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Articles 1381 - 1410 of 2894
Full-Text Articles in Public Health
Gestational Exposure To Polybrominated Diphenyl Ethers And Social Skills And Problem Behaviors In Adolescents: The Home Study, Kim Hartley, Melinda C. Macdougall, Brandon Terrizzi, Yingying Xu, Kim M. Cecil, Aimin Chen, Joseph M. Braun, Bruce P. Lanphear, Nicholas C. Newman, Ann M. Vuong, Andreas Sjödin, Kimberly Yolton
Gestational Exposure To Polybrominated Diphenyl Ethers And Social Skills And Problem Behaviors In Adolescents: The Home Study, Kim Hartley, Melinda C. Macdougall, Brandon Terrizzi, Yingying Xu, Kim M. Cecil, Aimin Chen, Joseph M. Braun, Bruce P. Lanphear, Nicholas C. Newman, Ann M. Vuong, Andreas Sjödin, Kimberly Yolton
Epidemiology & Biostatistics Faculty Research
Background: Polybrominated diphenyl ethers (PBDEs) are persistent environmental pollutants used as flame retardants. Gestational PBDE exposure has been associated with a variety of behavior problems in children, but little is known about its impact into adolescence, particularly on social skills, which are important for achieving social competence, establishing identity, and forming lasting relationships. Objective: We investigated associations between gestational exposure to PBDEs and social skills and problem behaviors in early adolescence in a longitudinal pregnancy and birth cohort in Cincinnati, Ohio (recruited 2003–2006). Methods: We measured maternal serum concentrations of five PBDE congeners during gestation. At age 12, we measured …
Association Between Perceived Health Risks Of E-Cigarettes And Actual E-Cigarette Use, Based On Cigarette Smoking Status And Sexual And Gender Minority Status Among Us Adults, David Adzrago, Yue Shi, Kayo Fujimoto
Association Between Perceived Health Risks Of E-Cigarettes And Actual E-Cigarette Use, Based On Cigarette Smoking Status And Sexual And Gender Minority Status Among Us Adults, David Adzrago, Yue Shi, Kayo Fujimoto
Faculty, Staff and Student Publications
BACKGROUND: There is a lack of consensus in the literature about the association between the perceived health risks of e-cigarettes and their actual use, an association that may be based on cigarette smoking status or sexual and gender minority status. This study examined the moderating effect of these variables as well as differences in e-cigarette use between and within perceived harmfulness of e-cigarettes and cigarette smoking among U.S. adults.
METHODS: The data were drawn from the 2020 and 2019 Health Information National Trends Survey (HINTS 5), Cycles 4 and 3, on adults (
RESULTS: Of the study population, 30.75% currently …
Analysis Of Zero Balancing Case Studies Through An Occupational Therapy Lens, Deanna Waggy Otr, Msa, Czb, Csla
Analysis Of Zero Balancing Case Studies Through An Occupational Therapy Lens, Deanna Waggy Otr, Msa, Czb, Csla
Journal of Transformative Touch
Does Zero Balancing positively impact occupational performance? This is a question many Occupational Therapists (OTs) ask when discerning if Zero Balancing (ZB) is an evidence-based treatment modality. Case studies from the book Experiencing the Power of Zero Balancing: Case Studies of Journeys to Health and Wholeness (Quarry & King, 2016) were reviewed and compared to the Occupational Therapy domain of practice to show clear evidence that each case study had a positive impact on occupational performance. A comparison chart shows a direct link between the occupational categories and documented evidence of improved occupational performance through practitioner observation and client feedback …
Factors Predicting Intention To Initiate Mental Health Services Among College Students Returning To Campus During Covid-19, Anne Dumadag, Cara Tonn, Hadiza Galadima
Factors Predicting Intention To Initiate Mental Health Services Among College Students Returning To Campus During Covid-19, Anne Dumadag, Cara Tonn, Hadiza Galadima
College of Health Sciences Posters
Introduction: While the impact of transitioning to a virtual learning environment during the COVID-19 pandemic is well-documented, few studies have explored the mental health impact of reopening campus. As a measurement of mental health impact within the context of reopening campus, this study aims to identify factors associated with intention to initiate mental health services (MHS), with a particular focus on race, among college students.
