Why I love reading

Google images 2023

by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

Reading is a fundamental and robust activity that plays a crucial role in personal, intellectual, social, and cultural development. The importance of reading cannot be overstated. Reading can profoundly impact individuals and society as a whole. Here are some key reasons why I think reading is essential:

1. Knowledge and Learning: Reading is one of the primary ways we acquire knowledge and learn about the world. It exposes us to various information, perspectives, ideas, and experiences. We can understand different cultures, historical events, scientific discoveries, and much more through reading.
2. Critical Thinking and Analytical Skills: Reading encourages critical thinking and helps us develop analytical skills. It requires us to comprehend, evaluate, and interpret information, fostering a deeper understanding of the material and improving our critical thinking ability.
3. Vocabulary and Language Development: Reading exposes us to new words, phrases, and sentence structures, enhancing our vocabulary and language skills. A richer vocabulary improves communication and allows us to express ourselves more effectively in writing and speaking.
4. Empathy and Understanding Others: Reading literature, especially fiction, helps us understand characters' thoughts, feelings, and experiences from diverse backgrounds and cultures. Reading cultivates empathy and a broader understanding of human emotions and behaviors.
5. Mental Stimulation and Cognitive Health: Using written material stimulates the brain, improving cognitive function and memory. Regular reading reduces the risk of cognitive decline and conditions like Alzheimer's.
6. Stress Reduction and Relaxation: Reading can be a means of escaping the stresses of daily life. It provides a way to relax, unwind, and transport oneself to different worlds, allowing for a break from reality and promoting mental well-being.
7. Improves Focus and Concentration: Reading demands concentration and focus, skills that can translate to other areas of life. Concentrating and sustaining attention is crucial for productivity and success in various endeavors.
8. Enhanced Imagination and Creativity: Reading encourages imagination and creativity by exposing us to imaginative worlds, characters, and scenarios. It fuels creativity and expands our capacity to think beyond the conventional and envision new possibilities.
9. Personal Growth and Self-Improvement: Reading self-help, motivational, or inspirational books can aid personal growth and self-improvement. It provides guidance, strategies, and advice on overcoming challenges, setting goals, and becoming a better version of ourselves. Books often offer insights into human behavior, personal development, and self-improvement. Reading self-help or motivational books can inspire individuals to set goals, overcome challenges, and work towards becoming the best versions of themselves.
10. Social Connection and Communication: Sharing and discussing books can foster social connections and provide a platform for meaningful conversations. Book clubs, for example, encourage dialogue, diverse perspectives, and a sense of community.
11. Connection with Humanity and History: Through historical texts and literature, readers can connect with the experiences, struggles, and triumphs of people from the past. This connection to history and humanity fosters a sense of belonging and awareness of our collective journey.
12. Better Decision-Making: Reading exposes individuals to different perspectives and diverse viewpoints. This diversity of thought enhances critical thinking and decision-making skills by providing a broader range of considerations and options.

Reading is a cornerstone of education, personal development, and societal progress. It enriches our lives, broadens our horizons, and equips us with the knowledge and skills to navigate the world's complexities.

Reading is often touted as one of the most rewarding activities a person can engage in. The benefits of reading extend far beyond mere enjoyment; it is a practice that can profoundly shape and enhance our lives in numerous ways. Here are compelling reasons why people should read more:

Reading is a timeless and invaluable activity that enriches the mind and nourishes the soul. It's a journey through words that offers boundless opportunities for growth, learning, and discovery. Incorporating reading into one's daily routine not only expands knowledge but also enhances mental well-being, empathy, and the ability to navigate the complexities of our world. In an era abundant with information, reading becomes more crucial than ever, empowering individuals to discern, analyze, and thrive in a rapidly evolving society.

Awake in the Dark: Unveiling the Struggles of Insomnia

Image by Harvard Health, 2022.

By Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

Sleep, an essential pillar of human health and well-being, has increasingly eluded many in our fast-paced, digitally connected world. Insomnia, the inability to fall or stay asleep, is a prevalent yet often overlooked condition affecting a substantial portion of the population. As we shed light on this often underestimated issue, we must recognize the profound impact of insomnia on individuals and society.

