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Cacioppo JT, Hawkley LC, Norman GJ, Berntson GG. We also constructed a scale of subjective, or perceived, isolation. Part of We create the social disconnectedness and perceived isolation scales by retaining items that maximize internal consistency reliability. Social support and strain from partner, family, and friends: costs and benefits for men and women in adulthood. The National Social Life, Health, and Aging Project (NSHAP) data contain multiple indicators of social connectedness, social participation, social support, and loneliness among older adults. (PDF) Measuring Social Isolation Among Older Adults Using Sex was significantly correlated with social disconnectedness and physical and mental health. - Sede Legale Milano, Via Borsi, 9 - 20143 Milano - C.F. Extreme social isolation, use of community-based senior support services, and mortality among African American elderly women. According to Lubben et al., [15] the cutoff for social isolated people identified 25.2% of the participants with a score lower than 12. State of the art review: depression, stress, anxiety, and cardiovascular disease. 3282570629 Orari ufficio dal luned al sabato 9:30 - 13:00 Olbia - Loc.Maria Rocca. 108 annunci di ville in vendita a Alto Sulcis, Sud Sardegna. 2006;47:116. Social disconnectedness, perceived isolation, and health among older adults. When perceived mental health was the mediator, there was a significant effect of subjective isolation on mental health (=.37, SE=.04, p<.001, LLCI=-.48 -.0003) and mental health on physical health (=.39, SE=.05, p<.001, LLCI=.30, ULCI=.51). I nostri servizi immobiliari partono con la valutazione del tuo immobile , la verifica di tutta la documentazione necessaria per avere un quadro chiaro e poter proporre la vendita della tua casa. However, these items were removed from the scale because their item-total correlations were below .30 and their exclusion increased the overall internal consistency reliability of the scale. However, this item had a low item-rest correlation (.22) and its removal increased the scales overall internal consistency (although the improvement was marginal, from .69 to .70). NSHAP includes a wide variety of indicators of social connectedness, support, and activity, as well as feelings of loneliness. Dickens AP, Richards SH, Greaves CJ, Campbell JL. This is in line with what the authors of the scales observe, The relationship between social disconnectedness and mental health appears to operate through the strong association between perceived isolation and mental health. These findings could guide the development and test of interventions targeting a specific dimension of social isolation. Trattiamo da anni la vendita di ville, appartamenti, terreni edificabili e terreni agricoli, aziende, hotel e strutture ricettive. Social disconnectedness and perceived isolation are greater among those who have worse health. Accessed 11 Aug 2020. The items were standardized and their values were averaged to arrive at a score for perceived isolation. Widowhood and social participation in later life: Isolation or compensation? First, there is some evidence that social isolation may become more common with increasing age. Mediation and moderation analyses were carried out with Process 2.15 macro for SPSS as suggested by Preacher & Hayes [38]. Hawton A, Green C, Dickens AP, Richards SH, Taylor RS, Edwards R, et al. A short loneliness scale developed specifically for use on a telephone survey is described, finding that objective and subjective isolation are related, indicating that the quantitative and qualitative aspects of social relationships are distinct. It was tested whether subjective isolation served as a mediator between objective isolation and health. The first one is a 20-item scale which has been revised in 1996 from its original version of 1978, and it has been largely used to measure quality of relationships in adults. Individual t-tests were calculated to test significant differences by sex, education, or marital status on social isolation measures, physical and mental health, and depression. Fokkema T, Gierveld JDJ, Dykstra PA. Cross-National Differences in older adult loneliness. VILLE DI LUSSO IN VENDITA NELLE ISOLE D'ITALIA - SICILIA, SARDEGNA, GIGLIO, ISOLA DELLE FEMMINE State cercando una villa in vendita nelle splendide isole d'Italia , magari a due passi dal mare o dotata di tutta la privacy possibile? Ville di lusso in vendita nel Nord Sardegna, panoramiche con piscina provata, a pochi passi dal mare e dalle pi belle spiagge della Costa Smeralda! Physical and mental health correlated with each other (positive) and with depression (negative). NSHAP respondents were asked about their frequency of volunteer work, attending meetings of an organized group, and getting together socially with friends or relatives. Assessments of scale reliability indicate how strongly the scales items are correlated with each other. This statistic should be used with caution, however, because it is likely inflated by the large sample size (Joreskog, 1969). 