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Full-Text Articles in Health and Medical Administration

Ob-Pdcds Polish, Marianne E. Weiss, Malgorzata Nagorska Jan 2024

Ob-Pdcds Polish, Marianne E. Weiss, Malgorzata Nagorska

Quality of Discharge Teaching Scale

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …


Ob Qdts, Polish, Marianne E. Weiss, Malgorzata Nagorska Jan 2024

Ob Qdts, Polish, Marianne E. Weiss, Malgorzata Nagorska

Quality of Discharge Teaching Scale

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …


Pdcds-Adult Bahasa Indonesian, Marianne E. Weiss, Azizah Khoiriyati Jan 2024

Pdcds-Adult Bahasa Indonesian, Marianne E. Weiss, Azizah Khoiriyati

Quality of Discharge Teaching Scale

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …


Ped-Pdcds German, Marianne E. Weiss, Gaby Stoffel Jan 2024

Ped-Pdcds German, Marianne E. Weiss, Gaby Stoffel

Quality of Discharge Teaching Scale

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …


Pdcds - Adult Portugese (Brazil), Marianne E. Weiss, Clediane Trindade Jan 2024

Pdcds - Adult Portugese (Brazil), Marianne E. Weiss, Clediane Trindade

Post-Discharge Coping Difficulty Scale (PDCDS)

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …


Short Adult Qdts, English, Marianne E. Weiss Jan 2024

Short Adult Qdts, English, Marianne E. Weiss

Quality of Discharge Teaching Scale

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …


Ped-Pdcds Norwegian, Marianne E. Weiss, Nina Ellefsen Lindberg Jan 2024

Ped-Pdcds Norwegian, Marianne E. Weiss, Nina Ellefsen Lindberg

Post-Discharge Coping Difficulty Scale (PDCDS)

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …


Pdcds - Adult Portugese (Brazil), Marianne E. Weiss, Clediane Trindade Jan 2024

Pdcds - Adult Portugese (Brazil), Marianne E. Weiss, Clediane Trindade

Quality of Discharge Teaching Scale

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …


Ob-Pdcds Polish, Marianne E. Weiss, Malgorzata Nagorska Jan 2024

Ob-Pdcds Polish, Marianne E. Weiss, Malgorzata Nagorska

Post-Discharge Coping Difficulty Scale (PDCDS)

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …


The Benefits Of Prenatal Education Via Virtual And Mobile Applications Before, During, And After Pregnancy: A Quality Improvement Project, Lindsay Farland Jan 2024

The Benefits Of Prenatal Education Via Virtual And Mobile Applications Before, During, And After Pregnancy: A Quality Improvement Project, Lindsay Farland

Master's Theses and Capstones

Background: The advancements of technology has led to a substantial increase in the use of pregnancy applications among expecting parents. Studies indicate that a majority of pregnant individuals utilize virtual education platforms for various purposes, including accessing information on nutrition, exercise, baby development, and pregnancy symptoms. Despite the potential benefits, participation in these platforms remains low, emphasizing a need for enhanced resources and engagement strategies. Research shows that engagement with antenatal education through mobile applications can lead to improved maternal and fetal outcomes, such as reduced rates of caesarean births and fewer complications related to hypertension or preeclampsia.

Methods: …


Wellness In Motion: A Quality Improvement Initiative To Support Resident Mobility And Reduce Falls., San N. Pham Jan 2024

Wellness In Motion: A Quality Improvement Initiative To Support Resident Mobility And Reduce Falls., San N. Pham

Master's Theses and Capstones

Background: Falls are a significant concern in community living centers for older adult veterans. Promoting physical activity and resident engagement is crucial for reducing fall risk among this population.

Local Problem: A specific microsystem within this setting has a fall rate of 3 falls per month. This discrepancy underscores the need for targeted interventions to effectively address this issue.

Methods: This study measured key metrics related to falls and resident engagement in mobility programs both before and after the implementation of an exercise program within the microsystem.

