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Articles 301 - 330 of 375
Full-Text Articles in Social Work
Testing The Mediating Effects Of Resilience And Mental Health On The Relationship Between Acculturative Stress And Binge Drinking Among International Students, Youn Kim
Social Work Dissertations - Archive
The purpose of this study was to test the mediating effects of resilience and mental health (depression and anxiety) on the relationship between acculturative stress and binge drinking among international students in the United States. International students constitute approximately 4% of the total U.S. higher education population. Between 2014 and 2015, nearly 974,926 international students studied at U.S. colleges and universities. This rapidly increasing population faces multiple stressors such as cultural adjustment, academic pressure, financial concerns, language difficulties, and perceived discrimination. According to Hahn (2010), 22.6% of international students were clinically depressed, which is two times higher than domestic undergraduate …
The Effects Of Combat Zones On Mental Health Among Civilian Contractors, Vanessa Trupiano
The Effects Of Combat Zones On Mental Health Among Civilian Contractors, Vanessa Trupiano
Social Work Theses - Archive
As the number of suicides among the military and veteran population continue to increase each year, concern has generated program and research development. The Department of Defense (2012) discovered 40% of suicides in the military were in the age range of 17 and 24. They also reported that among military members, 42.1% had a mental health diagnosis, 23.0% had a history of substance abuse or addiction, and 13.5% reported a history of self-harm (DoD, 2012), all pieces to the theory of suicide (Van Orden et al., 2010). Another population with similar combat experiences to military members and veterans are civilian …
A Pilot Evaluation Of Jail Programming, Laura Frank
A Pilot Evaluation Of Jail Programming, Laura Frank
Social Work Dissertations - Archive
Women within the corrections system in the United States has reached staggering numbers. Suicide in the United States corrections system is the leading cause of natural death. This research provides an examination of jail programming's impact on women's suicidality and mental health symptomology. Results showed preliminary support for a holistic, trauma informed program to decrease suicidal ideation and the presence of mental health symptomology.
Protective Sex: How Being In-Tune With Sexuality Protects Young Women, Catherine Elinor Ertel Baggett
Protective Sex: How Being In-Tune With Sexuality Protects Young Women, Catherine Elinor Ertel Baggett
Social Work Theses - Archive
Sexuality has been a widely studied topic which has produced a diverse body of literature covering many different perspectives. However, despite the wealth of knowledge on the topic of sexuality, society maintains a strong taboo on the subject, especially concerning the sexuality of women. Sexual expression is often discouraged in women and used to judge their worth. Coming from a feminist perspective, Objectification Theory (Frederickson & Roberts, 1997) posits that the sexual objectification of women’s bodies, forcing women to value themselves only in terms of how sexually attractive they are to others, has resulted in lower self-esteem and higher instances …
Best Practice Methods For Social Work With North Koreans, Bethany Johnson
Best Practice Methods For Social Work With North Koreans, Bethany Johnson
Selected Honors Theses
The people of North Korea are in deep need of social work aid. This systematic literature review highlights key best practices for working with North Koreans, both in and out of their home country. Areas of work highlighted included addressing mental illnesses, specifically PTSD, reintegration into South Korea and other neighboring nations, advocating for international human rights policies, and humanitarian aid. Specific best practice suggestions are made for each section. In addition to this review, interviews were conducted with two expert professors in order to gain greater insight on the topic.
Factors Associated With Polypharmacy And Excessive Polypharmacy In Older People With Intellectual Disability Differ From The General Population; A Cross-Sectional Observational Nationwide Study, Maire O'Dwyer, Jure Peklar, Philip Mccallion, Mary Mccarron, Martin C. Henman
Factors Associated With Polypharmacy And Excessive Polypharmacy In Older People With Intellectual Disability Differ From The General Population; A Cross-Sectional Observational Nationwide Study, Maire O'Dwyer, Jure Peklar, Philip Mccallion, Mary Mccarron, Martin C. Henman
Social Welfare Faculty Scholarship
Objectives: (1) To evaluate the prevalence of polypharmacy (5–9 medicines) and excessive polypharmacy (10+ medicines) and (2) to determine associated demographic and clinical characteristics in an ageing population with intellectual disabilities (IDs).
Design: Observational cross-sectional study.
Setting: Wave One (2009/2010) of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA).
