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Articles 1 - 30 of 101
Full-Text Articles in Community Health
Salutogenesis And The Prevention Of Social Death: Cross-Cultural Lessons From Genocide-Impacted Rwandans And Indigenous Youth In Canada, Jobb D. Arnold
Salutogenesis And The Prevention Of Social Death: Cross-Cultural Lessons From Genocide-Impacted Rwandans And Indigenous Youth In Canada, Jobb D. Arnold
Genocide Studies and Prevention: An International Journal
Combining trans-disciplinary theories with cross-cultural ethnographic research, this paper explores community-based approaches to genocide prevention among Canadian-Indigenous groups as well as with Rwandan student genocide survivors. A Salutogenic framework is used to examine community responses to the micro-foundations of genocide (Antonovsky 1987). These processes are explored using first-hand accounts from “New Family” networks of student genocide survivors in Rwanda and members of a Canadian urban-Indigenous “Village.” These perspectives shed light on how locally adaptive, socially networked practices can help promote emergent forms of genocide prevention (Williams 1977). This paper focuses on three areas of local practice that have helped build …
How Does Access To Healthcare Affect Life Expectancy?, Yara Mahmoud
How Does Access To Healthcare Affect Life Expectancy?, Yara Mahmoud
Senior Honors Projects, 2010-2019
Access to health care is a pressing issue in the United States, whether it be the cost of care or not having enough of it. To emphasize the importance of this topic, this paper assesses the impact of access to health services on life expectancy. A comparison is made between the universal health systems in France and Spain and the mixed system in the United States. Even though the United States spends the most on health care in the world, its statistics fall below those of other developed countries. After addressing other risk factors, it was found that individuals under …
Offering Medical Providers Capacity And Competence In Caring For Transgender And Non-Binary Patients: Evaluation Of A Pilot Digital Training Program, Lexis Manzara
Master's Projects and Capstones
Purpose: Stigma and discrimination in health care settings contribute to health disparities for transgender and non-binary (TGNB) people. Evidence suggests that a lack of training on the care for transgender and non-binary TGNB patients in medical school curricula has contributed to providers feeling unprepared to provide quality care for this population. Health care providers have the opportunity to play a key role in the reduction of health disparities for TGNB patients.
Methods: Twenty-five health care providers completed the eight-module digital training program. Pre- and post-tests assessed provider knowledge, self-efficacy, preparedness, and behavior. Paired samples t-tests were conducted to compare pre-and …
Ontrack: A Program Evaluation, Justin Mynatt
Ontrack: A Program Evaluation, Justin Mynatt
Doctoral Projects
OnTrack is a program that provides coordinated specialty care (CSC) services for patients who have experienced their first episode of psychosis (FEP). Appropriately identifying and aggressively treating this vulnerable population, while providing support to both them and their families is critical for improved outcomes. Appropriate treatment of FEP patients can improve their quality of life, preserve brain matter, improve overall functioning, and lessen the burden of the clients’ family who may be involved in their care, such as caregiver strain or financial hardship. The purpose of this project is to evaluate the success of OnTrack, a FEP program, at improving …
Chapter 12: Dementia: Detection, Assessment, And Intervention, Sally Pelon
Chapter 12: Dementia: Detection, Assessment, And Intervention, Sally Pelon
Books and Contributions to Books
This chapter considers various forms of dementia as well as the assessment and diagnosis process from a uniquely social work perspective. It also explores various psychosocial and practical interventions that may utilized by social workers as they support and assist both those with a dementia diagnosis and their loved ones.
