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Association Between Covid-19 Health Knowledge, Self-Efficacy And Preventive Behaviors Among Nursing Students, Josephine Miane Britanico Jan 2023

Association Between Covid-19 Health Knowledge, Self-Efficacy And Preventive Behaviors Among Nursing Students, Josephine Miane Britanico

Walden Dissertations and Doctoral Studies

Abstract Nursing students possess valuable public health knowledge to prevent the spread of COVID-19 infection. They can provide health education to the public with reliable information and adequate resources. To better understand the role nursing students can take in prevention efforts, the purpose of this quantitative correlational study was to examine the association between COVID-19 health knowledge, self-efficacy, and preventive behavior among undergraduate nursing students. The health belief model was the theoretical framework that guided this study. The primary research questions assessed (a) if there was a statistically significant association between COVID-19 health knowledge and preventive behavior among nursing students, …


Help-Seeking Behavior Of African American And Non-African American Victims Of Elderly Abuse, Tesfaye Yigletu Wosene Jan 2023

Help-Seeking Behavior Of African American And Non-African American Victims Of Elderly Abuse, Tesfaye Yigletu Wosene

Walden Dissertations and Doctoral Studies

Elderly abuse is a pervasive public health problem in the United States. Most abuse and neglect go unreported due to barriers including fear for safety, concerns about the consequences, culture, lack of knowledge about elder abuse, shame, and self-blame. However, there is limited research on how race and ethnicity impact help-seeking behaviors of the elderly. This cross-sectional quantitative study examined the difference in reporting and help-seeking behavior between African American and non-African American victims of elderly abuse. Applying the behavioral model of health services use, this study involved a secondary data analysis using the Nation Elderly Mistreatment Study Wave II …


Personal Hardiness As An Unexamined Component Of The Healthy Volunteer Effect, Angelique E. Blann Jan 2023

Personal Hardiness As An Unexamined Component Of The Healthy Volunteer Effect, Angelique E. Blann

Walden Dissertations and Doctoral Studies

Clinical trials are the standard for approving medicines for public use. To conduct trials, researchers depend on a declining number of volunteers. The healthy volunteer effect, a phenomenon in which participants demonstrate better outcomes than their peers, limits the generalizability of trial outcomes. The healthy volunteer effect does not fully explain the outcome difference between volunteers and nonvolunteers. The purpose of this cross-sectional quantitative study was to examine personal hardiness as an unexplored component of the healthy volunteer effect and determine whether personal hardiness is associated with willingness to participate. Hardiness was a personality construct that represented resilience to stress. …


Environmental Factors And Breast Cancer Mortality, Joel Collazo Rodriguez Jan 2023

Environmental Factors And Breast Cancer Mortality, Joel Collazo Rodriguez

Walden Dissertations and Doctoral Studies

Breast cancer is a public health problem in the United States that impacts diverse ethnic female groups in different ways regarding incidence and mortality. Much is known about the factors increasing the risk of developing breast cancer, but little is known about those that increase the chances of dying from it, other than access to health care, screening, and appropriate treatment. This study aimed to understand the association between exposure to Environmental Protection Agency-regulated air pollutants and breast cancer mortality, including how the interaction between these air contaminants impacts the outcome of interest, considering median income, education level, and percentage …


Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande Jan 2023

Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande

Walden Dissertations and Doctoral Studies

Physical therapy (PT) educational programs are faced with the problem of securing thenecessary clinical experiences for their students, particularly in long-term care settings. Student physical therapists (SPTs) must complete clinical education requirements to graduate and transition from learner to entry-level practitioner. Clinical instructors (CIs) provide SPT supervision and are responsible for meeting industry-standard productivity expectations. There is the notion that SPTs negatively impact PT productivity, creating a reluctance for organizations to host SPTs for clinical experiences. This quantitative pilot study aimed to determine if there was a statistically significant difference between PT productivity with and without SPTs in skilled nursing …


Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby Jan 2023

Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby

Walden Dissertations and Doctoral Studies

AbstractEnsuring high quality and safe patient care are among the main goals of all acute care hospitals. This study found that quality of patient care is not consistent across all patient populations, which draws attention to the issue of disparity in access to safe and quality health care. The purpose research questions of this quantitative study examined if patient care quality and safety are related to hospitals’ socioeconomic status (SES) among Chicago’s acute care hospitals. Secondary data were derived from a sample of 20 acute care hospitals (i.e., 10 acute care hospitals of high SES and 10 of low SES) …


Effect Of Treatment, Stage Of Lung Cancer, And Socioeconomic Status On Life Expectancy Within Marginalized Communities, Elsadig Ahmed Elsharif Jan 2023

Effect Of Treatment, Stage Of Lung Cancer, And Socioeconomic Status On Life Expectancy Within Marginalized Communities, Elsadig Ahmed Elsharif

Walden Dissertations and Doctoral Studies

Lung cancer is one of the most common cancers in the United States, and it accounts for 25% of cancer deaths. About 70% of cancer cases are diagnosed during late stages, leading to poor outcomes. An estimated 60% of cancer cases involve underserved and disadvantaged communities. However, there are limited studies had addressed effects of treatment, stage of lung cancer, and socioeconomic status on life expectancy within marginalized communities. Research questions examined effect of treatment, stage of lung cancer, and socioeconomic status on life expectancy of lung cancer patients between 2009 and 2019. This study was grounded in the deductive …


Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks Jan 2023

Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks

Walden Dissertations and Doctoral Studies

Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …


Relationship Between Screentime And Depressive Symptoms And Associated Mediators For African American Adolescents In The United States, Brittney Jones Jan 2023

Relationship Between Screentime And Depressive Symptoms And Associated Mediators For African American Adolescents In The United States, Brittney Jones

Walden Dissertations and Doctoral Studies

The prevalence of adolescent depression in the United States is increasing as adolescents’ use of electronic screen devices increases. Some studies have found associations between screentime and adolescent depression, and other researchers have posited that screentime is not intrinsically harmful. High screentime in African American adolescents may place them at risk for worse depressive symptom outcomes, but the relationship between screentime and depressive symptoms for this population is unknown. The three research questions of this study addressed whether there is a relationship between screentime and depressive symptoms in African American adolescents, and whether sleep duration and the frequency of physical …


Traditional Healing And Biomedicine Use In Urban American Indians Living With Diabetes, Elin Elise Kambuga Jan 2023

Traditional Healing And Biomedicine Use In Urban American Indians Living With Diabetes, Elin Elise Kambuga

Walden Dissertations and Doctoral Studies

The purpose of this interpretative qualitative study was to describe influences that affect the use of traditional healing and biomedical health services for type 2 diabetes to help health educators develop more culturally competent diabetes education programs for urban American Indian/Alaska Native (AI/AN) communities in the United States. The theoretical framework used for this study was the social ecological model (SEM). Using the SEM, the research questions were crafted to explore experiences of participants connected to personal, interpersonal, community, institutional, policy, and educational factors that influenced the use of traditional healing and biomedical health services. Urban AI/AN adults living in …


Experiences With Access To Seeking And Maintaining Home Health Care Services In Low-Income Communities, Staci Yvette Kennedy Jan 2023

Experiences With Access To Seeking And Maintaining Home Health Care Services In Low-Income Communities, Staci Yvette Kennedy

Walden Dissertations and Doctoral Studies

AbstractHome health care services (HHCS) are a cost-effective service option often underutilized by individuals living in low-income communities. For this population, barriers to care may result in higher health care costs and poor health outcomes. Gaps in literature indicated a need to explore experiences of accessing and maintaining home health care among individuals living in low-income communities. The purpose of this qualitative research study was to gain insight into how individuals living in low-income communities perceive their access to HHCS. The conceptual framework used for this phenomenological study was Penchansky and Thomas’s model of access, which addresses access from seven …