Participants: A nationally representative sample of 753 persons with ID, aged between 41 and 90 years. Participants/proxy reported medicines ( prescription and over the counter) taken on a regular basis; medication data was available for 736 participants (98%).
Main outcome measures/interventions: Participants were divided into those …
A Qualitative Study Of Mental Health Experiences And College Student Identity, Erin M. Frawley
A Qualitative Study Of Mental Health Experiences And College Student Identity, Erin M. Frawley
Theses, Dissertations, and Projects
This study uses a qualitative approach to capture the voices of nine students who self identified as having mental health experiences and who were also taking actions to cope with their mental health experiences from a small private arts college on the west coast. Students participated in one hour-long interviews that focused on students’ conceptions of mental health in relation to their identity, students’ actions related to mental health and students beliefs about the role of mental health in their sense of mattering. The findings suggest that mental health is constructed within student experience and identity differently depending on the …
How Different Technological Mediums May Reduce Attitudinal Barrier To The Utilization Of Psychotherapeutic Relationships, Collin T. Browne
How Different Technological Mediums May Reduce Attitudinal Barrier To The Utilization Of Psychotherapeutic Relationships, Collin T. Browne
Theses, Dissertations, and Projects
This qualitative study explored the use of communication technologies in the context of psychotherapeutic relationships, examining how technology might affect attitudinal barriers preventing young people from utilizing psychotherapy. Research findings emerged from semistructured Skype interviews with 10 participants (age 18-30 years) focused on their beliefs on psychotherapy, communications technology, and the idea of integrating technology into the psychotherapeutic relationship.
A theme analysis of the interviews produced four major findings: (1) psychotherapy is an especially difficult endeavor to begin and maintain; (2) certain qualities of the therapist (trust, expertise, and ‘fit’) are of particular importance; (3) voice and body language are …
"Stop Resisting!" : An Exploratory Study Of Police Brutality And Its Impacts On Black And Latino Males, Their Communities, Mental Health And Healing, Manuel A. Ortiz
"Stop Resisting!" : An Exploratory Study Of Police Brutality And Its Impacts On Black And Latino Males, Their Communities, Mental Health And Healing, Manuel A. Ortiz
Theses, Dissertations, and Projects
The purpose of this qualitative research study was to explore the impacts of police violence on Black and Latino males and their communities while also examining avenues of healing that could be helpful for survivors. Generally, this study focused on this question: What is the potential mental health effect of police brutality on Black and Latino males and what are avenues for healing for those affected? Twelve individual participants who identified as activists, advocates, or organizers in the Bay Area of Northern California participated in qualitative interviews that explored the impact of police violence and healing avenues. Participants were asked …
Servicenet Participatory Action Research Program Evaluation : A Project Based On An Independent Investigation At Servicenet In Northampton, Ma, Heather L. Crawford, Caroline W. Evans, Margot E. Reilly
Servicenet Participatory Action Research Program Evaluation : A Project Based On An Independent Investigation At Servicenet In Northampton, Ma, Heather L. Crawford, Caroline W. Evans, Margot E. Reilly
Theses, Dissertations, and Projects
This research project sought to evaluate if program participants of ServiceNet’s Mental Health Recovery Services (MHRS) feel supported to meet their self defined needs and goals. These researchers were guided by the principles of Participatory Action Research (PAR) and facilitated three focus groups who designed a mixed methods survey tool to be distributed by ServiceNet Recovery Counselors. Twelve surveys were refused and returned unopened, 56 program participants received the survey envelopes and did not return them, and 34 surveys were returned completed (n=34).