Development Of A Text Message Stress Management Intervention And Its Impact On Perceived Stress And Coping Self-Efficacy Among Student Nurses, Kristin Jaye Henderson
Development Of A Text Message Stress Management Intervention And Its Impact On Perceived Stress And Coping Self-Efficacy Among Student Nurses, Kristin Jaye Henderson
Graduate Theses and Dissertations
Purpose: The purpose of the two studies was to develop a text message intervention and examine its effects on lowering perceived stress and increasing coping self-efficacy among nursing students. We also explored stress perceptions and investigated student satisfaction with the text message stress management program. Methods: For the first study, twenty three students participated in the focus groups for intervention development. Sample messages were presented to participants and feedback was requested. The messages were modified based on student feedback. The second study utilized an experimental pre/post design with a convenience sample (N=101) to examine the effects of the text message …
Collection Of Analyzed Data From Health And Human Services Professionals: Stressors And Self-Care Practices, Yesenia Alcala
Collection Of Analyzed Data From Health And Human Services Professionals: Stressors And Self-Care Practices, Yesenia Alcala
Capstone Projects and Master's Theses
Alliance on Aging is a nonprofit agency in Salinas, California. It was established in 1970, and they help serve the needs of the senior citizen community by offering multiple services. Working professionals experience high levels of stress in the workplace. Although there are many contributing factors for high stress in the workplace, the main factors at play are the lack of self-care and lack of support Zastrow (pg. 332, 2015). Because working professionally in the human services field experience high stress the consequences they may face are burnout, high turnover rates, and poor overall health. The capstone project will assess …
Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan
Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan
Dissertations
Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).
Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.
Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …
Does Depressed Persons With Non-Cardiovascular Morbidity Have A Higher Risk Of Cvd? A Population-Based Cohort Study In Sweden, Aysha Almas, Jette Moller, Romaina Iqbal, Andreas Lundin, Yvonne Forsel
Does Depressed Persons With Non-Cardiovascular Morbidity Have A Higher Risk Of Cvd? A Population-Based Cohort Study In Sweden, Aysha Almas, Jette Moller, Romaina Iqbal, Andreas Lundin, Yvonne Forsel
Section of Internal Medicine
Background: Depression often co-exists with non-cardiovascular morbid conditions. Whether this comorbidity increases the risk of cardiovascular disease has so far not been studied. Thus, the aim of this study was to determine if non-cardiovascular morbidity modifies the effect of depression on future risk of CVD.
Methods: Data was derived from the PART study (acronym in Swedish for: Psykisk hälsa, Arbete och RelaTioner: Mental Health, Work and Relationships), a longitudinal cohort study on mental health, work and relations, including 10,443 adults (aged 20-64 years). Depression was assessed using the Major Depression Inventory (MDI) and self-reported data on non-cardiovascular morbidity was assessed …
Suicide Among Persons Who Entered Same-Sex And Opposite-Sex Marriage In Denmark And Sweden, 1989–2016: A Binational, Register-Based Cohort Study, Annette Erlangsen, Sven Drefahl, Ann Haas, Charlotte Bjorkenstam, Merete Nordentoft, Gunnar Andersson
Suicide Among Persons Who Entered Same-Sex And Opposite-Sex Marriage In Denmark And Sweden, 1989–2016: A Binational, Register-Based Cohort Study, Annette Erlangsen, Sven Drefahl, Ann Haas, Charlotte Bjorkenstam, Merete Nordentoft, Gunnar Andersson
Publications and Research
Background
People belonging to sexual minority groups have higher levels of suicidality than heterosexuals. However, findings regarding suicide death are sparse. Using unique national data from two countries, we investigated whether individuals entering a same-sex marriage (SSM), a proxy group of sexual minority individuals, had higher suicide rates than those entering opposite-sex marriage (OSM).
Methods
A cohort study of all males and females who entered an SSM (n=28 649) or OSM (n=3 918 617) in Denmark and Sweden during 1989–2016 was conducted. Incidence rate ratios (IRRs) for suicide were calculated using adjusted Poisson regression models.
