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Articles 2071 - 2100 of 2877
Full-Text Articles in Psychiatry and Psychology
Burnout-Depression Overlap: A Review, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent
Burnout-Depression Overlap: A Review, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent
Publications and Research
Whether burnout is a form of depression or a distinct phenomenon is an object of controversy. The aim of the present article was to provide an up-to-date review of the literature dedicated to the question of burnout–depression overlap. A systematic literature search was carried out in PubMed, PsycINFO, and IngentaConnect. A total of 92 studies were identified as informing the issue of burnout–depression overlap. The current state of the art suggests that the distinction between burnout and depression is conceptually fragile. It is notably unclear how the state of burnout (i.e., the end stage …
Predicting Antidepressant Treatment Without Controlling For Depression Is Ill-Advised, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent
Predicting Antidepressant Treatment Without Controlling For Depression Is Ill-Advised, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent
Publications and Research
All in all, the link observed by Madsen et al. (2015) between burnout and antidepressant intake may well conceal an expected relationship between depression and antidepressant intake. The impossibility of ruling out this reasonable alternative hypothesis renders the study inconclusive. We recommend that future research on (psychotherapeutic or pharmacologic) treatments for burnout incorporate measures of depression in order to facilitate research advance on burnout's characterization and burnout-depression overlap.
Developing Executive Functions Through Mindfulness Training In School-Aged Children, Ashley Black Adams
Developing Executive Functions Through Mindfulness Training In School-Aged Children, Ashley Black Adams
PCOM Psychology Dissertations
Well-developed executive functions are necessary for successful classroom functioning. Students with executive function deficits can fall behind academically as well as socially and emotionally, relative to their same-aged peers. Effective interventions for developing executive functions within the school environment are essential for addressing this issue. This study examines changes in students’ executive functions as a result of their participation in a mindfulness training intervention. Participants included four ten-year old elementary school boys who took part in a ten-week mindfulness training intervention. The data were generated through pre and post assessments with an executive function teacher rating scale and a Goal-Attainment …
The Anxiolytic Effects Of Self-Selected Music Among Primary Care Patients, Jennifer West-Gavin
The Anxiolytic Effects Of Self-Selected Music Among Primary Care Patients, Jennifer West-Gavin
PCOM Psychology Dissertations
The primary care setting is commonly referred to as the first line of medical treatment sought for health related services. Anxiety is one of the most frequently encountered mental health issues in primary care. The purpose of this study was to examine the level of state anxiety experienced among primary care patients, attending for routine and nonroutine appointments; its further purpose was to examine if self-selected relaxing music accounts for the greatest reductions in state anxiety among primary care patients, as compared with investigator-selected (classical) music, audio commercials, or no music. Patients included a primarily underserved primary care population between …
The Relationship Between Adhd And Trait Facets Of The Five-Factor Model, Todd William Bennett
The Relationship Between Adhd And Trait Facets Of The Five-Factor Model, Todd William Bennett
PCOM Psychology Dissertations
Facets of the Five-Factor Model (FFM) were examined in order to understand its interaction with Attention Deficit Hyperactivity Disorder (ADHD)-symptoms. By utilizing archival data, in a correlational design, adults between the ages of 18-66 were tested for the presence of ADHD, which was then compared with data gathered from the NEO-PI-R. Comorbid psychiatric conditions often associated with ADHD were accounted for in the design. Results partially supported the hypotheses, specifically, that altruism was inversely related to Impulsivity, as predicted. However, other findings largely did not support a relationship between other specific NEO-PI-R facets and ADHD. Other significant relationships that were …
Impacts Of Objective And Subjective Social Inclusion On The Quality Of Life Of Individuals With Schizophrenia Spectrum Disorders And Major Depressive Disorder, Katie A. Johanning-Gray
Impacts Of Objective And Subjective Social Inclusion On The Quality Of Life Of Individuals With Schizophrenia Spectrum Disorders And Major Depressive Disorder, Katie A. Johanning-Gray
PCOM Psychology Dissertations
