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A Comparative Study Of The Quality Of Life Of Elderly Attendees At Hussein Sports City Based On Demographic Variables, Qusai Al-Yassin, Rosol Atiyat Mar 2024

A Comparative Study Of The Quality Of Life Of Elderly Attendees At Hussein Sports City Based On Demographic Variables, Qusai Al-Yassin, Rosol Atiyat

Jordan Journal of Applied Science-Humanities Series

This study aimed to determine the quality of life of elderly visitors at Hussein Sports City and to compare it according to various demographic variables. The study sample consisted of men and women aged 60 years and older who attended the Hussein City for Youth in the Amman Governorate, totaling 42 individuals. The World Health Organization's quality of life measure, WHOQOL-BREF (1998), was used for the assessment. The findings indicated that the quality of life for elderly men was higher than that for women, and elderly individuals living outside the capital reported a higher quality of life compared to those …


The Level Of Psychological Security Among Syrian Refugee Students In Ajloun Governorate Schools From Their Viewpoint, Ahmad Rathwan, Husni Salem, Loai Al-Issa, Reham Al-Refae Mar 2024

The Level Of Psychological Security Among Syrian Refugee Students In Ajloun Governorate Schools From Their Viewpoint, Ahmad Rathwan, Husni Salem, Loai Al-Issa, Reham Al-Refae

Jordan Journal of Applied Science-Humanities Series

This study aimed to identify the level of psychological security among Syrian refugee students in Ajloun Governorate schools from their perspective and to examine the impact of variables such as gender, educational stage, and type of school on their perceptions of psychological security. A descriptive survey method was used, and a questionnaire was distributed randomly to 425 Syrian refugee students to collect the necessary data. The results indicated that the psychological security level of the study sample was high overall and in all domains. The study also revealed significant differences at the α = 0.05 level in participants' perceptions of …


Medical School Watercooler Newsletter - March 24, 2024, Lindsey Lyle Mar 2024

Medical School Watercooler Newsletter - March 24, 2024, Lindsey Lyle

Watercooler Newsletter

This is the March 24, 2024 edition of the Frederick P. Whiddon College of Medicine’s newsletter - Watercooler.

Contents Include

  • ODI Staff to discuss health disparities and equities
  • Whiddon College of Medicine welcomes new associate dean for finance and administration
  • Special OB-GYN grand rounds to focus on Black maternal mortality
  • Meet a Med Student: Kramer Crider
  • USA investigators identify potential biomarker for early pancreatic cancer diagnosis
  • The Final Countdown: Doc Rock is Thursday Night
  • DiPalma honored at 19th Annual Distinguished Alumni & Service Awards


Emotional Support Animals And Mental Health, Kyla E. Barnett, Kaia Miller Mar 2024

Emotional Support Animals And Mental Health, Kyla E. Barnett, Kaia Miller

SACAD: Scholarly Activities

Depression and anxiety disorders are a significant problem in adults and teenagers. These disorders continue to increase in prevalence year by year. One way to combat this is the use of emotional support animals (ESA’s), which have become increasingly popular. This study investigates the relationship between the use of emotional support animals and mental well-being of students with mental health disorders. This study is designed to illustrate the increase in sense of well-being in patients with mental health disorders who utilize ESA’s. This study applies both a qualitative and quantitative study design, the qualitative design of this study is phenomenological. …


Effects Of Postpartum Depression On Mothers And Children, Natalie Taylor, Kennedy Harrington, Jeffrey Wick Mar 2024

Effects Of Postpartum Depression On Mothers And Children, Natalie Taylor, Kennedy Harrington, Jeffrey Wick

SACAD: Scholarly Activities

Postpartum depression plagues many women in today’s society. To look deeper into postpartum depression, we questioned who could be affected other than the mother in this issue? The objective of this study is to analyze how postpartum affects children’s cognitive and behavioral development. We investigated cognitive and behavioral development of children 1-3 years old. Our research design of this study was a non-experimental observation approach. The setting used for our research was the Women’s Health Center at HaysMed. This research focuses on patients in the obstetrics department who recently gave birth. Participants of this study were the children of 75 …


Understanding Resilience: Exploring The Experience Of Complex Trauma And Post-Traumatic Growth Among Survivors Of Violence, Ziwei Qi Mar 2024

