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Articles 751 - 780 of 3145
Full-Text Articles in Psychiatric and Mental Health
On Versus Off-Campus Living: An Exploration Of College Students' Mental Well-Being, Sameer Siddiqui
On Versus Off-Campus Living: An Exploration Of College Students' Mental Well-Being, Sameer Siddiqui
Theses/Capstones/Creative Projects
The World Health Organization defines mental health as “a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community” (“Mental Health,” 2022). Risk and protective factors can be used to predict mental health outcomes. Both positive and negative outcomes can be predicted, respectively. The categories of these include individual, relationship, community, and societal. When examining college students, it is most reasonable to study the relationship and community factors. This study examined whether living on or off campus impacts predicted mental health outcomes in …
Considerations And Strategies For Incorporating Lived Experience In Mental Health Research, Elizabeth Bernier, Elias Peirce, Elizabeth M. Mutina, Saras Yerlig, Kristen A. Woodberry
Considerations And Strategies For Incorporating Lived Experience In Mental Health Research, Elizabeth Bernier, Elias Peirce, Elizabeth M. Mutina, Saras Yerlig, Kristen A. Woodberry
Costas T. Lambrew Research Retreat 2023
Introduction: Incorporating lived experience in mental health research deserves special focus due to the unique stigma faced by those with lived experience and the unique gap between the experience and expression of mental health struggle.
Strengthening The Understanding Of South Partnerships And Rigor In Addressing Social Determinants Of Child And Adolescent Mental Health, Manasi Kumar
Brain and Mind Institute
The Journal of Adolescent Health's current supplement presents the work of a highly active team of researchers who are focusing on developing a strong body of evidence around child and adolescent mental health in Sub-Saharan Africa. The supplement lays out scholarship generated through years of partnership between researchers based in the United States—some of whom are from Sub-Saharan context, specifically Uganda—in connecting applied social work, community mental health for children and adolescents, and family development. The work comprises a series of articles embedded within several National Institutes of Health–funded grants by authors based in the United States in partnership with …
A Research Review Of Antidepressants For The Treatment Of Major Depressive Disorder, Connor Grady
A Research Review Of Antidepressants For The Treatment Of Major Depressive Disorder, Connor Grady
Senior Honors Theses
The prevalence of major depressive disorder (MDD) in the U.S. has been significantly on the rise between 2015 and 2020, with adolescents and young adults (ages 18-34) contributing the most to this increase (Goodwin et al., 2022). The trend represents a disturbing downturn in the mental health of U.S. adults and warrants close attention and consideration. As the case number of MDD has continuously risen in the recent past, medical practitioners have been searching for more effective solutions. The techniques for combating the symptoms and curing the disease have varied, but one option consistently respected throughout the literature has been …
From Inpatient Facility To The Everyday Classroom - Examining The Process Of Reintegration For Arkansas Youths, Grace Webb
Honors Theses
This thesis focuses on analyzing the current policies set in place within the state of Arkansas for student reintegration following a prolonged absence from school due to mental health issues. It is designed to explore what barriers and disconnections there are between mental health care and continued care after discharge of youths from an inpatient mental health facility and re-entry into the classroom. Within this thesis, current conditions impacting youth mental health and education are explored, as well as current school counseling plans throughout four school districts in various regions across the state. To my knowledge gathered from my findings, …
Therapists’ Observations In Reduction Of Unpleasant Emotions Following Advanced Integrative Therapy Interventions, Gregory Brown, Kavita Batra, Suzie Hong, Robert Sottile, Raveena Bakhru, Emily Dorin
Therapists’ Observations In Reduction Of Unpleasant Emotions Following Advanced Integrative Therapy Interventions, Gregory Brown, Kavita Batra, Suzie Hong, Robert Sottile, Raveena Bakhru, Emily Dorin
Psychiatry & Behavioral Health Faculty Research
Energy Psychology has evolved into a general field with hundreds of research studies to support efficacy: these range from RCTs to functional brain imagery, to physiological correlates, to meta-analyses. The vast majority of research within EP has been focused on the Emotional Freedom Technique (EFT) authored by Gary Craig, PhD.
