Occupational Health and Industrial Hygiene Commons^™

Whole Body Vibration Exposure To Crane Operator’S, Steven Campbell

Graduate Theses & Non-Theses

Whole body vibration (WBV) has been linked to lower back disorders (LBD’s). The purpose of this study is to determine whether crane operators are exposed to whole body vibration (WBV). If exposure exists then, do they exceed a current consensus standard. This information will be used to determine whether WBV should become a larger discussion item when purchasing cranes and or rebuilding. This information can also be used to make the case for seat replacement or at the very least a qualification to consider when purchasing replacement seats.

While many studies exist relating WBV to LBD, I could not find …

An Exploratory Study Of Carbon Monoxide Exposures In Ice Rink Volunteers, Jonathan Triner

Graduate Theses & Non-Theses

Hockey has grown in popularity in the United States substantially in the last fifty years. The combustion engine has primarily been utilized to power the ice resurfacing equipment to make the ice smooth and able to support the next activity. The exhaust from the combustion engine creates a source of CO that could be harmful to the bystanders if the exhaust is not ventilated from the area properly. Many studies have investigated CO concentrations in ice rinks, but few have evaluated carboxyhemoglobin (COHb) levels as a biological indicator of CO exposure, in order to evaluate the potential health effects of …

An Analysis Of Helmet Sound Attenuation During Abrasive Blasting, Michael Lindsey

Graduate Theses & Non-Theses

During abrasive blasting, the operator is exposed to a process consisting of combined sound pressure levels from compressed air propelling an abrasive media through the hose, the abrasive striking metal substrate, the flow of breathing air inside the helmet, and the reverberation of sound inside the walls of the blast booth. The resulting noise can reach peak sound pressure levels (Lpeak) of 128 dBA, exceeding allowable occupational exposure levels.

The objectives of this study were to investigate the noise levels produced during abrasive blasting, attempt to further quantify total noise exposure to the abrasive blast operator, and calculate combined attenuation …

Making It Sound As Good As It Tastes: Noise Reverberation Reduction In A Micro Distillery Tasting Room, Andrew Sheehy

Graduate Theses & Non-Theses

Noise reverberation in micro distillery tasting rooms can interfere with speech communication and negatively impact the acoustic quality of live music. Noise reverberation was characterized in a tasting room in Butte, MT by calculated and quantified methods. Sound absorbing baffles were then installed in an effort to reduce reverberation and improve room acoustics. The overall reverberation time and speech interference level were decreased by measureable amounts that corresponded with an increase in overall absorption in the space. Reverberation time decreased from 0.85 seconds to 0.49 seconds on average. As shown by a customer survey given before and after the installation, …

Advancing The Knowledge Of Organic Farming Data In New Mexico: Health And Injury Surveillance Systems, Virginia Sedore

Population Health

While the concept and practice of organic farming has been around since the mid-1800s, there is little data currently being collected on injury, illness, or fatality within the organic farming population, leaving the health risks unknown. This paper intends to look at the surveillance systems currently in place to collect injury and illness data as it relates to organic farmers, and in particular, the New Mexico organic farmer. Evaluations of the current surveillance systems were conducted, and organic farmer demographics were analyzed using rate ratio comparisons of United States(U.S.), Texas, and New Mexico. The results show that the current surveillance …

Critical Heat Stress Evaluation In Two Ebola Ensembles, Christopher T. Lee

USF Tampa Graduate Theses and Dissertations

Ebola, a type of filovirus that causes hemorrhagic fevers, dominated global headlines in 2014 when the largest Ebola epidemic in history took place in West Africa. Healthcare practitioners were at particular risk of contracting Ebola while taking care of patients with the disease because they were easily exposed to bodily fluids such as blood, urine, saliva, and feces, quite often in the intensive care unit (ICU). While personal protective equipment (PPE) protects the healthcare practitioner by providing an effective barrier against the virus, users were also at risk for heat stress because of the type of protective clothing. In this …

Using Artificial Neural Networks To Predict Disease Associations For Chemicals Present In Burn Pit Emissions, Amanda R. Taylor

