Evidence-Based Practice Implementation in the Treatment of Breast Research Paper

Proof Based Practice Implementation in the Treatment of Breast Cancer - Research Paper Example As the paper states proof based practice is an approach to convey social insurance to patients that objectives issues in the current framework by coordinating the practices that yielded the best outcomes through exploration of important examinations and precise patient-care information, alongside the skill of masters and the contribution of patients with respect to their inclinations and qualities. The best patient results can be acknowledged when EBP is led with regards to mind, inside a strong authoritative structure and on the off chance that it is coordinated into the organization’s culture. Throughout the years, numerous social insurance establishments have adjusted EBP in making clinical practice rules for the treatment and care of patients tormented with different infections. From this report it is away from the maladies that EBP has been applied to, the most significant can ostensibly be bosom malignant growth. Bosom malignant growth is as yet the main source of disease related passings in ladies worldwide and it is the most widely recognized kind of malignant growth to distress females with over 1.1 million new cases analyzed every year. Bosom malignant growth is likewise considered as the absolute most common disease on the planet since more than 4.4 million ladies determined to have bosom disease over the most recent five years are presently alive and are taking in-tolerant and out-persistent consideration from various social insurance establishments around the world. It has been guessed that with the guide of EBP to improve clinical practice, 5-year endurance after bosom disease treatment could increment by up to 10%.... 5-year endurance after bosom disease treatment could increment by up to 10% (Sainsbury, Haward, Rider, Johnston, and Round, 1995 as refered to in Sacerdote et al., 2013). Sacerdote et al. (2013) led an investigation in Piedmont, Italy to assess the distinction in bosom malignant growth persistent consideration quality before the usage of an EBP rule and after the execution of the EBP rule. The rule that Sacerdote et al. assessed was the Piedmont rule (PGL) and it comprises the consistence of 14 nature of-care markers in understanding to EBP. The focal point of their examination is to assess the impacts of EBP on bosom disease treatment and to decide how well the PGL has been actualized. Rundown of the Study Since Sacerdote et al.’s study was worried about the status of bosom malignancy care when the usage of the PGL, two patient gatherings were chosen. Bosom malignancy patients analyzed and rewarded during the first 50% of 2002 were the pre-PGL gathering while patients who wer e analyzed and rewarded after 2004 were the post-PGL gathering. The practices suggested in the PGL were at that point being done in the provincial medical clinics even before the usage of the PGL. Somewhere in the range of 2002 and 2004, 8 markers out of the 14 moved towards the normal norm, anyway just 4 of these 8 upgrades were factually critical. It is strongly prescribed for patients with medium-to-high danger of inaccessible metastasis to experience chemotherapy or radiation after Breast Conservative Surgery however for patients with generally safe of far off metastasis, the presentation to radiation and chemo may really exacerbate their condition or hurry the repeat of malignant growth. Following the suggestions of medical attendants and experts utilizing EBP, the level of generally safe patients that took chemo-and

Civil Engineering Research Paper Example | Topics and Well Written Essays - 2500 words

Structural Engineering - Research Paper Example Structural building is perhaps the best calling since it gives affirmation of a decent profession ahead with colossal open doors for development and administration to society on the grounds that a structural designer works for the improvement of offices and administrations gave to individuals as framework and solace of living. Taking up structural designing as a calling offers boundless inventiveness, a decent vocation development, and mental fulfillment as a result of the chance to serve the people.Civil building is an immense field and in this manner gives various alternatives to proficient development. Beginning from examining the plausibility of a task the following occupation of the structural specialist is to design the execution of the undertaking. The following stage is the plan of the task which is a basic period of the undertaking and configuration requires the specialists to have a solid order over the specialized abilities identified with auxiliary and geotechnical design ing. From that point forward, the agreement procedure starts and there is a broad association of lawful procedures. The development period of the venture is where the genuine execution of thoughts is done and the plans are acknowledged on a ground surface. The activity of structural architect doesn't end here, the upkeep of the structures, the waste administration and arrangement of access to the structure are likewise the duties of a structural designer. In this way respectful designing as a calling offers a wide scope of chances and an individual can choose the field which suits his capacities and inclination.

