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Vahedi L, Stark L, Ding R, Masboungi C, Erskine D, Poulton C, Seff I. A qualitative investigation of gender-based violence prevention and response using digital technologies in low resource settings and refugee populations. Eur J Psychotraumatol 2024; 15:2347106. [PMID: 38722768 PMCID: PMC11085956 DOI: 10.1080/20008066.2024.2347106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
Background: Governmental and non-governmental organizations across medical, legal, and psychosocial sectors providing care to survivors of gender-based violence (GBV) and their families rapidly digitalized services during the COVID-19 pandemic. GBV prevention/response services working with women and children who are forcibly displaced and/or living in low-and-middle income countries (LMIC) were no exception to the rapid digitalization trend. Literature is lacking a critical synthesis of best practices and lessons learned since digitalization replaced major operations involved in GBV prevention/response.Objective: This research qualitatively investigated how GBV service providers, located in a range of socio-political settings, navigated the process of digitalizing GBV prevention/response during the COVID-19 crisis.Method: Semi-structured key informant interviews (KII) with GBV service providers in varied sectors were implemented virtually (2020-2021) in Brazil, Guatemala, Iraq, and Italy (regarding forcibly displaced women/girls for the latter). Participants were recruited using purposive and snowball sampling. Interview guides covered a range of topics: perceived changes in violence and service provision, experiences with virtual services, system coordination, and challenges. The KIIs were conducted in Portuguese, Spanish, Arabic, and Italian. Interviews were audio-recorded, transcribed, and translated into English. The research team conducted thematic analysis within and between countries using a structured codebook of data driven and theory driven codes.Results: Major themes concerned the: (1) spectrum of services that were digitalized during the COVID-19 crisis; (2) gender digital divide as a barrier to equitable, safe, and effective service digitalization; (3) digital violence as an unintended consequence of increased digitalization across social/public services.Conclusion: Digitalization is a balancing act with respect to (1) the variety of remotely-delivered services that are possible and (2) the access/safety considerations related to the gender digital divide and digital violence.
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Affiliation(s)
- Luissa Vahedi
- Brown School, Washington University, St. Louis, MO, USA
| | - Lindsay Stark
- Brown School, Washington University, St. Louis, MO, USA
| | - Rachel Ding
- Brown School, Washington University, St. Louis, MO, USA
| | | | | | | | - Ilana Seff
- Brown School, Washington University, St. Louis, MO, USA
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García-López DDM, Jiménez-Lasserrotte MDM, Briones-Vozmediano É, Ruiz-Fernández MD, Hernández-Padilla JM, Granero-Molina J. Experiences of male irregular migrants during their migration process and reception in Spain: lessons learned from the COVID-19 pandemic. Front Public Health 2024; 12:1387715. [PMID: 38706544 PMCID: PMC11066255 DOI: 10.3389/fpubh.2024.1387715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/11/2024] [Indexed: 05/07/2024] Open
Abstract
Background The causes behind migration movements are complex. The COVID-19 pandemic highlighted how several countries failed to respond to the virus adequately, while simultaneously infringing on people's rights. Male irregular migrants fled their countries of origin and embarked on a perilous migration journey to Spain. The highly restrictive COVID-19 measures and border closures affected the mobility of male irregular migrants, whose reception in the host country posed a challenge. It led to the establishment of emergency facilities to accommodate male irregular migrants affected by COVID-19, which had repercussions on their mental health. The aim of this study was to describe and understand the experiences of male irregular migrants throughout their migration process and reception in Spain during the COVID-19 pandemic. Methods Qualitative descriptive study. Sixteen male irregular migrants participated in this study. Data were collected between January and March 2023 through 16 one-on-one in-depth interviews. Thematic analysis was used to analyze the qualitative data using ATLAS.ti computer software. Results Three main themes emerged: (1) How the COVID-19 pandemic drove male irregular migrants to leave their countries of origin, (2) How COVID-19 lockdown policies affected the migration journey, and (3) Receiving male irregular migrants in a pandemic: a housing labyrinth marked by isolation and loneliness. Conclusion The COVID-19 pandemic increased the social, employment and health inequalities experienced by male irregular migrants. Border closures exacerbated the migration journey and the social stigmatization of this group, who were seen as carriers of the virus in both transit and host countries. Strict control measures in emergency and reception facilities had a significant psychological impact on the male irregular migrants due to the social isolation they experienced. Health institutions should develop programs to guarantee the care needs of irregular migrants.
