Feelings Of Sadness Research Articles

‘Leaving the child behind was not easy’: lived experiences of mothers returning to work after maternity leave in Ghana

ABSTRACT This study explored the lived experiences of employed mothers returning to work after maternity leave in the Ghanaian context. Using a qualitative research approach, in-depth interviews were conducted with 21 employed postpartum mothers who had returned to work within one year after birth. Using reflexive thematic analysis, four themes were generated that speak to mothers’ experiences of returning to work after maternity leave: setting the stage for work return, embracing the emotions of work return, re-adapting to the workplace, and impact on personal and family health. Mothers’ return to work after maternity leave was preceded by extensive physical and psychological preparations including childcare arrangements that enhanced their readiness for paid work. Despite such preparations, most mothers experienced their return to work as emotionally challenging marked by feelings of sadness, guilt, and frustration. Childbirth and return to work also negatively impacted mothers’ work performance as well as their personal and family wellbeing. Moreover, combining the increased responsibilities associated with childbirth and work demands emerged as a major source of stress for postpartum mothers. These findings underscore the need for policies, organisational practices, and comprehensive support structures that facilitate mothers’ return to work after maternity leave.

Negative Emotions in Children's Drawings and Their Emotion Regulation Strategies

This research was carried out in order to reflect the negative emotions of children on their paintings and to examine the strategies they use while regulating these emotions. The phenomenological design was adopted in this study in accordance with the qualitative research approach. The participants were chosen by means of homogeneous sampling and on a voluntary basis. The data of this study, which was conducted with a total of 50 children aged between 6 and 10 years, were obtained through drawing and interview techniques. The children were allowed to draw the emotions they assumed as negative in their natural environment without time limitation. Then, one-to-one semi-structured interviews were conducted with each child about the picture they drew. The obtained data were analyzed by content analysis method. As a result of the research, it was seen that there were no negative emotions such as anxiety and fear in the pictures and interviews of the six-year-old children. On the other hand, these feelings were encountered in ten-year-old children. According to another result, feelings such as jealousy, loneliness and insecurity were not encountered in children in the ten-year-old group, unlike the children in the six-year-old group. It was observed that children generally included feelings of sadness and anger in their drawings. In addition, it is noteworthy that ten-year-old children also include anxiety and fear. In the context of emotion regulation strategies, it was revealed that ten-year-old children used more emotion regulation strategies than six-year-old children.

Classification of Depression Expressions on Twitter Using Ensemble Learning with Word2Vec

One of the mental health disorders experienced by people is depression. Depression is a mental disorder characterized by feelings of sadness, loss of interest or pleasure in daily activities, and decreased cognitive function that can affect social life, work, and general physical health. Early detection is needed to prevent the occurrence of bad risks. One of the early detections can be done through social media. This is because social media is one of the tools used to channel expression. This research uses data taken from Twitter social media to create a machine learning model. Before model building, data pre-processing will be carried out using Word2Vec to convert text into a continuous vector representation. The algorithm used is ensemble learning by combining five algorithms: Logistic Regression, Decision Tree, K-Nearest Neighbor, Artificial Neural Network, and Support Vector Machine. The results show that different Word2Vec architectures can give the model another performance. Ensemble Learning can improve the performance of using a single model. The best results were obtained by using a data ratio of 90:10 using the Skip-gram architecture to get an accuracy value and f1-score of 94%.

Internal and External Conflict of the main characters in the short stories Tuhan, Pawang Hujan, dan Petarung yang Remis by A.S Laksana

This research aims to describe the internal conflict and external conflict of the main character named Alit in the short stories Tuhan, Pawang Hujan, dan Petarung yang Remis by A.S Laksana. Alit works as a magician and rain charmer. This research uses descriptive qualitative methods. The data collection technique in this research uses library techniques. Based on the data collection technique used, the data is analyzed using descriptive analysis. The steps in analyzing the data are as follows: Grouping the data based on data type, Reducing data from the data corpus according to the problem being studied, Describing the data to make it clearer. easy to understand, Analyzing data based on predetermined formulas and drawing conclusions. Based on the results of the analysis of the short stories Tuhan, Pawang Hujan, dan Petarung yang Remis by A.S Laksana. There are internal conflicts and external conflicts. Internal conflict is a problem or event that occurs to Alit because of an inner struggle with himself caused by the emergence of desires or feelings that arise from within the character. External conflict in the short stories Tuhan, Pawang Hujan, dan Petarung yang Remis by A.S Laksana, is an event that arises due to the involvement of other people or influences from outside the characters which give rise to feelings of happiness, sadness, disappointment, anger and revenge. This is a description of events that often occur in real life when living in the real world.