In the news 2 Assignment Example | Topics and Well Written Essays - 250 words

In the news 2 - Assignment Example ed individuals have been joined with their families and the news that the pioneer of the gathering had was to be re-joined with her grandson evoked feelings in Argentina. Powers that were unified to the legislature grabbed babies somewhere in the range of 1976 and 1983 throughout military dictatorship which was probably the murkiest period in a period that was entitled the Dirty war. Carlotto’s little girl was a piece of a guerilla bunch when she was captured and detained in 1977at when she was just about a quarter of a year pregnant. She needed to bring forth her so at a military clinic and she was come back to her phone without her child and later executed. The tyranny removed Carlotto’s girl and she had no clue what had befallen her grandson despite the fact that she kept her expectation. The grandson who was brought together with his grandma is a 36 years of age who is named Ignacio Hurban and fills in as a music executive in a school in Olavarria however at first had questions concerning an incredible narrative which drove him to contact the grandmas with an amazing account where he submitted DNA. After the DNA was tried, it was seen as a 99.99 percent coordinate despite the fact that the first run through the grandson had questions are not satisfactory. The leader of Argentina was among the individuals who called the grandma after the updates on discovering her grandson had been uncovered to

Human Resource Management Essay Example | Topics and Well Written Essays - 2500 words - 4

Human Resource Management - Essay Example Numerous organizations need more assets to put resources into the enlistment procedure. In actuality, for an organization to pull in the most appropriate competitors they have to promote however much as could be expected and the most financially savvy and proficient way is that of electronic enrollment. It is imperative to convey appropriately and have elegantly composed portrayals. To draw in the potential applicants it is huge to have an elegantly composed portrayal of the position which is neither too long nor excessively short. It ought to appropriately convey all the significant data. Presentation A procedure of pulling in the most appropriate competitors and causing them to go after that specific position in an organization or association is known as enlistment. It is a procedure and an approach to enlist the correct sort of contender for the correct activity. Enrollment is turning into a basic and critical part of the human asset structure (Alvesson, 2010). It is profoundly cr itical to enlist individuals who have more characteristics and are progressively gifted. For this an extremely fine and appropriately adjusted enlistment process is required. This is to guarantee that the employed individuals are the most skilled ones and are the most ideal fit for the activity. So as to quantify the viability of the enlistment procedure the association needs to offer significance to the input from interior clients, its representatives and from the outside clients. There are a few techniques for enlistment process. The two expansive headings for the enrollment technique are that of inside enlistment and outer enrollment (Becker, 2007). Occupation commercial, enrollment and business organizations, inner announcements and the proposals actually, work focuses of government and the new online life are the couple of most usually utilized strategies for enlistment. Occupation notice is the most broadly utilized enrollment strategy. In this technique the association basica lly and deliberately searched out the spots it needs to publicize in. A run of the mill work ad incorporates all the significant data like employment title, the area, portrayal, remuneration bundle and guidelines to go after the position (Thompson and Luthans, 1990). Associations now and again utilize the offices like enlistment organizations and business offices to draw in the most reasonable competitors and recruit them. The offices help the association in the screening of the resumes in the underlying stage, the evaluation of capabilities and their test, and furthermore the reference checks. Individual proposals and interior announcement is likewise a technique for enrollment (Sheridan, 2002). This is finished by the associations to caution the staff for the accessible positions. The associations go through this technique to put a motivating force for the ones who are looking for progression and furthermore to look for the worker referrals. This strategy can be a viable one as th e workers are now connected with the organization and aides in setting aside the time and cash of the organization. Another technique is work focuses of government that normally promote the activity for the improvement of representatives with an end goal to serve the residents looking for business. The new and the most recent method of enrollment is that of online networking. This is the quickest and the most productive asset for enlistment nowadays. It enables the experts to interface all adjust the globe. This technique is exceptionally proficient in pulling in the most extreme number of applicants in the briefest conceivable time (Wanous

White House Official Jason Bordoff joins SIPA COLUMBIA UNIVERSITY - SIPA Admissions Blog