Results
In total, 97 suicides …
Aberrant Epigenomic Modulation Of Glucocorticoid Receptor Gene (Nr3c1) In Early Life Stress And Major Depressive Disorder Correlation: Systematic Review And Quantitative Evidence Synthesis, Laurens Holmes Jr., Emily Shutman, Chinacherem Chinaka, Kerti Deepika, Lavisha Palaez, Kirk W. Dabney
Aberrant Epigenomic Modulation Of Glucocorticoid Receptor Gene (Nr3c1) In Early Life Stress And Major Depressive Disorder Correlation: Systematic Review And Quantitative Evidence Synthesis, Laurens Holmes Jr., Emily Shutman, Chinacherem Chinaka, Kerti Deepika, Lavisha Palaez, Kirk W. Dabney
Community & Environmental Health Faculty Publications
Early life stress (ELS) induced by psychological trauma, child maltreatment, maternal separation, and domestic violence predisposes to psycho-behavioral pathologies during adulthood, namely major depressive disorder (MDD), anxiety, and bipolar affective disorder. While environmental data are available in illustrating this association, data remain to be established on the epigenomic underpinning of the nexus between ELS and MDD predisposition. Specifically, despite the observed aberrant epigenomic modulation of the NR3C1, a glucocorticoid receptor gene, in early social adversity and social threats in animal and human models, reliable scientific data for intervention mapping in reducing social adversity and improving human health is required. We …
Implication Of Spiritual Network Support System In Epigenomic Modulation And Health Trajectory, Laurens Holmes Jr., Chinacherem Chinaka, Hikma Elmi, Kerti Deepika, Lavisha Palaez, Michael Enwere, Olumuyiwa T. Akinola, Kirk W. Dabnet
Implication Of Spiritual Network Support System In Epigenomic Modulation And Health Trajectory, Laurens Holmes Jr., Chinacherem Chinaka, Hikma Elmi, Kerti Deepika, Lavisha Palaez, Michael Enwere, Olumuyiwa T. Akinola, Kirk W. Dabnet
Community & Environmental Health Faculty Publications
With challenges in understanding the multifactorial etiologies of disease and individual treatment effect heterogeneities over the past four decades, much has been acquired on how physical, chemical and social environments a ffect human health, predisposing certain subpopulations to adverse health outcomes, especially the socio-environmentally disadvantaged (SED). Current translational data on gene and adverse environment interaction have revealed how adverse gene-environment interaction, termed aberrant epigenomic modulation, translates into impaired gene expression via messenger ribonucleic acid (mRNA) dysregulation, reflecting abnormal protein synthesis and hence dysfunctional cellular differentiation and maturation. The environmental influence on gene expression observed in most literature includes physical, chemical, …
Power In The Counseling Relationship: The Role Of Ignorance, Izaak L. Williams, Peg O'Connor
Power In The Counseling Relationship: The Role Of Ignorance, Izaak L. Williams, Peg O'Connor
Journal of Human Services: Training, Research, and Practice
This article explores the role of therapist self-disclosure in clinical settings. Distinctions are made between the enmeshed concepts of privacy, secrecy, and confidentiality to elucidate the role of ignorance in maintaining the power dynamics in therapeutic relationships. While some measure of privacy is essential to counseling practice, secretive behavior (in which the counselor divulges too little about themselves) can have a negative impact on the therapeutic relationship and the client’s therapeutic outcomes. There is, therefore, an under-appreciated and delicate balancing act between withholding information to protect the client and the counselor and revealing enough personal details to empower the client’s …
Near Real-Time Determination Of The Prevalence Of Cannabinoids, Cathinones, And Synthetic Opioids, Catherine O'Rourke, Bikram Subedi
Near Real-Time Determination Of The Prevalence Of Cannabinoids, Cathinones, And Synthetic Opioids, Catherine O'Rourke, Bikram Subedi
Scholars Week
Unregulated new psychoactive substances (NPS) in “pure” or “preparation” forms are designed to mimic the effects of controlled substances, and are introduced and reintroduced in the market as a cheap substitute of established regulated drugs in quick succession to loophole the law enforcement efforts on combating drugs. For example, carfentanil, a synthetic opioid activates the opioid receptors similar to morphine but it is astoundingly potent compared to a typical drug of abuse (100 times more potent than fentanyl and 10,000 times more powerful than morphine). Based on the cost- and time-intensive forensic analysis, National Drug Early Warning System reported the …
Addressing Postpartum Smoking Relapse Among Low-Income Women: A Randomized Control Trial, Kristine Alaniz, Bruce Christiansen, Tingting Sullivan, Lisette Khalil, Michael C. Fiore
Addressing Postpartum Smoking Relapse Among Low-Income Women: A Randomized Control Trial, Kristine Alaniz, Bruce Christiansen, Tingting Sullivan, Lisette Khalil, Michael C. Fiore
Journal of Patient-Centered Research and Reviews
Purpose: Smoking during pregnancy can have dire consequences for both the baby and mother. Low-income pregnant women smoke at particularly high rates. Among women who quit during pregnancy, postpartum relapse is high. This randomized control trial tested the effect of adding postpartum assistance to an existing smoking cessation program (First Breath) designed for low-income women.
