The drop in the world’s economy has been depending more on the quality of health care that is delivered in the whole world. More o the United States, the health care becomes the largest industry in the growth and the development of the Gross domestic products which is increasing annually. However, the health care industry is more complicated and inefficient and thus having the need to have many kinds of reforms (World Health Organization, 2008). These reforms will help it in having a huge role in the improvement of the benefits that are enjoyed by the Americans and the government. This means that the health care reform in the United States is an affordable care approach that was made by the Obama’s law. It gives the policy to influence the positive changes in the standards of the country’s health care activities. Since the reforms were set, the partners of the approach are doing their best in getting the reformational goals (World Health Organization, 2008).
The health Insurance exchanges are one of the reforms. This approach is one of the largest features of the health care reform. The health insurance exchanges are mainly the online marketplaces where individuals log in to websites, type their data and get the insurance cover service. The State will drop unless it brings the solution that the national government should run their insurance exchange. Most of the Americans have opted to be run by the national government. This means that if one is employed, and the employer does not give them the health insurance, then they can get them through the coverage exchanges. This is important as there will be a health marketplace that will be suitable for everyone (Twaddle, 2002).
The Reform of the Medical Loss proportion and the discount Checks. The Health care system needs the insurance companies to spend much of their premiums in the medical costs. The proportion of the health failure is the executive analysis of how much the finest income is used in the medicinal outlay. These proportions are analyzed for the position of the States and the legal unit breakouts. This means that the more the insurer spends on the medical in Arkansas has no effect on the MLR ratio on the Indians and vice versa. This makes it more complex but gets the ration of MLR at a higher level (Twaddle, 2002).
Due to the way the law is set, whether the fitness coverage spend $0 or $ 100k on the checkup expenses on a person, it is basically inappropriate. Thus it is purposed on how much was used on the medical on the whole State which has set relative the premium revenue of the whole State. This reform shows that companies have also improved in their pricing based on the MLR. This is quite okay to say unless the medical approach changes drastically, making the amount of the medical payments dropping in every year (Twaddle, 2002).
The reform of covering the long term disease. This is a main constituent of the fitness care improvement in that no one is denied the treatment due to much long term status. This is important to those who figure out how to get their pre-existing conditions that are treated without one going bankrupt. The way to make the health insurance affordable is by bringing each person whether health or not into the health care systems through exchanges. This means that if one does not have the pre-existing condition, the condition of your health will be covered by the health insurance. This will also improve the health cost care which is needed to be in part in bringing each person into the health insurance (Gruber & Newquist, 2011).
The Reform of the Rate bands. As it is better explained, there are the reasons why health Insurance will increase for the young adults in America and how the rate bands are important part of the health care reform. Mainly they are proposed to limit the rate of difference or the amount of the premiums costs that vary from one person to the other. There are several factors that are used in rating the premiums. They include the age, family engagement, the location or the use of tobacco. This means that the rate bands raises the costs of insurance for the individuals which are healthier and leads to the reduction of the costs of the insurance to those whose insures their cost the most. If a person is in the age of 20’s to 30’s, their rates will increase due to the approach of the health care reform (Gruber & Newquist, 2011).
The reform of the dependents remaining under their parent’s insurance up to the age of 26. This is the five and also a major feature of the health care reform. It is a rule that tries to help in making the transition easier to the young adults who face a lot of challenges when going from the high school to work o from work to school. This shows that there is a weak economic status that is affected by having the regulation. This means that if a person is 26 years or younger, they will be able to remain in their parent’s health plan when their employers will only cover them under some conditions making the coverage on the parents uncommon (Gruber & Newquist, 2011) .
If the parent will be worried on whether their children can join college and be covered by the health insurance by an employer, this can make it easier knowing that they will have to remain under the parent’s insurance. As the insurance exchanges were established, the safety net reform rule loses some of its effects as each person who is not covered by insurance will not be able to get their State’s exchanges or the insurance cover. It may also seem cheaper though not free if one has to think of the families with three children covered by their own insurance will have to pay the same price whether they are in or not in it (Gruber & Newquist, 2011).
