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“At risk” and ”vulnerable”! Reflections on inequities and the impact of COVID-19 on disabled people “有风险”和“脆弱”!反思不公平现象和COVID-19对残疾人的影响
Q3 Health Professions Pub Date : 2020-12-04 DOI: 10.15619/nzjp/48.3.02
M. Perry, T. Ingham, B. Jones, Brigit Mirfin-Veitch
This professional perspective provides background knowledge and evidence to support reflection on disability outcomes internationally and in Aotearoa New Zealand Over one billion people live with disability worldwide Approximately 4 5% of the world’s population live with significant difficulties in function, activity, and participation In Aotearoa New Zealand, approximately 1 1 million (24%) people have a disability, making disability the largest minority group Yet disabled people face extreme health inequities These are exacerbated when response planning and service delivery during times of humanitarian emergency, such as COVID-19, fail to include and consider the impact decisions will have for disabled people Disabled people are more “at risk” of contracting COVID-19, and some disabled people are “at risk” of poorer health outcomes from COVID-19 However, “vulnerability” arises from the continuation and exacerbation of discriminatory policies, including health professionals’ conscious and unconscious biases, in times of crisis but also within conventional health service delivery As part of the health system, it is perhaps timely for physiotherapists to reflect upon their knowledge of the health inequities disabled people experience, and to consider personal and collective bias There are strategies physiotherapists might adopt to challenge interpersonal, internalised, and institutional bias These steps will help affirm disability inclusiveness at all levels of the health system and support a human rights expectation that all New Zealanders should have equitable health outcomes © 2020, Physiotherapy New Zealand All rights reserved
这一专业观点提供了背景知识和证据,以支持在国际上和新西兰奥特亚对残疾结果的反思。全世界有超过10亿人生活在残疾中。世界上约有4.5%的人口在功能、活动和参与方面存在重大困难。在新西兰奥特亚,大约有100万(24%)人患有残疾,使残疾成为最大的少数群体。然而,残疾人面临着极端的健康不平等。在人道主义紧急情况下,如新冠肺炎、,未能纳入并考虑决策对残疾人的影响残疾人感染新冠肺炎的“风险”更大,一些残疾人因新冠肺炎而“面临”健康状况较差的风险。然而,“脆弱性”源于歧视性政策的持续和恶化,包括卫生专业人员的意识和无意识偏见,作为卫生系统的一部分,理疗师反思他们对残疾人所经历的健康不平等的认识,并考虑个人和集体偏见,也许是时候了。理疗师可能会采取一些策略来挑战人际关系、内在化、,和制度偏见这些步骤将有助于确认卫生系统各级的残疾包容性,并支持所有新西兰人都应该享有公平健康结果的人权期望©2020,Physitherapy New Zealand保留所有权利
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引用次数: 10
Physiotherapists adapting to a changing world 物理治疗师适应不断变化的世界
Q3 Health Professions Pub Date : 2020-07-23 DOI: 10.15619/nzjp/48.2.01
Anonymous
Physiotherapists are constantly updating their knowledge of treatment techniques, equipment, and effective patient care strategies using evidence-based guidelines as part of a lifelong commitment to continuing education within our field While there Is debate among public health officials and political leaders regarding the ways In which to address these growing numbers, our priority continues to be providing effective and quality care to our patients Other barriers and likely contributors to rising COVID-19 Infection rates Include a lack of understanding among the general public about ways they can help to prevent the spread of the Infection, In particular cough and sneeze etiquette, wearing a mask, socially distancing at least 2 m apart, and hand washing
物理治疗师正在使用循证指南不断更新他们对治疗技术、设备和有效患者护理策略的了解,这是我们领域终身致力于继续教育的一部分。公共卫生官员和政治领导人之间就如何应对这些不断增长的数字存在争议,我们的首要任务仍然是为患者提供有效和高质量的护理其他障碍和可能导致新冠肺炎感染率上升的因素包括公众对如何帮助防止感染传播缺乏了解,特别是咳嗽和打喷嚏的礼仪、戴口罩、保持至少2米的社交距离和洗手