Theses and Dissertations

In June of 2015, 27,378 of the 28,000 returning Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans report being exposed to burn pits. According to Barth et al. (2014), 9,660 returning OIF/OEF veterans were diagnosed with respiratory diseases, to include asthma, bronchitis, and sinusitis, thus strengthening the need to develop decision support tools that can be used to understand the relationships between chemical exposure and disease. In this study an Artificial Neural Network (ANN) was used to predict the chemical-disease associations for burn pit constituents. Ten burn pit constituents were tested using varying hidden layers, similar chemical structure relationships, and three …

Neck Injury Criteria Development For Use In System Level Ejection Testing; Characterization Of Atd To Human Response Correlation Under -Gx Accelerative Input, Craig M. Zinck

Theses and Dissertations

The use of Helmet Mounted Displays is ubiquitous in the field of aviation, adding operational capability, increasing head-supported weight and potential neck injury risk. Developing neck injury criteria to evaluate and quantify neck injury is important to ensure ejection systems are produced within acceptable standards. An ATD to human transfer function is developed that quantifies the difference between ATD and human neck response from -Gx accelerative tests, and demonstrates how this function can be applied to ATD test data to make previously developed human risk functions directly applicable to interpreting ATD data with a human based neck injury criterion. A …

Comparison Of Urinary Pahs Among Firefighters And Asphalt Pavers, Theodore Aquino

USF Tampa Graduate Theses and Dissertations

Firefighters and asphalt pavers are exposed to polycyclic aromatic hydrocarbons (PAHs) during various work activities. The purpose of this study was to evaluate urinary PAH levels and compare these bio-monitoring levels among firefighters, asphalt pavers, and non-occupationally exposed individuals. The National Institute of Standards and Technology (NIST) urinary PAH levels were used for non-occupationally exposed controls. When compared to the NIST standard for smokers and non-smokers, firefighters demonstrated statistically significant differences in urinary concentration differences for the following metabolites: 2-OH-fluorene, 3-OH-fluorene and 1-OH-pyrene, which were lower in firefighters than the NIST mean for smokers. 1-OH-phenanthrene, 2-OH-phenanthrene and 3-OH-phenanthrene were higher …

Risk Factors Associated With Non-Compliance With The Respiratory Protection Program Among Firefighters, Brandon Dawkins

USF Tampa Graduate Theses and Dissertations

Introduction: Non-compliance with respiratory protection programs among firefighters may put them at increased risk of injury and illness from occupational exposures during fire extinguishing activities. This research aims to characterize respiratory protection practices among Florida firefighters. This information will allow better understanding of factors that are associated with non-compliance with respiratory protection guidelines.

Methods: Survey questionnaire was used to characterize Florida fire departments in this cross sectional study. Four hundred and seventy-seven surveys were administered to Florida firefighters both in person and electronically to collect information regarding firefighter knowledge and participation in their respective respiratory protection programs during the past …

Estimation Du Chargement Au Dos : Développement D’Une Méthode Ambulatoire Intégrant La Cinématique Du Dos Et De L’Électromyographie, Alain Delisle, André Plamondon, Denis Gagnon, Christian Larivière, François Thénault, François Michaud, Jean Rouat

Rapports de recherche scientifique

De nombreux travailleurs sont atteints de maux de dos chaque année. La région lombaire est de loin celle qui est la plus fréquemment atteinte, et ce type de troubles musculosquelettiques est principalement occasionné par des efforts excessifs, surtout en soulevant quelque chose, et les chargements aux tissus de la colonne qu’ils engendrent. Il n’existe pas de méthode de mesure directe de ces chargements qui puisse être utilisée en milieu de travail, d’où la nécessité de recourir à des modèles biomécaniques pour les estimer. Or, jusqu’à présent, les modèles biomécaniques existants ne permettent pas l’estimation des chargements de manière satisfaisante.

