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Articles 2221 - 2250 of 2432
Full-Text Articles in Public Health
Lingkungan Rumah Dan Kejadian Difteri Di Kabupaten Tasikmalaya Dan Kabupaten Garut, Basuki Kartono
Lingkungan Rumah Dan Kejadian Difteri Di Kabupaten Tasikmalaya Dan Kabupaten Garut, Basuki Kartono
Kesmas
Kejadian Luar Biasa (KLB) difteri yang terjadi di Kabupaten Tasikmalaya (55 kasus dan 15 meninggal) dan Kabupaten Garut (17 kasus dan 2 meningal, CFR = 11,76%, AR = 1,5%). Penelitian ini bertujuan untuk mengetahui hubungan lingkungan rumah dengan kejadian difteri pada Kejadian Luar Biasa difteri tersebut. Penelitian dengan desain kasus kontrol dengan kasus adalah anak usia 1 – 15 tahun penderita atau karier difteri berdasarkan hasil diagnosis klinis dan pemeriksaan laboratorium. Kontrol adalah anak usia 1 – 15 tahun yang bukan penderita atau karier. Pengumpulan data dilakukan wawancara terstruktur pada ibu anak pada kelompok kasus dan kelompok kontrol dengan menggunakan …
Kontaminasi Air Dan Infeksi Amuba Asimptomatik Pada Anak Usia Sekolah Di Kampung Melayu Jakarta Timur, Hera Agustina
Kontaminasi Air Dan Infeksi Amuba Asimptomatik Pada Anak Usia Sekolah Di Kampung Melayu Jakarta Timur, Hera Agustina
Kesmas
Di kelurahan Kampung Melayu, penyakit infeksi amuba menempati urutan 9 dari 10 besar penyakit di wilayah tersebut. Diduga di sana banyak terdapat kasus infeksi amuba asimptomatik yang dapat menular ke orang lain akibat kondisi sanitasi lingkungan dan higiene yang buruk. Penelitian ini bertujuan untuk menilai hubungan antara kontaminasi air oleh E.histolytica dengan kejadian infeksi amuba asimptomatik pada anak usia sekolah. Penelitian dengan desain penelitian case control ini dilakukan terhadap 46 kasus dan 46 kontrol. Data dikumpulkan melalui pemeriksaan laboratorium, wawancara dan observasi. Analisa data dengan metode distribusi frekuensi, uji chi square dan regresi logistik. Prevalensi kejadian infeksi amuba asimptomatik dengan …
Nuclear Energy, Steve Kraft
Nuclear Energy, Steve Kraft
Native American Forum on Nuclear Issues
Abstract:
-Why Nuclear Energy?
-The lesson of the last 20 years in U.S. electricity policy:
– Diversified fuel and technology portfolio is essential
– All fuels and technologies (nuclear, coal, natural gas, renewables, efficiency) have a legitimate role
-The challenge for the future:
– Preserving/restoring diversified portfolio
– Ensuring resource adequacy, particularly in competitive markets
-Expanded use of nuclear energy is part of the answer
– Integrated used fuel management supports nuclear competitiveness
Nrc’S Decision Process: Judging The Safety Of A Proposed Repository, Janet Kotra
Nrc’S Decision Process: Judging The Safety Of A Proposed Repository, Janet Kotra
Native American Forum on Nuclear Issues
Abstract:
-Provide an overview of the role of the U.S. Nuclear Regulatory Commission (NRC) at Yucca Mountain
-Describe the process NRC will use to decide whether or not to authorize construction of a repository at Yucca Mountain
-Explain options and highlight important milestones that apply to Tribes as potential participants in NRC’s process
Native American Forum On Nuclear Issues Meet And Greet, Slideshow, And Attendance List
Native American Forum On Nuclear Issues Meet And Greet, Slideshow, And Attendance List
Native American Forum on Nuclear Issues
Slideshow, 58 PowerPoint slides & Attendance list
Tribes And Yucca Mountain: Native American Forum On Nuclear Issues, Fred Dilger
Tribes And Yucca Mountain: Native American Forum On Nuclear Issues, Fred Dilger
Native American Forum on Nuclear Issues
Abstract:
-Yucca Mountain: Extensive history of social-cultural studies
-No interaction on transportation
-Unsuccessful effort began in 1993 and ended in 1995
-DOE tribal policy was a very good start
-Restarted again in 2004-DOE invites tribes to TEC meeting
-Shape future interaction between DOE and other Tribes
-Tribes identify themselves as affected by DOE differently than DOE defines affected tribes
Yucca Mountain- Could The End Be Near?, Steve Frishman
Yucca Mountain- Could The End Be Near?, Steve Frishman
Native American Forum on Nuclear Issues
Presentation & Biography
Nuclear Risk Management For Native Communities, Ian Zabarte
Nuclear Risk Management For Native Communities, Ian Zabarte
Native American Forum on Nuclear Issues
Abstract:
-NCAC The Native Community Action Council (NCAC) is a grassroots organization of Western Shoshone and Southern Paiute peoples.
