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A prospective examination of disease management program use by complex cardiac outpatients.

https://arctichealth.org/en/permalink/ahliterature126092
Source
Can J Cardiol. 2012 Jul-Aug;28(4):490-6
Publication Type
Article
Author
Shannon Gravely
Robert D Reid
Paul Oh
Heather Ross
Donna E Stewart
Sherry L Grace
Author Affiliation
York University, Toronto, Ontario, Canada.
Source
Can J Cardiol. 2012 Jul-Aug;28(4):490-6
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - rehabilitation
Aged
Ambulatory Care - utilization
Angioplasty, Balloon, Coronary - rehabilitation
Cardiac Valve Annuloplasty - rehabilitation
Cohort Studies
Comorbidity
Coronary Artery Bypass - rehabilitation
Coronary Disease - epidemiology - rehabilitation
Disease Management
Female
Follow-Up Studies
Heart Failure - epidemiology - rehabilitation
Heart Valve Prosthesis Implantation - rehabilitation
Humans
Male
Middle Aged
Ontario
Prospective Studies
Referral and Consultation - statistics & numerical data
Treatment Outcome
Abstract
The use of disease management programs (DMPs) by patients with cardiovascular disease (CVD) is associated with improved outcomes. Although rates of cardiac rehabilitation (CR) use are well established, less is known about other DMPs. The objectives of this study were to describe the degree of DMP utilization by CVD outpatients, and examine factors related to use.
This study represents a secondary analysis of a larger prospective cohort study. In hospital, 2635 CVD inpatients from 11 hospitals in Ontario Canada completed a survey that assessed factors affecting DMP utilization. One year later, 1803 participants completed a mailed survey that assessed DMP utilization.
One thousand seventy-three (59.5%) participants reported using at least 1 DMP. Overall, 951 (52.7%) reported participating in cardiac rehabilitation, and among participants with a comorbid indication, 212 (41.2%) reported attending a diabetes education centre, 28 (25.9%) attended stroke rehabilitation, 35 (12.9%) used a heart failure clinic, and 13 (11.7%) attended a smoking cessation program. A multinomial logistic regression analysis showed that compared with no DMP use, participants that attended 1 or multiple programs were younger, married, diagnosed with a myocardial infarction, less likely to have had a percutaneous coronary intervention and had higher perceptions of personal control over their heart condition. There were few differences between participants that used 1 vs multiple DMPs, however, having diabetes or comorbid stroke significantly increased the likelihood of multiple DMP use.
Approximately 40% of CVD outpatients do not access DMPs. An integrated approach to vascular disease management appears warranted.
PubMed ID
22424663 View in PubMed
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Discrete choice experiment produced estimates of acceptable risks of therapeutic options in cancer patients with febrile neutropenia.

https://arctichealth.org/en/permalink/ahliterature126093
Source
J Clin Epidemiol. 2012 Jun;65(6):627-34
Publication Type
Article
Date
Jun-2012
Author
Lillian Sung
Shabbir M Alibhai
Marie-Chantal Ethier
Oliver Teuffel
Sylvia Cheng
David Fisman
Dean A Regier
Author Affiliation
Department of Pediatrics, Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. lillian.sung@sickkids.ca
Source
J Clin Epidemiol. 2012 Jun;65(6):627-34
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Administration, Oral
Adolescent
Adult
Aged
Algorithms
Ambulatory Care - statistics & numerical data
Anti-Bacterial Agents - administration & dosage
Antineoplastic Agents - administration & dosage - adverse effects
Child
Choice Behavior
Female
Fever - drug therapy
Follow-Up Studies
Humans
Infusions, Parenteral
Inpatients - statistics & numerical data
Male
Middle Aged
Neoplasms - drug therapy - mortality
Neutropenia - chemically induced - drug therapy - mortality
Ontario - epidemiology
Parents - psychology
Patient Preference - psychology
Questionnaires
Retrospective Studies
Risk assessment
Abstract
To use a discrete choice experiment (DCE) to describe patient/proxy tolerance for the number of clinic visits, and chances of readmission, intensive care unit admission, and mortality to accept oral outpatient management of low-risk febrile neutropenia.