Ce …

Phylogenetic Organization Of Bacterial Activity., Ember M Morrissey, Rebecca L Mau, Egbert Schwartz, J Gregory Caporaso, Paul Dijkstra, Natasja Van Gestel, Benjamin J Koch, Cindy M. Liu, Michaela Hayer, Theresa A Mchugh, Jane C Marks, Lance B. Price, Bruce A Hungate

Environmental and Occupational Health Faculty Publications

Phylogeny is an ecologically meaningful way to classify plants and animals, as closely related taxa frequently have similar ecological characteristics, functional traits and effects on ecosystem processes. For bacteria, however, phylogeny has been argued to be an unreliable indicator of an organism's ecology owing to evolutionary processes more common to microbes such as gene loss and lateral gene transfer, as well as convergent evolution. Here we use advanced stable isotope probing with (13)C and (18)O to show that evolutionary history has ecological significance for in situ bacterial activity. Phylogenetic organization in the activity of bacteria sets the stage for characterizing …

Cord Blood Methylmercury And Fetal Growth Outcomes In Baltimore Newborns: Potential Confounding And Effect Modification By Omega-3 Fatty Acids, Selenium, And Sex, Ellen M Wells, Julie B Herbstman, Yu Hong Lin, Jeffery Jarrett, Carl P Verdon, Cynthia Ward, Kathleen L Caldwell, Joseph R Hibbeln, Frank R Witter, Rolf U Halden, Lynn R. Goldman

Environmental and Occupational Health Faculty Publications

BACKGROUND: Methylmercury (MeHg) may affect fetal growth; however, prior research often lacked assessment of mercury speciation, confounders, and interactions.

OBJECTIVE: Our objective was to assess the relationship between MeHg and fetal growth as well as the potential for confounding or interaction of this relationship from speciated mercury, fatty acids, selenium, and sex.

METHODS: This cross-sectional study includes 271 singletons born in Baltimore, Maryland, 2004-2005. Umbilical cord blood was analyzed for speciated mercury, serum omega-3 highly unsaturated fatty acids (n-3 HUFAs), and selenium. Multivariable linear regression models controlled for gestational age, birth weight, maternal age, parity, prepregnancy body mass index, smoking, …

Pregnant Women’S Health Consequences Following Exposure To Pbdes, Alison Chiaramonte, Ami R. Zota

GW Research Days 2016 - 2020

PBDEs (Polybrominated diphenyl ethers) are chemicals introduced by industry in the 1970s to serve as flame-retardants on common consumer products like electronics, plastics, and foam in furniture. They are also suspected to disrupt thyroid activity during pregnancy, which is a time of increased demand on the thyroid gland. Maternal thyroid fluctuations and disease as a result of exposure to PBDEs are therefore a concern. This systematic review aimed to capture all of the relevant peer-reviewed literature investigating the association between PBDEs and maternal thyroid activity. Use of the PRISMA checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), a best …

Les Conditions Pour Une Intégration Sécuritaire Au Métier : Un Regard Sur Le Secteur Minier Québécois, Élise Ledoux, Sylvie Beaugrand, Caroline Jolly, Sylvie Ouellet, Pierre-Sébastien Fournier

Rapports de recherche scientifique

Les questions de recrutement et d’intégration d’une nouvelle main-d’oeuvre sont au coeur des préoccupations des entreprises minières qui font face au départ à la retraite de la génération des bébé-boumeurs, à la mobilité de la main-d’oeuvre et à des périodes de croissances liées à l’effervescence du marché dans le secteur. C’est dans ce contexte qu’une demande a été formulée par l’Association paritaire pour la santé et la sécurité du travail du secteur minier (APSM) à un groupe de chercheurs pour documenter les conditions favorisant une intégration sécuritaire et compétente des nouveaux mineurs notamment celles aidant à la transmission des …

Knowledge And Behavior Change Of People Living With Hiv Through Nutrition Education And Counseling, Fitri Hudayani, Ratu Ayu Dewi Sartika

Kesmas

HIV, AIDS, dan gizi saling berhubungan. Pada Unit Pelayanan Terpadu HIV Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, layanan edukasi dan konseling gizi disediakan secara kolaboratif untuk orang yang hidup dengan HIV. Penelitian ini bertujuan untuk mengetahui pengaruh pendidikan dan konseling gizi terhadap pengetahuan dan perilaku orang yang hidup dengan HIV. Penelitian ini dilakukan dengan desain kuasi eksperimental menggunakan kelompok perlakuan dan kontrol. Kelompok perlakuan terdiri dari 25 sampel dan 29 sampel untuk kelompok kontrol, dilakukan sebelum dan setelah perlakuan. Sampel berusia dewasa antara 18 – 50 tahun dipilih dengan menerapkan kriteria inklusi dan eksklusi. Sampel uji-t berpasangan digunakan …