Association Between Knowledge Of Human Papillomavirus, Related Cancers, And Barriers To Information, Joycelyn Larbie Jan 2023

Association Between Knowledge Of Human Papillomavirus, Related Cancers, And Barriers To Information, Joycelyn Larbie

Walden Dissertations and Doctoral Studies

Globally, over 250,000 women die every year from cervical cancer and human papillomavirus (HPV). The purpose of this quantitative study was to discover the relation between sociodemographic factors of age, educational attainment, socioeconomic status, personal belief, and knowledge about HPV and related cancers. A cross-sectional design was used to determine statistical relationships. Secondary de-identified data from the Health Information National Trends Survey 2018 was accessed from the National Center Institute and was employed in the study. The study used a simple random technique to select a sample of 3,504 women. Logistic regression was used to estimate the odds of knowing …


Health Education Needs For Mortality Surveillance In Machakos County, Kenya, James S. Mwanza Jan 2023

Health Education Needs For Mortality Surveillance In Machakos County, Kenya, James S. Mwanza

Walden Dissertations and Doctoral Studies

Reporting mortality information is the primary data source from which evidence can be drawn to monitor disease trends and inform public health policy to improve population health. Still, only two-thirds of expected annual deaths are reported globally. Health education and promotion play a significant role in empowering communities to uptake public health services such as mortality surveillance. This qualitative descriptive study aimed to understand health workers’ (HWs’) perspectives regarding the need for health education to support mortality surveillance in Machakos County, Kenya. The capabilities, opportunities, and motivation for the behavior change model guided the study. Semi-structured interviews were used to …


Factors Associated With Intent To Quit Smoking Among U.S. Adult Smokers, Patrese Ann Nesbitt Jan 2023

Factors Associated With Intent To Quit Smoking Among U.S. Adult Smokers, Patrese Ann Nesbitt

Walden Dissertations and Doctoral Studies

Smoking and tobacco use continue to be a public health issue for over 40 million Americans, which explains the appropriateness and abundance of smoking cessation programs throughout the United States. The purpose of this quantitative correlational study was to examine the associations between independent variables of marital status, advice from a medical clinician, and use of community smoking cessation resources and the dependent variable of intent to quit smoking, controlling for race, ethnicity, gender, and age. The theory of reasoned action was used to guide the study. Data from the National Adult Tobacco Survey (N = 12,357) were analyzed using …


Hiv Testing And Counseling Uptake Predictors Among University Students In Southwest Cameroon., Lilian Belole Motia Pencille Jan 2023

Hiv Testing And Counseling Uptake Predictors Among University Students In Southwest Cameroon., Lilian Belole Motia Pencille

Walden Dissertations and Doctoral Studies

AbstractDespite public health efforts to increase human immuno-deficiency virus testing and counseling (HTC) uptake, screening among college students remains low and understudied. The purpose of this cross-sectional correlational quantitative study was to explore the relationship between the constructs of the health belief model (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy) and HTC uptake while controlling for age, sex settlement type, relationship status, area of residence, religious affiliation, and level of education. Four hundred and eighty-seven (N = 487) university students in Southwest Cameroon were recruited using a convenience sampling method. Data were collected using …


Lived Experience Of Women Veterans Navigating The Veteran Healthcare System, Candance Willett Jan 2023

Lived Experience Of Women Veterans Navigating The Veteran Healthcare System, Candance Willett

Walden Dissertations and Doctoral Studies

Many women veterans who navigate the Veterans Affairs (VA) healthcare system across the United States have felt that their voices have not been heard regarding their input and lived experiences concerning inclusion to the quality-of-care delivery for their health needs. The purpose of this study was to explore the lived experiences of women veterans who were currently facing or had previously faced difficulty navigating the VA healthcare system. The framework used for this qualitative study was interpretive phenomenological analysis. The qualitative method used was hermeneutics which was designed by Edmund Husserl and Martin Heidegger. Semi structured interviews were of 12 …


Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae Jan 2023

Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae

Walden Dissertations and Doctoral Studies

Abstract Managing HIV requires lifelong therapy. Retaining clients on lifelong therapeutic antiretroviral therapy (ART) ensures the suppression of viral replication and better health outcomes. The time of the start of ART management is also a factor in determining better health outcomes for persons living with HIV. This study examined the association between initiation criteria (treat all, Option B+, and CDC T-cell count < 500) and retention on ART at 12 months for 17,974 randomly selected clients in the Ghana Health Service's HIV patient electronic database. Analyses controlled for age, gender, educational status, alcohol use, treatment/adherence monitoring, and tuberculosis disease treatment. Bronfenbrenner's ecological systems theory guided the interpretation of the findings. Results shows that retention was positively associated with all treatment initiation criteria. Clients initiated with CD4 count ≤ 500 criteria seemed to be retained at 12 months on ART at a higher rate than initiation criteria based on Option B+ and treat all. The study results may contribute to positive social change by supporting CD4 testing for clients before initiation of ART to improve retention and ensure the availability and use of adherence counseling, no tuberculosis disease and its prevention, and low use of alcohol among people living with HIV. The results of this study may also provide opportunities for public health policy intervention efforts requiring a personalized, group-based approach to service delivery at the intrapersonal level, interconnected with interpersonal, meso, and meta factors at the community level.


Relationship Between Food Insecurity, Depression, And Race/Ethnicity Among U.S. Adults Aged 60–69 Years, Patrick E. Crandon Jan 2023

Relationship Between Food Insecurity, Depression, And Race/Ethnicity Among U.S. Adults Aged 60–69 Years, Patrick E. Crandon

Walden Dissertations and Doctoral Studies

Abstract Food insecurity (FI) and depression among older populations in the United States are public health concerns. Although FI has declined in the United States, it is a psychosocial stressor prevalent among the growing population of adults over 60. It is unknown to what extent FI contributes to depression among racial/ethnic minorities in this population. The purpose of this quantitative cross-sectional study was to examine the relationships between FI and race and depression among U.S. adults aged 60–69 years when adjusting for other variables. The social-ecological model was used to understand the interplay between individual and environmental factors that may …


African American Baby Boomers’ Lived Experiences In Skilled Nursing Facilities For Post-Acute Care Admissions, Dr. Charles A. Fraiser Jan 2023

African American Baby Boomers’ Lived Experiences In Skilled Nursing Facilities For Post-Acute Care Admissions, Dr. Charles A. Fraiser

Walden Dissertations and Doctoral Studies

AbstractPrevious studies have examined the quality of elderly healthcare offered in skilled nursing facilities (SNFs) among older adults, in general, but the studies have not emphasized ex-periences unique to African America baby boomers and the factors they consider when making SNF-related decisions for post-acute care. The purpose of the study was to exam-ine the lived experiences of African American baby boomers who are currently in or have been treated in SNFs for post-acute care to learn about their decisions to select an SNF. Andersen’s behavioral model of health services served as the conceptual framework. A descriptive phenomenological qualitative design was …


Predictors Of Psychoactive Substance Abuse Among Eastern Nigeran Youth, Kingsley Chidiebere Izuka Jan 2023

Predictors Of Psychoactive Substance Abuse Among Eastern Nigeran Youth, Kingsley Chidiebere Izuka

Walden Dissertations and Doctoral Studies

AbstractPsychoactive substance (PAS) abuse is a major public health problem leading to increased morbidity and mortality. In Nigeria, the incidence rate of PAS abuse has remained high, particularly in the youth population. The purpose of this study was to examine the influence of social factors and school enrollment status on PAS abuse in youth in Southeast Nigeria. The social ecological model and the theory of reasoned action were the theoretical frameworks used for this study; they were selected due to their focus on multiple levels of factors that influence behavior. A quantitative cross-sectional study design approach was used to determine …


