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Best Practice Toolkit For Burnout Prevention In Emergency Department Nurses, Moises A. De Oleo Jul 2025

Best Practice Toolkit For Burnout Prevention In Emergency Department Nurses, Moises A. De Oleo

Student Scholarly Projects

Practice Problem: Burnout Syndrome (BS) is a serious problem in emergency department (ED) nurses and is associated with higher nurse turnover rates. A burnout prevention toolkit is needed.

PICOT: The project was guided by the following PICO question: "For emergency department nurses (P), how does the development of the best practice burnout prevention toolkit (I), compared to the absence of a structured intervention (C), support the establishment of nurse burnout best practices when evaluated using the CDC Program Evaluation Framework? (O)".

Evidence: The analysis of the literature supported the implementation of active interventions in the form of workshops.

Intervention: A …


"We Have Such Fantastic People Working Here": Using Action Research To Address Community College Burnout, Christine Pipitone Jul 2025

"We Have Such Fantastic People Working Here": Using Action Research To Address Community College Burnout, Christine Pipitone

Theses and Dissertations

This mixed-methods action research dissertation explores faculty burnout at a New Jersey community college to propose actionable, faculty-led solutions through a collaborative approach. Grounded in a theoretical framework that integrates theories of action, critical theory, and job demands–resources theory, the study included three phases that followed an explanatory sequential design. In the first phase, quantitative and qualitative data obtained through an anonymous questionnaire provided baseline information about the dimensions of burnout participants experienced. The data informed the second phase, which consisted of semi-structured focus group interviews. In the third phase, an action research team worked together to make recommendations based …


“You Learn To Control What You Can Control”: A Mixed-Methods Examination Of Burnout In Rural Pk–12 Administrators Using The Pillar-Integration Process, Brooke Hildebrand Clubbs, Eu Gene Chin, Rollin D. Nordgren Jun 2025

“You Learn To Control What You Can Control”: A Mixed-Methods Examination Of Burnout In Rural Pk–12 Administrators Using The Pillar-Integration Process, Brooke Hildebrand Clubbs, Eu Gene Chin, Rollin D. Nordgren

Journal of Educational Research and Practice

Teacher burnout is a growing concern among educators and the communities they serve, due to a nationwide shortage of teachers. Burnout of principals and other school administrators, however, is relatively unexamined. This mixed-methods study of pre-kindergarten through twelfth grade (PK-12) administrators in rural Midwestern school districts found that contributors to burnout included safety concerns and student behavior, lack of resources and support, and mandatory assessments of student learning. Factors that mitigated burnout included choosing to protect personal energy, getting support from colleagues and administrators, and making a difference in students’ lives. Forty-three administrators completed a survey adapted from the Maslach …


The Burden Of Burnout: Understanding Its Prevalence And Organizational Drivers In Medical Physics, Deborah Schofield, C Lynn Chevalier, Laurence Court, William Harmsen, Akiva Turner Jun 2025

The Burden Of Burnout: Understanding Its Prevalence And Organizational Drivers In Medical Physics, Deborah Schofield, C Lynn Chevalier, Laurence Court, William Harmsen, Akiva Turner

Faculty, Staff and Student Publications

Background: Burnout is a work-related syndrome characterized by increased levels of emotional exhaustion (EE) and depersonalization (DP) along with decreased levels of personal achievement. In the healthcare setting, higher burnout levels have been associated with negative impacts on personnel, an increased risk of errors, and a decrease in the quality of delivered care.

Purpose: The purpose of this study was to assess the prevalence of burnout among medical physicists working in the United States. Additionally, the impact of personal and organizational features on burnout risk was examined.

Methods: The anonymous survey was distributed to 1962 full members of the American …


Building A Sustainable System: Reimagining Nonprofit Leadership Through Critical And Creative Thinking, Darius Tafadzwa Shenje Peyton May 2025

Building A Sustainable System: Reimagining Nonprofit Leadership Through Critical And Creative Thinking, Darius Tafadzwa Shenje Peyton