White House Official Jason Bordoff joins SIPA COLUMBIA UNIVERSITY - SIPA Admissions Blog Jason Bordoff, a special assistant to President Obama and senior director for energy and climate change on the staff of the National Security Council, has joined Columbia University’s School of International and Public Affairs, SIPA officials announced. Bordoff will join the faculty as a professor of professional practice and will serve as director of SIPA’s Center on Global Energy Policy. One of the nation’s top energy policy experts, Bordoff also held senior policy roles in the White House’s National Economic Council and Council on Environmental Quality. He joined the Obama administration in April 2009. “I’m thrilled to join the Columbia faculty and to build the Center on Global Energy Policy,” Bordoff said. “As we have seen, there are few policy issues more important on the world stage. Energy policy has a profound impact on the global economy and geopolitics. As someone who has relied on academic and think-tank analysis to help inform policy decisions, I know there is a need for more independent, rigorous analysis of the energy policy choices that our leaders face. And there are few places better positioned than Columbia to fill that need, with its world-class reputation, New York location, highly international student body and faculty, and depth and strength in a wide range of disciplines. To read Jason Bordoffs biography, click here.

Analysis of the American Reality, Possibility, and Dream found in Nickel and Dimed and The Outsiders - Literature Essay Samples

Every American is familiar with the concept of the American Dream. It is the social myth at the very core of the nation’s identity. Unlike other countries, the United States is not rooted in a shared ancestry, history, or language. Instead, Americans find their unity in a common aspiration—the hope of a better future for themselves and their children in the Land of Opportunity. This is the vision that drove the Puritans to brave the sea, inspired the founding fathers to sign the Declaration of Independence, and continues to bring immigrants teeming into the country. The American Dream is deeply rooted in the culture and psyche of the United States and its citizens. It is a common theme in literature as American authors struggle to interpret the social myth in light of reality. One of the most beloved discussions and deconstructions of the American Dream is a novel written by Susan Eloise Hinton when she was only sixteen. The Outsiders chronicles the story of seven boys and their struggle to overcome the stereotypes forced on them by their community. Through the eyes of adolescence, Hinton analyzes the American Dream by addressing the gulfs that separate the Dream from reality, and the reality from the possibility of achieving the Dream. Another book with a similar purpose is Barbara Ehrenreich’s Nickel and Dimed: On (Not) Getting by in America. Unlike The Outsiders, Nickel and Dimed is a nonfictional account of Ehrenreich’s experiences as she attempts to support herself by working various blue collar jobs. Ehrenreich accuses America of abandoning the working poor who, she argues, are unable to support themselves on current minimum wage salaries. Furthermore, her exposà © shows an economic system that encourages the abuse and dehumanization of its low-income workers. Even while she stresses the importance of financial stability to the fulfillment of the American Dream, Ehrenreich spends a large portion of the book illustrating how a lack of humanity, in the system and between the classes, is the root cause of the large gap between rich and poor. While Hinton and Ehrenreich approach the American Dream from two very different perspectives, both conclude that a mutual respect and understanding between all people, regardless of class, is essential to fully restore the Dream for all Americans. The United States of America was founded on the notion that â€Å"life, liberty and the pursuit of happiness† should be available to every citizen. The belief that these rights are available to every citizen is a great American myth. In his book The American Dream: The Short History of an Idea that Shaped a Nation, Jim Cullen calls this â€Å"idea that individuals have control over the course of their lives†¦ the very core of the American Dream, the bedrock premise upon which all else depends† (10). Hinton and Ehrenreich both attack the validity of the myth that equal opportunity is a reality in America and identify it as a source of prejudice and misunderstanding between the classes.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Ehrenreich’s opinions about poverty, before she began her undercover journalism research, correspond strongly with the way average middle and upper class Americans think. She describes how she â€Å"grew up hearing over and over, to the point of tedium, that ‘hard work’ was the secret of success† (Ehrenreich 220). When she attempts to support herself as a blue collar worker, however, she finds that â€Å"you [can] work hard—harder even than you ever thought possible—and still find yourself sinking ever deeper into poverty and debt† (Ehrenreich 220). In his book, Beyond the American Dream, Charles Hayes describes how the disconnection between the myth and reality stigmatizes the poor: The higher the level of social position reached†¦ the more the people on that level seem blinded by the relative advantage of their position. For example, the middle class expects the bottom level to simply go out and get a job, failing to see the dist inct advantage they themselves maintain through quality education and social connections. The typical middle-class businessman†¦ sees himself as deserving while he sees those at lower economic levels as being lazy and undeserving. (18-19) During her experience as a temporary member of working class America, Ehrenreich found the work exhausting, both physically and emotionally. Working as a maid, she describes the â€Å"exercise† as â€Å"totally asymmetrical, brutally repetitive, and as likely to destroy the musculoskeletal structure as to strengthen it† (Ehrenreich 90). Many of her coworkers work through pain, malnutrition, or pregnancy in order to keep their jobs and because they can’t afford to take unpaid days off. Several of the maids have injuries, treated and untreated, due to their work. Despite the prevalent idea that the poor can break free from poverty simply by working hard, Ehrenreich’s coworkers endure body-breaking work without having the opportunity to save enough to change their situation or seek out a different job.      