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引用次数: 0
Knowledge, attitudes, and behaviours of New Zealand physiotherapists to sports-related concussion 新西兰物理治疗师对运动相关脑震荡的知识、态度和行为
Q3 Health Professions Pub Date : 2020-03-01 DOI: 10.15619/nzjp/48.1.03
D. Reid, P. Hume, C. Whatman, A. Theadom, S. Walters, N. Hardaker, M. Fulcher
Sports-related concussion (SRC) is a risk across all sports. New Zealand physiotherapists are more frequently in attendance at sporting events than medical doctors. The aim of this study was to determine the knowledge, attitudes, and behaviours of physiotherapists working with SRC, using a 35-item, multi-choice questionnaire. The survey was completed by 122 physiotherapists (response rate 10%). Physiotherapists were knowledgeable regarding SRC and showed positive attitudes towards correct management of the injury. Of the respondents, 98% recognised the key signs and symptoms of SRC, and 88% would refer to a medical practitioner for further assessment of SRC. Physiotherapists indicated a strong desire to be more involved in sideline management and testing, and would like to see a more multidisciplinary approach to return-to-play decision-making after SRC. Given that the knowledge, attitudes, and behaviours of New Zealand physiotherapists to SRC were very good, it is suggested that the processes in New Zealand be reviewed to enable physiotherapists to be more involved in the assessment and management of concussion.
运动相关脑震荡(SRC)是所有运动项目都存在的风险。新西兰的物理治疗师比医生更频繁地参加体育赛事。本研究的目的是确定物理治疗师与SRC工作的知识,态度和行为,使用35项,选择问卷。调查由122名物理治疗师完成(回应率10%)。物理治疗师了解SRC,并对正确处理损伤表现出积极的态度。在受访者中,98%的人认识到SRC的关键体征和症状,88%的人会向医生咨询SRC的进一步评估。物理治疗师表示,他们强烈希望更多地参与到场边管理和测试中,并希望看到一种更多多学科的方法来帮助SRC术后的康复决策。鉴于新西兰物理治疗师对脑震荡的知识、态度和行为都非常好,我们建议对新西兰的过程进行审查,使物理治疗师能够更多地参与脑震荡的评估和管理。
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引用次数: 7
The tipping point for engagement in professional supervision by physiotherapy private practitioners 理疗私人执业医师参与专业监督的临界点
Q3 Health Professions Pub Date : 2020-03-01 DOI: 10.15619/nzjp/48.1.04
L. Holder, Kiri Windross, N. Kayes
The aim of this study was to explore the experience and perspectives of physiotherapists working in private practice in New Zealand regarding their decision to engage (or not) in professional supervision (PS). There is a scarcity of research on PS in the physiotherapy profession, despite recommendations by Physiotherapy New Zealand that all physiotherapists should engage in this professional development activity. Using a qualitative descriptive methodology, eight participants were interviewed who identified as either (1) having never experienced PS, or (2) previously but no longer engaged in PS, or (3) currently engaged in PS. Thematic analysis was used to analyse the data. Four themes were constructed: (1) PS and the capitalistic lens, (2) PS is not normal, (3) professional identity and vulnerability, and (4) the relationship in the supervisory context. The drive for increased productivity, cost-effectiveness, and, ultimately, profit continues to dictate practice habits. PS can require the practitioner to share uncertainties about practice, creating a tension in maintaining one's professional identity and credibility which can deter engagement. Balancing professional identity and vulnerability requires the supervisor to create a safe space for recipients to navigate these tensions and sustain their engagement in the process. A significant shift in practice habits and the value ascribed to PS would be required before PS is likely to be normalised as part of physiotherapy private practice culture.