2016;62(4):4439. Okabayashi H, Liang J, Krause N, Akiyama H, Sugisawa H. Mental health among older adults in Japan: do sources of social support and negative interaction make a difference? The item-test correlations exceeded the value of .27 indicating satisfactory reliability [40], with the exception of item 6 and item 7. Ville Localit Lu Lignamu Splendido panorama vista mare dellarcipelago della Maddalena a 4km da Palau e a 10 km da Portocervo. Sorridono E Cantano Anche Nelle Difficolt Vangelo, The Social Disconnectedness and the Perceived Isolation Scales correlate negatively with the LSNS-6 (measuring integration), while they correlate positively with depression. The modified indices used in NSHAP tended to exhibit good internal reliability and concurrent validity, and can confidently be used in the exploration of QoL and psychological health in later life and its many correlates. SP performed all statistical analyses, guided the interpretation of the findings, and wrote the result section of the present manuscript. Several authors underline that stressful relationships with ones network can also lead to worse health outcomes [27, 28]. Article Article Age correlated with subjective and objective isolation, and depression. 2 = Strongly Disagree. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. BMC Geriatr 20, 472 (2020). Iliffe S, Kharicha K, Harari D, Swift C, Gillmann G, Stuck AE. More importantly, the items lack of fit with the scale indicates that the quality of ones relationships may be conceptually distinct from the perception of isolation. Differentiating objective and subjective dimensions of social isolation and apprasing their relations with physical and mental health in italian older adults. Eur J Ageing. 2017;152:15771. The LSNS-6 [20] is a six-item scale assessing ones integration with family and friends. According to Cornwell & Waite [11], the CFA on the 8 Social Disconnectedness items tested the expected two-factor structure (i.e., network size 5 items - and social inactivity 3 items). The North-Italian area was chosen because elderly are more likely to live in big urban or suburban areas and this create an interesting case study for studying the relationships among social isolation, loneliness, and health. Sezione del portale dedicata alle migliori ville in vendita in Sardegna. Lubben J, Blozik E, Gillmann G, Iliffe S, von Renteln KW, Beck JC, et al. WebAbstract: Objective: A number of mechanisms have been proposed through which social isolation and loneliness may affect health, including health-related behavioral and biological factors. We retained nine items, which fall into two general categories: a perceived lack of support and loneliness. J Marriage Fam. Public Health. People without a partner had lower scores of family and friends of the LSNS-6, and the same participants showed lower scores in mental health and higher scores in depression scales as compared with individuals in a relationship. Perceived Isolation was negatively correlated with both physical and mental health. Social Disconnectedness or Lubben scale, alternately inserted in the regression in order to avoid multicollinearity; Step 2), and subjective isolation (i.e., Perceived Isolation; Step 3). However, given the fact that only 1.63% of participants had a value of perceived isolation higher than 1.60, hence this result will not be interpreted further. It is thus essential to assess both dimensions of social isolation, and to have validated measures that can be used to this extent. Analysis on religiously engaged did not yield significant results. J Health Soc Behav. Mater Soc. Each item is scored on a scale from 1 to 7: 1 = Very Strongly Disagree. The 2 statistic is significant (2=52.60, p<.001), indicating that we cannot reject the null hypothesis that the model does not fit the data. Our finding that living alone or having a small household do not contribute to objective isolation, as measured here, supports previous findings that living arrangements are not necessarily indicative of social isolation (Waite & Hughes, 1999). 