Critical and Creative Thinking Capstones Collection

This synthesis introduces the Critical and Creative Thinking Leadership Toolbox (CCTLT), a practitioner-oriented framework designed to support nonprofit leaders navigating staff engagement, organizational complexity, and long-term sustainability. Drawing on lived experience, scholarly literature, and graduate coursework in the Critical and Creative Thinking (CCT) program, the project challenges traditional leadership models that treat employee buy-in as a binary status or compliance metric. Instead, it reframes buy-in as a dynamic spectrum shaped by trust, clarity, psychological safety, and reciprocal accountability. The work critiques unsustainable leadership practices common in mission-driven organizations and offers an actionable alternative grounded in reflection, systems awareness, and dialogic …


Remind: Raising Awareness Of Nurse Burnout Using An Educational Intervention, Emily Louise Missimer May 2025

Remind: Raising Awareness Of Nurse Burnout Using An Educational Intervention, Emily Louise Missimer

Doctoral Dissertations and Projects

Burnout is an international occupational phenomenon that can negatively impact one’s physical, emotional, and psychological well-being. Although burnout affects all occupations, professionals working in the healthcare field are known to be at high risk for occupational burnout secondary to factors such as high-stress environments, critically ill patients, increased patient care requirements, frequent exposure to mortality, and shiftwork with long hours, among other factors. Of the subgroup of healthcare providers, it is also widely known that nurses who have a high exposure to death, such as hospice nurses, are at an even higher risk for occupational burnout. At a hospice care …


Exploring The Lived Experiences Of Sub-Sahara African Catholic Priests On Their Transition Through The Covid-19 Global Pandemic In The United States: A Phenomenological Study, Cornelius Kelechi Anyanwu May 2025

Exploring The Lived Experiences Of Sub-Sahara African Catholic Priests On Their Transition Through The Covid-19 Global Pandemic In The United States: A Phenomenological Study, Cornelius Kelechi Anyanwu

Doctoral Dissertations and Projects

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2, COVID-19) has disrupted significant aspects of societal life worldwide, forcing individuals, communities, health organizations, educational institutions, consumer industries, and governments all over the world into unprecedented challenges. Likewise, religious organizations like the Catholic Church were not spared. African Catholic priests in the United States provide pastoral ministries in US dioceses and parishes, fulfilling the roles of shepherding their congregations and offering spiritual, moral, social, and emotional support in times of great adversity, such as the COVID-19 global pandemic. This transcendental phenomenological qualitative study was conducted to explore how sub-Saharan African Catholic priests …


Stress And Burnout Among Icu Nurses, Jaspreet Kaur May 2025

Stress And Burnout Among Icu Nurses, Jaspreet Kaur

2025 Spring Honors Capstone Projects - Archive

Burnout is a significant occupational hazard for Intensive Care Unit (ICU) nurses. High patient acuity, staffing shortages, and long shift hours increase stress and diminish well-being among nurses, affecting patient care outcomes. This study examined the prevalence of stress and burnout among ICU nurses to identify contributing factors and potential interventions. An anonymous online survey was conducted among 110 ICU nurses, utilizing the Maslach Burnout Inventory (MBI) and the Perceived Stress Scale(PSS). Findings revealed that 42.5% of nurses reported high emotional exhaustion, while 37.5% felt they had little to no control at work. The most frequently cited workplace stressors were …


Resiliency Training For Music Therapy Students During Fieldwork Experiences, Crystal Weaver May 2025

Resiliency Training For Music Therapy Students During Fieldwork Experiences, Crystal Weaver

Dissertations

All music therapy undergraduate and equivalency students in the United States must complete 1,200 hours of fieldwork experience to obtain degree conferment from an accredited and approved higher education program (American Music Therapy Association, 2023b, p. 1). While engaging in fieldwork had several benefits for music therapy students, such as the opportunity to build practical experience and refine skills, the experience also involved several challenges (Forinash, 2019; Tien & Trang, 2020). A challenge not yet thoroughly examined by faculty and staff within higher education music therapy programs was student mental health. To date, researchers had not examined the prevalence of …


Burnout Among Mental Health Professionals In Northern California: A Mixed-Methods Study, Sade Butler May 2025

Burnout Among Mental Health Professionals In Northern California: A Mixed-Methods Study, Sade Butler