Cadmium Contamination In Farmland Soil And Water Near Zinc Mining Site, Kanitta Jiraungkoorskul, Sara Arphorn, Mathuros Tipayamongholgul, Wattasit Siriwong

Kesmas

Penelitian ini merupakan penelitian potong lintang yang dilakukan di Kecamatan Phatadpaeng, Kota Mae Sod, Provinsi Tak, Thailand. Penelitian ini bertujuan untuk mengetahui konsentrasi kadmium pada air dan tanah pertanian serta pada pemukiman petani dan rumah tangga. Konsentrasi kadmium pada 48 sampel tanah dan air pemukiman petani, 12 sampel rumah tangga, enam sampel tanah pertanian, dan delapan sampel air pertanian ditelusuri menggunakan Graphite Furnace Atomic Absorption Spectrophotometer. Uji Mann-Whitney U digunakan untuk analisis perbedaan konsentrasi kadmium antara tanah pertanian dan tanah pemukiman, air pertanian dan air pemukiman. Hasil penelitian menunjukkan tidak terdapat perbedaan secara statistik pada seluruh matriks, namun air dan …

Study On Clinical, Histopathological Features And Evaluation Results Of Skin Cancer Treatment In Can Tho Oncology Hospital, Nguyen Van Qui, Phan Nguyen Ngoc

Kesmas

Kanker kulit, diagnosis kanker paling umum, cenderung mengalami peningkatan. Kondisi ini secara khusus merupakan isu penting di negara-negara maju. Penelitian ini bertujuan untuk mendeskripsikan fitur klinis, fitur hispatologis, komplikasi dan hasil pengobatan bedah awal kanker kulit di Rumah Sakit Onkologi Can Tho dari tahun 2014 sampai 2015. Penelitian deskriptif prospektif ini melibatkan seluruh pasien dengan kanker kulit nonmelanoma yang diuji dan diobati di Rumah Sakit Onkologi Can Tho dari Juli 2014 sampai Maret 2015. Terdapat 78 kasus terpilih. Kanker kulit ditemukan lebih umum pada pasien yang lebih tua. Prevalensi karsinoma sel basal ditemukan lebih tinggi dibandingkan karsinoma sel skuamosa dengan …

Communication Of Parents, Sexual Content Intake And Teenage Sexual Behavior At Senior High School In Banjarmasin City, Rusmilawaty Rusmilawaty, Yuniarti Yuniarti, Tri Tunggal

Kesmas

Perilaku seks bebas di kalangan remaja Kota Banjarmasin belakangan ini semakin mengkhawatirkan para orangtua. Kurangnya pendidikan seksologi berdampak para remaja cenderung melakukan hubungan seksual pranikah yang akan berakibat pada kehamilan yang tidak diinginkan dan pernikahan dini. Komunikasi orangtua-anak dan paparan media baik media cetak maupun elektronik merupakan cara untuk mengurangi perilaku seksual berisiko. Tujuan penelitian ini untuk mengetahui hubungan komunikasi orangtua dan asupan muatan seksual dengan perilaku seksual remaja sekolah menengah atas (SMA) di Kota Banjarmasin. Untuk mencapai tujuan tersebut, penelitian survei analitik dengan pendekatan potong lintang dilakukan pada bulan Juli – Oktober 2015 di dua sekolah negeri dan satu …

Influence Of Household Environment And Maternal Behaviors To Upper Respiratory Infection Among Toddlers, Reny Fahdiyani, Ardini S. Raksanagara, Hadyana Sukandar

Kesmas

Infeksi saluran pernapasan akut atas (ISPA atas) di negara berkembang menyebabkan morbiditas tinggi pada anak bawah usia lima tahun (balita). Kementerian Kesehatan Republik Indonesia melaporkan bahwa ISPAnonpneumonia meningkat 2,6% dari tahun 2007 ke 2011. Faktor risiko yang dapat berkontribusi termasuk lingkungan dan perilaku. Penelitian ini bertujuan untuk menyelidiki faktor perilaku dan lingkungan dengan ISPA atas pada balita. Studi kasus kontrol ini dilakukan dari Februari-April 2015 pada balita di Tamansari yang merupakan daerah kumuh di Kota Bandung. Kasus adalah 55 ibu dengan balita menderita ISPA atas yang datang ke puskesmas, sedangkan kontrol dua kali lebih besar dari kasus dipilih dari lingkungan …