Relationship between emotional awareness, symptoms, and protective factors in children exposed to intimate partner violence.

This study was designed to analyze the associations between emotional awareness (EA) and internalizing and externalizing symptoms, and mood states in children ages 8-12 who were previously exposed to intimate partner violence (EIPV). The study also aimed to explore the association between EA and external and internal protective factors of resilience. A descriptive design study was used; participants were 61 children (M = 10 years, 52.5% girls) who were EIPV patients from three Child and Adolescent Mental Health Centers in the Barcelona metropolitan area, Spain. The hypotheses of this study were that (a) an increased capacity for EA would be associated with less severity of internalizing and externalizing symptoms in children EIPV and (b) an increased capacity for EA would correlate with greater resilience. Lower EA was found to be associated with more symptoms, specifically trait anxiety, depression, somatic complaints, total externalizing and internalizing symptoms, and increased feelings of anger and sadness. Greater EA was linked to improved social skills, higher self-esteem, empathy, humor, and both external and internal resilience, as well as with reduced aggressiveness/antisocial behavior and loneliness/social anxiety. The variables that best explained the EA factors were trait anxiety, dysphoria, problem attention, sadness, humor, self-esteem, internal and external protective factors, appropriate social skills, and friendship. This study highlights the relevance of EA for children EIPV. Lower EA was associated with higher symptom severity, while higher EA was linked to better self-esteem, social skills, and resilience. The findings suggest the significance of addressing EA in therapeutic interventions for this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prevalence of Depression Among Older Adults Visiting the Primary Healthcare Centers in Jizan City, Saudi Arabia: An Analytical Cross-Sectional Study.

Background and objective Older adults are susceptible to various disorders, including depression. Depression manifests as a disorder characterized by a persistent depressed mood, feelings of sadness and loneliness, sleep disturbances, and loss of interest lasting for two weeks or more. This condition can significantly affect the quality of life for older adults, resulting in adverse outcomes that have a negative impact on their overall well-being. In this study, our objective was to assess the prevalence of depression and identify associated risk factors among individuals aged 60 years and above who attended Primary Healthcare Centers (PHCCs) in Jizan City. Methodology We conducted an analytical cross-sectional study among older people attending PHCCs in Jizan City between May and December 2022. In this study, we interviewed 300 participants using the Patient Health Questionnaire-9 (PHQ-9) to assess depression. IBM SPSS Statistics for Windows, Version 25.0 (IBM Corp., Armonk, NY) was used for data entry and analysis. We used the chi-square test and binary logistic regression model to detect the associations and predictors of depression among older adults. Results One-third of the study participants experienced depression, with 49 (16%) exhibiting mild depression, 33 (11%) reporting moderate depression, and 17 (6%) individuals indicating moderately severe depression. Depression was more common among females (158, 52.7%) than males (142, 47.3%). The predictors of depression among the study participants were the dependency to perform daily tasks and abnormal sleep duration. Conclusions Depression is a prevalent health problem among older people in Jizan City, particularly among females, those who are divorced or widowed, individuals dependent on others for daily tasks, and those with abnormal sleep duration. We concludethat we need more research on older adults to assess their mental problems and fill in the literature gap.

Is impairment of facial emotion recognition independent of cognitive dysfunction in multiple sclerosis?

