Digital Commons Network^™

Are Accountability Courts In Georgia A Cost-Effective Public Health Policy Alternative?, Brian D. Graves, Orion Mowbray, Leaanne Derigne, Holly Lynde, Angel Ellis, Rachel Meyer

Journal of the Georgia Public Health Association

Background: This study evaluates the cost-effectiveness of accountability courts in Georgia, presenting them as a viable alternative in public health policy.

Methods: The research utilized survey data collected from 37 court programs across 40 distinct accountability court programs; it was conducted by the University of Georgia’s Carl Vinson Institute of Government in collaboration with the Council of Accountability Court Judges. The analysis includes a comparative assessment of cost savings, benefits, and differences among various court types, specifically focusing on drug courts, DUI courts, mental health courts, family treatment courts, and veterans treatment courts.

Results: Results reveal that …

Demographic And Socioeconomic Factors Influence Perceived Community Needs And Risk Factors For Firearm Violence In Mississippi, Masoumeh Karimi, Matthew Morris, Xiaoshan Gordy, Matthew Kutcher, Leila Seidfaraji, Michelle Brassfield, Erin Dehon, Alyscia Severance, Rukia Lumumba, Fredrick Womack, Lei Zhang

Journal of Public Health in the Deep South

Background: The burden of firearm-related injuries and deaths is not borne equally across sociodemographic groups. The present study investigated the perceived needs and risk factors of firearm related injuries and mortality across gender, education, and income levels through a quantitative needs assessment completed by community members and firearm injury survivors living in the greater Jackson, Mississippi, metropolitan area.

Methods: A total of 93 participants including gunshot wound patients, survivors and community members who have been recruited through community organizations completed the needs assessment survey collecting data on demographic information, firearm exposure, substance use, community exposure to crime and …

Pilot Evaluation Of A Cross-Disciplinary Training Addressing Substance Use Among Mississippi Mothers, Saijun Zhang, Catherine Poehling, Xiaoshan Gordy, Chinedu P. Chukwu, Jerome R. Kolbo, Masoumeh Karimi, Matthew Morris, Andrew Voluse, Erin Dehon, Michelle Brassfield, Danielle Lahn, Lisa Slade, Deanna Howington, Kathleen Rhodes, Tearsenee Davis, Sonja Fuqua, Lei Zhang

Journal of Public Health in the Deep South

Background: Intimate partner violence (IPV) and substance use co-occurring is often managed in siloed systems. Training IPV and related service providers on substance use topics may strengthen screening, response, and referral.

Purpose: To assess whether a pilot training program on substance use disorders (SUDs) in Mississippi improved service providers’ knowledge, preparedness, and attitudes around substance use and satisfaction with the training.

Methods: Pre–post surveys were administered to healthcare and community service providers who completed the training, assessing substance use service-related knowledge, preparedness, and attitudes.  Descriptive statistics and t-tests were used to analyze the data.

Results: Fifty-nine providers completed a …

Integrating Public Health Into Communication Sciences And Disorders Curriculum, Whitney D. Perkins, Yalanda M. Barner, Jennifer Wiles, Brandi Newkirk-Turner

Teaching and Learning in Communication Sciences & Disorders

The field of Communication Sciences and Disorders (CSD) is increasingly integrating public health into its practice and research. This is because less than 10% of speech-language pathology and audiology graduate programs are housed within Colleges or Schools of Public Health (PH), reducing the likelihood that students in CSD have the opportunity for coursework and co-curricular activities that integrate PH and CSD. In this paper, we discuss the holistic approach we used to integrate PH into a CSD program at a Historically Black University. The approach was guided by PH and CSD accreditation standards and involved a didactic course, CSD courses …

A Mixed Methods Study Of Inpatients’ Experiences, Priorities, And Health-Related Quality Of Life During High- Flow Nasal Cannula Therapy, Cintamani H. Ellsworth, Rebecca S. Bartlett

Journal of Patient-Centered Research and Reviews

Purpose: High-flow nasal cannula (HFNC) is an oxygen delivery method with numerous benefits for severely ill patients. There is a paucity of research focused on the perspectives of patients receiving HFNC oxygen therapy. This study aimed to engage with patients to gain a clearer understanding of their experiences, priorities, and health-related quality of life.

