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Articles 2521 - 2550 of 7985
Full-Text Articles in Public Health
Nurses' Experiences Caring For Patients With Opioid Use Disorder, Pamella Maureen Campbell
Nurses' Experiences Caring For Patients With Opioid Use Disorder, Pamella Maureen Campbell
Walden Dissertations and Doctoral Studies
Over the past 2 decades, opioid use in the United States has taken thousands of lives, reached the level of epidemic in 2017, and has been an area of study among scholars. The problem is health care professionals, including nurses, lack training on how to care for people with opioid use disorder (OUD). Nurses are at the frontline of patient care and understanding the nurses’ experiences in the care of patients with OUD may help to improve the patients’ quality of care. The purpose of this qualitative descriptive study was to develop an understanding of the experiences of nurses with …
Fortitude, Spiritual Fortitude, And The Cancer Care Continuum In African American Breast Cancer Survivors, Karen Y. Boone
Fortitude, Spiritual Fortitude, And The Cancer Care Continuum In African American Breast Cancer Survivors, Karen Y. Boone
Walden Dissertations and Doctoral Studies
African American breast cancer survivors (AABCS) struggle with physical, emotional, psychological, spiritual, and financial challenges. Navigating these challenges can require the use of inner resources such as fortitude and spiritual fortitude. Using Folkman and Lazarus’ transactional model of stress and coping as the theoretical framework, the purpose of this study was to examine fortitude and spiritual fortitude as coping responses by African American women living with breast cancer and whether fortitude and spiritual fortitude were associated with phases of the cancer care continuum. A quantitative nonexperimental cross-sectional design was used for primary data collection that involved using Pretorius’ Fortitude Questionnaire …
The Impact Of Electronic Health Records Meaningful Use On Patient Safety And Satisfaction, Paulette Brown
The Impact Of Electronic Health Records Meaningful Use On Patient Safety And Satisfaction, Paulette Brown
Walden Dissertations and Doctoral Studies
AbstractThe widespread adoption of electronic health records (EHRs) is encouraged because of their potential to improve the quality of care provided. It was unknown to what extent the meaningful use of EHRs would impact patient safety and satisfaction in general and specialty hospitals. The researcher’s purpose for this quantitative correlational research was to examine the impact of meaningful EHR use of EHRs on patient safety and satisfaction outcomes in general and specialty hospitals in Philadelphia (PA). The constructs of the institutional theory guided the study. The hypotheses that guided the study included (a) Meaningful EHR use positively influences patient satisfaction …
Working Mothers’ Lived Experiences Of Maintaining An Exercise Practice During A Pandemic, Sabrina Marie Cali
Working Mothers’ Lived Experiences Of Maintaining An Exercise Practice During A Pandemic, Sabrina Marie Cali
Walden Dissertations and Doctoral Studies
Working mothers have been associated with low levels of exercise during the COVID-19 pandemic. This population faces many challenges and obstacles to exercise as they manage a household and work; this lack of exercise could leave their health at risk. Researchers have not yet considered working mothers’ lived experiences with exercise during a pandemic. Existing research on working mothers indicates there are barriers to exercise for this population, but more information on what allows these mothers to sustain exercise is needed. This qualitative narrative study was conducted to explore the lived experiences of working mothers who maintained an exercise practice …
Obesity's Impact Among Asian Americans In Southern California, Alyssa Mae Sunga Carlos
Obesity's Impact Among Asian Americans In Southern California, Alyssa Mae Sunga Carlos
Walden Dissertations and Doctoral Studies
Obesity continues to be an important public health issue in the United States, especially among minority populations. However, one minority group experiences the lowest obesity rate: Asian Americans. As a result, there is not much research available involving the impact of obesity and weight gain among this population. The purpose of this basic qualitative exploratory study was to improve the understanding of obesity’s impact on the Asian American population, specifically in Southern California, whose goals were to lose weight and become more informed about obesity’s impact on health. The study consisted of three main research questions. Twenty-five participants were interviewed …
