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Ownsworth T, Mols H, O'Loghlen J, Xie Y, Kendall M, Nielsen M, Mitchell J, Jones R, Geraghty T. Stigma following acquired brain injury and spinal cord injury: relationship to psychological distress and community integration in the first-year post-discharge. Disabil Rehabil 2024; 46:1796-1806. [PMID: 37128900 DOI: 10.1080/09638288.2023.2205173] [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: 11/07/2022] [Accepted: 04/14/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE This study aimed to compare stigma levels after acquired brain injury (ABI) and spinal cord injury (SCI) during the first 12-months post-discharge and investigate relationships between stigma, psychological distress and community integration. METHODS 110 adults with ABI (55%) or SCI (45%) were recruited from brain and spinal cord injury inpatient rehabilitation units of a tertiary healthcare facility. They were administered Neuro-QOL Stigma subscale and Depression Anxiety and Stress Scales (DASS-21) at discharge, 3-months and 12-months post-discharge, and Community Integration Measure at 12-months post-discharge. RESULTS Stigma levels did not significantly differ between individuals with ABI and SCI. However, stigma significantly decreased between discharge and 12-months post-discharge for the total sample. Stigma was positively associated with psychological distress at discharge and 3-months post-discharge, but not at 12-months post-discharge. Lower functional status and power wheelchair use were associated with higher stigma at 12-months post-discharge. Stigma at 3-months post-discharge predicted community integration at 12-months post-discharge, controlling for psychological distress and functional status. CONCLUSION Experience of stigma in the first few months post-discharge may negatively impact individuals' community reintegration. The early post-discharge period may be a pivotal time for supporting individuals to explore disability and injury-related appraisals and enhance connection to their community.
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Affiliation(s)
- Tamara Ownsworth
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Helen Mols
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Jessica O'Loghlen
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Yanfei Xie
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
| | - Melissa Kendall
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Division of Rehabilitation, Metro South Health Hospital and Health Service, Brisbane, Australia
| | - Mandy Nielsen
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Division of Rehabilitation, Metro South Health Hospital and Health Service, Brisbane, Australia
| | - Jessie Mitchell
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Rachel Jones
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Division of Rehabilitation, Metro South Health Hospital and Health Service, Brisbane, Australia
| | - Timothy Geraghty
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Division of Rehabilitation, Metro South Health Hospital and Health Service, Brisbane, Australia
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Bennett R, Sullivan KA. A psychometric evaluation of a new social subscale for the Common Misconceptions about Traumatic Brain Injury (CM-TBI) questionnaire: toward the CM-TBI-II. Brain Inj 2023; 37:1253-1261. [PMID: 37525435 DOI: 10.1080/02699052.2023.2237891] [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: 08/26/2022] [Revised: 05/18/2023] [Accepted: 05/27/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVE Existing TBI misconception measures are critiqued for failing to measure postinjury social experiences. This study developed a social subscale for the Common Misconceptions about TBI (CM-TBI) questionnaire for use in the general public. METHODS Seven experts independently review items drawn from the literature. Shortlisted items were administered online to 158 adults (aged ≥18 years; 51% postschool educated; 60% no TBI experience), the CM-TBI, and a measure of construct validity (a published TBI-adaptation of the Community Attitudes Towards the Mentally Ill; CAMI-TBI). One week later, the new items were redeployed (n = 46). RESULTS Expert review and iterative correlations identified a 10-item social subscale (internal consistency, test-retest reliability, α's>.80). When added to the CM-TBI (ie. CM-TBI-II), the internal consistency was .71. The social subscale was significantly correlated with CAMI-TBI measures (p's <.05, r's > .3). There was no significant difference on the social subscale for education subgroups (school vs post-school, p = 0.056) or previous TBI experience; but there was a difference for the CM-TBI-II (post-school>school; Cohen's d = 7.83, large effect). CONCLUSION This study found strong preliminary psychometric support for a new social subscale, administered as the CM-TBI-II. This subscale shows promise as a measure of misconceptions about social functioning post-TBI. The CM-TBI-II could support evaluations of programs aiming to improve social engagement and community participation for people with TBI.