Increased social inclusion and enhanced quality of life for individuals with severe mental illnesses (SMIs) are goals of the recovery movement. The present study examined the differences in reported subjective social inclusion (SubSI) and objective social inclusion (ObjSI) between individuals diagnosed with schizophrenia spectrum disorders (SSDs) and those diagnosed with Major Depressive Disorder (MDD). Furthermore, the amount of variance in quality of life (QOL) which can be predicted by type of diagnosis, SSDs or MDD, symptom severity, and SubSI and ObjSi was determined. An archival data set was used. Participants were 337 individuals whose primary diagnosis was an SSD or …
Burnout: Absence Of Binding Diagnostic Criteria Hampers Prevalence Estimates, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent
Burnout: Absence Of Binding Diagnostic Criteria Hampers Prevalence Estimates, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent
Publications and Research
Comments on an article by Jef Adriaenssens et al. (see record 2015-00662-015). In a recent review paper, Adriaenssens et al. concluded that about 26% of emergency nurses (EN) suffer from burnout and described their results as alarming. While commentators applaud Adriaenssens et al. efforts to provide a clearer picture of ill-health in EN, they thought that these authors' conclusions were weakened by a fundamental fact, namely, the absence of consensual, clinically valid diagnostic criteria for burnout. Trying to determine the prevalence of a condition that has no binding diagnostic criteria is problematic. Indeed, depending on how researchers decide to …
Hiroshima And Mass Trauma Today: Treating Post-Traumatic Stress Disorder In Individuals And Communities, Ashley Martinez
Hiroshima And Mass Trauma Today: Treating Post-Traumatic Stress Disorder In Individuals And Communities, Ashley Martinez
International ResearchScape Journal
At 8:15 am on August 6th, 1945, the world and the way in which we fight wars changed forever. Immediately following the drop of the Little Boy atomic bomb, the city of Hiroshima was decimated, leaving the surviving citizens to deal with poverty, starvation, loss of loved ones, and utter destruction of their lives. After the bombing, survivors were left with burns, radiation poisoning, and physical scars. Unknown to the survivors of the atomic bombings, or Hibakusha, were the ensuing psychological and emotional damages. In 2014, we know more about traumatic experiences than in 1945. Studies from …
Adhd Children And Mental Health Service Use: Maternal Determinants, Katarina Krizova
Adhd Children And Mental Health Service Use: Maternal Determinants, Katarina Krizova
Theses and Dissertations--Family Sciences
The current study investigated maternal determinants of mental health service use, namely, individual child therapy, among preadolescent children diagnosed with ADHD. The Behavioral Model of Health Care Utilization (Andersen, 2008) was used as a theoretical framework for the study. Data from the last three rounds of ECLS-K dataset were employed to test a longitudinal model using Bayesian analysis. Socio-demographic variables and maternal mental health were tested as exogenous variables and mother-child relationship variables, discipline variables, and perceived maternal concern about child’s overall behavior and child’s emotional symptoms were tested as intervening variables. Results showed that only maternal mental health remained …
Behavioral Effects Of Fluoxetine On Aggression And Associative Learning In Betta Splendens, Benjamin Eisenreich
Behavioral Effects Of Fluoxetine On Aggression And Associative Learning In Betta Splendens, Benjamin Eisenreich
Graduate Student Theses, Dissertations, & Professional Papers
While the link between serotonin and the behaviors of aggression and learning has been elucidated, few studies have examined the impact serotonin has on learning for aggressive rewards. In particular, the SSRI fluoxetine has been demonstrated to reduce aggression as well the acquisition of instrumental responding for rewards indicating that this drugs behavioral effect may be related to motivational processes important for learning. To examine the relationship between fluoxetine and motivational process important for learning, two experiments were conducted using Betta splendens, a species well known for their robust aggressive response and drive to engage in aggressive behaviors, to examine …
Trauma In Patients With Serious Mental Illness: The Acceptability And Impact Of A Brief Psychoeducational Intervention For Trauma In The General Acute Inpatient Psychiatric Setting, Kevin E. A. Giangrasso
Trauma In Patients With Serious Mental Illness: The Acceptability And Impact Of A Brief Psychoeducational Intervention For Trauma In The General Acute Inpatient Psychiatric Setting, Kevin E. A. Giangrasso
PCOM Psychology Dissertations