Understanding Resilience: Exploring The Experience Of Complex Trauma And Post-Traumatic Growth Among Survivors Of Violence, Ziwei Qi

SACAD: Scholarly Activities

This research investigates survivors' experiences of gender-based violence (GBV) through qualitative interviews. Using semi-structured interviews, the study explores survivors' emotional landscapes, coping mechanisms, support systems, resilience, reflections, growth strategies, and feedback. Emphasizing safe, inclusive, and trauma-informed spaces, seven interviews were conducted, lasting 60 to 75 minutes each, prioritizing participant comfort. Through this qualitative inquiry, the study aims to enhance understanding of GBV survivors' experiences and inform the development of support interventions.


Characterizing Antibiotic Regimen Modification Behavior, Patient Characteristics, And Outcomes For Patients With Gram-Negative Bacterial Infections, A Retrospective Single-Center Study, Jason Yamaki, Mirna Mikhail, Richard Beuttler, Philip Robinson, Emre Yücel, Alexandre H. Watanabe Mar 2024

Characterizing Antibiotic Regimen Modification Behavior, Patient Characteristics, And Outcomes For Patients With Gram-Negative Bacterial Infections, A Retrospective Single-Center Study, Jason Yamaki, Mirna Mikhail, Richard Beuttler, Philip Robinson, Emre Yücel, Alexandre H. Watanabe

Pharmacy Faculty Articles and Research

Few studies describe the frequency of antibiotic regimen modification behaviors in the acute care setting. We sought to ascertain patient and treatment characteristics, details of regimen modification, and clinical outcomes with antibiotic modifications. This retrospective study included patients admitted to Hoag Memorial Hospital from 1 January 2019–31 March 2021 with a complicated infection caused by a Gram-negative organism resistant to extended-spectrum cephalosporins or with the potential for resistance (AmpC producers). A total of 400 patients were included. The predominant sources were bloodstream (33%), urine (26%), and respiratory (24%), including patients with multiple sources. The most isolated organisms were Pseudomonas spp. …


Pharmacological Interventions Versus Non-Pharmacological Interventions On Pain In Chronic Pain Patients, Harley Page, Olivia Mcswain Mar 2024

Pharmacological Interventions Versus Non-Pharmacological Interventions On Pain In Chronic Pain Patients, Harley Page, Olivia Mcswain

SACAD: Scholarly Activities

The study is a comparison experiment that looks at the different types of interventions to treat chronic pain. This study is set at Haysmed Rehabilitation to gather data on adult patients with chronic pain. When studying the interventions used for chronic pain, we found numerous ways of treatment. They are categorized as pharmacological and non-pharmacological interventions. During the study we found, that an understanding of what is causing the pain and the use of both interventions is the best way to go about treating/managing chronic pain.


Childhood Obesity In Relation To Screen Time, Megan Vance, Jade Schroer, Alyvia Zeigler Mar 2024

Childhood Obesity In Relation To Screen Time, Megan Vance, Jade Schroer, Alyvia Zeigler

SACAD: Scholarly Activities

Objective: analyze the correlation of the rate of increased childhood obesity on the increased rate of screen time

Design: Non-Experimental, Longitudinal Correlation

Setting: Midwestern homes

Participation: Midwestern homes in Kansas

Results/conclusions: Pending results and data collection


The Chronicle, Kennedy Ballinger, Lara Jones, Dashae Engler, Bella Perez, Emily Riley, Riley Dickerson, Maya Pierce, Andy Langager Mar 2024

The Chronicle, Kennedy Ballinger, Lara Jones, Dashae Engler, Bella Perez, Emily Riley, Riley Dickerson, Maya Pierce, Andy Langager

Campus Chronicle

No abstract provided.


Ohio’S Failure To Protect Motorcyclists' Heads: A Law Enforcement Perspective, B. Thomas Mar 2024

Ohio’S Failure To Protect Motorcyclists' Heads: A Law Enforcement Perspective, B. Thomas

Et Cetera

As a former police officer, the aftereffects of helmetless motorcycle crashes will forever haunt me. This Article discusses the need for helmet laws for all motorcyclists.


