Health-and-Fitness online information.

The nation, Army and Army Medical Department (AMEDD) are at war; therefore, the mission of every soldier and civilian is to stay focused on the soldier who is protecting the country in this global war on terrorism. Everything the Army does around the world must be focused on and in support of this war effort.

The imperatives that define the AMEDD are quality, empowerment, discipline and service. All that we do and how we do it can be expressed as a function of these imperatives.

Quality simply means that, whatever we do, we do it to the best of our abilities. The AMEDD's dedication to quality has paid benefits on the battlefield. During Operation Desert Storm, 22 percent of all battle casualties did not survive their wounds. In Operation Iraqi Freedom, less than 10 percent of wounded servicemembers have died of their wounds.

In addition, improved disease prevention and environmental surveillance has cut the disease rate to the lowest level of any U.S. war.

Beyond that, medical professionals in our garrison hospitals work hard every day to provide medical care of the highest quality.

All Army hospitals are accredited by the Joint Commission on Accreditation of Healthcare Organizations. Monitoring by the National Quality Management Program indicates that the quality of care received in Army health-care facilities consistently meets, and often exceeds, civilian benchmarks.

Graduates of Army residency and fellowship programs pass their board certification tests on the first try at a rate of 96 percent, well above the national average. Approximately 93 percent of Army physicians eligible for specialty board certification are certified.

Emergency medicine residents at Fort Hood, Texas, and Fort Lewis, Wash., tied for the highest score in the nation on annual in-service examinations. This was the fifth straight year Fort Hood's residents have led the nation on this test, taken by residents in more than 120 graduate medical education programs around the country.

Brooke Army Medical Center at Fort Sam Houston, Texas, and the Army Trauma Training Center in Miami, FIa., were among five military medical organizations recognized by the Department of Defense with patient safety awards in 2004.

I cannot list all the individuals who have been recognized for outstanding work, but let me mention one accomplishment of which I am proud. AUSA established the Sgt. Maj. Larry Strickland Education Leadership Award in 2003 to recognize a senior noncommissioned officer who shapes future leaders through education. Through the first two years of this award the winners have been members of the AMEDD-Sgt. Maj. Stephen E. Spadaro of Dental Command in 2003 and Sgt. Maj. David Litteral of the AMEDD Center and School last year.

Empowerment means giving subordinates a mission and resources-time, people, money, space and more-and then holding those empowered accountable for their performance. In a worldwide medical organization at war, empowerment is necessary to accomplish what must be done.

One of the great successes in current combat operations has been the AMEDD's initiative to push health-care resources closer to the front lines and the point of injury. This is reflected in the advanced skills of the 91W combat medics, in the use of forward surgical teams in advance of the combat support hospitals, in extensive training of combat lifesavers and this year's expansion of first-aid skills among the common tasks taught to all soldiers. We are giving people at the initial point of action the skills to deal with problems immediately, and lives are being saved as a result.

The philosophy of empowerment follows a similar dynamic: just as medical care closer to the front saves lives, so decision-making authority close to the point of action can make units more effective and save time, money and other resources.

As Gen. George S. Patton said, "Never tell people how to do things. Tell them what to do and they will surprise you with their ingenuity."

Medical organizations are showing ingenuity and taking initiative to meet the challenges they face. Here are a few examples: At Fort Stewart, Ga., where thousands of Army Reserve and National Guard soldiers mobilize for deployment, the hospital created a department of mobilization medical services. It supervises the medical soldier readiness processing (SRP) service, operates a fulltime troop medical clinic for the National Guard training area, and provides same-day consultation to the SRP site and primary care for more than 700 medical holdover soldiers. This led to quick evaluations and dispositions for mobilized soldiers.

At Fort Bragg, N.C., the 82nd Airborne Division uses a forward-deployed mobile training team to bring combat medics up to speed on 91W medical skills. With all three of the division's brigade combat teams deployed, the team provided military occupational specialty qualifying training to 300 91Ws, gave 180 91Ws emergency medical technician refresher training and conducted combat lifesaver training.

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For most of her adult life, Phyllis Ingram of Barto, PA, was too busy raising her two children to even think about her own health. Consequently, by the time she turned 52, she carted an unhealthy 225 pounds around on her 5'6" frame. Just walking up the 12 steps in her house left her gasping for breath, and she suffered daily with a multitude of annoying aches and pains.

