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Full-Text Articles in Medicine and Health Sciences

An Observational, Retrospective, Study To Assess Sehetna Wellness Program Impact On Employees’ Well-Being And Health, Wafaa Saeed, Lina Shaker, Laila Ghanem, Mohamed El Aziz, Omer Mostafa, Rabab Youssef May 2024

An Observational, Retrospective, Study To Assess Sehetna Wellness Program Impact On Employees’ Well-Being And Health, Wafaa Saeed, Lina Shaker, Laila Ghanem, Mohamed El Aziz, Omer Mostafa, Rabab Youssef

BAU Journal - Health and Wellbeing

Wellness is an ongoing process that leads to realizing one's full potential, with studies showing reduced inpatient admissions, healthcare costs, and improved health-related quality of life through participation in large-scale wellness programs. SEHETNA program is a wellness initiative conducted with the Egyptian Group for Import and Export (EGMED) to enhance employees’ well-being. This study aimed to assess the SEHETNA wellness program impact on the general health of employees. This is a retrospective descriptive observational study including employees enrolled in wellness program for up to 12-months in 2021. Data were entered and analyzed using SPSS. Descriptive analysis was done, categorical variables …


A Conceptual Model Of Organizational Compassion In Healthcare, Rachel Thienprayoon, Eli Awtrey, Teresa Pestian, Beth A. Lown, Naomi Winick, Jason Kanov Apr 2024

A Conceptual Model Of Organizational Compassion In Healthcare, Rachel Thienprayoon, Eli Awtrey, Teresa Pestian, Beth A. Lown, Naomi Winick, Jason Kanov

Journal of Wellness

Introduction: In healthcare, while the suffering of patients is often evident, the suffering of clinicians receives less focus. Some sources of clinician distress are directly related to constant exposure to patient suffering, but others are caused by the health care system, and thus potentially preventable. Looking at clinician suffering through the lens of compassion fosters a new paradigm of individual, team, and organizational capabilities, and moves the responsibility to alleviate this suffering from the individual onto the organization and team. Yet research into the impact of organizational compassion in healthcare has been extremely limited.

Approach: Our conceptual model of organizational …


Implementation Of Mindfulness & Stress Reduction Training For Medical Students, Jill Berenato Mar 2024

Implementation Of Mindfulness & Stress Reduction Training For Medical Students, Jill Berenato

SACAD: John Heinrichs Scholarly and Creative Activity Days

Abstract

This proposal advocates for implementing mandatory mindfulness and stress reduction training sessions for surgical students at Philadelphia College of Osteopathic Medicine (PCOM). It is well-documented that medical students, particularly those in surgical disciplines, experience high levels of stress, which can negatively impact their mental health, academic performance and overall well-being. Mindfulness-based interventions have shown promise in reducing stress and enhancing resilience among medical students. By integrating mindfulness training into the surgical curriculum, PCOM aims to equip students with essential coping skills to effectively manage stress, thereby promoting their mental health and academic success. This handout serves to accompany the …


Use Of An Education And Coaching Intervention To Promote Occupational Balance In Graduate Occupational Therapy Students, Linda M. Rini, Ingrid Provident Jan 2024

Use Of An Education And Coaching Intervention To Promote Occupational Balance In Graduate Occupational Therapy Students, Linda M. Rini, Ingrid Provident

Journal of Occupational Therapy Education

This small-scale pilot study was developed to examine the perceived occupational balance of graduate occupational therapy students and implement an education and coaching intervention to promote occupational balance for those who have difficulty achieving and maintaining it. Although literature provides many examples of interventions to facilitate stress relief in graduate students, this is the first to address the promotion of occupational balance in this effort, which has been identified as a student-reported need. A sequential explanatory mixed-methods approach was used to obtain quantitative and qualitative data on occupational therapy students’ satisfaction with their balance of activity in all areas of …


Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker Dec 2023

Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker

Journal of Wellness

Introduction: The 2023 Part 1 summary reviews research on wellness in healthcare professionals published outside of JWellness from January 1, 2023 to June 30, 2023.