Inequitable By Design: The Strategic Distribution Of Costs And Benefits By Business Improvement Districts And Special Assessments, Molly Gillespie Mar 2024

Inequitable By Design: The Strategic Distribution Of Costs And Benefits By Business Improvement Districts And Special Assessments, Molly Gillespie

Et Cetera

Business Improvement Districts (BIDs) are most commonly credited for their innovative strategies in rejuvenating the economic vitality in American cities. However, their implementation raises concerns about fairness and equity. The current practice of financing BIDs through special assessments, particularly applying the front footage method, disproportionately burdens certain property owners for the benefit of others. Consequently, property owners face a range of issues, including financial strain, involuntary annexation, and potential threats to property ownership. However, the existing framework of state constitutions lack the necessary provisions to adequately address these challenges, underscoring the need for significant reform.

This Note addresses these concerns …


Faculty Senate Meeting Agenda And Minutes, March 24, 2024 Mar 2024

Faculty Senate Meeting Agenda And Minutes, March 24, 2024

Faculty Senate Minutes and Agendas

Agenda and minutes from the Wright State University Faculty Senate Meeting held on, March 24, 2024.


Use Of An Electronic Health Record System In The Nursing Education Lab & Simulation Setting, Easlyn Koch Mar 2024

Use Of An Electronic Health Record System In The Nursing Education Lab & Simulation Setting, Easlyn Koch

SACAD: Scholarly Activities

Simulation has become a significant component of nursing education in recent years, especially with the increasing demand for high-fidelity simulations. However, nursing education struggles to keep up with the ever-changing healthcare technology, specifically electronic health records (EHR). Integrating EHRs into nursing education in areas such as the lab or simulation settings has the potential to impact overall patient safety, familiarity with similar technology, critical thinking skills, and practice readiness of student nurses. A review of the literature was performed, and it was found that the implementation and integration of an EHR in nursing education has overwhelming effects on overall student …


Undergraduate Nursing Education Simulation Training Using Virtual Reality Goggles And Teamstepps Methodology, Jennifer Koalenz Mar 2024

Undergraduate Nursing Education Simulation Training Using Virtual Reality Goggles And Teamstepps Methodology, Jennifer Koalenz

SACAD: Scholarly Activities

Abstract

Due to changes in educational processes during global pandemic restrictions and the rapid pace of innovation and developments in virtual reality technology, this modality of education is expected to become a common presence in healthcare education. Immersive simulation activities can be an effective way to facilitate collaboration and communication skills in a constructivist-based classroom. Evidence shows that virtual simulation improves critical thinking skills, psychomotor skills, and decision making (Padilha et al., 2019). In addition, the availability of an on-demand, customizable scenario is highly useful to supplement clinical learning when necessary. But many caution that virtual simulation, just like any …


Creating Accessible Instruction Materials, Rachel E. Trnka Mar 2024

Creating Accessible Instruction Materials, Rachel E. Trnka

Faculty Scholarship and Creative Works

Webinar for the Tampa Bay Library Consortium (TBLC)

Have you attended multiple webinars and trainings on accessibility and feel a little overwhelmed with information and resources? Join me as we focus on specific strategies for making your library instruction materials accessible. Rather than offering generalized information about web accessibility, this presentation will address accessibility issues related to specific types of instructional materials, including presentation slides, LibGuides, and videos. In this session, we’ll discuss

  • Interpreting common accessibility standards and vocabulary
  • Creating an inventory to help plan your approach to updating materials
  • Specific tools to help you evaluate and improve the accessibility …


The Invasive Bank Vole (Clethrionomys Glareolus); A Longitudinal Investigation Into Rodents And Their Pathogen Communities, Using The Irish Rodent Invasion As A Model System., Andrew Mcmanus Mar 2024

The Invasive Bank Vole (Clethrionomys Glareolus); A Longitudinal Investigation Into Rodents And Their Pathogen Communities, Using The Irish Rodent Invasion As A Model System., Andrew Mcmanus

Theses

The recent emergence of zoonotic pathogens such as, SARS-CoV-2, Ebola and Mpox, have emphasised the necessity to study wildlife and their pathogens. A knowledge gap currently exists in longitudinal studies of biological invasions, which are needed to understand the change in pathogen communities caused as the invader becomes more established. The invasion of Clethrionomys glareolus in Ireland provides a unique model system to study these changes at different stages of the bio-invasion. This is due to the depauperate small mammal community in Ireland, identifiable source population, introduction point, and ongoing expansion of C. glareolus in Ireland. Extensive work has been …


