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Perceptions Of Stress In Community Clinic Nurses During The Covid-19 Pandemic, Jomeka Smith Dec 2023

Perceptions Of Stress In Community Clinic Nurses During The Covid-19 Pandemic, Jomeka Smith

Dissertations

The COVID-19 pandemic is one of the largest healthcare crises that has affected the entire healthcare industry. Community health nurses in the front-line roles are greatly threatened by the COVID-19 pandemic that has decimated healthcare systems. The well-being of nurses is vital to perform their full potential of adequate patient care. Increased demands and pandemic related stressors can increase the risk of mental health problems. Nurses work in a variety of healthcare settings, however, the expectations, the fear of the unknown, and changes in demands have largely contributed to the unprecedented stressors that accompany nurses in clinical settings. Stress among …


Encouraging Medication Compliance By Implementing A Medication Adherence Tool, Regina Taylor Dec 2023

Encouraging Medication Compliance By Implementing A Medication Adherence Tool, Regina Taylor

Doctoral Projects

Medication non-adherence has been a common and challenging problem in health care, especially among mental health patients. Studies show medication compliance among psychiatric patients has been at a lower rate than patients with physical conditions. Non-compliance with medications has been one of the considerable contributions to rapid psychiatric hospital readmission. Rapid readmissions have been costing health care billions of dollars annually. The stigma behind mental health has a large contribution to why mental health patients are non-compliant with their psychotropics. Utilization of the Medication Adherence Rating Scale (MARS) on a patient to evaluate the patient's willingness and ability to take …


Implementing A Systematic Depression Screening In The Primary Care Setting, Cassandra Moore Dec 2023

Implementing A Systematic Depression Screening In The Primary Care Setting, Cassandra Moore

Doctoral Projects

The Advanced Practice Nurse is responsible for providing quality care and treatment for the whole person. 3 John 1:2 KJV states, “I wish above all things that you may prosper and be in health, even as your soul prospers” (King James Bible, 2023, para. 2). To prosper and be in health refers to a holistic approach in which the mind, body, and spirit of an individual is considered. Mental health care is an integral part of the holistic health approach.

Mental illness affects approximately one in five adults (52.9 million) in the United States alone (National Institute of Mental Health …


Studying The Impact Of Hyperlipidemia Monitoring Tools On Referral Rates In Patients Taking Antipsychotics, Jasmyn S. Allen Oct 2023

Studying The Impact Of Hyperlipidemia Monitoring Tools On Referral Rates In Patients Taking Antipsychotics, Jasmyn S. Allen

Doctoral Projects

The purpose of this DNP project is to determine how well an evaluation tool may be used to track hyperlipidemia in patients using antipsychotic medicines who are between the ages of 20 and 50. Elevated lipid contents in the bloodstream, or hyperlipidemia, increase the danger of heart-related illnesses. Antipsychotic drugs, frequently administered for mental health disorders and dyslipidemia, have been connected. The goal is to ascertain whether utilizing an evaluation tool raises the three-month referral rates for hyperlipidemia to primary care (Dayabandara et al., 2017). The foundation of the research is found in several articles collected from different websites. According …


Effectiveness Of Staff Training On Trauma-Informed Care, Brandy Tramel Williams Oct 2023

Effectiveness Of Staff Training On Trauma-Informed Care, Brandy Tramel Williams

Doctoral Projects

The connection between experiencing trauma and the development of substance use disorder is widely recognized. Although trauma is more prevalent among individuals with substance use disorders, healthcare professionals have limited access to training focused on trauma informed care. It is crucial for those working in addiction treatment to receive training and education on trauma informed care to understand the impact of trauma and its association with substance use disorders.

This DNP project's objective was to develop and evaluate an educational presentation for staff emphasizing the importance of trauma-informed care in the context of addiction. The effectiveness of this intervention was …


Implementing A Medication Preference Questionnaire In Schizophrenia To Decrease The Risk Of Relapse, Chelsea Aldridge May 2023

Implementing A Medication Preference Questionnaire In Schizophrenia To Decrease The Risk Of Relapse, Chelsea Aldridge

