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Articles 1441 - 1470 of 2053
Full-Text Articles in Psychiatry and Psychology
Barriers To Epilepsy Care In Central Uganda, A Qualitative Interview And Focus Group Study Involving Plwe And Their Caregivers, Martha Sajatovic, Carol Blixen
Barriers To Epilepsy Care In Central Uganda, A Qualitative Interview And Focus Group Study Involving Plwe And Their Caregivers, Martha Sajatovic, Carol Blixen
Faculty Scholarship
Background: Epilepsy is a common neurological disease with substantial impact on the subject and their caretakers. This exploratory study identified barriers to care for persons living with epilepsy (PLWE) to develop a culturally acceptable nurse led self-management intervention for PLWE previously developed in the United States. Methods: The study involving 48 participants (31 PLWE and 17 caregivers) with in depth interviews and focus groups was conducted. We obtained insights into barriers to care in PLWE and their caregivers. Using a thematic analytic procedure emphasizing the dominant themes the qualitative responses were analyzed. Median age of PLWE was 24 years (IQR …
Identifying Depression In The National Health And Nutrition Examination Survey Data Using A Deep Learning Algorithm, Jihoon Oh, Kyongsik Yun, Uri Maoz, Tae-Suk Kim, Jeong-Ho Chae
Identifying Depression In The National Health And Nutrition Examination Survey Data Using A Deep Learning Algorithm, Jihoon Oh, Kyongsik Yun, Uri Maoz, Tae-Suk Kim, Jeong-Ho Chae
Psychology Faculty Articles and Research
Background
As depression is the leading cause of disability worldwide, large-scale surveys have been conducted to establish the occurrence and risk factors of depression. However, accurately estimating epidemiological factors leading up to depression has remained challenging. Deep-learning algorithms can be applied to assess the factors leading up to prevalence and clinical manifestations of depression.
Methods
Customized deep-neural-network and machine-learning classifiers were assessed using survey data from 19,725 participants from the NHANES database (from 1999 through 2014) and 4949 from the South Korea NHANES (K-NHANES) database in 2014.
Results
A deep-learning algorithm showed area under the receiver operating characteristic curve (AUCs) …
Autonomic Response In Autism Spectrum Disorder: Relationship To Social And Cognitive Functioning, Michelle A Patriquin, Elizabeth M Hartwig, Bruce H Friedman, Stephen W Porges, Angela Scarpa
Autonomic Response In Autism Spectrum Disorder: Relationship To Social And Cognitive Functioning, Michelle A Patriquin, Elizabeth M Hartwig, Bruce H Friedman, Stephen W Porges, Angela Scarpa
Staff and Researcher Publications
Individuals with autism spectrum disorder (ASD) may exhibit chronic autonomic nervous system (ANS) hyperarousal (e.g., lower respiratory sinus arrhythmia and higher heart rate) compared to their typically developing peers, reflecting a chronic biological threat response. The sustained nature of this cardiac threat suggests tonic nervous system perception of threat in safe contexts. Herein, the cardiac literature in adult and child populations with ASD is reviewed and placed within a continuum of functioning in order to inform the relationship between cardiac response and functioning in ASD. Findings from this review support the relationship between chronic autonomic hyperarousal and emotional and behavioral …
Brief Of Amicus Curiae 290 Criminal Law And Mental Health Law Professors In Support Of Petitioner's Request For Reversal And Remand, Kahler V. Kansas, 18-6135 (U.S. June 6, 2019), Paul F. Rothstein
Georgetown Law Faculty Publications and Other Works
Amici curiae are a group of philosophically and politically diverse law school professors and scholars in the fields of criminal law and mental health from a variety of disciplines who have been teaching and writing about the insanity defense and related issues throughout their careers. They include the authors of leading criminal law and mental health law treatises and casebooks and numerous important scholarly books and articles.
