In recent years, the term “virtual first” has been making waves in the healthcare industry. Health insurance companies are embracing this approach, and initiatives like the IMPACT consortium by the Digital Medicine Society are further supporting the virtual first concept.
Exploring Virtual First Healthcare
Derived from the tech sector, “virtual first” entails receiving services primarily through virtual or remote means rather than traditional centralized physical locations. This approach gained momentum during the COVID-19 pandemic, with companies like Dropbox adopting it and influencing healthcare delivery.
Distinguishing Virtual First from Telehealth and Virtual Visits
While virtual first may sound akin to terms like telehealth or virtual visits, distinctions exist. Telehealth encompasses remote care delivery through communication technologies, offering services from administrative tasks to consultation scheduling. Virtual visits are part of telehealth and involve virtual interactions between doctors and patients.
On the other hand, virtual first healthcare operates as a hybrid model, emphasizing initial virtual interactions complemented by in-person services when necessary to optimize care delivery.
Implementation of Virtual First Care
The adoption of virtual first healthcare models has primarily been observed in the US. Companies like Wheel and Firefly offer such plans through their virtual care platforms. UPMC in Central Pennsylvania has also introduced a virtual-first, full-service primary care clinic, encompassing consultations, diagnostics, coaching, and nutrition services.
Dr. Salim Saiyed, Vice President and CMIO at UPMC Central Pennsylvania, notes that virtual-first primary care enhances patient access to medical services digitally, particularly benefiting busy professionals and individuals in remote areas who face challenges in accessing in-person care.
Challenges of Virtual First Healthcare
Despite the advantages, virtual first care models face challenges. Research indicates that these models are more appealing to younger, healthier individuals, potentially leading to increased profits for insurers without substantial improvements in care accessibility.
Dr. Robert Vinetz from the California Physicians Alliance emphasizes the importance of aligning virtual-first visits with patient-centric values to prevent perpetuating accessibility disparities. Policymakers need to familiarize themselves with these novel care approaches to establish regulations that prioritize patient well-being.
While virtual first healthcare may encounter growing pains, addressing these challenges promptly is crucial considering the benefits it offers to patients.
Authored by Dr. Bertalan Meskó & Dr. Pranavsingh Dhunnoo. This article was originally posted on The Medical Futurist.
Frequently Asked Questions
What are the Five Alternative Medical Systems (Alternatives)?
There are five alternatives to traditional medicine: Ayurveda and Ayurveda; homeopathy; energy healing; aromatherapy; and Ayurveda.
Acupuncture involves inserting fine needles into specific points of the body to stimulate the flow (qi) of energy throughout the entire body.
Ayurvedic medicines is an ancient system to balance the three senses of air, fire,, and water. It involves diet and exercise, herbal remedies as well massage and meditation.
Homeopathic Medicine’s name derives from the Greek words homoios and pathos. Homeopaths believe all diseases are caused by natural causes, but not always symptoms. Homeopaths treat patients by prescribing small amounts of substances that produce similar symptoms to the ones experienced when the patient is sick.
Energy Healing is also known as Reiki, EFT, Rolfing, Therapeutic Touch, and many others. This therapy is based in the belief we all have a connection to a universal life force called Ki. If this Ki flows freely though us, it makes us feel well. Energy healers work with touch and intention to restore harmony and balance between our mental, spiritual, and physical selves.
Aromatherapy uses essential oil extracted from plants for therapeutic purposes. Aromatherapists believe that certain smells can affect mood and behavior. The most common essential oil used in aromatherapy is lavender.
What are alternative medicine examples?
Alternative medicine refers only to alternative treatments that are not considered to be effective in treating diseases. These include traditional Chinese medicine and homeopathy, chiropractic, acupuncture and herbal medicines, nutritional therapy, energy healing techniques, such as Reiki, and acupuncture.
Alternative medicine could also refer to any practice that has not been supported by scientific evidence but is used in clinical practice. Meditation, yoga, aromatherapy and reflexology are some examples.
What is the alternative to holistic medicine?
Holistic medicine is an approach to health care that considers all aspects of the human body and its emotional, social, spiritual, and environmental dimensions. Holistic medicine is based upon the belief that all illnesses must have multiple causes. Therefore, it requires a combination treatment to maximize effectiveness.