Adults and children aged 12-18 years with cancer and parents of pediatric cancer patients were asked to choose between outpatient oral and inpatient intravenous management of low-risk febrile neutropenia. Using a DCE, we varied the attribute levels with the outpatient option and kept them constant for the inpatient option.
Seventy-eight adults, 153 parents, and 43 children provided responses. All four attributes significantly affected choices. The mean tolerance (95% confidence interval) for the number of clinic visits per week was 3.6 (2.2-4.8), 2.1 (1.1-3.2), and 4.3 (2.5-6.0) to accept outpatient management among adults, parents, and children, respectively. With thrice weekly clinic visits and 7.5% chance of readmission, probabilities of accepting the outpatient strategy were 50% (44-54%) for adults, 43% (39-48%) for parents, and 53% (46-59%) for children.
Using a DCE, we determined that a 7.5% chance of readmission and clinic visits more frequently than thrice weekly are unlikely to be acceptable.
PubMed ID
22424607 View in PubMed
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Pain coping in injured workers with chronic pain: what's unique about workers?

https://arctichealth.org/en/permalink/ahliterature126094
Source
Disabil Rehabil. 2012;34(21):1774-82
Publication Type
Article
Date
2012
Author
Leah A Phillips
Linda J Carroll
Donald C Voaklander
Douglas P Gross
Jeremy R Beach
Author Affiliation
Department of Public Health, Concordia University College of Alberta, Edmonton, Alberta, Canada. leah.phillips@concordia.ab.ca
Source
Disabil Rehabil. 2012;34(21):1774-82
Date
2012
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Age Factors
Alberta
Catastrophization
Chronic Pain - psychology - rehabilitation
Cross-Sectional Studies
Depression - psychology
Disability Evaluation
Female
Humans
Male
Middle Aged
Multivariate Analysis
Occupational Injuries - psychology - rehabilitation
Self Concept
Sick Leave
Socioeconomic Factors
Work
Young Adult
Abstract
Pain caused by a work injury is a complex phenomenon comprising multiple factors, e.g. age, gender, prior health status, occupation, job demands, and severity of injury. Little research has focused on injured workers with chronic pain. This study investigates injured workers' pain coping.
A descriptive cross-sectional study design was used to measure coping strategies of injured workers in a work rehabilitation program. Differences in coping strategies by demographics, injury-related variables, pain, disability, and depression were measured.
n = 479. The coping strategy with the highest mean score was "coping self statements" (Mean?=?19.4, SD?=?7.6), followed by "praying/hoping" (Mean?=?18.2, SD?=?9.7), and "catastrophizing" (Mean?=?17.5, SD?=?8.0). Statistical differences for coping strategies were noted between gender, marital status, depression levels, self-perceived disability levels, and pain (p
PubMed ID
22424583 View in PubMed
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Cultural practices and medical beliefs in pre-revolutionary Russia compared to modern textbook advice: did Russian women breastfeed the "wrong" way?

https://arctichealth.org/en/permalink/ahliterature126095
Source
Breastfeed Med. 2012 Dec;7(6):514-20
Publication Type
Article
Date
Dec-2012
Author
Natalie Gerbeda-Wilson
Nancy G Powers
Author Affiliation
Wichita State University, Wichita, Kansas, USA. nvwilson@gmail.com
Source
Breastfeed Med. 2012 Dec;7(6):514-20
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Anthropology, Cultural
Breast Diseases - history - therapy
Breast Feeding - history - methods
Female
History, 19th Century
History, 20th Century
History, 21st Century
Humans
Infant Food
Infant, Newborn
Medicine, Traditional
Russia
Social Change
Time Factors
Weaning
Abstract
Historical accounts of infant feeding practices can inform our understanding of current-day practices and the ways in which cultural traditions are incorporated into infant care. Pre-revolutionary Russian feeding practices have not previously been summarized, to our knowledge. The purpose of this study is to collect information about pre-revolutionary feeding practices. We may then be able to better understand the motivation for suboptimal practices and tailor feeding messages to the specific population.