Amici believe this case raises important questions about principles of criminal responsibility, the integral role of the insanity defense in Anglo-American law, and the inadequacy of the “mens rea alternative” to the traditional …
Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney
Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney
Publications and Research
Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …
Get Engaged: Results Of Ncpg 2018 National Survey Of Gambling Attitudes & Experiences, Keith Whyte, Don Feeney
Get Engaged: Results Of Ncpg 2018 National Survey Of Gambling Attitudes & Experiences, Keith Whyte, Don Feeney
International Conference on Gambling & Risk Taking
The National Survey of Gambling Attitudes and Gambling Experiences (NGAGE) is the largest published survey of gambling participation and problems in the US. This unprecedented look into how Americans gamble, what they gamble, how they think about it in every state. Includes a special focus on sports gambling. Presenters will review the findings and implications for everyone involved in gambling issues.
Human Learning, Memory, And Student Development, Alan R. Erickson
Human Learning, Memory, And Student Development, Alan R. Erickson
Contemporary Issues in Educational Leadership
My educational interests have largely been informed by my career in the sciences and medicine. My professional education has been both formative and transformative, opening doors to the joy of learning and a realization in the importance of memory. As an educator, clinician, and student, I have been greatly impacted by issues of curricular design, curricular development, learning and memory. My current responsibilities in student affairs also have exposed me to the delicate balance between student development, curricular design, learning and memory. Patton, Renn, Guido, and Quaye (2016) noted the importance of educators being able to use different literature sources …
Do Not Miss Your Shot: Improving Follow-Up In Patients Receiving Long-Acting Injectable Medications, Mary O'Hara
Do Not Miss Your Shot: Improving Follow-Up In Patients Receiving Long-Acting Injectable Medications, Mary O'Hara
Doctor of Nursing Practice Final Manuscripts
Background: Serious mental illness including schizophrenia and bipolar disorder affects 1 in 24 adults in California. These chronic disorders are difficult to treat and often sabotaged by medication nonadherence. Long-acting injectable (LAI) medications are one strategy to combat medication nonadherence. Effectively providing treatment with LAI medications can be challenging at the clinic level.
Objectives: Reduce the number of days without medication by reducing the number of days between injection due date and injection administration for patients receiving LAI medications.
Design: Establish appointments for all injection visits. Standardize visit protocol for injection encounters to optimize provider time. Arrange immediate follow-up and …
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 …
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. …
Orthorexia Nervosa Among Collegiate Female Student-Athletes, Maryse Bard-Martel
Orthorexia Nervosa Among Collegiate Female Student-Athletes, Maryse Bard-Martel
Graduate Theses/Dissertations
Orthorexia nervosa (ON) is a specific style of disordered eating defined as an unhealthy obsession with eating healthy food, or going to extremes in the pursuit of a diet that is supposed to be good for you. The purpose of this study was to explore the prevalence of orthorexia nervosa tendencies in college female soccer players in the NCAA Division 1. Purposive sampling was used, and participants were current student-athletes from the Missouri State women’s soccer team (n=18). Survey research was utilized to assess athletes’ attitudes and behaviors related to various aspects of diet and training, and the control it …
Efficacy Of Integrated Mental Health Care With Dual Diagnosis Patients And Their Utilization Of Psychiatric Emergency Services, Denton Scott
Efficacy Of Integrated Mental Health Care With Dual Diagnosis Patients And Their Utilization Of Psychiatric Emergency Services, Denton Scott
Doctoral Dissertations
Historically, patients with dual diagnosis have been subjected to ineffective treatment and negative attitudes from healthcare providers. Further, these patients are plagued with myriad afflictions that exist beyond substance abuse and mental illness. The treatments and collateral damage associated with the diagnosis impose excessive healthcare costs and can be of significant detriment to society. Largely, patients suffering from dual diagnosis do not receive adequate treatment. As such, psychiatric emergency services are frequently utilized as an alternate treatment, wherein the main focus of care is on the substance abuse alone. This study argues that solely treating the substance abuse is not …
Trajectories Of Self-Reported Sleep Disturbance Across Inpatient Psychiatric Treatment Predict Clinical Outcome In Comorbid Major Depressive Disorder And Generalized Anxiety Disorder, Elizabeth M Hartwig, Katrina A Rufino, Cara A Palmer, Christopher Shepard, Candice A Alfano, Bella Schanzer, Sanjay J Mathew, Michelle A Patriquin
Trajectories Of Self-Reported Sleep Disturbance Across Inpatient Psychiatric Treatment Predict Clinical Outcome In Comorbid Major Depressive Disorder And Generalized Anxiety Disorder, Elizabeth M Hartwig, Katrina A Rufino, Cara A Palmer, Christopher Shepard, Candice A Alfano, Bella Schanzer, Sanjay J Mathew, Michelle A Patriquin
Staff and Researcher Publications
Background: As there has been a demonstrated link between sleep disturbance and suicide, the present study investigated the relationship between self-reported sleep disturbance during inpatient psychiatric treatment and clinical outcomes at discharge and six months post-discharge.