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Affiliation(s)
- Ryleigh Bennett
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Karen A Sullivan
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
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Whiting DL, Chuah SL, Simpson GK, Deane FP, Reynolds J. Video-consulting to address mental health needs after traumatic brain injury: evaluation of a training workshop to build capacity among psychologists. Brain Inj 2021; 35:1065-1074. [PMID: 34334058 DOI: 10.1080/02699052.2021.1953594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) can lead to significant psychological distress, but few psychologists in Australia are trained in working with this complex clinical group. Despite government funding to provide video-consulting (VC) services in Australia, uptake before COVID-19 was limited. OBJECTIVE This mixed methods study evaluated whether training in eHealth and evidence based TBI psychological therapies increased provider uptake of VC in clinical practice, and delivery of mental health services to individuals with TBI. METHODS Mental health professionals completed a range of self-report measures before (n = 50), after (n = 48), and four months following (n = 30) a one-day workshop. Participants' TBI knowledge, client-base and levels of access, confidence, motivation and attitudes toward VC were assessed. Knowledge did not increase after training but participants had significant increases in their confidence and motivation to using VC at follow up. Significant reductions in pragmatic barriers to using VC were reported post training and at follow up, all barrier categories indicated significant reductions. There was no significant change in clinical practice of the participants. CONCLUSIONS Training to increase TBI knowledge requires specific assessment tools and although training appears to reduce barriers to using VC, uptake in clinical practice may require additional supervision and warrants further research.
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Affiliation(s)
- Diane L Whiting
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Liverpool, Australia.,School of Psychology, University of Wollongong, Wollongong, Australia
| | - Sarah L Chuah
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Grahame K Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Liverpool, Australia.,John Walsh Centre for Rehabilitation Research, Sydney School of Medicine, the University of Sydney, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Julia Reynolds
- Research School of Psychology, The Australian National University, Australia
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Bryant E, Williams C, Horry R, Worthington A. Measuring misconceptions about traumatic brain injury: are existing scales misconceived? Brain Inj 2020; 34:1150-1158. [DOI: 10.1080/02699052.2020.1795721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Eleanor Bryant
- Department of Psychology, Swansea University, Swansea, UK
| | | | - Ruth Horry
- Department of Psychology, Swansea University, Swansea, UK
| | - Andrew Worthington
- Department of Psychology, Swansea University, Swansea, UK
- Headwise, Birmingham, UK
- Swansea University Medical School, Swansea University, Swansea, UK
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5
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Schneider-Cline W, Bush E, McKelvey M. Using the OSU TBI-ID method for screening rural, older adults: a mixed methods feasibility study. Brain Inj 2019; 33:899-915. [DOI: 10.1080/02699052.2019.1606450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Erin Bush
- Division of Communication Disorders, University of Wyoming, Laramie, WY, USA
| | - Miechelle McKelvey
- Department of Communication Disorders, University of Nebraska Kearney, Kearney, NE, USA
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Schofield PW, Doty RL. The influence of head injury on olfactory and gustatory function. HANDBOOK OF CLINICAL NEUROLOGY 2019; 164:409-429. [PMID: 31604560 DOI: 10.1016/b978-0-444-63855-7.00023-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Head injury, particularly that resulting in brain injury, is a significant public health concern. For example, annual incidence rates of traumatic brain injury, a common consequence of head injury, range from 54 to 60 million people worldwide, including 2.2-3.6 million people whose trauma is moderate to severe. Trauma to the face and brain, including blast injuries common in modern warfare, can result in alterations in the ability to both smell and taste. In the case of smell, these include total loss of function (anosmia), decreased sensitivity (hyposmia), alterations in odor quality (dysosmia), and hallucination (phantosmia). Although taste dysfunction, i.e., altered perception of such basic taste-bud-mediated sensations as sweet, sour, bitter, salty, and savory (umami), can be similarly influenced by head trauma, the effects are typically more subtle and less studied. The present review provides an up-to-date assessment of what is known about the impact of head injury on quantitative measures of taste and smell function, including the influences of severity, type of injury, location of insults, prognosis, and approaches to therapy.
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Affiliation(s)
- Peter W Schofield
- Neuropsychiatry Service, Hunter New England Local Health District and Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle, NSW, Australia.