本研究的目的是探讨在新西兰私人诊所工作的理疗师在决定是否参与专业监督(PS)方面的经验和观点。尽管新西兰理疗协会建议所有理疗师都应参与这一专业发展活动,但理疗专业中对PS的研究却很少。使用定性描述方法,对八名参与者进行了访谈,他们被确定为(1)从未经历过PS,或(2)以前但不再从事PS,或者(3)目前从事PS。专题分析用于分析数据。构建了四个主题:(1)PS与资本主义镜头,(2)PS不正常,(3)职业身份和脆弱性,以及(4)监管背景下的关系。提高生产力、成本效益以及最终利润的动力继续决定着练习习惯。PS可能会要求从业者分享实践中的不确定性,从而在保持自己的职业身份和可信度方面产生紧张关系,从而阻止参与。平衡职业身份和脆弱性需要主管为接受者创造一个安全的空间,以应对这些紧张局势,并维持他们在这一过程中的参与。在PS可能作为理疗私人实践文化的一部分而正常化之前,需要对实践习惯和PS的价值进行重大转变。
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引用次数: 1
New Zealand secondary school students’ knowledge, attitude and behaviours towards sports-related concussion 新西兰中学生对运动相关脑震荡的知识、态度和行为
Q3 Health Professions Pub Date : 2020-03-01 DOI: 10.15619/nzjp/48.1.02
Emily Churton, Suzy Falconer, D. Reid
Sports-related concussion is a significant problem in New Zealand, with an estimated 21% of all traumatic brain injuries occurring in the sporting environment. The symptoms of sports-related concussion experienced by high school-aged athletes are often associated with a decline in academic performance, and are commonly more severe and persistent then those experienced by adult athletes. A 35-item, multi-choice questionnaire was used to ascertain New Zealand secondary school students’ knowledge, attitudes, and behaviours of sports-related concussion. By comparing results from 2018 to those obtained in 2017, this study investigated the impact that a 2018 Accident Compensation Corporation (ACC) social media campaign may have had on New Zealand secondary school students' knowledge, attitudes, and behaviours regarding sports-related concussion. The main findings of this study show that the ACC social media campaign did not alter students’ knowledge, attitudes, and behaviours toward sports-related concussion. Students were knowledgeable regarding concussion and showed positive attitudes towards correct management of the injury. Students had specific knowledge gaps regarding the onset of symptoms, activities to avoid post-concussion, the possible complications of multiple injuries, and recognition of the less discernible symptoms of concussion. These results suggest that secondary school students would benefit from further education on the possible long-term effects of sports-related concussion and the importance of effective management once a concussion has occurred.
在新西兰,与运动有关的脑震荡是一个严重的问题,估计有21%的创伤性脑损伤发生在运动环境中。高中运动员所经历的运动相关脑震荡的症状通常与学习成绩下降有关,并且通常比成年运动员所经历的症状更严重和持续。采用35项多项选择问卷,了解新西兰中学生对运动相关脑震荡的认知、态度和行为。通过将2018年的结果与2017年的结果进行比较,本研究调查了2018年事故赔偿公司(ACC)的社交媒体活动可能对新西兰中学生关于运动相关脑震荡的知识、态度和行为产生的影响。本研究的主要发现表明,ACC社交媒体活动并没有改变学生对运动相关脑震荡的知识、态度和行为。学生对脑震荡有一定的了解,对正确处理脑震荡表现出积极的态度。学生在症状的发生、避免脑震荡后的活动、多重损伤可能的并发症以及对不太明显的脑震荡症状的认识方面存在特定的知识空白。这些结果表明,中学生将受益于进一步的教育,了解运动相关脑震荡可能产生的长期影响,以及脑震荡发生后有效管理的重要性。
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引用次数: 1
The Nijmegen Questionnaire: A valid measure for hyperventilation syndrome 奈梅亨问卷:一种有效的过度换气综合征测量方法
Q3 Health Professions Pub Date : 2019-11-25 DOI: 10.15619/nzjp/47.3.04
Vickie Li Ogilvie, N. Kayes, P. Kersten
Hyperventilation syndrome is often undiagnosed due to its multi-systemic and 5 apparently unrelated symptoms. The Nijmegen Questionnaire is used by clinicians to 6 assess susceptible individuals, based on self-reporting symptoms attributed to 7 hyperventilation syndrome. However, evidence of psychometric properties of this 8 questionnaire is lacking. This study investigated two types of validity, using 9 interviews and Rasch analysis. Data showed that the Nijmegen Questionnaire met 10 criteria for content validity but not for structural validity. Content validity was 11 supported by a high matching percentage between the symptoms identified within 12 interview data and the current items on the Nijmegen Questionnaire (94%). Reported 13 symptoms from study participants were conceptually congruent with most of the 14 questionnaire items with minor language inconsistencies between patients and 15 clinicians. Rasch analysis indicated a poor fit of the Nijmegen Questionnaire to the 16 Rasch model, demonstrating poor structural validity. This study also developed a 17 revised version of the Nijmegen Questionnaire, which did meet criteria for structural 18 validity. Subsequently, a conversion table was created for transforming raw total 19 scores of the questionnaire in the clinical and research settings. Physiotherapists 20 should use the revised 15-item Nijmegen Questionnaire for clinical and research 21 purposes since it provides more accurate representation of the severity of patients’ 22 symptoms than the original scoring.