Margin In Life And Stress Of Community College Adult Learners, Joseph Ryan Mar 2024

Margin In Life And Stress Of Community College Adult Learners, Joseph Ryan

Graduate Theses, Dissertations, and Capstones

Nontraditional adult learners (NALs) account for near 40% of all students enrolled in postsecondary institutions in the United States. NALs differ from traditional college students in that they are more likely to be over the age of 23, have dependents, be a single parent, or be employed full-time in conjunction with college enrollment. During the onset of the COVID-19 pandemic, and the years following, community colleges suffered substantial enrollment declines raising concerns for both state policymakers and higher education administrators.

This study sought to understand the relationship of perceived stress and perceived margin to meet new challenges of NALs enrolled …


Advancing Primary Ciliary Dyskinesia Diagnosis Through High-Speed Video Microscopy Analysis, Wilfredo De Jesús-Rojas, Zachary J Demetriou, José Muñiz-Hernández, Gabriel Rosario-Ortiz, Frances M Quiñones, Marcos J Ramos-Benitez, Ricardo A Mosquera Mar 2024

Advancing Primary Ciliary Dyskinesia Diagnosis Through High-Speed Video Microscopy Analysis, Wilfredo De Jesús-Rojas, Zachary J Demetriou, José Muñiz-Hernández, Gabriel Rosario-Ortiz, Frances M Quiñones, Marcos J Ramos-Benitez, Ricardo A Mosquera

Faculty, Staff and Student Publications

Primary ciliary dyskinesia (PCD) is an inherited disorder that impairs motile cilia, essential for respiratory health, with a reported prevalence of 1 in 16,309 within Hispanic populations. Despite 70% of Puerto Rican patients having the RSPH4A [c.921+3_921+6del (intronic)] founder mutation, the characterization of the ciliary dysfunction remains unidentified due to the unavailability of advanced diagnostic modalities like High-Speed Video Microscopy Analysis (HSVA). Our study implemented HSVA for the first time on the island as a tool to better diagnose and characterize the RSPH4A [c.921+3_921+6del (intronic)] founder mutation in Puerto Rican patients. By applying HSVA, we analyzed the ciliary beat frequency …


Digital Safe Spaces: Nonbinary Community Building On Tiktok, Xan Daggett Mar 2024

Digital Safe Spaces: Nonbinary Community Building On Tiktok, Xan Daggett

Theses and Dissertations

Queer and trans individuals have long relied on the Internet for community building and support; however, with the introduction of more than 700 anti-trans bills since the beginning of 2023 (Trans Legislation Tracker, 2024), conservatives’ consistent mocking and dehumanization of gender nonconforming people (ADL, 2023; Berg-Brousseau, 2022), and a record increase in violence specifically against nonbinary individuals (Astor, 2023), trans and nonbinary people are turning to online spaces more than ever as they endure this hostile social and political climate. While nonbinary people make up over 60% of trans adults in the U.S. (Kirzinger et al., 2023), there is very …


Promoting Faculty Research Excellence And Visibility In Nigerian Universities Through The Open Access Paradigm Shift, Colette Ogugua Onyebinama Dr., Ngozi Chima-James Dr. Mar 2024

Promoting Faculty Research Excellence And Visibility In Nigerian Universities Through The Open Access Paradigm Shift, Colette Ogugua Onyebinama Dr., Ngozi Chima-James Dr.

Library Philosophy and Practice (e-journal)

The primary objective of this article is to promote faculty research excellence and visibility in Nigerian universities through open access publishing. The article begins by briefly discussing the vital role that universities play in research, which is a fundamental duty of faculty members. The study provides a succinct definition of research excellence and visibility, as well as the methods for assessing research excellence. This leads to a brief discussion on promoting faculty research visibility through publication on open access platforms such as open access journals and open access institutional repositories to increase citations rates and enhance visibility. The paper further …


[Discussions] Vol. 19 Iss. 1 Mar 2024

[Discussions] Vol. 19 Iss. 1

Discussions

This issue of Discussions was published for the Spring 2023 cycle.


