The document summarizes an analysis of a sexual risk reduction (HIV/AIDS) intervention program for African American women led by Ralph DiClemente. The randomized controlled trial aimed to increase consistent condom use through skills training based on social cognitive theory and the theory of gender and power. Results found women in the intervention had 2.1-4.1 higher odds of consistent condom use and improved communication compared to the control group. However, the study had limitations like not measuring long-term condom use and a p-value above 0.05, indicating no significant association between treatment and other factors.
This article co-written by Dr. Robert J. Winn which aims to quantify the number of lesbian, gay, bisexual, and transgender (LGBT) people in Philadelphia who report to be victims of domestic violence.
AIDSTAR-One Prevention of Alcohol-Related HIV Risk BehaviorsAIDSTAROne
A growing body of research suggests that alcohol consumption is associated with the sexual behaviors that put people at risk for HIV. In developing countries battling severe HIV epidemics, addressing harmful drinking in conjunction with interventions to reduce sexual risk behavior may reduce HIV transmission more quickly than conventional HIV prevention interventions alone. Developed for program planners and implementers, this technical brief reviews the evidence on new and innovative programs in this emerging area. The brief catalogs what is known about the relationship between harmful alcohol use and HIV sexual risk behavior and offers a critical analysis of interventions to address the issue.
www.aidstar-one.com/focus_areas/prevention/resources/technical_briefs/prevention_alcohol_related_risk_behavior
This article co-written by Dr. Robert J. Winn which aims to quantify the number of lesbian, gay, bisexual, and transgender (LGBT) people in Philadelphia who report to be victims of domestic violence.
AIDSTAR-One Prevention of Alcohol-Related HIV Risk BehaviorsAIDSTAROne
A growing body of research suggests that alcohol consumption is associated with the sexual behaviors that put people at risk for HIV. In developing countries battling severe HIV epidemics, addressing harmful drinking in conjunction with interventions to reduce sexual risk behavior may reduce HIV transmission more quickly than conventional HIV prevention interventions alone. Developed for program planners and implementers, this technical brief reviews the evidence on new and innovative programs in this emerging area. The brief catalogs what is known about the relationship between harmful alcohol use and HIV sexual risk behavior and offers a critical analysis of interventions to address the issue.
www.aidstar-one.com/focus_areas/prevention/resources/technical_briefs/prevention_alcohol_related_risk_behavior
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Rape Victimization and High Risk Sexual Behaviors Longitudinal Stud.docxmakdul
Rape Victimization and High Risk Sexual Behaviors: Longitudinal Study of African-American Adolescent Females
Delia L. Lang, PhD, MPH,* Jessica M. Sales, PhD,* Laura F. Salazar, PhD,* James W. Hardin, PhD,†Ralph J. DiClemente, PhD,* Gina M. Wingood, ScD, MPH,* and Eve Rose, MSPH*
Author information ►Article notes ►Copyright and License information ►Disclaimer
This article has been cited by other articles in PMC.
Go to:
Go to:Abstract
Go to:
Go to:Objectives:
African-American women are affected by disproportionately high rates of violence and sexually transmitted infections (STI)/human immunodeficiency virus (HIV) infection. It is imperative to address the intersection of these two urgent public health issues, particularly as these affect African-American adolescent girls. This study assessed the prevalence of rape victimization (RV) among a sample of African-American adolescent females and examined the extent to which participants with a history of RV engage in STI/HIV associated risk behaviors over a 12-month time period.
Go to:
Go to:Methods:
Three hundred sixty-seven African-American adolescent females ages 15–21, seeking sexual health services at three local teenager-oriented community health agencies in an urban area of the Southeastern United States, participated in this study. Participants were asked to complete an audio computer-assisted self-interview (ACASI) at baseline, 6- and 12-month follow-up. We assessed sociodemographics, history of RV and sexual practices. At baseline, participants indicating they had experienced forced sex were classified as having a history of RV.
Go to:
Go to:Results:
Twenty-five percent of participants reported a history of RV at baseline. At 6- and 12-months, victims of RV had significantly lower proportions of condom-protected sex (p=.008), higher frequency of sex while intoxicated (p=.005), more inconsistent condom use (p=.008), less condom use at last sex (p=.017), and more sex partners (p=.0001) than non-RV victims. Over the 12-month follow-up period, of those who did not report RV at baseline, 9.5% reported that they too had experienced RV at some point during the 12-month time frame.