Prevalence rates of posttraumatic stress disorder (PTSD) for individuals with serious mental illnesses (SMIs) are high, with an estimated 49% to 100% being exposed to potentially traumatic events. The consequences of these disorders are serious and lasting, with PTSD being the costliest of mental health disorders. At the same time, established evidence-based treatments for PTSD are often not feasible in treatment settings utilized by individuals with SMIs, namely the general acute inpatient psychiatric hospital. Psychoeducational approaches have been incorporated as a component of evidence-based interventions for trauma and have been feasibly implemented in the general acute inpatient psychiatric hospital. The …
Inventory Of Cognitive Distortions: Validation Of A Measure Of Cognitive Distortions Using A Community Sample, Michael B. Roberts
Inventory Of Cognitive Distortions: Validation Of A Measure Of Cognitive Distortions Using A Community Sample, Michael B. Roberts
PCOM Psychology Dissertations
The purpose of this study was to examine and evaluate further the psychometric properties of a self-report inventory of cognitive distortions using a nonclinical, community sample. A group of 474 individuals were contacted via the social networking site, Facebook, and through a college list-serve and were asked to complete multiple measures and also to send the link to other individuals, thus utilizing a snowball sample. The measures used included the Inventory of Cognitive Distortions (ICD), Dysfunctional Attitude Scale (DAS), Perceived Stress Scale (PSS), and a brief questionnaire to collect demographic information on each participant. Results revealed positive psychometric properties for …
The Effectiveness Of A Computer-Assisted, Cognitive-Behavior Program For Treating Anxiety Symptoms In Children With Autism Spectrum Disorder, Jennifer A. Zabel
The Effectiveness Of A Computer-Assisted, Cognitive-Behavior Program For Treating Anxiety Symptoms In Children With Autism Spectrum Disorder, Jennifer A. Zabel
PCOM Psychology Dissertations
Autism Spectrum Disorder (ASD) is a complex and multifaceted, neurodevelopmental disorder that severely impacts children and families across a variety of settings. Prevalence rates of ASD are continuing to increase rapidly, with sizeable intervention and treatment costs placed on families and society. Further complicating the matter, many individuals with ASD also evidence co-occurring anxiety symptoms or disorders and tend to be at a higher risk for developing such problems when compared to other clinical populations or typically developing children. This study investigated the effectiveness of a computer-assisted CBT program, Camp Cope-A-Lot (CCAL), in regards to reducing anxiety symptoms in four …
Impact Of Group Cognitive Behavior Therapy On Adolescents With Deficits In Inhibition, Jessica L. Morley
Impact Of Group Cognitive Behavior Therapy On Adolescents With Deficits In Inhibition, Jessica L. Morley
PCOM Psychology Dissertations
Existing literature connects impulse control dysfunction to high-risk behaviors and negative life outcomes. Evidence-based interventions for children and adolescents who are at-risk or who are displaying significant levels of impulsive behavior are necessary in order to promote self-control, and in turn, positive life outcomes. This study investigated the impact of an eight-week, school-based GCBT intervention on cognitive inhibition and behavioral impulsivity in adolescent participants. The intention of the study was to evaluate the trend in inhibition and impulsivity from baseline to post-intervention assessments across five middle school students dually enrolled in a residential treatment facility and a center-based emotional support …
The Relationship Between Coaching Environment And Athlete Attributional Style, Una Britton
The Relationship Between Coaching Environment And Athlete Attributional Style, Una Britton
Online Theses and Dissertations
This study examined the relationship between attributional style and perceived coaching behaviors in collegiate cross-country/track and field athletes in the USA and Ireland. Participants included seventy-three collegiate athletes (Ireland: n = 24 male, n = 18 female, mean ± SD age: 20.39 ± 1.61 years. USA: n = 9 male, n = 22 female, mean ± SD age: 21.02 ± 2.18 years). Participants completed the Sport Attributional Style Scale (SASS; Hanrahan et al., 1989) and the Leadership Scale for Sport (LSS; Chelladurai & Selah, 1980) to assess attributional style and perceived coaching behaviors. Explanatory pessimism, total internality, stability, and globality …
Compassion Development In Higher Education, Roxanne Rashedi, Thomas G. Plante, Erin S. Callister
Compassion Development In Higher Education, Roxanne Rashedi, Thomas G. Plante, Erin S. Callister
Psychology
Many schools of psychology and religious studies intend to promote the cultivation of compassion. Compassion is currently an integral area of study in psychology, religious studies, and higher education, specifically in faith-based higher education. While secular universities in the United States strive to generate disciplinary-based knowledge through scholarship, their ability to promote students' use of the information they are learning to create positive social change has typically lagged. Conscious of the magnitude of today's global issues and dissatisfied with the current disparity between the world's reality and university curricula, scholars have begun to re-imagine the role of higher education in …
