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Articles 151 - 180 of 245
Full-Text Articles in Psychological Phenomena and Processes
Exploring Attentional And Emotional Biases As A Function Of Trauma And Dissociation Symptomology, Claudia Clinchard
Exploring Attentional And Emotional Biases As A Function Of Trauma And Dissociation Symptomology, Claudia Clinchard
Department of Psychology: Dissertations, Theses, and Student Research
There is evidence that threatening facial expressions (e.g., angry faces) direct attention toward the target, and that for facial expressions that are less threatening but still convey negative valence (e.g., fear faces) direct attention outward and to one’s environment, therefore causing a shift in memory performance and attentional bias depending on the level of threat in emotional facial expressions presented. Extant literature provides evidence for attentional biases both towards and away from threat in those with posttraumatic stress disorder (PTSD) symptomology. The current study aimed to replicate the previous findings of the effects stimulus and emotion have on memory performance …
Oxytocin, Cortisol, And Cognitive Control During Acute And Naturalistic Stress, Shari Young Kuchenbecker, Sarah D. Pressman, Jared Celniker, Karen M. Grewen, Ken D. Sumida, Naveen Jonathan, Brendan Everett, George M. Slavich
Oxytocin, Cortisol, And Cognitive Control During Acute And Naturalistic Stress, Shari Young Kuchenbecker, Sarah D. Pressman, Jared Celniker, Karen M. Grewen, Ken D. Sumida, Naveen Jonathan, Brendan Everett, George M. Slavich
Health Sciences and Kinesiology Faculty Articles
Although stress is a strong risk factor for poor health, especially for women, it remains unclear how stress affects the key neurohormones cortisol and oxytocin, which influence stress-related risk and resilience. Whereas cortisol mediates energy mobilization during stress, oxytocin has anti-inflammatory, anxiolytic, and analgesic effects that support social connection and survival across the lifespan. However, how these neurohormones interrelate and are associated with cognitive control of emotional information during stress remains unclear. To address these issues, we recruited 37 college-aged women (Mage = 19.19, SD = 1.58) and randomly assigned each to a one-hour experimental session consisting of …
Illness Perception And Social Support Among Cardiac Patients Attending Rehabilitation Programme And Their Experiences, Sukhbeer Kaur Darsin Singh
Illness Perception And Social Support Among Cardiac Patients Attending Rehabilitation Programme And Their Experiences, Sukhbeer Kaur Darsin Singh
Student Works (2020-2029)
Cardiovascular disease (CVD) and coronary heart disease (CHD) have emerged as the leading causes of death in Malaysia. In developed countries, heart disease is the leading cause of death in men and women in Europe, CHD accounts for an estimated 1.95 million deaths each year. In Europe, according to the World Health Organisation (WHO 2012), it is recorded that 42 percent of deaths were caused by CVD and 41 percent was by CHD which was 2,655,364 people has died. Secondary prevention through cardiac rehabilitation (CR) is a key component of the ongoing care of these patients, immediately following discharge from …
A Cross Sectional Study On Resilience And Coping Strategies Among Medical Officers During The Covid-19 Pandemic And It's Association With Depression And Anxiety, Rahul Yong Wern Kean
A Cross Sectional Study On Resilience And Coping Strategies Among Medical Officers During The Covid-19 Pandemic And It's Association With Depression And Anxiety, Rahul Yong Wern Kean
Student Works (2020-2029)
Introduction: The mental well-being of medical officers during the Covid-19 pandemic is becoming an increasing concern. The on-going pandemic has drastically increased work demands for doctors and this resulted in high levels of stress, depression and burnout among medical officers. Objectives: This study aims to determine the patterns of resilience and coping strategies of front-line medical officers during the Covid-19 pandemic, as well as their association with depression and anxiety. Study design: This is a single center, cross sectional study on Covid-19 front-line medical officers posted in medical wards in Hospital Tuanku Ja’afar, Seremban. The instruments used were a sociodemographic …
Evaluation Of Hyperhomocysteinemia In The Progression Of Parkinson's Disease, Marisa A. Ducach, Pritpal S. Saggu
Evaluation Of Hyperhomocysteinemia In The Progression Of Parkinson's Disease, Marisa A. Ducach, Pritpal S. Saggu
Physician Assistant Capstones, 2020-current
Abstract:
Objective:To assess the prevalence of hyperhomocysteinemia in Parkinson’s Disease (PD) and if this elevated serum level can be used as a predictive biomarker in risk assessment for the progression of cognitive decline in PD.
