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Full-Text Articles in Psychiatric and Mental Health

Teachers’ Views On Preparation For Employment Of Young Autistic People, Biranavan Thavapalan, Emanuele Maria Merlo Oct 2021

Teachers’ Views On Preparation For Employment Of Young Autistic People, Biranavan Thavapalan, Emanuele Maria Merlo

Journal of Mind and Medical Sciences

Background. Contemporary literature indicates that there is significant support and assistance provided by schools for young autistic people, which has had a positive impact on the accessibility of jobs. Nevertheless, the employment rate of autistic people is unacceptably low in the UK. The current study investigated teachers’ views on the preparation for employment of young autistic people in the UK. Methods. Interviews were conducted with individuals from the educational field and thematic analysis was used to explore the teachers’ views regarding the factors that have an impact on the preparation for employment of young autistic people. Results. …


The Effect Of Postpartum Depression Screening Education For Postpartum Nurses, Shecarra S. Cook Oct 2021

The Effect Of Postpartum Depression Screening Education For Postpartum Nurses, Shecarra S. Cook

Electronic Theses and Dissertations

Depression affects about 13% of pregnant women and about 10% of women after childbirth. Some cases are so severe, the mother may even commit suicide. If left untreated, postpartum depression (PPD) affects both the mother’s and the infant’s health as well as their quality of life. The gap in clinical practice is that currently, patients only complete a postpartum depression screening tool during their 6-week follow-up appointment with their OB/GYN, leaving a gap in PPD detection and care during the immediate postpartum period. Postpartum nurses are not usually given specialized training in postpartum depression. The purpose of this study was …


Emergency Medicine Shift Factors Causing The Most Stress Among Emergency Medicine Residents, Mohamad Moussa, Kristen Hayden, Chia-Hao Shih, Sadik Khuder, Zayd Safadi, Connor Parsell Sep 2021

Emergency Medicine Shift Factors Causing The Most Stress Among Emergency Medicine Residents, Mohamad Moussa, Kristen Hayden, Chia-Hao Shih, Sadik Khuder, Zayd Safadi, Connor Parsell

Journal of Wellness

Introduction: Past studies demonstrate that stress and anxiety affect emergency medicine physicians, but the causal factors identified are usually from sources outside the work shift. We attempt to show the relationship between intrinsic factors of a work shift and anxiety perceived by residents, while also examining differing gender responses.

Methods: In 2018, a cross-sectional survey of emergency medicine residents in the United States was distributed anonymously through the Emergency Medicine Residents Association. The survey consisted of demographic questions, novel questions identifying intrinsic factors, and the Generalized Anxiety Disorder 7-item (GAD-7) scale. Spearman correlation, independent t-test, and multivariate analysis of variance …


Reducing “Treble” With Performance Focused Music Programs In Medical School: A Student Driven Needs Assessment To Clarify Participation Barriers Amongst Undergraduate Medical Students, Alexander Tu, Tiffany Truong, Kristy J. Carlson, Matthew J. Brooks, Jayme R. Dowdall Jul 2021

Reducing “Treble” With Performance Focused Music Programs In Medical School: A Student Driven Needs Assessment To Clarify Participation Barriers Amongst Undergraduate Medical Students, Alexander Tu, Tiffany Truong, Kristy J. Carlson, Matthew J. Brooks, Jayme R. Dowdall

Journal of Wellness

Introduction: The beneficial impact of performing arts involvement within undergraduate medical education, such as music, has been studied, but support for the arts varies significantly by institution. Research has suggested that medical student involvement in the arts can help develop their identities as physicians and may reduce stress and burnout, an increasingly difficult problem within the medical student community.

Methods: We used a mixed-method cross-sectional study design, using a questionnaire and semi-structured interview designed amongst a team of music professionals and healthcare providers with music backgrounds. Out of 511 enrolled medical students, 93 students participated in the study for a …


Medical Schools Ignore The Nature Of Consciousness At Great Cost, Anoop Kumar Jul 2021

Medical Schools Ignore The Nature Of Consciousness At Great Cost, Anoop Kumar

Journal of Wellness

The essential question of the relationship between consciousness and matter is ignored in medical school curricula, leading to a machine-like view of the human being that contributes to physician burnout and intellectual dissatisfaction. The evidence suggesting that the brain may not be the seat of consciousness is generally ignored to preserve the worldview of the primacy of matter. By investigating new frameworks detailing the nature of consciousness at different levels of hierarchy, we can bring intellectual rigor to a once opaque subject that supports a fundamental reality about our experience: We are human beings, not only human bodies.