Methods: Editors conducted a Boolean search of titles and abstracts in PubMed utilizing keyword identifiers pairing healthcare personnel (providers, nurses, and other staff) with a well-being metric. Of 416 relevant articles, an intriguing and innovative 30 were selected for inclusion, with two additional articles manually curated.

Literature in Review: This sample of the recent literature into healthcare professional wellness included multiple targeted interventions and studies of resilience. Main themes that emerged include: positive systematic healthcare …


The Case For Patient-Reported Pleasure, Preston Long, Tanja Stamm Nov 2023

The Case For Patient-Reported Pleasure, Preston Long, Tanja Stamm

Patient Experience Journal

Pleasure is a cornerstone of human behavior. Its lack of consideration in the medical sciences has been to the detriment of all patients. The process of including pleasure as a medical outcome has multiple beginnings. A health-related pleasure scale must be developed for clinical purposes and original research must be conducted to establish the added value of measuring pleasure. Treatment comparisons, prediction models for recovery, side-effect investigations, and more may benefit from the collection of patient-reported pleasure. Furthermore, simply inquiring about a patient’s pleasure may serve as a positive intervention by giving them permission to discuss more than the illness …


Sexual Well-Being Among Medical Residents At A Community-Based Academic Institution, Fiore Casale, Hinduja Nallamala, Todd Foster, Christine Alicea, Laurel Fick Sep 2023

Sexual Well-Being Among Medical Residents At A Community-Based Academic Institution, Fiore Casale, Hinduja Nallamala, Todd Foster, Christine Alicea, Laurel Fick

Journal of Wellness

Introduction: Medical residency training is demanding, with challenging workloads, long hours, and excessive stress that impact residents’ physical, mental, and emotional health. Although the concept of health and wellness in residency has become more widespread across programs, few studies have explored the sexual health of medical residents during training.

Methods: To better understand the current state of sexual health and well-being of resident physicians, physicians in training across Internal Medicine, Pediatrics, Family Medicine, OB/GYN, Transitional Year, and General Surgery completed anonymous surveys that incorporated validated questionnaires, including the International Index of Erectile Function (IIEF) and the Index of Premature Ejaculation …


(2017) School Counselors’ Wellness Behavior And Its Effect On Compassion Fatigue, Burnout And Compassion Satisfaction, Mary G. Mayorga, Sabina Devries, Ann Wardle Aug 2023

(2017) School Counselors’ Wellness Behavior And Its Effect On Compassion Fatigue, Burnout And Compassion Satisfaction, Mary G. Mayorga, Sabina Devries, Ann Wardle

Louisiana Journal of Counseling

As stated by Myers (1992), wellness, prevention and developmental approaches in counseling are the cornerstone of the counseling profession. Wellness needs to be emphasized, not only from the client but also from the professional counselor perspective. The value of the wellness behavior for the helping professional is well documented by several entities including the American Counseling Association, which has embraced wellness from a comprehensive, holistic perspective (Myers, 2014). The aim of this study was to examine a group of school counselors to obtain data regarding compassion satisfaction, burnout, and compassion fatigue. Another goal was to determine the correlation between wellness …


Utilization Of Wellness Practices For Burnout And Stress During Covid-19 Among An Interdisciplinary Cohort Of Emergency Healthcare Workers, Michael J. Zdradzinski, Sheri-Ann O. Kaltiso, Roslyn Seitz, Timothy P. Moran, Jennifer Clements, Sheryl L. Heron, Michelle D. Lall Aug 2023

Utilization Of Wellness Practices For Burnout And Stress During Covid-19 Among An Interdisciplinary Cohort Of Emergency Healthcare Workers, Michael J. Zdradzinski, Sheri-Ann O. Kaltiso, Roslyn Seitz, Timothy P. Moran, Jennifer Clements, Sheryl L. Heron, Michelle D. Lall

Journal of Wellness

Introduction: The Coronavirus Disease (COVID-19) introduced additional stress to the baseline occupational stressors of emergency care workers. The objectives of this study were to evaluate perceived stress and burnout and the utilization and perceived benefit of wellness practices among emergency healthcare workers (EHCWs), including: emergency physicians, advanced practice providers (APPs), nurses, and departmental administrative staff during the COVID-19 pandemic.