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Affiliation(s)
| | | | - Érica Briones-Vozmediano
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Grupo de Estudios en Sociedad, Salud, Educación y Cultura (GESEC), University of Lleida, Lleida, Spain
- Grupo de Investigación en Cuidados en Salud del Instituto de Investigación Biomédica de Lleida (GRECS IRB Lleida), Lleida, Spain
| | | | | | - José Granero-Molina
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Temuco, Chile
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Panchenko S, Gabster A, Mayaud P, Erausquin JT. Sexual health challenges in migrant, immigrant, and displaced populations 2022-2023. Curr Opin Infect Dis 2024; 37:46-52. [PMID: 38054795 DOI: 10.1097/qco.0000000000000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
PURPOSE OF REVIEW This article reviews recently published research on sexual health challenges and HIV and sexually transmitted infections (STIs) among migrant, immigrant and displaced people (MIDP) worldwide. We aimed to identify current evidence gaps regarding HIV/STI epidemiology, sexual health needs and interventions. RECENT FINDINGS Incidence and prevalence of HIV, hepatitis B virus, hepatitis C virus and syphilis were higher among MIDP compared to host populations. However, research studies are limited in geographical distribution and few routine surveillance data are collected. Barriers to sexual health services use and participation in preventive interventions include low HIV/STI symptom knowledge and risk awareness, and intersectional experiences of stigma/discrimination. Better targeted promotion messages are needed to increase utilization of preventive sexual health interventions. SUMMARY Access to, and use of, sexual health services and interventions are evident needs among MIDP. These needs are intertwined with social determinants of health, including cultural/language barriers and stigma. Effective interventions require involvement of multiple stakeholder groups, encouraging engagement and providing social protection. Promising directions for interventions and further research include developing sexual health supportive environments through peer-strategies and provider training in trauma-informed care.
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Affiliation(s)
- Sofya Panchenko
- London School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, UK
| | - Amanda Gabster
- Instituto Conmemorativo Gorgas de Estudios de la Salud
- National Research System, National Secretariat of Science, Technology and Innovation, Panama City, Panama
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, Florida
| | - Philippe Mayaud
- London School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, UK
| | - Jennifer Toller Erausquin
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, Florida
- University of North Carolina Greensboro, School of Health and Human Sciences, Greensboro, North Carolina, USA
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Schmitt VGH, Olter-Castillo AE, Cequea MM, Chayña HH. Co-production for the integration of migrant human capital into the decent work. PLoS One 2023; 18:e0295756. [PMID: 38091284 PMCID: PMC10718452 DOI: 10.1371/journal.pone.0295756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
During the last few years, the mass exodus of Venezuelan citizens to other countries has turned Venezuela into an emigration country, with Peru receiving the second-highest number of migrants. This article explains the co-production process of integrating Venezuelan migrants and refugees into the host society under decent work conditions. This is a qualitative, cross-sectional explanatory case study covering the second half of 2022. It shows that within the co-production effort, civil society organisations entail a role in creating collective mechanisms and spaces to enable communication and information, helping to identify existing problems and vulnerabilities, and finding alternatives to mitigate them. Additionally, in the process of integrating migrants' human capital under the decent work condition there is the relevance of migrant-based civil society organisations, due to the fact that they can enhance trust and the quality of the interaction and dialogue with the beneficiary public, identify their specific needs and potential solutions and, therefore, increase the quality and efficiency of the services provided.
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Affiliation(s)
| | | | - Mirza Marvel Cequea
- Escuela de Ciencias Empresariales, Universidad Católica del Norte, Coquimbo, Chile
| | - Helder Huaranga Chayña
- Instituto de Desarrollo de la Investigación Científica, Universidad de Lima, Santiago de Surco, Peru
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Eapen DJ, Tsusaki RB, Mullassery DG, Goolsby C, Lee K, Wardell DW. A Systematic Review of Women's Experiences of Interpersonal Violence During the COVID-19 Pandemic. Nurs Womens Health 2023; 27:435-447. [PMID: 37866396 DOI: 10.1016/j.nwh.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/03/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE To explore and synthesize women's experiences of interpersonal violence during the COVID-19 pandemic. DATA SOURCES The MEDLINE, Ovid, Embase, Cochrane, Web of Science, and CINAHL databases were searched to identify articles published between December 2019 and November 2022. STUDY SELECTION Seventeen peer-reviewed studies were included, for a total of 2,046 women. DATA EXTRACTION Data were extracted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. DATA SYNTHESIS COVID-19 brought many challenges for women experiencing interpersonal violence. Women reported worsening of abuse during the pandemic. The pandemic led to severe economic challenges, which eventually precipitated more abuse. Additionally, women experienced mental health distress from social isolation and increased surveillance and control from their abusive partners. Several factors affected their ability to access health care and support services; these included limited availability of services, fear of contracting the virus, and an abusive partner who restricted their movement outside the home. CONCLUSION The pandemic presented multiple challenges and additional stressors for women who experienced interpersonal violence during pandemic-related restrictions on services, gatherings, and work and school outside of the home. The findings from this review signify the need to raise public awareness about violence against women and to plan for coordinated efforts to decrease violence against women and address victims' needs in the event of future pandemics or other public health emergencies.