Doctoral Projects

Schizophrenia is a debilitating disorder that affects the mind causing individuals to have delusions, hallucinations, disorganized thought processing, and or negative symptoms ranging from isolation to anhedonia. Schizophrenia has capabilities of becoming a disabling disorder if symptoms are not properly managed with appropriate psychotropic medications. Psychiatrists, Primary Care Providers (PCPs), and Psychiatric- Mental Health Nurse Practitioners (PMHNPs) typically treat the symptoms of schizophrenia with antipsychotics. Antipsychotics fall into two drug classes: first- generation or typical antipsychotics and second- generation or atypical antipsychotics that can be given orally or intramuscularly. Typical antipsychotics generally have more side effects than atypical antipsychotics. However, …


Does The Use Of Mental Health Screenings And Targeted Stress Interventions Improve Mental Health Outcomes In Outpatient Clinic Staff?, Mary Benson Dec 2022

Does The Use Of Mental Health Screenings And Targeted Stress Interventions Improve Mental Health Outcomes In Outpatient Clinic Staff?, Mary Benson

Doctoral Projects

The Perceived Stress Scale (PSS) has been used as a classic stress assessment instrument to evaluate perceived stress across many settings. As stress is the primary phenomenon in this review due to varying stressors, including infectious diseases among healthcare workers, the PSS is the most appropriate scale for evaluating the degree to which a health worker feels stressed. In addition, the PSS is valuable as it encompasses ten items that researchers use to explore how respondents react to stress due to unpredictable events. Thus, this DNP project is based on the postulation that screening with the PSS and applying stress …


Implementing A Depression Screening Process Within A Primary Care Setting Initiative To Improve Quality Patient-Centered Healthcare, Mark Beech Oct 2022

Implementing A Depression Screening Process Within A Primary Care Setting Initiative To Improve Quality Patient-Centered Healthcare, Mark Beech

Doctoral Projects

Depression is more widespread than many people understand. Depression is a common mental disorder involving millions of people from all backgrounds, races, and socioeconomic levels (World Health Organization [WHO], 2020). Depression not only affects one’s mental well-being but can be often linked to one’s physical well-being. Additionally, depression is often misdiagnosed and can many times go undetected. The stigma of depression or any mental health disorder still has many patients feeling shameful and the need to be secretive which can prevent proper treatment. The implementation of a depression screening process by utilizing a tool for early depression detection is essential …


Quality Improvement For Patients With Alcohol Withdrawal Syndrome Starts With An Evaluation Tool, Jessica Bass Oct 2022

Quality Improvement For Patients With Alcohol Withdrawal Syndrome Starts With An Evaluation Tool, Jessica Bass

Doctoral Projects

Patients with alcohol withdrawal syndrome (AWS) have adverse outcomes to the traditional methods of assessing for and treating withdrawal within the intensive care unit (ICU), which includes a standardized treatment plan. Some negative outcomes include acquiring costly and dangerous hospital-acquired infections, safety concerns, and traumatic experiences that deter further treatment. More individualized assessments and treatments are needed to prevent or decrease the severity of AWS from occurring in critical care settings, which will facilitate more positive outcomes and experiences for the staff and patients. The Minnesota detoxification scale has been shown to be a more appropriate tool for the critical …


Ethnic/Racial Differences In Alcohol Use: Does Drinking Refusal Self-Efficacy Matter?, P. Priscilla Lui, Savannah M. Krantz, Michael B. Madson Aug 2022

Ethnic/Racial Differences In Alcohol Use: Does Drinking Refusal Self-Efficacy Matter?, P. Priscilla Lui, Savannah M. Krantz, Michael B. Madson

Faculty Publications

Introduction: College students—including those of Hispanic backgrounds—are at risk for hazardous drinking. Research has shown robust group differences between Hispanic and White individuals in alcohol use outcomes. The ability to resist alcohol consumption can be leveraged to reduce hazardous drinking; however, little research has examined Hispanic-White differences and whether drinking refusal self-efficacy accounts for group differences in hazardous drinking. Considering Hispanic individuals make up the largest ethnic/racial minority group in the United States, it is important to identify malleable psychological factors that prevent and reduce drinking problems. Method: Hispanic and White college students at two predominantly White institutions …


Medical Laboratory Science Students At The University Of Southern Mississippi Response To The Covid-19 Pandemic, Kaitlyn Mcginnis May 2022

Medical Laboratory Science Students At The University Of Southern Mississippi Response To The Covid-19 Pandemic, Kaitlyn Mcginnis