Methods: A cross-sectional, mixed methods study was completed with 10 adult inpatients who had received HFNC oxygen therapy during their hospital admission. Semi-structured interviews and the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale were used to identify participant perceptions of their physical and …

Under Pressure And Underrecognized: The Role Of Social Workers And Case Managers In Screening For Social Determinants Of Health In The United States, Melissa L. Habrat, Lindsay D. Nelson, David A. Nelson

Journal of Patient-Centered Research and Reviews

Social determinants of health (SDOH) screening is increasingly embedded in clinical care, yet the work of asking, documenting, and responding to social needs often falls to social workers and nurses or professional case managers who operate under significant time, staffing, and system constraints. We conducted a narrative review to examine how SDOH influence outcomes, identify systemic and emotional barriers to effective screening, and synthesize evidence-informed strategies that support implementation. Across included sources, findings clustered into three domains: challenges in integrating screening (policy and accreditation pressure, staffing and resource constraints, EHR documentation and interoperability limits, closed-loop referral and cross-sector partnership gaps, …

Cost Analysis Of Integrated Genderaffirming And Sexual Health Services For Transgender Women In Thailand: Evidence From The Tangerine Clinic, Braprut Sawatwipachai, Kunncadah Anuwong, Nittaya Phanuphak, Rena Janamnuaysook, Kritima Samitpol, Sujin Nitadpakorn

The Thai Journal of Pharmaceutical Sciences

Background: Transgender women experience a disproportionate burden of human immunodeficiency virus (HIV) globally and in Thailand. Integrating gender-affirming care into sexual health services may improve uptake of HIV and sexually transmitted infections (STIs) testing, treatment, and prevention. Cost data are essential to inform program planning and policy decisions regarding inclusion of such services within Thailand’s Universal Health Coverage (UHC) system.
Objectives: To estimate the full and unit costs of trans-led, integrated gender-affirming and sexual health services along the HIV care cascade.
Methods: Costs of Tangerine Clinic services in 2021 were assessed from the provider perspective, using standard and activity-based costing …

Gene-Environment Interactions In Cardiovascular Aging: Volunteering, Polygenic Risk, And Biomarker Change In European And African Ancestry Populations, Seoyoun Kim, Byeongju Ryu, Erin Ware, Koichiro Shiba, Cal J. Halvorsen

Brown School Faculty Publications

Volunteering has been associated with better cardiovascular health, but whether this association varies by genetic susceptibility to cardiovascular disease remains unclear. This study examined associations between volunteering and cardiovascular biomarkers, assessed associations between biomarker-specific polygenic scores (PGSs) and these outcomes, and tested whether polygenic risk moderated volunteering–biomarker associations among U.S. adults aged 51 years and older.

New York City Women’S Experiences With Perinatal Depression Inquiries, Diagnosis, And Treatment Initiation, Caterina Pisciotta

Dissertations, Theses, and Capstone Projects

Perinatal depression represents a significant public health concern, yet many women who experience depression symptoms during the perinatal period (either during pregnancy and/or after birth) do not receive treatment. Initiatives, such as ThriveNYC, were designed to address these gaps by screening and treating perinatal women for maternal depression, integrating screening into routine perinatal care and strengthening pathways to treatment. Using representative survey data collected between 2016 and 2021 via the Center for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System (PRAMS), this study examined trends in perinatal depression inquiries (a proxy for “screening”) and postpartum diagnosis, as well as …

Responding To Medetomidine In Philadelphia: Narrative Summary Of The Public Health Response To A New Psychoactive Substance, Tareva Warrick-Stone, Serge-Emile Simpson, Phil Durney, Dennis Goodstein, Catherine Abrams, Raymond Bobb, Kory London, Daniel Teixeira Da Silva

Division of Internal Medicine Faculty Papers & Presentations

BACKGROUND: Despite the emergence of medetomidine as the dominant adulterant in Philadelphia's illicit opioid supply, coordinated public health responses are limited or non-existent in the literature. Thus, we summarize a recent Summit in Philadelphia of outpatient and inpatient service providers who specialize in the care of persons who use drugs to discuss medetomidine response readiness and building ongoing community readiness for potential destabilizing drug supply changes.