Life Balance – A Mindfulness-Based Mental Health Promotion Program: Conceptualization, Implementation, Compliance And User Satisfaction In A Field Setting, Lisa Lyssenko, Gerhard Müller, Nikolaus Kleindienst, Christian Schmal, Mathias Berger, Georg Eifert, Alexander Kölle, Siegmar Nesch, Jutta Ommer-Hohl, Michael Wenner, Martin Bohus
Life Balance – A Mindfulness-Based Mental Health Promotion Program: Conceptualization, Implementation, Compliance And User Satisfaction In A Field Setting, Lisa Lyssenko, Gerhard Müller, Nikolaus Kleindienst, Christian Schmal, Mathias Berger, Georg Eifert, Alexander Kölle, Siegmar Nesch, Jutta Ommer-Hohl, Michael Wenner, Martin Bohus
Psychology Faculty Articles and Research
Background
Mental health disorders account for a large percentage of the total burden of illness and constitute a major economic challenge in industrialized countries. Several prevention programs targeted at high-risk or sub-clinical populations have been shown to decrease risk, to increase quality of life, and to be cost-efficient. However, there is a paucity of primary preventive programs aimed at the general adult population. “Life Balance” is a program that employs strategies borrowed from well-established psychotherapeutic approaches, and has been made available to the public in one federal German state by a large health care insurance company. The data presented here …
Asthma-Related Anxiety And Quick-Relief Medication Use In Urban Children With Asthma, Sarah E. Astrab, Robin Everhart
Asthma-Related Anxiety And Quick-Relief Medication Use In Urban Children With Asthma, Sarah E. Astrab, Robin Everhart
UROP Posters
Among children, asthma is the most common chronic illness. Although not curable, asthma is manageable with the use of both daily controller medication and quick relief or rescue medication. Anxiety has been found to increase asthma symptoms in children. Caregivers who are anxious about their child’s asthma symptoms may perceive their child’s asthma as more severe or doubt their ability to manage their child’s asthma, which can result in the misuse of asthma medication. This study focused on the association between asthma-related anxiety and the use of quick-relief asthma medications in a low-income, urban sample in Richmond, Virginia. Child participants …
Smoking Patterns Among Vcu Students, Jasmine Saini
Smoking Patterns Among Vcu Students, Jasmine Saini
UROP Posters
For some individuals, college can be a high risk time for the development of problems associated with alcohol use and other substances. The purpose of this study is to examine these initiation and use patterns as they relate to nicotine use among college students 18 years of age and older enrolled in Spit for Science: The VCU Student Survey. The Spit for Science research project evaluates how genetic and environmental factors contribute to substance use and emotional health among college students at VCU. This study uses data from the Spit for Science 2011 cohort (n=2007) to investigate smoking patterns among …
Differences In Stress Biomarkers In Women With High And Low Stress Appraisal, Clarissa Sara Gomez
Differences In Stress Biomarkers In Women With High And Low Stress Appraisal, Clarissa Sara Gomez
Open Access Theses & Dissertations
Measures of physiological biomarkers have been widely used in the field of stress research to explain how stress negatively impacts health outcomes. Women in particular have been shown to be more at risk for developing physiological and psychological stress-induced conditions (e.g., hypertension, depression) due to hormonal differences (Kirschbaum et al., 1992), but more importantly, because of their appraisal of stressful events (Schamus et al., 2008). Few studies however have examined whether womenâ??s stress appraisal is predictive of stress reactivity, as measured by stress biomarkers, during stressful events. The goal of this study was to examine whether stress appraisal predicted stress …
The Rewarding Nature Of Anger Rumination In Borderline Personality Disorder: An Fmri Investigation, Jessica R. Peters
The Rewarding Nature Of Anger Rumination In Borderline Personality Disorder: An Fmri Investigation, Jessica R. Peters
Theses and Dissertations--Psychology
Anger rumination, or persistently dwelling on feelings of anger, is associated with borderline personality disorder (BPD) and related features, such as aggressive behavior and cognitive distortions. To develop more effective treatments, it is crucial to understand why individuals with BPD engage in anger rumination despite its negative outcomes. The activation of energy associated with anger, as well as feelings of justification and validation, may be experienced in the short-term as rewarding. This may prevent individuals with BPD from attempting to reduce their rumination.