Intervention: The "GIMME 10" exercise program, grounded in evidence-based practices and emphasizing resident-centric …


Implementation Of A Targeted “Micro-Learning” Inpatient Diabetes Education Program In A Rural Hospital Setting, Melissa Lynn Fannon-Wisner Jan 2024

Implementation Of A Targeted “Micro-Learning” Inpatient Diabetes Education Program In A Rural Hospital Setting, Melissa Lynn Fannon-Wisner

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: Diabetes affects a large portion of Americans and West Virginians annually. Inpatient hospitalization provides an opportunity to provide evidence-based diabetes education to patients. A lack of access to diabetes education at rural hospitals across the United States exists, creating a need for patients who require education while hospitalized. An intervention needs to be explored to bridge the gap for patients that need education when the diabetes educator is not available.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project is to create and implement a video micro-learning diabetic education series that can be utilized for diabetes self-management …


Implementation Of A Pilot Quality Improvement Project To Guide The Administration Of Intraoperative Dexamethasone For Postoperative Nausea And Vomiting Prophylaxis In Patients With Diabetes Undergoing Orthopedic Procedures, Brittany W. Hall Jan 2024

Implementation Of A Pilot Quality Improvement Project To Guide The Administration Of Intraoperative Dexamethasone For Postoperative Nausea And Vomiting Prophylaxis In Patients With Diabetes Undergoing Orthopedic Procedures, Brittany W. Hall

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: At a local tertiary care hospital, there was no recommendation to guide anesthesia providers in the administration of intraoperative dexamethasone to patients with diabetes. While dexamethasone is a highly effective antiemetic, it may promote hyperglycemia in patients with diabetes.

Purpose: The purpose of this project was to guide and educate about current recommendations for the administration of dexamethasone for PONV prophylaxis in patients with diabetes.

Intervention: 1) Examined pre-intervention practices of dexamethasone administration. 2) Educated about current and best practices to anesthesia staff. 3) Developed badge buddy cards outlining the guideline. 4) Examined post-intervention practices. 5) Evaluated the effect …


Power Safety Plan Checklist As An Intervention In The Operating Room, Scott John Fankhauser Jan 2024

Power Safety Plan Checklist As An Intervention In The Operating Room, Scott John Fankhauser

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Power Safety Plan Checklist as an Intervention in the Operating Room

Scott J. Fankhauser

Background: Intraoperative power failures (IOPF) force anesthesia providers to quickly make decisions to prevent patient harm when equipment does not operate as designed. Familiarity with alternative methods is critical during this decision process to deliver high-quality care during IOPF events. Purpose: The purpose of this project was to assess the impact of a checklist on anesthesia providers’ perceptions regarding continuation of care during an IOPF. Interventions: Pre- and post-intervention surveys were conducted during a simulation and education setting for annual competencies. Methods: The study …


Implementation Of The Academic Autistic Spectrum Partnership In Research And Education (Aaspire)-Based Guidelines To Improve Perioperative Care Of Patients With Autism Spectrum Disorder, Kayleigh Brink Jan 2024

Implementation Of The Academic Autistic Spectrum Partnership In Research And Education (Aaspire)-Based Guidelines To Improve Perioperative Care Of Patients With Autism Spectrum Disorder, Kayleigh Brink

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Implementation of the Academic Autistic Spectrum Partnership in Research and Education (AASPIRE)-based Guidelines to Improve Perioperative Care of Patients with Autism Spectrum Disorder

Kayleigh Brink

Introduction: Autism Spectrum Disorder (ASD) is becoming more prevalent with an increasing need to identify and eliminate barriers to care. Healthcare Providers (HCP) have shown limited knowledge and confidence when managing patients with ASD. The inability to provide specialized care and recognize symptoms of pain or discomfort could result in behavioral difficulties.

Purpose: The purpose of this project was to improve confidence among HCPs to identify ASD characteristics and to improve the use of …


Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia Dec 2023

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …


Non-Clinical Perspectives On Sepsis: A Project For Enhanced Awareness, Anjali Kumari Singh Dec 2023

Non-Clinical Perspectives On Sepsis: A Project For Enhanced Awareness, Anjali Kumari Singh

Master's Projects and Capstones

Problem: This project aimed to enhance non-clinical staff knowledge of sepsis through a targeted awareness campaign, while also seeking to uphold or enhance the organization's sepsis-related performance.

Context: Clinical Nurse Leader students conducted a microsystem assessment in five crucial non-clinical departments of an urban Bay Area hospital, each playing a vital role in the organization's efficiency at different levels.

Intervention: During Sepsis Awareness Month, a sepsis awareness campaign was implemented. This involved a concise presentation on sepsis, its consequences, and the significance of awareness in each department. Additionally, informational fliers detailing sepsis signs and symptoms were distributed.

Measures: A pre-and …


Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso Dec 2023

Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso

Master's Projects and Capstones

Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.