PURPOSE: Describe a public health intervention that distributed information about practices across health care settings and mobilized key informants to identify and address barriers to treatment.

METHODS: Descriptive summary of the in-person Summit organized …

Deaths Of Despair Among Cancer Survivors In Rural/Urban Appalachia (2000-2022), Jason Semprini, Anders Erickson, Nosa Osazuwa-Peters

Journal of Appalachian Health

Introduction: Rising deaths of despair (premature deaths from suicide, overdose, alcohol, and violence) in adults under age 65 persist across the United States, especially in Appalachia. People diagnosed with cancer may face elevated risks of such deaths due to pain, psychosocial distress, and financial hardship.

Purpose: Deaths of despair trends were compared among adults with cancer across Appalachian and non-Appalachian regions, stratified by sex and rurality.

Methods: Analyzing SEER-21 Incidence-Based Mortality data (2000–2022), deaths caused by suicide, cirrhosis of the liver, or accidents (includes overdose) were identified among adults aged 20–64 years. Annual mortality rates per 100,000 total population were …

Plan Of Day | Plan Of Stay: How Inter-Disciplinary Communication Improved Patient Experience And Hospital Throughput, Theresa Jean Dionne, Felicia Hurst, Danna Qunibi, Lauren Lazar, Sydney Mccurdy, Ashlyn Coenraad, Brittney Ward, Whitney Black, Ashley Nelson, Judd Salem, Luisa Restrepo

Patient Experience Journal

Background: Effective communication among healthcare team members is critical for delivering high-quality, patient- and family-centered care while optimizing hospital operations. This case study examines the implementation of a structured ``Plan of Day | Plan of Stay'' model, leveraging bedside whiteboards to enhance inter-disciplinary communication in a pediatric hospital setting. By providing a clear, visual summary of daily care plans, care team members, and discharge goals, whiteboards foster transparency, empower patients and families, and facilitate coordinated clinical decision-making. Purpose: This quality improvement initiative evaluated the implementation of a standardized Plan of Day | Plan of Stay communication model on a pediatric …

Fuimos Olvidados Y Descuidados [Forgotten And Neglected]: Lessons Learned And Findings From On-Farm Covid-19 Education And Vaccine Clinics For Agricultural Workers And Their Multigenerational Families In Texas, Anabel Rodriguez, David I Douphrate, Ana L Pineda Reyes, Susana Zavala, Lus Chavez, Sofia Nicole Lopez, Andrea V Cabrera Cruz, Annie J Keeney, Nora Hernandez, Brenda Berumen-Flucker, Eva M Shipp, Matthew W Nonnenmann, Shannon P Guillot-Wright, Bethany Boggess Alcauter, G Lopez Ixta, Paula M Cuccaro, Higinio Fernandez-Sanchez, David Gimeno Ruiz De Porras

Faculty, Staff and Student Publications

Background: Despite being deemed essential non-healthcare workers, agricultural workers were excluded from COVID-19 vaccine prioritization in Texas. This professional practice report describes the multifaceted worker health and safety approaches to protecting agricultural workers and their families during the COVID-19 pandemic.

Methods: Between March 2020 and January 2025, several outreach, education, and training grants from various funding agencies were leveraged to deliver training, personal protective equipment, vaccines, and economic relief to agricultural workers in partnership with community-based organizations, industry, local public health departments, and academic institutions.