Nutrition And Physical Exercise Prevention Strategies To Reduce Obesity During The Covid-19 Pandemic, Carmesha Vajill Carter
Nutrition And Physical Exercise Prevention Strategies To Reduce Obesity During The Covid-19 Pandemic, Carmesha Vajill Carter
Walden Dissertations and Doctoral Studies
Obesity has reached an epidemic level of 75 million obese adults and 15 million obese children in the United States. The research problem addressed in this study is the lack of information on how obese people manage their weight-loss strategies to prevent or reduce obesity during shut-in place restrictions for the COVID-19 Pandemic. This study included the Prochaska and DiClemente Trans-Theoretical Model of Behavioral Change and the Stage of Change Theory. The phenomenon approach using phenomenology described participants' lived experiences of being obese. The researcher completed data collection and evaluation among sixteen participants using email questionnaires to analyze participant's responses …
Pharmacists’ Responses To Medication Management Following Disasters, Rellamichelle W. Tyree
Pharmacists’ Responses To Medication Management Following Disasters, Rellamichelle W. Tyree
Walden Dissertations and Doctoral Studies
Disasters, both natural and human made, can cause emerging health threats in the United States and the Caribbean. The disasters that pharmacists experienced and reported for this study included hurricanes, snowstorms, ice storms, flooding, and a pandemic. The purpose of this research was to investigate the challenges and outcomes associated with pharmacists’ medication management practices during and following disasters. This generic qualitative study focused on pharmacists’ experiences and their responses to disaster planning and medication management activities. The ecological model of disaster management was the conceptual framework used to investigate the pharmacists and their responses and actions used to address …
Parents' And Caregivers' Attitudes About Child Passenger Safety, Latoya Wider
Parents' And Caregivers' Attitudes About Child Passenger Safety, Latoya Wider
Walden Dissertations and Doctoral Studies
Motor vehicle crashes are a leading cause of childhood injury and death in the United States. Many car seats are installed incorrectly, and many children under the age of 6 are seriously injured or killed in a motor vehicle crash. The purpose of this study was to examine the relationship between age of child, age of parent/caregiver, attitudes, and behaviors of child passenger safety among parents and caregivers in South Carolina. The influence of age and attitude on consistent car seat use was also examined. The study was based on the theory of planned behavior. A survey design featuring questions …
Birthing While Black: Anti-Oppressive Social Work Practices For Improved Maternal Health Outcomes, Sara Hall
Birthing While Black: Anti-Oppressive Social Work Practices For Improved Maternal Health Outcomes, Sara Hall
DSW Capstone Projects
Black women die at a disproportionate rate than white women in the United States due to maternal mortality. Black women are three times more likely to die because of a maternal complication than any other demographic. Although the United States has a highly developed healthcare system, it also has the worst maternal mortality rate out of developed nations. The focus of this research is social work practices that can be implemented to improve Black maternal health outcomes.
The systematic literature review focuses on gaps in social work literature related to maternal mortality and health equity, solutions for social workers to …
A Systematic Approach To Multiple Case Study Design In Professional Counseling And Counselor Education, Charmayne R. Adams, Casey A. Barrio Minton, Jennifer Hightower, Ashley J. Blount
A Systematic Approach To Multiple Case Study Design In Professional Counseling And Counselor Education, Charmayne R. Adams, Casey A. Barrio Minton, Jennifer Hightower, Ashley J. Blount
Office of Health Promotion Scholarship
Case study research is a qualitative methodology that allows researchers to explore complex phenomena in a structured way, that is rigorous and provides an enormous amount of depth. Three scholars are credited with major contributions to the case study literature: Merriam (1998), Stake (1995/2006), and Yin (1994). The purpose of this paper is to explore case study design for use in the counseling profession. The authors provide instruction on the case study scholars, data collection, analysis, and reporting for both single and multiple case study research designs. Finally, implications for student counselors, counselor educators, and counseling professionals are provided.