Methods: A cross-sectional 28-item electronic survey of EHCWs at three hospitals in a major United States city was used to measure participants’ utilization and perceived benefit of wellness practices, burnout (2-item measure), overall stress (perceived stress scale), and stress …


How Covid-19 Changed Frontline Healthcare Workers’ Experiences: A Narrative Inquiry Into The Impact Of Chronic Burnout On A Surgical Physician Assistant’S Wellness, Lihua Dishman, Rhionna J. Smith Aug 2023

How Covid-19 Changed Frontline Healthcare Workers’ Experiences: A Narrative Inquiry Into The Impact Of Chronic Burnout On A Surgical Physician Assistant’S Wellness, Lihua Dishman, Rhionna J. Smith

Patient Experience Journal

Burnout is an occupational phenomenon resulting from unmanaged chronic workplace stress. Since COVID-19 started, burnout among healthcare workers has worsened and become a public health crisis. Wellness is about leading a physically, mentally, and spiritually healthy lifestyle to achieve one’s full potential through positive affirmations. Its multiple dimensions include (1) physical, (2) emotional, (3) intellectual, (4) occupational, (5) social, and (6) spiritual. Extant empirical literature lacked regarding surgical physician assistants and how chronic burnout affected their wellness. This longitudinal narrative inquiry thus aimed to explore the perceived impact of a surgical physician assistant’s chronic burnout during the COVID-19 pandemic on …


Navigating The Legal Landscape Of Mental Health In The Workplace: Insights For The Dental Practice, Gary Chamberlin Milr, Jd Aug 2023

Navigating The Legal Landscape Of Mental Health In The Workplace: Insights For The Dental Practice, Gary Chamberlin Milr, Jd

The Journal of the Michigan Dental Association

Dealing with an employee’s mental health situation poses complex challenges for human resource professionals. Dental practices, typically run by busy dentists or administrative managers, often lack a human resource professional and the legal expertise needed to navigate the intricacies of employment laws pertaining to mental health disabilities. Moreover, mental health issues in the workplace are sensitive, private matters that intersect with disability and leave laws and are still associated with cultural stigmas despite evolving societal attitudes. This article provides specific scenarios that give insights into the legal issues when managing dental office employees with mental health conditions. Readers should address …


J Mich Dent Assoc August 2023 Aug 2023

J Mich Dent Assoc August 2023

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

  • A cover story on new dentist’s perceptions of professionalism.
  • A feature on legal considerations when addressing employee wellness.
  • A feature on the meaning of wellness by ADA Trustee Dr. Brett Kessler.
  • Practice guidance on conducting a HIPAA security risk analysis.
  • Commentary “The New Golden Age of Dentistry.”
  • Editorial and regular department articles on MDA Foundation …


J Mich Dent Assoc July 2023 Jul 2023

J Mich Dent Assoc July 2023

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

  • A cover story on recognizing mental health concerns in the dental workplace.
  • Commentary by a foreign-trained dentist on difficulties in obtaining licensure.
  • MDA 2023-04 Continuing Education Course Catalog
  • A feature on addressing the current dental assisting workforce shortage.
  • News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff …


Women Physicians And Medical Conferences: A Pilot Survey Study Of Participation Challenges And Options To Optimize Wellness And Work-Life Integration, Marah N. Kays, Ekas Singh Abrol, Ariela L. Marshall Jun 2023

Women Physicians And Medical Conferences: A Pilot Survey Study Of Participation Challenges And Options To Optimize Wellness And Work-Life Integration, Marah N. Kays, Ekas Singh Abrol, Ariela L. Marshall

Journal of Wellness

Introduction: Women physicians experience challenges in career advancement, work-life integration (WLI), and wellness. Participation (attending and speaking) at academic conferences is one way for women physicians to advance their careers, but barriers to physical participation (travel, WLI) pose challenges. Virtual participation options may enhance career advancement. In this pilot study, we explored women physicians’ conference participation patterns and preferences regarding virtual participation options.

