Online Counseling Research Articles

(O-30) ONLINE GROUP THERAPY ASSOCIATED WITH PAROXETINE HYDROCHLORIDE FOR COMPULSIVE SEXUAL BEHAVIOR DISORDER´S TREATMENT: A CASE REPORT

Abstract Compulsive Sexual Behaviour Disorder (CSBD) is characterized in ICD-11 as a persistent inability to control intense sexual urges resulting in repetitive sexual behaviours and negative effects in personal life. Due to the limited research on CSBD´s treatment, our goal is to report a successful case of 39-year-old symptomatic male patient, treated in a structured closed online group focused on self and CSBD´s knowledge, new habits acquisition, particularities of these patients´ profile, associated with medication use. Method the information in this report were obtained through patient interviews, psychiatric and psychological records and literature review. The treatment took place in an outpatient service specialized in sexuality at a public institution. Following CSBD diagnosis, Paroxetine Hydrochloride (20mg/day) was prescribed with regular psychiatric follow-ups. And was referred to an online psychotherapy group consisting of 4 CSBD participants, 2 therapists, weekly 1-hour sessions held for 10 months. The therapy addressed pertinent issues to the treatment and utilized neuropsychoeducational sessions to establish new habits, along with reflective “homework” tasks. Results Psychotherapeutic treatment enhanced self-knowledge leading to a loss of meaning to his compulsive behaviours, therefore, a decrease in its frequency. The patient developed a healthy sexuality, free from guilt and risky behaviours, improved emotional management and diversified interests. Paroxetine Hydrochloride (20mg/day) facilitated the psychotherapy process (10 months), allowing gradual dosage reduction upon symptom alleviation. Conclusion The combination of themed online group psychotherapy, a well-established group bond, neuropsychoeducation, and medication effectively addressed CSBD symptoms, enhanced emotional management, and improved quality of life. The positive outcome encourages future research into this treatment approach for CSBD. Financing No conflict.

Metalk

Abstract- Nowadays it is a common problem among various people whether they are teen, young or old that they are feeling isolated within their community or even within their family members. Because sometimes it is not possible for them to discuss their every problem or they can be introvert also. Because of which they may go through problems like anxiety, stress, depression, etc. which can make their life harder and not easy to manage. Every year almost 10.7% people suffer from mental disorder because there is no one available for them to discuss their problems or they are not able to explain or discuss their problems or sometimes environment can also be a problem. Keeping this thing in mind we came up with a solution of providing online counselling for people in need through website where they can freely and easily discuss their problems and overcome their insecurities and strengthen their weakness. Keywords—online counselling, E-counselling

Inter‐modality comparison of working alliance and client satisfaction in online counselling during the COVID‐19 pandemic: An exploratory study

AbstractPurposeMental health suffered during the COVID‐19 pandemic lockdown in Scotland. While there was limited availability for face‐to‐face counselling, online counselling was available via telephone, videoconference, email, one‐to‐one chat and group basis. Existing research has failed to examine inter‐modality comparisons of client experiences of online counselling during the COVID‐19 pandemic.MethodsScottish participants (n = 94) who received online counselling during the COVID‐19 pandemic completed an online survey using quantitative methodology, which explored their experiences of one of five online counselling modalities measured by two reliable scales: the Working Alliance Inventory‐Short Revised and factor one of the Satisfaction with Therapy and Therapist Scale. Additional exploratory analysis investigated whether age, gender, choice of online counselling modality and pre‐COVID‐19 pandemic familiarity with online counselling affected these outcomes.ResultsWorking alliance and satisfaction outcomes were positively correlated. No significant differences between working alliance and satisfaction scores were found between the five modalities. Female participants, and those who received their preferred choice of counselling modality, had significantly greater working alliance than those who did not.ConclusionThese findings provide insights to clients and practitioners about the variety of synchronous and asynchronous online platforms that can facilitate good therapeutic outcomes. The importance of participant choice of counselling modality was reiterated. The broader implications of the findings and the future direction of a hybrid online and face‐to‐face counselling model were discussed.