Design:Systematic Literature Review
Methods:A literature search was conducted through Google Scholar and Pubmed using phrases such as, “Parkinson's Disease”, and “homocysteine”, “Parkinson’s progression. Three articles, measuring serum homocysteine levels and cognitive functioning in PD patients, were selected, analyzed, and compared to assess for a relationship between homocysteine levels and cognitive decline in PD.
Results: Elevated homocysteine levels are associated with worse cognitive …
Historical Trauma Response Scores As A Function Of Unresolved Grief And Substance Use Disorder In American Indian Populations, Andrew R. Saunders
Historical Trauma Response Scores As A Function Of Unresolved Grief And Substance Use Disorder In American Indian Populations, Andrew R. Saunders
Undergraduate Research Symposium
Abstract
Researchers are interested in the outcomes of interventions, specifically, measuring historical trauma (HT) among American Indian/Alaska Native communities and the long-term distress and substance abuse as a result of historical trauma response (HTR). Previous literature has implicated limitations in the clinical conceptualization of the relationship between intergenerational transfer of HTR and substance abuse. The aim of the current study is to examine treatment efficacy of 50 homosexual, American Indian males randomized to a culturally-adapted juxtaposition of (1) Group Interpersonal Psychotherapy (IPT), (2) Cognitive Processing Therapy (CPT), and (3) Historical Trauma and Unresolved Grief Intervention (HTUG), or (4) waitlisted on …
Attachment, Exploration, And Internalized Homonegativity, Gregory J. Gagnon
Attachment, Exploration, And Internalized Homonegativity, Gregory J. Gagnon
Dissertations, Theses, and Capstone Projects
Background: Internalized homonegativity (IH; a.k.a. internalized homophobia), has been implicated in health disparities between lesbian, gay, and bisexual persons (LGBs) and their heterosexual peers. Yet, little available research has explored factors that may increase or decrease IH.
Objective: This dissertation investigates relations between child and adult attachment and IH. It further examines the mediating and moderating roles of exploration and mentalization, respectively, in the attachment–IH relation.
Method: One hundred fifty cisgender LGB adults participated in two waves of an online survey. The first assessed recalled child–maternal and child–paternal attachment and current attachment to the romantic partner. The second, conducted two …
Flattening The Curve Of Distress: A Public-Facing Webinar For Psychoeducation During Covid-19, Grant Smith, Stephanie Harman, Keri Brenner
Flattening The Curve Of Distress: A Public-Facing Webinar For Psychoeducation During Covid-19, Grant Smith, Stephanie Harman, Keri Brenner
Patient Experience Journal
This case report describes the development, implementation and evaluation of a public-facing webinar that provided psychoeducation addressing the emotional distress that has accompanied the coronavirus pandemic. Using a webinar was an effective strategy for reaching a large, public audience and making content from expert clinicians accessible. Participants were likely to recommend the webinar to friends or family. Participants appreciated that the webinar acknowledged the presence of distressing emotions and provided practical advice for reducing the negative psychological sequelae of the coronavirus pandemic. Areas for improvement included addressing technical issues and incorporating additional information into the webinar.
Experience Framework
This article …
Creatively Exploring Self: Applying Organic Inquiry, A Transpersonal And Intuitive Methodology, Larisa J. Bardsley Phd
Creatively Exploring Self: Applying Organic Inquiry, A Transpersonal And Intuitive Methodology, Larisa J. Bardsley Phd
The Qualitative Report
This article explores the merit of using Organic Inquiry, a qualitative research approach that is most effectively applied to areas of psychological and spiritual growth. Organic Inquiry is a research approach where the psyche of the researcher becomes the instrument of the research, working in partnership with the experiences of participants and guided by liminal and spiritual influences. Organic Inquiry is presented as a unique methodology that can incorporate other non-traditional research methods, including intuitive, autoethnographic and creative techniques. The validity and application of Organic Inquiry, as well as its strengths and limitations are discussed in the light of the …