Maximal Strength Training Increases Metabolic Energy Expenditure In Sedentary Adults Classified As Obese, Robert E. Anderson Iii
Maximal Strength Training Increases Metabolic Energy Expenditure In Sedentary Adults Classified As Obese, Robert E. Anderson Iii
Theses and Dissertations--Nutrition and Food Systems
Background: Metabolic adaptations reduce resting and non-resting energy expenditure to account for approximately 120 kcal/day. Weight loss promotes greater skeletal muscle efficiency, reducing the energy cost of physical activity and is correlated with declines in skeletal muscle glucose oxidation. Maximal Strength Training (MST) has the potential to upregulate glucose utilization and may offset these metabolic adaptations. Objective: To determine if MST offsets markers of metabolic adaptation by increasing resting and non-resting energy expenditure in sedentary individuals classified as obese. Methods: Five (5) participants (2 females, 3 males), ages 18-35 years, with obesity (BMI 30–45 kg/m2) were enrolled in an 8-week …
How Comprehensive And Effective Are Waste Management Policies During The Covid-19 Pandemic? Perspectives From The Philippines, Geminn Louis C. Apostol, Angelina Gabrielle A. Acolola, Michelle Alexandra Edillon, Sary Valenzuela
How Comprehensive And Effective Are Waste Management Policies During The Covid-19 Pandemic? Perspectives From The Philippines, Geminn Louis C. Apostol, Angelina Gabrielle A. Acolola, Michelle Alexandra Edillon, Sary Valenzuela
Ateneo School of Medicine and Public Health Publications
This study presents a comprehensive analysis on policies governing the management of COVID-19 waste in the Philippines, highlighting gaps in pre-existing policies and opportunities for further policy development and adaptation in the context of present and future public health emergencies. A hybrid search strategy and consultative process identified fifty (50) policy documents directly impacting the management of wastes (general domestic, healthcare, and household healthcare waste) released prior to and during the pandemic. Content analysis revealed comprehensive policy coverage on managing general domestic waste and healthcare waste. However, there remains a dearth in policies for managing household healthcare waste, an emerging …
Exposure To Family Planning Messages And Teenage Pregnancy: Results From The 2017 Philippine National Demographic And Health Survey, Veincent Christian F. Pepito, Arianna Maever L. Amit, Clinton S. Tang, Luis Miguel B. Co, Neil Andrew K. Aliazas, Sarah J. De Los Reyes, Raymundo S. Baquiran, Lourdes Bernadette S. Tanchanco
Exposure To Family Planning Messages And Teenage Pregnancy: Results From The 2017 Philippine National Demographic And Health Survey, Veincent Christian F. Pepito, Arianna Maever L. Amit, Clinton S. Tang, Luis Miguel B. Co, Neil Andrew K. Aliazas, Sarah J. De Los Reyes, Raymundo S. Baquiran, Lourdes Bernadette S. Tanchanco
Ateneo School of Medicine and Public Health Publications
Background
Teenage pregnancy is known to have physical, emotional, and psychosocial effects. Because of these risks, family planning and contraception messages have been disseminated in various forms of media, but their association with teenage pregnancy has not been studied previously in the Philippines. This study aims to examine the association between exposure to various family planning and contraception messages disseminated in various media channels and pregnancy among Filipino women aged 15–19. The study also intended to examine interactions between the different media channels where these family planning and contraception messages are being disseminated on their effect on teenage pregnancy.
Methods …
Covid-19 Vaccine Brand Hesitancy And Other Challenges To Vaccination In The Philippines, Arianna Maever L. Amit, Veincent Christian F. Pepito, Lourdes S. Tanchanco, Manuel Dayrit
Covid-19 Vaccine Brand Hesitancy And Other Challenges To Vaccination In The Philippines, Arianna Maever L. Amit, Veincent Christian F. Pepito, Lourdes S. Tanchanco, Manuel Dayrit
Ateneo School of Medicine and Public Health Publications
Effective and safe COVID-19 vaccines have been developed at a rapid and unprecedented pace to control the spread of the virus, and prevent hospitalisations and deaths. However, COVID-19 vaccine uptake is challenged by vaccine hesitancy and anti-vaccination sentiments, a global shortage of vaccine supply, and inequitable vaccine distribution especially among low- and middle-income countries including the Philippines. In this paper, we explored vaccination narratives and challenges experienced and observed by Filipinos during the early vaccination period. We interviewed 35 individuals from a subsample of 1,599 survey respondents 18 years and older in the Philippines. The interviews were conducted in Filipino, …
Exploring Predictors In The Receipt Of Patient/Family-Centered Care, Arami Anwell
Exploring Predictors In The Receipt Of Patient/Family-Centered Care, Arami Anwell
Theses and Dissertations
Study 1
OBJECTIVES: The research aim of this study was to identify predictors associated with the receipt of PFCC among U.S. children/families
METHODS: Caregivers of 38,803 non-institutionalized children, aged 0 to 17 years, were surveyed by the National Survey of Children’s Health (NSCH) 2018–20019. Patient/family-centered care (PFCC) was measured using five components of health care delivery that were answered on a 4-point Likert scale. Logistic regression models were analyzed for the overall receipt of PFCC and each component of PFCC, with survey weighting added to adjust for complex sampling design.