Effectiveness of online counselling during COVID-19 in Zambia: clients' and therapists' perspectives

Population-based studies have shown that a growing number of counsellors have been providing counselling via the Internet. There are mixed findings regarding the effectiveness of online counselling compared to traditional face-to-face counselling and other modalities. During the COVID-19 outbreak, online counselling services were advanced as the only safe means of attending to mental health conditions, especially during the lockdowns. However, the effectiveness of online counselling remains unclear, especially in developing countries with low digital literacy and poor Internet connectivity. This study's main purpose was to investigate and determine the clients' and therapists' perspectives on the effectiveness of online counselling during the pandemic based on the level of preparedness, mode of delivery, and challenges faced. The study used mixed methods employing a parallel convergent design and collected data from 284 participants (44 therapists and 240 counselling clients). The study found that therapists were not prepared to offer online counselling services, but were compelled by high demands for counselling services from clients during the pandemic. Both clients and therapists cited the cost of data bundles to connect to the Internet as a major barrier. Furthermore, both clients and therapists indicated that the most effective platform was video conferencing. The findings also show that therapists observed slowed progress in the client's recovery due to clients missing sessions. Logistic regression results on factors associated with preparedness and positive perception of online counselling showed that older therapists and lay counsellors were less likely to be prepared and evaluate sessions as less effective, respectively. Living in Lusaka (the capital) was associated with higher odds of perceiving online counselling as effective. Client results showed that older clients had lower odds of being prepared, and the counsellor being prepared increased the odds of the online counselling being perceived as effective. The researchers conclude that online counselling, in the context of a developing country, is ineffective because of the cost of Internet connection, the multiplicity of information communication technology (ICT) channels, low digital literacy, and lack of knowledge or experience using these platforms.

Indonesian COVID-19 lesson: A mixed-methods study on adolescent health status and health services during pandemic.

The COVID-19 pandemic affected adolescents' physical and psychological health. There must be specific services to cater to the needs of adolescents during COVID-19 in Indonesia. Lessons learned from previous pandemics will be beneficial for nurses and other health professionals to prepare services for future pandemics. This mixed-method study aimed to examine 459 Indonesian adolescents' health, literacy, preventive measures, and preferred health services during the COVID-19 pandemic. This study also examines sociodemographics, respondent characteristics, health information sources, and media choices. A total of 47.5% of adolescents knew about COVID-19, 26.8% experienced physical health changes, and 61.7% considered wearing masks. Adolescent health information came from teachers (26.6%) and the Internet (32.9%). Psychological changes showed 67.8% irritation. Indonesians preferred online counseling (53.8%) and WhatsApp (45.8%) for pandemic health services. COVID-19 literacy did not affect physical or mental health (p > 0.05). Most adolescents reported mental and physical health changes during COVID-19. Our data suggest that adolescents' strong COVID-19 knowledge did not prevent anxiety and other psychological difficulties. The longitudinal studies could be utilized if pandemic demands social and physical distance. The government, as well as nurses, might utilize WhatsApp-based remote online treatment for health services.

Initial evaluation of the TALES (technology and literacy engagement after stroke) programme targeting functional literacy and social engagement in people with aphasia after stroke

ABSTRACT Background and aims Literacy skills are typically affected in people with stroke aphasia, leading to reduced engagement in functional everyday reading/writing tasks, such as email/messaging via social media. The aim of this study was to investigate the outcomes of the TALES (Technology And Literacy Engagement after Stroke) programme, a group-based online literacy-focused programme for people with aphasia after stroke. This first evaluation of this programme aimed to examine outcomes related to feasibility, changes in language, literacy and self-ratings of communication skills. Methods Five participants with aphasia were assessed on a range of outcome measures relating to language and self-perception of communication skills. These were: the Western Aphasia Battery-Revised (WAB-R; (Kertesz, 2007)), literacy subtests from the Psycholinguistic Assessment of Language Processing in Aphasia (PALPA; (Kay et al., 1996)) and the Communication Outcomes after Stroke (COAST; (Long et al., 2008)). TALES consisted of a weekly group online session, 1:1 supported telehealth reading/writing practice and regular messaging via email. Results and main contribution From a descriptive statistics perspective, the mean gains across the cohort were 7.94 (from 84.24 to 92.18) on the WAB AQ (aphasia quotient), 8.92 (from 81.18 to 90.10) on the WAB LQ (language quotient). Additionally, there was a change in the mean scores for PALPA subtests (31, 37 and 40) observed between the pre-treatment assessment and post-treatment assessment. Finally, the mean score increased by 8.8 (from 49.40 to 58.20) on the COAST (max score = 80). Results indicated gains in literacy and communication measures as well as changes to self-rating of communication reflecting changes in communication confidence. Conclusions Mindful of the threats to the internal validity inherent in the study design, the reported online therapy can overcome barriers such as distance and mobility limitations and may provide greater accessibility to therapy for individuals with aphasia. TALES was a low-therapist-input yet reasonably intensive treatment approach which embedded language practice immediately in functional use through the social group format and personally-relevant written communication. Implications The TALES programme meets many neuroscience principles of neurorehabilitation including “use it or lose it”, salience and transference. Future research may usefully investigate the contribution of the group format versus the functional literacy components towards these potentially promising early data.