Go to:
Go to:Conclusion:
African-American adolescent females who experience RV are engaging in more risky sexual behaviors over time than non-RV girls, thereby placing themselves at higher risk for contracting STIs. In light of the results from this unique longitudinal study, we discuss considerations for policies and guidelines targeting healthcare, law enforcement and educational and community settings. The complexities of RV screening in healthcare settings are examined as is the need for tighter collaboration between healthcare providers and law enforcement. Finally, we consider the role of prevention and intervention programs in increasing awareness about RV as well as serving as an additional safe environment for screening and referral.
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Go to:INTRODUCTION
Due to jeopardized health of adult and adolescent w ...
Perception of Child Abuse 2COLLEGE STUDENTS’ AND PROFESSIO.docxherbertwilson5999
Perception of Child Abuse 2
COLLEGE STUDENTS’ AND PROFESSIONALS’ PERCEPTION OF CHILD ABUSE IN CORRELATION TO STRESS
Introduction
Throughout the growth and development of society, child abuse and maltreatment has expanded into many different aspects; it occurs within socioeconomic levels, ethnic and cultural lines, all religions and all levels of education. Within the United States children are suffering from a hidden epidemic of child abuse and neglect. Every year 3.3 million reports of child abuse are made in the United States involving nearly 6 million children (a report can include multiple children). The United States has the worst record in the industrialized nation – losing five children every day due to abuse-related deaths (U.S. Department of HHS, 2011). The estimated cost of child abuse and neglect in the United States for 2008 is $124 billion (Fang, 2012). The Department of Children and Families (DCF) defines child maltreatment as any act or series of acts of commission or omission by a parent, guardian, or other caregiver that results in harm, potential for harm, or threat of harm to a child (Leeb, Paulozzi, Melanson, Simon, & Arias, 2008). There are four major categories of childhood abuse and maltreatment: physical abuse, psychological and emotional abuse, sexual abuse, and neglect (Goldman, Salus, Wolcott, & Kennedy, 2003).
According to Brian H. Bornstein, Debra L. Kaplan, and Andrea R. Perry (2007), people have stereotypes about the circumstances and consequences of child abuse, and these expectancies can influence their judgments about individuals involved in abuse cases. Heim (2000) reported that participants with a history of abuse experience greater levels of perceived stress than participants without a history of abuse. They often perceive daily stressors more severely and longer in duration than their counterparts. It is also suggested that their history of abuse compromises these participants’ abilities to cope with stress, but the researchers noted that the data from their study is inconclusive, making it difficult for them to either support or refute this claim.
The perception of child abuse is very influential to students and upcoming professionals. Society’s definition and perception will guide current social work students into practice, which is a very important factor within the professional realm of social work.
Research Question
The purpose of this study is to examine college students and professionals’ perception of child abuse and how it relates to stress. The independent variable is the college students and professionals’ perception of child abuse and the dependent variable is how it relates to stress. The operational definition of perception remains closely allied to the continually developing behavioral theory of discrimination (Schoenfeld, 1962). The operational definition of child abuse is as any act or series of acts of commission or omission by a parent, guardian, or other caregiver that results.
Serieswww.thelancet.com Vol 379 June 23, 2012 2373.docxlesleyryder69361
Series
www.thelancet.com Vol 379 June 23, 2012 2373
Lancet 2012; 379: 2373–82
See Editorial page 2314
See Comment page 2316
See Perspectives page 2333
This is the fi rst in a Series
of three papers about suicide
Centre for Suicide Research,
University Department of
Psychiatry, University of
Oxford, Oxford, UK
(Prof K Hawton DSc,
K E A Saunders MRCPsych); and
Suicidal Behaviour Research
Group, School of Natural
Sciences, Stirling University,
Stirling, Scotland
(Prof R C O’Connor PhD)
Correspondence to:
Prof Keith Hawton, Centre for
Suicide Research, University
Department of Psychiatry,
Warneford Hospital,
Oxford OX3 7JX, UK
[email protected]
Suicide 1
Self-harm and suicide in adolescents
Keith Hawton, Kate E A Saunders, Rory C O’Connor
Self-harm and suicide are major public health problems in adolescents, with rates of self-harm being high in the teenage
years and suicide being the second most common cause of death in young people worldwide. Important contributors to
self-harm and suicide include genetic vulnerability and psychiatric, psychological, familial, social, and cultural factors.