Advanced Integrative Therapy: Origins, Research, Theory, And Practice, Gregory P. Brown, Elizabeth V. Pace, Tabatha Bird Weaver
Advanced Integrative Therapy: Origins, Research, Theory, And Practice, Gregory P. Brown, Elizabeth V. Pace, Tabatha Bird Weaver
Psychiatry & Behavioral Health Faculty Research
Advanced Integrative Therapy (AIT) is a novel therapy grounded in Energy Psychology combined with cognitive and somatic therapy techniques. As more research is being conducted into the efficacy of AIT and other trauma-based therapies, there is a need to define the modality more clearly for researchers, the clinical community, and potential clients. This article aims to discuss the theory behind AIT and its mechanism of action, compare it with other somatic trauma and Energy Psychology techniques, and explore the gap in the available data and knowledge of AIT. Additionally, a case study will be discussed to report on the potential …
Surviving The Stigma: Incorporating Mental Health Literacy To Increase Help-Seeking In California First Responders, Yvonne C. Newson
Surviving The Stigma: Incorporating Mental Health Literacy To Increase Help-Seeking In California First Responders, Yvonne C. Newson
Master's Projects and Capstones
First responders are at risk of developing mental health problems due to repeated exposure to traumatic incidents, increasing their chance of developing Post Traumatic Stress Disorder, substance abuse, suicidal ideation, and suicide. Unfortunately, first responders do not recognize that they may have a mental illness and are reluctant to seek help. This paper will discuss the prevalence of mental health problems among first responders and the barriers to their help-seeking. These barriers include the stigma around mental illness within the culture, the assessability of professional help, and the lack of mental health literacy regarding their well-being. Further discussion will focus …
Ga(Y)Zing Backward: Queer Desire In Ovid, Shakespeare, And Scaimma, Falynn Blayre Brickler
Ga(Y)Zing Backward: Queer Desire In Ovid, Shakespeare, And Scaimma, Falynn Blayre Brickler
UNLV Theses, Dissertations, Professional Papers, and Capstones
As Ovidian myth is a central influence on queer stories throughout time, I am interested in how the female/sapphic gaze impacts the retellings of these narratives. In this thesis, I analyze the action of the gaze as an expression of desire and discuss its multiple meanings in both text and performance. Through tracing the gaze within the queer/sapphic narratives of Shakespeare’s Twelfth Night and Sciamma’s Portrait of a Lady on Fire, I show that the gaze is an intersecting act through which non-normative desire is conveyed. In constructing the gaze as an ephemeral action of queer desire in practice, I …
Rated T For Therapy: How Video Games Portray Mental Illness And Their Effects On Social Stigmas, Christine Wendell
Rated T For Therapy: How Video Games Portray Mental Illness And Their Effects On Social Stigmas, Christine Wendell
All Theses
Mental illness has always been a tricky subject for us to tackle as a society due to the social stigmas surrounding it. Historically, people with mental illness were seen as violent and unstable and would often need to be committed for public safety; however, a large majority of people with mental illness do not fit that bracket and often don’t reach out for help due to that fear of being “othered” by society. As time went on, these tropes faded to purely entertainment mediums but the stigmas still remain. Many video games specifically hold onto these tropes for shock value …
Reducing The Mental Health Treatment Gap In Kashmir: Scaling Up To Maximise The Potential Of Telepsychiatry, Arshad Hussain, Bhupinder Kumar, Manasi Kumar, Fazle Roub
Reducing The Mental Health Treatment Gap In Kashmir: Scaling Up To Maximise The Potential Of Telepsychiatry, Arshad Hussain, Bhupinder Kumar, Manasi Kumar, Fazle Roub
Brain and Mind Institute
No abstract provided.
Mental Health Awareness Month Display, Isabella Piechota, Arianna Tillman, Kalea Brown
Mental Health Awareness Month Display, Isabella Piechota, Arianna Tillman, Kalea Brown
Library Displays and Bibliographies
A bibliography created to accompany a display about Mental Health Awareness Month in May 2023 at the Leatherby Libraries at Chapman University.