Mental Health Treatment And The Criminal Justice System, Susana Lehan-Trasente Jan 2023

Mental Health Treatment And The Criminal Justice System, Susana Lehan-Trasente

Walden Dissertations and Doctoral Studies

The criminal justice system has established interventions for those who have mental illness and have been charged with criminal complaints. In New York State, the Mental Health Court has been established to address these issues and is to be used by all counties. However, the treatment and probation interventions vary from county to county. Saratoga County uses a Single Point of Access (SPOA) which receives referrals from the general court and probation officers. SPOA refers clients to a variety of treatment interventions available in the county. In Monroe County, the Mental Health Court refers the criminally involved/mentally ill individual to …


Factors Impacting College Students’ Receipt Of Human Papillomavirus Vaccination, Joy Yvette Payne Jan 2023

Factors Impacting College Students’ Receipt Of Human Papillomavirus Vaccination, Joy Yvette Payne

Walden Dissertations and Doctoral Studies

Less than half of U. S. students entering college have had a human papillomavirus (HPV) vaccination, placing them at risk for HPV-related cancers. This study’s purpose was to identify predictors of HPV vaccination initiation in college students. Andersen’s behavioral model of health services use was used to examine the differences in predisposing, enabling, and need factors in U.S. college students ages 18–26 years who received an initial HPV vaccination in college compared to those who never received an HPV vaccination. The study was a quantitative, cross-sectional survey design using multivariable logistic regression for data analyses. Data were collected through an …


Education To Increase Nurse Knowledge And Compliance With Social Determinants Of Health Screening, Bonnie Rieger Jan 2023

Education To Increase Nurse Knowledge And Compliance With Social Determinants Of Health Screening, Bonnie Rieger

Walden Dissertations and Doctoral Studies

To provide holistic care and ensure positive patient health outcomes, the social determinants of health (SDOH) must be addressed. Research demonstrates that while medical care is a contributor to wellness, the SDOH serve an influential role in patient health outcomes. There is limited literature describing how to best educate practicing nurses about SDOH concepts. The purpose of this DNP project was to provide an educational intervention to increase inpatient staff nursing knowledge of the SDOH. Sources of evidence used to create the education module included scholarly literature describing the SDOH concepts and their application to patient, community, and population health. …


The Effects Of Vesico-Vaginal Fistula In The Lives Of Women In Southeastern Nigeria, Chioma Esther Amutaigwe Jan 2023

The Effects Of Vesico-Vaginal Fistula In The Lives Of Women In Southeastern Nigeria, Chioma Esther Amutaigwe

Walden Dissertations and Doctoral Studies

Vesico-vaginal fistula (VVF) is a maternal health problem faced by women in developing countries. VVF is one of the most devastating consequences of prolonged obstructed labor and is still prevalent in resource-poor countries like Nigeria where fertility is high, the status of women is low, and obstetric services are often inadequate. The objective of this study was to enrich our understanding of the effects of VVF as it relates to women’s experiences in southeastern Nigeria. I adopted the Transactional Model of Stress and Coping in this study; this theory posits that people, when contending with any kind of stressors, are …


Personal Hardiness As An Unexamined Component Of The Healthy Volunteer Effect, Angelique E. Blann Jan 2023

Personal Hardiness As An Unexamined Component Of The Healthy Volunteer Effect, Angelique E. Blann

Walden Dissertations and Doctoral Studies

Clinical trials are the standard for approving medicines for public use. To conduct trials, researchers depend on a declining number of volunteers. The healthy volunteer effect, a phenomenon in which participants demonstrate better outcomes than their peers, limits the generalizability of trial outcomes. The healthy volunteer effect does not fully explain the outcome difference between volunteers and nonvolunteers. The purpose of this cross-sectional quantitative study was to examine personal hardiness as an unexplored component of the healthy volunteer effect and determine whether personal hardiness is associated with willingness to participate. Hardiness was a personality construct that represented resilience to stress. …