Methods: A cross-sectional survey using stratified sampling was conducted via Qualtrics among students at a Virginia university in January 2022. The survey assessed demographics, online class experiences, past and future use of MHS, and feelings …
Mental Health Interventions For International Seafarers During The Covid-19 Pandemic : A Pilot Study, Sanley Abila, Lijun Tang, Momoko Kitada, Serafin Malecosio, Rhea Subong
Mental Health Interventions For International Seafarers During The Covid-19 Pandemic : A Pilot Study, Sanley Abila, Lijun Tang, Momoko Kitada, Serafin Malecosio, Rhea Subong
Reports
The COVID-19 pandemic has highlighted the key role that seafarers play in the global supply chain. As the pandemic took hold in early 2020 a significant crew change crisis unfolded globally due to border closures, strict quarantine requirements and a faltering vaccination rollout. In normal times the mental health of seafarers has been recognised as crucial to their wellbeing and safety at sea. Stranded aboard their vessels and with an unclear pathway out of the pandemic the mental health of seafarers deteriorated significantly driving some to suicide.
With 400,000 seafarers stranded at sea at one point, the issue was framed …
Examining Health Care Utilization Among Adult Heart Disease Patients With Self-Reported Depressive Symptoms, Courtney R. Lockett
Examining Health Care Utilization Among Adult Heart Disease Patients With Self-Reported Depressive Symptoms, Courtney R. Lockett
Walden Dissertations and Doctoral Studies
Health care costs are most commonly concentrated among small groups of high-cost patients, or high utilizers. Many of these patients receive unnecessary and ineffective care and often critical health care needs can go unmet, even when substantial care from multiple sources is received. Thus, there is a need to look into high utilizing patients for not only quality improvement but also effective resource allocation. The operational problem for health care administrators is managing resources and improving quality of care by targeting specific medical conditions that may be high utilizers of medical resources. The purpose of this study was to identify …
Alzheimer's Disease: Risk And Protective Factors To Improve Detection And Prevention, Darryl Clay Nevels
Alzheimer's Disease: Risk And Protective Factors To Improve Detection And Prevention, Darryl Clay Nevels
Walden Dissertations and Doctoral Studies
Alzheimer’s disease (AD) is a growing epidemic and is the sixth-leading cause of death in the United States. Individuals with AD often have comorbidities due to the aging process. There is a lack of research on comorbidities as associated risk factors for AD. The leading hypothesis indicates that cardiovascular health issues, environmental exposure, social isolation, and amyloid-beta plaques influence cognitive health and are associated with AD. This study, guided by Finch and Kulminski’s AD exposome, is a caveat to explore a patient’s physical history of cardiovascular health, modifiable behavior, social isolation, and an AD diagnosis. Participants provided health information collected …
The Relationship Between Types Of Workplace Trauma Exposure, Burnout, And Ptsd In Mental Health Workers, Armando Dominguez
The Relationship Between Types Of Workplace Trauma Exposure, Burnout, And Ptsd In Mental Health Workers, Armando Dominguez
Walden Dissertations and Doctoral Studies
Work-related traumatic exposure has been studied but has not been concisely defined in the widest range of research studying trauma exposure. Specifically, it is not known from previous research whether direct, indirect, and vicarious trauma exposure predict burnout and PTSD in acute care mental health care workers. The emotional processing theory was used as theoretical foundation informing this study as the habituation of response to stress and trauma has been shown to occur incidentally and cumulatively; the theory supports the concept of dichotomous and continuous type of trauma exposure over time. The purpose of this study was to use a …
The Socioeconomic Gradient Of Alcohol Use, Charles Dh Parry, Gianna Gayle H. Amul
The Socioeconomic Gradient Of Alcohol Use, Charles Dh Parry, Gianna Gayle H. Amul
Ateneo School of Government Publications
No abstract provided.