Holistic medicine is a form of holistic medicine. They believe prevention is better than treatment. They are able to work closely with patients in order to ensure optimal wellness.
They look for the root causes of disease to prevent them from returning. Holistic physicians look at the whole person and not just the physical organs. Holistic physicians often refer to the whole being as “the Body”.
This means they see beyond the skin and treat your body holistically. The doctor may suggest changes to diet, lifestyle, and exercise. He may also recommend meditation or yoga exercises, herbal supplementation, massage or chiropractic treatment, as well as acupuncture and other forms of alternative medicine.
How safe are holistic medicines?
Holistic medicines are safe as they aren’t harmful drugs, but natural remedies that have been used for centuries by people who use them.
They have been shown in many cases to treat conditions such as arthritis and chronic pain, asthma.
Millions of people worldwide suffer from various diseases and can also use holistic medicines. They include homeopathy. It also includes chiropractic care. Herbal treatments. Massage therapy. Yoga. Meditation. Hypnosis. Nutrition. Counseling. Exercise. These therapies address the whole person instead of just the symptoms.
What is the difference between alternative medicine and complementary medicine?
Alternative medicine is any treatment that isn’t considered standard by mainstream medical practitioners but which has been shown to have benefits for some conditions. Examples include acupuncture, homeopathy, aromatherapy, reflexology, herbal remedies, traditional Chinese medicine (TCM), Ayurveda, and naturopathy. Complementary therapies are those treatments that go beyond conventional treatment. They can also be used with conventional medicine. These include dietary supplements such as vitamins, minerals, herbs, amino acids, enzymes, probiotics, and other natural substances.
While both forms of medicine are commonly used, many conventional doctors do not recommend them due to insufficient evidence or safety concerns.
The best way to integrate CAM into patient care is not a consensus among health care professionals.
Many CAM treatments are based off theories that have been around for thousands years. However, clinical trials over the past 20 years suggest that some of these therapies might work.
A number of studies suggest that acupuncture may be able to relieve pain. Similarly, preliminary data show that it may reduce nausea and vomiting associated with chemotherapy. A number of studies also suggest that acupuncture might improve symptoms like irritable and fibromyalgia as well as chronic fatigue syndrome, Multiple Sclerosis, multiple sclerosis, migraines tension headaches, anxiety, and anxiety.
Some CAM therapies may also be effective in the treatment of diseases like HIV/AIDS/Asthma, diabetes, heart disease (hypertension), Alzheimer’s and Parkinson’s diseases, as well as rheumatoid.
While there are still questions about the effectiveness of CAM in treating different ailments, most experts agree it is possible.
People are turning to CAM practitioners more often for relief from common diseases.
Despite the popularity of alternative and complementary medicine, many people are still unsure what they mean.
Who uses holistic medicine?
Holistic medicine treats the whole person and not only specific symptoms. It considers both the mental, and physical aspects.
Holistic medicine also includes chiropractic treatment, acupuncture, nutrition counseling, yoga, and various other complementary therapies.
Holistic medicine is for people who have been diagnosed as having cancer, heart disease, diabetes, arthritis and depression.
Statistics
- The concept of regression toward the mean implies that an extreme result is more likely to be followed by a less extreme result. (en.wikipedia.org)
- According to a 2005 book by a US [116]Institute of Medicine panel, the number of RCTs focused on CAM has risen dramatically. (en.wikipedia.org)
- These studies found that 38.4% concluded positive or possibly positive effects for CAM (12.4%), 4.8% concluded no effect, 0.7% concluded harmful effects, and 56.6% concluded insufficient evidence. (en.wikipedia.org)
- An assessment of conventional treatments found that 41.3% concluded positive or possibly positive effects, 20% concluded no effect, 8.1% concluded net harmful effects, and 21.3% concluded insufficient evidence. (en.wikipedia.org)
- A 15-year systematic review published in 2022 on the global acceptance and use of CAM among medical specialists found the overall acceptance of CAM at 52% and the overall use at 45%. (en.wikipedia.org)
External Links
nccih.nih.gov
cam.cancer.gov
ncbi.nlm.nih.gov
- BIOFEEDBACK TRAINING and TENSION-TYPE HeADACHE – PubMed
- PubMed: Randomized controlled trial examining the effects of foot reflexology on hospital anxiety and depression in female older adults.
liebertpub.com
- Games for Health Journal, Mary Ann Liebert, Inc., publishers
- Acupuncture for Treatment of Insomnia: A Systematic Review of Randomized Controlled Trials
How To
What type of products are used for holistic medicine?