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Vahedi L, McNelly S, Lukow N, Fonseca AC, Erskine D, Poulton C, Stark L, Seff I. "The pandemic only gave visibility to what is invisible": a qualitative analysis of structural violence during COVID-19 and impacts on gender-based violence in Brazil. BMC Public Health 2023; 23:1854. [PMID: 37741981 PMCID: PMC10517463 DOI: 10.1186/s12889-023-16675-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 08/31/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic produced alarming rates of disease and mortality globally, yet few nations were as severely impacted as Brazil. The pandemic also exposed and exacerbated persistent forms of structural violence across Brazil, which complicated gender-based violence (GBV) prevention and response efforts. While structural violence is not new, the systemic pressure and uncertainty introduced by COVID-19 intensified the detrimental impact of structural violence on the lives of Brazilians impacted by GBV. This work qualitatively investigated how the COVID-19 pandemic amplified structural violence and GBV in Brazil. METHODS We analyzed key informant interviews (KII) conducted with 12 service providers working in sectors related GBV prevention and response in Roraima, Boa Vista, and Rio de Janeiro. Interviews were audio-recorded, transcribed, and translated from Portuguese or Spanish into English, before applying deductive and inductive coding approaches through a collaborative data reduction process. The theoretical lens of structural violence outlined by Farmer and Rylko-Bauer guided the thematic development. RESULTS Analyses identified three themes. First, structural violence manifests as policies of inaction and erasure, which reduce the opportunity for upward social mobility among GBV survivors including Black women, trans persons, and people who live in the favelas. Policies of inaction and erasure fail to acknowledge/adequately respond to the significant health and safety needs of these communities. Second, structural violence is a fundamental cause of violence against women and children. Finally, service providers described community driven responses that address the dire survival needs (i.e., food insecurity) imposed by COVID-19, within a context of structural violence. These community driven responses were innovative, agile, and based on dire needs expressed to, and observed by, the service providers interviewed. CONCLUSION This analysis highlights how the COVID-19 pandemic exacerbated existing forms of structural violence prevalent throughout Brazil. Findings stress the urgency with which the Brazilian government and international organization must act to support community driven programs that strive to address the most basic human needs.
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Affiliation(s)
- Luissa Vahedi
- Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Samantha McNelly
- Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Nina Lukow
- Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | | | | | | | - Lindsay Stark
- Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Ilana Seff
- Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO, 63130, USA.
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Trentin M, Rubini E, Bahattab A, Loddo M, Della Corte F, Ragazzoni L, Valente M. Vulnerability of migrant women during disasters: a scoping review of the literature. Int J Equity Health 2023; 22:135. [PMID: 37481546 PMCID: PMC10362632 DOI: 10.1186/s12939-023-01951-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 07/06/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND Disasters have an unequal impact on the population because of differences in conditions of vulnerability, exposure, and capacity. Migrants and women are among the groups that are at greater risk for and disproportionately affected by disasters. However, despite the large body of evidence that analyzes their vulnerability separately, disaster research that targets migrant women is scant. The aim of this scoping review was to analyze the published scientific literature concerning the vulnerability of migrant women and the consequent negative impact they experience during disasters. METHODS A literature search was conducted on December 15th, 2021 on Pubmed, Scopus, and Web of Science databases. No time filter was applied to the search. Information regarding the article's main characteristics and design, migrant women and their migration experience, as well as about the type of disaster was collected. The factors responsible for the vulnerability of migrant women and the negative outcomes experienced during a disaster were extracted and inductively clustered in main themes reflecting several vulnerability pathways. The review followed the Joanna Briggs Institute methodology for scoping reviews and relied on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). RESULTS After full text review, 14 articles met the inclusion criteria. All of them adopted a qualitative methodology and focused on COVID-19. The pandemic negatively affected migrant women, by triggering numerous drivers that increased their level of exposure and vulnerability. Overall, six vulnerability factors have been identified: legal status, poverty conditions, pre-existing health conditions, limited agency, gender inequality and language and cultural barriers. These resulted in nine impacts: worsening of mental health status, poor access to care, worsening of physical health conditions, fraud, exacerbation of poverty, gender-based violence, jeopardization of educational path, and unfulfillment of their religious needs. CONCLUSIONS This review provided an analysis of the vulnerability factors of migrant women and the pathways leading to negative outcomes during a disaster. Overall, the COVID-19 pandemic demonstrated that health equity is a goal that is still far to reach. The post-pandemic era should constitute the momentum for thoroughly addressing the social determinants of health that systematically marginalize the most vulnerable groups.