Insomnia is more than just the occasional restless night; it's a persistent condition that disrupts the natural sleep cycle, leaving individuals tired, irritable, and impaired daily. The toll it takes on one's physical, mental, and emotional well-being cannot be understated. Chronic insomnia is linked to risks of developing various health issues, including cardiovascular diseases, diabetes, depression, anxiety disorders, and compromised immune function.

In our modern world, where the demands of work, technology, and personal responsibilities often infringe upon the sanctity of rest, insomnia has become a pervasive problem. The ceaseless notifications on our screens, the ever-urgent emails, and the demands of a competitive society often conspire against a good night's sleep. Our 24/7 society has blurred the boundaries between day and night, making it difficult for individuals to establish healthy sleep routines.

Furthermore, the prolonged uncertainty and disruptions of the pandemic have exacerbated sleep disorders, including insomnia. Heightened stress levels, financial concerns, social isolation, and health anxieties have all contributed to sleeplessness. Insomnia isn't just borne by those who experience it directly; it extends to families, workplaces, and communities.

Addressing insomnia requires a multi-faceted approach. First and foremost, raising awareness about the gravity of insomnia and its consequences is crucial. Education and public discourse can help dispel misconceptions, reduce stigma, and encourage individuals to seek timely help.

Moreover, prioritizing self-care and establishing healthy sleep habits are essential. A few behaviors can help improve our sleep quality. These healthy behaviors include creating a conducive sleep environment, maintaining a regular schedule, reducing screen time before bed, and engaging in relaxation techniques. Employers should also promote a healthy work-life balance, discourage after-hours emails, and foster a culture that values and supports well-being.

Access to adequate and affordable healthcare for people with insomnia is also pivotal. Tailored treatment plans, which may involve cognitive-behavioral therapy for insomnia (CBT-I) or pharmacological interventions when necessary, should be accessible to all who need them. Insurance coverage and mental health support should be inclusive and readily available.

In creating a set of practices and habits promoting good, restorative sleep, we refer to sleep hygiene. These various behavioral and environmental factors can influence the quality and duration of our sleep. 

Let us discuss some critical aspects of sleep hygiene:

1. Consistent Sleep Schedule: Going to bed and waking up at the same time every day, even on weekends. This helps regulate the body's internal clock (circadian rhythm).
2. Create a Relaxing Bedtime Routine: Establish a pre-sleep routine that signals to the body that it's time to wind down. Activities include reading a book, listening to soft music, gentle stretching, and meditation before bed.
3. Comfortable Sleep Environment: Keep the bedroom cool, dark, and quiet to promote better sleep. Use blackout curtains, earplugs, or white noise machines as needed. Having a comfortable mattress and pillows that support the body well.
4. Limit Exposure to Screens: Avoid screens (phones, computers, TVs) at least an hour before bedtime. It is known that the blue light emitted by digital screens can interfere with melatonin production, a hormone that regulates sleep.
5. Mind Your Diet and Hydration: Heavy meals, caffeine, and nicotine close to bedtime should be avoided before bedtime, as they can disrupt sleep. Opt for a light, healthy snack if you're hungry before bed. Stay hydrated throughout the day, but reduce liquids close to bedtime to minimize nighttime awakenings for bathroom visits.
6. Regular Exercise: Have a normal exercise routine with regular physical activity during the day, but avoid intense workouts close to bedtime. Exercise can help us fall asleep faster.
7. Manage Stress and Anxiety: Deep breathing, meditation, or any other technique, such as progressive muscle relaxation, can be beneficial to reduce stress and calm the mind before bedtime. Consider keeping a worry journal to jot down any anxieties or concerns, allowing you to clear your mind before sleep.
8. Limit Daytime Naps: Naps should be short (20-30 minutes). Avoid naps late in the afternoon or evening, as it can interfere with nighttime sleep.
9. Expose Yourself to Natural Light: Get exposure to natural light during the day, especially in the morning. Natural light helps regulate the circadian rhythm and improve sleep quality.

Implementing these sleep hygiene practices can significantly improve sleep quality and overall well-being. If sleep problems persist, consulting a healthcare professional for further evaluation and guidance should be considered.