Electronic Theses, Projects, and Dissertations

Burnout, characterized by prolonged emotional, physical, and mental exhaustion, is a widespread issue affecting millions of professionals in the United States and globally. Previous research has not adequately addressed the phenomenon of burnout, particularly in California. This study took a mixed-methods approach to determine the scope of, contributing factors to, and coping strategies for burnout among mental health professionals in Northern California. A sample of 93 mental health professionals completed a survey that contained both closed-ended and open-ended questions on burnout. Descriptive statistics indicated that 89.2% of participants experienced a moderate to severe level of burnout at work. Meanwhile, thematic …


The Green Room: Creating An Environment To Combat Burnout In The Emergency Department, Vitaliy Kovdiy Apr 2025

The Green Room: Creating An Environment To Combat Burnout In The Emergency Department, Vitaliy Kovdiy

Theses and Graduate Projects

BACKGROUND: In 2020 a pandemic created dangerous workloads leading to many nurses quitting their careers due to chronic stress. This project will create the green room, which is the name of this recharge room, where staff can go to experience a moment of peace to decrease their stress levels. This room had a spa aesthetic with comfortable seating and green plants. METHODS: This quality improvement project follows the plan-do-study-act model. When participants arrived, they filled out a questionnaire before using the room. They were then shown all the things they could do to utilize the room. After they were done …


The Relationship Between Solidarity And Job Satisfaction, Burnout, Work Stress, And Turnover Intention, Marcella R. Ronyak Jan 2025

The Relationship Between Solidarity And Job Satisfaction, Burnout, Work Stress, And Turnover Intention, Marcella R. Ronyak

Doctoral Dissertations and Projects

This quantitative study examined the relationship between supervisor-subordinate solidarity and subordinates’ level of job satisfaction among Indian Health Services (IHS) employees. Research has indicated that supervisor solidarity influenced job satisfaction, which allowed job satisfaction to serve as a mediator variable to negatively induce burnout and work stress and positively impact turnover intention. This study examined these variables using the Interpersonal Solidarity Scale © (Wheeless, 1976), Job Satisfaction Survey © (Spector, 1985), Maslach Burnout Inventory (Maslach & Jackson, 1981), Perceived Stress Scale (Cohen & Williamson, 1988), and Turnover Intention (adapted Wei-Yuan et al., 2023). Correlations were used to analyze relationships between …


Burnout In The Emergency Room: Corrective Measures Vs. The Absence Of Solutions, Zane Walters, Zachary Woodall Jan 2025

Burnout In The Emergency Room: Corrective Measures Vs. The Absence Of Solutions, Zane Walters, Zachary Woodall

Theses, Dissertations and Capstones

Introduction: Physician burnout has become an increasingly prevalent and critical issue in healthcare systems worldwide, particularly among emergency room physicians who face high-stress, high-demand working conditions. Burnout manifests as emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, leading to negative outcomes for physicians’ mental health, job satisfaction, and overall career longevity. This phenomenon not only threatens the well-being of physicians but also compromises patient care quality and contributes to costly turnover within healthcare organizations.

Purpose of the Study: The aim of this study was to systematically investigate the impact of burnout interventions on emergency room physicians. …


Factors That Motivate Special Education Teachers To Stay In Their Profession In A Rural South Carolina School District, Sherrod J. Davis Jan 2025

Factors That Motivate Special Education Teachers To Stay In Their Profession In A Rural South Carolina School District, Sherrod J. Davis

Doctor of Education Dissertations

This study was designed to contribute to our understanding of the different motivating factors that contribute to the long-term retention of special education teachers after they have been in the field for over 5 years. They set out to ascertain predominant mechanisms that motivate these teachers to stay in their positions as well as to inform on the associated struggles and support structures that are helping to both retain their teaching workforce as well as to support their commitment to their teaching lives. Using a descriptive convergent parallel mixed methods design, the study combined quantitative data from online surveys with …


Burnout In The Workplace- Organizational Influences On Counselor Burnout, Serene Hasan Jan 2025

Burnout In The Workplace- Organizational Influences On Counselor Burnout, Serene Hasan

Graduate Thesis and Dissertation post-2024

This study is a two-part manuscript dissertation that examined the impact of the six organizational influencers of burnout: Workload, Control, Reward, Community, Fairness, and Values on mental health counselors’ (MHCs) burnout, using Maslach’s three subscales of burnout: Emotional Exhaustion, Depersonalization, and Personal Accomplishment. Additionally, Work Setting and Age were assessed for their influence on MHC burnout, when the six organizational influencers were accounted for. The focus on this topic is crucial as burnout has a detrimental effect on counselors, clients, and organizations. The growing population in need of support surpasses the amount of MHCs that our nation has to offer. …