-A common need to address the adverse human health impacts known to be plausible from exposure to ionizing radiation.
Fighting Nuclear Waste At Skull Valley, Margene Bullcreek
Fighting Nuclear Waste At Skull Valley, Margene Bullcreek
Native American Forum on Nuclear Issues
Abstract:
-Reasons We Oppose Nuclear Waste
-Sovereignty
-Traditional values must be protected
-Protect sacredness of our culture, plants,
animals, air, and water
-Affects on community health
-Protect reservation and homeland
-To protect the air and water
-To protect future generations
-Environmental Justice
Native American Forum On Nuclear Issues Agenda
Native American Forum On Nuclear Issues Agenda
Native American Forum on Nuclear Issues
Conference agenda
Sponsored by: UNLV Department of Environmental Studies, UNLV Libraries, UNLV Department of History, UNLV Department of Sociology and the Native Community Action Council
Dampak Penggunaan Briket Batubara Dibandingkan Dengan Bahan Bakar Lain Terhadap Keluhan Pernafasan Kronik Pekerja Di Ukm, Johan Mardansyah
Dampak Penggunaan Briket Batubara Dibandingkan Dengan Bahan Bakar Lain Terhadap Keluhan Pernafasan Kronik Pekerja Di Ukm, Johan Mardansyah
Kesmas
Pemerintah Indonesia berencana meningkatkan penggunaan batubara sebagai bahan bakar alternatif. Untuk itu, diperlukan studi mengenai dampak kesehatan akibat pengguna briket batubara. Tujuan penelitian untuk mengetahui hubungan antara pajanan di udara tempat kerja dengan keluhan pernafasan kronik pekerja pengguna kompor briket batubara di UKM. Penelitian dengan disain Kohort Retrospektifl ini dilakukan terhadap data primer hasil wawancara dan pemeriksaan fisik pekerja serta hasil pengukuran pajanan di udara tempat kerja. Pajanan yang diukur meliputi debu total, NO2, SO2, Benzen, Cd dan Mn. Sampel terdiri dari 61 responden pada kelompok yang terpajan briket batubata dan 61 responden pada kelompok pembanding yang terpajan bahan bakar …
Developing An International Competence-Based Curriculum For Environmental Health, R. Steven Konkel, Maurice Brennan, Tony Lewis
Developing An International Competence-Based Curriculum For Environmental Health, R. Steven Konkel, Maurice Brennan, Tony Lewis
Environmental Health Science Faculty and Staff Research
In 1998, the International Federation of Environmental Health (IEFH) commissioned the International Faculty Forum (IFF) of environmental health educators to develop an international curriculum for environmental health. In commissioning such a curriculum, IFEH implicitly recognised and sought to address the ongoing issues of professional identity, status and the transportability of qualifications for Environmental Health Practitioners (EHPs). A draft model for an international curriculum based on competence was proposed by Brennan, Konkel and Lewis and developed and supported by IFF members when they met in May 2008 in Brisbane, Australia. Development of the model and its underpinning concepts of 'environmental healthiness' …
Factors That Influence The Distribution Of Antibiotic Resistant Bacteria In The Mud River, Wv, Timothy Shaun Dotson
Factors That Influence The Distribution Of Antibiotic Resistant Bacteria In The Mud River, Wv, Timothy Shaun Dotson
Theses, Dissertations and Capstones
Background: Prior studies of the Ohio and Mud Rivers have shown that fecal contamination alone does not explain the distribution of antibiotic resistant bacteria (ARB) in surface waters. The objectives of this study were to determine effects on the distribution of ARB in the Mud.