The eff ects of media and contagion are also important, with the internet having an important contemporary role.
Prevention of self-harm and suicide needs both universal measures aimed at young people in general and targeted
initiatives focused on high-risk groups. There is little evidence of eff ectiveness of either psychosocial or pharmacological
treatment, with particular controversy surrounding the usefulness of antidepressants. Restriction of access to means for
suicide is important. Major challenges include the development of greater understanding of the factors that contribute
to self-harm and suicide in young people, especially mechanisms underlying contagion and the eff ect of new media.
The identifi cation of successful prevention initiatives aimed at young people and those at especially high risk, and the
establishment of eff ective treatments for those who self-harm, are paramount needs.
Introduction
Adolescent self-harm is a major public health concern.
Although suicide is uncommon in adolescents compared
with non-fatal self-harm, it is always a tragic outcome, and
prevention of suicide in young people is under standably a
focus of national strategies for suicide prevention. In this
paper, we discuss self-harm and suicide in adolescents in
terms of epidemiology (especially international diff er-
ences); developmental aspects of self-harm, including
short-term and long-term outcomes; factors that contribute
to the behaviour; and treatment and prevention. This is a
selective paper directed at any professional with an interest
in adolescent suicide and self-harm. We have two aims: to
provide a synthesis of the evidence for adolescent self-
harm and suicide and to identify key areas of uncertainty.
Only a small proportion of individuals who self-harm
present to hospitals, meaning that this behaviou.
Do you feel the assessment was an appropriate tool If so, why, an.docxelinoraudley582231
Do you feel the assessment was an appropriate tool? If so, why, and how could it be beneficial? If not, what were the drawbacks of the assessments?
The Female Sexual Function Index comes out as an assessment tool which mainly focuses on women, therefore, accomplishing its intended purpose. Each of the 19 items tested by the series of questions in the questionnaire touches on the sexual experiences of women prior to, during, or before sexual intercourse making it an appropriate tool to measure the sexual functioning of women. This tool is beneficial for clinical diagnosis of female sexual dysfunction and can be used to identify signs and symptoms of female orgasmic disorder (FOD) and hypoactive sexual desire disorder (HSDD) in women (Metson, 2003).
How? The series of questions focuses on six domains which are; desire, arousal, lubrication, orgasm, satisfaction, and pain. Each of the questions is classified under either domain mainly focusing on the female experiences over time. For example, when it comes to desire, there are two questions which ask about the frequency of sexual desire in the past one month as well as the degree of sexual desire over the same time period. Thus, we can argue that each of the domains has been intensively investigated to come up with the most viable result to be used for the relevant clinical purposes. Besides this, the assessment tool is reliable and relevant since it can be used to indicate different variables in each of the tested domains. The different responses for every question have been assigned different scores which are consistent with the kind of feedback which is to be expected.
References
Cindy M. Metson, (2003). Validation of the Female Sexual Function Index (FSFI) in Women with Female Orgasmic Disorder and in Women with Hypoactive Sexual Desire Disorder. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872178/
According to the CDC the HIV/AIDS reports, African-Americans are disproportionately affected by HIV/AIDS and disparity continues to widen. African Americans represent approximately 12% of the U.S. population, but they account for approximately 43% of HIV diagnoses. The African-Americans who die of HIV/Aids represents 44% of the deaths in the U.S. The worst hit category are the black women, the youths, gays and bisexual men. Dr. Donna Hubbard McCree (2013) notes that HIV/AIDS epidemics among the blacks results from factors including poverty, lack of awareness of HIV status, stigma that prevent the majority from seeking help, high rate of sexually transmitted infection, sexual networks, lack of access to adequate health care and lack sexual education among the most affected population.