Findings: Timely funding efforts led to the distribution of 1,000 PPE kits, with more than …

Oral History With John Barry, Dan Royles

History Faculty Scholarship

Oral history interview with John Barry, who has served as Executive Director of the Southern Tier AIDS Program (STAP) since 2008. He was born in Endicott, New York in 1966, grew up in Vestal, and attended high school at Seton Catholic Central in Binghamton before serving in Germany with the United States Army during the early 1980s. When he returned to Broome County in 1987, some of his friends had been affected by HIV/AIDS and, while earning a degree at SUNY Binghamton, Barry became involved in mutual aid efforts to help people affected by the disease. He went to work …

Policy Brief: North Dakota Maternal Mortality Committee, Kilyn R. Parisien

Public Health Student Publications

The following policy brief was created to examine North Dakota policies that are specific to maternal mortality and morbidity reviews. The North Dakota Maternal Mortality Committee (NDMMRC) is responsible for conducting maternal mortality and morbidity reviews in the state of North Dakota. This brief is guided by policies from North Dakota and MMRC reviews from surrounding states to inform six recommendations intended that guarantee the highest quality data collection and data reporting on maternal mortality and morbidity.

Bridging The Gap: Critical Resources For Grandparent Caregivers And Their Grandchildren, Kathy Dial, Cara Tonn, Omotomilola Jegede, Cindy Kekeh, Loriena Yancura, Michele Kekeh

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

US population estimates indicate that approximately 2.5 million children live apart from both parents. Family relatives, often called kinship caregivers, care for 70% to 90% of these children, with grandparents making up the largest category (Radel et al., 2016). This study aimed to identify the most helpful resources and sources for grandparent caregivers to support the overall well-being of their families. Phone or Zoom interviews were conducted among a purposive sample of 24 grandparent caregivers from February to March 2022 to examine their initial experiences as caregivers, the current support services and resources they received, and other resources and services …

Montana Kinship Navigator Program: A Statewide Frontier Initiative Promoting Kinship Family Health And Wellness, Daniel J. Koltz Dr., Peyton Vining, Yu Jiang

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This practice brief report describes the development, implementation, and new updates of the Montana Kinship Navigator Program (MTKNP), a statewide initiative designed to support kinship caregivers in a large, rural frontier context. Montana’s geographic isolation, limited infrastructure, and sparse population create significant barriers for kinship families, including restricted access to healthcare, transportation, childcare, and social services. These challenges are compounded when caregivers unexpectedly assume responsibility for children, often with limited resources and support. MTKNP addresses these gaps through a comprehensive, evidence-informed model that integrates information and referral services with individualized case management. The program serves both formal and informal kinship …

Small Cell Lung Cancer In A Never-Smoking Patient: A Case Highlighting Diagnostic And Screening Gaps In Primary Care, Edward Hamilton, Alexandra She, Francis Jenney

The Journal of Integrated Primary Care

Small cell lung cancer (SCLC) is best known in relation to tobacco exposure and tends to be seen in advanced disease. Contemporary guidelines in lung cancer screening demonstrate a strong emphasis on smoking exposure, which may serve as a barrier to recognition in never-smokers who lack conventional risk factors. As a result, SCLC in never-smokers remains an important but underrecognized consideration in general and primary care settings. The current case involves a 65-year-old African American man who has never been a smoker but who presented with progressive thoracic pain, shortness of breath, and unintended weight loss, leading to the discovery …

Promoting Equity For Children And Adolescents Through Implementation Processes In Health And Social Care: A Scoping Review, Michelle Gooey, Heather Morris, Rebecca Madill, Callie Walsh-Bailey, Ahlia Griffiths, Melissa Savaglio, Claire Blewitt, Amanda O'Connor, Sara Holton, Helia Khalesi, Sofia Grage-Moore, Maria Fernandez, Echezona E Ezeanolue, Allison Metz, Ana Baumann, Helen Skouteris

Faculty, Staff and Student Publications

Background: Despite the many existing implementation methods, theories, and frameworks, implementation science is insufficiently closing the research-to-practice gap. Bridging this gap is critical to achieving healthy and thriving communities globally, and requires implementation processes that promote equity and reach diverse populations, especially those most in need. The aim of this scoping review was to identify, thematically analyse, categorise, and provide examples of implementation processes described in equity-focused literature, with a focus on health and social care interventions for children and adolescents from birth to 18 years of age.