BackgroundEmotions expressed on the face play a key role in social cognition and communication by providing inner emotional experiences. This study aimed to evaluate facial emotion identification and discrimination and empathy abilities in patients with MS and whether it is related to cognitive dysfunction.MethodsOne hundred twenty patients with relapsing–remitting MS and age- and sex-matched 120 healthy controls were enrolled in the study. All the subjects were evaluated with the Facial Emotion Identification Test (FEIT), Facial Emotion Discrimination Test (FEIDT), and Empathy Quotient (EQ). We used the Beck Depression Inventory (BDI) for depression and detailed cognitive tests, including the Montreal Cognitive Assessment (MoCA), the Symbol Digit Modalities Test (SDMT), and the Paced Auditory Serial Addition Test (PASAT). The quality of life was assessed with Multiple Sclerosis Quality of Life-54 (MSQL-54).ResultsPatients with MS were 37.6 ± 9.5 years old, had a mean disease duration of 8.8 ± 6.6 (8–28) years, and a mean EDSS score of 1.6 ± 1.3 (0–4.5). We found significant differences in the identification of facial emotions, discrimination of facial emotions, and empathy in MS patients compared to controls (p < 0.05). Especially the recognition of feelings of sadness, fear, and shame was significantly lower in MS patients. The multivariate logistic regression analysis showed low SDMT and FEIDT scores which showed an independent association with MS.ConclusionsOur findings indicate that facial emotion recognition and identification deficits are remarkable among patients with MS and emotion recognition is impaired together with and independently of cognitive dysfunction in MS patients.

“They Told me I Should Feel Sad”: Narrative and Personal Story Telling as a Sensemaking and Ownership Tool for Young People Who Have Experienced Bereavement

AbstractThis research focused on listening to the voices of children who have experienced the death of someone important to them. Through a personalized narrative methodology working with practitioners, and with regard for cultural and religious beliefs, children were given safe space to tell their own truths to sense‐make rather than prescribing how they should be feeling or what they should be experiencing as part of their grief journey. Findings suggest this impacted positively on the children's wellbeing. The recommendations are to use this approach to open up dialogue instigated by the child, which is currently missing from contemporary policy and practice, as well as adding to the limited literature. Furthermore, the engagement with the topic of death is advocated for all children rather than simply retrospectively with those who have experienced it. As this was a small‐scale study, more research is needed.

Cli-fi videos can increase charitable donations: experimental evidence from the United Kingdom.

Recent research has begun to investigate if climate fiction, or cli-fi, can increase people's support for pro-climate initiatives. Emerging evidence focuses on whether cli-fi stories affect people's self-reported emotions, attitudes, and intentions. Few studies, however, examine the effect of such stories on revealed behavior, and whether the cli-fi story medium, i.e., whether stories are presented in text, audio, or audio-visual format, matters. We investigate the causal effect of cli-fi stories, and the medium through which they are communicated (textual, audio, or audio-visual) on self-reported support for climate policy, individual and collective action intentions, and a revealed measure of charitable donations. In a pre-registered online experiment (n = 1,085 UK adults), participants were randomly assigned to one of 5 conditions - to read scientific information about climate change (scientific information condition), read a story unrelated to the environment (control), read a cli-fi story in which a protagonist took intentional pro-environmental actions (fiction text), listen to the same cli-fi story in audio format (fiction audio), or watch an animation of the cli-fi story (fiction video). When comparing the fiction-text, fact-text, and control conditions, we found that cli-fi stories are not always more effective than alternative climate communications: participants in the fact-text condition reported higher support for climate policies, and intentions of taking individual environmental actions, and negative feelings of sadness, disappointment, and guilt, compared to the text-based control and cli-fi text condition. When comparing the cli-fi media format, we found that cli-fi videos were most effective in increasing pro-environmental charitable donations in an incentivized choice task, and self-reported feelings of happiness, hope, and inspiration. The findings show that scientific information about the climate and climate-fiction have an important place in the climate communications toolkit and can offer distinct pathways to enhance support for policy and behavioral change. Communicators seeking to inspire individual pro-environmental actions can consider telling cli-fi stories in video, which may be more compelling. And communicators seeking to enhance public support for societal changes, via climate policies, may benefit from disseminating scientific information about climate change.

A REVIEW ARTICLE ON DEPRESSION WITH SPECIAL REFERENCE TO KAPHAJA UNMADA

Depression, a prevalent mental disorder, is characterised by symptoms such as a persistent feeling of sadness, diminished interest or enjoyment, self-perceived guilt or low self-esteem, disrupted sleep patterns or appetite, decreased energy levels, and difficulties with concentration. Despite advances in diagnostics and therapeutics, depression is quickly becoming a public health crisis. At the height of the COVID-19 pandemic, the prevalence of depression shows a sharp rise. Mind encroaches on physical health through our behaviour and body chemistry. Manasa Vikara is considered an abnormal mental condition characterized by impairment of cognitive functions. The most elaborately dealt Mano Vyadhi in Ayurveda is Unmada. The symptoms caused by the aggravated dosas that spread to the higher channels of the body resemble intoxication and are classified as "Unmada." A broad spectrum of diseases is included under Unmada by various Acharyas. In the Ayurvedic perspective, Depression can be explained under Kaphaja Unmada.