Materials were collected from libraries and from the Internet regarding medical, demographic, and ethnographic literature of the 19(th) century and early 21(st) century, primarily in Russian.
Breastfeeding was pervasive in pre-revolutionary Russia, but suboptimal patterns such as withholding colostrum and early introduction of other foods and liquids were common. Breast problems were treated with folk remedies and comfort measures, some of which are similar to modern-day treatments. Around 1906, child rearing and infant feeding recommendations were subsumed by male physicians espousing the "scientific approach."
Many of these medical recommendations were detrimental to the previously successful breastfeeding practices that, despite barriers, had allowed Russian women to continue breastfeeding for 2 years or longer.
PubMed ID
22424467 View in PubMed
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Delayed management of giant omphalocele using silver sulfadiazine cream: an 18-year experience.

https://arctichealth.org/en/permalink/ahliterature126096
Source
J Pediatr Surg. 2012 Mar;47(3):494-500
Publication Type
Article
Date
Mar-2012
Author
Sigmund H Ein
Jacob C Langer
Author Affiliation
Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8. a_ein@istar.ca
Source
J Pediatr Surg. 2012 Mar;47(3):494-500
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Administration, Topical
Anti-Infective Agents, Local - economics - therapeutic use
Child
Child, Preschool
Drug Costs
Female
Hernia, Umbilical - complications - drug therapy - mortality - surgery
Herniorrhaphy
Humans
Infant
Infant, Newborn
Male
Ointments
Ontario
Retrospective Studies
Silver Sulfadiazine - economics - therapeutic use
Treatment Outcome
Abstract
To assess the value of topical silver sulfadiazine (SSD) cream in the treatment of babies with a giant omphalocele.
From 1991 to 2008 inclusive, 20 infants with giant omphalocele (defined as >10 cm diameter) were treated with SSD, leaving a large ventral hernia to be repaired at a later date.
There were 12 boys and 8 girls. Thirteen had prenatal ultrasound diagnosis at a mean gestational age of 23 weeks. The mean gestational age at delivery was 37 weeks, and mean birth weight was 2.5 kg. Nineteen had other anomalies and/or medical problems, 18 of them multiple. The most common was pulmonary hypoplasia (70%). Mechanical ventilation and/or oxygen treatment was required in 15 (75%) for a mean of 10 weeks. SSD was used as primary sac treatment in 5 and secondary treatment in 15 (after Silon pouch 11, Op-site 3, povidone-iodine 1). Six omphalocele sacs were ruptured within the first 5 days of life. SSD was used for a mean of 6 months at a cost of $1 per day. Complications included 2 instances of staphylococcal sepsis and 1 jejunal perforation inside a Silon pouch. Six (30%) died from pulmonary hypoplasia at a mean age of 18 weeks. There were 14 (70%) survivors who went home after a mean of 14 weeks. Of the 14 survivors, 12 had ventral hernias repaired (18 operations with 2 recurrences), and 2 remain with their original ventral hernia.
Initial topical coverage with SSD is associated with excellent outcomes for infants with giant omphalocele who cannot undergo immediate closure.
PubMed ID
22424344 View in PubMed
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Management of pediatric splenic injuries in Canada.