In conclusion, insomnia is a pressing public health concern that demands our attention. By acknowledging its impact and taking proactive steps to mitigate its effects, we can pave the way for a society that values and prioritizes good sleep. Let us unite in advocating for better sleep hygiene, encouraging open dialogues about mental health, and working towards a world where the tranquility of a restful night is no longer an elusive dream.

Understanding Non-HDL Cholesterol: A Comprehensive Overview

Image by Harvard Health 2022.

by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

Perhaps every year during an annual physical, your provider checks your lipids (cholesterol levels) as part of a routine examination. This blood test helps evaluate the risk of developing heart disease and other cardiovascular conditions. While looking at the laboratory report, did you wonder what that meant?

Let's review the main components of a lipid panel.

1. Total Cholesterol: This is the total amount of cholesterol in the blood, including low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol.
2. Low-Density Lipoprotein (LDL) Cholesterol: Often called "bad" cholesterol, this cholesterol carries cholesterol from the liver to the cells. High LDL levels can contribute to the buildup of plaque in the arteries (atherosclerosis), leading to heart disease and stroke.
3. High-density lipoprotein (HDL) Cholesterol: The so-called "good" cholesterol. Its job is to help remove LDL cholesterol, the bad cholesterol, from the bloodstream and transport it to the liver for excretion. Higher HDL levels are associated with a reduced risk of heart disease.
4. Triglycerides: Triglycerides are a type of fat found in the blood and are stored in fat cells. Elevated triglycerides are associated with a higher risk of heart disease, especially when combined with high LDL and low HDL cholesterol.
5. Non-High-Density Lipoprotein (Non-HDL) Cholesterol: As mentioned earlier, this is calculated by subtracting HDL cholesterol from the total cholesterol. It includes LDL cholesterol and other atherogenic lipoproteins, providing a more comprehensive cardiovascular risk assessment.
6. Very Low-Density Lipoprotein (VLDL) Cholesterol: VLDL is a lipoprotein carrying triglycerides that can be converted into LDL cholesterol.

What is precisely non-HDL cholesterol?

Non-HDL (Non-High-Density Lipoprotein) cholesterol is a type of cholesterol that includes all the cholesterol carried in lipoproteins other than high-density lipoprotein (HDL). Unlike HDL cholesterol, which is often referred to as "good" cholesterol because it helps remove low-density lipoprotein (LDL) cholesterol from the bloodstream, non-HDL cholesterol includes LDL cholesterol, very-low-density lipoprotein (VLDL) cholesterol and intermediate-density lipoprotein (IDL) cholesterol.

Here's some essential information about non-HDL cholesterol:

1. Composition: Non-HDL cholesterol includes LDL, VLDL, and IDL cholesterol. It represents a combination of atherogenic lipoproteins associated with an increased risk of cardiovascular disease.
2. Calculation: Non-HDL cholesterol is calculated by subtracting HDL cholesterol from the total cholesterol level. The formula is Non-HDL cholesterol = Total cholesterol - HDL cholesterol.
3. Atherogenicity: Non-HDL cholesterol is a better predictor of cardiovascular risk than LDL cholesterol alone. It accounts for all the cholesterol within atherogenic lipoproteins, providing a more comprehensive risk assessment.
4. Cardiovascular Risk: An elevated level of non-HDL cholesterol increases the risk of atherosclerosis, cardiovascular disease, heart attacks, and strokes.
5. Management and Treatment: Lowering non-HDL cholesterol through lifestyle changes (e.g., diet, exercise) and, if necessary, medication (e.g., statins) is an essential strategy for managing cardiovascular risk.
6. Recommended Levels: According to guidelines from organizations like the American Heart Association, the optimal level of non-HDL cholesterol is typically 30 mg/dL higher than the recommended LDL cholesterol level. Individuals with existing heart disease or diabetes may have more aggressive non-HDL cholesterol targets.
7. Diet and Lifestyle: Dietary modifications should help reduce saturated and trans fats, increase fiber intake, and incorporate heart-healthy foods, which can help lower non-HDL cholesterol. Getting regular physical activity as well as weight management are also important.
8. Monitoring: Non-HDL cholesterol levels should be monitored regularly, especially in individuals with a history of heart disease or those at high risk for cardiovascular events.