Participants demonstrated high satisfaction around housing, transportation, personal growth, emotional support, feeling treated like a human being, …
Missoula’S Homeless Children: Effects Of Homelessness On Mental, Emotional And Social Health, Sarah L. Shapiro
Missoula’S Homeless Children: Effects Of Homelessness On Mental, Emotional And Social Health, Sarah L. Shapiro
Undergraduate Theses, Professional Papers, and Capstone Artifacts
Missoula’s Homeless Children: Effects of Homelessness on Mental, Emotional and Social Health
The mental, emotional, and social health of children are greatly affected by being homeless. Being homeless as a child could effect a person’s coping skills and lead to mental health issues that increase the likelihood of substance abuse , suicide attempts, or adult homelessness. The purpose of this research project is to explore the negative effects of homelessness on Missoula children, and to identify services that could be useful in combating those effects. Methods for this project, included two data collection strategies. First, a literature review was completed …
Toxic Stress : Exploring Mental Health Narratives Of Environmental Justice In Richmond, California, Elizabeth Gonzalez
Toxic Stress : Exploring Mental Health Narratives Of Environmental Justice In Richmond, California, Elizabeth Gonzalez
Theses, Dissertations, and Projects
The purpose of this exploratory study was to gather narratives of residents and/or community members who perceive the presence of the Richmond Chevron Oil Refinery in their community as a psychological stressor. The study used semi-structured interviews with eight community organizers and activists to gather qualitative data providing personal accounts of the possible psychological impact of living near a toxic facility with great political power in the city. The common trend among the narratives was the tendency of the participants to focus on a macro interpretation of how mental health is affected by a corporate giant. A collective sense of …
The Role Of Trauma And Mental Health Problems In The Perpetration Of Intimate Partner Violence In Post-Genocide Rwanda, Sarah Myers Tlapek
The Role Of Trauma And Mental Health Problems In The Perpetration Of Intimate Partner Violence In Post-Genocide Rwanda, Sarah Myers Tlapek
Arts & Sciences Graduate Student Theses and Dissertations
Exposure to political violence or war is associated with intimate partner violence (IPV) in post-conflict settings (Clark et al., 2010; Gupta, Reed, Kelly, Stein, & Williams, 2012), and civilians and veterans who develop posttraumatic stress disorder (PTSD) after exposure to combat or violence are more likely to perpetrate violence against an intimate partner (Taft, Watkins, Stafford, Street, & Monson, 2011). Rwandan health professionals estimate that after the 1994 genocide more than one-quarter of the country’s population now suffers from PTSD (Munyandamutsa, Nkubamugisha, Gex-Fabry, & Eytan, 2012). Although the majority of Rwandan women (56%) have experienced IPV in their lifetime (National …
Reducing Stress And Increasing Hope Among Typhoon Yolanda Survivors, Maria Victoria Del Fierro, Mary Elizabeth Huxster
Reducing Stress And Increasing Hope Among Typhoon Yolanda Survivors, Maria Victoria Del Fierro, Mary Elizabeth Huxster
Electronic Theses, Projects, and Dissertations
Hundreds of thousands of people are affected by natural disasters every year. Many of these people face mental and emotional consequences from the traumatic experience. Research indicates that the aftereffects of such experiences can result in social, familial, and educational impairments in children. The current study tested the efficacy of a brief cognitive behavioral intervention on elementary school aged children intended to alleviate the mental and emotional consequences following a natural disaster. The study applied quantitative methods through pre and post intervention assessments measuring stress and hope. The participants assessed included 18 Filipino children between the ages of 10-12 years, …
University Scholar Series: Ed Cohen, Edward Cohen
University Scholar Series: Ed Cohen, Edward Cohen
University Scholar Series
Mental Health and Cultural Context in Vietnam
On May 6, 2015, Dr. Ed Cohen spoke in the University Scholar Series hosted by Provost Andy Feinstein at the Dr. Martin Luther King, Jr. Library. In this presentation, Dr. Cohen explored current research about mental illness and approaches to treatment in Vietnam, in addition to this country’s world view about illness, wellness and emotional health. Cohen is an Associate Professor in the School of Social Work and a Co-Investigator of SJSU's Social Work Education Enhancement Program in Vietnam.