https://arctichealth.org/en/permalink/ahliterature126097
Source
J Pediatr Surg. 2012 Mar;47(3):473-6
Publication Type
Article
Date
Mar-2012
Author
Lindsay A McDonald
Natalie L Yanchar
Author Affiliation
Department of Surgery, Dalhousie University, Halifax, NS, Canada. lamcdona@dal.ca
Source
J Pediatr Surg. 2012 Mar;47(3):473-6
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Blood Transfusion - statistics & numerical data
Canada
Child
Child, Preschool
Female
Hospitals, Pediatric
Humans
Intensive Care Units - statistics & numerical data
Length of Stay - statistics & numerical data
Logistic Models
Male
Multivariate Analysis
Outcome and Process Assessment (Health Care)
Patient Admission - statistics & numerical data
Spleen - injuries
Splenectomy - statistics & numerical data
Wounds, Nonpenetrating - therapy
Abstract
Nonoperative management (NOM) of blunt splenic injuries has become the standard of care in hemodynamically stable children. This study compares the management of these injuries between pediatric and nonpediatric hospitals in Canada.
Data were obtained from the Canadian Institute of Health Information trauma database on all patients aged 2 to 16 years, admitted to a Canadian hospital with a diagnosis of splenic injury between May 2002 and April 2004. Variables included age, sex, associated major injuries, splenic procedures, intensive care unit (ICU) admissions, blood transfusions, and length of stay. Hospitals were coded as pediatric or nonpediatric. Univariate analysis and logistic regression were used to determine associations between hospital type and outcomes.
Of 1284 cases, 654 were managed at pediatric hospitals and 630 at nonpediatric centers. Patients at pediatric centers tended to be younger and more likely to have associated major injuries. Controlling for covariates, including associated major injuries, patients managed at pediatric centers were less likely to undergo splenectomy compared with those managed at nonpediatric centers (odds ratio [OR], 0.2; 95% confidence interval, 0.1-0.4). The risk of receiving blood products, admission to the ICU, and staying in hospital for more than 5 days was associated only with having associated major injuries.
Even in the presence of other major injuries, successful NOM of blunt splenic injuries occurs more frequently in pediatric hospitals in Canada. This has policy relevance regarding education of adult surgeons about the appropriateness of NOM in children and developing guidelines on appropriate regional triaging of pediatric patients with splenic injury in Canada.
PubMed ID
22424340 View in PubMed
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Effects of alcohol retail privatization on excessive alcohol consumption and related harms: a community guide systematic review.

https://arctichealth.org/en/permalink/ahliterature126098
Source
Am J Prev Med. 2012 Apr;42(4):418-27
Publication Type
Article
Date
Apr-2012
Author
Robert A Hahn
Jennifer Cook Middleton
Randy Elder
Robert Brewer
Jonathan Fielding
Timothy S Naimi
Traci L Toomey
Sajal Chattopadhyay
Briana Lawrence
Carla Alexia Campbell
Author Affiliation
Community Guide Branch, Epidemiology and Analysis Program Office, CDC, Atlanta, Georgia 30333, USA. rhahn@cdc.gov
Source
Am J Prev Med. 2012 Apr;42(4):418-27
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Alcohol Drinking - economics - epidemiology - legislation & jurisprudence
Alcohol-Related Disorders - epidemiology - prevention & control
Alcoholic Beverages - economics - supply & distribution
Commerce - legislation & jurisprudence
Finland - epidemiology
Humans
Privatization
Sweden - epidemiology
Abstract
Excessive alcohol consumption is the third-leading cause of preventable death in the U.S. This systematic review is one in a series exploring effectiveness of interventions to reduce alcohol-related harms.
The focus of this review was on studies evaluating the effects of the privatization of alcohol retail sales on excessive alcohol consumption and related harms. Using Community Guide methods for conducting systematic reviews, a systematic search was conducted in multiple databases up to December 2010. Reference lists of acquired articles and review papers were also scanned for additional studies.