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Like Ehrenreich, Hinton also argues that equal opportunity is a myth that contributes to prejudice. In The Outsiders, Ponyboy, the narrator, lives in a world divided by social class. The poor kids living on the East side, labeled â€Å"greasers† by the rest of the community, endure a multitude of stereotypes and stigmas. Ponyboy, and the other boys who make up his adopted family, or gang, know the labels well. On their way to a fight, they â€Å"embrace the stereotypes† (Inderbitzen 360), chanting: â€Å"‘I am a greaser†¦, I am a JD and a hood. I blacken the name of our fair city. I beat up people. I rob gas stations. I am a menace to society. Man, do I have fun O victim of environment, underprivileged, rotten, no-count hood!’† (Hinton 144). Despite their willingness to unite under these stereotypes, however, Ponyboy’s account of events brings the reader to a different understanding of the greasers. One member of the gang, in particular, allows the reader a fresh perspective on these dehumanizing stereotypes. Dally, who has â€Å"spent three years on the wild side of New York and had been arrested at the age of ten,† is the hardest kid of the group: â€Å"tougher, colder, meaner† (Hinton 19). Even Ponyboy, though he respects Dally, doesn’t like him. The tough faà §ade rapidly crumbles, however, when Johnny, Dally’s friend, dies from injuries sustained while rescuing children from a burning building. â€Å"‘That’s what you get for tryin’ to help people, you little punk,’ Dally blurts at Johnny’s body, ‘that’s what you get†¦Ã¢â‚¬â„¢Ã¢â‚¬  (Hinton 157). Dally’s own life circumstances have taught him that selflessness, such as Johnny’s heroic efforts, results only in personal disaster and pain. Since his childhood, Dally has learned to meet the world with a cold detachment in order to survive the harsh, inner-city streets. When he loses the only person who had slipped past his defenses and grown close to him, the pain overwhelms Dally. He pulls an unloaded gun on the police, forcing them to shoot him. Though Dally embodied many of the stereotypes forced onto all greasers, ultimately he was just a child trying to protect himself in a world where no parent had ever cared for him. The great tragedy of his death is that Dally still had the potential to be an extraordinary person. In him, Johnny saw a strong, â€Å"gallant† hero (Hinton 84), someone to look up to. Dally’s efforts to save Johnny from the fire at the risk of his own life provide a glimpse into the person he might have become had the circumstances been different. Unlike the labels suggest, Dally was not ruined beyond repair or redemption by his environment. He was still a human being, and, as such, he still had the ability to choose who he might have become. The myth, therefore, perpetuates stereotypes that prevent empathy and g uidance from being given to kids because they are viewed as already beyond help.     Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Despite the myth of equal opportunity, the American Dream is still carried in the hearts of poor and rich Americans alike. Ehrenreich and Hinton each comment on what the Dream looks like through the eyes of the poor and compare it to the Dream as interpreted by the middle and upper classes. After examining the Dream of each class, both authors conclude that the Dreams are complimentary, not antagonistic. In Nickel and Dimed, the viewpoints of those struggling with poverty come in the form of interviews with Ehrenreich’s coworkers. Near the end of her job as a maid, Ehrenreich asks the women who she was working with how they felt about the owners of the houses they clean, â€Å"who have so much while others, like themselves, barely get by† (118). Answers two of the women give shed light on a commonality in the Dream held by each person struggling with poverty. Lori responds, â€Å"All I can think of is like, wow, I’d like to have this stuff someday. It motivates me and I don’t feel the slightest resentment because, you know, it’s my goal to get to where they are† (Ehrenreich 118). Colleen’s answer is somewhat different: â€Å"I don’t mind, really, because I guess I’m a simple person, and I don’t want what they have. I mean, it’s nothing to me. But what I would like is to be able to take a day off now and then†¦ if I had to†¦ and still be able to buy groceries the next day† (Ehrenreich 119). Though Lori and Colleen have different Dreams, the need for economic security is common to both. Without enough income to begin saving, the poor are trapped in their current situation without hope of escape. Even the ability to find a higher paying job is severely limited by lack of time, energy, and transportation. The smallest disaster could push their delicately balanced lives over the edge and leave them without either a job or money.