Even though recent reports demonstrate encouraging trends of reducing HIV infections among the black population, new diagnoses still occur among the black gay and bisexual men. Therefore, even with continued intervention, disproportionate trends continue among the black population continue to be re.
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Building the Evidence for Violence Prevention and Mitigation Interventions: A...JSI
A systematic review was conducted of peer-reviewed literature published between 2006 and 2017 to identify outcomes that lie along the pathway from interventions to outcomes. It was concluded that focusing on intermediate outcomes may help address measurement challenges and build a persuasive evidence base, critical to elevate violence in policy and practice change discussions and secure resources to prevent, address, and reduce the impact of violence.
This poster will be presented by Karuna Chibber at the 2018 American Public Health Association Conference in San Diego, CA.
1. Analysis of Sexual Risk Reduction (HIV/AIDS)
Chiao-Chin Lin
BACH 5300
11/23/2013
1
1
2. School of Public Health
Academic Integrity
Honor Statement
I did not receive, nor did I give any unauthorized assistance on this assignment.
I have adhered to the Academic Integrity Agreement of the School of Public Health at the
University of NorthTexas Health Science Center, in which I promised to conduct myself in a professional and
ethical manner during all of my academic pursuits.
_Chiao-Chin Lin_____________ __November 23, 2013___________________ _Chiaochin
Lin____________
Name (print) Signature Date
2
3. Introduction
According to CDC factual data, AIDS is the fourth leading cause of death among married
women. More than half of the AIDS cases are reported among African American women. AIDS cases
attributable to heterosexual transmission are rapid upsurge. In the past decades, AIDS cases
attributed to heterosexual contact in women increased more than double of the percentage.
Around two decades ago, Ralph DiClemente hosted an intervention program focusing on the
sexual behaviors of young African-American women. The program was meant to enhance condom
usage as comprehensible means to prevent human immunodeficiency virus (HIV). Overall
effectiveness of the program was estimated to reduce HIV incidence by 80%. Therefore, condom
usage was selected as a good means of suppressing -the transmission of HIV since its efficacy has
been proven. The community-based skills prevention program evaluated factors implicated in the
transmission of HIV and power imbalance was mentioned. Power imbalance in sexual interaction can
make people engage in unsafe sex and this may contribute to the spread of HIV.
Actually, gender power imbalance considerably affects female capability to ask their partners to
use condom. The report indicated that women with older male partners more than a decade, suffering
from abuse, and those have disadvantaged income comparing to their partners are relatively
unwilling to ask for condom usage. It also affects men’s tendency to reject condom use. If they are
husbands and wives, and there is no communication about HIV/AIDS between them. The most
stunning part is that men with more than one partners tend to reject condom usage.
Across through upper and lower social levels, it is necessary to observe social prototypes to alter
relationships between women and men. From unequal sociality with dominance presenting
3
4. imbalance of rights in patriarchal societies to the social structure with equality and respect, both of
them have delivered bipolar cognitive value to the sociality between them. Moreover, there are also
physical and psychological factors that involve behavioral and social variables mediate the linkage
between social economic status (SES) and three types of stress hormones: cortisol, adrenaline and
norepinephrine. Lower SES was associated with a grading patterns of higher basal levels of cortisol
and catecholamine. The above associations occurred alone with race, such as African-American.
Through it is minority, the dataset keeps consistent in harmony of health practices and social factors.
With development of SES, defined as education, occupational, and employment growth are
associated with higher morning cortisol levels in middle-aged Germen. Therefore, it is proven that
education and income were correlated
Applied Theories
The program choose a randomized controlled trial (RCT) as its study design. Randomized
controlled trials are the gold standard to distribute the sample to particular group and engage the
clinical trials on each group. As a result, RCTs can collect information which may play critical roles on
relevant effects. For examples, there are several factors can be found through the RCT study design,
4
5. such as HIV knowledge and abstinence. Furthermore, there are two theories which had been applied
into the research process. They are social cognitive theory (SCT) and the theory of power and
gender (TGP) respectively.