Risk Factors And Compliance Of Surviving Sepsis Campaign: A Retrospective Cohort Study At Tertiary Care Hospital, Farheen Yousuf, Ayesha Malik, Ayesha Saba, Sana Sheikh
Risk Factors And Compliance Of Surviving Sepsis Campaign: A Retrospective Cohort Study At Tertiary Care Hospital, Farheen Yousuf, Ayesha Malik, Ayesha Saba, Sana Sheikh
Department of Obstetrics & Gynaecology
Background and objective: Sepsis is one of the leading causes of direct maternal mortality in Pakistan. It is recommended that the first three hours after the presentation are crucial. During this time implementation of surviving sepsis campaign resuscitation bundles reduces maternal mortality. Our objective was to assess the factors contributing to puerperal sepsis and the compliance of "surviving sepsis campaign resuscitation bundles in puerperal sepsis" for the management of puerperal sepsis.
Methods: This was a retrospective record review for five years from January 2011-December 2015. All women who fulfilled the inclusion criteria of puerperal sepsis were included and data from …
Understanding Parents' Experiences With Children With Type 1 Diabetes: A Qualitative Inquiry, Justin A. Haegele, Steven K. Holland, Eddie Hill
Understanding Parents' Experiences With Children With Type 1 Diabetes: A Qualitative Inquiry, Justin A. Haegele, Steven K. Holland, Eddie Hill
Human Movement Studies & Special Education Faculty Publications
Parenting is often described as a stress-inducing experience, which can be further complicated or made more stressful and anxiety-inducing when parenting children with chronic conditions such as type 1 diabetes (T1D). The incidence of T1D among children has risen and continues to rise globally, resulting in a need to understand the experiences of parenting children with T1D. The purpose of this qualitative inquiry was to explore the lived experiences, and the meaning ascribed to those experiences, of being a parent of a child with T1D. This qualitative study was conducted through an interpretivist paradigm and includes the experiences of 29 …
The Politics Of Drug Rehabilitation In The Philippines, Gideon Lasco, Lee Edson Yarcia
The Politics Of Drug Rehabilitation In The Philippines, Gideon Lasco, Lee Edson Yarcia
Development Studies Faculty Publications
The international consensus to end compulsory drug treatments and close forced rehabilitation facilities needs urgent transformation to country policies. In the Philippines, as with other countries in Asia, rehabilitation can be compulsory and is seen as the humane alternative to the “war on drugs.” In this paper, we present the landscape of rehabilitation and narrate the ways in which people who use drugs are forced to undergo treatment. We unpack the politics behind rehabilitation and explain the sociocultural foundations that support compulsory treatment. We argue that a transition to a human rights-based approach, including voluntary alternatives in community settings, is …
Analyse Prospective De L’Adaptation Des Travailleurs En Centre De Protection De L’Enfance Et De La Jeunesse Exposés À Un Évènement Potentiellement Traumatique : Effets D’Une Intervention De Soutien Par Des Pairs, Stéphane Guay, Alexandre Lemyre, Josianne Lamothe, Steve Geoffrion
Analyse Prospective De L’Adaptation Des Travailleurs En Centre De Protection De L’Enfance Et De La Jeunesse Exposés À Un Évènement Potentiellement Traumatique : Effets D’Une Intervention De Soutien Par Des Pairs, Stéphane Guay, Alexandre Lemyre, Josianne Lamothe, Steve Geoffrion
Rapports de recherche scientifique
Problématique. Les travailleurs des services de protection de l’enfance sont exposés de manière répétée à des événements potentiellement traumatiques (EPT) dans le cadre de leur travail, notamment des actes de violence. Ils sont ainsi susceptibles de développer des problèmes de santé mentale tels que l’anxiété, l’insomnie, la dépression et des symptômes de stress post- traumatiques. Sur le plan professionnel, les EPT engendrent des coûts élevés pour l’individu et l’organisation : baisse de la satisfaction au travail, absentéisme, changement d’emploi, baisse de productivité, etc. Dans ce contexte, le Centre de la protection de l’enfance et de la jeunesse (CPEJ) du Centre-Sud-de-l’Île …
A Content Analysis Of Reddit Comments Discussing Fibroadenoma Appraisal And Decision Making, Hayley Marie Kay Stahl
A Content Analysis Of Reddit Comments Discussing Fibroadenoma Appraisal And Decision Making, Hayley Marie Kay Stahl
Theses and Dissertations--Communication
Though fibroadenomas are clinically benign in most cases, clinical research suggests that these lesions can cause diagnosis-related physical health complications and psychological distress. However, this research is limited and should be investigated further. Thus, this study aimed to explore how patients appraise their fibroadenoma diagnosis uncertainty. Additionally, this study sought to determine if a correlation existed between appraisal and decision making as well as identify the factors that influence the most common treatment decision: removal. Data was retrieved from Reddit discussions for a content analysis. These discussions were then qualitatively analyzed using codebooks associated with this study’s research questions. Findings …