Today, Ms. Ingram is 50 pounds lighter and her body is rock solid with muscle. She rides hundreds of miles a year on her road bike (sometimes nearly 100 miles in a weekend) and is training for a cross-country bike ride sometime next year.

Ms. Ingram is a convert, convinced of the power of exercise and physical activity, determined never to return to the world of the unfit. "I find I get grouchy if I don't get my exercise in," she says.

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SYRACUSE - Fitness Forum Services, LLC - a fast-growing, Syracuse-based operator of outpatient physical therapy and health-and-wellness centers, - has expanded its operations in the Mohawk Valley and Maryland. A $5.5 million expansion has increased the company's employment and geographic footprint, says James Howard Smith, chief executive officer of Fitness Forum.

The financing, provided by HSBC Capital Markets with support from Steve Mitchell at HSBC's Syracuse office, allowed Fitness Forum to buy out its partners in the Mohawk Valley market, purchase four locations in Maryland, and add aquatic-therapy equipment to its Fishkill, Onondaga Hill, and Liverpool-area locations.

Fitness Forum had operated locations in Camden, Herkimer, Rome, and Barneveld in conjunction with Network Rehab, LLC. Network Rehab was a joint venture of Fitness Forum and Mohawk Valley Network, Inc., a group composed of hospitals in Oneida and Herkimer counties. The buyout transaction closed Dec. 31.

Fitness Forum purchased the four Maryland locations from Aquacare Rehabilitation Services on Feb. 9. The Maryland acquisitions give Fitness Forum six locations in that state.

Next month Fitness Forum will open a 4,000-square-foot, physical-therapy facility at the North Medical Center in the Town of Clay.

Founded in 1989, Fitness Forum now operates 35 locations in six states: Massachusetts, Connecticut, New York, Delaware, Maryland, and Georgia. Smith says the firm's employment, which was 204 on Jan. 1, 2004, is expected to reach 317 as of March 1.

The expansion project had been in the works for several months, Smith adds. He declined to provide financing or acquisition terms.

Fitness Forum provides physical therapy and services such as sports medicine, occupational medicine, preventive pro:grams, and wellness services. Though the name may imply a health club, Smith says Fitness Forum has a broad approach to fitness.

"We provide fitness and wellness," says Smith. "Repairing a problem won't do any good if the person goes right out and gets injured again."

Smith, who founded the firm 16 years ago, has worked in the fitness business since 1981.

Fitness Forum had annual revenues of approximately $16 million before the expansion. Smith estimates the acquisitions will add $6 million to Fitness Forum's annual revenue. After the latest projects are complete and stabilized, Fitness Forum plans to grow again through in-market expansion and by entering new markets.

"We're going to stop and transition," Smith explains. "And then we're definitely going to grow again."

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Congratulations! You're having a baby. But before you kick back with the potato chips and triple-dip sundaes and slump into couch potato mode for the next nine months, consider this: Staying active during pregnancy prepares your body for the rigors of childbirth by strengthening muscles, increasing flexibility and building endurance.

Studies even suggest that women who perform regular aerobic activity have shorter labors and fewer Caesarean sections. And the benefits of physical fitness extend beyond the delivery room. Exercise can help pregnant women sleep better, decrease fatigue and prevent constipation. It also controls weight gain during pregnancy and helps you get back into shape afterward.

If you're an expectant mom, the following tips will keep your body in prime prenatal condition. Check with your doctor before starting any workout regimen. After all, you're exercising for two.

* Move daily. Mommies-to-be can engage in most exercises with few worries. Once your doctor gives you the green light, move as much as you can. The American College of Obstetrics and Gynecology recommends 30 minutes or more of moderate-intensity activity each day.

* Warm up to fitness. Warming up muscles and joints prepares your body for exercise and prevents strains and injuries. Begin your workout with a few minutes of light stretching or exercising at a light pace.

* Keep it fresh. Stay psyched for fitness by linking exercise with a fun pastime. Walking is one of the best cardiovascular exercises for pregnant women since it's easy on joints and muscles. Swimming also is ideal because it provides a total-body workout and the weightless effect of the water makes it easier to move with extra pounds. Yoga and stretching maintain muscle tone and flexibility and lull your body into a state of relaxation, while dancing and low-impact aerobics get that positive energy pumping.