Honors Theses

The COVID-19 pandemic has changed educators’ and students’ perspectives on virtual teaching of the laboratory sciences. This study aims to determine the perceived effects of the COVID-19 pandemic on Medical Laboratory Science (MLS) students at the University of Southern Mississippi. This study will evaluate how the changes to the instruction of the MLS curriculum and overall student mental health affected their grades and retention of academic content during and post-pandemic. The goal is to determine students’ perception of the effectiveness of virtual learning during the COVID-19 quarantine period, and whether it is a sustainable learning resource. Five students enrolled in …


Measuring The Development Of Depression In A Long-Term Care Facility, Cantrell Anderson Oct 2021

Measuring The Development Of Depression In A Long-Term Care Facility, Cantrell Anderson

Doctoral Projects

Depression is a severe global health problem (Almond, 2009; Brewis et al., 2018; Liu et al., 2019). According to the World Health Organization [WHO] (2020), depression is a problem that more than 264 million people suffer from. In comparison to older adults in the community, depression rates are significantly higher among older adults in long-term care. The treatment of older adults in long-term care is challenging. There are several risk factors that contribute to depression in this population, however, they are still not clear.

The purpose of this Doctor of Nursing Practice (DNP) project was to measure the development of …


Evaluating The Effectiveness Of Adverse Childhood Experiences And Trauma Informed Care Training For Mental Health Nurses, Felicia Gathings Dec 2020

Evaluating The Effectiveness Of Adverse Childhood Experiences And Trauma Informed Care Training For Mental Health Nurses, Felicia Gathings

Doctoral Projects

Adverse Childhood Experiences (ACEs) are traumatic events that happened to a person at a young age, and when untreated they have a higher risk of developing a mental illness. ACEs are associated with social problems, illnesses, and physiological issues. ACEs are related to increased health risks and an increase in high-risk behaviors. Despite increase evidence relating ACEs to physical and mental issues, nurses lack training in ACEs and trauma-informed care (TIC). The overall goal of this project was to increase knowledge of ACEs and TIC in mental health nurses when caring for mentally ill patients. Pre-test and Post-test surveys were …


Post-Traumatic Stress And Marijuana Outcomes: The Mediating Role Of Marijuana Protective Behavioral Strategies, Hallie R. Jordan, Michael B. Madson, Adrian J. Bravo, Matthew R. Pearson Jul 2020

Post-Traumatic Stress And Marijuana Outcomes: The Mediating Role Of Marijuana Protective Behavioral Strategies, Hallie R. Jordan, Michael B. Madson, Adrian J. Bravo, Matthew R. Pearson

Faculty Publications

Background: The present study investigated the mediating role of protective behavioral strategies for marijuana (PBSM) on the relationship between posttraumatic stress disorder (PTSD) and marijuana outcomes (i.e. marijuana use frequency, marijuana use quantity, cannabis use disorder (CUD) symptoms, and marijuana-related problems).

Methods: Participants were 1,107 traditional age college students (Mage = 20.26, SD = 3.32; 66.5% White, non-Hispanic; 68.8% female), who reported consuming marijuana at least once in the last 30 days and completed measures of PTSD symptoms, PBSM, and marijuana-related outcomes.

Results: PBSM significantly mediated the positive relationships between PTSD symptoms and both CUD symptoms and marijuana-related …


Addressing The Social Vulnerability Of Mississippi Gulf Coast Vietnamese Community Through The Development Of Community Health Advisors, Susan Mayfield-Johnson, Danielle Fastring, Daniel Le, Jane Nguyen May 2020

Addressing The Social Vulnerability Of Mississippi Gulf Coast Vietnamese Community Through The Development Of Community Health Advisors, Susan Mayfield-Johnson, Danielle Fastring, Daniel Le, Jane Nguyen

Faculty Publications

Background:Resiliency is the ability to prepare for, recover from, and adapt to stressors from adverse events. Social vulnerabilities (limited access to resources, political power, and representation; lack of social capital; aspects of the built environment; health inequities; and being in certain demographic categories) can impact resiliency. The Vietnamese population living along the Mississippi Gulf Coast is a community that has unique social vulnerabilities that impact their ability to be resilient to adverse events. Objectives: The purpose of this project was to address social vulnerability by implementing and evaluating a volunteer Community Health Advisor (CHA) project to enhance community resiliency in …