A Multi-Faceted Approach To Understanding Acceptability Of Docs K-5: A Qualitative Analysis, Andrea Guarnieri Jun 2021

A Multi-Faceted Approach To Understanding Acceptability Of Docs K-5: A Qualitative Analysis, Andrea Guarnieri

USF Tampa Graduate Theses and Dissertations

This qualitative study investigated the acceptability of DOCS K-5, a behavior parenting program adapted for parents of elementary aged children. Despite proven efficacy in preventing maladaptive behaviors, parenting programs have historically suffered from low attendance and engagement. Participants (N = 13) attending the pilot DOCS K-5 program took part in six group interviews while enrolled in the program to examine the facilitators and barriers to attendance, perceived effectiveness, and collateral benefits received from participation in the program. This study considered possible cognitive, affective, instructional, and pragmatic facilitators or barriers to attendance and engagement. Participants described motivations to learn various types …


Demographics, Activities, And Environmental Factors Impact Burnout In A National Survey Of Emergency Medicine Residents, Nicole Battaglioli, Tim P. Moran, Simiao Li-Sauerwine Jun 2021

Demographics, Activities, And Environmental Factors Impact Burnout In A National Survey Of Emergency Medicine Residents, Nicole Battaglioli, Tim P. Moran, Simiao Li-Sauerwine

Journal of Wellness

Introduction: Burnout in emergency medicine and in residency training has been well-described. The impact of demographic, individual, and programmatic factors on burnout have not previously been determined in a national survey of emergency medicine residents. This study aimed to identify personal and environmental factors impacting resident burnout in a national sample of emergency medicine residents.

Methods: A prospective Emergency Medicine Resident Wellness Survey was administered in 2017. We surveyed respondents on demographic, personal, and environmental factors; each respondent also completed the Maslach Burnout Inventory - Human Services Survey. Linear regressions were used to identify variables associated with the Maslach Burnout …


Exploring The Usefulness Of Mindfulness Practices Through Zoom Meetings In Reducing Anxiety And/Or Stress Of Adults With Learning And Developmental Disabilities During The Covid-19 Pandemic, Thatiane Abra May 2021

Exploring The Usefulness Of Mindfulness Practices Through Zoom Meetings In Reducing Anxiety And/Or Stress Of Adults With Learning And Developmental Disabilities During The Covid-19 Pandemic, Thatiane Abra

Expressive Therapies Capstone Theses

This thesis explored which mindfulness meditations or mindfulness practices could be beneficial in the online sessions, the extent to which adults with learning and developmental disabilities could learn the practices remotely, and how stress and anxiety disorders could be reduced through online mindfulness interventions. Furthermore, it was also necessary to address the online sessions as the only mental health treatment possibility during the Coronavirus pandemic for the clients observed and the benefits and limitations of these interventions. Additionally, the importance of structure and routine for this population, the multi-modal structure of the interventions, and how attunement plays an important role …


Exploring Accessible & Responsive Trauma-Informed Schools: A Regenerative Approach To Student & Educator Support, Kennidy Stood May 2021

Exploring Accessible & Responsive Trauma-Informed Schools: A Regenerative Approach To Student & Educator Support, Kennidy Stood

Capstone Collection

Young people are particularly vulnerable to the negative impacts of stress and trauma. This research explores educator perspectives of school-based trauma-informed care programs in order to understand how programs can become more accessible and culturally responsive. While there are several widely used guidelines for school-based trauma-informed care programs that seek to mitigate trauma and its effects in the classroom, there is not a universally accepted standard. As such, programs vary across settings. This study employed a mixed-methods strategy to survey and interview educators and care providers regarding factors that may limit or enhance the availability of, access to, and appropriateness …


Examining The Experiences Of Lgbtq Dpt Students: A Critical Ethnography, Catherine Turner May 2021

Examining The Experiences Of Lgbtq Dpt Students: A Critical Ethnography, Catherine Turner

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to examine the experiences of LGBTQ Doctor of Physical Therapy (DPT) students at a large public university in the south-western United States, as it relates to the culture and climate of the program and campus. The LGBTQ community faces its own unique health disparities. Research in medicine suggests improving the diversity of the healthcare profession is a vital component in improving access to care, and this requires the creation of inclusive and supportive educational environments for LGBTQ identifying healthcare students. However, minimal research exists examining the experiences of LGBTQ physical therapy students.