RESULTS: Many predictors were associated with the receipt of PFCC. …
Status Anxiety And Overall Life Satisfaction Of Young Adults In The Bay Area, Samuel Casco
Status Anxiety And Overall Life Satisfaction Of Young Adults In The Bay Area, Samuel Casco
Global Public Health | Senior Theses
The published literature suggests social comparisons have significant negative effects on an individual’s psychological well-being. However, there is little to no research to suggest that an individual’s attainment of societal success has a relationship with one’s perceived life satisfaction.
A mixed-methods study involved young adults ages 18-29 in the Bay Area and were selected via a student researcher in the Global Public Health department of Dominican University of California. 115 participants completed surveys regarding self-perceived life satisfaction and status anxiety through the Qualtrics Survey Collection Tool. A Pearson’s Chi-Squared Test was conducted to find an association between life satisfaction and …
Parental Status As A Modifying Factor In Covid-19 Vaccination Status: A Mixed Methods Approach, Mackenzie Carter
Parental Status As A Modifying Factor In Covid-19 Vaccination Status: A Mixed Methods Approach, Mackenzie Carter
All Master's Theses
Introduction: Vaccines are the best protection against COVID-19 and have been proven to be safe and effective. Parental efforts to protect their children by complying with or refusing pediatric vaccinations have previously been studied. However, the author found little research on how parental status affects the vaccination decisions for the parents. Using an explanatory sequential mixed-methods approach and the Health Belief Model, this study examines how parental status influences parental COVID-19 vaccination status. Methods: A local health department conducted a quantitative survey on COVID-19 vaccination attitudes and beliefs from September to October 2021. The COVID-19 vaccination status of parents of …
Trauma-Informed Care Training For Medical Students, Tanisha Clark, Jill Mcleigh, Hilda Loria, Laura Lamminen
Trauma-Informed Care Training For Medical Students, Tanisha Clark, Jill Mcleigh, Hilda Loria, Laura Lamminen
Integrated, Trauma-Informed Care
Due to the high prevalence of trauma and secondary trauma and the associated potential adverse health outcomes for both patients and providers, it is imperative that medical and allied professionals receive training in trauma as a constitutive element of their professional development. Despite the growing recognition of the importance of TIC, Ditcher and colleagues (2018) found in a survey of 263 family medicine residency programs that only 27.0% had TIC in the curriculum. Following a review of the literature and discussions with healthcare providers offering TIC in an integrated pediatric primary care setting, a brief, 45-minute online TIC training adapted …
Exploring Infant Massage As Standard Nonpharmacological Treatment For Neonatal Opioid Withdrawal Syndrome, Christine Ann Perez
Exploring Infant Massage As Standard Nonpharmacological Treatment For Neonatal Opioid Withdrawal Syndrome, Christine Ann Perez
Walden Dissertations and Doctoral Studies
The opioid epidemic in the United States has increased opioid use in women of reproductive age, leading to in utero exposure causing withdrawal symptoms in newborns known as neonatal opioid withdrawal syndrome (NOWS). State perinatal quality collaboratives (SPQCs) have been used in hospitals with quality initiatives (QIs) to improve standardization for NOWS; however, there remains a gap in knowledge in interventions to support the mother-infant dyad such as infant massage. This general qualitative research study explored the process and experiences of implementing infant massage as a standard practice for NOWS to inform national, state, and local policy. Participants in the …
Extent Of Inclusion Of “Rural” In Comprehensive Cancer Control Plans In The United States, Inti Barrientos-Gutierrez, Katia Gallegos-Carrillo, Lizeth Cruz-Jimenez, Rosibel Rodriguez- Bolaños, Edna Arillo-Santillán, Jim F. Thrasher Ph.D., Ma, Ms
Extent Of Inclusion Of “Rural” In Comprehensive Cancer Control Plans In The United States, Inti Barrientos-Gutierrez, Katia Gallegos-Carrillo, Lizeth Cruz-Jimenez, Rosibel Rodriguez- Bolaños, Edna Arillo-Santillán, Jim F. Thrasher Ph.D., Ma, Ms
Faculty Publications
Objectives. To evaluate the prevalence of exposure to Internet communications on and advertising of electronic cigarettes (e-cigarettes) and their association with perceptions of the social acceptability of e-cigarettes in Mexico.