Methods: Of 185 study participants, 94 women were randomly assigned to the standard First Breath program (control) and 91 to an enhanced program. First Breath consisted of evidence-based smoking cessation counseling provided at every prenatal visit. The enhanced program included all First Breath services plus …
Determination Of Cannabinoids, Cathinones, And Synthetic Fentanyls Using Wastewater-Based Epidemiology, Catherine O'Rourke, Bikram Subedi
Determination Of Cannabinoids, Cathinones, And Synthetic Fentanyls Using Wastewater-Based Epidemiology, Catherine O'Rourke, Bikram Subedi
Posters-at-the-Capitol
Unregulated new psychoactive substances (NPS) in “pure” or “preparation” forms are designed to mimic the effects of controlled substances, and are introduced and reintroduced in the market as a cheap substitute for established regulated drugs in quick succession to loophole the law enforcement efforts on combating drugs. For example, carfentanil, a synthetic opioid activates the opioid receptors similar to morphine but it is astoundingly potent compared to a typical drug of abuse (100 times more potent than fentanyl and 10,000 times more powerful than morphine). Based on the cost- and time-intensive forensic analysis, National Drug Early Warning System reported the …
Associations Among Knowledge, Attitudes, And Practices Toward Palliative Care Consultation Service In Healthcare Staffs: A Cross-Sectional Study, Li-Chun Huang, Ho-Jui Tung, Pei-Chao Lin
Associations Among Knowledge, Attitudes, And Practices Toward Palliative Care Consultation Service In Healthcare Staffs: A Cross-Sectional Study, Li-Chun Huang, Ho-Jui Tung, Pei-Chao Lin
Health Policy & Community Health: Faculty Publications
Background
The palliative care consultation service (PCCS) of the National Health Insurance payments has been promoted in Taiwan since 2011, although few studies have been conducted on healthcare staffs’ knowledge, attitudes, and practices regarding PCCS in Taiwan; consequently, the main objective of this study was to explore any correlations regarding the above by cross-sectional design using convenience sampling.
Methods
A total of 210 healthcare staff members were enrolled from a regional hospital from June 1, 2018, to September 30, 2018. Questionnaire items on the Palliative Care Consultation Service Inventory (KAP-PCCSI) were used to measure healthcare staff’s knowledge, attitudes, and practices …
Farm To School For All: Federal Farm To School Policy Under The Equity Lens, Chloe Marshall
Farm To School For All: Federal Farm To School Policy Under The Equity Lens, Chloe Marshall
Year on Climate Change: Events
This session explores federal child nutrition policy and how to apply an equity lens in advocacy using the National Farm to School Network's Racial and Social Equity Assessment tool.
Leveraging Technology To Address Patient-Centered Outcomes In Sickle Cell Disease, Tilicia Mayo-Gamble, Delores P. Quasie-Woode
Leveraging Technology To Address Patient-Centered Outcomes In Sickle Cell Disease, Tilicia Mayo-Gamble, Delores P. Quasie-Woode
Health Policy & Community Health: Faculty Publications
Work published by Georgia Southern University Press.