The study …


I Matter: Understanding The Self-Care Practices Of School Counselors During The Covid-19 Pandemic And How Internal And External Factors Create Barriers, Alisha Rene Marie Jones May 2021

I Matter: Understanding The Self-Care Practices Of School Counselors During The Covid-19 Pandemic And How Internal And External Factors Create Barriers, Alisha Rene Marie Jones

Graduate Theses and Dissertations

Diminished self-care practices and heightened stress of school counselors is a continuing problem in education. With role ambiguity, high student-to-counselor ratios, emotional exhaustion, and others adding pressure to the roles and responsibilities of school counselors, this study investigated the self-care practices of Missouri school counselors and the internal and external factors which influence them, specifically within the context COVID-19. Clayton Alderfer’s (1972) Existence, Relatedness, and Growth theory was used as a theoretical framework for chosen self-care practices represented in this study and was supported by Robert Kegan’s and Lisa Lahey’s (2009) Immunity to Change theory to understand the competing commitments …


Mental Illness Diagnosis And The Construction Of Stigma, Katie Lynn Walkup Mar 2021

Mental Illness Diagnosis And The Construction Of Stigma, Katie Lynn Walkup

USF Tampa Graduate Theses and Dissertations

This dissertation explores how mental health legislation and related policy documents contribute to identification, diagnosis, and stigmatization. Using a mixed methods approach including content and stylometric text analysis with R as a heuristic for close and critical reading, I demonstrate how these documents normalize mental health concerns as a public threat. To do this work, I analyze how the Florida Mental Health Act (Chapter 394) and the Florida Marjory Stoneman Douglas High School Public Safety Act (SB 7026) circulate and sustain dominant narratives about mental illness. I trace where these narratives are distributed into Florida school districts’ mandatory mental health …


Gme: Gym In Medical Education-Maintaining Physical And Mental Well Being During The Covid-19 Pandemic, Brian J. Nguyen, Elana A. Meer, Joyce E. Nguyen Mar 2021

Gme: Gym In Medical Education-Maintaining Physical And Mental Well Being During The Covid-19 Pandemic, Brian J. Nguyen, Elana A. Meer, Joyce E. Nguyen

Journal of Wellness

No abstract provided.


Wellness Review 2020, Part 2, Brian Ferguson, Martin Huecker Feb 2021

Wellness Review 2020, Part 2, Brian Ferguson, Martin Huecker

Journal of Wellness

Introduction: This article comprises Part 2 of the Journal of Wellness review of 2020 wellness literature (July – December). In this review, JWellness editors continue the goal of offering a cohesive summary of recent publications within the wellness domain. We summarize new science and resilience initiatives published outside of JWellness that seek understanding of either burnout and its prevention or thriving in the medical community.

Methods: From the interval of 01 July – 31 Dec 2020, PubMed was queried for empirical research studies, review articles, and editorials in accordance with the following algorithm: an article was required to …


Benefits Of Child Life Procedural Preparation In Postoperative Long Term Recovery Of Pediatric Patients, Adriana Silva-Nevers Jan 2021

Benefits Of Child Life Procedural Preparation In Postoperative Long Term Recovery Of Pediatric Patients, Adriana Silva-Nevers

Graduate Student Independent Studies

This literature review is an examination of the benefits of child life preparation in children undergoing surgery, and the significant minimization of trauma from such interventions from the framework of family-centered care. This article also explores the harmful consequences of accumulated trauma, such as not receiving appropriate interventions prior to surgery. The cultural implications surrounding family centered care serve to suggest options for adapting to the particular needs of children and families. Consideration of current research in child life services and the reported benefits to patients, families, staff, and hospitals are included.