Methods: In this cross-sectional pilot study of 70 women physicians from the Physician Women in Leadership (PWL) and Physician Moms Group (PMG) Facebook groups, we collected demographic, burnout, and WLI data, information on barriers to …


J Mich Dent Assoc June 2023 Jun 2023

J Mich Dent Assoc June 2023

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

  • A cover story interview introducing new MDA President Eric Knudsen of Escanaba.
  • A feature review of the 2023 MDA Annual Session held in Grand Rapids.
  • MDA President Dr. Benivegna's Opening Remarks before the 2023 House of Delegates.
  • News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, …


J Mich Dent Assoc May 2023 May 2023

J Mich Dent Assoc May 2023

The Journal of the Michigan Dental Association

In this issue, the reader will find the following original content:

  • A case study on recognizing the oral signs of Acute Lymphatic Leukemia
  • A special pull-out section to assist clinicians in identifying and treating common oral lesions
  • Advice on personal Wellness: "Finding Calm Amidst Chaos."
  • State of Michigan C.E. Requirements for License Renewal of Dentists, Hygienists, and Registered Dental Assistants.
  • A 10Minute EBD contrasting clinical success of composite restorations vs. glass ionomers.
  • Guest commentary "Pretty Good Dentistry."
  • News you need, Editorial, and an Advocacy Spotlight.


Wellness Review 2022, Part 2, Martin Huecker, Brian A. Ferguson, Jacob Shreffler Apr 2023

Wellness Review 2022, Part 2, Martin Huecker, Brian A. Ferguson, Jacob Shreffler

Journal of Wellness

Introduction: Similar to prior reviews, the Journal of Wellness editors searched the literature from the second half of 2022 for an interesting and impactful selection of publications on wellness in healthcare professionals.

Methods: Editors conducted a standard keyword search in Pubmed, focusing chiefly on large journals, interventional trials, and other prospective research. We included papers published between July 1, 2022 and December 31, 2022.

Literature in Review: Finding several hundred publications, we excluded editorials, reviews, and some smaller, less generalizable papers. A final 25 significant studies focusing on wellness in medical professionals were sorted into the following categories: logistics, creativity …


The Teacher - Volume 7, Nova Southeastern University Apr 2023

The Teacher - Volume 7, Nova Southeastern University

be Still

No abstract provided.


Variable Shift Lengths Negatively Affect Emergency Medicine Resident Wellness, Marcus Fazzari, Joseph Longobardi, Joseph Mccarthy, Matthew Hysell, Sidney Hann Mar 2023

Variable Shift Lengths Negatively Affect Emergency Medicine Resident Wellness, Marcus Fazzari, Joseph Longobardi, Joseph Mccarthy, Matthew Hysell, Sidney Hann

Journal of Wellness

Introduction: Burnout is very common in emergency medicine and there has been extensive research evaluating factors that contribute to burnout. We sought to examine the contributions of post-graduate year (PGY), shifts worked per month, patients seen per shift, and length of shifts to emergency medicine resident burnout.

Methods: All emergency medicine residents were surveyed with regards to their PGY, shifts worked per month, patients seen per shift, and length of shifts. They were administered the Stanford Wellness Survey and asked to globally rate their degree of burnout. We then modeled whether consideration of the surveyed factors increased the …


Assessing The Efficacy Of A Meditation Intervention On Dispositional Mindfulness Among Medical Students And Resident Physicians, Kelsey Stefan, Michael Villeneuve, Varun Konanki, Erica Rarity, Rahul Mhaskar, Liwei Chen, Amelia Phillips Jan 2023

Assessing The Efficacy Of A Meditation Intervention On Dispositional Mindfulness Among Medical Students And Resident Physicians, Kelsey Stefan, Michael Villeneuve, Varun Konanki, Erica Rarity, Rahul Mhaskar, Liwei Chen, Amelia Phillips

Journal of Wellness

Introduction: Dispositional mindfulness is the act of paying attention to one’s thoughts and feelings with an open and non-judgemental attitude. Medical students and resident physicians are under immense pressure and stress daily, and they need effective tools to help increase their dispositional mindfulness. This project examined the impact of a meditation intervention on medical students’ dispositional mindfulness.