过度换气综合征由于其多系统和5种明显不相关的症状而常常无法诊断。奈梅亨问卷被临床医生用来评估易感个体,基于过度通气综合征的自我报告症状。然而,这8份问卷的心理测量特性的证据是缺乏的。本研究采用9次访谈和Rasch分析,调查了两种效度类型。数据显示,奈梅亨问卷符合10项内容效度标准,但不符合结构效度标准。在12个访谈数据中确定的症状与奈梅亨问卷上的当前项目之间的高匹配百分比(94%)支持内容效度。研究参与者报告的13种症状在概念上与14个问卷项目中的大多数一致,患者和15名临床医生之间存在轻微的语言不一致。Rasch分析显示,Nijmegen问卷与16 Rasch模型拟合较差,结构效度较差。本研究还开发了修订后的奈梅亨问卷,该问卷确实符合结构效度标准。随后,创建了一个转换表,用于在临床和研究设置中转换问卷的原始总19分。物理治疗师应将修订后的15项奈梅亨问卷用于临床和研究目的,因为它比原来的评分更准确地反映了患者症状的严重程度。
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引用次数: 4
Individuals’ experiences of the consequences of anterior cruciate ligament reconstruction surgery 前交叉韧带重建手术的个人经验
Q3 Health Professions Pub Date : 2019-07-16 DOI: 10.15619/NZJP/47.2.03
M. Kaur, D. C. Ribeiro, J. Theis, K. Webster, G. Sole
Anterior cruciate ligament (ACL) injuries have a profound impact on an individual’s life. The aim of this study was to explore participants’ experiences and perspectives of outcomes of their ACL reconstruction (ACLR) from two to 10 years following surgery, in relation to physical activity, sports, occupation and quality of life. Ten participants completed patient-reported outcome measures (PROM), namely the Tegner Activity Scale, the Knee Outcome and Osteoarthritis Score (KOOS) and the Sports Confidence Scale; and they participated in individual face-to-face semi-structured interviews. The interviews were recorded and transcribed verbatim. The general inductive approach was used for data analysis, and PROMs were analysed descriptively. Two themes were identified from the interviews: “Continuum of fear of re-injury versus confidence” and “Ongoing knee-health related problems and need of health professional advice”. Anterior cruciate ligament reconstruction may lead to long-term fear of injury and behavioural manifestations, with fluctuating levels of confidence during sports. Participants had ongoing knee health-related problems and were concerned about the future risk of re-injury or osteoarthritis. Participants reported good knee function, and yet scored low on quality of life scales (KOOS, median 53/100). The Sports Confidence Scale indicated low knee-related confidence levels (median 41.5/80). Health professionals should consider long-term individual-specific maintenance programmes that improve and maintain confidence and selfefficacy for those with ACLR. Kaur, M., Ribeiro, D. C., Theis, JC., Webster, K. E., & Sole, G. (2019). Individuals’ experiences of the consequences of anterior cruciate ligament reconstruction surgery. New Zealand Journal of Physiotherapy, 48(2), 76-93. https://doi. org/10.15619/NZJP/47.2.03
前交叉韧带(ACL)损伤对个人的生活有着深远的影响。本研究的目的是探讨参与者在手术后2至10年的ACL重建(ACLR)结果与身体活动、运动、职业和生活质量的关系。10名参与者完成了患者报告结果测量(PROM),即Tegner活动量表、膝关节结果和骨关节炎评分(KOOS)以及运动信心量表;他们参加了个人面对面的半结构化访谈。采访被逐字记录下来。数据分析采用一般归纳法,并对PROM进行描述性分析。采访中确定了两个主题:“对再次受伤的恐惧与信心的持续”和“持续的膝盖健康相关问题和健康专业建议的需求”。前交叉韧带重建可能会导致对受伤和行为表现的长期恐惧,在运动中信心水平会波动。参与者有持续的膝盖健康问题,并担心未来再次受伤或骨关节炎的风险。参与者报告膝关节功能良好,但在生活质量量表上得分较低(KOOS,中位数53/100)。运动信心量表显示膝关节相关的信心水平较低(中位数为41.5/80)。卫生专业人员应考虑长期的个人特定维护计划,以提高和保持ACLR患者的信心和自我效能。Kaur,M.,Ribeiro,D.C.,Theis,JC。,韦伯斯特,K.E.和索莱,G.(2019)。个人对前交叉韧带重建手术后果的经验。《新西兰物理疗法杂志》,48(2),76-93。https://doi.org/10.15619/NZJP/47.2.03