The Effectiveness Of Targeted Education On Improving Nurses’ Self-Efficacy In Caring For Psychiatric Patients On Medical Surgical Units, Rachel Shirey
The Effectiveness Of Targeted Education On Improving Nurses’ Self-Efficacy In Caring For Psychiatric Patients On Medical Surgical Units, Rachel Shirey
Doctor of Nursing Practice Scholarly Projects
Individuals with mental illness are occasionally hospitalized on medical units, specifically medical-surgical units. Nurses working on medical-surgical units may find patients with mental illness more challenging due to the complexity of care they sometimes require. Nurses’ perceived ability to provide quality care for these patients is reduced in comparison to their perceived ability to care for patients without mental illness. Consequently, low self-efficacy can result in the provision of a lower quality of care for this population. The purpose of this quality improvement project was to improve the care that patients with mental illness receive while hospitalized on medical-surgical units. …
A Model To Integrate Mental Health Services With Gynecological Care, Simerjeet Singh, Theresa A. Moore, Hannah White
A Model To Integrate Mental Health Services With Gynecological Care, Simerjeet Singh, Theresa A. Moore, Hannah White
Undergraduate Research Symposium
Half of the world’s population experiences changes in life relating to gynecological health which may involve stigmatized conditions. Stigma is defined as unfavorable societal beliefs about a topic which impacts healthcare significantly. Menopause is a stage 12 months after a woman’s last menstrual cycle and the menopausal transition (MT) is the years leading up to this stage. Symptoms of MT may include night sweats and hot flashes accompanied by psychological changes. Postpartum depression (PPD) is a mental health condition that one in seven women experience after having a baby. PPD may occur during the first six months after delivery when …
Interaction Between Fluoxetine And Risperidone And Its Association With Clinical Outcomes In Schizophrenic Patients, Fitri Rachmaini, Dian Ayu Juwita, Rahmad Abdillah, Rezy Dwi Afrianti, Fatma Sri Wahyuni
Interaction Between Fluoxetine And Risperidone And Its Association With Clinical Outcomes In Schizophrenic Patients, Fitri Rachmaini, Dian Ayu Juwita, Rahmad Abdillah, Rezy Dwi Afrianti, Fatma Sri Wahyuni
Pharmaceutical Sciences and Research
The concurrent use of fluoxetine and risperidone to treat schizophrenia may result in drug interactions. This study aims to analyse the clinical outcomes of fluoxetine-risperidone therapy and the possibility of their interaction in schizophrenic patients. The clinical outcomes are patient status at the time of hospital discharge, the length of hospitalisation and the Positive and Negative Syndrome Scale- Excitement Component (PANSS-EC). This study was conducted prospectively in psychiatric ward of HB Saanin Mental Hospital from May to October 2021 and study subjects were selected using consecutive sampling technique with inclusion criteria. Forty-three patients were eligible for this study. Research data …
A Retrospective Comparison Of The Effectiveness Of Buprenorphine Versus Baclofen For Acute Opioid Withdrawal, Matthew Hermenau, Benton Stamper, Kitty Leung, Raymond Pomm, Christina Guerrier, Joseph Cammilleri, Brittany Johnson
A Retrospective Comparison Of The Effectiveness Of Buprenorphine Versus Baclofen For Acute Opioid Withdrawal, Matthew Hermenau, Benton Stamper, Kitty Leung, Raymond Pomm, Christina Guerrier, Joseph Cammilleri, Brittany Johnson
HCA Healthcare Journal of Medicine
Background
A significant impediment to opioid cessation or dose reduction is mitigating withdrawal severity that has been shown to affect the course of opioid dependence. Current guidelines recommend the use of buprenorphine and methadone over alpha-2 adrenergic agonists. Baclofen, a GABA-B agonist, has promising results as an adjunct agent for opioid withdrawal but has not been compared to buprenorphine. This study compared the ability of buprenorphine and baclofen to mitigate acute opioid withdrawal.