Predisposing Factors With Complementary Feeding Practices Among 9-11 Month-Old Infants In Jakarta Urban Slum Area, Septriana Septriana, Gita Ardelia Suhartono

Kesmas

Penyebab utama kekurangan gizi selain dari penyakit infeksi adalah pola asuh yang tidak sesuai dan pemberian makan yang optimal menjadi salah satu cara untuk mengatasi konsekuensi jangka panjang dari kekurangan zat gizi. Penelitian ini bertujuan untuk mengetahui hubungan antara faktor pendukung praktik pemberian makanan pendamping air susu ibu (MPASI) pada bayi usia 9 - 11 bulan di daerah kumuh perkotaan Jakarta. Penelitian potong lintang ini melibatkan 50 orang pengasuh bayi usia 9 – 11 bulan. Data dikumpulkan melalui wawancara menggunakan kuesioner. Tidak terdapat hubungan yang bermakna antara usia pengasuh dengan praktik pemberian makan (nilai p = 0,645). Demikian juga dengan …

Residential Density, Parents’ Sexual Activity And Teenage Sexual Behavior In Yogyakarta, Luluk Rosida, Evi Martha, Besral Besral

Kesmas

Pada daerah kumuh dan padat, orangtua sering terpaksa harus berbagi ruang tidur dengan anak-anaknya sehingga anak-anaknya sudah terpapar dengan aktivitas seksual sejak dini. Penelitian ini bertujuan mengetahui kepadatan hunian, aktivitas seksual orangtua, dan efeknya terhadap perilaku seksual remaja di Yogyakarta. Penelitian ini menggunakan desain potong lintang dengan mewawancarai 268 keluarga yang memiliki anak remaja yang dipilih secara acak di daerah kumuh perkotaan dan daerah pedesaan pada bulan Maret – Mei 2015. Analisis data dilakukan menggunakan uji kai kuadrat dan regresi-cox multivariat. Hasil penelitian ini menunjukkan bahwa orangtua yang tinggal di hunian padat memiliki risiko dua kali lebih besar untuk melakukan …

Effects Of Mothers’ Attitude As Breeders And Distance Of Stockyard Toward Diarrhea Incidence Among Toddlers, Yarmaliza Yarmaliza, Sugito Sugito, Teuku Reza Ferasyi, Nurliana Nurliana, Razali Razali

Kesmas

Diare merupakan penyakit dengan perubahan bentuk dan konsentrasi tinja yang melembek sampai mencair, dan bertambahnya frekuensi buang air besar lebih dari biasanya (tiga kali atau lebih dalam sehari). Di Provinsi Aceh, terdapat kasus diare sebanyak 48/1.000 kelahiran hidup pada 2013. Di Kabupaten Aceh Barat, pada tahun 2014 terdapat 1.071 kasus, sedangkan di Kecamatan Meureubo terdapat sebanyak 70 kasus pada anak bawah lima tahun (balita). Penelitian ini bertujuan untuk mengetahui hubungan sikap ibu sebagai peternak dan jarak kandang ternak terhadap kejadian diare pada balita di wilayah kerja Puskesmas Kecamatan Meureubo. Penelitian ini dilakukan secara potong lintang pada bulan Juli – September …

Chiropractors’ Perception Of Occupational Stress And Its Influencing Factors: A Qualitative Study Using Responses To Open-Ended Questions, Shawn Williams

Publications and Research

Background: Job stress and emotional exhaustion have been shown to have a negative impact on the helping professional. The development and causal relations of job stress and emotional exhaustion are rather unclear in the chiropractic profession. The objective of this study is to understand the main sources of occupational stress and emotional exhaustion among doctors of chiropractic.

Methods: Analysis of the written responses to web-based open-ended questionnaire was performed using an interpretive research methodology. Additionally, cross tabulation and Chi square statistical tests were conducted to match and couple the demographic data with the categorical themes.