Risk Factors Of Human Papillomavirus Positive Oropharyngeal Cancer In Men, Kentress Davison Jan 2023

Risk Factors Of Human Papillomavirus Positive Oropharyngeal Cancer In Men, Kentress Davison

Walden Dissertations and Doctoral Studies

The human papillomavirus (HPV) is a leading domestic and global sexually transmitted disease. The purpose of this secondary quantitative, cross-sectional study is to investigate if there is an relationship between the rate of oral HPV-oropharyngeal squamous cell carcinoma (OPSCC) and race, exposure to smoking cigarettes (tobacco), risky sexual behavior, and participation in oral sex of male-to-male contact vs. male-to-female contact. The social cognitive theory grounded this study. The University of Alabama at Birmingham cancer database population supplied the study’s sample size of 337 males greater than 18 years of age with a diagnosis of OPSCC. I conducted descriptive analyses using …


Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande Jan 2023

Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande

Walden Dissertations and Doctoral Studies

Physical therapy (PT) educational programs are faced with the problem of securing thenecessary clinical experiences for their students, particularly in long-term care settings. Student physical therapists (SPTs) must complete clinical education requirements to graduate and transition from learner to entry-level practitioner. Clinical instructors (CIs) provide SPT supervision and are responsible for meeting industry-standard productivity expectations. There is the notion that SPTs negatively impact PT productivity, creating a reluctance for organizations to host SPTs for clinical experiences. This quantitative pilot study aimed to determine if there was a statistically significant difference between PT productivity with and without SPTs in skilled nursing …


Long-Term Psychological Adaptation Of U.S. Human Resource Personnel In Response To The Covid-19 Pandemic, Samantha Ann Denson Jan 2023

Long-Term Psychological Adaptation Of U.S. Human Resource Personnel In Response To The Covid-19 Pandemic, Samantha Ann Denson

Walden Dissertations and Doctoral Studies

Previous research indicated that the COVID-19 pandemic negatively impacted employee psychological outcomes in various workforce sectors. Although research showed that U.S. human resource (HR) employees experienced unique occupational challenges during the pandemic, the literature did not explore pandemic-related psychological outcomes in this population. This quantitative survey-based study included a purposive sample of 294 U.S. HR professionals to explore the pandemic’s impact on their psychological well-being. The transactional model of stress and coping served as the theoretical framework to understand the independent effects of appraisal, meaning-based coping, and coping efforts on psychological well-being. A mediation analysis was used to understand the …


Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby Jan 2023

Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby

Walden Dissertations and Doctoral Studies

AbstractEnsuring high quality and safe patient care are among the main goals of all acute care hospitals. This study found that quality of patient care is not consistent across all patient populations, which draws attention to the issue of disparity in access to safe and quality health care. The purpose research questions of this quantitative study examined if patient care quality and safety are related to hospitals’ socioeconomic status (SES) among Chicago’s acute care hospitals. Secondary data were derived from a sample of 20 acute care hospitals (i.e., 10 acute care hospitals of high SES and 10 of low SES) …


Relationship Of Acetaminophen And Alcohol To Incipient Renal Insufficiency: The Role Of Race In Estimating Glomerular Filtration Rate, Preston Eledu Jan 2023

Relationship Of Acetaminophen And Alcohol To Incipient Renal Insufficiency: The Role Of Race In Estimating Glomerular Filtration Rate, Preston Eledu

Walden Dissertations and Doctoral Studies

There are increasing concerns about the incorporation of race in the estimated glomerular filtration rate (eGFR) prediction equation. which has been used to measure renal function in studies that have shown a relationship between therapeutic dose of acetaminophen and light-moderate alcohol use to incipient renal insufficiency. The purpose of this study was to assess the same relationship, using a redefinition of renal insufficiency based on the chronic kidney disease–epidemiology collaboration creatinine-based eGFR, with and without race, and exploring the potential impact of race in the hypothesized relationship. Data from the 2003-2004 National Health and Nutrition Examination Survey were analyzed using …