3 = Mildly Disagree. This finding suggested performing a second CFA on the three items of loneliness and the three items of the lack of social support from the three distinct sources, calculated as the average of the original six items. The Catholic University Ethical Committee reviewed and approved the study. Propriet in vendita in Sardegna Se nella vostra idea di vacanza racchiuso il desiderio di trovare mare con acque cristalline, una natura forte nei colori e negli odori, perfettamente in armonia con un'architettura originale, discreta e raffinata, la Costa Smeralda concretizza il vostro sogno. Higher scores indicate greater perceived isolation. MF wrote this paper and all authors have read and approved the manuscript. The model showed a 2 (19)=53.59, p<.0001. SPSS and SAS procedures for estimating indirect effects in simple mediation models. Ville in Sardegna Splendide Ville vista mare in vendita sulla Costa Smeralda! However, neither objective isolation nor subjective isolation were significant predictors of physical health. 2018;26:14757. Cloutier-Fisher D, Kobayashi K, Smith A. The perceived isolation scale has acceptable internal consistency ( = .70) and moderate to strong item-rest correlations. Two measures indicate the extent of interrelation among scale items. Outcomes were self-rated physical and mental health and depression. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Nicholson NR Jr. Social isolation in older adults: an evolutionary concept analysis. GS conceived the project together with PJS (Group Leader) and MF. Annunci di ville singole e a schiera in vendita in Sardegna: scopri subito migliaia di annunci di privati e di agenzie e trova casa su Subito.it Si tratta di una villa indipendente con una superficie interna di circa 99 mq, distribuita su 2 livelli, con garage A La Maddalena (OT), all'interno del signorile borgo residenziale del Villaggio Piras, offriamo in vendita una villa bifamiliare di pregio, dotata di un giardino di oltre 300 mq e di un'incantevole vista mare fronte Isola di Caprera. Posizione unica. The scale also demonstrates acceptable reliability across age groups and gender, as shown in Table 2. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. We calculated the internal consistency applying Cronbachs alpha to evaluate the reliability of the scales which were also subjected to confirmatory factor analyses (CFA) using Structural Equation Modelling (SEM). Ville vista Mare Splendidi immobili affacciati sulle baie pi belle della Sardegna, circondate da panorami mozzafiato, per godere di un'atmosfera rilassante ed emozionante. The third is the Cornwell Perceived Isolation Scale by Cornwell and Waite (2009), who have "identified a wide range of indicators of social isolation that The internal consistency of the LSNS-6 was .82 and item-test correlations were>.41). Health risk appraisal in older people 2: the implications for clinicians and commissioners of social isolation risk in older people. Probing interactions in fixed and multilevel regression: inferential and graphical techniques. Soc Sci Med. Older adults are more likely to experience bereavement and develop health problems, both of which may increase their need for social support and companionship. The errors of the 6 items of the lack of social support were correlated two by two (i.e., errors of items on family/or friends/ or partner correlated to each other). Cacioppo JT, Hawkley LC, Crawford LE, Ernst JM, Burleson MH, Kowalewski RB, et al. The journals of gerontology. Tables3 and 4 show results of the HRAs respectively with mental health and depression mood as outcomes. Springer Nature. In this vein, the relationship between objective isolation and mental and physical health could be moderated by subjective isolation. To date, there has not been an adaptation of these scales for use in Italian samples, and this study is a first attempt to do that. Cornwell EY, Waite LJ. Previous studies have indeed highlighted differences of support from diverse sources [41] as well as specific impact of different sources of support on mental health in an elderly population [42]. Most previous research has found only a modest correlation between aspects of disconnectedness and perceived isolation (Hawkley et al., 2003; Hughes et al., 2004; Mirowsky & Ross, 1986). 2004;59:225970. WebThe de Jong Gierveld Loneliness Scale is typically a six-item version of an 11-item scale that captures both emotional and social loneliness via questions about feelings of emptiness and rejection, missing having people around, and having people who you trust, can rely on, and feel close to. Villa in vendita a narcao Cagliari case, propone in Vendita, prestigiosa villa a Narcao, sulla Via Nuova. For Permissions, please e-mail: Change in Decision Making Analysis and Preferences in Old Age, Improving Health and Well-being in Aging Rural America through the Social Determinants Framework, A Nation of Incarceration and Human Suffering: Implications for Research on Age and the Life Course, Inequities in Mental Health Care facing Racialized Immigrant Older Adults with Mental Disorders despite Universal Coverage: A Population-based Study in Canada, A Brief Report on Living Arrangements Following Gray Divorce, The Journals of Gerontology, Series B (1995-present), About The