Methods: Participants were 2,970 adults receiving care in a long-term inpatient psychiatric hospital. Greater than 90% of inpatients reported at least mild sleep disturbance throughout treatment. Group-based trajectory modeling was used to determine patterns of sleep disturbance changes over time.
Results: Participants fit into distinct categories based on their trajectories of sleep problems across treatment: No Sleep Problems (10.3% of participants, no sleep problems …
An Introduction To Transformative Inquiry: Understanding Compelling And Significant Relationships For Personal And Societal Transformation, Mark L. Mccaslin, Kelly A. Kilrea
An Introduction To Transformative Inquiry: Understanding Compelling And Significant Relationships For Personal And Societal Transformation, Mark L. Mccaslin, Kelly A. Kilrea
The Qualitative Report
Transformative inquiry is a theoretical model designed to facilitate the inquiry of important and meaningful relationships that transform and potentiate us. Creswell (2007) described the essential elements of a research agenda: the axiological, ontological, epistemological, methodological, and rhetorical. Each carries with it assumptions that hold implications for practice and research. Transformative inquiry addresses all of these elements through considerations given to deep ecology, transdisciplinarity, integral meta-theory, heuristic research, and eudaimonistic philosophy, respectively. Transformative inquiry is an approach to understanding and fostering the full range of deep and meaningful relationships from the personal to the political, and beyond. It is a …
Affective Disturbance In Mild Cognitive Impairment, Jason Greenhagen, Emily Matusz, Sheina Emrani, David Libon, Sherry Pomerantz
Affective Disturbance In Mild Cognitive Impairment, Jason Greenhagen, Emily Matusz, Sheina Emrani, David Libon, Sherry Pomerantz
Rowan-Virtua Research Day
Mild cognitive impairment (MCI) is an identifiable, prodromal stage of cognitive impairment and has been further defined into subtypes: amnestic, language, executive functioning, and multi domain/mixed MCI (Jak et al. 2009 ). The purpose of this study is to (1) examine the differences in depression, anxiety, and apathy between MCI subtypes; and (2) assess the relationship between the neurocognitive domains (executive functioning, language, and memory and affective symptoms. We hypothesize that apathy will be greater in dysexecutive/mixed MCI (dys/mixed MCI) and be more highly correlated to neurocognitive deficits compared to depression or anxiety. This is a retrospective study of 113 …
Survey Of Primary Care Physicians’ And Pediatricians’ Competency In Identifying Prodromal Symptoms In Schizophrenia And Psychotic Disorders, Mark Shephard, Joanna Petrides
Survey Of Primary Care Physicians’ And Pediatricians’ Competency In Identifying Prodromal Symptoms In Schizophrenia And Psychotic Disorders, Mark Shephard, Joanna Petrides
Rowan-Virtua Research Day
• To address whether primary care physicians and pediatricians are equipped to recognize the prodromal symptoms of psychotic disorders
• Patients of primary care physicians exhibited increased help seeking behaviors prior to schizophrenia diagnosis [1]
• Primary care physicians in numerous countries have shown a lack of sufficient knowledge related to diagnosing and treating schizophrenia [2,3,4,5,6]
• Unclear if primary care physicians in the United States are adequately trained and prepared to recognize prodromal signs of schizophrenia, and diagnose and treat a variety of psychotic disorders
Development Of A School Boredom Proneness Scale For Children, Taylor Carrington
Development Of A School Boredom Proneness Scale For Children, Taylor Carrington
Educational Specialist, 2009-2019
One common phrase heard from students is, “I’m bored.” However, there is no real understanding of what this actually means. In this study, elementary-age students were asked to respond to a newly developed School Boredom Proneness Scale (SBPS) including questions relating to a five-factor model of boredom. Students were also asked to rate how often they become bored at school and how bored they seem compared to classmates. In addition to student responses, parents and teachers were asked to rate how bored they thought the student was, and teachers were additionally asked to rate students’ level of work completion. The …