This makes the health care reform seem more complicated. Some of these reforms do not affect people and will never while others will have a major influence on the lives of people. These reforms take the States into the changes of the health care system as the way of expanding the reform coverage is just a beginning to the reforms. One the United States move close to their national dream of seeing all their citizens have a good health care system, they will be having many ideas for getting its medical system into something that will make them more essential and effective. Though we are not sure whether these reforms will turn the health care around, it may take some time to fully implement these reforms as they need to be responsibly implemented (World Health Organization, 2008).
References
Gruber, J., & Newquist, H. P. (2011). Health care reform: What it is, why it's necessary, how it works. New York: Hill and Wang.
Twaddle, A. C. (2002). Health care reform around the world. Westport, Conn: Auburn House.
World Health Organization. (2008). the world health report 2008: Primary health care: now more than ever. Geneva, Switzerland: World Health Organization.
Reflecting on the rationale behind my choice of becoming a woman Nurse practitioner and forsaking all other specialties is now clear that I have been guided by my passion. I have always been fascinated by the Pathophysiology intricate of women’s care particularly obstetric care and for this reason, I desire to be an essential element in offering the prime care in regard to the special needs held by women in the society. It is widely known that the best way to offer care to a whole family best begins with the mother or rather the woman. My nursing school attendance has provided me with increased aspirations to be consistent in my education and professional which will permit me to obtain both personal as well as professional development. My passion in particular is the core of the choice to becoming a Women’s Health Nurse Practitioner and my heart is situated on this path.
In order to achieve my desire of bringing major differences in the lives of women, I want to be an advanced practicing Women’s nurse. This is an opportunity to obtain more knowledge that will be essential in my professional practice. I want to be involved primarily in the evaluation, diagnosis, treatment and eventually generating better relations amid a professional and patients for increased corporation. I will endeavor to acquire a comprehensive strategy in the provision of care to diversified women including all age brackets by offering them treatment that is characterized by dignity, respect as well as compassion. Being an Women’s nurse with advanced practice will offer me the general freedom of independent practice, a more close teaming with a physician which will depend on my professional working scope. I am very eager to offer preventative care which I extremely believe to be a crucial healthcare aspect. My professionalism will be grounded on heartening and sanctioning women to taking charge of their individual health.
Women’s health care provision is one that is characterized by uniqueness thus necessitating vast knowledge and experience. The female gender being a representative of the highest population globally motivates me in being part of offering solutions to their rising health needs. The possession of evidence-based knowledge in treating patients is significant equally to offer care. Offering comfort to patients increases their ability to be open and highly responsive to care. I believe strongly in patient’s freedom and confidentiality. As a women’s nurse practitioner, I will offer a space where patients can comfortably express their health concerns at ease. I want to be open to the needs of the community and particularly women’s through helping them in meeting their healthcare aims while offering updated, considerate, competent and authoritative care.
I have high expectations regarding the program with the positivity that I will acquire the significantly needed education which will be of the essence in succeeding as a Women’s Health Nurse Practitioner. My professional opportunities are open as I have no specific set locations to work. My core passion is based on ensuring that the health needs of women are handled in a professional and unique way and that is my prime focus. With the mention, becoming a Women’s Health Nurse Practitioner is the next big step for me as it will offer me with the greatest opportunity of helping individuals by offering the best care.
This course has influenced my policy competence in that I have gained skills and knowledge required in creating effective policies, managing health care services and offering quality services. With policy competence, I have improved health services in my organization by ensuring the implementation of effective policy based on access and quality (Storey, Howard, & Gillies, 2002). In addition, the course has influenced my policy competency since I have gained management skills, interpersonal skills and leadership skills.