A Case For Delirium Risk Prediction Models To Aid In Triaging Resources To Those Most At Risk An Integrative Literature Review, Tammy Perttula
A Case For Delirium Risk Prediction Models To Aid In Triaging Resources To Those Most At Risk An Integrative Literature Review, Tammy Perttula
Nursing Masters Papers
Abstract
Delirium is a complex syndrome resulting from compounding effects of acute illness, comorbidities, and the environment. It results in adverse outcomes: elevated mortality rates, length of stay, readmissions, institutionalization, long-term cognitive changes, and diminished quality of life. The rate of iatrogenic delirium is astounding, ranging from 10%-89%. There are no curative treatments; thus, primary prevention is the key. The purpose of this literature review is to identify and critique the research for the accuracy of risk stratification and feasibility in practice. Support for interventions that prevent delirium is mounting; however, interventions are resource-intensive and often not implemented. Researchers have …
Scope Of Attention Variation As A Function Of Anxiety And Depression, Kathleen Anne O'Donnell
Scope Of Attention Variation As A Function Of Anxiety And Depression, Kathleen Anne O'Donnell
Electronic Theses, Projects, and Dissertations
As a social species, correct emotional perception is so vital, that the human brain has evolved a mechanism to control attentional choices by exerting a narrowed field of perception during danger, called the scope of attention (SoA). The SoA determines what information will be focused on or ignored by blocking the perception of non-relevant items and increasing selective focus on danger; even if danger is merely a sad-face. The emotional items blocked from perception cannot be remembered because they were never perceived. But, attention-control to emotional stimuli also varies with mood, as seen in mood-disorders. A mood-disorder’s effect upon the …
Public Stigma And Self-Stigma Of Depression In College Students, Peyton Lee
Public Stigma And Self-Stigma Of Depression In College Students, Peyton Lee
DNP Projects
A large body of literature portrays the long-term, increased presence of mental illness stigma in college students, a vulnerable population at high risk of victimization. However, literature lacks sufficient research differentiating between the separate forms of mental illness stigma as well as consistent research examining stigma specific to the mental illness of depression in college students. A cross-sectional, web-based survey design was utilized to collect quantitative data from 432 students at a private, four-year university in the southeastern United States. The primary investigator both described the presence of and relationship between levels of perceived public stigma, personal public stigma, and …
Impact Of Indian Demonetization On Working And Non-Working Married Women: An Interpretative Phenomenological Analysis, Naved Iqbal, Imtiyaz A. Dar, Irum Khan
Impact Of Indian Demonetization On Working And Non-Working Married Women: An Interpretative Phenomenological Analysis, Naved Iqbal, Imtiyaz A. Dar, Irum Khan
The Qualitative Report
The sudden announcement of demonetization in India caused an immediate financial crisis that cascaded throughout the whole country and consequently caused suffering in the lives of many people, one such group being married women. Therefore, the present study aimed to explore and understand how married women were impacted by the demonetization policy. A total of 20 working and non-working women were selected from New Delhi and a qualitative research design based on interpretative phenomenological analysis (IPA) was employed. The present study identified three themes (i.e., problems due to demonetization, coping with demonetization, and diverse experiences associated with hidden money) and …
The Efficacy Of Yoga As An Adjunctive Therapy To Standard Multidisciplinary Care In The Treatment Of Female Patients Presenting With Cognitive Eating Disorder Symptoms, Cassidy Nagle
Capstone Showcase
Introduction: Current treatment of patients exhibiting cognitive eating disorder symptoms is standard multidisciplinary care (SMDC) involving behavioral therapy, medical management and dietetics. Because these symptoms often persist or relapse despite treatment, research has begun to explore adjunctive therapies like yoga for this population. This review will explore seven studies in order to analyze the effect of yoga (I) on cognitive eating disorder symptoms (O) in teenage and adult females (P) when added to SMDC compared to symptom reduction with SMDC alone (C).