Exposure to Instagram junk food content negatively impacts mood and cravings in young adults: A randomized controlled trial

Exposure to different types of images on social media is known to affect physical and mental wellbeing including changes in perception of body image (BI) and dietary behavior. The present study aimed to assess the effects of junk food-related Instagram content exposure on body image, overall mood, and cravings in young adults. A randomized crossover experimental design was used. After filling out a baseline survey, participants (n = 63, aged 18–24) browsed either a control Instagram account feed or an account rich in junk food images during 15 min. They then filled a short survey evaluating their state BI, mood, and cravings (T1). After a 1-week washout period (T2), participants browsed the other account type followed by the same short survey as in T1. Results showed that exposure to junk food content was associated with increased feelings of hunger, stress, sadness, and exhaustion, in addition to higher salty, savory, and fatty food cravings. Moreover, participants showed higher desire for junk food and lower desire for healthy food items from a virtual food tray after junk food content exposure. There was no impact of content type on state BI dissatisfaction. In conclusion, exposure to junk-food related content on social media negatively affects mood and cravings, subsequently influencing food choices. The present findings shed light on the need for interventions aimed at providing cognitive and emotional competencies for enhancing media literacy and promoting mindful social media use.

Analisis Konflik Batin Tokoh Utama Rani Dalam Cerpen Saat Mas Ingin Menikah Lagi Karya Nirmala Rustini

This research aims to describe the form of inner conflict of the main character Rani in the short story Saat Mas Wants to Marry Again by Nirmala Rustini. The problem in this research is more focused on the form of inner conflict of the main character Rani. The method used in this research is a qualitative descriptive method, using a short story literary work entitled When Mas Wants to Marry Again by Nirmala Rustini as a research source. The data collection technique uses the note-reading method, by reading the entire short story and recording relevant data to be used as a source of research data. From the results of this research, it was found that there were five inner conflicts found in the short story When Mas Wants to Marry Again, namely feelings of sadness, feelings of anger, feelings of fear, feelings of anxiety, and feelings of disappointment.

School personnel suicide prevention training: No clear option

Youth and young adult deaths from suicide have been increasing in the United States over the past two decades. According to the Centers for Disease Control and Prevention's National Center for Health Statistics for those between the ages of 10 and 24 from 2011 to 2021 the death by suicide rate rose 60% to 11.0 per 100,000. Paralleling these highly troubling rates of death by suicide is information from the Centers for Disease Control (CDC) Youth Risk Behavior Survey Data Summary and Trends Report: 2011–2021. The report reinforces a picture of our nation's youth in serious mental health crisis. In response to the 2021 survey an increasing number of students reported persistent feelings of sadness and hopelessness. This included 57% of girls, 29% of boys and 69% of LGBTQ students. More than 20% of teens reported having seriously considered suicide!

Post-traumatic Effects in Survivors of Childhood Sexual Abuse: A Study Literature

Childhood sexual abuse can result in long-term effects that remain in the survivors to confront and encounter continually. This study aimed to examine behavioral indicators that indicate trauma, which is one of the long-term effects of child sexual violence against children. The study used a literature study technique. There were three behavioral indications developed as long-term consequences of trauma endured by survivors of child sexual abuse. The first indicator was cognitive distortions characterized by self-blame, self-criticism, and a sense of worthlessness. Then, concerns regarding emotional regulation, which present persistent feelings of anxiety or sadness, can appear as the second implication. The last behavioral indication was difficulties regarding the ability to resist impulsive urges, evidently via the engagement in substance misuse and the development of deviant sexual conduct.