| | - Richard L Doty
- Smell and Taste Center and Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Navarro-Main B, Castaño-León AM, Munarriz PM, Gómez PA, Rios-Lago M, Lagares A. [Brain injury knowledge in family members of neurosurgical patients]. Neurocirugia (Astur) 2017; 29:1-8. [PMID: 29128284 DOI: 10.1016/j.neucir.2017.09.007] [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: 03/29/2017] [Revised: 09/06/2017] [Accepted: 09/19/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Several studies have shown misconceptions about brain injury in different populations. The aim of this study was to assess the knowledge and perceptions about brain injury of family members of neurosurgical patients in our hospital. MATERIAL AND METHODS The participants (n=81) were relatives of patients admitted to the neurosurgery department between February and August 2016. They voluntarily completed a 19-item true-false format survey about brain injury based on a translation of other questionnaires used in previous studies from other countries (USA, Canada, UK, Ireland and New Zealand). Also, some sociodemographic data were collected (age, sex, education level and the patient's pathology). Data analysis was developed through graphical modelling with a regularisation parameter plotted on a network representing the association of the items of the questionnaire from the response pattern of participants. RESULTS Data analysis showed two conceptual areas with a high rate of wrong answers: behaviour and management of patients, and expectations about acquired brain injury recovery. CONCLUSIONS The results obtained in this study would enable us to objectify misconceptions about acquired brain injury in patients' relatives attended in the neurosurgery department. This lack of knowledge could be a great obstacle in patients' recovery process. Therefore, we suggest placing the emphasis on the provision of information on brain injury to patients' families, especially with regard to its symptoms and course of development.
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Affiliation(s)
- Blanca Navarro-Main
- Servicio de Neurocirugía, Hospital 12 de Octubre, Instituto de Investigación i+12, Universidad Complutense de Madrid, Madrid, España; Departamento de Psicología Básica II, UNED, Madrid, España.
| | - Ana M Castaño-León
- Servicio de Neurocirugía, Hospital 12 de Octubre, Instituto de Investigación i+12, Universidad Complutense de Madrid, Madrid, España
| | - Pablo M Munarriz
- Servicio de Neurocirugía, Hospital 12 de Octubre, Instituto de Investigación i+12, Universidad Complutense de Madrid, Madrid, España
| | - Pedro A Gómez
- Servicio de Neurocirugía, Hospital 12 de Octubre, Instituto de Investigación i+12, Universidad Complutense de Madrid, Madrid, España
| | - Marcos Rios-Lago
- Unidad de Daño Cerebral Beata María Ana de Jesús, Madrid, España; Departamento de Psicología Básica II, UNED, Madrid, España
| | - Alfonso Lagares
- Servicio de Neurocirugía, Hospital 12 de Octubre, Instituto de Investigación i+12, Universidad Complutense de Madrid, Madrid, España
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Fresson M, Dardenne B, Geurten M, Meulemans T. Stereotype content of people with acquired brain injury: Warm but incompetent. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2017. [DOI: 10.1111/jasp.12459] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Megan Fresson
- Psychology and Neurosciences of Cognition Unit; University of Liège
| | - Benoit Dardenne
- Psychology and Neurosciences of Cognition Unit; University of Liège
| | - Marie Geurten
- Psychology and Neurosciences of Cognition Unit; University of Liège
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Barry DM, Ettenhofer ML. Assessment of Performance Validity Using Embedded Saccadic and Manual Indices on a Continuous Performance Test. Arch Clin Neuropsychol 2016; 31:963-975. [PMID: 27625047 DOI: 10.1093/arclin/acw070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2016] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE In addition to manual (i.e., "button press") metrics, oculomotor metrics demonstrate considerable promise as tools for detecting invalid responding in neurocognitive assessment. This study was conducted to evaluate saccadic and manual metrics from a computerized continuous performance test as embedded indices of performance validity. METHOD Receiver operating characteristic analyses, logistic regressions, and ANOVAs were performed to evaluate saccadic and manual metrics in classification of healthy adults instructed to feign deficits ("Fake Bad" group; n = 24), healthy adults instructed to perform their best ("Best Effort" group; n = 26), and adults with a history of mild traumatic brain injury (TBI) who passed a series of validity indices ("mTBI-Pass" group; n = 19). RESULTS Several saccadic and manual metrics achieved outstanding classification accuracy between Fake Bad versus Best Effort and mTBI-Pass groups, including variability (consistency) of saccadic and manual response time (RT), saccadic commission errors, and manual omission errors. Very large effect sizes were obtained between Fake Bad and Best Effort groups (Cohen's d range: 1.89-2.90; r range: .75-.78) as well as between Fake Bad and mTBI-Pass groups (Cohen's d range: 1.32-2.21; r range: .69-.71). The Fake Bad group consistently had higher saccadic and manual RT variability, more saccadic commission errors, and more manual omission errors than the Best Effort and mTBI-Pass groups. CONCLUSIONS These findings are the first to demonstrate that eye movements can be used to detect invalid responding in neurocognitive assessment. These results also provide compelling evidence that concurrently measured saccadic and manual metrics can detect invalid responding with high levels of sensitivity and specificity.