Pastors As Gatekeepers: Congregational Encounters With Mental Health And Substance Abuse Issues, Curtis J. Vanderwaal, Andrea Opei, Edwin I. Hernandez
Pastors As Gatekeepers: Congregational Encounters With Mental Health And Substance Abuse Issues, Curtis J. Vanderwaal, Andrea Opei, Edwin I. Hernandez
Faculty Publications
The vocation of a pastor is to care for the spiritual needs of a congregation and community. However, as many clergy know well, pastoral care is multifaceted and complex. For example, one of the hats that pastors frequently wear is that of pastoral counselor. Although pastors have traditionally offered support and pastoral care to congregants, they are beginning to spend more hours counseling both congregants and community members. One study indicated that pastors were spending time in pastoral counseling equivalent to that of marriage and family therapists in private practice.1 The same study showed that pastors are encountering persons and …
Practice Recommendations For Mental Health Professionals: Perspectives From Grandparents And Their Adolescent Grandchildren, Kendra A. O'Hora, Megan L. Dolbin-Macnab
Practice Recommendations For Mental Health Professionals: Perspectives From Grandparents And Their Adolescent Grandchildren, Kendra A. O'Hora, Megan L. Dolbin-Macnab
GrandFamilies: The Contemporary Journal of Research, Practice and Policy
Although grandfamilies are consumers of a variety of mental health services, less is known about what these families, particularly the grandchildren, want from practitioners. To gain insight into how practitioners can best meet the needs of grandfamilies, 40 custodial grandmothers and their adolescent grandchildren were interviewed. Results of a qualitative analysis indicated that grandmothers and grandchildren did not make clear distinctions between various types of services and service providers. Grandchildren, in particular, emphasized the need for mental health professionals to facilitate mentoring and to provide opportunities for grandchildren to socialize with other grandchildren who have been through similar circumstances. Grandmothers …
Grief And At-Risk Behavior: A Look At The Effectiveness Of Grief Counseling Groups For Adolescents In Public Schools, Kiana Battle
Grief And At-Risk Behavior: A Look At The Effectiveness Of Grief Counseling Groups For Adolescents In Public Schools, Kiana Battle
National Youth Advocacy & Resilience Conference
Brief Description: This presentation will explore the affects that grief has on adolescents, including at–risk behaviors, identity confusion, issues of self-worth, and many more. The presentation will illustrate the positive impact that grief counseling groups have among adolescents (with a special focus in the public school environment). Barriers that hinder the effective delivery of group counseling within the public school arena will also be addressed (such barriers are amount of time in the school day, student caseload, and administrative support). This presentation will also address the critical role that school social workers play, in effectively providing group counseling interventions to …
Some Secrets Should Be Shared: Implementing An Evidence-Based Suicide Prevention Program, Meghan W. Diamon
Some Secrets Should Be Shared: Implementing An Evidence-Based Suicide Prevention Program, Meghan W. Diamon
National Youth Advocacy & Resilience Conference
Youth suicide prevention is critical in schools and local communities. Participants will discuss published research on risk factors for youth suicide, how to implement an evidence-based prevention program, and how to tackle common obstacles encountered. Participants will be prepared to mobilize school staff, parents, and community members to address the critical issues of depression awareness and suicide prevention.
Metaphoric Generative Genograms: A Journey To Bring Genograms To Life Through Metaphorical Components, Elisa Garcia
Metaphoric Generative Genograms: A Journey To Bring Genograms To Life Through Metaphorical Components, Elisa Garcia
Department of Family Therapy Dissertations and Applied Clinical Projects
The purpose of this dissertation is to offer a greater understanding of the potential of genograms through my clinical work from a Bowen Family Systems lens. I account for how I processed and effectively blended metaphorical components, by examining six cases from my two-year journal entries, of bringing genograms to life in sessions. I also explain how I created a useful tool, the Metaphoric Generative Genogram, that can benefit other clinicians working with children and families in the foster care community.