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引用次数: 4
The physiotherapy management of patients undergoing abdominal surgery: A survey of current practice 腹部手术患者的物理治疗管理:现状调查
Q3 Health Professions Pub Date : 2019-07-16 DOI: 10.15619/NZJP/47.2.02
J. Reeve, L. Anderson, Y. Raslan, C. Grieve, J. Ford, L. Wilson
The aim of this study was to determine the physiotherapy management of patients undergoing upper and lower abdominal surgery performed via open or laparoscopic approaches in public hospital surgical units throughout New Zealand. The study also aimed to establish factors influencing physiotherapy practice and determine how New Zealand practice compares to current best evidence. A purpose-designed survey was distributed via post to the senior surgical ward physiotherapist of all public hospitals in New Zealand offering abdominal surgery (n = 23). A response rate of 83% (n = 19) was obtained. No respondents reported routine physiotherapy input with patients prior to surgery. Only one surgical centre (5%) provided prehabilitation, and this was to highrisk patients only. Postoperatively most respondents reported routine assessment and treatment of patients following open upper abdominal surgery, but not following open lower abdominal surgery or laparoscopic surgery. Early mobilisation and respiratory physiotherapy interventions were the most commonly implemented interventions postoperatively. This study identified that physiotherapy interventions for patients receiving abdominal surgery mainly focus on postoperative assessment and treatment of patients undergoing open upper abdominal surgery. Few units routinely assess these patients preoperatively or offer prehabilitation. This study will allow physiotherapists working with patients undergoing abdominal surgery in New Zealand to compare their own practice to that of others and consider their use of current best available evidence. Reeve, J., Anderson, L., Raslan, Y., Grieve, C., Ford, J., & Wilson, L. (2019). The physiotherapy management of patients undergoing abdominal surgery: A survey of current practice. New Zealand Journal of Physiotherapy, 47(2), 66-75. https://doi.org/10.15619/NZJP/47.2.02
本研究的目的是确定在新西兰公立医院外科单位通过开放或腹腔镜方法进行上腹部和下腹部手术的患者的物理治疗管理。该研究还旨在确定影响物理治疗实践的因素,并确定新西兰的实践与目前的最佳证据相比如何。通过邮寄的方式向新西兰所有提供腹部手术的公立医院的高级外科病房物理治疗师分发了一项目的调查(n = 23)。有效率为83% (n = 19)。没有应答者报告在手术前与患者进行常规物理治疗。只有一家外科中心(5%)提供康复服务,且仅针对高危患者。术后大多数受访者报告了开放性上腹部手术后的常规评估和治疗,但没有报告开放性下腹部手术或腹腔镜手术后的常规评估和治疗。早期活动和呼吸物理治疗干预是术后最常用的干预措施。本研究发现,腹部手术患者的物理治疗干预主要集中在开放性上腹部手术患者的术后评估和治疗上。很少有单位对这些患者进行术前常规评估或提供康复治疗。这项研究将允许在新西兰与接受腹部手术的患者一起工作的物理治疗师将他们自己的做法与他人的做法进行比较,并考虑他们使用当前最有效的证据。里夫,J.,安德森,L.,拉斯兰,Y.,格里夫,C.,福特,J.,和威尔逊,L.(2019)。腹部手术患者的物理治疗管理:现状调查。新西兰物理治疗杂志,47(2),66-75。https://doi.org/10.15619/NZJP/47.2.02