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Affiliation(s)
- Monica Trentin
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy.
| | - Elena Rubini
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
| | - Awsan Bahattab
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
| | | | - Francesco Della Corte
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
| | - Luca Ragazzoni
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
| | - Martina Valente
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
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Mothupi M, Dasgupta J, Hosseini Jebeli SS, Stevenson J, Berdichevsky K, Vong S, Barasa E, George A. Using an intersectionality approach to transform health services for overlooked healthcare users and workers after covid-19. BMJ 2023; 381:e072243. [PMID: 37286226 DOI: 10.1136/bmj-2022-072243] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Mamothena Mothupi
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | | | | | - Jacqui Stevenson
- United Nations University International Institute of Global Health, Kuala Lumpur, Malaysia
| | - Karla Berdichevsky
- National Center for Gender Equity and Reproductive Health, Ministry of Health, Mexico City, Mexico
| | | | - Edwine Barasa
- Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Asha George
- Complexity and Social Change, School of Public Health, University of the Western Cape, Cape Town, South Africa
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Qushua N, Gillespie A, Ramazan D, Joergensen S, Erskine D, Poulton C, Stark L, Seff I. Danger Zone or Newfound Freedoms: Exploring Women and Girls' Experiences in the Virtual Space during COVID-19 in Iraq. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3400. [PMID: 36834092 PMCID: PMC9965249 DOI: 10.3390/ijerph20043400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
During the COVID-19 pandemic, women and girls across the globe faced increased reliance on the digital space to access education, social support, and health and gender-based violence (GBV) services. While research from the last three years has explored how women and girls navigated and responded to their new virtual reality, minimal evidence has been generated from low-resource settings where access to technology may be limited. Further, no studies to date have examined these dynamics in Iraq, where women and girls already face numerous threats to safety due to various forms of structural violence and patriarchal family structures. This qualitative study aimed to examine women and girls' experiences in the digital space during COVID-19 in Iraq, including the benefits and risks of engagement as well as how access to the digital space was controlled. Data for the present analysis come from the authors' larger multi-country study investigating women and girls' safety and access to GBV services in the context of the COVID-19 pandemic and related public health measures employed to control the spread of the virus. In Iraq, semi-structured key informant interviews were conducted virtually with fifteen GBV service providers. Following the translation and transcription of interviews, the thematic analysis highlighted several benefits and challenges women and girls experienced as they tried to access and utilize technology for schooling, support services, and obtaining and spreading information. While many women and girls increasingly and successfully relied on social media to spread awareness of GBV cases, key informants noted that women and girls also faced increased risks of experiencing electronic blackmail. In addition to a substantial digital divide in this context-which manifested as differential access to technology by gender, rural/urban status, and socioeconomic status-intrahousehold control of girls' access to and use of technology left many adolescent girls unable to continue schooling and contributed to their further marginalization and consequent decline in well-being. Implications for women's safety and mitigation strategies are also discussed.
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Affiliation(s)
- Najat Qushua
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Alli Gillespie
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63130, USA
| | | | | | | | | | - Lindsay Stark
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Ilana Seff
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63130, USA
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Gillespie A. Peace Beyond the Binary: A Creative Intersectional Perspective on Global Forced Displacement. Am J Public Health 2023; 113:146-148. [PMID: 36652640 PMCID: PMC9850609 DOI: 10.2105/ajph.2022.307177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Alli Gillespie
- Alli Gillespie is with the Brown School at Washington University, St Louis, MO
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