Review Of The Safety And Efficacy Of Trauma-Focused Treatment Among Patients With Psychosis, Mary Eggers Mar 2024

Review Of The Safety And Efficacy Of Trauma-Focused Treatment Among Patients With Psychosis, Mary Eggers

Discussions

Among people who experience psychosis, many have comorbid post traumatic stress disorder (PTSD) that is frequently undiagnosed and untreated. Symptoms have long-term implications, such as hallucinations, posttraumatic intrusions, and an increased risk of physical health conditions, like heart disease and respiratory issues. Many clinicians believe that diagnosing and treating PTSD in this population will be dangerous, so these patients are often excluded from trauma-focused treatment based on their psychosis symptoms. This paper will review current data regarding the rates of undiagnosed PTSD among this population as well as the safety and efficacy of treatment options. PubMed was used to identify …


The Increasing Prevalence Of Cleft Lip With Or Without Cleft Palate In The Rio Grande Valley Of Texas, Yossef Alsabawi, Aaron I. Dadzie, Tyler Torres, Elias Arellano, Paul A. Berry Mar 2024

The Increasing Prevalence Of Cleft Lip With Or Without Cleft Palate In The Rio Grande Valley Of Texas, Yossef Alsabawi, Aaron I. Dadzie, Tyler Torres, Elias Arellano, Paul A. Berry

Research Symposium

Background: Orofacial clefts are a subset of birth defects that include cleft lip with or without cleft palate (CLP) and cleft palate alone (CP). The treatment for orofacial clefts is surgical repair, ideally within the first six months of life. Their impacts on patients and families are various and substantial. Babies with orofacial clefts can have trouble with breastfeeding, speech, recurrent ear infections, and hearing loss as they age. Additionally, there is a significant economic burden, with the average repair costing nearly $20,000, not including the costs of medical devices, postoperative care, and rehabilitation. Additionally, children with orofacial clefts face …


The Dog That Broke My Heart, Eunbee Cho, Shakirat Ganiyu, Edgar Dorsey Trevino, Elimar Gonzalez Morales, Johanne Chaglasian Mar 2024

The Dog That Broke My Heart, Eunbee Cho, Shakirat Ganiyu, Edgar Dorsey Trevino, Elimar Gonzalez Morales, Johanne Chaglasian

Research Symposium

Introduction: Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy or "broken heart syndrome" is a reversible form of acute heart failure characterized by temporary left ventricular dysfunction, typically precipitated by intense emotional or physical distress. Its clinical presentation mimics that of acute coronary syndrome with chest pain, shortness of breath, elevated troponins, and sometimes with electrocardiogram(EKG) changes, which makes initial diagnosis challenging. This case report presents a Takotsubo cardiomyopathy in an 81-year-old female, which developed after the loss of her beloved Basenji puppy.

Case Report: An 81-year-old female presented to the emergency department(ED) with worsening dyspnea for one day. On the …


The Cardiac Cost Of Cancer Care: Atezolizumab-Induced Dilated Cardiomyopathy, Jian Garcia Cruz, Conrad Chouinard, Elimar Gonzalez Morales, Martha Solis, A. Pena Mar 2024

The Cardiac Cost Of Cancer Care: Atezolizumab-Induced Dilated Cardiomyopathy, Jian Garcia Cruz, Conrad Chouinard, Elimar Gonzalez Morales, Martha Solis, A. Pena

Research Symposium

Atezolizumab is a humanized immunoglobulin G1 (IgG1) monoclonal antibody that binds to programmed cell death-ligand 1 (PD-L1) and blocks interactions with the PD-1 and B7.1 receptors on activated T cells. It activates PD-L1/PD-1 pathway-mediated inhibition of the immune response, leading to activation of an anti-tumor effect. This drug is commonly used for urothelial cancer, non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), breast cancer, and hepatocellular cancer. Many side effects of this medication have been listed, but the most common cardiovascular effects are arrhythmia (1%), hypotension (5%), myocarditis (rare), and venous thromboembolism (4%). We present a case of …


Stress Hormone And Heart Rate Responses To Various Exercise Training Methods, Tomas Gomez Jr., Rebekah Schlatter, Megan Zamora, Marco Arriago, Sue Anne Chew, Murat Karabulut Mar 2024

Stress Hormone And Heart Rate Responses To Various Exercise Training Methods, Tomas Gomez Jr., Rebekah Schlatter, Megan Zamora, Marco Arriago, Sue Anne Chew, Murat Karabulut

Research Symposium

Background: Blood Flow Resistance (BFR) training has garnered attention for its ability to induce positive physiological adaptations with low-load resistance exercise. The present study aimed to examine the responses of catabolic hormones and heart rates (HR) to various BFR training protocols. This investigation seeks to provide insights into the stress levels induced by different protocols and identification behind the most effective protocol for optimal positive exercise-related adaptations.