Burnout And Job Satisfaction Among Behavior Technicians In Applied Behavior Analysis: Implications For Practice And Workforce Sustainability, Faryna V. Navar Jan 2025

Burnout And Job Satisfaction Among Behavior Technicians In Applied Behavior Analysis: Implications For Practice And Workforce Sustainability, Faryna V. Navar

Research Papers

Burnout is a significant concern for behavior technicians in the field of applied behavior analysis (ABA), where high emotional demands and turnover rates pose challenges to workforce sustainability. This paper explores existing research on burnout in ABA and related fields, with a focus on strategies to mitigate its impact. Drawing on the principles of Acceptance and Commitment Therapy (ACT), the literature suggests that components such as values clarification and committed action may serve as effective tools to reduce burnout and improve job satisfaction among behavior technicians. This paper reviews various studies that examine the role of supervisor support, emotional resilience, …


Investigating Trauma-Informed Practices Impact On Teacher Well-Being And Burnout, Philip Walter Schonebaum Jan 2025

Investigating Trauma-Informed Practices Impact On Teacher Well-Being And Burnout, Philip Walter Schonebaum

Dissertations and Theses

Trauma-informed practices are a way to reduce the negative impacts of trauma without retraumatizing trauma victims (SAMHSA, 2014). Using trauma-informed training for staff, this study herein sought out to examine the overall impacts on utilizing trauma-informed care strategies on teacher well-being and burnout. The action research project, relying on qualitative data collection techniques, was an immersive approach to impact change in the educational landscape of a small, rural school district. Findings showed implementing trauma-informed practices in the school district led to a greater job satisfaction, reduced stress, and a sense of camaraderie with the students within the school. This study …


Navigating Stress In Higher Education Leadership: The Role Of Mindful Meditation For Women Administrators, Christine T. Harper Jan 2025

Navigating Stress In Higher Education Leadership: The Role Of Mindful Meditation For Women Administrators, Christine T. Harper

Theses and Dissertations--Educational Leadership Studies

Women higher education administrators encounter distinct stressors which can significantly impact wellbeing and lead to burnout. These challenges include implicit bias, difficulty achieving work-life balance, and increasing institutional expectations. This study utilizes a Mixed Methods Action Research (MMAR) framework to assess stress levels, trait mindfulness, coping mechanisms, and the effectiveness of a structured mindfulness-based intervention. While the quantitative analysis revealed only a slight increase in trait mindfulness and no notable reduction in stress levels, the qualitative findings showcased meaningful personal benefits to the participants. They reported heightened awareness of stress triggers, improved emotion regulation, and an ability to apply the …


Compassion Fatigue And Satisfaction Among Nurses At A State Psychiatric Hospital: An Opportunity To Educate, Santhi Avula Dec 2024

Compassion Fatigue And Satisfaction Among Nurses At A State Psychiatric Hospital: An Opportunity To Educate, Santhi Avula

Dissertations

This Doctor of Nursing Practice (DNP) project aims to bring awareness to psychiatric nurses at NOPH about CF and burnout and educate them on ways to improve resiliency and compassion satisfaction as professional nurses.

PICOT: How do psychiatric nurses at NOPH (P) who are at increased risk for CF benefit from a webinar-based educational intervention (I) to identify and reduce symptoms of CF and improve compassion satisfaction (O) one month after intervention (T) compared to preintervention (C)?


The Effect Of A Structural Wellness Intervention On Id Fellows And Faculty, Michael T. Czapka, Christopher Lehmann, John Flores, Erica Mackenzie, Elizabeth Bell, Aniruddha Hazra Nov 2024

The Effect Of A Structural Wellness Intervention On Id Fellows And Faculty, Michael T. Czapka, Christopher Lehmann, John Flores, Erica Mackenzie, Elizabeth Bell, Aniruddha Hazra

Journal of Wellness

Introduction: Physician burnout is prevalent amongst Infectious Diseases (ID) physicians and trainees in the United States. There is limited data assessing the impact of structural interventions in reducing burnout among medical professionals.