Methods: A comprehensive search of literature was undertaken across six electronic databases …

Exploring Primary Care Providers’ Compassionate Care And Their Evidence-Based Practice With Death, Grief, And Loss: Patient Experience And Perspective, Kathryn Krzykala

Dissertations

Research on primary care providers’ (PCPs) education regarding Death, Grief, and Loss (DGL) remains limited. Specifically, data is lacking regarding patients' perceptions and opinions on what they need and expect from their PCPs regarding grief and loss. This exploratory mixed-method study comprised 146 participants who had experienced death and non-death loss. It examined participants' perceptions of 1) PCP compassion, 2) PCP utilization of evidence-based grief and loss practices, 3) their own level of comfort discussing DGL with their PCPs during medical visits, and 4) their personal grief and loss experiences. The findings revealed that PCPs' grief-informed evidence-based treatment, as reflected …

Kelelahan Kerja, Kualitas Tidur, Dan Pengetahuan Mengemudi Defensif Sebagai Faktor Risiko Perilaku Defensive Driving Pada Pengemudi Grabcar Malang, Elisa Lutfiyah Azizah, Dian Puspitaningtyas Laksana, Marji Marji, Agung Kurniawan

National Journal of Occupational Health and Safety

Online transportation activities contribute to the increasing volume of vehicles, particularly GrabCar drivers in Malang City, which has the potential to worsen traffic congestion. Identification results showed that GrabCar drivers experienced drowsiness while driving and work fatigue due to the habit of working at night and for more than eight hours per day, accompanied by limited understanding related to defensive driving. This study aimed to determine the effect of work fatigue and knowledge, as well as differences in sleep quality scores, on defensive driving behavior. This study employed an observational analytic design with a cross-sectional approach involving 87 GrabCar drivers …

A Scoping Review Of Preventive Interventions To Reduce Violence Against Women And Girls In The Islamic Republic Of Iran, Wahiba Abu-Ras, Leena Babiker Idris, Shahira Amin, Ashley Butler, Patricia J. Kelly, Basil H. Aboul-Enein

College of Nursing Faculty Papers & Presentations

In Iran, violence against women (VAWG) remains highly prevalent, with reported rates ranging from 22.9% to 66%, underscoring the need for effective, contextually grounded interventions.   This scoping review aimed to systematically identify, map, and critically appraise intervention strategies addressing VAWG in Iran.   Guided by PRISMA-ScR and the PICOS framework, comprehensive searches were conducted across nine databases from 2000 to September 2024. Eligible studies included intervention-based research conducted in Iran that reported outcomes related to violence reduction, psychological well-being, or empowerment. Thirteen studies met the inclusion criteria.   The included studies demonstrated heterogeneous designs, theoretical frameworks, and outcome measures. Four interventions targeted …

Epidemiology And Outcomes Of Geriatric Trauma At Uab, Lindy Reynolds

ETDs from 2020-2029

Adults over the age of 65 are the fastest growing portion of the population and account for a growing percentage of the trauma patient volume at trauma centers around the country. Older adults experience longer length of stays, higher mortality and complication rates than their younger counterparts. As a result, there has recently been an increased focus on models of geriatric trauma care, one of which is the addition of geriatric medicine consults for older trauma patients. The primary objectives of this dissertation were to examine the effect of the consult policy on outcomes using an interrupted time series approach, …

If Pets Are Family: Pet Loss And The Need For Grief Equity In One Health, Michele L. Whitney

Journal of One Health Systems

One Health frameworks increasingly recognize pets as integral to human health and well-being. However, these models often overlook the health and equity implications of pet loss. Culturally mediated grief experiences following pet bereavement represent a critical grief equity gap in One Health systems. Drawing on findings from a qualitative study of African American adults who experienced pet loss, along with existing literature, this Viewpoint highlights how pet loss is not only an emotional experience but also a socially structured one shaped by cultural norms, social recognition, and access to support. These dynamics contribute to inequities in how grief is experienced …

Motherwise In Nicaragua: The Implementation Of Culturally Adapted Relationship Education For Women During Pregnancy And Postpartum, Amanda Key Correa Love