Functional magnetic resonance imaging (fMRI) and behavioral methods were utilized to examine this theory in a sample …
Development Of An Avian Model For Identifying Individual Differences In Drug Vulnerability, Beth A. Rice
Development Of An Avian Model For Identifying Individual Differences In Drug Vulnerability, Beth A. Rice
Theses and Dissertations--Psychology
The attribution of incentive salience to cues that become associated with drugs of abuse is a critical characteristic of individuals who may be vulnerable to drug addiction. Rodents with the propensity to sign track are thought to be vulnerable to drug abuse. The goal of the current work was to investigate whether sign trackers (STs) would acquire cocaine conditioned place preference (CPP) to a discrete cue using an avian species. In Experiment 1, sign and goal trackers (GTs) were first identified using a one third rank order split. Following identification, cocaine-CPP was conducted with a discrete cue in each end …
Interpersonal Rejection Sensitivity Predicts Burnout: A Prospective Study, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent
Interpersonal Rejection Sensitivity Predicts Burnout: A Prospective Study, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent
Publications and Research
We examined whether interpersonal rejection sensitivity (IRS)—the hallmark of atypical depression – prospectively predicted burnout, controlling for baseline symptoms, history of depressive disorders, antidepressant intake, gender, age, and length of employment (mean between-assessment duration: 21 months; n = 578; 74% female). IRS was related to a 119% increased risk of burnout at follow-up. Three of four burned out participants reported to be affected by IRS, or 2.5 times the rate observed in participants with no (or subthreshold) burnout symptoms. Our study highlights a dispositional factor in burnout’s etiology also known to be a key component of atypical depression’s etiology. The …
Burnout Does Not Help Predict Depression In French Schoolteachers, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent
Burnout Does Not Help Predict Depression In French Schoolteachers, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent
Publications and Research
Objectives: Burnout has been viewed as a phase in the development of depression. However, supportive research is scarce. We examined whether burnout predicted depression among French school teachers.
Methods: We conducted a 2-wave, 21-month study involving 627 teachers (73% female) working in French primary and secondary schools. Burnout was assessed with the Maslach Burnout Inventory and depression with the 9-item depression module of the Patient Health Questionnaire (PHQ-9). The PHQ-9 grades depressive symptom severity and provides a provisional diagnosis of major depression. Depression was treated both as a continuous and categorical variable using linear and logistic regression analyses. We controlled …
A Narrative Study Of Emotions Associated With Negative Childhood Experiences Reported In The Adult Attachment Interview, Lynne Hartman
A Narrative Study Of Emotions Associated With Negative Childhood Experiences Reported In The Adult Attachment Interview, Lynne Hartman
Antioch University Dissertations & Theses
Attachment patterns, which tend to be stable over time, are passed from one generation to the next. Secure attachment has been linked to adaptive social functioning and has been identified as a protective factor against mental illness. The parents’ state of mind with regard to attachment—as measured with the Adult Attachment Interview (AAI) (Main, Goldwyn, & Hesse, 2002)—predicts the attachment classification for the infant in Ainsworth’s Strange Situation Procedure (Ainsworth, Blehar, Waters, & Wall, 1978). Earned-secure individuals have overcome negative childhood experiences to achieve a secure state of mind in adulthood. Earned security, like continuous security, strongly predicts infant security …
Developing A Neuroplasticity-Based Treatment Program For Psychopathy: Treatment Foci And Options, Mariah Villanueva
Developing A Neuroplasticity-Based Treatment Program For Psychopathy: Treatment Foci And Options, Mariah Villanueva
UROP Posters