Methods: The multifaceted intervention included increased faculty presence over the weekend and faculty support during the week. ID fellows were surveyed before and after the intervention and faculty were surveyed after the intervention using the Maslach Burnout Inventory for Medical Personnel and additional questions regarding wellness and time for education. Pre- and post-intervention responses were compared. Free response answers were analyzed to determine major themes. Metrics of clinical …


Thriving Or Surviving In Virtual Sales: The Connection Between Virtual Work And Job Satisfaction Amongst Salespeople In The Pharmaceutical Industry, Amit Garg Oct 2024

Thriving Or Surviving In Virtual Sales: The Connection Between Virtual Work And Job Satisfaction Amongst Salespeople In The Pharmaceutical Industry, Amit Garg

USF Tampa Graduate Theses and Dissertations

The post COVID 19 sales environment for salespeople in pharmaceuticals has shifted to becoming hybridized within a continuum of face-to-face and virtual interactions, when engaging with health care professionals. This dissertation reports on a study investigating the relationship of virtual work with job satisfaction and burnout. There were two questions that were addressed in this study to understand the impact virtual work has had on overall job satisfaction and burnout. First, what is the relationship of virtuality to job satisfaction and burnout in the pharmaceutical sales environment? Second, which facets of job satisfaction and burnout are most strongly related to …


Work-Family Conflict And Burnout In Healthcare: A Qualitative Study, Alison H. Busick Oct 2024

Work-Family Conflict And Burnout In Healthcare: A Qualitative Study, Alison H. Busick

Electronic Theses and Dissertations

Work-family conflict and burnout in the healthcare industry are significant problems resulting in cognitive, physical, and emotional challenges for healthcare workers and dangerous consequences for patient care. Due to the work-family conflict and burnout they experience, many healthcare workers are leaving the industry altogether. Most studies on work-family conflict and burnout focus on the hospital setting. However, it is estimated that likely more than a million healthcare workers work in the private practice setting. Consequently, this study’s problem is that little is known about how the private practice healthcare setting affects employees’ work-family conflict and burnout. The purpose of this …


Exploring The Role Of High School Administrator's Emotional Intelligence In Classroom Teachers' Perceptions Of Administrator Support: A Transcendental Phenomenological Study, James Alex Weaver Aug 2024

Exploring The Role Of High School Administrator's Emotional Intelligence In Classroom Teachers' Perceptions Of Administrator Support: A Transcendental Phenomenological Study, James Alex Weaver

Doctoral Dissertations and Projects

The purpose of this study was to discover the role and influence of high school administrator’s emotional intelligence on classroom teachers’ perceptions of administrative support at a public high school in northern Delaware. The theory guiding this study is Goleman’s theory of emotional intelligence. This transcendental phenomenological study was concerned with ensuring that high school classroom teachers’ shared experiences regarding perceptions of administrator support at a public high school in northern Delaware as affected by emotional intelligence are described in a manner that allows for the phenomenon’s thematic elements to increase understanding. The study used individual interviews, focus groups, and …


The Price We Pay: An Integrative Review Exploring The Effects Of Wellness Culture On Nurse Burnout Rates, Rebekah Lillian Vance Jul 2024

The Price We Pay: An Integrative Review Exploring The Effects Of Wellness Culture On Nurse Burnout Rates, Rebekah Lillian Vance

Doctoral Dissertations and Projects

The purpose of this integrative review is to identify cultural factors contributing to nurse burnout and to explore the strategies and effectiveness of wellness culture and cultural changes on nurse burnout rates. Nurse burnout has been attributed to a myriad of factors and has been identified in nursing since the 1970s. While other professions with similar burnout issues have investigated and implemented culture-wide changes to address burnout, nursing has remained stagnant in the field of burnout research, often applying single interventions that fall short of creating significant, lasting change. An integrative review of nursing, peer-reviewed literature was conducted in an …


Exploring Burnout Program Effectiveness With Adult Day Health Providers, Katy R. Maguire Jul 2024

Exploring Burnout Program Effectiveness With Adult Day Health Providers, Katy R. Maguire