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引用次数: 5
Attitudes and beliefs towards physical activity participation in individuals with below-knee amputation 膝下截肢患者参与体育活动的态度和信念
Q3 Health Professions Pub Date : 2019-07-16 DOI: 10.15619/NZJP/47.2.06
P. Jayakaran, M. Perry, Marko Kondov, T. McPherson, Leigh Sutherland, A. Wypych
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引用次数: 1
Knowledge and perceptions of cardiopulmonary resuscitation amongst New Zealand physiotherapists 新西兰物理治疗师对心肺复苏术的知识和认知
Q3 Health Professions Pub Date : 2019-07-16 DOI: 10.15619/NZJP/47.2.04
D. Harvey, D. O'Brien, K. Moran, J. Webber
Cardiopulmonary resuscitation (CPR) is an essential life-saving skill shown to save lives and improve outcomes of survivors. Physiotherapists are ethically obliged to ensure the safety of patients and to assist in an emergency if required. The purpose of this study was to explore the knowledge and perceptions of CPR amongst New Zealand physiotherapists. Chi-square statistics were used to test associations between the independent variables of age, sex, years of experience, scope and place of work, and postgraduate qualification against CPR training, beliefs and knowledge. A total of 688 physiotherapists completed the online survey. Only half of respondents (56%) had received formal CPR training in the previous year. One-fifth had used CPR in an emergency, with most applications being successful. Physiotherapists working in private practice, public hospitals and community settings were more likely to have CPR certification compared to other settings (p = 0.004). Significant CPR knowledge gaps existed in older (>39 years) physiotherapists (p = <0.001). The current low frequency of CPR training and the likelihood of having to perform CPR in an emergency (1 in 5) is a risk for physiotherapists. Future research should focus on a practical assessment of physiotherapists’ CPR skills to assess competency. Harvey, D., O’Brien, D., Moran, K., & Webber, J. (2019). Knowledge and perceptions of cardiopulmonary resuscitation amongst New Zealand physiotherapists. New Zealand Journal of Physiotherapy, 47(2), 94-104. https://doi.org/10.15619/ NZJP/47.2.04
心肺复苏术(CPR)是一项重要的救生技能,可以挽救生命并改善幸存者的预后。物理治疗师在道德上有义务确保病人的安全,并在需要时提供紧急援助。本研究的目的是探讨新西兰物理治疗师对心肺复苏术的认识和认知。使用卡方统计来检验年龄、性别、经验年限、工作范围和地点、研究生资格等自变量与CPR培训、信仰和知识之间的关联。共有688名物理治疗师完成了在线调查。只有一半的受访者(56%)在前一年接受过正式的心肺复苏术培训。五分之一的人在紧急情况下使用过心肺复苏术,大多数应用都是成功的。与其他机构相比,在私人诊所、公立医院和社区机构工作的物理治疗师更有可能获得心肺复苏认证(p = 0.004)。年龄较大(0 ~ 39岁)的物理治疗师存在显著的心肺复苏知识差距(p = <0.001)。目前心肺复苏术培训的低频率和在紧急情况下进行心肺复苏术的可能性(1 / 5)对物理治疗师来说是一种风险。未来的研究应侧重于对物理治疗师CPR技能的实际评估,以评估其能力。哈维,D.,奥布莱恩,D.,莫兰,K.,和韦伯,J.(2019)。新西兰物理治疗师对心肺复苏术的知识和认知。新西兰物理治疗杂志,47(2),94-104。https://doi.org/10.15619/ NZJP / 47.2.04
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引用次数: 3
期刊
New Zealand Journal of Physiotherapy
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