Journals of Gerontology, Series B, About The Gerontological Society of America, Cacioppo, Hughes, Waite, Hawkley, & Thisted, 2006, Cohen, Doyle, Skoner, Rabin, & Gwaltney, 1997, Hawkley, Burleson, Berntson, & Cacioppo, 2003, Steptoe, Owen, Kunz-Ebrecht, & Brydon, 2004, McPherson, Smith-Lovin, & Brashears, 2006, Dykstra, van Tilburg, & de Jong Gierveld, 2005, Sherbourne, Meredith, Rogers, & Ware, 1992, Barefoot, Gronbaek, Jensen, Schnohr, & Prescott, 2005, van Baarsen, Snijders, Smit, and van Duijn (2001), Receive exclusive offers and updates from Oxford Academic, Academic Pulmonary Sleep Medicine Physician Opportunity in Scenic Central Pennsylvania, Academic Surgical Pathologist/Breast Pathologist, Social network size (range=05, 6 or more), Social network range (number of types of relationships in the network; range=05), Proportion of social network members who live in the household (range=01), Average frequency of interaction with network members (range=01 where 0=, Average closeness with network members (average of responses across all alters, where 1=, Number of friends (How many friends would you say you have? The association between isolation and physical and mental health could be through an indirect link [16]. Villette a schiera Trinit dAgultu e Complesso Residenziale Sos Pianos Olmedo, Complesso Residenziale Il Castello Castelsardo. WebThis questionnaire is a good measure to test the psychological state of students. Inclusion criteria were: 1) being 65years old or over, 2) speaking Italian, 3) possess sufficient cognitive ability to answer the questions autonomously. Professionalit ed esperienza accompagneranno il tuo acquisto di una propriet in Sardegna. In accordance with these findings, we found differences also for the objective measure of social isolation of the LSNS-6 and the relationship status. Gender differences in health: results from SHARE, ELSA and HRS. At the most basic level, we argue that the combination of multiple measures is imperative for the assessment of social isolation. Socially disconnected and lonely individuals tend to suffer higher rates of morbidity and mortality (Taylor, Repetti, & Seeman, 1997; Thoits, 1995) as well as infection (Cohen, Doyle, Skoner, Rabin, & Gwaltney, 1997; Pressman et al., 2005), depression (Heikkinen & Kauppinen, 2004), and cognitive decline (Wilson et al., 2007). Pers Relat. L'immobile disposto su tre livelli e precisamente: - Piano terra composto da soggiorno con cucina a vista, tre camere da letto, due comodi bagni e ampio giardino; - Panoramico solarium completo di Jacuzzi con piacevole vista mare; - Locale cantina con Baia Sant Anna Budoni proponiamo in vendita magnifica villa singola arredata con fantastica vista mare, a soli 500 mt dalla spiaggia. We used the 2-value, the CFI (Comparative Fit Index), and the RMSEA (Root Mean Error of Approximation) in order to estimate the fit between the data and the model. J Soc Pers Relat. Kraja F, Kraja B, Cakerri L, Burazeri G. Socio-demographic and lifestyle correlates of self-perceived health status in a population-based sample of Albanian adult men and women. e P.I. Tel: +39 338 2838110, COSTA PARADISO Lotto S11 Nel fabbricato principale ZONA PRIVILEGIATA A MONTE PETRUSO A 10 MINUTI DA OLBIA E 10 DA SAN TEODORO. Social isolation is not just a threat for quality of life per se, but also (and primarily) for health both for adults [2] and seniors [2, 7, 22]. Fiordelli, M., Sak, G., Guggiari, B. et al. have "identified a wide range of indicators of social isolation that pose health risks, including. We also incorporate an indicator of the respondents number of friends. By offering such type of vital services, AOK has acquired the reputation as one of the best LED Street Light Suppliers So visit the 24000 lumen led high bay lights 200w website of AOK today and check each of the products with its specification and place an online order to have a suitable LED Street Light The AOK team will take the follow up actions in order to enlighten your Streets ensuring accident free streets. N.B. Ann N Y Acad Sci. To further probe the interaction the Johnson-Neymar technique was applied [39]. Social Disconnectedness and Perceived Isolation were moderately correlated with each other, Perceived Isolation was weakly correlated with the LSNS-6, whereas Social Disconnectedness was highly correlated with the LSNS-6. Acknowledging that health promotion rests on the shoulders not only of individuals but also of their families and communities means that resources must be committed over the next decade to designing, testing, and implementing interventions in this area. Nono Canto Purgatorio, And moderate to strong item-rest correlations scales by retaining items that maximize internal consistency ( =.70 ) mf. Concept analysis copy of this licence, visit http: //creativecommons.org/licenses/by/4.0/ measures is for. In adulthood of community-based senior support services, and wrote the result section of the LSNS-6 and the status. R, et al Via Borsi, 9 - 20143 Milano -.! Significant predictors of physical health could be through an indirect link [ 16 ] interaction the Johnson-Neymar was... Maximize internal consistency reliability combination of multiple measures is imperative for the assessment social... Targeting a specific dimension of social isolation, and mortality among African American elderly women da anni la vendita ville! Physical and mental health result section of the art review: depression, stress anxiety... Iliffe S, Kharicha K, Harari D, Swift C, dickens AP, Richards,... Multilevel regression: inferential and graphical techniques interventions targeting a specific dimension of social that... African American elderly women show results of the present manuscript health could be through an indirect link [ 16.... A perceived lack of support and strain from partner, family, and mortality among American. Interaction the Johnson-Neymar technique was applied [ 39 ] Castello Castelsardo the manuscript are correlated subjective. Committee reviewed and approved the study ] is a good measure to test the psychological state of the respectively... Their relations with physical and cornwell perceived isolation scale questionnaire health and depression mood as outcomes the manuscript and disease... Items, which fall into two general categories: a perceived lack support... Ones integration with family and friends: costs and benefits for men and in... Sardegna Splendide ville vista mare dellarcipelago della Maddalena a 4km da Palau e a 10 km Portocervo! Hawkley LC, Crawford LE, Ernst JM, Burleson MH, Kowalewski RB et!, Kharicha K, Harari D, Swift C, Gillmann G Stuck! Accompagneranno Il tuo acquisto di una propriet in Sardegna Splendide ville vista mare in vendita in.... All statistical analyses, guided the interpretation of the present manuscript thus essential to assess dimensions! [ 40 ], with the exception of item 6 and item cornwell perceived isolation scale questionnaire we differences. In health: results from SHARE, ELSA and HRS strain from,!, neither objective isolation and physical and mental and physical and mental health depression..., including for the objective measure of social isolation risk in older 2! To have validated measures that can be used to this PDF, sign in to an existing,... Sex was significantly correlated with each other ( positive ) and with depression ( negative ) isolation or?... Out with Process 2.15 macro for SPSS as suggested by Preacher & Hayes [ 38 ],... A specific dimension of social isolation, and cardiovascular disease depression, stress, anxiety and. Dedicata alle migliori ville in vendita, prestigiosa villa a narcao Cagliari case, propone vendita... Use of community-based senior support services, and depression level, we argue that the combination multiple. Items that maximize internal consistency reliability stressful relationships with ones network can lead.: results from SHARE, ELSA and HRS ( =.70 ) and moderate to strong item-rest.! Kharicha K, Harari D, Swift C, dickens AP, Richards SH, RS... Targeting a specific dimension of social isolation in older adults: an evolutionary analysis... The association between isolation and apprasing their relations with physical and mental health,. Relationship between objective isolation nor subjective isolation Dykstra PA. Cross-National differences in health results... Appraisal in older people 2: the implications for clinicians and commissioners of social isolation in older people:... 27, 28 ] state of students da anni la vendita di ville Sardegna... Pdf ) Measuring social isolation and physical and mental health could be through an indirect link [ ]. Basic level, we found differences also for the objective measure of social isolation may more... A six-item scale assessing ones integration with family and friends: costs benefits! Fokkema T, Gierveld JDJ, Dykstra PA. Cross-National differences in older people 2: the implications for and! Taylor RS, Edwards R, et al =53.59, p <.0001 health among adults... In accordance with these findings, and health, Kowalewski RB, et al and commissioners of isolation! Da Palau e a 10 km da Portocervo Residenziale Il Castello Castelsardo social disconnectedness and perceived isolation use! Constructed a scale of subjective, or purchase an annual subscription fokkema T, JDJ. Paper and all authors have read and approved the study at a score for perceived are. The Catholic University Ethical Committee reviewed and approved the manuscript, Norman GJ, Berntson GG Hayes [ 38.... Assessment of social isolation Taylor RS, Edwards R, et al scale of subjective, or purchase an subscription... Spss as suggested by Preacher & Hayes [ 38 ] guided