International and domestic university students' mental health over the course of the COVID-19 pandemic in Germany: Comparison between 2020, 2021, and 2022.

The COVID-19 pandemic affected university students' mental health worldwide. International students were presenting high levels of stress, anxiety, and depressive symptoms before the pandemic. This study aimed to investigate (i) differences between various timepoints of the COVID-19 pandemic (2020, 2021, and 2022) in mental health outcomes and social and emotional aspects in domestic and international students, separately, (ii) differences between international and domestic students between the three timepoints on mental health outcomes and social and emotional aspects, and (iii) possible moderation effects of timepoints on mental health outcomes and social and emotional aspects of domestic and international students. Data from three cross-sectional anonymous online surveys conducted in German universities were analyzed and compared. Data were collected in 2020, 2021, and 2022, respectively, with a total N = 14,498. Depressive symptoms, hazardous alcohol use, social support, self-efficacy, resilience, perceived stress, and loneliness were assessed through standardized self-report instruments. Differences between domestic and international students in mental health outcomes, and social and emotional aspects across three timepoints were assessed with one-way and two-way ANCOVAs. Regardless of the timepoint, international students presented more depressive symptoms and perceived stress, lower perceived social support and resilience, but higher levels of self-efficacy and less alcohol consumption compared to domestic students. A significant interaction effect between timepoint and student status emerged only for loneliness. International students generally presented poorer mental health outcomes than domestic students. Mental health care and prevention such as low-threshold, online counseling should address university students, especially international students.

Analisis Etika Profesi BK terhadap Pelaksanaan Layanan Konseling Berbasis Online

The development of the internet for information and communication has given rise to a new design approach known as Online-based Counseling. This style, influenced by technological advances, has become easier to achieve due to existing trends. Advances in communication technology have opened up new possibilities for counselors to be creative, especially in the application of e-counseling as a way for counselors to provide alternative methods in dealing with matters related to counseling. Nevertheless, the aim of this article is to examine the influence of Bk ethics on the provision of online counseling services. For this situation, a qualitative approach is used. Utilize scientific literature from national and international academic journals, including resources such as Google Scholar.

Evaluation of Online Counseling through the Working Experiences of Mental Health Therapists Amidst the COVID-19 Pandemic.

This study aimed to reflect on mental health professionals' experiences with online counseling during the COVID-19 pandemic, as well as their perceptions and recommendations for the future. The method of qualitative research with semi-structured interviews was used. The sample consisted of 17 mental health professionals working in the public or private sectors. A framework analysis revealed four main themes, namely (a) the evaluation of online counseling; (b) comparing in-person and online counseling; (c) factors influencing the effectiveness of online counseling; and (d) suggestions for the future use of online counseling. Most therapists reported that their overall experience with online counseling was positive. The main advantages cited were the accessibility for everyone and the reductions in time, money, and distance. Its primary drawbacks included less nonverbal communication, the inability to employ certain therapeutic tools, problems with confidentiality, lack of experience, and technical difficulties during online sessions. Its effectiveness depends on contextual factors and factors related to the therapeutic process itself. Organizational planning, training, and a solid implementation strategy may help ensure that this communication medium is used to its fullest potential. In addition, the possible utilization of remote counseling combined with in-person psychotherapeutic intervention methods will provide solutions for the future, especially in crisis situations.