It would be best to describe these products as “natural”, but not necessarily organic. These products could have been grown naturally without pesticides or fertilizers. But they were also processed in a way that is safer for your health. For example, some herbs can cause allergic reactions in some individuals, so they may need to be prepared differently depending on their needs. Herbs sold at health food stores are more standardized than those sold at grocery stores. Higher levels of herbicides or fungicides can be found in these latter products.
Herbal supplements are often made from dried herbs. People prefer to buy them in liquid form as they are cheaper. But, liquid herbs are not necessarily safer. Liquid herbs can lose nutrients during processing. The product may lose its original potency. In addition, most herbal supplements don’t undergo quality control testing before being put on store shelves.
Usually, herbs and spices are added to food after it has been cooked. These spices can be found in sauces, condiments, dressings, soup mixes, marinades, and salad dressings.
Supplements are generally taken orally (by taking them by mouth). Most vitamins are available in tablet form. Some vitamins and minerals are also available in capsules.
Homeopathic remedies may be high-diluted substances that have been extracted from either plant, animal, mineral or synthetic sources. They can stimulate the body’s healing abilities. They are homeopathic, but do not function like regular medications. They activate the immune system of the body to restore balance and promote well-being. Homeopathic remedies have been proven safe and effective. They are widely used in Europe, Canada, Australia, New Zealand, South America, Asia, Africa, and the Middle East.
Acupuncture involves inserting needles at specific points on the meridians of your bodies. This is based on traditional Chinese medical theories that energy channels are the pathways through which life force flows. According to this theory, illness is caused by blockages in these channels. Energy flow can be restored by stimulating certain points along meridian lines with fine needles. This is how the body returns back to normal functioning.
Chiropractors manipulate the spine to correct misalignments of the bones. American doctor Daniel David Palmer created this technique in 1895. He claimed that he could diagnose illness and cure them by manipulating the vertebrae. His methods included spinal adjustments. Muscle tests. And percussion.
Chiropractic has grown in popularity over the last few years. Many people think it is more effective than traditional medicine for back pain.
Massage therapy is a form of massage that involves massaging, kneading or tapping muscles, joints and other body parts. Massage is used to loosen tight muscles and relieve tension. Swedish massage, deep tissue massage, sports, reflexology or myofascial release are all methods used by massage therapists.
Reflexology is an alternative medicine involving pressure applied to specific areas of the feet and hands using thumb pads, fingers, and toes. This method, according to reflexologists, stimulates the body’s natural healing ability.
Aromatherapy is the use of essential oils obtained from plants to alleviate stress, enhance well-being, and elevate moods. The chemical composition of essential oils can help with a wide range of conditions, including headache relief and arthritis treatment. Aromatherapy can be used in many ways, including:
Craniosacral Therapy utilizes gentle touch to help alleviate pain and discomfort. Cranial is the skull. Sacrum in Latin refers to “sac”, and Cranial Sacral Therapy combines both. This therapy uses light pressure to apply pressure to specific areas on the head and neck, shoulders or arms. It also involves moving the hands around the body of the patient.
Cupping therapy is performed by applying cups to the skin to create suction and draw out toxins. Cupping therapy can also be combined with moxibustion (burning of herbs) or acupuncture to help detoxify.
Supplements are either oral or topical products that contain vitamins and minerals, herbs extracts, enzymes, probiotics. antioxidants, and other fatty acids. Dietary Supplements Health and Education Act of94 is the FDA’s regulation of dietary supplements. A dietary supplement must meet two criteria to be sold legally. First, the product must be a “dietary ingredient” which means it contains more that one percent of a vitamin mineral, herb or other botanical on the Food and Drug Administration’s Generally Recognized As Safe List. It must also have adhered to Good Manufacturing Practices. This means that its ingredients were properly handled during production.
Electrotherapy uses electric currents to stimulate muscles and nerves. TENS (transcutaneous electric nerve stimulation) is the most commonly used form of electrotherapy. The skin electrodes used to place TENS devices allow for low-level electrical pulses. These pulses activate receptors in the brain that block pain signals. Intermittential current therapy and magnetic field therapy are other forms of electrotherapy.