Modal Sosial Bonding Dalam Pengembangan Kampung Wisatakreatif Dago Pojok Kota Bandung, Provinsi Jawa Barat, Alfrojems Alfrojems, Triyanti Anugrahin
Modal Sosial Bonding Dalam Pengembangan Kampung Wisatakreatif Dago Pojok Kota Bandung, Provinsi Jawa Barat, Alfrojems Alfrojems, Triyanti Anugrahin
Jurnal Ilmu Kesejahteraan Sosial
The development of a tourism village has become one of the primaries in community development, especially in rural areas, carried out either by the government or other parties. This is an effort to alleviate poverty in rural areas which is currently an area with a reasonably large amount of poverty with 15.15 million people. But the process of this development provides a dilemma and question about how the process can develop bondsin the community itself that are relevant to the context of bonding social capital. This article aims to explore information about how Dago Pojok creative tourism village community develops …
Hambatan Serikat Pekerja Dalam Penyelesaianpermasalahan Hubungan Industrial, Fitriyah Fitriyah, Rakha Gusti Wardhana
Hambatan Serikat Pekerja Dalam Penyelesaianpermasalahan Hubungan Industrial, Fitriyah Fitriyah, Rakha Gusti Wardhana
Jurnal Ilmu Kesejahteraan Sosial
Although labore unions can help their members in solving problems related to industrial relations, it still takes a long time due to the lack of it’s ability to negotiate with companies. This can be seen in the process of resolving layoffs and work status at PT X which took 4 years, from 2013 to 2016 to reach an agreement. This research aims to describe the obstacles faced by labor unions in conducting negotiations and the efforts they have made to improve their capabilities. This research is a qualitative descriptive study and using purposive sampling techniques to selected the informant and …
Hubungan Tingkat Work-Life Balance Terhadap Tingkatkepuasan Kerja Karyawan Organisasi Pelayanankemanusiaan, Karyawan Yayasan Plan Internationalindonesia, Iga Larasati, Ety Rahayu
Hubungan Tingkat Work-Life Balance Terhadap Tingkatkepuasan Kerja Karyawan Organisasi Pelayanankemanusiaan, Karyawan Yayasan Plan Internationalindonesia, Iga Larasati, Ety Rahayu
Jurnal Ilmu Kesejahteraan Sosial
This undergraduate thesis discusses about the correlation of work-life balance to job satisfaction among Yayasan Plan International Indonesia’s Employees. This research is a quantitative research with descriptive design. This research is background by the importance of employee’s satisfaction in the Human Service Organization’s setting. Meanwhile, the research about employee’s job satisfaction among Human Service Organization is still rare. The result of this research shows that there’s a very weak correlation between the level work-life balance to the level of job satisfaction among Yayasan Plan International Indonesia’s Employees. This can be caused by the difference in characteristic between HSO and company. …
Strategi Bertahan Hidup Nelayan-Nelayan Kecil Desa Batu Ampar,Kecamatan Palmatak, Kabupaten Anambas, Lutfiana Nur Azizah, Triyanti Anugrahini
Strategi Bertahan Hidup Nelayan-Nelayan Kecil Desa Batu Ampar,Kecamatan Palmatak, Kabupaten Anambas, Lutfiana Nur Azizah, Triyanti Anugrahini
Jurnal Ilmu Kesejahteraan Sosial
Common problems faced by fishermen include the limited availability of fish resources, due to over fishing, climate change and the instability of fish selling prices. This condition is also experienced by small fishermen in Batu Ampar Village who carry out traditional fishing activities on the high seas. Facing the limitations of accessible fish resources and the uncertainty of the climate, they made various efforts so that they could survive. The purpose of this study was to describe the survival strategies of small fishermen in Batu Ampar Village in dealing with the problems faced while they were at sea. This research …
Penyandang Disabilitas Di Indonesia:Perkembangan Istilah Dan Definisi, Dini Widinarsih
Penyandang Disabilitas Di Indonesia:Perkembangan Istilah Dan Definisi, Dini Widinarsih
Jurnal Ilmu Kesejahteraan Sosial
Riset menunjukkan keterkaitan erat antara pemahaman publik tentang disabilitas dan penyandang disabilitas dengan perilaku diskriminatif yang mereka alami dalam kehidupan sehari-hari. Pemahaman umum masyarakat di dunia, termasuk Indonesia, tentang penyandang disabilitas masih cenderung negatif. Pemahaman negatif itu karena masyarakat umumnya mendefinisikan dan memperlakukan penyandang disabilitas berdasarkan pada pola pikir yang didominasi oleh konsep kenormalan yang berimplikasi pada stigmatisasi dan diskriminasi terhadap para penyandang disabilitas. Hal itu, termasuk di Indonesia terutama disebabkan masih terbatasnya diseminasi informasi dan edukasi resmi dari pemerintahan atau otoritas terkait serta hasil kajian ilmiah tentang disabilitas dan penyandang disabilitas. Artikel ini bertujuan mendeskripsikan kajian literatur terkait pemahaman …
Adicción Como Un Hecho Político Económico: Un Análisis De Servicios De Atención De Abuso De Drogas Y Alcohol En Arica, Chile, Jack Steffy
Independent Study Project (ISP) Collection
Research question – What is the current landscape of drug abuse in Chile and how has the state attempted to address this problem?