Therapists' Perspectives On Aiding Individuals To Maintain Social Connection While Struggling With Health Concerns, Shari Howington-Carlin Jan 2021

Therapists' Perspectives On Aiding Individuals To Maintain Social Connection While Struggling With Health Concerns, Shari Howington-Carlin

Theses and Dissertations

This applied dissertation was designed to explore therapists’ perspectives on aiding individuals to maintain social connection while struggling with health concerns. Social relationships support physical and psychological well-being, yet individuals struggling with physical or mental health issues often have difficulty maintaining their relationships. Therapists, as health professionals, often discuss physical as well as emotional health concerns with their patients, including components of physiological and psychological heath care. Emerging neuroscience is aiding in understanding how research in this field supports early intervention for health outcomes around healthy social and family relationships during chronic disease or illness onset.The researcher conducted a phenomenological …


Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich Jan 2021

Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich

Walden Dissertations and Doctoral Studies

When working with patients who have the potential to become physically aggressive, verbal de-escalation is an important technique that can defuse a dangerous situation. At the project site in the mental health emergency department (MHED), workplace violence was on the rise based on the reported use of physical interventions (rates of brief holds and physical restraint use). The purpose of this quality improvement evaluation project was to determine whether an educational training program on verbal de-escalation techniques would increase staff’s confidence in the use of verbal de-escalation and decrease the rate of physical interventions used in the MHED. The change …


Academic Stress Examination And Its Sources Among Saudi Students In The United States, Nawaf Alshammari Jan 2021

Academic Stress Examination And Its Sources Among Saudi Students In The United States, Nawaf Alshammari

Online Theses and Dissertations

Academic stress has been identified as one of the major concerns in current academic circles. Academic stress is an example of mental distress associated with anticipation or awareness of academic failure and/or the result of being in a given educational facility or pursuing academic work. Academic stress is a major concern because its effects are pervasive and have serious consequences. Research has shown that mental disorders, physical challenges, substance abuse and high rates of drop-outs are attributed to academic stress. Research has shown that the level of academic stress is highest amongst university students in general and international students in …


The Impact Of Mindfulness On Mental And Emotional Health, Physical Fitness, And Academic Performance, Melanie B. Smith Jan 2021

The Impact Of Mindfulness On Mental And Emotional Health, Physical Fitness, And Academic Performance, Melanie B. Smith

Online Theses and Dissertations

Past research has indicated promising results with mindfulness and mental health. This study examines the relationship between mindfulness and mental health, physical fitness, and academic performance for middle and high school students enrolled in health and physical education courses. The Calm app was utilized in part of the Calm Schools Initiative. (n.d.) as part of the intervention. The treatment group took part in mindfulness activities twice per week for the duration of the study. Measurers were recorded using the Mindful Attention Awareness Scale – Adolescents (Brown, West, Loverich, & Biegel, 2011), Perceived Stress Scale (Cohen, Karmarck, & Mermelstein, 1983), Patient …


The Rise In Use Of Emotional Support Animals By College Students: The Impact Of Parenting Styles, Misty G. Smith, Samantha Ballard, Jill Willis Jan 2021

The Rise In Use Of Emotional Support Animals By College Students: The Impact Of Parenting Styles, Misty G. Smith, Samantha Ballard, Jill Willis

Journal of Higher Education & Student Affairs

As the generational context of higher education shifts, a rise of Emotional Support Animals (ESA) and mental health concerns are present for students on college campuses. While previous studies have aimed to address the relevancy and controversy of ESAs in higher education as well as their effectiveness in supporting individuals, less research has explored underlying factors that contribute to the use of an ESA. The purpose of this study was to explore the parenting behaviors of parents/caregivers of students with ESAs in comparison to parents/caregivers of students without ESAs. An embedded mixed methods design was used. Participants completed the Parenting …


Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich Jan 2021

Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich

Walden Dissertations and Doctoral Studies

When working with patients who have the potential to become physically aggressive, verbal de-escalation is an important technique that can defuse a dangerous situation. At the project site in the mental health emergency department (MHED), workplace violence was on the rise based on the reported use of physical interventions (rates of brief holds and physical restraint use). The purpose of this quality improvement evaluation project was to determine whether an educational training program on verbal de-escalation techniques would increase staff's confidence in the use of verbal de-escalation and decrease the rate of physical interventions used in the MHED. The change …