Methods. Data were analyzed from eight surveys (2018–2021) of an online sample of Mexican adult (> 18 years) smokers and dual users (of combustible and electronic cigarettes). Self-reported exposure to e-cigarette advertising across various marketing channels was assessed, as well as visits to e-cigarette websites. Logistic regression analysis was used to evaluate the association between perceptions of the social acceptability of e-cigarette use and level of advertising exposure and visits …
Parents’ Perspectives On Early Intervention For Children With Autism, Tiffany Schmidt
Parents’ Perspectives On Early Intervention For Children With Autism, Tiffany Schmidt
Walden Dissertations and Doctoral Studies
The purpose of this study was to analyze parent perspectives on early intervention services for children with autism. Research has shown a significant positive impact of early intervention on children with autism. A total of eight parents participated in this basic qualitative study guided by social cognitive theory. Participating parents were those whose child had an autism diagnosis and were receiving or had received early intervention services in Southeast Michigan. Data analysis included establishing themes and codes to organize the data into categories. Thematic analysis was applied by analyzing interview transcripts. The research questions used to collect data addressed parents’ …
Lived Experience Of Albanian Migrants Who Became Obese After Moving To The United States, Briseida Xhelaj
Lived Experience Of Albanian Migrants Who Became Obese After Moving To The United States, Briseida Xhelaj
Walden Dissertations and Doctoral Studies
The problem of obesity is significant in the United States, and more information is needed about the factors that increase the risk for obesity among migrant populations like Albanian Americans. The purpose of this study was to discover the lived experience of Albanian migrants who became obese after moving to the United States. This study was guided by the social ecological model. The research questions were used to examine how individual, relationship, community, and societal level factors impacted lifestyle changes and obesity for Albanian American migrants after moving to the United States. This qualitative study involved the use of a …
Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques
Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques
Walden Dissertations and Doctoral Studies
AbstractZika virus is an infectious disease caused by the bite of an infected mosquito that has been linked to increased rates of microcephaly and other devastating birth defects. The existing body of knowledge has focused on the individual-level factors that influence a person’s decisions about prevention activities and risk perceptions related to Zika virus. The purpose of this study was to determine the relationship between state-level plans for prevention and education and individual-level risk perceptions. Rosenstock’s health belief model lays a foundation for why individuals make the health decisions they do and helps explain how these can be influenced for …
Perceptions Of Implicit Bias In New York City Healthcare System During Covid-19, Kiesha Jackson
Perceptions Of Implicit Bias In New York City Healthcare System During Covid-19, Kiesha Jackson
Walden Dissertations and Doctoral Studies
Implicit bias has been identified as a significant problem that hinders effective healthcare delivery. The purpose of this qualitative exploratory phenomenological study was to examine whether implicit bias influenced healthcare services for African Americans with comorbidities aged 30 and over living in New York City during the COVID-19 pandemic. Current studies show healthcare disparities, revealing barriers with healthcare delivery; however, they do not disclose a patient’s lived experience qualitatively, which constituted a gap in the literature. The frameworks of the behavioral model of health services use, and social construction and policy design guided this study. Research questions addressed (a) whether …
Attitudes Of State Public Health Laboratory Directors Towards Iso/Iec 17025 Accreditation, Christine Kilonzo
Attitudes Of State Public Health Laboratory Directors Towards Iso/Iec 17025 Accreditation, Christine Kilonzo