First of all, social cognitive theory requires participants to learn social skills, norms, and suitable
knowledge on the purpose of avoiding risky sexual behaviors. As African American women with
assorted factors follow the social norms and skills, the sessions in the HIV intervention program
specifically addressed issues relevant to social cognitive theory. In the initial session, it provided
ample information regarding HIV risk reduction, such as associated risk behaviors and preventative
strategies. This session intended to provide participants with appropriate information. Later, they can
gain more supportive knowledge to enter into the next session.
In the fourth session, it successfully sets up and stresses on proper socially positive norms
towards the primary outcome, consistent condom usage.
On the other hand, the theory of gender and power (TGP) in conjunction with social cognitive
theory (SCT) were both used to create bonds between the cultural and gender among African-
American women. In 1987, Robert Connell developed on the theories of sexual inequality and gender
and power imbalances. According to the theory of gender and power, there are three primary social
structures that peculiarize the affiliations among sexes. With the gradual alteration of societies, these
structures remain unscathed among societal levels in long terms.
Target Population
As a matter of fact, African American women represent 13% of the U.S. female population and
67% of the AIDS cases among women. Hence, participants in Ralph DiClemente’s study include 128
5
6. women recruited the Bayview-Hunter’s Point community of San Francisco. Actually, African-American
contributes 84% population in the community; one out of four people in the neighborhood were
regarded as poor. It was best to use this population because they have a low socioeconomic status
and they are mostly unemployed. The author further narrowed the demographic factors to African
-American women between 18 to 29 years old and with heterosexual desires. The researchers also
required all of the participants to be sexually active. The author found that twenty-five percent of them
consistently used condom more than 3 months.
Analysis of HIV Sexual Risk-reduction Intervention
The author applied logistic regression analyses due to its bifid characters from diversified
variables. All of the variables were considered. There was another three-month-follow-up survey to
evaluate the effectiveness of the treatment conditions. Furthermore, potential confounders were
controlled by using analysis of variance (ANOVA). However, the P value was below 0.1 which
indicates that there is no association between these factors and the treatment
The adjusted odds ratio (OR) was applied to count for consequences of HIV intervention. African
American women who join the HIV sexual risk-reduction intervention had 2.1 times higher odds on
consistent condom usage than those who are with limited time to acquire HIV education.
Furthermore, those who were in the HIV sexual risk-reduction intervention had 4.1 times higher odds
on sexual communications comparing to women with delayed HIV education conditions. It showed
that the intervention program had proven every population had its own demographic features, and
controlling the gender and cultural factors as variables can compose to a clear comparison among
variables.
6
7. Results
The result of the study showed that Outcome measures can be categorized into several parts.
First, interpersonal skills intervention has positive effects on persistent condom usage. (Adjusted
Odds Ratio=4.15) Second, perceived partner norm also performs positive effects on the progress of
intervention. (Adjusted Odds Ratio=2.1) Third, sexual self-control in women who had the intervention
program was increased 1.9 times higher than in women who didn’t participat. Fourth, the sexual
communication play crucial role on the intervention program and the odds present 4.1 times higher
than the control group. Besides, there is 1.8 times higher odds on the intervention group about sexual
assertiveness. Eventually, partners’ adoption of condom usage has 2.1 time higher odds.
In sum, through the community orientated HIV risk-reduction intervention, it seems that the
demographic information and cultural features can both be applied to be effective ways to improve
social interpersonal skills among the risk-exposed population. Consequently, the persistent condom
usage is the ultimate goal to lower the HIV infection risks.
Strength and Weakness
The straight patterns of designs save plenty of time to discover proper variables on behaviors.
Moreover, the fusion basis of the diversified knowledge on behavior science broaden the horizons of
the HIV intervention. While the author host the survey on African American women as target
population, he can definitely match the relevant behavioral theories patterns in his mind and create
more thoughtful ways. For examples, the appliance of theory of power and gender (TGP) transmits
distinctness between genders and causes the issues of uneven distribution of power. This theory
7
8. fitted in the target population who were not merely women but also African Americans, the relatively
low SES groups.