Moving-sensing-feeling bodies clamouring for contact in on-line therapy groups

ABSTRACT The author examines working with groups on-line from a Gestalt therapy perspective, an integrated therapeutic approach. The growing occurrence of the therapeutic group online setting brings the need to reconsider clinical tools to use bodily processes in the therapeutic relationship. This article provides a detailed and nuanced consideration of embodied process on-line and offers a practical and useful framework for clinicians, from a phenomenological, aesthetic and field oriented epistemological ground. In the on-line therapeutic group consideration needs to be given to the way embodied vitality can be engendered as supports for contact between members. Vitality is supported through a renewing of attention to the lived body as a support for spontaneous interactions, yet care is required in the on-line domain as there is a tendency towards disinhibition. The author explores how the relational grail of on-line therapy is an inter-embodied experience. This can be supported by the therapist cultivating an embodied presence, accompanied by an intentional disposition to wander with wonder as a way of surrendering to the unknowing of the virtual between. Such an orientation includes the therapist adopting an embodied hermeneutic phenomenological approach in group work that supports the co-creating of meaning between members in this trans-subjective situation.

Evaluating the usability and effectiveness of the Go PainFree telehealth system (beta version) for musculoskeletal pain management in the Philippines

Biomechanical Taping has been shown to effectively reduce pain and enhance function in patients with musculoskeletal pain. When used as an adjunct to physiotherapy, BMT may contribute to increased stability, leading to improved pain management and functionality. Telehealth has emerged as an effective and cost-efficient alternative to traditional physiotherapy. The Go PainFree Telehealth System, employs BMT to alleviate pain and improve functionality, enhancing the overall effectiveness of online therapy services for patients with musculoskeletal conditions.The study determined the usability of the system in managing musculoskeletal conditions for patients accessing healthcare online, focusing on its usefulness, ease of use and learnability, interface quality, interaction quality, reliability, satisfaction, and future use. Also, the study examined the effectiveness of BMT on pain and function in individuals with musculoskeletal conditions when integrated into the system after a single session.This retrospective study reviewed the records of the system between November 2022 and February 2023. Evaluating the system's usability involved the integration of the Telehealth Usability Questionnaire within the system survey, serving as a reliable instrument for assessing the quality of telehealth applications from the users' perspective. Participants rated various parts, including usefulness, ease of use and learnability, interface quality, interaction quality, reliability, and satisfaction and future use. To determine the effectiveness of BMT, the 100-mm Visual Analogue Scale (VAS) was used before and after a single session. Data analysis was conducted using descriptive statistics, allowing for the summarization of demographic information and the reporting of average mean (95 % (CI)) for each usability category of the TUQ. The effectiveness of BMT on pain and function was determined using the Wilcoxon test for paired samples after one session. P < 0.05 indicates significant improvement in pain and function. This study involved 33 participants, with a mean (SD) age of 34.94 ± 2.04, who used the system between November 2022 and February 2023. The majority of reported musculoskeletal conditions pertained to the upper extremity (n = 19), followed by the lower extremity (n = 8), and spine (6). The findings revealed that participants generally considered the system useful, easy to use and learn, and had good interface and interaction quality, as shown by average scores of five in these categories, indicating "somewhat agree." Conversely, participants expressed reservations about the system's reliability, with an average score of 3 reflecting "somewhat disagree." As for their satisfaction with the system and the likelihood of future use, participants showed mixed opinions, with an average score of 4 representing "neither agree nor disagree." The study showed BMT significantly reduced pain scores (Z = −4.80, p < 0.001, two-tailed) and enhanced function scores (Z = −4.87, p < 0.0001, two-tailed) for participants with musculoskeletal conditions.The system was generally regarded by the participants as useful, user-friendly, and characterized by high-quality interface and interaction. Despite these positive perceptions, concerns about the platform's reliability emerged, and opinions about satisfaction and future use were mixed. Still, the integration of BMT into the system yielded significant reductions in pain and improvement in function for the participants with musculoskeletal conditions.

Impact of COVID-19 on the use of online mental health services among adults in Riyadh: a cross-sectional study.

Online therapies are licensed online programs designed to aid the use of psychotherapy via the Internet or mobile phone applications by providing effective treatments through digital communication. The number of individuals seeking online therapy has increased during the COVID-19 pandemic. Thus, this study aimed to assess the impact of COVID-19 on the use of online mental health services among Saudi adults in Riyadh. The research design was a cross-sectional descriptive study. The data collection tool was an online survey distributed through social media and email. The survey consisted of two parts: a sociodemographic questionnaire and the e-Therapy Attitudes and Process (eTAP). A total of four hundred participants have completed the survey. Most of the respondents had used online therapy for the first time during the COVID-19 pandemic, and most of the users had a relatively positive experience with online interventions for mental health services. The findings showed that COVID-19 had an impact on the use of online therapy, as it caused an increase in the number of users of these services, and most of the users have found online therapy to be helpful.