As a leader in health care, I would make a positive impact by using my policy competence. First of all is to understand the policymaking process and make decision based on formulation and implementation (Storey, Howard, & Gillies, 2002). Since my policy competency encompass management skills, health system skills and analytical skills, the competency will bring a positive change because as a leader I will provide patient-centered care through valuing patients’’ differences and preferences and provide continuous care and healthy lifestyles. In addition, policy competency will assist in operating effectively and so as a leader I will ensure continuous care through creating interdisciplinary teams (Storey, Howard, & Gillies, 2002). In addition, I will ensure optimum care through evidence-based care such as research activities. By having policy competency, I will apply principles for safety design for quality improvement. I will also use informatics in health care for knowledge and decision making management.
I work at a hospital and it is interested with health care policy. The hospital in general wants policies based on standards of practice. There is a need for future decisions in order to prevent legal problems and develop consistency and quality measurement. Generally, the hospital needs a management system which will offer a plan of action and fundamental guidelines so that the organization can accomplish desired outcomes and cost-effective care (Storey, Howard, & Gillies, 2002). The policy related interest is shaped by environmental forces such as workforces issues. Issues such as lack of ethics are shaping the interest and the hospital is forced to create ethical policies which will ensure trust and transparency in the organization.
Reference
Storey, L., Howard, J., & Gillies, A. (2002). Competency in healthcare: A practical guide to competency
frameworks. Abingdon, U.K: Radcliffe Medical Press.
There exists different mortality rates among different countries and although the goal is to ensure that all children survive childbirth, the culture of a nation greatly determines the survival and health safety of infants. The Swedish culture in labour pain and post partum care considers giving birth to be a personal and fulfilling experience which gives the mother giving birth the right to make most of the decisions before, during and after child birth. As part of their culture, most births take place in hospitals where inducement of labor and caesarian delivery is fairly common. When dealing with labor pains, pain medication is used to help the mother cope with the pain. The mother is informed of the pain management options available to her, when not to use various types of medications and any side effects that may be experienced from the medication. The mother is then left to make the decision of whether to use medication to relieve her pain or not (Johnson, 2015).
The mother tends to have a lot of say when it comes to giving birth in Swedish culture. While a physician is present, the mother makes the decision of whether the mid wife, the husband or any other family relative or friend will be in the delivery room (Johnson, 2015). The midwife is very informed and knows a lot about child delivery and what procedures to follow. The mother on the other hand decides whether to include the midwife, her husband, a friend or all of them as she is giving birth. Privacy is however valued and the mother can decide to only be with the physician and only the person she chooses to be with her during the delivery process (Johnson, 2015).
When it comes to post birth cage, parenting is done, by both parents who greatly contribute in ensuring the child’s positive development. The personal relationship associated with giving birth is extended to parenting where parents make decisions on what is best for the child (Johnson, 2015). In today’s society, a lot of technology is involved in securing the health safety of infants especially in the case of caesarean deliveries. However, it is still up to the mother to decide what actions will be done to enhance the child’s safety. The decisions however are well informed as the mother is given adequate input from the midwife, the physician and any other person involved in the prenatal and postnatal process of child birth (Davis, 2017).
While the mother has more say over post and pre birth care, she can decide to choose her husband as a non specialist attendant during childbirth. It is therefore the father’s responsibility to ensure that the wise makes the best decisions during and after childbirth to ensure the safety of the child. While the immediate family is expected to contribute in ensuring the well being of the child, most decisions are made by the mother. Advice and suggestions from family members are however welcomed as mothers rely on such information to help assess what is best for the baby. When it comes to the diet, women often prefer to consume hot food such as warm rice and drinking warm water. Cold foods are avoided but the diet soon changes to accommodate all types of diets regardless of whether hot or cold (Davis, 2017).
This paper discusses the wealth distribution in United States in terms of income levels and how it affects the country’s health using the life expectancy as a parameter for this measure. It considers the disparities in income level, how it influences health expenditure which is translated in life expectancy among individuals, various groups and communities. Data is analysed to reach a conclusion on how wealth relates to health affordability and access.