Objectives – The objectives of the paper were to characterize drug use patterns in Chile since 1994, revise drug abuse services, and offer possible improvements for the system of drug abuse treatment.
Background – Chile, despite being one of the most well economically-developed countries in South America, has some of the worst mental health indicators, one of these being drug abuse. Since 1994, use of alcohol and marihuana has increased, while use of cocaine products has remained …
A Need For Patient-Friendly Language For Those With Low Health Literacy In Advanced Care Planning, Denisha Allicock, Addison Mickens, Tilicia Mayo-Gamble
A Need For Patient-Friendly Language For Those With Low Health Literacy In Advanced Care Planning, Denisha Allicock, Addison Mickens, Tilicia Mayo-Gamble
Health Policy & Community Health: Faculty Publications
Work published by Georgia Southern University Press.
Characteristics Of The Health Information Technology Workforce In Georgia, Imaobong Ekpo, Emmanuel Akowuah, Bettye Apenteng, Samuel T. Opoku
Characteristics Of The Health Information Technology Workforce In Georgia, Imaobong Ekpo, Emmanuel Akowuah, Bettye Apenteng, Samuel T. Opoku
Health Policy & Community Health: Faculty Publications
Background: Advancement in medical technology, as well as the Health Information Technology for Economic and Clinical Health Act, has in part influenced the demand for health information technology (HIT) workers. While other sectors have experienced a tremendous increase in the information technology workforce, the health sector lags in this regard. The aim of this study was to describe the characteristics of the HIT workforce in Georgia, relative to surrounding states and the United States.
Methods: The supply of the HIT workforce in Georgia, surrounding states, and the United States was estimated using data from the 2014-2016 American Community Survey (ACS). …
Adult Food Security And The Relationship With Adverse Childhood Experiences Among Residents Of Appalachian North Carolina, Manan Roy, Erin Bouldin, Maggie Bennett, Adam Hege
Adult Food Security And The Relationship With Adverse Childhood Experiences Among Residents Of Appalachian North Carolina, Manan Roy, Erin Bouldin, Maggie Bennett, Adam Hege
Journal of Appalachian Health
Introduction: The Appalachian region has worse health outcomes than the remainder of the United States. These disparities are often linked to the underlying social and environmental determinants of health. Adverse childhood experiences (ACEs) are associated with poor health outcomes across the lifespan and have a significant impact on future social determinants as an adult, including food security status.
Purpose: To explore the relationships between ACEs and food security among adults in the Appalachian counties of North Carolina and make comparisons with the rest of the state.
Methods: Researchers used North Carolina’s 2012 Behavioral Risk Factor Surveillance System data; namely, …
Systems Approach To Evaluating Mih-Cp (Mobile Integrated Healthcare – Community Paramedicine): A Case Study Of East Baton Rouge Parish (Ebrp) Emergency Medical Services (Ems) Community Paramedicine Program Initiative, Oluwakemi Aiyedun
LSU Doctoral Dissertations
This study applied a holistic method of healthcare program assessment, known as systems approach, to evaluate the efficacy of the East Baton Rouge Parish (EBRP) EMS Community-integrated Health Program (CIHP). The author developed assessment metrics following the Quadruple Aim Framework: IHI (Institute for Healthcare Improvement) Triple Aim + Provider Experience.
Results showed that the CP program in this study delivers high ratings on patient experience and provided a 51% return on investment (ROI) through reduced emergency service utilization, ED visits and inpatient hospital admissions. However, findings did not demonstrate meaningful improvement in patients’ health-related quality of life (HRQoL) and self-efficacy …
Reflection: Reducing Long-Term Mortality In Suicidal Adolescents, Nina R. Bihani
Reflection: Reducing Long-Term Mortality In Suicidal Adolescents, Nina R. Bihani
Clinical Research in Practice: The Journal of Team Hippocrates
A transformative method to reducing mortality in suicidal adolescents involves a novel approach of educating and empowering their loved ones.