Energy healing is based in the belief that everyone has inherent healing abilities. Also, that our thoughts, emotions, and beliefs can have an impact on our physical health. Although energy healing has existed since ancient times, modern practitioners generally accept that there are multiple layers of energy within and around us. Emotional energy is one layer. Another layer of energy is called mental. There are many other energy types, including spiritual, physical, chakras, vital and life force, prana. Kundalini, biofield. aura. quantum fields. These energies may be connected to the entire universe, according to some. Some believe that these energies can be used to heal other people using only their minds. There is not much scientific evidence supporting energy medicine.
Energy psychology studies how human emotions impact physiological functions. Because it doesn’t focus on the past but focuses more on helping clients change their behavior now, energy psychology is sometimes considered an alternative or complementary to psychotherapy. Although energy psychology does not have a particular theoretical framework, it draws from many disciplines including cognitive behavioral therapy (CBT), transactional analysis, interpersonal psychoanalysis and attachment theory.
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By: Pranavsingh Dhunnoo
Title: Understanding Virtual First in Healthcare
Sourced From: medicalfuturist.com/what-does-virtual-first-mean-in-healthcare
Published Date: Thu, 29 Feb 2024 08:30:00 +0000
Frequently Asked Questions
What are the Five Alternative Medical Systems (Alternatives)?
There are five alternatives to traditional medicine: Ayurveda and Ayurveda; homeopathy; energy healing; aromatherapy; and Ayurveda.
Acupuncture involves inserting fine needles into specific points of the body to stimulate the flow (qi) of energy throughout the entire body.
Ayurvedic medicines is an ancient system to balance the three senses of air, fire,, and water. It involves diet and exercise, herbal remedies as well massage and meditation.
Homeopathic Medicine’s name derives from the Greek words homoios and pathos. Homeopaths believe all diseases are caused by natural causes, but not always symptoms. Homeopaths treat patients by prescribing small amounts of substances that produce similar symptoms to the ones experienced when the patient is sick.
Energy Healing is also known as Reiki, EFT, Rolfing, Therapeutic Touch, and many others. This therapy is based in the belief we all have a connection to a universal life force called Ki. If this Ki flows freely though us, it makes us feel well. Energy healers work with touch and intention to restore harmony and balance between our mental, spiritual, and physical selves.
Aromatherapy uses essential oil extracted from plants for therapeutic purposes. Aromatherapists believe that certain smells can affect mood and behavior. The most common essential oil used in aromatherapy is lavender.
What are alternative medicine examples?
Alternative medicine refers only to alternative treatments that are not considered to be effective in treating diseases. These include traditional Chinese medicine and homeopathy, chiropractic, acupuncture and herbal medicines, nutritional therapy, energy healing techniques, such as Reiki, and acupuncture.
Alternative medicine could also refer to any practice that has not been supported by scientific evidence but is used in clinical practice. Meditation, yoga, aromatherapy and reflexology are some examples.
What is the alternative to holistic medicine?
Holistic medicine is an approach to health care that considers all aspects of the human body and its emotional, social, spiritual, and environmental dimensions. Holistic medicine is based upon the belief that all illnesses must have multiple causes. Therefore, it requires a combination treatment to maximize effectiveness.
Holistic medicine is a form of holistic medicine. They believe prevention is better than treatment. They are able to work closely with patients in order to ensure optimal wellness.
They look for the root causes of disease to prevent them from returning. Holistic physicians look at the whole person and not just the physical organs. Holistic physicians often refer to the whole being as “the Body”.
This means they see beyond the skin and treat your body holistically. The doctor may suggest changes to diet, lifestyle, and exercise. He may also recommend meditation or yoga exercises, herbal supplementation, massage or chiropractic treatment, as well as acupuncture and other forms of alternative medicine.
How safe are holistic medicines?
Holistic medicines are safe as they aren’t harmful drugs, but natural remedies that have been used for centuries by people who use them.
They have been shown in many cases to treat conditions such as arthritis and chronic pain, asthma.
Millions of people worldwide suffer from various diseases and can also use holistic medicines. They include homeopathy. It also includes chiropractic care. Herbal treatments. Massage therapy. Yoga. Meditation. Hypnosis. Nutrition. Counseling. Exercise. These therapies address the whole person instead of just the symptoms.