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Affiliation(s)
- David M Barry
- Department of Medical and Clinical Psychology, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Mark L Ettenhofer
- Department of Medical and Clinical Psychology, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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10
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Towards Measuring Community Understanding of Traumatic Brain Injury: The Structure and Potential Utility of the Head Injury Knowledge Scale. BRAIN IMPAIR 2015. [DOI: 10.1017/brimp.2015.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background and aims: International research has shown the public hold various misconceptions about traumatic brain injury (TBI). Yet, relatively little has been done towards developing appropriate measures of public knowledge of TBI. The Head Injury Knowledge Scale (HIKS, Ono, Ownsworth, & Walters, 2011) is a newly developed measure of misconceptions and expectations about the effects of TBI. Additional investigation of its psychometric properties appeared warranted. The aims of this further preliminary study were to examine the factor structure of the HIKS and the relationship between psychosocial variables and factor scores.Method: A convenience sample comprising 167 adults, of whom 65% were females, responded to an online survey including the HIKS. The two-factor HIKS structure was tested using confirmatory factor analyses and the relationships between psychosocial variables and the HIKS factors were investigated.Results: A good fit was found for the structure of the HIKS. All items loaded adequately onto the HIKS Over-generalisation and Minimisation factors and their internal consistencies were good. Significant differences between gender groups and for level of education were observed on the HIKS Over-generalisation scale, suggesting various groups in the community may have differing levels of knowledge of TBI.Conclusion: This study confirmed the robustness of the HIKS factor structure. The HIKS is likely to be an important measure of community understanding of TBI in future research.
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Block CK, West SE, Goldin Y. Misconceptions and Misattributions About Traumatic Brain Injury: An Integrated Conceptual Framework. PM R 2015; 8:58-68.e4. [PMID: 26054960 DOI: 10.1016/j.pmrj.2015.05.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 05/19/2015] [Accepted: 05/22/2015] [Indexed: 10/23/2022]
Abstract
The objective of the present narrative review was to provide a conceptual framework to address common misconceptions in the field of traumatic brain injury (TBI) and enhance clinical and research practices. This framework is based on review of the literature on TBI knowledge and beliefs. The comprehensive search of the literature included seminal and current texts as well as relevant articles on TBI knowledge and education, misconceptions, and misattributions. Reviewed materials ranged from 1970 to 2013 and were obtained from PubMed and PubMed Central online research databases. Research findings from the reviewed literature were integrated with existing social and cognitive psychological concepts to develop a framework that includes: (1) the identification antecedents of TBI-related misconceptions and misattribution; (2) understanding of how inaccurate beliefs form and persist as the result of pre- and postinjury cognitive operations such as informational cascades and attribution biases; and (3) a discussion of ways in which these beliefs can result in consequences in all domains of a survivor's life, including physical and mental health, stigma, and discrimination. This framework is intended to serve as a first stage of development of a model that will improve treatment endeavors and service delivery to individuals with TBI and their families.
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Affiliation(s)
- Cady K Block
- The Institute for Rehabilitation and Research (TIRR)/Memorial Hermann, 1333 Moursund Avenue, Houston, TX 77030(∗).
| | - Sarah E West
- JKF-Johnson Rehabilitation Institute, Edison, NJ(†)
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McKendry Y, Ownsworth T, Bettens GF. Comparing accuracy of knowledge of functional effects of schizophrenia and brain injury. Psychiatry Res 2014; 219:225-7. [PMID: 24889843 DOI: 10.1016/j.psychres.2014.05.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 03/18/2014] [Accepted: 05/06/2014] [Indexed: 10/25/2022]
Abstract
This study developed and validated the Brain Injury and Schizophrenia Awareness Scale (BISAS) to compare accuracy of knowledge of functional effects of schizophrenia and TBI. The BISAS displayed good internal consistency and evidence of construct validity. Overall, general community participants (n=143) lacked understanding of the shared effects of these conditions, and attributed emotional and behavioural deficits to schizophrenia and cognitive deficits to TBI.
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Affiliation(s)
- Yvette McKendry
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Tamara Ownsworth
- School of Applied Psychology, Griffith University, Brisbane, Australia.
| | - Gemma F Bettens
- School of Applied Psychology, Griffith University, Brisbane, Australia
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