Clinical Encounters With Immigrants: What Matters For U.S. Psychiatrists., Carolina Hausmann-Stabile, Peter J. Guarnaccia
Clinical Encounters With Immigrants: What Matters For U.S. Psychiatrists., Carolina Hausmann-Stabile, Peter J. Guarnaccia
Graduate School of Social Work and Social Research Faculty Research and Scholarship
About 3.2 percent of the population across the globe are migrants. Today, unprecedented numbers of people are relocating in the U.S. and more than ever, psychiatrists find themselves caring for immigrant patients. International migration is a multilayered issue that often has implications for the mental health of migrants. Thus, there is an increasing interest in understanding how the different factors associated with migration processes affect the mental health outcomes of immigrants. We group these factors into three categories: immigrant process, clinical encounter, and mental health services. When possible, we incorporate a gendered and life span perspective and suggest avenues for …
Time-Limited Case Management For Homeless Mothers With Mental Health Problems: Effects On Caregiver Mental Health., Judith Samuels, Patrick J. Fowler, Andrea Ault-Brutus, Dein-In Tang, Katherine Marcal
Time-Limited Case Management For Homeless Mothers With Mental Health Problems: Effects On Caregiver Mental Health., Judith Samuels, Patrick J. Fowler, Andrea Ault-Brutus, Dein-In Tang, Katherine Marcal
Brown School Faculty Publications
Objective: In this study we test the effect of a time-limited case management model targeting homeless mothers who are experiencing mental health problems. Adapted from an empirically informed intervention to prevent recurrent homelessness among individuals, the Family Critical Time Intervention (FCTI) supports mothers with children for a 9-month period as they move from homeless shelters into affordable housing. The case management team uses a structured intervention to encourage mothers to create and maintain necessary connections in the community for key family supports. Method: We use a longitudinal randomized controlled trial (N = 210) to test whether homeless mothers referred to …
The Early Good News About Child Development Accounts, Sondra G. Beverly, Margaret Clancy, Michael Sherraden
The Early Good News About Child Development Accounts, Sondra G. Beverly, Margaret Clancy, Michael Sherraden
Center for Social Development Research
This brief summary of early research findings from the SEED for Oklahoma Kids experiment may help Child Development Account (CDA) proponents communicate the value of such accounts to policymakers, educators and others.
Incarceration And Reintegration: How It Impacts Mental Health, April M. Marier, Alex Alfredo Reyes
Incarceration And Reintegration: How It Impacts Mental Health, April M. Marier, Alex Alfredo Reyes
Electronic Theses, Projects, and Dissertations
ABSTRACT
Background: Previous criminal justice policies have been non-effective leading to overpopulated prisons and unsuccessful reintegration. There is a lack of effective supportive and/or rehabilitative services resulting in high rates of recidivism and mental health implications. Objective: This study investigated the perceived impact that incarceration and reintegration with little to no supportive and/or rehabilitative services has on the mental health status of an individual. The emphasis was on participant perception and not on professional reports because of underreporting and lack of attention to mental health in the criminal justice system. Methods: Focus groups in the Inland Empire and Coachella Valley …
Estimating The Prevalence And Correlates Of Psychiatric Disorders And Mental Health Problems Among Undocumented Mexican Immigrants Using The National Latino And Asian American Study, Elián P. Cabrera-Nguyen
Estimating The Prevalence And Correlates Of Psychiatric Disorders And Mental Health Problems Among Undocumented Mexican Immigrants Using The National Latino And Asian American Study, Elián P. Cabrera-Nguyen
Arts & Sciences Graduate Student Theses and Dissertations
This study examines the prevalence and correlates of psychiatric disorders and mental health problems among undocumented Mexican immigrants using the National Latino and Asian American Study (NLAAS). Two approaches were used to obtain estimates for likely undocumented Mexican immigrants (LUMIs): (1) creation of a proxy variable, and (2) multiple imputation using chained equations. Results indicated that LUMIs had greater prevalence rates for specific anxiety disorders, depressive disorders and poor self-rated mental health compared to documented Mexican immigrants. Next, potential mediators of poor mental health were identified. Finally, LUMIs were compared with other Latino groups by nativity status. This study concludes …
Perspectives Of Social Work Students On Nutrition And The Nutrition Effects On Mental Health, Diana Tran
Perspectives Of Social Work Students On Nutrition And The Nutrition Effects On Mental Health, Diana Tran
Electronic Theses, Projects, and Dissertations
