 21 years, all of whom were convicted of violent crimes. This study had the objective of exploring the climate of therapy in this correctional youth facility where rehabilitative programs were …
Opioid Withdrawal Post Incarceration, Samantha Spampinato
Opioid Withdrawal Post Incarceration, Samantha Spampinato
CURCE Annual Undergraduate Conference
This literature review attempts to provide a more complete understanding of the increasing opioid concern and its detrimental effects from withdrawal in incarcerated individuals. Opioid-related fatal overdoses will significantly decrease with the implementation of opioid treatment in jails and prisons nationwide. The incarcerated populations that are typically affected by Opioid Use Disorder (OUD) include about 8.5% of Hispanics and Whites, and about 7.4% of Blacks. One solution involves Medication-Assisted Treatment (MAT) with the use of opioid agonists, such as methadone and buprenorphine-naloxone. These medications offer a slow release of dopamine and can reduce the patient’s opioid withdrawal effects. However, fewer …
Importance Of Social Support In Athletics As It Relates To Injury Recovery And Preparedness To Return To Play, Haleigh Gray
Importance Of Social Support In Athletics As It Relates To Injury Recovery And Preparedness To Return To Play, Haleigh Gray
Graduate Theses
Background: Recent studies have evaluated the physical problems as well as the psychological complications that arise from sport injuries. However, little research has been done on techniques to address or mitigate these psychological issues. Objective: The purpose of this study was to investigate how social support was perceived during the injury rehabilitation process and how it influenced return to play preparedness. Setting: National Collegiate Athletic Association (NCAA) Division I mid-major university. Participants: A total of 21 previously injured student-athletes participated in the study. Methods: Through this mixed method study, each student-athlete completed a validated social support survey that evaluated perceived …
A Bilingual Approach To Pediatric Occupational Therapy: The Importance Of Communication Between Providers & Spanish-Speaking Families In Northwest Arkansas, Emily Ann Davidson
A Bilingual Approach To Pediatric Occupational Therapy: The Importance Of Communication Between Providers & Spanish-Speaking Families In Northwest Arkansas, Emily Ann Davidson
World Languages, Literatures and Cultures Undergraduate Honors Theses
Due to the demographic demands of Northwest Arkansas and the prevalence of disparities in health care, this study aims to assess the current practices, perceived need, and willingness to provide bilingual Spanish-English outpatient pediatric occupational therapy options in Northwest Arkansas. The hope of this study is to better inform pediatric occupational therapy providers of the growing need for bilingual services so that they may respond appropriately in order to better serve Latino and Spanish-speaking patients and their families or caregivers.
A Sensory-Based Program To Enhance Occupational Performance For Dementia, Ivy Annahi Torres-Flores, Jacob Gantan, Heather Anne August, Naomi Grace Wong
A Sensory-Based Program To Enhance Occupational Performance For Dementia, Ivy Annahi Torres-Flores, Jacob Gantan, Heather Anne August, Naomi Grace Wong
Occupational Therapy | MSOT Capstone Projects
Dementia is a neurological disease, causing behavioral and cognitive symptoms, that progressively impairs an individual’s ability to engage in meaningful activities. Progressive deterioration associated with dementia impacts occupational performance and independence and quality of life. Sensory based interventions, such as drumming groups, have been hypothesized to be a non-pharmacological intervention for individuals with dementia. The purpose of this study was to analyze the effects of a sensory based intervention program, in this case participation in a drumming group, on functional engagement during self-feeding for individuals with dementia. Researchers gathered data over the course of two days using the Functional Behavior …
The Role Of Horticultural Therapy In The Treatment Of Refugees With Post-Traumatic Stress Disorder, Molly Nadeau
The Role Of Horticultural Therapy In The Treatment Of Refugees With Post-Traumatic Stress Disorder, Molly Nadeau
Senior Honors Theses
The United Nations High Commissioner for Refugees (UNHCR) cites that there are an unprecedented number of refugees. As of 2017, over 68.5 million people have been forcibly displaced from their homes, with 25.4 million of this group being classified as refugees (United Nations High Commissioner for Refugees, 2018). Often, mental health issues arise from the trauma that they face. Recently, the use of horticultural therapy, which uses gardening and plant-based activities as a form of treatment, has shown mental health improvements in military veterans and active duty soldiers diagnosed with stress related disorders. This paper will describe the role of …
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.
Measuring Emotional Response To A Planting Activity For Staff At An Urban Office Setting: A Pilot Study, Amy E. Wagenfeld, Sandra Schefkind, Nancy Hock
Measuring Emotional Response To A Planting Activity For Staff At An Urban Office Setting: A Pilot Study, Amy E. Wagenfeld, Sandra Schefkind, Nancy Hock
The Open Journal of Occupational Therapy
Background: Interaction with occupation-centered activities, such as gardening, is associated with improved mental health. With limited evidence supporting the effects of short-term nature-based interventions on employees’ emotional states, the purpose of this research was to understand the impact of a one-time, short-term nature-based intervention on the emotional state of employees at an urban office building.
Method: This pretest/posttest design study used a visual analogue emoticon assessment tool, the Interaction with Nature scale, to measure differences in the participants’ emotional states before and after participating in a planting activity. Twenty-two participants engaged in the study. Each participant potted a …
Experiences Of Veterans With Ptsd And Sud In An Outpatient Setting, Andrew Breault, Hannah Shifflett-Kohler
Experiences Of Veterans With Ptsd And Sud In An Outpatient Setting, Andrew Breault, Hannah Shifflett-Kohler
Thinking Matters Symposium Archive
In 2014, there were approximately 7.9 million adults in the United States with co-occurring Post Traumatic Stress Disorder (PTSD) and Substance Use Disorders (SUD) (SAMHSA, 2014). Of the veterans who served in the conflicts in Iraq and Afghanistan alone, 30% of those in SUD treatment also meet the criteria for PTSD (Seal et al, 2008, pp. 476). Furthermore, statistics show that about 20 Veterans in the United States complete suicide daily (Spiva, 2019, p. 8). The Department of Veterans Affairs is urgently seeking successful approaches to addressing the high incidence of suicides among all veterans along with the low retention …