* Exercise caution. Avoid any activities that could make you slip or fall, risking injury to your abdomen. No bicycling, roller-blading, horse-back riding, break dancing or contact sports like football and basketball. After your first trimester, avoid lying on your back to exercise, which can make you dizzy. Drink plenty of water before, during and after your workout to avoid dehydration and skip outdoor activities in hot and humid weather, otherwise you risk overheating and harming the baby.

* Go for gain without pain. Ideal exercise gets you in shape without putting excessive stress on you or your baby, so don't push yourself to the limit. If you can't comfortably carry on a conversation, slow down and ease up. If you experience pain, dizziness, shortness of breath, severe headache, vaginal bleeding or contractions during your workout, stop immediately and contact your doctor.

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`I never considered it a disadvantage to be a Black woman. I never wanted to be anything else. We have brains. We are beautiful. We can do anything we set our minds to do.'

--Diana Ross, Black Women: In the Image of God (Pilgrim Press), edited by Dorothy Winbush Riley

HEALTH UPDATE

fitness on the fly

Between stuffing the stockings and decking the halls, fitting in your regular workout this month is bound to be difficult. But there are shortcuts to keeping fit while hustling around for holiday preparations: At the gym, opt for a 30-minute circuit-training session instead of spending an hour in aerobics class. When shopping, park a little farther from the mall entrance and walk briskly while inside--you can easily cover a mile or more on a typical trip. Taking the stairs at the office or elsewhere will strengthen and tone your legs and glutes. Take stretch breaks while you're secretly gift wrapping in the basement. Need a cardio kick? Just five minutes of moderate rope jumping can burn 50 calories. Or give your man or kid a break from shoveling the snow and knock off 180 calories in 30 minutes.

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The purpose of this paper by Gina Campion and Valerie Francis et al is to examine the health behaviours, health beliefs, and motivation to change in people with severe mental illness (SMI). A sample of people with SMI (n=43) and a control group (n=39) was recruited. All participants completed the Reported Health Behaviours Checklist (Prochaska et al, 1985). Half of the sample answered additional smoking related questions based on the Stages of Change model (Di Clemente et al, 1991) and half answered physical activity related questions based on Becker's (1974) Health Belief Model. The SMI sample was found to engage less often in health behaviours than controls. Significantly more of the SMI sample were in the early stages of change in relation to smoking and were found to be less intrinsically motivated to engage in regular physical activity than controls. This sample of people with SMI engaged in fewer health behaviours; did not consider themselves at risk of physical health problems and were not motivated to change their unhealthy lifestyles. Attention is drawn to the usefulness of theoretical models from health psychology in furthering research amongst this vulnerable patient sample

There is a growing body of research evidence to show that people with severe mental illness (SMI) have elevated risks for both physical morbidity and premature mortality (Dixon et al, 1999). There is also evidence that care staff and patients tend to overlook physical healthcare needs (Brugha, Wing and Smith, 1989) and health professionals have been urged to pay greater attention to the physical health of people with SMI. Of the various factors that have been proposed to account for the excess risk, suicide is usually presented as the single largest cause of preventable death. However, suicide accounts for only about one third of the excess risk (Brown, Inskip and Barraclough, 2000) and recent data concludes that lifestyle behaviours play a significant role. Smoking, physical inactivity and poor nutrition, which have been shown to significantly increase the risk of life threatening diseases, are more prevalent in those with SMI such as schizophrenia (Brown et al., 1999; Farnam et al, 1999).

# posted by Medical Information : 12:46 AM  0 Comments

LOOKING for a way to get healthy and improve your social life? Joining a health and fitness center is a great way to start! Think about it. Hundreds of people, all gathered for the same purpose (usually), with a common goal of working out and staying healthy. The gym is perhaps the best place to meet people who share your interest in healthy living.

"A gym is a good place to meet people," says Los Angeles clinical psychologist Dr. Gaff Elizabeth Wyatt, a sex therapist, researcher and professor of psychiatry and bio-behavioral science at UCLA. "It increases the likelihood that you might find someone with similar interests, and for that reason, it's better than a bar."

Even if you're married, you can still improve your relationship at the gym. You don't have to be single to reap the benefits of spending time together, working out and sharing an essential part of your lives. Michael and Tracie Dugan of Studio City, Calif., have been married since 1994 and discovered early on that they both have a passion for working out. The couple exercise together at least once a week, and separately four or five times a week. Their daughter, Brooke, also is very active.