Understanding The Help-Seeking Behaviors Of Student-Athletes: Effect Of A Multidisciplinary Healthcare Team And The Perception Of Barriers And Facilitators For Seeking Help, Lauren M. Sander
Masters Theses, 2010-2019
This study was aimed at identifying barriers and facilitators that influence help-seeking as well as the effect of implementing an integrated healthcare approach based on current recommendations. A total of 411 student-athletes from 18 intercollegiate teams at a mid-major Division I institution in the mid-Atlantic region completed a 12–item instrument comprised of ten quantitative items and two open-ended questions. The quantitative data was analyzed using SPSS software, and a constant comparative method was used to code responses from the open-ended questions. Findings suggested a prevalence of mental health challenges among student-athletes, especially overwhelming stress, struggles with time management, and anxiety. …
The Effects Of A Dementia Simulation Experience On Attitudes Towards People With Dementia, Micah Huckabee
The Effects Of A Dementia Simulation Experience On Attitudes Towards People With Dementia, Micah Huckabee
Health, Human Performance and Recreation Undergraduate Honors Theses
Introduction: The neurodegenerative effects of dementia resulting in cognitive and behavioral impairments is plausibly one of the reasons for a societal stigma towards individuals with dementia. Societal stigmas are associated with decreased life satisfaction, depressive symptoms, and decreased psychological well-being for stigmatized individuals. In an effort to improve attitudes towards individuals with dementia, this study utilized a dementia simulation to measure attitudinal changes after a dementia simulation. Methods: There were 33 participants in this study (13 male and 20 female) between the ages of 18 and 25. Participants completed a Dementia Attitudes Scale (DAS) survey, and then they dressed in …
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 …
Measuring Neural Time Series Data In A Sensory Deprivation Tank, Jackson Gregory, Tian Lan, Uri Maoz, Amir Raz
Measuring Neural Time Series Data In A Sensory Deprivation Tank, Jackson Gregory, Tian Lan, Uri Maoz, Amir Raz
Student Scholar Symposium Abstracts and Posters
We are interested in studying the neurological and physiological effects of the float pod, also known as REST therapy, or sensory deprivation tank. Float pods rely on the concept of depriving most senses (from sound and light to temperature and proprioception) in a pool filled with buoyant salt water at body temperature. While float pods are most commonly used in spa environments, we intend to look at the potential benefits of floating under the empirical lens. In this study, we aim to measure neural activity using electroencephalography (EEG). We intend to look at the different levels of relaxation and the …
A Phenomenological Study Of The Lived Experiences Of Counseling Students In A Co-Facilitated Experiential Group, Alexandra Meyers
A Phenomenological Study Of The Lived Experiences Of Counseling Students In A Co-Facilitated Experiential Group, Alexandra Meyers
Graduate Theses and Dissertations
Research in the fields of experiential learning, group psychotherapy, and neuroscience has supported the inclusion of the experiential group in counseling training programs due to the potential for positive impact on students’ personal and professional development (Badenoch & Cox, 2010; Denninger, 2010). Investigations exploring counseling students’ experiences of the experiential group have been primarily limited to quantitative studies, while in-depth qualitative inquiry has been minimal. Additionally, an extensive review of the literature has found there have been no qualitative studies examining experiential groups co-facilitated by a course instructor and a doctoral student. The purpose of this phenomenological study was to …
Effects Of Therapeutic Music On Improving Depressive Symptoms Among Long-Term Care Facility Residents, Yi Jin
Evidence-Based Practice Project Reports