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The Dream of the rich, as expressed in Nickel and Dimed, comes from the author’s own perspective. Both Ehrenreich’s desire to research and write the book, as well as comments she makes about her own state of mind, reveal her own, middle-class Dream. Reflecting upon her â€Å"savior complex,† Ehrenreich admits, â€Å"Even my motives seem murky at the moment. Yes, I want to help Holly and everyone else in need, on a worldwide basis if possible. I am a ‘good person,’†¦, but maybe I’m also just sick of my suddenly acquired insignificance. Maybe I want to ‘be somebody,’†¦, somebody generous, competent, brave, and perhaps, above all, noticeable† (Ehrenreich 99). The need to matter is one she constantly wrestles with while preforming the menial tasks required of her from the various blue collar jobs she works. In order to cope with each of her jobs, Ehrenreich either finds meaning in it or creates meaning from pure fanta sy. In what she calls a â€Å"psychic flotation device† (108), Ehrenreich pretends, â€Å"I am not working for a maid service; rather, I have joined a mystic order dedicated to performing the most despised of tasks, cheerfully and virtually for free—grateful, in fact, for this chance to earn grace through submission and toil† (108). Unlike those who risk going hungry day by day, with no foreseeable route of escape, Ehrenreich is not really in any danger of starvation. Her basic needs are met and her current situation is only a charade. Her Dream focuses much more heavily on the upper levels of Maslow’s hierarchy: belonging, esteem, and self-actualization (â€Å"Need-Hierarchy Theory†). It is, in fact, these needs that have driven her to spend time living as one of America’s working poor. By temporarily giving up her privileged position, Ehrenreich is fulfilling her own Dream of doing meaningful work and being somebody who matters.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In The Outsiders, the Dream of the lower class is expressed through the narrator. Like Ehrenreich, Ponyboy also shares with the reader his own fantasy: I loved the country. I wanted to be out of towns and away from excitement. I only wanted to lie on my back under a tree and read a book or draw a picture, and not worry about being jumped or carrying a blade The gang could come out on weekends, and maybe Dallas would see that there was some good in the world after all, and Mom would talk to him and make him grin in spite of himself†¦ She could talk to Dallas and keep him from getting into a lot of trouble. (Hinton 56) Like Colleen and Lori, Ponyboy also desires a certain amount of economic stability and freedom, but his Dream goes much deeper than that; he also wants peace. In his neighborhood, torn apart by social class, the greasers cannot even walk alone without fear of being jumped by the socs, kids from wealthy families who â€Å"had so much spare time and money that they jumped [greasers] and each other for kicks, had beer blasts and river-bottom parties because they didn’t know what else to do† (Hinton 51). Ponyboy’s idyllic version of the country represents his Dream for the world: a place where nobody has so little money that they are â€Å"hardened beyond caring† (Hinton 67) like Dally or so much money that they have nothing left to work for, like the socs. In his Dream, he is once again cared for by his parents. He is allowed to enjoy his childhood rather than wrestling with adult problems in an adult-less world.      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The Dream of the upper class is related by the soc Cherry Valence who confides in Ponyboy, telling him that being rich isn’t all it’s made out to be: ‘We’re sophisticated—cool to the point of not feeling anything. Nothing is for real with us. You know, sometimes I’ll catch myself talking to a girl-friend, and realize I don’t mean half of what I’m saying†¦ Rat race is a perfect name for it,’ she said. ‘We’re always going and going and going, and never asking where. Did you ever hear of having more than you wanted? So that you couldn’t want anything else and then started looking for something else to want? It seems like we’re always searching for something to satisfy us, and never finding it. Maybe if we could lose our cool we could.’ (Hinton 46) Cherry’s Dream, ironically, is to have a Dream—something to strive for. Like Ponyboy, she lives in a world consumed by money, only, rather than having too little, she has too much. The class culture she grew up in demands she meet social expectations, never letting her true self shine through. In talking to Ponyboy, she is able to make a genuine connection with another human being because she does not have to worry about keeping up appearances or fitting into cultural stereotypes. Just as Ehrenreich was able to fulfill her Dream of bettering the world and doing something meaningful by entering into the world of the working class poor, Cherry also found her Dream fulfilled when she stepped outside of her own social class and befriended a greaser. For both Hinton and Ehrenreich, the only way to restore equal opportunity to America and allow each individual the possibility of living the American Dream is through mutual friendship and respect between social classes. Works Cited Cullen, Jim. The American Dream: A Short History of an Idea That Shaped a Nation. New York: Oxford, 2003. Print. Ehrenreich, Barbara. Nickel and Dimed: On (Not) Getting By in America. New York: Henry Holt, 2002. Print. Hayes, Charles, D. Beyond the American Dream: Lifelong Learning and the Search for Meaning in a Postmodern World. Wasilla, AK: Autodidactic Press, 1998. Print.    Hinton, S. E. The Outsiders. New York: The Viking Press, 1967. Print. Inderbitzin, Michelle. â€Å"Outsiders and Justice Consciousness.† Contemporary Justice Review. 6.4 (2003): 357-352. Web. 29 Dec. 2011.   Ã‚   Need-Hierarchy Theory.  Ã‚  A Dictionary of Psychology. Oxford Reference Online. Web. 25 Jan. 2012.