Allocation Of Resources And Health Professionals’ Burden During The Covid-19 Pandemic: Reflections On Advanced Directives, Informed Consent And Social Perception In Mexico, Karen Herrera-Ferrá, Leonardo Souza-García, Antonio Muñoz-Torres Jan 2020

Allocation Of Resources And Health Professionals’ Burden During The Covid-19 Pandemic: Reflections On Advanced Directives, Informed Consent And Social Perception In Mexico, Karen Herrera-Ferrá, Leonardo Souza-García, Antonio Muñoz-Torres

Journal of Health Ethics

One of the main problems in the COVID-19 pandemic is the insufficient availability of resources. This deficiency has resulted in emotional and moral burdens of health professionals. Decisions are having to be made as to who will live and who will die. Moreover, given the global impact of this pandemic, negative impacts are heightened in low and middle-income countries such as Mexico.

Authors focus on two issues related to, but not exclusive, to the Mexican healthcare system in an attempt to partially address scarce resources and health professionals’ burden. First, is the empowerment of patients’ autonomy through the incorporation of …


The George Floyd Of Healthcare, Sheila P. Davis, Phd, Fnp-C, Faan, Lsm-Bc, Gary Davis, Md Jan 2020

The George Floyd Of Healthcare, Sheila P. Davis, Phd, Fnp-C, Faan, Lsm-Bc, Gary Davis, Md

Journal of Health Ethics

Authors explore the infamous murder of an unarmed black man, George Floyd, and juxtaposition it to systemic racial practices in healthcare as documented by the Institute of Medicine Report: Unequal Treatment. The current COVID-19 pandemic is presented as a situation which has the potential to ignite unresolved discriminatory healthcare practices. Proposed are policies which could possibly mitigate this phenomenon.


Implementation Of A Psychiatric Admission Acuity Tool In The Pediatric Behavioral Health Unit, Tyler T. Wansley Oct 2019

Implementation Of A Psychiatric Admission Acuity Tool In The Pediatric Behavioral Health Unit, Tyler T. Wansley

Doctoral Projects

Staffing, patient ratios, and acuity are not new concepts in health care. While these are popular concepts in medical units, inpatient psychiatric facilities are lacking the tools to correctly quantify patient acuity. An even considerably larger gap exists in the literature regarding the quantification of acuity in pediatric behavioral health units.

A needs assessment was conducted to determine if an existing psychiatric acuity tool would prove useful after implementation in a pediatric behavioral health unit. A need for such a tool was found which led to the purpose of this doctoral project, which was to measure nurse satisfaction with the …


The Relationship Between Social Anxiety And Alcohol And Marijuana Use Outcomes Among Concurrent Users: A Motivational Model Of Substance Use, Margo C. Villarosa-Hurlocker, Adrian J. Bravo, Matthew R. Pearson, Protective Strategies Study Team Apr 2019

The Relationship Between Social Anxiety And Alcohol And Marijuana Use Outcomes Among Concurrent Users: A Motivational Model Of Substance Use, Margo C. Villarosa-Hurlocker, Adrian J. Bravo, Matthew R. Pearson, Protective Strategies Study Team

Faculty Publications

Background: College students with more social anxiety symptoms are particularly vulnerable to problematic alcohol and marijuana use given their susceptibility for elevated anxiety symptoms in social settings combined with the normative nature of substance use. Existing research has established substance use as coping motivated for these students when examining alcohol and marijuana use problems separately. The next step is to determine whether students with more social anxiety who use both substances do so for similar or different reasons. The current study tested a comprehensive (i.e., all variables in the same model) motivational model of alcohol/marijuana use in a sample …


Supporting Mental Wellness In The Public Service Professions, Reilly L. Mcqueston, Peter A. Depergola Ii Jan 2019

Supporting Mental Wellness In The Public Service Professions, Reilly L. Mcqueston, Peter A. Depergola Ii

Journal of Health Ethics

The nature of the work of public service professionals – understood in the present context as including, but not limited to, police officers, firefighters, emergency medical technicians, paramedics, emergency dispatchers, and telecommunicators – exposes them to great amounts of suffering and trauma. Mental wellness is wavering for many in the field, and progressive, holistic support is needed. Public service professionals receive remarkable amounts of training to meet competencies within their role, but they are not provided with the same level of training to protect and serve themselves. Many factors contribute to decreased mental wellness in public service professionals, including the …