Psychopathy is a neurodevelopmental disorder that is commonly misunderstood as the condition of criminals, and many people believe the best cure is simple confinement for those who ignore society’s laws. Psychopathy, though, is a genuine condition with a genetic basis that manifests itself through neurotransmitter system disruption and hormone imbalances. Psychopathy has a serious neurological impact on an individual, with impairments largely focused in the prefrontal cortex and amygdala, as well as overall negatively affecting the limbic system of the brain. Together, the total impact causes issues with that individual’s ability to empathize, to experience emotions normally, to develop a …
The Nonreligious – Nonspiritual Scale (Nrnss): Measuring Everything From Atheists To Zionists, Ryan T. Cragun, Joseph H. Hammer, Michael Nielsen
The Nonreligious – Nonspiritual Scale (Nrnss): Measuring Everything From Atheists To Zionists, Ryan T. Cragun, Joseph H. Hammer, Michael Nielsen
Psychology: Faculty Publications
Although hundreds of measures of personal religiousness and spirituality exist, none are capable of reliably and validly assessing individuals who identify as nonreligious and nonspiritual. There is a need to develop a valid and reliable measure of (non)religiousness and (non)spirituality. This article discusses these problems, and presents the development and initial validation of a 17-item Nonreligious-Nonspiritual Scale (NRNSS) across three studies. The NRNSS exhibited high internal consistency (α > .94) and high test-retest reliability (r = .92). Two exploratory and one confirmatory factor analysis of the NRNSS supported the hypothesized two-factor solution: (a) institutional religiousness and (b) individualistic spirituality. The NRNSS …
Behavioral Adjustment In Children With Life Threatening Illness A Qualitative Study, E. Joseph Becher Jr.
Behavioral Adjustment In Children With Life Threatening Illness A Qualitative Study, E. Joseph Becher Jr.
Antioch University Dissertations & Theses
This study investigated factors that affect adjustment in children with life-threatening illness from the viewpoint of the parents/caregivers. The data were collected from parents/caregivers whose children have a life threatening diagnosis. Parents/caregivers were interviewed and asked to complete the Parent Request Questionnaire (PRQ) which was given to them after the in-person interview. This newly developed PRQ was utilized into prior research to predict the levels of adjustment in children. It includes age, whether the child has been informed of the diagnosis, whether the child engages in age-appropriate activities, the child's prior experience with death, the child's family's involvement in treatment, …
Effects Of Nicotine Withdrawal On Motivation, Reward Sensitivity And Reward-Learning, Jason A. Oliver
Effects Of Nicotine Withdrawal On Motivation, Reward Sensitivity And Reward-Learning, Jason A. Oliver
USF Tampa Graduate Theses and Dissertations
Research on addictive behavior has traditionally emphasized the role that primary reinforcing effects of drugs of abuse plays in the development and maintenance of dependence. However, contemporary behavioral economic theory and animal models of nicotine dependence suggest the need for greater attention to the impact that response to alternative rewards may have on smoking behavior. The present study sought to investigate the impact of nicotine withdrawal on self-report, behavioral and neural indices of motivation, immediate response to rewards and the capacity to learn and modify behavior in response to positive and negative feedback. Heavy smokers (n = 48) completed two …
Undergraduate College Students’ Attitudes About Internet-Based Mental Health Interventions, Kathleen Palmer
Undergraduate College Students’ Attitudes About Internet-Based Mental Health Interventions, Kathleen Palmer
USF Tampa Graduate Theses and Dissertations
Millennial-aged young adults, often referred to as “digital natives,” comprise the typical college-age population, and there has been a growing number college students at risk for mental health problems (Mowbray, Mandiberg, Stein, Kopels, Curlin, Megivern, Strauss, Collins & Lett, 2006; Eisenberg, Gollust, Golberstein & Hefner, 2007). Suicide is the second leading cause of death among college students (Suicide Statistics, 2014); however, their rate of utilizing mental heath counseling is decreasing. Providing the types of mental health services college students are likely to use can mitigate factors thought to impede their use (e.g., stigma, anonymity, confidentiality), as well as help improve …