What is the difference between alternative medicine and complementary medicine?
Alternative medicine is any treatment that isn’t considered standard by mainstream medical practitioners but which has been shown to have benefits for some conditions. Examples include acupuncture, homeopathy, aromatherapy, reflexology, herbal remedies, traditional Chinese medicine (TCM), Ayurveda, and naturopathy. Complementary therapies are those treatments that go beyond conventional treatment. They can also be used with conventional medicine. These include dietary supplements such as vitamins, minerals, herbs, amino acids, enzymes, probiotics, and other natural substances.
While both forms of medicine are commonly used, many conventional doctors do not recommend them due to insufficient evidence or safety concerns.
The best way to integrate CAM into patient care is not a consensus among health care professionals.
Many CAM treatments are based off theories that have been around for thousands years. However, clinical trials over the past 20 years suggest that some of these therapies might work.
A number of studies suggest that acupuncture may be able to relieve pain. Similarly, preliminary data show that it may reduce nausea and vomiting associated with chemotherapy. A number of studies also suggest that acupuncture might improve symptoms like irritable and fibromyalgia as well as chronic fatigue syndrome, Multiple Sclerosis, multiple sclerosis, migraines tension headaches, anxiety, and anxiety.
Some CAM therapies may also be effective in the treatment of diseases like HIV/AIDS/Asthma, diabetes, heart disease (hypertension), Alzheimer’s and Parkinson’s diseases, as well as rheumatoid.
While there are still questions about the effectiveness of CAM in treating different ailments, most experts agree it is possible.
People are turning to CAM practitioners more often for relief from common diseases.
Despite the popularity of alternative and complementary medicine, many people are still unsure what they mean.
Who uses holistic medicine?
Holistic medicine treats the whole person and not only specific symptoms. It considers both the mental, and physical aspects.
Holistic medicine also includes chiropractic treatment, acupuncture, nutrition counseling, yoga, and various other complementary therapies.
Holistic medicine is for people who have been diagnosed as having cancer, heart disease, diabetes, arthritis and depression.
Statistics
- The concept of regression toward the mean implies that an extreme result is more likely to be followed by a less extreme result. (en.wikipedia.org)
- According to a 2005 book by a US [116]Institute of Medicine panel, the number of RCTs focused on CAM has risen dramatically. (en.wikipedia.org)
- These studies found that 38.4% concluded positive or possibly positive effects for CAM (12.4%), 4.8% concluded no effect, 0.7% concluded harmful effects, and 56.6% concluded insufficient evidence. (en.wikipedia.org)
- An assessment of conventional treatments found that 41.3% concluded positive or possibly positive effects, 20% concluded no effect, 8.1% concluded net harmful effects, and 21.3% concluded insufficient evidence. (en.wikipedia.org)
- A 15-year systematic review published in 2022 on the global acceptance and use of CAM among medical specialists found the overall acceptance of CAM at 52% and the overall use at 45%. (en.wikipedia.org)
External Links
nccih.nih.gov
cam.cancer.gov
ncbi.nlm.nih.gov
- BIOFEEDBACK TRAINING and TENSION-TYPE HeADACHE – PubMed
- PubMed: Randomized controlled trial examining the effects of foot reflexology on hospital anxiety and depression in female older adults.
liebertpub.com
- Games for Health Journal, Mary Ann Liebert, Inc., publishers
- Acupuncture for Treatment of Insomnia: A Systematic Review of Randomized Controlled Trials
How To
What type of products are used for holistic medicine?
It would be best to describe these products as “natural”, but not necessarily organic. These products could have been grown naturally without pesticides or fertilizers. But they were also processed in a way that is safer for your health. For example, some herbs can cause allergic reactions in some individuals, so they may need to be prepared differently depending on their needs. Herbs sold at health food stores are more standardized than those sold at grocery stores. Higher levels of herbicides or fungicides can be found in these latter products.
Herbal supplements are often made from dried herbs. People prefer to buy them in liquid form as they are cheaper. But, liquid herbs are not necessarily safer. Liquid herbs can lose nutrients during processing. The product may lose its original potency. In addition, most herbal supplements don’t undergo quality control testing before being put on store shelves.
Usually, herbs and spices are added to food after it has been cooked. These spices can be found in sauces, condiments, dressings, soup mixes, marinades, and salad dressings.