Network Analysis of Depression Levels in Adolescents with Non-suicidal Self-injury

Adolescence is a critical developmental period characterized by a notable increase in the prevalence of depression and self-harming behaviors. Thus, understanding their interplay is crucial for intervention and prevention strategies. This study uses network analysis to investigate the characteristics of the depressive symptom network in non-suicidal self-injury among adolescents and identify potential intervention targets. Between June 2023 and October 2023, a total of 171 non-suicidal self-injury adolescents were recruited. The Chinese version of the Center for Epidemiologic Studies Depression Scale was used to assess depressive symptoms. Statistical analysis and visualization of the network were conducted using the R software. In order to make quantitative research on the depressive symptom network structure, indicators of closeness, strength, and betweenness were utilized to identify symptoms that play a central role in the net work. Network analysis unveiled a group of central nodes with significant influence, assuming pivotal roles in the network. The symptoms of felt sad, thought life as a failure, could not get going, felt that everything I did was an effort were central to the network. Furthermore, this network exhibited good stability and accuracy of edge weights. The findings from this study not only advance peoples comprehension of the connection between non-suicidal self-injury and depression in adolescents but also provide new insights for future intervention strategies. This research underscores the need for comprehensive approaches to address this intricate issue, offering guidance for precise interventions and clinical practices.

The Effectiveness of Cognitive Behavioral Therapy in Reducing Depression Levels in Adolescents from the Perspective of Big Five Personality Traits

Adolescence experience various changes characterized by significant transformations in physical, cognitive, emotional, and psychological aspects, which can influence depression. Depression is a common mental disorder among adolescents and adults, marked by feelings of sadness, worthlessness, guilt, and somatic symptoms like fatigue, eating disorders, and sleep disturbances. Personality traits play a crucial role in shaping how individuals think and behave, influencing their susceptibility to depression. This study aims to evaluate the efficacy of cognitive behavioral therapy (CBT) in alleviating depression among adolescents, considering the influence of the big five personality traits. The population for this study consists of 170 students from SMPN “X.” The sampling method used is purposive sampling, with a determined sample size of 114 students, aged 12-18 years. This study employed an experimental method with a pre-experimental design, using a one-group pre-test and post-test approach. The instruments used were the Depression Scale and BFI-II, with validity and reliability scores of 0.924 and 0.914, respectively. Data analysis was conducted using the paired sample t-test and kruskal wallis test. the paired sample t-test results showed an asymp. sig. (2-tailed) value &lt; 0.05, or 0.000 &lt; 0.05, indicating a difference between pretest and posttest results after the CBT intervention. This demonstrates that CBT is effective in reducing depression levels in adolescents. the kruskal wallis test results showed an asymp. sig. (2-tailed) value &gt; 0.05, or 0.104 &gt; 0.05, indicating no significant differences in depression level reduction among adolescents with the personality traits of neuroticism, agreeableness, openness, and conscientiousness. Based on the findings, it is recommended that schools implement CBT-based interventions as part of mental health programs to help reduce depression in adolescents. Additionally, future studies should examine whether personalized CBT approaches tailored to specific personality traits could enhance the effectiveness of therapy.

Identifying factors, such as low sleep quality, that predict suicidal thoughts using machine learning

Every year, around 800,000 people die by suicide worldwide, and it is the second leading cause of death for individuals aged 15-24 years. The National Survey on Drug Use and Health (NSDUH) is conducted annually to ask the general United States population aged 12 years and older questions about mental health, substance use, and suicidal thoughts. Some of the factors the survey considers are substance use, including need for treatment and disorders, and mental health topics, including major depressive episodes, suicidal ideation and attempts, and mental illness. In our research, we sought to identify associations between suicidal ideation and relevant variables, such as sleep quality, hopelessness, and anxious behavior, by analyzing survey responses from the 2020 NSDUH. Due to the density of the survey and no obvious direct relationship between any variables with suicidal ideation, through our research we aimed to clearly find and display any association. We hypothesized that frequent anxious thoughts and behavior (such as fidgeting and restlessness), feelings of sadness, and/or low sleep quality would be the factors most predictive of having suicidal thoughts. Using a random forest classifier, we found that sleep problems were highly predictive of suicidal ideation. Professionals and clinicians should keep these findings in mind when developing suicide prevention efforts, such as identifying and supporting people potentially at risk, intervening to improve sleep quality, and teaching coping skills.