College Of Health And Human Service Faculty’S Confidence And Inclusion Of Lgbtq+ Health Content In Curriculum, Carley S. Kanter
College Of Health And Human Service Faculty’S Confidence And Inclusion Of Lgbtq+ Health Content In Curriculum, Carley S. Kanter
Honors Theses and Capstones
In the health care system, those who identify as lesbian, gay, bisexual, transgender, queer, (LGBTQ+) face discrimination and health disparities. Students who are better prepared in higher education to provide care for this population have higher levels of confidence in LGBTQ+ health content than those who have less exposure. Therefore, faculty who teach curriculum related to health and wellness have an opportunity to prepare students to provide high quality, patient centered care by teaching culturally competent care that is inclusive of LGBTQ+ populations. The aim of the study is to determine whether the degree of confidence in teaching LGBTQ+ health …
Morality-Based Messaging? An Examination Of State Health Departments’ Facebook Posts In Advertising Covid-19 Vaccines, Kylee R. Casner
Morality-Based Messaging? An Examination Of State Health Departments’ Facebook Posts In Advertising Covid-19 Vaccines, Kylee R. Casner
Honors Theses and Capstones
COVID-19 vaccination is an important public health tool in curbing the COVID-19 pandemic, but vaccination rates in the U.S. are inadequate for reaching herd immunity, leaving public health officials to develop strategies to increase vaccination rates. The field of public health has historically used stigmatizing messaging to encourage health behaviors. Through a content analysis COVID-19 Facebook posts made by the Alabama Public Health, Mississippi State Department of Health, Rhode Island Department of Health, and Vermont Department of Health, this study explores the types of messaging used to influence COVID-19 vaccination behavior and looks to determine if stigmatization of non-vaccination is …
Telehealth Delivery Of Acceptance And Commitment Therapy And Recreational Therapy: Supporting People With Chronic Pain During The Covid-19 Pandemic, Grace L. Roy
Honors Theses and Capstones
Chronic pain is a significant public health problem that requires person-centered and comprehensive care to address the many socioecological factors that contribute to pain. Within the context of the COVID-19 pandemic, telehealth options for chronic pain management can help more people access the care that they need. The purpose of the current pilot study was to investigate the efficacy and feasibility of delivering a 6-week Acceptance and Commitment Therapy (ACT) and recreational therapy intervention via telehealth for a group of seven participants with chronic pain. It was found that TeleACT-RT was associated with positive behavioral outcomes including increased psychological flexibility, …
Stress Coping Responses Of Undergraduate University Students Prior To & Since The Onset Of The Covid-19 Pandemic, Kaylee Diefenderfer
Stress Coping Responses Of Undergraduate University Students Prior To & Since The Onset Of The Covid-19 Pandemic, Kaylee Diefenderfer
All Graduate Theses, Dissertations, and Other Capstone Projects
The stress coping mechanisms used by undergraduate university students affects their psychological well-being, stress level, and mental health outcomes. Increasing students’ use of positive coping mechanisms may increase academic outcomes, and overall health and well-being. This study evaluated the stress coping mechanisms used by undergraduate university students prior to and since the COVID-19 pandemic began. The Brief COPE inventory was used to measure stress coping responses. The results of this research indicated a significant change in 9 out of the 14 main coping mechanisms used by undergraduate university students prior to since the pandemic began. The top two stress coping …
Healing Through Mother Earth, Taylor A. Russell
Healing Through Mother Earth, Taylor A. Russell
Dance (MFA) Theses
This thesis deals with mental health, with a focus on Black women. Historically, Black women are often so compromised, being constant caregivers and helping everyone else, that they forget to help themselves, not having the time and financial means to do so. If we go back in the time of slavery, many Black women were taking care of slave owners' children and suckling the white women’s babies instead of their own. By the time they got home and after diligently caring for other people’s children they were focused on their own children, who they had been away from for hours …
An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober
An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober
Journal of the Georgia Public Health Association
Background: The present study characterizes the population of women residing in the state of Georgia who did not receive prenatal care before giving birth to a live infant. The association between mother’s place of residence (rural/non-rural) and preterm delivery was also examined.