A total of 17 studies assessed the impact of privatizing retail alcohol sales on the per capita alcohol consumption, a well-established proxy for excessive alcohol consumption; 9 of these studies also examined the effects of privatization on the per capita consumption of alcoholic beverages that were not privatized. One cohort study in Finland assessed the impact of privatizing the sales of medium-strength beer (MSB) on self-reported alcohol consumption. One study in Sweden assessed the impact of re-monopolizing the sale of MSB on alcohol-related harms. Across the 17 studies, there was a 44.4% median increase in the per capita sales of privatized beverages in locations that privatized retail alcohol sales (interquartile interval: 4.5% to 122.5%). During the same time period, sales of nonprivatized alcoholic beverages decreased by a median of 2.2% (interquartile interval: -6.6% to -0.1%). Privatizing the sale of MSB in Finland was associated with a mean increase in alcohol consumption of 1.7 liters of pure alcohol per person per year. Re-monopolization of the sale of MSB in Sweden was associated with a general reduction in alcohol-related harms.
According to Community Guide rules of evidence, there is strong evidence that privatization of retail alcohol sales leads to increases in excessive alcohol consumption.
Notes
Comment In: Am J Prev Med. 2012 Apr;42(4):430-222424258
PubMed ID
22424256 View in PubMed
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Age at menarche and current substance use among Canadian adolescent girls: results of a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature126099
Source
BMC Public Health. 2012;12:195
Publication Type
Article
Date
2012
Author
Ban Al-Sahab
Chris I Ardern
Mazen J Hamadeh
Hala Tamim
Author Affiliation
Kinesiology & Health Science, York University, Ontario, Canada. bsahab@yorku.ca
Source
BMC Public Health. 2012;12:195
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Age of Onset
Alcohol Drinking - epidemiology - psychology
Canada - epidemiology
Cross-Sectional Studies
Educational Status
Father-Child Relations
Female
Health Knowledge, Attitudes, Practice
Humans
Logistic Models
Longitudinal Studies
Menarche - physiology - psychology
Prevalence
Questionnaires
Sampling Studies
Self Report
Smoking - epidemiology - psychology
Substance-Related Disorders - epidemiology - psychology
Abstract
Substance use is among the key public health threats that find its genesis during adolescence. Timing of puberty has been lately researched as a potential predictor of subsequent substance abuse. The present study, therefore, aims to assess the effect of age at menarche on current practices of smoking, alcohol drinking and drug use among 14-15 year old Canadian girls.
The analysis of the study was based on all female respondents aged 14 to 15 years during Cycle 4 (2000/2001) of the National Longitudinal Survey of Children & Youth (NLSCY). The main independent variable was age at menarche assessed as the month and year of the occurrence of the first menstrual cycle. The dependent variables were current smoking, heavy alcohol drinking in the past 12 months and drug use in the past 12 months. Three logistic regression models were performed to investigate the association between age at menarche and each of the substance use outcomes, adjusting for possible confounders. Bootstrapping was performed to account for the complex sampling design.
The total weighted sample included in the analysis represented 295,042 Canadian girls. The prevalence of current smokers, heavy drinkers (drunk in the past 12 months) and drug users in the past 12 months was approximately 22%, 38% and 26%, respectively. After adjusting of all potential confounders, no association was found between age at menarche and any of the substance use outcomes. School performance and relationship with the father, however, stood out as the main variables to be associated with smoking, heavy drinking and drug use.
Qualitative studies understanding the social and psychological changes experienced by early maturing Canadian adolescents are warranted to identify other correlates or pathways to substance use in this higher risk population.
Notes
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PubMed ID
22424106 View in PubMed
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Exploring therapeutic alliance with an internet-based self-management program with brief telephone support for youth with arthritis: a pilot study.