Supplements are generally taken orally (by taking them by mouth). Most vitamins are available in tablet form. Some vitamins and minerals are also available in capsules.
Homeopathic remedies may be high-diluted substances that have been extracted from either plant, animal, mineral or synthetic sources. They can stimulate the body’s healing abilities. They are homeopathic, but do not function like regular medications. They activate the immune system of the body to restore balance and promote well-being. Homeopathic remedies have been proven safe and effective. They are widely used in Europe, Canada, Australia, New Zealand, South America, Asia, Africa, and the Middle East.
Acupuncture involves inserting needles at specific points on the meridians of your bodies. This is based on traditional Chinese medical theories that energy channels are the pathways through which life force flows. According to this theory, illness is caused by blockages in these channels. Energy flow can be restored by stimulating certain points along meridian lines with fine needles. This is how the body returns back to normal functioning.
Chiropractors manipulate the spine to correct misalignments of the bones. American doctor Daniel David Palmer created this technique in 1895. He claimed that he could diagnose illness and cure them by manipulating the vertebrae. His methods included spinal adjustments. Muscle tests. And percussion.
Chiropractic has grown in popularity over the last few years. Many people think it is more effective than traditional medicine for back pain.
Massage therapy is a form of massage that involves massaging, kneading or tapping muscles, joints and other body parts. Massage is used to loosen tight muscles and relieve tension. Swedish massage, deep tissue massage, sports, reflexology or myofascial release are all methods used by massage therapists.
Reflexology is an alternative medicine involving pressure applied to specific areas of the feet and hands using thumb pads, fingers, and toes. This method, according to reflexologists, stimulates the body’s natural healing ability.
Aromatherapy is the use of essential oils obtained from plants to alleviate stress, enhance well-being, and elevate moods. The chemical composition of essential oils can help with a wide range of conditions, including headache relief and arthritis treatment. Aromatherapy can be used in many ways, including:
Craniosacral Therapy utilizes gentle touch to help alleviate pain and discomfort. Cranial is the skull. Sacrum in Latin refers to “sac”, and Cranial Sacral Therapy combines both. This therapy uses light pressure to apply pressure to specific areas on the head and neck, shoulders or arms. It also involves moving the hands around the body of the patient.
Cupping therapy is performed by applying cups to the skin to create suction and draw out toxins. Cupping therapy can also be combined with moxibustion (burning of herbs) or acupuncture to help detoxify.
Supplements are either oral or topical products that contain vitamins and minerals, herbs extracts, enzymes, probiotics. antioxidants, and other fatty acids. Dietary Supplements Health and Education Act of94 is the FDA’s regulation of dietary supplements. A dietary supplement must meet two criteria to be sold legally. First, the product must be a “dietary ingredient” which means it contains more that one percent of a vitamin mineral, herb or other botanical on the Food and Drug Administration’s Generally Recognized As Safe List. It must also have adhered to Good Manufacturing Practices. This means that its ingredients were properly handled during production.
Electrotherapy uses electric currents to stimulate muscles and nerves. TENS (transcutaneous electric nerve stimulation) is the most commonly used form of electrotherapy. The skin electrodes used to place TENS devices allow for low-level electrical pulses. These pulses activate receptors in the brain that block pain signals. Intermittential current therapy and magnetic field therapy are other forms of electrotherapy.
Energy healing is based in the belief that everyone has inherent healing abilities. Also, that our thoughts, emotions, and beliefs can have an impact on our physical health. Although energy healing has existed since ancient times, modern practitioners generally accept that there are multiple layers of energy within and around us. Emotional energy is one layer. Another layer of energy is called mental. There are many other energy types, including spiritual, physical, chakras, vital and life force, prana. Kundalini, biofield. aura. quantum fields. These energies may be connected to the entire universe, according to some. Some believe that these energies can be used to heal other people using only their minds. There is not much scientific evidence supporting energy medicine.
Energy psychology studies how human emotions impact physiological functions. Because it doesn’t focus on the past but focuses more on helping clients change their behavior now, energy psychology is sometimes considered an alternative or complementary to psychotherapy. Although energy psychology does not have a particular theoretical framework, it draws from many disciplines including cognitive behavioral therapy (CBT), transactional analysis, interpersonal psychoanalysis and attachment theory.