OTD DEx Reports - College of Pharmacy and Health Sciences

"Stress and burnout are frequently experienced by those in healthcare professions. While extensive research has been done on the impact of stress and burnout on nurses and physicians, other healthcare fields are less researched. One of these populations of health providers excluded from current studies is adult day health providers. Health providers at adult day health centers provide specialized services to persons with acquired, developmental, and intellectual disabilities. They orient these individuals to the community, administer their medications, provide opportunities for socialization and learning, accommodate leisure activities, and many other services that promote community and personal independence for their clients. …


Organizational Challenges: The Impact Of Role Clarity On Burnout In A Technology Division, Jessica Arriaza Jun 2024

Organizational Challenges: The Impact Of Role Clarity On Burnout In A Technology Division, Jessica Arriaza

The Scholarship Without Borders Journal

Organizations grapple with significant challenges such as burnout, turnover, and low job satisfaction. Studies indicate that emotional exhaustion, influenced by job demands and available resources, significantly impacts job performance positively or negatively. This quantitative study uses secondary data from the Work, Family, and Health Study to investigate the relationship between role clarity and burnout within Tomo, the technology division of a Fortune 500 company in the United States. The findings reveal a significant inverse correlation between role clarity and burnout, with participants reporting "Never" experiencing burnout more likely to have well-defined roles. Supported by chi-square and linear regression analyses, these …


Articulator Q2 2024 Jun 2024

Articulator Q2 2024

Metro Denver Dental Society Articulator Magazine

The MDDS Articulator magazine has been serving as the voice for Denver's dental community for over 100 years.

Distributed to approximately 2,000 dental professionals quarterly, the Articulator features local news, industry trends, practice management guidance, data-driven research and more. The award-winning publication is available to member dentists in both print and digital forms.

This issue features a deep dive in Denver's rich dental history, explores why dentists love the Mile City High, what's next for MDDS, updates from local nonprofits, the dangers of perfectionism, the importance of leaving yourself open to new opportunities and more.


Effects Of Covid-19 On Mental Health Workers' Job Satisfaction, Employee Burnout, And Intent To Leave, Colton Jacobs May 2024

Effects Of Covid-19 On Mental Health Workers' Job Satisfaction, Employee Burnout, And Intent To Leave, Colton Jacobs

Doctoral Dissertations and Projects

The COVID-19 disease emerged in December 2019 and created a worldwide pandemic. As the COVID-19 virus spread, healthcare workers faced increased workloads and burnout due to increased stress. With a current abundance of research to better understand how the pandemic affected healthcare workers, minimal research has been conducted to investigate the effects on mental health workers. It is imperative to better understand how the consequences of the pandemic affected mental health workers due to their importance in supporting the mental well-being of our communities. This study focused on how the COVID-19 pandemic influenced job satisfaction, burnout syndrome, and intent to …


One Stitch At A Time: Examining The Self-Care Of Art Therapists And The Potential Of Fiber Arts For Wellbeing, Elaine Chippero May 2024

One Stitch At A Time: Examining The Self-Care Of Art Therapists And The Potential Of Fiber Arts For Wellbeing, Elaine Chippero

Expressive Therapies Capstone Theses

The goal of this thesis was to understand why art therapists are particularly at risk for burnout, why it is essential for art therapists to engage artmaking for their own self-care, and why fiber crafts are particularly suited for self-care. The literature was collected and organized using reflective journaling and visual–tactile coding and then presented in the following review. The first two sections of the literature review include comprehensive definitions of burnout and self-care and how both concepts have been discussed in literature relating to the helping professions and specifically art therapists. The third section covers the historical context of …


Determining The Impact Of Mindfulness Activities To Increase Joy In Work And Decrease Burnout: An Integrative Review, Kimberly Gleason Bogart May 2024

Determining The Impact Of Mindfulness Activities To Increase Joy In Work And Decrease Burnout: An Integrative Review, Kimberly Gleason Bogart

Doctoral Dissertations and Projects

This integrative review aims to evaluate whether mindfulness effectively increases joy in work and decreases nursing burnout. A lack of joy leads to feelings of burnout and negatively affects nurses and their desire to leave the profession. Nursing is often accompanied by intense emotional and physical demands that can lead to job dissatisfaction, anxiety, and stress. Burnout diminishes the quality of care and negatively impacts nurses’ well-being. This integrative review aims to explore mindfulness interventions to increase joy within nursing and potentially alleviate burnout. Drawing upon existing literature, this paper examines various mindfulness interventions and factors contributing to burnout among …