Methods
This was a single-center, retrospective chart review of 63 patients with diagnosed opioid use disorder that received scheduled buprenorphine or baclofen for 3 days, in addition …
The Impact Of Nutrition On The Mental And Physical Health Of Young Adults, Dareena El-Far
The Impact Of Nutrition On The Mental And Physical Health Of Young Adults, Dareena El-Far
WRIT: Journal of First-Year Writing
Upon close examination by nutritional professionals, concern has arisen regarding the typical contents of a young adult diet. In terms of the rate at which young adults choose to consume nutritionally-dense food items, the rate at which nutrition-deficient junk food items are chosen over the former is significantly higher. Among further examinations of this issue by researchers, it has become evident that the nutritional decisions made by young adults are increasingly associated with several social, commercial, mental, educational, and economic influences. As a consequence of these factors, research has uncovered a connection between the consumption of a poor diet and …
Mental Health In M*A*S*H: An Analysis Of The Changing Portrayal Of Mental Health Topics In The 1970s And Early 1980s, Lyndsey Clark
Mental Health In M*A*S*H: An Analysis Of The Changing Portrayal Of Mental Health Topics In The 1970s And Early 1980s, Lyndsey Clark
Departmental Honors & Graduate Capstone Projects
This paper studies all eleven seasons of the hit television show M*A*S*H (1972-1973) and examines how the portrayal of mental health changed in the show’s plotlines in response to changing guidelines and mental health policy in the 1970s and early 1980s. This study focuses on the association of mental illness with homosexuality, the changes made to the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) in the 1970s and early 1980s, the rise and fall of mental health policies from the Kennedy Administration to the Reagan Administration, and the portrayal of several pertinent mental conditions, such as …
Wellness Review 2022, Part 2, Martin Huecker, Brian A. Ferguson, Jacob Shreffler
Wellness Review 2022, Part 2, Martin Huecker, Brian A. Ferguson, Jacob Shreffler
Journal of Wellness
Introduction: Similar to prior reviews, the Journal of Wellness editors searched the literature from the second half of 2022 for an interesting and impactful selection of publications on wellness in healthcare professionals.
Methods: Editors conducted a standard keyword search in Pubmed, focusing chiefly on large journals, interventional trials, and other prospective research. We included papers published between July 1, 2022 and December 31, 2022.
Literature in Review: Finding several hundred publications, we excluded editorials, reviews, and some smaller, less generalizable papers. A final 25 significant studies focusing on wellness in medical professionals were sorted into the following categories: logistics, creativity …
Recurrent Pregnancy Loss - A Life Changing Condition For Women, Denisa Oana Balalau, Fernanda-Ecaterina Augustin, Delia-Maria Bogheanu, Alin-Gabriel Negulescu, Romina-Marina Sima, Anca Silvia Dumitriu, Stana Paunica, Liana Ples
Recurrent Pregnancy Loss - A Life Changing Condition For Women, Denisa Oana Balalau, Fernanda-Ecaterina Augustin, Delia-Maria Bogheanu, Alin-Gabriel Negulescu, Romina-Marina Sima, Anca Silvia Dumitriu, Stana Paunica, Liana Ples
Journal of Mind and Medical Sciences
Recurrent pregnancy loss (RPL) is estimated to occur in 2.5% of women trying to conceive. Definition of RPL varies depending on used guideline. In Europe, RPL is defined as two or more lost pregnancies before 24 weeks’ gestation. Although many factors have been associated with a higher risk of recurrent miscarriage, the aetiology is unknown in about half of cases. Several factors have been related to recurrent pregnancy loss, such as: environmental, behavioral, genetic, endocrine, metabolic, autoimmune, anatomic, thrombophilia and male factor. Given the multitude of etiopathogenic factors, RPL frequently requires an interdisciplinary approach for diagnosis and treatment. By its …
The Relationship Between Quality Of Life And Functionality In Patients With Schizophrenia – A Preliminary Report, Vlad Dionisie, Mihnea Costin Manea, Manea Mirela, Lavinia Steluta Bonciu, Sorin Riga, Maria Gabriela Puiu
The Relationship Between Quality Of Life And Functionality In Patients With Schizophrenia – A Preliminary Report, Vlad Dionisie, Mihnea Costin Manea, Manea Mirela, Lavinia Steluta Bonciu, Sorin Riga, Maria Gabriela Puiu
Journal of Mind and Medical Sciences