In summary, non-HDL cholesterol is a valuable marker for assessing cardiovascular risk, encompassing multiple types of cholesterol within atherogenic lipoproteins. Lowering non-HDL cholesterol levels is a critical component of managing and reducing the risk of cardiovascular disease.

Non-Alcoholic Fatty Liver Disease (NAFLD): What is it?

Google images 2023
 

by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

Non-alcoholic fatty Liver Disease (NAFLD) is a term that describes people who consume little to no alcohol and still have fatty liver disease. NAFLD is fat accumulation in liver cells. Unfortunately, NAFLD can lead to inflammation and damage to the liver. NAFLD is becoming increasingly common, often associated with obesity, diabetes, high cholesterol, insulin resistance, and metabolic syndrome.

There are two main types of NAFLD:

1. Simple Fatty Liver (Steatosis): Fat accumulates in the liver in this early stage, but there is slight inflammation or liver cell damage. It often doesn't cause noticeable symptoms and typically doesn't progress to more severe liver disease.

2. Non-alcoholic steatohepatitis (NASH): A more severe form of NAFLD that causes inflammation and liver cell damage. In addition to fat accumulation, NASH can lead to fibrosis (scarring of the liver), cirrhosis, liver failure, and potentially liver cancer. Symptoms may include fatigue, abdominal pain, and enlargement of the liver.

NAFLD risk factors include obesity, diabetes, high blood pressure, high cholesterol, insulin resistance, metabolic syndrome, and a sedentary lifestyle. NAFLD is diagnosed through blood tests, imaging studies (like a liver ultrasound), and sometimes a liver biopsy.

Management and prevention of NAFLD involve lifestyle changes such as:

- Dietary changes: A balanced, healthy diet with reduced calorie intake can help manage weight and improve liver health.

- Regular exercise:  Regular physical activity, which can help with weight loss and improve insulin sensitivity, is essential to prevent NAFLD.

- Control of underlying conditions: Managing conditions like diabetes, high blood pressure, and high cholesterol is crucial.

- Avoidance of alcohol: Even though alcohol does not cause NAFLD, it's essential to avoid it as it can exacerbate liver damage.

It is important to have regular monitoring and follow-up with a healthcare provider are essential to track the progression of the disease and implement appropriate management strategies. In severe cases, advanced medical treatments and interventions may be necessary to manage the complications associated with NASH.

Unleashing the Potential of Technology in Healthcare: A Path to a Brighter Future

by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

In an era where technology drives progress in almost every facet of life, healthcare stands at the forefront of this transformation. The integration of advanced technologies into healthcare has the potential to revolutionize the way we approach and experience medical treatment, diagnostics, and patient care. From telemedicine to artificial intelligence, digital health tools are reshaping the healthcare landscape, offering a glimpse into a more efficient, accessible, and personalized future.

Telemedicine, a prime example of this technological wave, has proven its worth during the COVID-19 pandemic, breaking barriers to healthcare access and providing a lifeline to countless individuals. Virtual consultations have reduced the burden on healthcare systems and enabled timely healthcare delivery to remote or underserved areas. The convenience and accessibility of telemedicine will likely persist beyond the pandemic, transforming how patients and healthcare providers interact.

Artificial intelligence (AI) and machine learning have emerged as powerful tools in healthcare, promising to enhance diagnostic accuracy, treatment planning, and drug discovery. AI algorithms can analyze vast amounts of medical data to identify patterns and trends humans might overlook. By leveraging AI, we can detect diseases earlier, tailor treatments, and predict patient outcomes more precisely. This amalgamation of human expertise and machine intelligence has the potential to save lives and reduce healthcare costs.

The Internet of Things (IoT) is another game-changer, enabling interconnected devices to collect and transmit real-time health data. Wearable devices, intelligent sensors, and mobile applications can monitor vital signs, track physical activity, and manage chronic conditions. This data-driven approach allows for proactive healthcare management and empowers individuals to take charge of their health.

However, as we embrace the transformative power of technology in healthcare, we must also address critical concerns. Privacy and data security must remain at the forefront of these advancements, ensuring that sensitive health information is adequately protected. Additionally, bridging the digital divide and providing equitable access to technology-enabled healthcare services is imperative to prevent further disparities in healthcare outcomes.