Ethical Implications Of Treatment For Gender Dysphoria In Youth, Kelsey Hayes Nov 2018

Ethical Implications Of Treatment For Gender Dysphoria In Youth, Kelsey Hayes

Journal of Health Ethics

This manuscript explores ethical implications on treatment for youth with diagnosed gender dysphoria. The ethical considerations outlined and analyzed in this essay involve illuminating an understanding of whether the administration of pubertal suppression with GnRH agonists, and cross-sex hormones to children with gender dysphoria is morally justified as treatment to manage their psychological distress, or if safer more understood alternatives exist. This essay emphasizes that as health care professionals we must ensure youth with gender dysphoria receive adequate medical treatment and care however, this essay concludes through extensive literature review, that the use of inconclusive and under researched methods to …


The Prospective Influence Of Religiousness On Alcohol Use: What Role Do Perceived Norms Play?, Corey Todd Brawner May 2018

The Prospective Influence Of Religiousness On Alcohol Use: What Role Do Perceived Norms Play?, Corey Todd Brawner

Dissertations

Alcohol misuse is recognized as one of the most pressing health hazards for college students. Previous research has supported a protective relationship between religiousness and problematic alcohol use, but it is less clear what aspects of religiousness are protective and through what mechanisms its effect is exerted. The current study utilized a prospective design to accomplish three primary goals: (1) Delineate the protective effects of religious motivation and public participation on alcohol use and alcohol-related problems in a sample of undergraduates at a large public university in the southeastern United States, (2) determine whether effects were maintained long-term, and (3) …


Evaluation Of Delivery Methods Of Chemical Dependency And Wellness Education, Marissa Coggin Dec 2017

Evaluation Of Delivery Methods Of Chemical Dependency And Wellness Education, Marissa Coggin

Doctoral Projects

Anesthesia practice is learned in a stressful environment, and these stressors may lead to the students’ development of maladaptive coping mechanisms. Despite significant improvements in our understanding of addiction and our approaches to combat this problem, the risk of substance misuse remains high in nurse anesthesia students. Education and intervention are imperative when taking preventative measures. The purpose of this Doctor of Nursing Practice (DNP) project was to determine whether delivery method of chemical dependency/wellness educational program effects the level of understanding of anesthesia providers and substance misuse and the development of healthy coping mechanisms.

In determining whether the delivery …


The Development Of A Wayfinding Smart Phone Application As A Large Healthcare Facility Investment Opportunity, Jessie Fortson Marshall Dec 2017

The Development Of A Wayfinding Smart Phone Application As A Large Healthcare Facility Investment Opportunity, Jessie Fortson Marshall

Doctoral Projects

Health care is a continually growing field. New hospitals are constantly being built, while older facilities are experiencing renovation and expansion. With this growth comes a set of difficulties for patients as they try to navigate through large, multi-building facilities. Most large facilities have multiple parking garages, numerous buildings, and medical towers with an unending number of floors. Patients are forced to rely on directional signage to find their destination that is often insufficient. Attempting to navigate through large facilities is often overwhelming for visitors leading to frustration and stress.

New technology has allowed a convenient solution to this problem …


A Social Network Study To Improve Collaborative Partnerships Among The Southeastern Health Equity Council (Shec), Candace Forbes Bright, Hannah Scott, Braden Bagley, Jonathan Dennis Oct 2017

A Social Network Study To Improve Collaborative Partnerships Among The Southeastern Health Equity Council (Shec), Candace Forbes Bright, Hannah Scott, Braden Bagley, Jonathan Dennis

Faculty Publications

This report presents research conducted on the relationships among and attributes of members of the Southeastern Health Equity Council (SHEC, herein Council) to provide recommendations for partnerships, collaboration, and the recruitment of new members. The background, methods, results, and recommendations are outlined in detail throughout this report. Social networks are measured and defined as connections among people, organization, and/or other units. SNA is a valuable and innovative tool for recognizing strengths and weaknesses in collaborative partnerships. The evaluative study presented herein can be replicated in other councils within the Regional Health Equity Councils to improve collaborations not only among SHEC …


The Influence Of Parental Communication About Sexual Health On Quality Of Emerging Adult Romantic Relationships, Jaclyn Denise Powers Aug 2017