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Intimate partner violence (IPV) is a concerning public health issue of global proportions, particularly within rural and under-resourced settings. Communities in these settings face elevated risk for relationship abuse, further compounded by barriers to access culturally responsive preventive intervention programming. This qualitative study investigated participant experiences, cultural adaptation, and implementation of the MotherWise program, a healthy relationship education intervention in rural Leon, Nicaragua. Semi-structured interviews were conducted with former and current program participants as well as the program facilitator following the initial program implementation. Data were analyzed using thematic analysis to identify patterns related to participant experiences, the types of …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Understanding Moral Injury In Emergency Department Clinicians: Predictors, Outcomes, And Evidence Gaps, Rose Doering Lightspeed

University Honors Theses

Moral injury (MI) is an emerging construct for understanding clinician distress in high-acuity healthcare settings, yet its application to Emergency Department (ED) clinicians remains limited. MI refers to psychological distress resulting from exposure to, or participation in, situations that conflict with deeply held moral or ethical standards, often due to systemic or organizational constraints. Although prior research has examined MI in heterogeneous healthcare samples, the ED remains underexamined despite its unique combination of high patient acuity, throughput pressure, and resource limitations.

This review synthesizes literature on MI among healthcare workers with a focus on ED clinicians, drawing on Industrial-Organizational psychology …

Auricular Point Acupressure Self-Management (Apa-Sm) Program For Chronic Musculoskeletal Pain Among Rural Populations: A Protocol For A Pragmatic, Randomized Controlled Trial, Jennifer Kawi, Jane Bolin, Hulin Wu, Jungkyung Min, Rupsikha Bora, Sarah Pace, Idara N Akpan, Alee Lockman, Tonychris Nnaka

Faculty, Staff and Student Publications

Introduction: Chronic musculoskeletal pain (CMP) is a leading cause of incurred personal healthcare costs and disability in the USA. It disproportionately affects rural populations, who are more likely to be uninsured, lack access to a regular healthcare provider and experience a higher prevalence of CMP. As a result of reduced access to non-pharmacological care, there is greater reliance on opioids. The Auricular Point Acupressure - Self-Management (APA-SM) program is a simple, needleless, evidence-based therapy that empowers individuals to self-manage their pain. Preliminary studies, including a recent UG3 pilot testing, demonstrated feasibility, safety and significant improvements in pain and function. Guided …

Strategies For High-Quality Community-Based Participatory Research Partnerships In Public Health Research., Emily M. D'Agostino, Rumour Piepenbrink, Lori Brand Bateman, Dana Keener Mast, Liliane Windsor, Debra Oto-Kent, Alan Wells, Jennifer Goldman, Jennifer E. Schuster, Rachel Kaufmann, Rachel Gurarie, Miriam Nuño

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Community-Based Participatory Research (CBPR) is grounded in trusting, reciprocal, and authentic relationships. We aimed to identify key strategies and actionable next steps to establish and sustain high-quality community-academic partnerships that foster community-based health equity.

STUDY DESIGN: Qualitative thematic analysis.

METHODS: We analyzed three recorded discussions from a roundtable session with community and academic partners from the Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) program (2020-2025), which supported 142 community-engaged public health research projects aimed at reducing COVID-19-related health inequities.

RESULTS: Key themes identified as most fundamental to support CBPR included establishing a long-term commitment, mutual co-learning among partners, flexible and …

Impact Of Institutional Expected Practice Guidelines On Oral And Long-Acting Intravenous Antibiotic Use For Serious Bacterial Infections, William Bradford

ETDs from 2020-2029

Expected practice interventions are a type of antimicrobial stewardship intervention in which local guidelines regarding antimicrobial prescribing are developed and released at an institutional level to establish an institutional standard of care. An expected practice intervention to encourage use of oral and long-acting IV (PO/LAIV) antibiotics for serious infections was performed at the University of Alabama at Birmingham Hospitals in November of 2022. We conducted a quasi-experimental pre/post study using a difference in differences approach to evaluate the effect of these guidelines on a primary outcome of length of stay (LOS) and secondary outcomes of inpatient antibiotic days, 3-month readmission, …