In conclusion, integrating technology in healthcare is a pivotal step toward improving patient care, enhancing efficiency, and achieving better health outcomes. As we continue to push the boundaries of what technology can achieve in healthcare, a collaborative effort between innovators, healthcare professionals, policymakers, and society is essential to navigate this remarkable journey's ethical, regulatory, and social implications. Embracing the potential of technology in healthcare is not merely an option—it is an essential path to a brighter, healthier future for humanity.

Musculoskeletal Disorders Among Post-Military Population: A Growing Concern

Image by Star and Stripes 2021

By Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

Musculoskeletal disorders (MSDs) are a pressing health concern affecting the post-military population. The rigorous physical demands and potential injuries sustained during military service can have lasting effects on the musculoskeletal system. This article explores the prevalence, types, contributing factors, and the need for comprehensive care for veterans dealing with musculoskeletal disorders.

Prevalence and Types of Musculoskeletal Disorders:

Among post-military individuals, musculoskeletal disorders are highly prevalent. These conditions encompass a range of issues involving muscles, bones, tendons, ligaments, and joints. Common MSDs in veterans include chronic pain, osteoarthritis, back problems, joint pain, and soft tissue injuries. These conditions often arise due to the physical strain and repetitive movements endured during their time in the military.

Contributing Factors:

Several factors contribute to the development of musculoskeletal disorders in the post-military population. Intense physical training, combat-related injuries, carrying heavy gear, prolonged standing, and exposure to repetitive motions increase the risk of developing MSDs. Additionally, mental health conditions such as post-traumatic stress disorder (PTSD) can exacerbate musculoskeletal issues, creating a complex interplay between physical and psychological well-being.

Challenges Faced by Veterans:

Musculoskeletal disorders can substantially impact a veteran's daily life, affecting mobility, employment opportunities, and overall quality of life. Chronic pain and physical limitations may hinder their ability to engage in regular activities, leading to frustration, depression, and loss. Accessing appropriate healthcare, rehabilitation, and social support can be challenging, amplifying the burden of these conditions.

Musculoskeletal disorders (MSDs) can have a profound and lasting impact on military veterans due to their unique physical demands and experiences during service. These disorders can affect their physical health, mental well-being, daily activities, employment opportunities, and overall quality of life.

Physical Health:

Veterans often experience musculoskeletal issues, including chronic pain, osteoarthritis, back problems, joint pain, and soft tissue injuries. These conditions can result from combat-related injuries, repetitive strain, heavy gear usage, and exposure to challenging physical environments during military service. The chronic nature of these conditions can significantly impede their ability to engage in physical activities and lead to a decreased quality of life.

Mobility and Functional Limitations:

MSDs can limit mobility and functionality, making it difficult for veterans to perform everyday tasks such as walking, lifting objects, or even getting out of bed. MSDs can lead to a loss of independence and increased reliance on others for assistance, impacting their sense of self-sufficiency and dignity.

Mental Health Impact:

Musculoskeletal disorders often coincide with mental health challenges such as depression, anxiety, and post-traumatic stress disorder (PTSD). This combination of physical pain and mental health issues can create a vicious cycle, where the physical discomfort exacerbates mental distress and vice versa, affecting their overall well-being.

Employment and Occupational Challenges:

Veterans may find securing or maintaining employment challenging due to their musculoskeletal issues. Specific jobs, especially those with physical demands, may become inaccessible, limiting their career options and potentially leading to financial strain and insecurity.

Social Isolation and Relationship Strain:

MSDs can result in social isolation as veterans may withdraw from social activities due to pain, mobility limitations, or discomfort. MSDs can strain relationships with family and friends, leading to feelings of isolation, frustration, and reduced overall life satisfaction.

Healthcare and Financial Burden:

Managing musculoskeletal disorders requires ongoing healthcare, medications, physical therapy, and potentially surgical interventions. The cost of treatment, especially for those without adequate healthcare coverage, can impose a significant financial burden on veterans and their families.

Reduced Quality of Life:

The physical, emotional, and social challenges of musculoskeletal disorders can drastically reduce veterans' overall quality of life. Pain, limited mobility, and associated mental health issues can lead to a diminished sense of fulfillment and happiness in their post-military lives.