Context: The endocrinology clinic serves a patient population, …


Patient Education Improvement Initiative For Self-Management Of Congestive Heart Failure Among Senior Residents Of A Long-Term Care Facility, Abigail A. Abella, Brooke Sheck, Daniela Ramos, Ivy H. Nguyen, Mary Tran, Roshni Nagarajan Dec 2023

Patient Education Improvement Initiative For Self-Management Of Congestive Heart Failure Among Senior Residents Of A Long-Term Care Facility, Abigail A. Abella, Brooke Sheck, Daniela Ramos, Ivy H. Nguyen, Mary Tran, Roshni Nagarajan

Master's Projects and Capstones

The purpose of this quality improvement project was to use evidence-based practices to determine if personalized education on disease self-management would lead to improved treatment adherence in a residential facility. The target population consisted of four elderly female patients who had been diagnosed with congestive heart failure (CHF) and were struggling with the self-management of their disease. Contributing barriers to effective CHF self-management were determined using a root cause analysis, and included a lack of educational templates, declining cognitive ability of the residents, and no electronic health record (EHR). Using the Self-Determination theory, the interventions were implemented. Phase one was …


Test Event Example 12/14/23, Metzalli Demolastname Dec 2023

Test Event Example 12/14/23, Metzalli Demolastname

Annual Research Symposium

No abstract provided.


Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Teela Sade Miller-Buford Dec 2023

Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Teela Sade Miller-Buford

Master's Projects and Capstones

Abstract

Problem: This quality improvement project aims to enhance early sepsis management and sepsis bundle compliance among Emergency Department nurses to reduce the risk of sepsis-related deaths and hospital length of stays.

Context: A group of students studying to become Clinical Nurse Leaders (CNLs) evaluated Hospital A's Emergency Department (a clinical microsystem) located in the greater Bay Area. This microsystem provides diverse emergency care for patients with various medical conditions and diagnoses. The CNL students concentrated on patients diagnosed with sepsis for their quality improvement project.

Interventions: Although time constraints prevented the implementation of interventions, the CNL students proposed recommendations …


Organizational Methods Of Reducing Burnout: The Impact Of Self-Rostering On Work-Life-Integration, Cory Authement Dec 2023

Organizational Methods Of Reducing Burnout: The Impact Of Self-Rostering On Work-Life-Integration, Cory Authement

MSN Capstone Projects

With burnout being at an all-time high, organizations must find new ways to prioritize staff wellbeing and promote work-life balance. According to the Emergency Nurses Association (ENA) turnover in emergency departments ranges from 15-30% within the first year of nursing, and 43% within the first three years (Roncallo et al., 2020). These turnover rates cost a 300-bed facility approximately four million dollars in annual expenditure (Hesse, 2016). This level of loss and expenditure is unsustainable for the future of nursing and diverts resources away from our patients.

In recent studies, it was shown that burnout leads to difficulties for nurses …


Assessing Social Determinants Of Health In Primary Care, Vicki Carpenter Dec 2023

Assessing Social Determinants Of Health In Primary Care, Vicki Carpenter

Doctoral Projects

The social determinants of health encompass the various circumstances and environments in which individuals reside, develop, labor, and experience aging (Social Determinants of Health, 2022). These variables significantly contribute to the existence of health inequities and disparities within populations. In order to effectively mitigate health disparities, it is imperative to consider the various determinants that influence health outcomes, as this consideration is crucial for advancing the goal of achieving health equity. This public health concern encompasses multiple sectors within our society, necessitating the collaboration of various organizations and communities to effectively address and mitigate its impact.

The fundamental …


Nurse Initiated Standing Orders: A Process Improvement At An Emergency Department In Interior Alaska, Justin D. Melberg Dec 2023

Nurse Initiated Standing Orders: A Process Improvement At An Emergency Department In Interior Alaska, Justin D. Melberg

Capstone Experience: Master of Public Health

Emergency Departments (EDs) are a valuable and limited public health resource. In addition to treating acute medical emergencies, EDs bridge the gaps in urgent care and primary care accessibility, operating twenty-four hours a day, seven days a week, providing care regardless of an individual’s ability to pay. EDs across the country operate at or above capacity regularly, and overcrowding is projected to increase due to decreased facilities and available inpatient beds. Innovative measures are necessary to increase patient throughput and decrease length of stay while maintaining quality care. Nurse initiated standing orders, also known as nurse driven protocols, standing orders, …