This research aimed to investigate the relationship between quality of life and level of functioning in a group of Romanian patients with schizophrenia. A cross-sectional, observational, prospective study on 47 patients with schizophrenia was conducted. Socio-demographic and clinical data were documented and WHOQOL-BREF and Life Skills Profile-16 instruments were further administered. To examine the correlation between variables, Person correlation test was employed. The mean age of the sample was 38.32±12.32 years and 66% of the patients were males. Significant correlations were found between all aspects of the quality of life (physical health, psychological, social relationships and environmental health) and total …
Postpartum Depression; Associated Factors And Underdiagnosis, Andra Iancu, Valeria-Anca Pietrosel, Teodor Salmen, Cristina Ioana Bica, Ioana Păunică, Liliana Florina Andronache, Florentina Gherghiceanu, Cecilia Curis
Postpartum Depression; Associated Factors And Underdiagnosis, Andra Iancu, Valeria-Anca Pietrosel, Teodor Salmen, Cristina Ioana Bica, Ioana Păunică, Liliana Florina Andronache, Florentina Gherghiceanu, Cecilia Curis
Journal of Mind and Medical Sciences
Post-partum depression is one of the most severe types of depression and can be developed at any age, no matter of cultural of social status. Objectives. To determine the factors associated with the psychological impact of pregnancy and to emphasize the psychological and psychiatric risks after giving birth for a woman. Materials and Methods. The study enrolled 35 patients diagnosed with postpartum depression that have been hospitalized in a tertiary-care center for psychiatric disorders between 2016 and 2020. Data were collected from patients’ observation charts. Results. The incidence of postpartum depression is higher in the age range 30-45 years old …
Dental Fear, Anxiety, And Phobia – Behavioral Management And Implications For Dentists, Nadya Tsetsova Avramova
Dental Fear, Anxiety, And Phobia – Behavioral Management And Implications For Dentists, Nadya Tsetsova Avramova
Journal of Mind and Medical Sciences
Clinical management of patients with dental fear, anxiety, and phobia could be a major challenge to daily practice of dental professionals. The aim of the current review was to expand the modern consideration with respect to these issues, and therefore to discuss basic approaches and psychological techniques for management of oral health behaviors that should be employed in dentistry. This paper presents detailed description of the characteristics of dentist-patient therapeutic relationship as well as the most used techniques to cope with dental fear, anxiety, and phobia - relaxation techniques, cognitive-behavioral therapy (CBT), hypnosis and melotherapy. We can still argue that …
Management Of Anxiety And Depression In Post Coronary Artery Bypass Graft Surgery, Mansour Jannati, Amir Aslani
Management Of Anxiety And Depression In Post Coronary Artery Bypass Graft Surgery, Mansour Jannati, Amir Aslani
Journal of Mind and Medical Sciences
Depression and anxiety are common events in 30-40 percent of post coronary artery bypass graft (CABG) surgery patients. Depression symptoms in patients with CAD are expected to be significantly more, comparing the public incidence rate. Impaired remedy after coronary artery events may partly be attributed to depression and anxiety. If anxiety continues, it may lead to elevate metabolism and oxygen consuming. High level of anxiety increases the pain sensation in post CABG patients. This paper aimed to review results and findings of previous studies in the field of anxiety and depression management of post coronary artery bypass graft surgery. Up …
Anxio-Depressive Disorders In A Pandemic Context: A Comparative Analysis: Year 2019 Versus 2020, Andreea Roxana Droahnă, Lavinia-Alexandra Moroianu, Valeria-Anca Pietroșel, Cristina Ioana Bica, Teodor Salmen, Cecilia Curis, Emanuele Maria Merlo, Roxana Adriana Stoica, Marius Moroianu
Anxio-Depressive Disorders In A Pandemic Context: A Comparative Analysis: Year 2019 Versus 2020, Andreea Roxana Droahnă, Lavinia-Alexandra Moroianu, Valeria-Anca Pietroșel, Cristina Ioana Bica, Teodor Salmen, Cecilia Curis, Emanuele Maria Merlo, Roxana Adriana Stoica, Marius Moroianu
Journal of Mind and Medical Sciences
The outbreak of SARS-CoV-2 pandemic has resulted in increased rates of anxiety and depression worldwide. Objective. To comparatively evaluate factors associated with the psychological impact of Coronavirus disease between 2019 and the pandemic year 2020. Materials and Methods. The study was performed on a group of 3224 patients, of which 197 were hospitalized, selected from Jan 1st 2019 until 30th Dec 2020 in a tertiary care center for psychiatric disorders. Data were collected from the observation charts. Results. The incidence of anxiety disorders is higher in the age range 40-70 years with an average value of 53 years old. In …
A Phenomenological Take On Mirror Self-Face Perception In Schizophrenia, Giovanni Pennisi