Potential Benefits of Cognitive Behavioral Therapy, Local Wisdom and Online Counseling for the Treatment of Generalized Anxiety Disorders, and Functional Gastrointestinal Disorders in College Adolescent Girls

Potential Benefits of Cognitive Behavioral Therapy, Local Wisdom and Online Counseling for the Treatment of Generalized Anxiety Disorders, and Functional Gastrointestinal Disorders in College Adolescent Girls

Evaluation of Adoption and Productiveness of Online Counseling in Colleges of Education in Southeast Nigeria (Case Study Nwafor Orizu College of Education, Nsugbe, Anambra State and Alvan Ikokwu College of Education, Owerri, Imo State)

Evaluation of Adoption and Productiveness of Online Counseling in Colleges of Education in Southeast Nigeria (Case Study Nwafor Orizu College of Education, Nsugbe, Anambra State and Alvan Ikokwu College of Education, Owerri, Imo State)

화상상담에 대한 태도와 사용 의도에 대한 연구

Objectives The purpose of this study was to validate the Unified Theory of Acceptance and Use of Technology (UTAUT). Methods For this, an online survey was conducted with a sample of 350 adults. For data analysis, an independent sample t-test, one-way ANOVA and structural equation model verification were conducted. Results As a result, men scored higher on intention to use online counseling than women and participants on their 60s scored higher on both usefulness of and intention to use online counseling. In addition, participants who re-ceived face-to-face counseling and online counseling showed higher levels of intention to use online counseling compared to those who did not received any counseling. Finally, results supported the UTAUT. Conclusions The results supported the UTAUT by revealing a casual chain in which perceived advantages of online counseling were positively related to utilization of online counseling through the perceived usefulness of online counseling. In contrast, perceived barriers of online counseling were negatively associated with utilization of on-line counseling through the perceived usefulness of online counseling.

Etika Profesi Bimbingan dan Konseling: Menghadapi Tantangan Kerahasiaan dalam Layanan Konseling Online

Rapid changes in the world of education triggered by technological advances have stimulated interest in the use of online counseling as a method of mental health services. The COVID-19 pandemic has also accelerated the shift to online counseling as a primary option. The research results show that online counseling has equivalent effectiveness to face-to-face counseling. However, there are a number of ethical issues that need to be considered in online counseling practices, especially those related to the confidentiality and security of client data. Efforts to maintain confidentiality are a priority, including the use of secure technology and communication via encrypted platforms. Counselors need to understand the potential risks involved and continually increase their knowledge of online counseling ethics. This study used a systematic literature review (SLR) approach to investigate the development of online counseling practices and related ethical issues. In Indonesia, ABKIN has not yet issued standard guidelines for counseling services via the internet, so this is a challenge in maintaining client confidentiality in this country.

Effect of online health training/counseling and progressive muscle relaxation exercise on postpartum depression and maternal attachment: A randomized controlled trial.

To evaluate the effect of online health training/counseling and a progressive muscle relaxation exercise (PMRE) program on postpartum depression and maternal attachment. The present study was a randomized, controlled, experimental trial. Participants were asked to complete the Prenatal Attachment Inventory (PAI) and the Edinburgh Postpartum Depression Scale (EPDS) at 35 weeks of pregnancy. Group assignment was done by stratified block randomization according to EPDS score (0-9, 10-30) and parity. Women in the experimental group received training in progressive muscle relaxation, postpartum depression, and maternal attachment via online video calls twice a week starting at 36-37 weeks of pregnancy. They were asked to complete the PMRE program from 36 weeks of pregnancy until 6 months postpartum, and online counseling was provided throughout this period. Participants completed the Maternal Postpartum Attachment Scale (MPAS) and the EPDS at 6 weeks postpartum. Mean PAI score was 64.24 ± 9.61 in the experimental group before the intervention and 62.14 ± 10.13 in the control group. The mean EPDS score of the experimental group was 9.12 ± 5.05 and the mean score of the control group was 9.77 ± 6.30 (P > 0.05). The mean MPAS score after the intervention was 13.92 ± 5.54 in the experimental group and 17.51 ± 6.12 in the control group. The mean EPDS score of the experimental group was 3.40 ± 3.00 and the mean score of the control group was 11.40 ± 5.91 (P < 0.05). Online health training/counseling and PMRE reduce the risk of postpartum depression and increase maternal attachment.