Methods: Water samples and physical parameters were collected twice per season in spring through fall at 12 sites on the Mud River. Aliquots were plated on R2A agar and R2A agar plus individual antibiotics for the enumeration of total cultivable bacteria, and cultivable bacteria resistant to ciprofloxacin, virginiamycin, or tetracycline respectively. The IDEXX Quanti-Tray/2000™ method …
Urban Containment Policies And Physical Activity A Time–Series Analysis Of Metropolitan Areas, 1990–2002, Semra Aytur, Daniel A. Rodriguez, Kelly R. Evenson, Diane J. Catellier
Urban Containment Policies And Physical Activity A Time–Series Analysis Of Metropolitan Areas, 1990–2002, Semra Aytur, Daniel A. Rodriguez, Kelly R. Evenson, Diane J. Catellier
Health Management & Policy
Background: Urban containment policies attempt to manage the location, character, and timing of growth to support a variety of goals such as compact development, preservation of greenspace, and efficient use of infrastructure. Despite prior research evaluating the effects of urban containment policies on land use, housing, and transportation outcomes, the public health implications of these policies remain unexplored. This ecologic study examines relationships among urban containment policies, state adoption of growthmanagement legislation, and population levels of leisure and transportation-related physical activity in 63 large metropolitan statistical areas from 1990 to 2002. Methods: Multiple data sources were combined, including surveys of …
Listening To The Stars: The Constellation Model Of Collaborative Social Change, Tonya Surman, Mark Surman
Listening To The Stars: The Constellation Model Of Collaborative Social Change, Tonya Surman, Mark Surman
Social Space
There has been much talk about social sector partnerships and networks. Tonya Surman and Mark Surman explain how the ‘constellation model’, developed for the Canadian Partnership for Children’s Health and the Environment, offers an innovative approach to organising such collaborative efforts.
Parasite Pathoecology Of Salmon Pueblo And Other Chacoan Great Houses: The Healthiest And Wormiest Ancestral Puebloans, Karl Reinhard
Parasite Pathoecology Of Salmon Pueblo And Other Chacoan Great Houses: The Healthiest And Wormiest Ancestral Puebloans, Karl Reinhard
Karl Reinhard Publications
Two fields of paleopathological investigation originated in the Southwest. Archaeoparasitology is the study of ancient parasite infection (Reinhard 1990, 1992b). It includes comparisons between time periods of single societies as well as comparisons of parasitism between different, contemporaneous cultures. For example, Fry (1980) compared Fremont and Anasazi parasitism, and also Archaic hunter-gatherer and ancestral Pueblo parasitism. All of these studies fall into the definition of archaeoparasitology.
By contrast, pathoecology is the reconstruction of relationships among behavior, environment, and disease organisms in the development of illness (Martinson et al. 2003; ReinhardandBuikstra2003; Reinhardet al. 2003; Santoro et al. 2003).1his field developed from …
Cranial Deformation As The Cause Of Death For A Child From The Chillon River Valley, Peru, Shelia M.F. Medoncade Souza, Karl J. Reinhard, Andrea Lessa
Cranial Deformation As The Cause Of Death For A Child From The Chillon River Valley, Peru, Shelia M.F. Medoncade Souza, Karl J. Reinhard, Andrea Lessa
Karl Reinhard Publications
Two small mummy bundles, found in a tomb at the Chillon River Valley, Lima Plains, Peru exist in the collections of the Museu Nacional, Rio de Janeiro, Brazil. They were donated to the collections at the beginning of the 20th century. A multidisciplinary team is now curating and studying them. CT scans confirmed both skeletons were of individuals less than one year old at death. One of the bundles is intact and will be preserved and displayed. The other one was partly decomposed and the authors received permission to unwrap it to analyze the bones in details. Mites and pollen …
A Child And His Fate: Tuberculosis, Perimortem Trauma And Mummification, Sheila M. M.De Souza, Karl J. Reinhard, Bernardo Tessarollo, Jose Fernando Cardona Zannier, Adauto Araujo
A Child And His Fate: Tuberculosis, Perimortem Trauma And Mummification, Sheila M. M.De Souza, Karl J. Reinhard, Bernardo Tessarollo, Jose Fernando Cardona Zannier, Adauto Araujo
Karl Reinhard Publications
A male child, sitting, 7 years, circumferential deformation, skin marked by coiled fibers, nostril plugs, consistent with Aymara practices was CT scanned. Puppae in the skin suggest exposition of the body previous to the funeral. Dark brown color at the skin suggest blood perfusion. A broken area at the right frontal with the skin partially inside is suggestive of perimorten trauma. There were no bone debris inside the skull and the CT images show two confluent fractures defined by radiating lines extending beyond the missing bone surface. The right eyeball is projected out, the tongue is outside the mouth, the …
Pathoecology And The Future Of Coprolite Studies In Bioarchaeology, Karl J. Reinhard, Vaughn M. Bryant Jr.