Anxiety and diet among elderly people suffering from diabetes mellitus in Banda Aceh, Indonesia: A correlational study

Successfully managing diabetes over a long period is challenging and requires close monitoring of one’s diet and lifestyle. However, mental health issues such as anxiety can make it difficult to manage diabetes effectively, especially in older people. This study aims to highlight the psychological challenges older people with diabetes face, emphasizing the importance of mental health in managing chronic illnesses. It explores how anxiety affects the eating habits of older individuals with diabetes. The study used a quantitative method and a descriptive correlational research design. It involved older people with diabetes mellitus, with about 300 participants selected through purposive sampling based on certain criteria. The study measured anxiety levels using the GAS questionnaire, which is highly reliable (0.93), and dietary patterns were assessed with the UK-DDQ, which has a reliability of 0.765. The findings show that most participants were female (62%), in their early elderly years (89.7%), and had finished high school (67.7%). Regarding income, 39.3% earned less than Rp. 1,500,000. Over half lived with a partner (51%) and felt sadness and depression (64%). A minority had no family history of diabetes (38.3%), and most were cared for by their children (54.3%). Most participants had been living with diabetes for 2-5 years (54.1%) and did not smoke (85%). In terms of treatment, the majority used metformin (73.7%), and just over half did not use traditional medicine (51.3%). The study found a significant link between anxiety and diet in older adults with diabetes mellitus, with a p-value of 0.006 (alpha = 0.05). It suggests that healthcare providers should consider the whole well-being of older adults with diabetes, recognizing that anxiety can hinder their ability to follow a diet plan. Therefore, it is crucial to understand a patient’s mental, emotional, and physical health for effective treatment.

Prevalence, Perceived Risk Factors and Effects of Enuresis among School-age Children in Nsukka Local Government Area, Enugu State, Nigeria

This study investigated the prevalence, perceived risk factors and effects of enuresis among school-age children in Nsukka local government area. The study adopted a descriptive cross-sectional survey research design with a population of 7,794 Junior Secondary Students within the age range of 9-12years in the study area. Multi-stage sampling technique was employed to select a sample of 820 students from 10 selected schools. A structured questionnaire was the instrument for data collection. The reliability of the questionnaire was 0.86 Cronbach’s alpha showing a good internal consistency of the test items. Data were analysed using frequencies, percentages means and standard deviations. Findings showed that prevalence of bedwetting among the respondents was 17.8%, 14.6% among males and 24.4% among females. The prevalence of primary bedwetting was 12.7%, 5.0% experienced secondary bedwetting, 15.0% experienced nocturnal enuresis and 2.6% experienced diurnal bedwetting. Dreaming of urinating, drinking a lot of fluid before bed and cold weather were some of the risk factors of bedwetting identified by the respondents. Some of the effects of bedwetting identified by the respondents were that bedwetting children often smell bad and bedwetting makes children feel sad. Preventive, curative, hygiene management and reinforcement strategies for enuresis were identified by the respondents. It was concluded that bedwetting negatively affects children in such ways as making them have an offensive smell, sad feelings, mockery and loss of respect from friends. School authorities should therefore make out time within the school year, to create awareness and teach school children about enuresis to reduce the stigma and embarrassment they face.

Mental health chatbot therapist

Mental health illness refers to conditions that affect thinking, feeling, mood, and behavior. These conditions may be occasional or long-lasting. Some examples of mental illness include depression, anxiety disorder, and addictive behaviors, to name a few. Mental health conditions can be caused by various factors, including substance abuse, psychological trauma, unhealthy habits, and genetics. Symptoms of mental illness may include feelings of sadness or hopelessness, extreme mood changes, excessive anger, hostility, and even violence. Individuals with mental health issues often require the assistance of a psychiatrist to undergo therapy, which is typically conducted face-to-face. This in- person approach to therapy can present several challenges, such as high costs, a shortage of psychiatric specialists in hospitals, and the reluctance of some patients to engage in the therapeutic process. Given these drawbacks associated with traditional face-to-face therapy, the concept of creating a mental health chatbot therapist emerged. This chatbot is a computer program designed to simulate conversation with human users, often utilizing Natural Language Processing (NLP) to interpret inputs and generative AI to automate responses. The chatbot aims to provide an interactive conversational experience between the user and the machine, facilitating both written and spoken communication. In this system, there is a user module that requires registration for access. After logging into their accounts, users can begin chatting with the chatbot. The Mental Health Chatbot System operates as a conversational agent, functioning like a real- time therapist that analyzes the user's emotions with each interaction and offers appropriate responses and feedback.