A Phenomenological Take On Mirror Self-Face Perception In Schizophrenia, Giovanni Pennisi
Journal of Mind and Medical Sciences
Studies concerning social deficits in schizophrenia has often been restrained to exploring facial recognition. Various investigations have shown that those diagnosed with schizophrenia have difficulties in perceiving the identities and emotions of those around them merely through observing their facial features. A few others have also taken into account the issue of self-face recognition in individuals with schizophrenia, finding that their capacity to associate photos or videos of their own face to themselves is hindered due to the illness. However, to my knowledge, only a few studies have so far delved into the intricacies of how individuals with schizophrenia or …
Targeting The Gap In Mental Health Advocacy For First-Year College Students, Hailey Kurtz
Targeting The Gap In Mental Health Advocacy For First-Year College Students, Hailey Kurtz
Honors Projects
The transition from high school to attending a university has been shown to have an impact on the mental health and well-being of first-year university students. First-year students struggle with anxiety and depression in relation to being in a new environment, feeling lonely, fitting in, and taking more academically rigorous coursework. Current students have an awareness of what mental health and well-being resources on their campus are available to them, but such resources are not widely used, though a majority of students indicate that they do or have struggled with their mental health. This indicates that though students are struggling …
The Utilization Of Depression Screening Tools In Patients With Diabetes Type 2, Hanna Book, Kennedy Eldridge, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Artangela Henry Dnp, Agacnp-Bc, Fnp-C, Laura Reed Dnp, Fnp-Bc
The Utilization Of Depression Screening Tools In Patients With Diabetes Type 2, Hanna Book, Kennedy Eldridge, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Artangela Henry Dnp, Agacnp-Bc, Fnp-C, Laura Reed Dnp, Fnp-Bc
Doctor of Nursing Practice Projects
Purpose/Background
Diabetes and depression are highly prevalent and concerning conditions impacting millions worldwide. Evidence-based guidelines recommend regular depression screening of individuals with type II diabetes (DM2) to appropriately diagnose and treat depression and proactively enhance clinical outcomes. The gold standard for determining depression in patients with chronic disease is the diagnostic clinical interview; however, many clinicians have turned to brief, self-reported screening tools such as the PHQ-2 and the PHQ-9 whose use are recommended by evidence-based guidelines. This study aims to assess the utilization of the PHQ-2 and PHQ-9 versus no screening on DM2 patients in a primary care setting. …
Case Series: Continued Remission Of Ptsd Symptoms After Discontinuation Of Prazosin, Christie Richardson, Jonathan Yuh, Jing Su, Martin Forsberg
Case Series: Continued Remission Of Ptsd Symptoms After Discontinuation Of Prazosin, Christie Richardson, Jonathan Yuh, Jing Su, Martin Forsberg
Rowan-Virtua School of Osteopathic Medicine Departmental Research
Post-traumatic stress disorder is a debilitating chronic illness that affects 6 out of 100 adults after a severe trauma. The alpha-adrenergic antagonist prazosin, which is prescribed off-label for flashbacks and nightmares due to trauma, is often continued indefinitely due to reports of symptoms returning upon discontinuation. There is no standard guidance for a trial of discontinuation of prazosin due to intolerance or side effects. In this case series, three patients are started on prazosin leading to remission of trauma-related symptoms, and symptoms continue to remit after treatment for an average of about 2 years followed by discontinuation of the medication. …
An Analysis Of Burnout And Wellness Of Healthcare Workers Based On Patient Population And Healthcare Worker Location, Spencer Brandenburg
An Analysis Of Burnout And Wellness Of Healthcare Workers Based On Patient Population And Healthcare Worker Location, Spencer Brandenburg
Undergraduate Theses
Healthcare workers, even with all of the positive work that they do, often suffer from increased burnout and decreased wellness/quality of life. This problem is not new and has been steadily worsening for many years, however, there are factors which impact burnout and wellness that have not been analyzed or have produced mixed results in prior burnout and wellness literature. There has been little to no research done on the impact of patient population demographics on burnout and wellness in healthcare workers, and the research analyzing the impacts of demographic healthcare worker location has consistently produced mixed results often based …