Pathoecology And The Future Of Coprolite Studies In Bioarchaeology, Karl J. Reinhard, Vaughn M. Bryant Jr.
Karl Reinhard Publications
Human coprolites currently provide an expanding array of information about the diet, health, and ecology of prehistoric people in the Southwest, but for many years coprolites were not recognized or preserved, or they were not considered important and thus were not saved (Bryant and Dean 2006). With the expansion of archaeological field work during the last half of the twentieth century archaeologists have increasingly explored the "complete" potentials of sites, including the collection and analysis of geomorphologic, botanical, and faunal data. In some ideal habitats (e.g., very dry or frozen) this includes exploring the scientific potential of human coprolite studies. …
Pathoecology Of Two Ancestral Pueblo Villages, Karl Reinhard
Pathoecology Of Two Ancestral Pueblo Villages, Karl Reinhard
Karl Reinhard Publications
Pathoecology is the study of the biotic, abiotic, and cultural environments of disease (Martinson et al. 2003). A parasitic infection is the result of the pathoecological interaction of host behavior, parasite life cycle, the environment in which both life forms live, the nutritional status of the host, and host physiological responses to all of these factors. Parasites contribute to anemia in many ways. Some, such as hookworm, actually consume blood and cause iron loss through their activities. For other parasites, symptoms such as profuse diarrhea reduce intestinal absorption of nutrients. Others, such as certain fish tapeworms, actually compete for absorption …
Paleoparasitology: Perspectives With New Techniques, Adauto Araújo, Karl Reinhard, Otilio M. Bastos, Ligia C. Costa, Claude Pirmez, Alena Iñighez, Ana Carolina Vicente, Carlos M. Morel, Luiz Fernando Ferreira
Paleoparasitology: Perspectives With New Techniques, Adauto Araújo, Karl Reinhard, Otilio M. Bastos, Ligia C. Costa, Claude Pirmez, Alena Iñighez, Ana Carolina Vicente, Carlos M. Morel, Luiz Fernando Ferreira
Karl Reinhard Publications
Paleoparasitology is the study of parasites found in archaeological material. The development of this field of research began with histological identification of helminth eggs in mummy tissues, analysis of coprolites, and recently through molecular biology. An approach to the history of paleoparasitology is reviewed in this paper, with special reference to the studies of ancient DNA identified in archaeological material.
Paleoparasitologia: perspectivas com novas técnicas
Paleoparasitologia é o estudo de parasitos encontrados em material arqueológico. O desenvolvimento deste campo da pesquisa teve início com a identificação de ovos de helmintos em tecidos mumificados, análise de coprólitos e, recentemente, através da …
Enterobius Vermicularis Ancient Dna In Pre-Columbian Human Populations, Alena Mayo Iniguez, Karl J. Reinhard, Luiz Fernando Ferreira, Adauto Araujo, Ana Carolina, Paulo Vincente
Enterobius Vermicularis Ancient Dna In Pre-Columbian Human Populations, Alena Mayo Iniguez, Karl J. Reinhard, Luiz Fernando Ferreira, Adauto Araujo, Ana Carolina, Paulo Vincente
Karl Reinhard Publications
In prehistoric populations the paleoparasitological findings show an Enterobius vennicularis homogeneous distribution among North American hunter-gatherers intensified with the advent of agriculture. The same occurred in the transition from nomad hunter-gatherers to sedentary farmers in South America, although E. vermicularis infection encompasses only the ancient Andean peoples. Since molecular techniques are sensitive in detecting ancient DNA (aDNA), in this work we have performed a molecular paleoparasitological study of E. vermicularis. aDNA was recovered from North and South American coprolites (4110 BC-AD 900). Human (cox 2 and HVR) and pinworm (5S rRNA spacer) sequences were determined. The sequence analysis confirmed E. …