Results: Fourteen professional stress categories …

Staphylococcus Aureus Nasal Carriage Among Beefpacking Workers In A Midwestern United States Slaughterhouse, Jessica Leibler, Jeanne A. Jordan, Kirsten Brownstein, Lina Lander, Lance B. Price, Melissa J. Perry

Environmental and Occupational Health Faculty Publications

Occupational contact with livestock is an established risk factor for exposure to livestock-associated methicillin-resistant Staphylococcus aureus (MRSA), particularly among industrial swine workers. While S. aureus is known to infect cattle, livestock-associated S. aureuscarriage among workers in the beef production chain has received limited attention. Beefpacking workers, who slaughter, butcher and process cattle, have intensified exposure to potentially infectious animal materials and may be at risk of livestock-associated S. aureusexposure. We conducted a cross-sectional study of beefpacking workers (n = 137) at an industrial slaughterhouse in the Midwestern United States to evaluate prevalence and characteristics of …

Ncrp Program Area Committee 7: Radiation Education, Risk Communication, Outreach, And Policy, S. M. Becker, P. A. Locke

Community & Environmental Health Faculty Publications

Recognizing the central importance of effective communication, education, and policy across all of the domains of radiation safety and radiation protection, the National Council on Radiation Protection and Measurements (NCRP) established a new committee in 2013. Program Area Committee 7 (PAC 7) was created to develop projects and provide guidance on Radiation Education, Risk Communication, Outreach, and Policy. After identifying individuals with relevant expertise who were willing to serve, the Committee held its inaugural meeting in 2014. In 2015, the Committee increased its membership and began carrying out an expanded program of activities. One area of activity has involved providing …

Aiha White Paper: Electronic Cigarettes In The Indoor Environment, Cheri Marcham

Publications

This presentation covers the effects of different volatile organic compounds released by electronic cigarettes which can cause health problems. More research on the effects of electronic "smoke" should be conducted on the generally recognized as safe (GRAS) ingredients in electronic cigarette exhaust.

Effets De La Posture De Travail Sur Les Patrons Musculaires De La Région Lombaire Lors D’Une Tâche Répétitive, Julie Côté, David Antle, Kim Emery, Suzy Ngomo

Rapports de recherche scientifique

En Amérique du Nord, la posture debout prolongée est largement utilisée dans les entreprises, alors que dans d’autres régions du monde, le travail s’effectue plutôt à partir de la position assise. Le travail en station debout prolongée a déjà été associé à divers symptômes comme la douleur lombaire et la fatigue généralisée. Des études récentes ont démontré une association entre la douleur lombaire en posture debout prolongée et des patrons de coactivation (activation coordonnée de paires de muscles) des muscles de la région lombo-pelvienne. Cependant, ces patrons n’ont jamais été mesurés pour d’autres postures de travail, ou lorsque la posture …

Recent Fast Food Consumption And Bisphenol A And Phthalates Exposures Among The U.S. Population In Nhanes, 2003-2010, Ami R. Zota, Cassandra Phillips, Susanna D. Mitro

Environmental and Occupational Health Faculty Publications

Background: Phthalates and bisphenol A (BPA) are widely used industrial chemicals that may adversely impact human health. Human exposure is ubiquitous and can occur through diet, including consumption of processed or packaged food.

Objective: To examine associations between recent fast food intake and BPA and urinary metabolites of di(2-ethylhexyl) phthalate (ΣDEHPm) and diisononyl phthalate (DiNPm) among the US population.

Methods: We combined data on 8877 participants from the National Health and Nutrition Examination Survey (NHANES 2003-2010). Using 24-hour dietary recall data, we quantified: 1) fast food intake (percent of total energy intake (TEI) from fast food); 2) fast food-derived fat …

Pesticide Exposure In The Caribbean: A Case From Nutmeg Processing, Muge Akpinar-Elci, My Ngoc Thuy Nguyen, Satesh Bidaisee, Omur Cinai Elci

Community & Environmental Health Faculty Publications

Many developed countries around the world have implemented regulations to phase out or greatly restrict the use of pesticides. Pesticides are still utilized with minimal restrictions, however, in fumigating agricultural commodities in developing countries such as Grenada. This special report presents the case of a nutmeg factory worker in Grenada who worked with various pesticides including methyl bromide, magnesium phosphide (magtoxin), and aluminum phosphide (phostoxin) without the proper awareness and utilization of health and safety measures. The nutmeg factory worker later developed metastatic bladder cancer, which may have been triggered by a combination of individual risk factors along with long-term …