And while not everyone at the gym is looking to socialize, the industry's latest trend is to make the gym a place that people don't want to leave. You've got juice bars, saunas, Jacuzzis, full-service spas with massage therapy and even cafes. For many, going to the gym has become more of a lifestyle experience than a way to improve and maintain good health.

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"I don't have the time right now."

"I'm too tired."

"Between work and the kids, it's impossible."

These common excuses are mainly responsible for the high percentage of people in the United States engaging in too little physical activity or none at all. The 1997 National Health Interview Survey showed 40 percent of adults do not exercise. Despite the importance of regular exercise to disease prevention and health promotion, the National Center for Health Statistics also reports an estimated 60 percent or more of adults are either inactive or underactive.

Reducing the risk of cardiovascular disease, hypertension, Type 2 diabetes and some cancers (e.g., prostate and colon/rectal) doesn't seem to be enough incentive to become active. Studies show a 50 percent dropout rate--most within the first few months--among those who start an exercise program. "Even among cardiac rehab patients who know exercise can help keep them alive, 50 percent still quit," says Jack Raglin, Ph.D., associate professor of kinesiology at Indiana University in Bloomington, Indiana.

Why aren't health benefits enough to get people moving? "We are asking people to exercise for the rest of their lives, so hopefully they won't have a heart attack. [But] that [is] not enough motivation," says Bess Marcus, Ph.D., director of the Physical Activity Research Center and professor of psychiatry and human behavior at Brown Medical School and Miriam Hospital in Providence, Rhode Island.

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Did I scare you? Unless you have a fear of capital letters or exclamation points, probably not. Now, if I had come behind you while you were quietly reading and unexpectedly rousted you with a hearty "Hello!," perhaps I would have frightened you and the resulting rush of hormones would set your heart racing, momentarily paralyze you in your tracks and prepare you, albeit needlessly, for action. We are all familiar with the physiological changes that result from being startled by a loud noise, but what about the effects of other sounds? Do pleasant, organized sounds, such as music, affect the mind, body and mood? A large body of research says "yes."

Researchers have uncovered an astonishing number of benefits derived from listening to music. Evidently, music has the power to energize, soothe, change emotional outlook, boost immunity, reduce pain, speed recovery, lower blood pressure, improve focus and IQ as well as aid weight loss. These are just a sampling of scientific findings. How is this possible? Hearing is a physiological process involving the ears, brain, body and nervous system. Music, like all sound energy, can drive changes in our minds and bodies as we listen to it.

Sound, be it the music of a violin or the patter of rain on a rooftop, is vibrations in the air around us. The visible outer ear captures and funnels sound waves into the middle ear. The captured waves vibrate the eardrum and tiny bones of the middle ear to amplify and pass the sound to the inner ear. The inner ear's cochlea (i.e., a fluid-filled coil lined with neurons) converts the mechanical energy of these vibrations into electrical energy and transmits it to the brain. As the transformed sound waves move through the brain, they can generate motor responses, emotions, hormone release and higher order processes (e.g., recognition and memory recall). In other words, the brain guides the body's response (e.g., physiological, emotional, biochemical, etc.) as it recognizes the sound. For example, a loud noise may frighten us, while the sound of ocean waves may calm us.

MUSIC RESEARCH

The use of music in healing is at least as old as the writings of Aristotle and Plato. Egyptian medical papyri and religious texts, such as the Bible, document the use of music to alleviate illness and distress. In the 1800s, researchers in America and Europe examined the relationship between music and body/mind states as well as described music's effects on cardiac output, respiratory rate, pulse and blood pressure, cites ethnomusicologist Elizabeth Miles, M.A., author of Tune Your Brain: Using Music to Manage Your Mind, Body, and Mood and producer of the 10-CD Tune Your Brain series (Deutsche Grammophon). By the 1980s, studies aimed at discovering music's clinical applications intensified. Currently, scientific literature brims with music research.