The Crossroads Of Wellness And Second Victim Syndrome: Identifying Factors That Alter The Pathway Of Caregiver Recovery Following An Unanticipated Adverse Patient Outcome, Kimia Zarabian, A. Katharine Hindle, Ivy Benjenk, Anita Vincent, Jamil M. Kazma, Benjamin Shambon, Raymond Pla, Eric Heinz Dec 2020

The Crossroads Of Wellness And Second Victim Syndrome: Identifying Factors That Alter The Pathway Of Caregiver Recovery Following An Unanticipated Adverse Patient Outcome, Kimia Zarabian, A. Katharine Hindle, Ivy Benjenk, Anita Vincent, Jamil M. Kazma, Benjamin Shambon, Raymond Pla, Eric Heinz

Journal of Wellness

Introduction: Second Victim Syndrome (SVS) describes the phenomenon in which a caregiver experiences a traumatic psychological and emotional response to an adverse patient event or medical error. Using quantitative survey analysis, we aim to better understand the personal factors that affect SVS development and recovery.

Methods: Caregivers at a small urban academic medical center who had experienced an adverse patient event in the past six months were invited to take part in this institution-wide, voluntary, quantitative, cross-sectional study. Three surveys were administered; the Holmes-Rahe Life Stress Inventory (HRLSI) was used as a surrogate to measure stressful life events. The …


Workplace Violence: An Urgent Call For Integrated Staff Education In Acute Care Hospitals, Nicole Bellisario Dec 2020

Workplace Violence: An Urgent Call For Integrated Staff Education In Acute Care Hospitals, Nicole Bellisario

Doctor of Nursing Practice (DNP) Projects

Problem: Type II workplace violence (WPV) in acute care hospital settings has become an epidemic of costly proportions in the United States. Regulatory mandates and healthcare accreditation standards increasingly require healthcare employers to provide a safe and healthy healing environment for patients and a safe work environment for staff. Implementation of a comprehensive WPV prevention program depends largely on organizational culture, participation and commitment from key stakeholders, and readiness for change.

Context: The patient-clinician relationship has drawn urgent attention, as healthcare organizations around the world implement key components of WPV prevention programs. The clinical management of patient aggression …


Promoting Resident Emotional Health Meaningful Connections: An Evaluation Of A Wellness Game, Bruce St. Amour, William B. Dehart Sep 2020

Promoting Resident Emotional Health Meaningful Connections: An Evaluation Of A Wellness Game, Bruce St. Amour, William B. Dehart

Journal of Wellness

Introduction

Physician wellness is a topic of significant national interest. Physician burnout is at its highest point during residency and is linked to many negative outcomes. The Core Emotional Needs are a useful framework to guide thinking toward wellness in residents: connection and acceptance, healthy autonomy and performance, reasonable limits, and healthy responsibility and standards. We examined the efficacy of a game (“Well, For Me…”) designed to improve social connection and acceptance among residents to reduce social isolation. We hypothesized that this activity would be viewed positively by the residents as an intervention to improve resident wellness.

Methods

Participants …


Overcoming Challenges In The Assessment And Treatment Of Problem Behavior In Adults With Autism, Julia A. Iannaccone Sep 2020

Overcoming Challenges In The Assessment And Treatment Of Problem Behavior In Adults With Autism, Julia A. Iannaccone

Dissertations, Theses, and Capstone Projects

Problematic behaviors, such as self-injurious behavior or aggression, demonstrated by adults with autism spectrum disorder (ASD), create many significant life complications, some life-threatening. Applied Behavior Analysis (ABA) is established as an evidence-based approach to treat problem behavior for children with ASD and shows promise as an effective treatment for adults, yet little research has been conducted within the adult population. Assessment and treatment of problem behavior with adults is often challenging due to funding limitations, increased severity and complexity of problem behavior, and underqualified staff. The purpose of the present study was to overcome these challenges by (1) identifying a …


Optimist Prime- Emergency Medicine Residents Are An Optimistic Group, Nicole Battaglioli, Sarah Mott, Tim P. Moran, Simiao Li-Sauerwine, Matt Melamed Jul 2020

Optimist Prime- Emergency Medicine Residents Are An Optimistic Group, Nicole Battaglioli, Sarah Mott, Tim P. Moran, Simiao Li-Sauerwine, Matt Melamed

Journal of Wellness

Introduction: No study before has been conducted looking at the level of optimism and pessimism in emergency medicine residents and how it may be linked to resident burnout. This is the first national- level assessment of these personality factors.