On the contrary, social cognition theory has limited capability to interpret the emotional
triggers to the risky behavior. Moreover, the intervention program lacks in suitable measurements
to evaluate the consistency of condom usage in the long run. Another shortage on the
intervention program can be the statistical outcome. According to the study, the outcome of p-
value is only below 0.1. If p-value is bigger than 0.05, we cannot reject the null hypnosis to
support our view. Hence, it seems like that there is no significantly association between
treatment conditions and potential confounders. In addition, selection bias can also be produced
while choosing the samples. It is still possible that young African American women who obtain
distinguished education but prefer to live in the forgotten edge of San Francisco. After all, as
researchers, we had better not to constrain our conditions on people before we discover the
truth.
Future Prospective
Owing to the inspiration from the experience of DiClemente, we are witnesses to see the
effective outcome from the intervention among communities. It shows that community intervention is
a more valuable way to address the risky behavior rather than providing clinical treatments to fight
against HIV viruses.
On the other hand, it is beneficial to stratify the target population by diversified
gender and cultural factors. In this way, researchers can save lots of time on irrelevant samples.
8
9. There are upcoming studies that can be found in the thesis database. Another one is mainly focus on
the risk exposure with the appliance of the theory of gender and authority. Basically, it seems to be
ideal on the HIV risk-reduction intervention program. With appropriate study design, since the
variables remains multiple causes, the RCT keep its steady positions on analysis of the HIV risk
consideration. The future studies are expected to conclude more psychical and emotional factors
rather than ignorance.
Reference
Weller Sc, Davis-Beaty K. (2007). Condom effectiveness in reducing heterosexual HIV transmission
http://apps.who.int/rhl/reviews/langs/CD003255.pdf
Ralph J. DiClemente. Efficacy of an HIV Prevention Intervention for African American Adolescent Girls.
JAMA. 2004;292(2):171-179
http://jama.jamanetwork.com/article.aspx?articleid=199083
A Joint Report by UNAIDS/UNFPA/UNIFEM: Using Education to Prevent HIV.
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of inner-city women. Health Psychol. 1993 Nov; 12(6):482-8
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The council of State Government. (2011) HIV and STD Prevention Policies: Focus on Rural Areas. 2011
April http://knowledgecenter.csg.org/kc/system/files/HIV_and_STD_Prevention_Policies_Rural.pdf
Gina M. Wingood, Ralph J. DiClemente. Application of the Theory of Gender and Power to Examine HIV-
Related Exposures, Risk Factors, and Effective Interventions for Women. Health Education Behavior
October 2000 vol. 27 no.5 539-565. http://heb.sagepub.com/content/27/5/539.abstract
Margrit Eichler. Power, dependency, love and the sexual division of labour: A critique of the decision-
making approach to family power and an alternative approach with an appendix: On washing my dirty
linen in public. Women’s Studies International Quarterly vol. 4, Issue 2 (1981) 201-219.
http://www.sciencedirect.com/science/article/pii/S0148068581932425
Langen TT. Gender power imbalance on women’s capacity to negotiate self-protection against HIV/AIDS
in Botswana and South Africa. African Health Science (2005) September; 5(3):188-97.
http://www.ncbi.nlm.nih.gov/pubmed/16245988
Gina M. Wingood and Ralph J. DiClemente. Partner Influences and Gender-Related Factors Associated
with Non-condom Use Among Young Adult African American Women. American Journal of Community
Psychology February 1998, Volume 26, Issue 1, pp 29-51
http://link.springer.com/article/10.1023/A:1021830023545
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Status Is Associated With Stress Hormones. Psychosomatic Medicine (2006) 68:414 – 420
http://www.psy.cmu.edu/~scohen/ses_and_stress_hormones.pdf
DiClemente RJ, Wingood GM. A randomized controlled trial of an HIV sexual risk-reduction intervention
for young African-American women. Journal of the American Medical Association. 274 (1995): 1271-1276.
http://www.ncbi.nlm.nih.gov/pubmed/7563531
http://jama.jamanetwork.com/article.aspx?articleid=389870
Cynthia Prather, Taleria R. Fuller, Winifred King, Mari Brown, Marilyn Moering, Stacey Little, and Keydra
Phillips. Diffusing an HIV Prevention Intervention for African American Women:
Integrating Afrocentric Components Into the SISTA Diffusion Strategy. AIDS Education and Prevention.
(2006) vol. 18 149-160.
http://www.ncbi.nlm.nih.gov/pubmed/16987096
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