Methods: In 2020, medical students and resident physicians at the University of South Florida were given the option to practice daily meditation for thirty days; time spent on the practice varied depending on comfort with the practice. Dispositional mindfulness levels were assessed using …


A Scientific Convention On The World Homoeopathy Day: ‘Homoeopathy: People’S Choice For Wellness’ – A Conference Report, Babita Rani Kondle, Divya Taneja, Subhash Kaushik Dec 2022

A Scientific Convention On The World Homoeopathy Day: ‘Homoeopathy: People’S Choice For Wellness’ – A Conference Report, Babita Rani Kondle, Divya Taneja, Subhash Kaushik

Indian Journal of Research in Homoeopathy

Three apex bodies, namely the Central Council for Research in Homoeopathy, the National Commission for Homoeopathy and the National Institute of Homoeopathy, jointly organised a scientific convention on the occasion of the World Homoeopathy Day to commemorate the 267th birth anniversary of the founder of Homoeopathy, Dr Christian Fredrich Samuel Hahnemann which was held on 9 and 10 April 2022 at New Delhi on the theme ‘Homoeopathy: People’s Choice for Wellness’. Over the 2 days, scientific sessions and interactive meets were held. This convention was an opportunity to review the developments in the field of Homoeopathy and formulate future strategies …


Technology For Faith Community Nursing Practice, Katrina Goodrich Dec 2022

Technology For Faith Community Nursing Practice, Katrina Goodrich

International Journal of Faith Community Nursing

Technology is an ever-expanding tool that can be utilized by Faith Community Nurses to enhance their practice. Technology offers options for organizing and promoting services, collaborating with others on an international level, education of both the Faith Community Nurse and their clientele, and multiple instruments for tracking and managing wellness plans.


Development And Use Of A Survey Tool To Prioritize And Catalyze Change Surrounding Faculty Wellness In A Department Of Pediatrics, Sarah Rhoads, Alison Riese, Mohammed Faizan, Lloyd Feit, Shuba Kamath, Albert Ross, Katherine Mason Nov 2022

Development And Use Of A Survey Tool To Prioritize And Catalyze Change Surrounding Faculty Wellness In A Department Of Pediatrics, Sarah Rhoads, Alison Riese, Mohammed Faizan, Lloyd Feit, Shuba Kamath, Albert Ross, Katherine Mason

Journal of Wellness

Introduction: Physician wellness is an important factor in the delivery of safe, effective and humanistic patient care. There is compelling data describing the widespread prevalence of physician burnout and its subsequent adverse impact on patient care, healthcare costs, and relationships. Initiatives to improve wellness are necessary to maintain the healthcare work force as well as to ensure high-quality care. This project investigated faculty physicians’ attitudes and priorities regarding physician wellness within the department of Pediatrics at a single-center academic institution.

Methods: A survey was created and distributed via e-mail to all faculty physicians employed within the Department of Pediatrics in …


Wellness Review 2022, Part 1, Martin Huecker, Brian A. Ferguson, Jacob Shreffler Oct 2022

Wellness Review 2022, Part 1, Martin Huecker, Brian A. Ferguson, Jacob Shreffler

Journal of Wellness

Introduction: This article represents the first of a two-part assessment of 2022 literature addressing wellness in healthcare professionals published from January 1, 2022 to June 30, 2022.

Methods: Three editors conducted a similar keyword search in Pubmed, also adding manually curated articles. Focusing chiefly on clinical trials and other prospective research, we settled on a final 25 significant papers focusing on wellness in medical professionals to include in this review.

Literature Review: Recent literature into HCW wellness continues to describe burnout factors and COVID-19 impact, but includes more resilience-targeting interventions and systematic reviews of trials seeking bolstering of well-being. Subsections …


Volume 6, Nova Southeastern University Oct 2022

Volume 6, Nova Southeastern University

be Still

No abstract provided.