Methods: Study population involved 10 healthy adult males (height: 175.0±5.0 cm, weight: 96.67±26.6 kg, age: 21.3±2.67 yr.) in a five-session investigation. Informed consent paperwork, pre-testing and anthropometric measurements served as session 1; sessions …


Risk Of Food Insecurity Reflects Health Status In Adult Relatives Of Prek Children – ​ Data From The Steps Snap-Ed Research Study​, Lisa M B Salinas, Karla Cortez, Brenda Rodriguez, Joseph Reyes, Moises Cisneros, Elizabeth Alanis, Zasha Romero, Lin Wang, Juan C. Lopez-Alvarenga, Roberto Treviño-Peña Mar 2024

Risk Of Food Insecurity Reflects Health Status In Adult Relatives Of Prek Children – ​ Data From The Steps Snap-Ed Research Study​, Lisa M B Salinas, Karla Cortez, Brenda Rodriguez, Joseph Reyes, Moises Cisneros, Elizabeth Alanis, Zasha Romero, Lin Wang, Juan C. Lopez-Alvarenga, Roberto Treviño-Peña

Research Symposium

Background: Past research shows a correlation between household food insecurity and chronic medical conditions such as diabetes in the general U.S. population as well as metabolic syndrome-related cardiometabolic markers in Hispanic/Latino youth. Furthermore, minority status, including Hispanic/Latino identity, shows an association with low food security and diabetes. The Hunger Vital Sign (HVS) is a validated screener designed to assess risk of food insecurity within households. This study analyzes associated factors related to the screener’s 2 questions, specifically targeting PreK 4-year-old children and their household relatives. The first question assesses concern about food running out before obtaining more due to financial …


Spontaneous Tumor Lysis Syndrome In A Patient With Recent Diagnosis Of Multiple Myeloma — An Unusual Presentation, Taha Al Hassan, Olga G. Cantu-Rodriguez, Eunbee Cho, Edgar G. Dorsey Trevino Mar 2024

Spontaneous Tumor Lysis Syndrome In A Patient With Recent Diagnosis Of Multiple Myeloma — An Unusual Presentation, Taha Al Hassan, Olga G. Cantu-Rodriguez, Eunbee Cho, Edgar G. Dorsey Trevino

Research Symposium

Background: Tumor lysis syndrome (TLS) is an oncologic emergency that surfaces as a constellation of metabolic imbalances due to the rapid destruction of cancer cells and subsequent dissemination of their contents. However, a markedly rare subtype of TLS, known as spontaneous TLS (STLS), occurs without an evident trigger, such as cytotoxic therapy, and carries a similar mortality risk. It is paramount to recognize high-risk cases early and implement therapeutic measures to prevent complications of STLS.

Case Presentation: We present the case of a 74-year-old gentleman with a recent diagnosis of Kappa-restricted multiple myeloma who presented with worsening weakness, tremors, ataxia, …


Social And Structural Determinants Of Health Associated With Cervical Cancer Screening Uptake In South Texas, Caroline Puckett, Dolores Garcia, Rebecca Jones Mar 2024

Social And Structural Determinants Of Health Associated With Cervical Cancer Screening Uptake In South Texas, Caroline Puckett, Dolores Garcia, Rebecca Jones

Research Symposium

Background: The Mays Cancer Center (MCC) is one of only four National Cancer Institute (NCI)-designated cancer centers in Texas and the only one in South Texas. The MCC serves 38 counties and over 4.9 million residents; 70% of residents are Hispanic, 25 of 38 counties are designated as rural areas; additionally, 25 of the 38 counties have census tracts designated as areas of persistent poverty. Catchment area residents are at disproportionately greater risk of developing liver and intrahepatic bile duct cancer (64%), cervical cancer (46%), gallbladder cancer (8%), gastric cancer (4%), and pediatric leukemia (32%) compared to the nation. Currently …