Methods: This was a prospective survey study leveraging data obtained through the 2017 National Emergency Medicine Resident Wellness Survey, which included the Life Orientation Test-Revised (LOT-R). The Life Orientation Test-Revised (LOT-R) is a 10-item tool that measures levels of optimism versus pessimism.

Results: We found that the majority of our resident respondents scored in the moderate category of the LOT-R. Additionally, …


The Influence Of Instructor Mental Illness Disclosure On The Perceptions Of Mental Illness, Classroom Climate, Teacher Credibility, Homophily, And Social Attraction, Kirsten L. Bridgemen Jul 2020

The Influence Of Instructor Mental Illness Disclosure On The Perceptions Of Mental Illness, Classroom Climate, Teacher Credibility, Homophily, And Social Attraction, Kirsten L. Bridgemen

Theses and Dissertations

This study uses the lens of Communication Privacy Management theory to analyze the impact an instructor’s depth of disclosure of their mental illness can have on mental illness stigmatization, classroom climate, as well as teacher credibility, homophily, and social attraction. Participants responded to a series of quantitative-based questions regarding a hypothetical syllabus with varied levels of a teacher disclosing their mental illness. Results indicated that none of the investigated dependent variables were negatively affected by the hypothetical instructor’s disclosure, and mental illness stigmatization was lessened. Implications, limitations, and areas for future research are discussed.


Perspective: Responding To The Well-Being Of Health Care Workers And Learners In Academic Medicine During The Covid-19 Pandemic, Cherie C. Hill, Paula G. Gomes, Alayna H. Feng, Cricket C. Gullickson, Carla I. Haack, Sheryl L. Heron Jul 2020

Perspective: Responding To The Well-Being Of Health Care Workers And Learners In Academic Medicine During The Covid-19 Pandemic, Cherie C. Hill, Paula G. Gomes, Alayna H. Feng, Cricket C. Gullickson, Carla I. Haack, Sheryl L. Heron

Journal of Wellness

No abstract provided.


Ethical Considerations For Outpatient Behavioral Healthcare In North Texas, Carolyn B. Guillory Jul 2020

Ethical Considerations For Outpatient Behavioral Healthcare In North Texas, Carolyn B. Guillory

All Theses And Dissertations

The purpose of this Interpretative Phenomenological Analysis (IPA) study was to examine caregivers’ perceptions of practices for outpatient behavioral health care. Effort was made to gain insight into the components of ethical service delivery. Significant data on the providers’ perceptions of care was identified in literature reviews, though it was not the case for perspectives of consumers or caregivers. This population has been identified as one which is likely to experience unaffordable, fragmented, and confusing behavioral health systems (Baker, 2015). Attempts to inform research by addressing the quality of treatment was a focus. The Research Problem: Since 2016, the suicide …


Long-Term Impact Of Child-Centered Play Therapy On Academic Achievement: A Longitudinal Examination Of Academic Success In At-Risk Elementary School Students, Brittany D. Massengale Jul 2020

Long-Term Impact Of Child-Centered Play Therapy On Academic Achievement: A Longitudinal Examination Of Academic Success In At-Risk Elementary School Students, Brittany D. Massengale

Graduate Theses and Dissertations

This study examined the long-term impact of child-centered play therapy (CCPT) implemented through Primary Project on at-risk second-grade elementary school students. The qualifying group received ten 30-minute play therapy sessions during one academic semester during their second-grade year. In a longitudinal analysis for academic growth, MAP testing was used to determine if there was a long-term impact on both the third grade and fourth-grade years for the original qualifying students. The findings reveal implications for identification of and interventions for at-risk elementary students and CCPT as an intervention for academic achievement; specifically, reading and mathematics scores. Recommendations for future research …