Kualitas Bakteriologis Air Minum Isi Ulang Di Wilayah Kota Bogor, Astri Wulandari Pratiwi
Kualitas Bakteriologis Air Minum Isi Ulang Di Wilayah Kota Bogor, Astri Wulandari Pratiwi
Kesmas
Kebutuhan masyarakat terhadap air minum yang meningkat terutama di perkotaan mendorong tumbuhnya Industri Air Minum Dalam Kemasan (AMDK) dan usaha Depot Air Minum (DAM) isi ulang yang siap melayani masyarakat. Tujuan penelitian ini mengetahui kualitas bakteriologis depot air minum isi ulang di Wilayah Kota Bogor. Jenis penelitian deskriptif, data primer yang digunakan mencakup peralatan yang digunakan pada 27 Depot Air Minum Isi Ulang, pemeriksaan laboratorium total coliform dan E.coli pada air sampel air minum isi ulang, observasi dan data sekunder yang diperoleh dari Dinas Kesehatan Kota Bogor tentang lokasi Depot Air Minum Isi Ulang. Hasil penelitian menunjukkan bahwa sumber air …
Lingkungan Fisik Kamar Tidur Dan Pneumonia Pada Anak Balita Di Puskesmas Kawalu Kota Tasikmalaya, Nur Widodo
Lingkungan Fisik Kamar Tidur Dan Pneumonia Pada Anak Balita Di Puskesmas Kawalu Kota Tasikmalaya, Nur Widodo
Kesmas
Pneumonia masih menjadi masalah kesehatan masyarakat yang penting di Indonesia termasuk di Kota Tasikmalaya. Diperkirakan proporsi penyakit pneumonia bayi adalah 16,4%, dan pada balita adalah 25%. Tujuan penelitian ini adalah untuk mengetahui hubungan kejadian pneumonia pada balita dengan faktor lingkungan fisik kamar tidur dan karakteristik anak. Desain penelitian yang digunakan adalah case control. Sampel sebanyak 300 responden terdiri dari 150 orang kasus dan 150 orang kontrol. Dari hasil uji multivariat tanpa interaksi, faktor dominan yang mempengaruhi kejadian penyakit pneumonia pada anak balita adalah status gizi dengan nilai B 1,799 dan OR = 6,041 (CI 95%=1,607-22,713). Sedangkan hasil uji interaksi diperoleh …
Parental Smoking As Health-Risk Factors Of Indoor Air Pollution, Rachmadi Purwana
Parental Smoking As Health-Risk Factors Of Indoor Air Pollution, Rachmadi Purwana
Kesmas
Pengaruh dari kebisaan merokok terhadap gejala gangguan pernapasan telah banyak diteliti. Tulisan ini merupakan bagian dari disertasi doktoral berdasarkan studi potong lintang mengenai kesehatan lingkungan di perumahan kumuh di Jakarta, ibukota Indonesia yang dikenal tinggi polusi udaranya. Studi ini menemukan bahwa di samping faktor-faktor lain, merokok adalah faktor risiko kesehatan untuk gangguan pernapasan pada 263 balita di wilayah penelitian. Anak-anak yang direkrut tidak menunjukkan gejala gangguan pernapasan pada awal observasi dan diikuti selama dua minggu untuk mendeteksi kemunculan gangguan pernapasan. Faktor-faktor yang berhubungan dengan kondisi fisik perumahan dan aktifitas rumah tangga juga dicatat. Analisis data dilakukan dengan pengendalian konfounder. Cut-off …
Analisis Risiko Asupan Oral Pajanan Mangan Dalam Air Terhadap Kesehatan Masyarakat, Taufik Ashar
Analisis Risiko Asupan Oral Pajanan Mangan Dalam Air Terhadap Kesehatan Masyarakat, Taufik Ashar
Kesmas
Mangan yang secara alami dapat ditemukan di air, tanah, dan udara adalah zat nutrisi esensial bagi manusia dan hewan. Asupan yang tidak mencukupi atau yang berlebihan dapat gangguan kesehatan. Pajanan kronik mangan pada dosis yang tinggi dapat mengakibatkan gangguan pada sistem saraf. Tujuan penelitian ini adalah mengetahui perkiraan risiko kesehatan akibat asupan mangan dari air sumur di wilayah penelitian. Penelitian dengan disain crossectional ini dilakukan terhadap masyarakat di wilayah sekitar TPA Rawakucing yang meliputi masyarakat yang bermukim di dalam kawasan (114 orang), dan di luar kawasan TPA (177 orang). Hasil penelitian menunjukkan rata-rata konsentrasi mangan dalam air sumur di wilayah …