Nutrition is related to the mental well-being of clients. However, the nutritional views and practices of social workers in the mental health field have not been thoroughly explored. By using the post-positivist paradigm, 15 mental health social work students were interviewed for their perspectives regarding nutrition and nutrition’s effect on stress. Their main ideas were identified, connected, and organized to develop a theoretical statement. The resulting theory focused on the development of social work students' perspectives in applying nutrition into their mental health practice. The students were influenced by a variety of background factors, including their education, barriers to applying …
Mental Health First Aid Usa: The Implementation Of A Mental Health First Aid Training Program In A Rural Healthcare Setting, Andrew M. O'Neill, Valerie L. Leyva, Michael N. Humble, Melinda L. Lewis, John A. Garcia
Mental Health First Aid Usa: The Implementation Of A Mental Health First Aid Training Program In A Rural Healthcare Setting, Andrew M. O'Neill, Valerie L. Leyva, Michael N. Humble, Melinda L. Lewis, John A. Garcia
Contemporary Rural Social Work Journal
Nearly one-quarter of adults in the United States suffer from a documented mental disorder. Consequently, anyone could encounter a person with symptoms of mental illness at some point as they carry out their daily life activities. Although laypersons may accurately identify physical illnesses, they may lack necessary skills to identify symptoms of mental disorders, or know how to adequately respond to persons in a mental health crisis. Mental Health First Aid USA is an evidence-based certification program designed to teach lay citizens to recognize certain symptoms of common mental illnesses, offer and provide first aid assistance, and guide a person …
Comorbidity Of Common Mental Disorders With Cancer And Their Treatment Gap: Findings From The World Mental Health Surveys, Ora Nakash, Itzhak Levav, Sergio Aguilar-Gaxiola, Jordi Alonso, Laura Helena Andrade, Matthias C. Angermeyer, Ronny Bruffaerts, Jose Miguel Caldas-De-Almeida, Slivia Florescu, Giovanni De Girolamo, Oye Gureje, Yanling He, Chiyi Hu, Peter De Jonge, Elie G. Karam, Viviane Kovess-Masfety, Maria Elena Medina-Mora, Jacek Moskalewicz, Sam Murphy, Yosikazu Nakamura, Marina Piazza, Jose Posada-Villa, Dan J. Stein, Nezar Ismet Taib, Zahari Zarkov, Ronald C. Kessler, Kate M. Scott
Comorbidity Of Common Mental Disorders With Cancer And Their Treatment Gap: Findings From The World Mental Health Surveys, Ora Nakash, Itzhak Levav, Sergio Aguilar-Gaxiola, Jordi Alonso, Laura Helena Andrade, Matthias C. Angermeyer, Ronny Bruffaerts, Jose Miguel Caldas-De-Almeida, Slivia Florescu, Giovanni De Girolamo, Oye Gureje, Yanling He, Chiyi Hu, Peter De Jonge, Elie G. Karam, Viviane Kovess-Masfety, Maria Elena Medina-Mora, Jacek Moskalewicz, Sam Murphy, Yosikazu Nakamura, Marina Piazza, Jose Posada-Villa, Dan J. Stein, Nezar Ismet Taib, Zahari Zarkov, Ronald C. Kessler, Kate M. Scott
School for Social Work: Faculty Publications
Objective This study aimed to study the comorbidity of common mental disorders (CMDs) and cancer, and the mental health treatment gap among community residents with active cancer, cancer survivors and cancer-free respondents in 13 high-income and 11 low-middle-income countries. Methods Data were derived from the World Mental Health Surveys (N = 66,387; n = 357 active cancer, n = 1373 cancer survivors, n = 64,657 cancer-free respondents). The World Health Organization/Composite International Diagnostic Interview was used in all surveys to estimate CMDs prevalence rates. Respondents were also asked about mental health service utilization in the preceding 12 months. Cancer status …
What Does The 'Q' Stand For Anyway? : Queerness And Agency Competence, Eleanor C. Taylor
What Does The 'Q' Stand For Anyway? : Queerness And Agency Competence, Eleanor C. Taylor
Theses, Dissertations, and Projects
This exploratory study’s purpose was to explore queer identity in mental health practice through the question, "Does queerness emerge as a distinct cultural category through the language of conversation, clinical practice, and administrative policy in mental health agencies that serve queer people, and in what practices is this reflected?” This project was undertaken in order to begin to fill gaps in existing cultural competence literature, particularly regarding queer identity.
This project entailed semi-structured interviews with ten participants, who worked in direct service at mental health agencies that serve LGBTQIA+ populations. This study examines the meanings and effects of queerness in …
Human - Animal Interaction And The Benefits To Mental Health: A Phenomenological Study, Jasmin Jau
Human - Animal Interaction And The Benefits To Mental Health: A Phenomenological Study, Jasmin Jau
Theses : Honours
The prevalence of mental illness is a major concern in Australia and worldwide. It is one of the leading causes of disability in Australia and it is estimated that globally one in four people will experience a mental illness at some point in their life. One of the lesser known therapies and activities in the mental health field are animal assisted interventions that incorporate animals as part of the therapeutic or ameliorative process. Although emerging research literature shows that interaction with animals has positive effects on mental health and wellbeing, it is not clearly understood how and why there are …