The Relationship Between Critical Thinking and Decision...

Critical thinking and decision-making are related in more ways than people think. This paper will define critical thinking and decision-making according to the book Whatever It Takes. It will also present a personal definition of critical thinking and decision-making from the author of this paper. The relationship between the two will be explained as well as the benefits of being a critical thinker. The author of this paper will also show how critical thinking is present in his organization and how he implements critical thinking techniques on a daily basis. The relationship between critical thinking and decision-making is much closer than what most people think. Once you look at the meanings of critical thinking and†¦show more content†¦Critical thinking is examining assumptions - not simply accepting arguments and conclusions at face value. Critical thinking is looking for hidden values, evaluating evidence and assessing multiple conclusions. I feel decision-making is an action. It is the destination of logical and analytical problem solving which is based in fact. Once the destination is reached, action in taken according to the resolution reached. Decision-making is the product of critical thinking. I believe that critical thinking and decision-making are inter-twined because you cant have one without the other. When you are trying to decide on something, you begin a critical thinking process. During this process, one evaluates information on a given problem. The process of reaching logical conclusions, solving problems, analyzing factual information, and taking appropriate actions based on the conclusions are called decision-making. While critical thinking and decision-making are interrelated and rely on one another, they are also independent. Critical thinking does not guarantee that a decision will be made and decisions can be made without processing information logically. There are benefits to being a critical thinker. It allows you to process problems or information in a systematical and logical fashion. It also allows you to come to the bestShow MoreRelatedCritical Thinking and Decision Making Essay example733 Words   |  3 PagesCritical Thinking 1 CRITICAL THINKING AND DECISION MAKING Critical Thinking and Decision-Making Paper Critical Thinking 2 Abstract Critical thinking and decision-making are related in more ways than people think. This paper will define critical thinking and decision-making according to the book Whatever It Takes. It will also present a personal definition of critical thinking and decision-making from the author of this paper. 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