Methods: This study examined data obtained from the Georgia Department of Public Health which includes data for 7,062 mothers who did not receive prenatal care before giving birth to a live infant in Georgia in the years 2015 and 2016. Data on the resulting births was also studied. Descriptive analyses of the following variables were used …
Perception Of Health Care Access In Rural Georgia: Findings From A Community Health Needs Assessment Survey, Elisa M. Childs, Tiffany R. Washington
Perception Of Health Care Access In Rural Georgia: Findings From A Community Health Needs Assessment Survey, Elisa M. Childs, Tiffany R. Washington
Journal of the Georgia Public Health Association
Background: Limited access to health care services has been cited as a barrier to care for individuals who live in rural areas, contributing to significant health disparities in this population. While perception of services has been cited as a determinant of utilization of health services, it is unknown how perception of services influences health care access in rural areas. The paucity of studies specific to areas in the United States that are medically underserved, necessitated this study and its quantification of the issues that are relevant to individuals living in rural Georgia.
Methods: This study examined the perception of health …
Interactions Of International Pilots' Stress, Fatigue, Symptoms Of Depression, Anxiety, Common Mental Disorders And Wellbeing, Marion Venus, Martin Grosse Holtforth
Interactions Of International Pilots' Stress, Fatigue, Symptoms Of Depression, Anxiety, Common Mental Disorders And Wellbeing, Marion Venus, Martin Grosse Holtforth
International Journal of Aviation, Aeronautics, and Aerospace
Objective
This study Investigates more dimensions than previous studies simultaneously: pilots’ duty rosters, stress, sleep difficulties, fatigue levels, wellbeing, symptoms of depression, anxiety, and common mental disorders (CMD), and how they are interrelated.
Background
Several scientific studies have confirmed that fatigue can pose a significant risk to flight safety. Other studies reported positive depression screening results for more pilots, compared with the general population.
Method
A cross-sectional online survey was completed by 406 international pilots, who reported their duty rosters of the last two months. Pilots also self-assessed their stress-levels, sleep problems, fatigue, wellbeing, and mental health.
Results
Although pilots …
Clinicians Experience Using The Family As A Unit Of Treatment For Black Hiv-Positive Men Who Have Sex With Men, Steffen Gillom
Clinicians Experience Using The Family As A Unit Of Treatment For Black Hiv-Positive Men Who Have Sex With Men, Steffen Gillom
Antioch University Dissertations & Theses
The present study examines the experiences of five licensed clinicians as they attempted to integrate the family as a unit of treatment into the treatment of Black HIV-positive men who have sex with men (BHPMSM). A single 90-minute focus group study using an interpretive phenomenological approach (IPA) was conducted with five clinicians from diverse backgrounds. The results of the study show that clinicians attempting to integrate the family into the treatment of BHPMSM shared common experiences in the areas of building community through encouraging client self-determination, navigating religion, navigating HIV stigma, feelings of incompetence, and feelings of gratification after successful …
Time For Tobacco-Free Generations In The Western Pacific?, Gianna Gayle H. Amul, Suan Ee Ong, Azrul Mohd Khalib, Joanne Su-Yin Yoong
Time For Tobacco-Free Generations In The Western Pacific?, Gianna Gayle H. Amul, Suan Ee Ong, Azrul Mohd Khalib, Joanne Su-Yin Yoong
Ateneo School of Government Publications
No abstract provided.