https://arctichealth.org/en/permalink/ahliterature126100
Source
Telemed J E Health. 2012 May;18(4):271-6
Publication Type
Article
Date
May-2012
Author
Meghan White
Jennifer N Stinson
Patricia Lingley-Pottie
Patrick J McGrath
Navreet Gill
Abi Vijenthira
Author Affiliation
Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada. meghan.white@sickkids.ca
Source
Telemed J E Health. 2012 May;18(4):271-6
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Arthritis, Juvenile
Canada
Child
Female
Health Status Indicators
Humans
Internet - instrumentation - organization & administration
Male
Pilot Projects
Program Development
Program Evaluation
Questionnaires
Self Care - instrumentation - methods
Statistics as Topic
Telemedicine - instrumentation - methods - organization & administration
Telephone
Abstract
Findings from a pilot study are presented exploring therapeutic alliance between adolescent juvenile idiopathic arthritis patients and a trained nonprofessional health coach during the feasibility testing of a 12-week self-management program delivered online with brief telephone support. Therapeutic alliance was measured using the Working Alliance Inventory Client Scale (WAI-C), and qualitative information about the experience was gathered using the Distance Experience Questionnaire. WAI-C scores were found to be comparable to previously published pediatric face-to-face data and pediatric distance treatment data. Therapeutic alliance scores were also found to be correlated with improved treatment outcomes (decreased reported pain).
PubMed ID
22424081 View in PubMed
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Migrant tuberculosis: the extent of transmission in a low burden country.

https://arctichealth.org/en/permalink/ahliterature126101
Source
BMC Infect Dis. 2012;12:60
Publication Type
Article
Date
2012
Author
Zaza Kamper-Jørgensen
Aase Bengaard Andersen
Axel Kok-Jensen
Mads Kamper-Jørgensen
Ib Christian Bygbjerg
Peter Henrik Andersen
Vibeke Ostergaard Thomsen
Troels Lillebaek
Author Affiliation
International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark. zazakj@me.com
Source
BMC Infect Dis. 2012;12:60
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cluster analysis
DNA Transposable Elements
Denmark - epidemiology
Disease Transmission, Infectious
Female
Genotype
Humans
Male
Middle Aged
Molecular Epidemiology
Molecular Typing
Mycobacterium tuberculosis - classification - genetics - isolation & purification
Polymorphism, Restriction Fragment Length
Transients and Migrants
Tuberculosis - epidemiology - transmission
Abstract
Human migration caused by political unrest, wars and poverty is a major topic in international health. Infectious diseases like tuberculosis follow their host, with potential impact on both the migrants and the population in the recipient countries. In this study, we evaluate Mycobacterium tuberculosis transmission between the national population and migrants in Denmark.
Register study based on IS6110-RFLP results from nationwide genotyping of tuberculosis cases during 1992 through 2004. Cases with 100% identical genotypes were defined as clustered and part of a transmission chain. Origin of clusters involving both Danes and migrants was defined as Danish/migrant/uncertain. Subsequently, the proportion of cases likely infected by the "opposite" ethnic group was estimated.
4,631 cases were included, representing 99% of culture confirmed cases during 1992 through 2004. Migrants contributed 61.6% of cases. Up to 7.9% (95% CI 7.0-8.9) of migrants were infected by Danes. The corresponding figure was 5.8% (95% CI 4.8-7.0) for Danes. Thus, transmission from Danes to migrants occurred up to 2.5 (95% CI 1.8-3.5) times more frequent than vice versa (OR = 1). A dominant strain, Cluster-2, was almost exclusively found in Danes, particular younger-middle-aged males.
Transmission between Danes and migrants is limited, and risk of being infected by the "opposite" ethnic group is highest for migrants. TB-control efforts should focus on continues micro-epidemics, e.g. with Cluster-2 in Danes, prevention of reactivation TB in high-risk migrants, and outbreaks in socially marginalized migrants, such as Somalis and Greenlanders. Fears that TB in migrants poses a threat for resident Danes seem exaggerated and unjustified. We believe this to be true for other low incidence countries as well.
Notes
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PubMed ID
22423983 View in PubMed
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299180 records – page 1 of 29918.