Methods: A literature search was conducted in PubMed, Academic Search Ultimate and Google Scholar starting November 2018. Seven …
Signaling Mechanism Responsible For 5-Ht2a Receptor Tolerance To Psychedelic Induced Head-Twitch Behavior In Mice, Audrey R. Mcmurtrie
Signaling Mechanism Responsible For 5-Ht2a Receptor Tolerance To Psychedelic Induced Head-Twitch Behavior In Mice, Audrey R. Mcmurtrie
Theses and Dissertations
In recent years, there has been a growing interest in psychedelic compounds stemming from their promising use as therapeutic agents and research tools that can be used to treat and study several neuropsychiatric disorders. Psychedelics have proven useful in a broad range of these diseases - they serve as models for psychosis in schizophrenia but have also had promising results in treating major depressive disorder, anxiety, and other common disorders. Decreased stigmatization surrounding psychedelics has further increased their use in research and clinical settings. In light of these trends and the promising nature of their use, a thorough understanding of …
Black Women And Body Image: Implications Of The Racialized Beauty Aesthetic, Rachel L. Boutte
Black Women And Body Image: Implications Of The Racialized Beauty Aesthetic, Rachel L. Boutte
Theses and Dissertations
Black women have the highest prevalence of overweight and obesity relative to any other demographic group in the United States, however current weight management interventions appear least effective for them. Although several hypotheses have been proposed to explain these outcomes, few studies have collected data to evaluate how well they fit the lived experiences of Black women. In particular, the potential roles of body image and body dissatisfaction in the development and maintenance of overweight and obesity in Black women are not well understood. Extant literature largely reports that Black women are inoculated from body dissatisfaction due to cultural factors, …
The Development Of Face Morphing Task To Assess Self Other Differentiation, Esen Karan
The Development Of Face Morphing Task To Assess Self Other Differentiation, Esen Karan
Dissertations, Theses, and Capstone Projects
Self-Other Differentiation (SOD) refers to a developmental process of acquiring a consolidated, integrated, and individuated sense of self. SOD develops at a) perceptual (e.g., facial perception) and b) representational (e.g., traits, mental states, and beliefs) levels. Impairments in representational SOD (R-SOD) are associated with many forms of psychopathology, particularly borderline personality disorder (BPD) and narcissistic personality disorder (NPD). Few studies to date have examined the perceptual aspects of SOD (P-SOD), which are hypothesized to develop from infancy onwards in tandem and in interaction with R-SOD. Given that the human face is one of the key characteristics that humans use to …
Does Ethnic Identity, In-Group Preference, And Acculturation Protect Latinas With A History Of Interpersonal Trauma From Developing Symptoms Of Ptsd?, Evelyn M. Ramirez
Does Ethnic Identity, In-Group Preference, And Acculturation Protect Latinas With A History Of Interpersonal Trauma From Developing Symptoms Of Ptsd?, Evelyn M. Ramirez
Dissertations, Theses, and Capstone Projects
Previous research suggests ethnic identity, a sense of belonging to a particular cultural group, may be protective against symptoms of post-traumatic stress disorder (PTSD). However, the role of ethnic identity, in-group preference (i.e., an individual’s preference for interactions with members of their own ethnic group) and acculturation (i.e., the level of comfort with the mainstream culture) have not been investigated as protective factors for Latinas with a history of interpersonal and sexual trauma. In this study, ethnic identity, in-group preference and acculturation were assessed via self-report on the Scale of Ethnic Experience in two samples of undergraduate Latina and non-Latina …
Recent Trends, Current Research In Cyberpsychology: A Literature Review, Amarjit Kumar Singh, Pawan Kumar Singh
Recent Trends, Current Research In Cyberpsychology: A Literature Review, Amarjit Kumar Singh, Pawan Kumar Singh
Library Philosophy and Practice (e-journal)
Cyberpsychology refers to the study of the mind and behavior in the context of interactions with technology. It is an emerging branch, which has focused on the psychological aspects connected to the increasing presence and usages of technology in modern lives. This paper traces recent advancement and trends of Cyberpsychology is an emerging domain of knowledge and goes on the give a literature review of the same. An analysis of the recent research and literature covering 300 most relevant research papers from the period of 2012 to 15, August 2019 was conducted to determine and shape the research pattern based …
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 …
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 …
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 …
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 …
Critical Embodied Praxis For Social Justice And Peace Educators: A Story Of Personal Transformation Through Analysis Of My Jewish And Settler Identities, Cara Michelle Silverberg
Critical Embodied Praxis For Social Justice And Peace Educators: A Story Of Personal Transformation Through Analysis Of My Jewish And Settler Identities, Cara Michelle Silverberg
Capstone Collection
In this paper, I examine definitions of and relationships between violence, oppression, peace, liberation, and embodiment in the context of critical pedagogy in order to construct a theory of critical embodied praxis for social justice and peace educators. Considering the body to be a tangible vessel through which narratives and mechanisms of violence are expressed and maintained, I explore the potential of the body to be a vessel through which liberatory narratives may be generated and shared. After constructing a theory of critical embodied praxis, I illustrate this framework in action through a personal narrative that explores the intersections …
Meeting Point: Partner Dancing As Couple's Therapy, Rami Eckhaus
Meeting Point: Partner Dancing As Couple's Therapy, Rami Eckhaus
Expressive Therapies Dissertations
This dissertation research explored the experience of partner dancing as a therapeutic process that reflects upon the dynamics and interactions of couples who are in the process of couple's therapy. The research also aimed to gain insight on the ways in which the experience of partner dancing can support these couples' therapeutic processes. Partner dancing is a dance-form that is based on the interaction between two individuals. Such interaction requires the dancing couples to communicate on many levels that may uncover layers of their relational dynamics. In this research, five couples who were undergoing couple's therapy were asked to participate …
An Exploratory Study Of Police Officers: Low Compassion Satisfaction And Compassion Fatigue, Heath Blair Grant, Cathryn F. Lavery, John Decarlo
An Exploratory Study Of Police Officers: Low Compassion Satisfaction And Compassion Fatigue, Heath Blair Grant, Cathryn F. Lavery, John Decarlo
Publications and Research
Background: Compassion fatigue, or the physical, mental, and emotional state experienced by professionals that assist others in distress, has been well documented in several caring professions such as nurses, firefighters, and emergency medical technicians. Until the current study, it has only rarely been examined in police samples despite their high rates of stress and suicide which is a likely result of a depletion of compassion satisfaction, or the pleasure an officer gets from relating to and helping others.