Emergency Department Patient Navigator Post Chest Pain Diagnosis Discharge, Nancy Simoes Dec 2023

Emergency Department Patient Navigator Post Chest Pain Diagnosis Discharge, Nancy Simoes

Seton Hall University Dissertations and Theses (ETDs)

Abstract The most common complaint seen in the Emergency Department, along with abdominal pain, is nonspecific chest pain. Often, these complaints cause prolonged lengths of stay in the ED, followed by hospital admissions and subsequent readmissions for various reasons. When thinking about these various reasons, the question for prevention of readmission comes to mind. What could we do as a department to keep patients from continuously using the Emergency Department as a primary point of care instead of outpatient facilities when necessary? Project Aim: The purpose of this quality improvement project was to initiate the need for a patient navigator …


A Case Study Of The Political Determinant Of Health On The Public Health Crisis Of Malaria In Nigeria, Bisola M. Olumegbon Dec 2023

A Case Study Of The Political Determinant Of Health On The Public Health Crisis Of Malaria In Nigeria, Bisola M. Olumegbon

Electronic Theses and Dissertations

Abstract

Globally, there were about 229 million cases of malaria in 2022. The sub-Saharan African region accounted for 92% of the reported cases and 94% of deaths. Nigeria had the highest number of malaria cases and deaths, representing 27% of global cases. This scholarly project was a case study guided by the political determinants of health. Triangulation of data using thematic analysis was used to identify the political determinants of malaria in Nigeria and to understand how the concept of interaction contributes to the persistence of the disease. The analysis involved a deductive and inductive approach based on the literature …


Emergency Remote Teaching And Transition To Nursing Practice During The Covid-19 Pandemic: An Interpretative Phenomenological Analysis, Carrie Watkins Jeffrey Dec 2023

Emergency Remote Teaching And Transition To Nursing Practice During The Covid-19 Pandemic: An Interpretative Phenomenological Analysis, Carrie Watkins Jeffrey

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this phenomenological study was to explore the lived experience of new nurses in the United States who experienced Emergency Remote Teaching (ERT) for most or all of their nursing education during the COVID-19 pandemic and how they perceive ERT influenced their transition to practice during their first year as registered nurses.

Background: The National Council of State Boards of Nursing reports that in 2021, the overall pass rate for first-time NCLEX-RN® demonstrated the sharpest decline since 2013. Most of the 185,000 nursing students who took the exam in 2021 and 2022 received their nursing education during …


Promoting Mammography Screenings In African American Women: Media, Church, And Health Providers, Lasonya Little, Debra C. Wallace, K.Jay Poole Nov 2023

Promoting Mammography Screenings In African American Women: Media, Church, And Health Providers, Lasonya Little, Debra C. Wallace, K.Jay Poole

Journal of Health Disparities Research and Practice

Due to the underutilization of screening mammography, African American women (AAW) are more likely to experience negative health outcomes after receiving a late-stage breast cancer diagnosis than White Women (WW). The purpose of this article is to examine the roles of the media, health community and the African American church and pastor and their potential impact in AAW screening decisions. Fifteen AAW, ages 45 and older, were invited to participate in a semi-structured interview. Most women agreed the African American pastor and church as well as the health community, and media are an integral part of their lives. Therefore, specific …


Conference Proceedings: Select Abstracts Presented At 2023 Advocate Aurora Scientific Day Nov 2023

Conference Proceedings: Select Abstracts Presented At 2023 Advocate Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

This abstract supplement includes findings presented at the 49th annual Advocate Aurora Scientific Day on May 24, 2023. The Scientific Day symposium provides a virtual forum for the sharing of preliminary results from research and case studies conducted by faculty, fellows, residents, and other health professionals associated with Illinois-based Advocate Health Care and Wisconsin-based Aurora Health Care.


Early Discharge Planning To Improve Throughput, Alan Chhith Nov 2023

Early Discharge Planning To Improve Throughput, Alan Chhith

Student Scholarly Projects

Early discharge planning can improve the safety and outcomes of hospitalized patients. The aim of the multidisciplinary team early discharge rounds was to manage patient flow by removing discharge barriers to reduce the length of stay in the medical/surgical unit. The overall goal of the process improvement project was to make inpatient beds available to admit patients from the emergency department, reducing long ED boarding, and decrease the hours of diversion. The PICOT question for this project was: in the Veteran population (P) in the VA medical/surgical unit, early discharge planning with an interdisciplinary team (I) compared to regular discharge …