Retention And Career Success Of Faculty: The Case For Building A Sense Of Belonging To The Academic Medicine Community, Wendy L. Ward Jul 2022

Retention And Career Success Of Faculty: The Case For Building A Sense Of Belonging To The Academic Medicine Community, Wendy L. Ward

Marshall Journal of Medicine

As attrition in the healthcare workforce rises, factors that positively impact retention, engagement, work satisfaction, and vitality for faculty in Colleges of Medicine are of critical importance. One important factor that is less often discussed is the need to develop a sense of belonging and connectedness to the institutional community. Underrepresented minority faculty particularly feel the benefit of feeling like they belong. Recommendations for enhancing faculty connectedness to a community in support of developing a sense of belonging to that community are offered.


J Mich Dent Assoc July 2022 Jul 2022

J Mich Dent Assoc July 2022

The Journal of the Michigan Dental Association

Monthly, The Journal of the Michigan Dental Association brings news, information, and feature articles to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists! In this July 2022 issue, the reader will find the following original content:

  • A cover feature on negotiating reimbursement rates with PPO contracts.
  • A cover feature on guarding against employee embezzlement.
  • A 10-Minute EBD on rampant caries management and prevention with ADHD patients taking stimulant medications.
  • A Back Page look at the 2022 MDA award winners.
  • News you need: an Editorial, guidance on dental practice cybersecurity, and regular department …


Wellness And Professional Quality Of Life In Counselor-In-Training Interns: Assessment Of Wellness And Non-Wellness-Infused Supervision, Ashley J. Blount, Abby L. Bjornsen, Daniel B. Kissinger, Kara Schneider, Lindsay Vik, Jessica Gonzalez-Voller May 2022

Wellness And Professional Quality Of Life In Counselor-In-Training Interns: Assessment Of Wellness And Non-Wellness-Infused Supervision, Ashley J. Blount, Abby L. Bjornsen, Daniel B. Kissinger, Kara Schneider, Lindsay Vik, Jessica Gonzalez-Voller

Journal of Wellness

Introduction: Counselors-in-training (CITs) commonly encounter issues of burnout, compassion fatigue, and/or vicarious traumatization due to the nature of their jobs in the helping profession. Wellness infused supervision may help CITs foster personal wellness and mitigate deleterious effects of helping. This investigation examined connections related to counselor-in-training wellness and professional quality of life during an internship-level supervision course across a wellness and control section.

Methods: A quasi-experimental design was piloted, comparing a wellness-focused supervision internship section with a non-wellness control group supervision internship section during one academic semester. Participants included 15 clinical mental health CITs (9 experimental; 6 control), who were …


From Liability To Asset: A Large Health System’S Approach To Transforming Hospital Food, Sven Gierlinger, Bruno Tison, Nicole Giammarinaro Apr 2022

From Liability To Asset: A Large Health System’S Approach To Transforming Hospital Food, Sven Gierlinger, Bruno Tison, Nicole Giammarinaro

Patient Experience Journal

Historically, hospitals are infamous for poor food quality. Valuing food as a tenant of health and well-being, Northwell Health, New York’s largest healthcare system, is transforming its hospital food program to become an asset and market competition differentiator. By focusing on structure, workforce, procurement and process, Northwell has improved patient experience performance “Quality of Food” by 61 percentile rank points within three years with minimal impact on budgetary cost.

Experience Framework

This article is associated with the Environment & Hospitality lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework).


Wellness Review 2021, Part 2, Brian A. Ferguson, Martin Huecker Apr 2022

Wellness Review 2021, Part 2, Brian A. Ferguson, Martin Huecker

Journal of Wellness

Introduction: This article presents Part 2 of the biannual JWellness Review of literature from 2021 (July – December). We emphasize new science and resilience initiatives published outside of JWellness that seek understanding of burnout and thriving among healthcare professionals (HCPs).

Methods: For the interval of July 1 to December 30, 2021, PubMed was queried for empirical and observational research studies, review articles, guideline summaries, letters, and editorials. Of 93 results, we reviewed methods and salient points to arrive at a final list of 48 articles for inclusion.

Literature in Review: Common themes that emerged included teamwork, EMR optimization, group decompression, …