Impact of the COVID-19 Pandemic on Early Intervention Services Use Among Children with Developmental Disabilities

Early Intervention (EI) is a federally-funded program that provides therapies for children with developmental delays. Due to the COVID-19 pandemic and lockdown restrictions in Philadelphia in 2020, these services made a rapid change to virtual service delivery. We sought to explore the experiences of families in accessing online therapy. We recruited families to participate in a mixed methods study in order to evaluate changes in the initiation and use of EI services pre- and post-pandemic lockdown. Of the 94 who completed surveys, 27 families were purposively sampled for semi-structured telephonic interviews to identify their perceptions of program assistance and needs. Themes developed from these interviews included participant satisfaction with the communication of program changes and concerns related to the effectiveness of virtual EI services. This information can be used in plans for transitioning to hybrid therapy as well as for future pandemics requiring a return to fully virtual services.

ONLINE CONSULTATION APPLICATION AT THE WOMEN AND CHILDREN PROTECTION UNIT OF THE INDRAGIRI HILIR RESORT POLICE STATION

This study aims to determine the role of the Protection of Women and Childre in dealing with children in legal cases in the jurisdiction of the Indragiri Hilir Resort Police Station. The form of online counseling services is an alternative problem solving that makes it easier for people to consult regarding problems within the family. Online counseling services are also a place to respond to any complaints, protect and facilitate the handling of complaints submitted by victims and the public, where the privacy of victims and suspects will be protected according to their rights. The research uses waterfall analysis modeling using UML (Unified Modeling Language). This system is made using the PHP programming language, MySQL database. The designed application works in accordance with the system design mechanism at the beginning of the research object. The final result of this research is an online consultation application, where on this website the public can fill out a consultation form directly and view information that is directly related to counselors, the Legal Aid Institute, psychologists and therapists from the Women's and Children's Protection Unit Indragiri Hilir Resort Police Station

Mental Health Counseling From Conversational Content With Transformer-Based Machine Learning

Use of asynchronous text-based counseling is rapidly growing as an easy-to-access approach to behavioral health care. Similar to in-person treatment, it is challenging to reliably assess as measures of process and content do not scale. To use machine learning to evaluate clinical content and client-reported outcomes in a large sample of text-based counseling episodes of care. In this quality improvement study, participants received text-based counseling between 2014 and 2019; data analysis was conducted from September 22, 2022, to November 28, 2023. The deidentified content of messages was retained as a part of ongoing quality assurance. Treatment was asynchronous text-based counseling via an online and mobile therapy app (Talkspace). Therapists were licensed to provide mental health treatment and were either independent contractors or employees of the product company. Participants were self-referred via online sign-up and received services via their insurance or self-pay and were assigned a diagnosis from their health care professional. All clients received counseling services from a licensed mental health clinician. The primary outcomes were client engagement in counseling (number of weeks), treatment satisfaction, and changes in client symptoms, measured via the 8-item version of Patient Health Questionnaire (PHQ-8). A previously trained, transformer-based, deep learning model automatically categorized messages into types of therapist interventions and summaries of clinical content. The total sample included 166 644 clients treated by 4973 therapists (20 600 274 messages). Participating clients were predominantly female (75.23%), aged 26 to 35 years (55.4%), single (37.88%), earned a bachelor's degree (59.13%), and were White (61.8%). There was substantial variability in intervention use and treatment content across therapists. A series of mixed-effects regressions indicated that collectively, interventions and clinical content were associated with key outcomes: engagement (multiple R = 0.43), satisfaction (multiple R = 0.46), and change in PHQ-8 score (multiple R = 0.13). This quality improvement study found associations between therapist interventions, clinical content, and client-reported outcomes. Consistent with traditional forms of counseling, higher amounts of supportive counseling were associated with improved outcomes. These findings suggest that machine learning-based evaluations of content may increase the scale and specificity of psychotherapy research.