Concurrent Panel Session 2: Health Challenges Facing Las Vegas, Carlos Brandenburg, Shawn Gerstenberger, Zaven Khachaturian, John Mcdonald, Dennis Pirages, Thom Reilly, Kathy Silver, Bonnie Sorenson, Carolyn B. Yucha, Maurizio Trevisan
Concurrent Panel Session 2: Health Challenges Facing Las Vegas, Carlos Brandenburg, Shawn Gerstenberger, Zaven Khachaturian, John Mcdonald, Dennis Pirages, Thom Reilly, Kathy Silver, Bonnie Sorenson, Carolyn B. Yucha, Maurizio Trevisan
Shaping the Future of Southern Nevada: Economic, Environmental, and Social Sustainability
Moderator: Marcia Turner, NSHE Health Science System Scribe: Candace Griffith, UNLV Department of Sociology Conference white paper & Full summary of panel session, 8 pages
Rural Utility Cooperative (Ruc): Final Evaluation Report, Steven Konkel
Rural Utility Cooperative (Ruc): Final Evaluation Report, Steven Konkel
Reports
No abstract provided.
Writing The World: Ursula K. Le Guin And Margaret Atwood’S Literary Contributions To Ecofeminism, Melissa Messer
Writing The World: Ursula K. Le Guin And Margaret Atwood’S Literary Contributions To Ecofeminism, Melissa Messer
Mahurin Honors College Capstone Experience/Thesis Projects
Along with the philosophical writings of ecofeminism’s greatest proponents and critics, the growth of ecofeminist philosophy has relied heavily on fiction writers. The term ecofeminism was coined in 1975, and the following year ecofeminism found fertile ground for exploration and growth in March Peircy’s science fiction novel, Woman on the Edge of Time (1976). The social, academic, and literary trends leading up to the emergence of ecofeminism, however, began well before 1975. Both Ursula K. Le Guin and Margaret Atwood are speculative fiction authors whose work before and after 1975 examines important ecofeminist topics and contributes to the growth of …
Suppression Of Peroxisomal Enzyme Activities And Cytochrome P450 4a Isozyme Expression By Congeneric Polybrominated And Polychlorinated Biphenyls, Larry W. Robertson, Isabelle Berberian, Tim Borges, Li-Chuan Chen, Ching K. Chow, Howard P. Glauert, Johannes G. Filser, Helmut Thomas
Suppression Of Peroxisomal Enzyme Activities And Cytochrome P450 4a Isozyme Expression By Congeneric Polybrominated And Polychlorinated Biphenyls, Larry W. Robertson, Isabelle Berberian, Tim Borges, Li-Chuan Chen, Ching K. Chow, Howard P. Glauert, Johannes G. Filser, Helmut Thomas
Toxicology and Cancer Biology Faculty Publications
The purpose of this study was to determine the effects of PCBs and PBBs on peroxisome proliferator-activated receptor-alpha-(PPARalpha-) associated enzyme activities or protein levels. Male Sprague-Dawley rats were administered a single IP injection (150 mu mol/kg) of either 3,3',4,4'-tetrabromobiphenyl, 3,3',4,4'-tetrachlorobiphenyl, 3,3',5,5'-tetrabromobiphenyl, 2',3,3',4,5-pentachlorobiphenyl, 3,3',4,4',5-pentachlorobiphenyl, 2,2',3,3',5,5'-hexachlorobiphenyl, or 3,3',4,4',5,5'-hexabromobiphenyl in corn oil (10 ml/kg). One week later, the activities of catalase, peroxisomal fatty acyl-CoA oxidase, and peroxisomal beta-oxidation as well as cytochrome P450 4A (CYP4A) protein content were determined in subcellular liver fractions. None of the peroxisomal enzyme activities were significantly increased by any of the halogenated biphenyl congeners tested. Except for minor …