Comprehensive Care and Support:

Addressing these challenges necessitates a holistic approach integrating medical care, rehabilitation, mental health support, community engagement, and accessible resources. A comprehensive approach is essential, which should encompass timely medical evaluations, specialized care from orthopedic specialists and physiotherapists, mental health support, and tailored rehabilitation programs. 

Providing comprehensive healthcare services with veteran-centric healthcare services and education on preventive measures that foster a supportive environment is essential to improving the lives of military veterans affected by musculoskeletal disorders.

All in all, musculoskeletal disorders are a significant health concern affecting post-military populations, with their origins rooted in the physical demands and injuries sustained during military service. Acknowledging the prevalence and impact of MSDs is crucial for developing tailored healthcare programs and support systems to enhance the quality of life for our veterans. By prioritizing comprehensive care, we can mitigate the challenges associated with musculoskeletal disorders and help our veterans lead fulfilling and healthy lives beyond their military service.

Shedding Light on Domestic Violence Awareness Month: Breaking the Silence

By Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

October is designated as Domestic Violence Awareness Month, a time to raise consciousness about a pressing societal issue affecting millions globally. This dedicated month provides an opportunity to educate, advocate, and support individuals affected by domestic violence, encouraging communities to take a stand against abuse and work towards creating a safer and more informed society.

Understanding Domestic Violence

Domestic violence, or intimate partner violence, involves abusive behaviors to gain control and power over a partner, family member, or household member. Domestic violence can occur between intimate partners, family members, or household members. It's a serious societal issue with detrimental effects on victims, encompassing immediate and long-term physical and emotional consequences. These behaviors can manifest as physical, emotional, psychological, financial, or sexual abuse, leaving victims in fear, isolation, and distress. Support, education, and legal interventions are vital in addressing and preventing domestic violence. If you need assistance or information regarding domestic violence, consider contacting a helpline or support organization.

The Importance of Awareness

Domestic Violence Awareness Month is a vital platform to disseminate information about this pervasive issue, dispel myths, and break down the barriers preventing survivors from seeking help. By promoting awareness, individuals are empowered to recognize signs of abuse, offer support, and access resources for themselves or those they know who may be experiencing domestic violence.

Domestic violence awareness involves promoting understanding, recognition, and action to address the issue of domestic violence within society. Attention and awareness include educating people about the signs, effects, and prevention of domestic violence, providing resources for victims, and promoting a culture that rejects violence in relationships. Awareness campaigns often emphasize the importance of early intervention, support for survivors, legal protection, and community involvement to break the cycle of abuse. The goal is to create a society where domestic violence is not tolerated, and victims can access help and support without fear or stigma.

Raising Awareness and Taking Action

Throughout October, many events, campaigns, and initiatives take place globally to spotlight domestic violence. These include awareness walks, educational workshops, social media campaigns, and informational seminars. Activists, survivors, and organizations come together to share stories, offer resources, and call for systemic change.

Supporting Survivors

One of the primary goals of Domestic Violence Awareness Month is to ensure that survivors feel heard, believed, and supported. Advocacy groups, shelters, hotlines, and counseling services are crucial in providing assistance and a haven for those seeking to escape an abusive environment.

Breaking the Silence

Silence perpetuates domestic violence, making it essential to encourage open dialogue. By sharing stories, survivors and advocates inspire others to break free from the cycle of abuse. They emphasize the importance of reporting abuse, seeking help, and offering a supportive environment to those affected.

Community Involvement

Community engagement is pivotal in combatting domestic violence. Local organizations, schools, workplaces, and religious institutions can actively participate by organizing awareness events, workshops, and fundraisers. By uniting communities and fostering understanding, we can work towards eradicating domestic violence.

The Role of Education

Education is a cornerstone of prevention. Schools and educational institutions must incorporate programs that educate students about healthy relationships, consent, and the signs of abuse. Teaching young individuals about respectful behavior can create a future where domestic violence is no longer tolerated.

Conclusion

Domestic Violence Awareness Month is a critical time to unite, educate, and advocate for change. It's a reminder that we all have a role in ending domestic violence. By fostering awareness, offering support, and empowering survivors, we can work together to break the silence, shatter the cycle of abuse, and create a world free from domestic violence.