The Influence Of Parental Communication About Sexual Health On Quality Of Emerging Adult Romantic Relationships, Jaclyn Denise Powers

Master's Theses

The research on relationships between parent-child communication about sexuality and sexual communication between adult partners is currently lacking. The current study aims to examine the influence of parent-child sexual communication on adult sexual communication when those children reach adulthood and engage in romantic relationships. Parent-child sexual communication, attachment styles, sexual attitudes, and partner sexual communication were examined for influence on the physical and emotional relationship satisfaction of emerging adults. Study 1 included a quantitative analysis with 553 emerging adults participating in an online survey, and study 2 incorporated a qualitative analysis with an additional 7 emerging adults participating in online …


A Clinical Practice Change Initiative To Incorporate Animal Assisted Therapy In Advanced Practice Registered Nurses' Clinical Practice For Children And Adolescents, Donna Rae Cowell May 2017

A Clinical Practice Change Initiative To Incorporate Animal Assisted Therapy In Advanced Practice Registered Nurses' Clinical Practice For Children And Adolescents, Donna Rae Cowell

Doctoral Projects

Background: Children and adolescents mental healthcare needs is vital for the future of our nation’s welfare (American Psychology Association, 2014). Research has indicated AAT may be a considerable choice to help with pediatrics mental healthcare and may be utilized as an adjunct to enhance the care within the psychiatric healthcare field (Chandler, 2012). AAT has become popular within the healthcare realm (Friesen, 2009; Uyemura, 2016) and is a unique method for providing “patients” health care, which may improve patient outcomes (Chandler, 2012; Cowell, 2013; McCullough, 2016; McQuarrie & Urichuk, 2008). Research supports that “providers” in the health care field may …


Childhood Obesity: Physiological And Psychological Implications And Ethical Responsibilities, Connie S. Lewis Jan 2017

Childhood Obesity: Physiological And Psychological Implications And Ethical Responsibilities, Connie S. Lewis

Journal of Health Ethics

Childhood obesity continues to be a health concern in the United States with physiological and psychological consequences. Research conducted in schools may address the physiological effects and exacerbate negative psychological effects, including weight bias and stigmatization. In the home, children are dependent on parents/caregivers to provide a healthy diet and exhibit a healthy lifestyle.The ethical theory, ethics of care, emphasizes dependence and interdependence on others, and ethical and moral responsibilities in the parent/child relationship. The assurance of ethical considerations involving children in research and parental provision for healthy dietary provision is of utmost importance. Any action or inaction that results …


The Associations Among Expressed Emotion, Relationship Satisfaction, Ptsd Symptoms, Alcohol Use, And Depression: A Longitudinal Investigation With A Military Sample, Laci Lee Zawilinski Aug 2016

The Associations Among Expressed Emotion, Relationship Satisfaction, Ptsd Symptoms, Alcohol Use, And Depression: A Longitudinal Investigation With A Military Sample, Laci Lee Zawilinski

Dissertations

PTSD in military personnel is highly prevalent and accompanied by elevated rates of additional issues such as depression, problematic alcohol use, and interpersonal relationship problems. Family members and spouses of military personnel have also been shown to be negatively impacted by PTSD symptoms. Previous research has indicated that family members and spouses’ expressed emotion regarding the PTSD patients’ symptoms negatively impacts treatment outcome in civilian populations. However, studies have yet to investigate the effect of expressed emotion on the course of PTSD symptoms and associated problems in military personnel. Therefore, the purpose of the present investigation was to examine the …


Relationship Between Parental Alcoholism And Family Unpredictability, Kamie L. Stephens May 2016

Relationship Between Parental Alcoholism And Family Unpredictability, Kamie L. Stephens

Honors Theses

This research is a retrospective study on adult children of alcoholics using a previous researcher’s, Dr. Ross, unpredictability scale. Family Unpredictability is defined as “a lack of consistency in family behaviors and regulatory systems,” (Ross and Hill, 2000). There is currently a lack of research related to parental alcoholism and its effect on family structure. The researcher hopes to gain insight on the relationship between parental alcoholism and family unpredictability. Previous research suggests children growing up with a caregiver who is an alcoholic experience a higher level of unpredictability in the home. Examples of this unpredictability are: a decreased amount …