Walden Dissertations and Doctoral Studies
The impact of ISO/IEC 17025 accreditation in state public health laboratories (SPHLs) is understudied. There is a scarcity of research on SPHLs involving behavioral intent regarding ISO/IEC 17025 accreditation. The theory of planned behavior (TPB) was utilized to evaluate SPHL directors’ attitudes towards and intent to seek or maintain ISO/IEC 17025 accreditation. To test the questions of whether the three constructs of the TPB, attitude, subjective norms and perceived behavioral control are significant predictors of intent to seek or maintain ISO/IEC 17025 accreditation, and whether there are significant differences in these constructs towards the accreditation between SPHL directors based on …
Assessing Sexual Assault And Harassment At Montclair State University: Research Abstracts, Amanda Birnbaum, Eva Goldfarb, Lisa Lieberman, Stephanie A. Navarro Silvera
Assessing Sexual Assault And Harassment At Montclair State University: Research Abstracts, Amanda Birnbaum, Eva Goldfarb, Lisa Lieberman, Stephanie A. Navarro Silvera
Department of Public Health Scholarship and Creative Works
No abstract provided.
Public Health Implications Of Cannabis Legalization: An Exploration Of Adolescent Use And Evidence-Based Interventions, Joseph Donnelly, Michael Young, Brenda Marshall, Michael L. Hecht, Elena Saldutti
Public Health Implications Of Cannabis Legalization: An Exploration Of Adolescent Use And Evidence-Based Interventions, Joseph Donnelly, Michael Young, Brenda Marshall, Michael L. Hecht, Elena Saldutti
Department of Public Health Scholarship and Creative Works
Abstract: This article examines the relaxation of state marijuana laws, changes in adolescent use of marijuana, and implications for drug education. Under federal law, use of marijuana remains illegal. In spite of this federal legislation, as of 1 June 2021, 36 states, four territories and the District of Columbia have enacted medical marijuana laws. There are 17 states, two territories and the District of Columbia that have also passed recreational marijuana laws. One of the concerns regarding the enactment of legislation that has increased access to marijuana is the possibility of increased adolescent use of marijuana. While there are documented …
Australian Teachers’ Perceptions And Experiences Of Food And Nutrition Education In Primary Schools: A Qualitative Study, Gozde Aydin, Claire Margerison, Anthony Worsley, Alison Booth
Australian Teachers’ Perceptions And Experiences Of Food And Nutrition Education In Primary Schools: A Qualitative Study, Gozde Aydin, Claire Margerison, Anthony Worsley, Alison Booth
Australian Journal of Teacher Education
Teacher delivered food and nutrition education (FNE) can be effective in improving children’s food literacy and eating habits. However, teachers are known to face some barriers to the delivery of FNE globally. To obtain a deeper understanding of Australian primary school teachers’ experiences and views, 17 teachers were interviewed. The results of the thematic analysis showed that teachers acknowledged the importance of FNE and were willing to include more FNE content into their teaching. We also identified the FNE topics taught, resources used, their teaching partners, and barriers encountered. The discussion presents strategies to overcome these barriers.
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 …
Experiences Of Individuals With Opioid Use Disorder In Medication Assisted Treatment Programs, Lynda M. Maxfield
Experiences Of Individuals With Opioid Use Disorder In Medication Assisted Treatment Programs, Lynda M. Maxfield
Walden Dissertations and Doctoral Studies
AbstractOpioid use accounts for many deaths each day in the United States. Although research has shown that retention in medication assisted treatment (MAT) programs increases quality of life for those individuals with opioid use disorder (OUD) and decreases premature death, there has been limited research on the perspectives of individuals with OUD in MAT programs and why they remained in or left the programs. The purpose of this qualitative phenomenological study, guided by Merleau-Ponty’s theory of perception, was to explore the lived experiences of those with OUD treated in a MAT program. An algorithm type interview was conducted to ask …