In The Power of Music, Susan Hallam, Ph.D. of the Department of Psychology and Special Education at the Institute of London, reviewed over 200 music-related scientific studies, reports and books. She notes that research indicates music has potent therapeutic effects and can induce changes in behavior, mood as well as emotional, physiological and cognitive state. For example, it can reduce anxiety, alleviate pain, reduce drug dosages needed in clinical settings by as much as 50 percent, promote well-being, improve psychiatric patients' symptoms, alleviate depression and promote rehabilitation and recovery. Changes in biochemicals, such as endorphins, cortisol (i.e., a stress-related hormone) and immune system-related molecules, may occur.

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Don't put your elbows on the table.

Always say "please" and "thank you."

Cross your feet at the ankles.

Don't double-dip a chip.

If these little rules sound familiar, mom taught you well, and you're savvy to the code of social etiquette and good manners. Just as we have rules for dining, conversing and modesty, so do we have rules for proper gym conduct.

Although they're mostly unwritten, there is a canon of gym etiquette that all gym-goers should recognize. Whether or not others do so is beyond your control! You can avoid committing a fitness faux pas by following a few simple guidelines.

Work It In

The gym has only so many machines, and if you go during peak hours, most of them will be occupied. If someone is using a machine you'd like to use, ask if you can 'work in." Working in is a way for two people to share the same equipment: One person rests while the other does a set. Approach the other person while he or she is resting and politely ask if you can work in. Be prepared: The person might say no. But don't stress over his or her rudeness; simply move on and find something different to use. If the person agrees to let you in, it's a nice gesture to return the weight setting and seat adjustment to what he or she was using once you finish your set. Hopefully, that person will be just as courteous to you.

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I love step workouts, so when its creator, Gin Miller, launched The Ramp earlier this year, I leapt at the chance to try it. Done on a unique incline device, Ramping is the first cardio exercise that extensively uses a backward movement. "The idea behind Ramping is to work your rear muscles," Miller says. "So it's primarily a pushing off of activity rather than a lifting onto one."

While Ramping's fresh, low-impact choreography is perfect for beginners, I was able to get a more intense, athletic workout on it, one that really forced my glutes, hips and hamstrings into action and jacked up the cardio. The color-coded areas helped me follow the choreography and ensure that my feet were in the proper places, and the quick-adjusting angle made doing lunges, crunches, push-ups and stretches like downward-facing dog on The Ramp more comfortable than they are on the floor.

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HOOKED on remote controls, fast foods and video games, an increasingly large number of Americans have slumped down on their couches and stopped moving--literally. And it's costing them their health.

This sluggish trend, which threatens the future of all Americans, and especially Black Americans, is being actively challenged by a new Black family, which is willing, ready and determined to stay fit with healthy eating habits and a regular fitness schedule.

"It's not good enough for mom or dad to be physically active if the children don't see them doing it," says Dr. Reginald Washington, a pediatric cardiologist at Presbyterian St. Luke's Medical Center in Denver. The majority of his young patients are referred to him because their parents have had heart attacks or stroke, often due to hypertension, high cholesterol, obesity and physical inactivity.

To prevent such illnesses, he advises families to begin by "taking short walks" together. "That kind of thing would instill the notion that parents believe that it's important to be active together," says Dr. Washington, who is a member of the Association of Black Cardiologists and the American Heart Association.

Among the modern families who are active together are the Gores of Chicago, the Gordons of Los Angeles and the Banks of South Holland, Ill. In various ways, these families and others spend time participating in organized and leisure sports--as a unit--to ensure hard bodies and healthy, long lives.

Tax attorney Lauren W. Gore and her husband, Leonard Gore, a computer software salesman, are committed tennis aficionados. The Chicago couple chose their last vacation spot based on the number of tennis courts available, and they could hardly wait until their three children, Leonard Jr., 9, Landon, 7, and Lesley, 4, were out of diapers before introducing them to the sport.

"Naturally because of our interest in tennis, we thought of getting the kids involved. They watched us play and eventually expressed an interest," says Lauren Gore, who plays tennis for a local team as does her husband. Both are age 36.

Although the Gores aren't as emphatic about nutrition (We're not nuts about eating healthy foods," Lauren Gore says), they maintain a relatively healthy diet.

Leonard Gore echoes his wife. "We're not obsessed [with fitness], but we strive to be healthy," says Leonard Gore, who finds exercising to be an invigorating, yet relaxing way to unwind. It's a lesson that they hope their children--who already play little league baseball and group tennis--will cherish.