Depression is a common mental disorder that can contribute to both physical and psychological suffering (Skinner, 2014). The prevalence rate of depression is especially high among long-term care facility residents (CounsultGeri, 2018; Lolk & Andersen, 2015). The purpose of this EBP project was to establish a protocol incorporating therapeutic music as an adjunct therapy for managing depressive symptoms among residents of a long-term care facility in the Midwest. Roy adaptation model (Roy, 2009) was utilized as the theoretical framework, and the model for evidence-based practice change (Rosswurm & Larrabee, 2009) guided the project implementation. A total of 13 subjects were …
Anxiety Is Something To Worry About: The Effects Of A Cognitive Behavioral Therapy And Selective Serotonin Reuptake Inhibitor Intervention Protocol On Generalized Anxiety Disorder, Alesha E. Mcclanahan
Anxiety Is Something To Worry About: The Effects Of A Cognitive Behavioral Therapy And Selective Serotonin Reuptake Inhibitor Intervention Protocol On Generalized Anxiety Disorder, Alesha E. Mcclanahan
Evidence-Based Practice Project Reports
Generalized anxiety disorder (GAD) is highly prevalent in the United States with at least 12% of the population affected (Edmund & Sheppard, 2018). GAD can pose significant distress and debilitation throughout the lifespan (Bystritsky, Khalsa, Cameron, & Schiffman, 2013; Edmund & Sheppard, 2018). Barriers to treatment include adverse effects, inaccessibility, and expense. The purpose of this project was to implement an evidence-based protocol involving combination therapy with self-administered cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medication in order to improve patient outcomes through more accessible, affordable, and standardized treatment of GAD. The Neuman Systems Model and Stetler …
Managing Madness: The Ethics Of Identifying And Treating Mental Illness, Mason Seely
Managing Madness: The Ethics Of Identifying And Treating Mental Illness, Mason Seely
Helene Lafrance Library Undergraduate Research Award
This essay analyzes different contemporary models for defining mental illness and offers a new framework that promotes the use of normative values during the clinical diagnostic process. Although ethic centric models for identifying mental illness do currently exist, these accounts are limited. Specifically, these accounts acknowledge the relationship between mental illness labels and implied responsibility in making their argument to support a normative framework, yet do not explain what capacities are necessary for an agent to have full responsibility. Recognizing this shortcoming, this paper provides an enriched model for identifying mental illness by marrying a normative conception of psychiatric dysfunction …
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.
The Effects Of Stress Mindset Interventions On University Students' Health And Functioning, Abigail Fate
The Effects Of Stress Mindset Interventions On University Students' Health And Functioning, Abigail Fate
Undergraduate Honors Papers
In modern society, the overwhelming cultural narrative proclaims that stress is detrimental to health and should be limited and avoided at all costs. However, recent research has demonstrated that it is one’s stress mindset, rather than their stress level, that determines the psychological and physiological outcomes. Mindsets are lenses that simplify and order the world, and have been proven to influence daily behavioral and physiological responses to create cascading effects. Recent research has demonstrated that one’s mindset about stress is the demining factor in health, performance, and productivity in response to stressful conditions, and that these mindsets can be manipulated …
Mental Health Stigma In College Students By Academic Major, Kristen Miller
Mental Health Stigma In College Students By Academic Major, Kristen Miller
Mahurin Honors College Capstone Experience/Thesis Projects
Stigma is best defined as the disapproval and shame felt by people who display characteristics not widely accepted in society. Although mental illness has become more prevalent in society through advocacy and awareness campaigns, it fails to be accepted and often individuals may feel shame that prevents them from seeking help (Dyrbye, Eacker, Durning, Brazeau, Moutier, Massie, S., et al, 2015; Givens & Tjia, 2002). Physicians in particular have been shown to have decreased help-seeking behaviors for psychological issues due to fear of professional repercussions (Dyrbye et al., 2015). Physicians also show increased levels of stress, anxiety, depression, and elevated …