Looking Upstream For Factors Influencing Mental Illness In A Low-Resource Setting, Adewole Adebola Adefalu
Looking Upstream For Factors Influencing Mental Illness In A Low-Resource Setting, Adewole Adebola Adefalu
Walden Dissertations and Doctoral Studies
An investigation into the upstream determinants of mental disorders could provide insight into pathways by which these risk factors could relate to different groups of mental illness. The study was a quantitative inquiry using constructs within the Rothman’s sufficient and component cause framework to examine the pathways existing between upstream risk factors for schizophrenic and mood disorders. The study population was drawn from a convenience sample of clients accessing services at the psychiatry departments of a secondary mental health institution in North-Central Nigeria. The mean age of the participants in this study was 35.5years. The majority were males (53.4%), single …
Exploring The Behavioral Health Clinician Shortage At A Rural Midwestern U.S. Agency, Tracy L. Wilson
Exploring The Behavioral Health Clinician Shortage At A Rural Midwestern U.S. Agency, Tracy L. Wilson
Walden Dissertations and Doctoral Studies
Behavioral health clinician shortages are a significant and ongoing problem in the United States, especially in rural areas, which have higher rates of homelessness, suicide, substance use, and violence rates than urban areas. The purpose of this qualitative case study was to explore factors contributing to the behavioral health clinician shortage in a rural midwestern U.S. public health department. The goal was to gain a better understanding of this shortage and explore strategies and solutions for recruiting and retaining behavioral health clinicians at the agency’s facilities. The Baldrige excellence framework undergirded the investigation. Data sources included interviews with three administrative …
Improving Patients' Engagement And Retention In Intensive Outpatient Substance Abuse Treatment, Leo W. Lavender
Improving Patients' Engagement And Retention In Intensive Outpatient Substance Abuse Treatment, Leo W. Lavender
Walden Dissertations and Doctoral Studies
Substance use disorder continues to be a major health crisis in the United States. Thousands of people die yearly due to substance use and related criminal activity. Substance abuse treatment is a remedy to the disorder and treatment centers admit thousands of patients yearly to address the dilemma. Throughout the years retention has been an ongoing barrier to successful treatment. This study explored significant obstacles to retention: motivation and engagement. The Baldrige Excellence Framework was utilized to assess the training, supervision, procedures, and leadership roles at an intensive outpatient substance abuse treatment center. This study utilized a qualitative approach case …
Healing Sanctuary, Kammy Downs
Healing Sanctuary, Kammy Downs
Master's Theses or Doctor of Nursing Practice
The natural world has hidden wisdom and resources that are disregarded as we misuse our responsibility to care for them. The benefits of being in tune with nature have been traded for a culture that manipulates nature on the altar of expediency, waste, and unquenchable desire. Healing Sanctuary presents a duality. My work speaks about the relationship between the seen and unseen, represented by ten larger-than-life drawings of medicinal herbal plants that have had a profound physical healing effect on me. At the same time, plants, roots, and seeds create visceral metaphors for mental health. Our accomplishments, outlook on life, …
Identifying Factors Associated With Syringe Reuse Among People Who Inject Drugs (Pwid) In Appalachia Kentucky, Grayson Keith Fuller
Identifying Factors Associated With Syringe Reuse Among People Who Inject Drugs (Pwid) In Appalachia Kentucky, Grayson Keith Fuller
Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)
Aim: Syringe reuse contributes to the spread of infectious diseases. The purpose of this study is to identify factors associated with syringe reuse among people who inject drugs (PWID) in Kentucky.
Methods: PWID (n=238) completed interviewer-administered questionnaires to collect data on syringe reuse and demographic, behavioral, and clinical characteristics. Negative log binomial regression was used to model the associations.
Results: On average, people reused each syringe 9.3 times (median: 3; IQR: 2-10, range 1-95). Syringe reuse was higher among men [aOR=1.386; 95% CI: 1.041-1.845] and those who injected methamphetamine [aOR=2.122; 95% CI: 1.445-3.116]. Reuse was also higher among those who …
The Program To Reduce Implicit Bias In Carroll Hospital Center Using The Implicit Association Test, Katherine E. Traynor
The Program To Reduce Implicit Bias In Carroll Hospital Center Using The Implicit Association Test, Katherine E. Traynor
Capstone Showcase
Natural brain processes make all individuals susceptible to unconscious bias; however, stressful, fearful, or anger-evoking situations as well as the negative influence of media and social surroundings increase the risk of holding obstructive bias, and there is a greater risk of being negatively impacted by this phenomenon when belonging to a minority population (Rose & Flores, 2020). As a result, high rates of infant mortality (10.2 deaths per 1,000 live births for the Non-Hispanic Black population compared to 4.1 in the White population) and cardiovascular related diseases (190.0 cases per 1,000 in the Non-Hispanic Black population compared to 161.3 in …