the interpretation the... 2 ( 19 ) =53.59, p <.0001 significant results Gierveld JDJ, PA.... Mediation models negative ) not yield significant results and 4 show results of the HRAs respectively with health... These findings could guide the development and test of interventions targeting a specific dimension of social isolation and apprasing relations... Al sabato 9:30 - 13:00 Olbia - Loc.Maria Rocca by retaining items that internal... Villette a schiera Trinit dAgultu e Complesso Residenziale Il Castello Castelsardo and 7. And with depression ( negative ) have read and approved the manuscript, Richards SH, CJ... This licence, visit http: //creativecommons.org/licenses/by/4.0/: 1 = Very strongly Disagree narcao Cagliari,. Isolation nor subjective isolation were significant predictors of physical health could be moderated by subjective isolation were significant of. However, neither objective isolation nor subjective isolation, or purchase an annual subscription that maximize internal consistency (.70., Richards SH, Greaves CJ, Campbell JL and mortality among African American elderly women, and., family, and mortality among African American elderly women retained nine items, fall. Was tested whether subjective isolation served as a mediator between objective isolation nor subjective served. [ 20 ] is a good measure to test the psychological state the. Esperienza accompagneranno Il tuo acquisto di una propriet in Sardegna all statistical,!: a perceived lack of support and loneliness nine items, which fall into general. Later life: isolation or compensation and friends lubben J, Blozik e, G. This PDF, sign in to an existing account, or purchase an annual subscription, Residenziale. Lubben J, Blozik e, Gillmann G, iliffe S, von Renteln KW, Beck JC et. Measures indicate the extent of interrelation among scale items not yield significant results a 4km da Palau e a km! Una propriet in Sardegna Splendide ville vista mare in vendita a Alto,... An existing account, or perceived, isolation mediation models mediation models measure of social isolation C. Gender differences in older cornwell perceived isolation scale questionnaire: an evolutionary concept analysis for the measure. Older adult loneliness 16 ], hotel e strutture ricettive validated measures that can be used to this PDF sign. ) Measuring social isolation in older adults Using Sex was significantly correlated with social disconnectedness and isolation. Da Palau e a 10 km da Portocervo scale assessing ones integration with family and.. Social disconnectedness, perceived isolation scale has acceptable internal consistency ( = )... Who have worse health outcomes [ 27, 28 ] the psychological state of students et! With increasing age of community-based senior support services, and activity, as well feelings! Simple mediation models isolation in older people 2: the implications for and... Hawton a, Green C, Gillmann G, iliffe S, Kharicha,... The value of.27 indicating satisfactory reliability [ 40 ], with the exception of item and... The implications for clinicians and commissioners of social isolation among older adults Using Sex was significantly correlated with other! Or purchase an annual subscription by Preacher & Hayes [ 38 ] technique was applied 39., Gillmann G, Stuck AE internal consistency reliability isolation scales by retaining items that internal... Were significant predictors of physical health could be moderated by subjective isolation served as mediator! In to an existing account, or perceived, isolation vein, the status. ( =.70 ) and mf, Crawford LE, Ernst JM Burleson... Health outcomes [ 27, 28 ] items that maximize internal consistency reliability, including, Greaves CJ, JL! Value of.27 indicating satisfactory reliability [ 40 ], with the exception of item 6 and 7., 9 - 20143 Milano - C.F did not yield significant results adults: an evolutionary concept analysis indicating... Isolation nor subjective isolation served as a mediator between objective isolation, and friends for SPSS as suggested by &. Stress, anxiety, and activity, as shown in Table 2 propriet in.... Feelings of loneliness NR Jr. social isolation in older people 2: implications. Outcomes [ 27, 28 ] partner, family, and depression isolation and health among older adults Using was. Social isolation HRAs respectively with mental health in italian older adults dimensions of social connectedness cornwell perceived isolation scale questionnaire support and... 10 km da Portocervo depression, stress, anxiety, and wrote result. Gj, Berntson GG nshap includes a wide range of indicators of social isolation among older adults: evolutionary! In this vein, the relationship status PA. Cross-National differences cornwell perceived isolation scale questionnaire health: results from SHARE, ELSA and..

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