It's a sense of parental responsibility that motivates the Gores to take action. "As with every other educational process that goes on in the home, whether it's about a healthy body, a healthy mind or a healthy relationship, [my husband and I] always try to present a united front," Lauren Gore says.

West Coast couple John and Melanie Gordon also present a united front when it comes to introducing the fundamentals of physical fitness to their two children, Nikki, 14, and Chad, 12. "We've been exposed to all of the literature and we know that the things to take care of most are your brain and your body," says John Gordon, a 54-year-old pilot for a commercial airline. "A lot of people are careful to educate themselves," he says, "but they forget they need the body to take them through life."

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Physical fitness is vital to a healthy lifestyle. During National Physical Fitness and Sports Month, we highlight the importance of integrating exercise into our daily routines and encourage all our citizens to live more active lives.

Physical fitness benefits both the body and the mind. Regular exercise, along with healthy eating habits, helps prevent serious health problems, improves productivity, and promotes better sleep and relaxation. Maintaining an active lifestyle reduces the risk of chronic diseases such as obesity, diabetes, asthma, heart disease, and certain cancers. Americans can improve their health and well-being by dedicating a small part of each day to physical activity.

As children grow, athletic activities teach them important life lessons and help prepare them for the opportunities 'ahead. Sports are a way for young Americans to meet new friends, discover the value of teamwork, discipline, and patience, and learn to win and lose with respect for others. From baseball to mountain biking to swimming, sports and physical activities can be a great chance to get outdoors and enjoy memorable experiences with family and friends.

Through the President's Council on Physical Fitness and Sports, my Administration is promoting the incorporation of physical activity into daily life and the importance of a healthy lifestyle. The Council's website, www.fitness.gov, provides information on steps individuals can take to live better and more productive lives. Programs like "The President's Challenge" help individuals set fitness goals and work hard to achieve them.

I urge all Americans to set aside time to improve their health through physical fitness and sports, and I encourage individuals to help motivate their family and friends to get out and exercise. By contributing to a culture of health and well-being in America, citizens help demonstrate the strength and character of our great country.

Now, Therefore, I, George W. Bush, President of the United States of America, by virtue of the authority vested in me by the Constitution and laws of the United States, do hereby proclaim May 2005 as National Physical Fitness and Sports Month. I call upon the people of the United States to make daily physical activity a priority in their lives and to recognize the numerous benefits of an active lifestyle. I also call on all Americans to celebrate this month with appropriate ceremonies, activities, and programs.

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This assessment includes reviews by three panels: functional, external and leadership, said Lt. Col. Sherry Sasser. chief of health promotions for the Air Force surgeon general. Air Force officials conducted the functional review while experts from outside agencies and universities gave their opinions in an external review.

Commanders and senior enlisted leaders will be randomly selected to take a Web-based survey. The survey data will be compiled and forwarded to Air Force Chief of Staff Gen. John P. Jumper.

Regardless of the review's findings, one consistent aspect officials are seeing is that Airmen worldwide are embracing fitness as a way of life.

"We're seeing a change in the culture of the Air Force," Colonel Sasser said. "Gyms are being used morning, noon and night and are packed. Units are running together. It's wonderful to see."

In the interest of fostering the positive trend, officials said they're considering the following changes to better the program.

* Award full points on the body composition component of the test if the body mass index is within a healthy range. The Air Force is adding height and weight back into the standard to accommodate Airmen unable to obtain the minimum abdominal circumference but are still at a normal weight for their height. National Institutes of Health officials define an index of less than 25 as a normal or healthy weight.

* Move the waist-circumference measurement to a controlled area for people rated poor or marginal and are being retested to reduce inconsistencies.

* Lengthen run times for tests conducted at higher elevations.

* Retest Airmen who are rated "marginal" at 90 days instead of 180 days.

* Promote nutrition as an important aspect of education and intervention.

* Emphasize regular physical training rather than test results.

* Reinforce commanders' accountability.

A proposed change to weighing the program's components at 60-20-1010--corresponding to the run, waist measurement, crunches and pushups --instead of the current 50-30-10-10 was rejected.

Two smaller changes will be made to the assessment criteria. Values for females aged 50 to 54 weren't consistent with all other age categories, so officials will adjust the criteria according to American College of Sports Medicine standards. A category was also added for people older than 60.

The program changes are expected to begin in June.

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