Aim: This study documents findings from an ongoing study of compassion fatigue amongst a sample of US urban police officers which suggests …
Addicted To The Answer, Charumathi Raman
Addicted To The Answer, Charumathi Raman
Capstones
Hypochondria, which is now broadly known as health anxiety, is the fear of a serious illness that continues despite evidence to the contrary from laboratory tests and the reassurance of physicians. In the past people with this disorder would go from doctor to doctor seeking an answer, but now many people rely solely upon online information.
For people with health anxiety, the Internet provides a lot of fodder. Researchers have recently coined the term "cyberchondria" to describe the phenomenon of increased health anxiety due to online health searches.
Entering questions like “Who started World War Two?” or “Who was the …
Measuring Novel Antecedents Of Mental Illness: The Questionnaire Of Unpredictability In Childhood, Laura M. Glynn, Hal S. Stern, Mariann A. Howland, Victoria B. Risbrough, Dewleen G. Baker, Caroline M. Nievergelt, Tallie Z. Baram, Elysia P. Davis
Measuring Novel Antecedents Of Mental Illness: The Questionnaire Of Unpredictability In Childhood, Laura M. Glynn, Hal S. Stern, Mariann A. Howland, Victoria B. Risbrough, Dewleen G. Baker, Caroline M. Nievergelt, Tallie Z. Baram, Elysia P. Davis
Psychology Faculty Articles and Research
Increasing evidence indicates that, in addition to poverty, maternal depression, and other well-established factors, unpredictability of maternal and environmental signals early in life influences trajectories of brain development, determining risk for subsequent mental illness. However, whereas most risk factors for later vulnerability to mental illness are readily measured using existing, clinically available tools, there are no similar measures for assessing early-life unpredictability. Here we validate the Questionnaire of Unpredictability in Childhood (QUIC) and examine its associations with mental health in the context of other indicators of childhood adversity (e.g., traumatic life events, socioeconomic status, and parenting quality). The QUIC was …
"Born Out Of Fear": A Grounded Theory Study Of The Stigma Of Bipolar Disorder For New Mothers, Walker Ladd Ph.D.
"Born Out Of Fear": A Grounded Theory Study Of The Stigma Of Bipolar Disorder For New Mothers, Walker Ladd Ph.D.
The Qualitative Report
Childbirth is an established trigger for the onset of bipolar disorders (BD) in the postpartum period, causing significant pathology and disability. Research has shown that the stigma of mental illness for new mothers is a powerful obstacle to care, preventing women from accessing critical treatment and social support. However, the majority of research has examined the relationship between the stigma and postpartum depression, leaving a gap in knowledge regarding stigma and postpartum bipolar disorder. The problem addressed in this grounded theory study was the lack of knowledge regarding the stigma of a diagnosis of bipolar disorder (BD) in the first …
What’S Your Story? Assessing Childhood Maltreatment Using The Thematic Apperception Test In An Adult Inpatient Population., Thachell C. Tanis
What’S Your Story? Assessing Childhood Maltreatment Using The Thematic Apperception Test In An Adult Inpatient Population., Thachell C. Tanis
Dissertations, Theses, and Capstone Projects
There is a robust evidence that childhood maltreatment contributes to the development of adult psychopathology (Brown & Anderson, 1991; Johnson, Cohen, Brown, Smailes, & Bernstein 1999; Johnson, Smailes, Cohen, Brown, & Bernstein, 2000; Ruggiero et al., 1999). However, the identification of childhood maltreatment remains a methodological problem that results in inconsistencies in the reported incidence and psychological sequelae of maltreatment. A primary method for identifying histories of childhood maltreatment among adults is retrospective self-report measures which are susceptible to multiple biases (Briere, 1992; Cicchetti & Rizley, 1981; Shaffer, Huston, & Egeland, 2008). This present study suggests that childhood maltreatment can …