Introduction and background
Though it may appear simple how the health of a person is linked to their income for both the rich and the poor, the relationship between health and income can be viewed as a gradient. This is to means that their connection is at every stage of economic ladder. How do American population relates to their health in terms of infant mortality and life expectancy among the various economic classes? This notion considers that income is normally a driving force behind the health disparities experienced in the Americans and is normally indicated among the Hispanics and blacks. In these populations, the rates of diseases and illnesses are higher than among the white and non-Hispanic communities and such differences are connected to the income disparities (CDC, 2013). In addition, the Hispanics, blacks and Native Americans who have higher incomes have better health as compared to their counterparts with less income. The families with higher incomes spend considerable amount of income in health schemes which ensures that they can access better health care and can afford to adopt preventive measures against illnesses (CDC, 2013). Moreover, higher incomes indicate greater longevity and life expectancy across various income groups increase over time. The relationship between health , life expectancies and income varies significantly across different areas , and the variations in longevity across different income groupings reduces in some area while increasing in others as per the statistics.
Wealth and better wealth enhance better directly since wealthier people can access or afford resources that offers protection or improves health. Similarly, middle-income people tend to have more flexible and stable jobs that offer good benefits like health insurance, paid leave, and fewer occupational hazards. Those individuals who are more affluent have higher disposable income and hence, can access healthy life styles and medical care and can extend these benefits to children. People with low incomes mostly have constrained access to medical care , are probably under-insured or uninsured and encounter more financial barriers to accessing deductibles and cost of medication and such expenses of health care(Woolf, et. al 2015). The poor people can only afford to live in neighborhoods with low quality in health services, poor socialization and peer pressure influences such that they are exposed to violence and crime, physical distance and even isolation. In addition, such neighborhoods expose them to unemployment, residential mobility and social disorder which mean that they access little economic opportunities to improve their health outcomes. The economic status of neighborhoods and individuals are linked with health of population since the local economy impacts on access to commerce, jobs and other resources that make it possible for families to enjoy local-based health benefits and economic success (Woolf, et. al 2015).
The United States authorities have spent a lot more on health care as compared to other nations over the years according to data on Gapminder website. As wealth in among the households goes up, so does the expenditure on health per person while generally fewer people are being insured. While mortality rate and life expectancy are crude, measures of health, they indicate the disparities in distribution of economic growth among households belonging to different population groupings. Adults with low incomes are more likely to report poor health as compared to adults with adults whose households have over 400 % poverty level as per the federal statistics. This is because such individuals are less likely to engage in economic activities because of chronic illness. Children from poor households are more likely to be in poor health which means that their mortality rates will be higher. Life expectancy rose steadily as income increased and at age 40 the life expectancy gap between individuals in bottom and top 1 percent of income distribution is 10 years among females and 15 years among females. For those individuals at the lower incomes levels the statistics shows reduced life expectancy. The data shows that inequality rose for life expectancy for the 2001 -2014 period and those people at the top 5 percent of income distribution increased their life expectancy with about 3 years and those in bottom 5 percent had no gains. In the 200-2008 period, prevalence of diseases such asthma is indicated as 8.2 % among the higher income children, 11.7 percent among the lower income children and 23.3 % among lower income Hispanic children (Gapminder, 2015). Children from poor households also have a higher risk of childhood obesity which strongly indicates the possibility of adulthood obesity.
The trend in life expectancy versus the income between 2001 and 2004 indicates that there is a large rise in life expectancy for groups with higher incomes especially during 2000s. The mean life expectancy rose from 2001 to 2014 by0.2 years in the highest income earners and only 0.08 years among the lowest income earners. For women, the changes comparable to men were 0.23 for the higher income earners and only 0.1 years for the lower income earners. These variations can also be observed to be substantial across areas or regions in United States more so for the low-income persons. Great variations are observed across low-income earners while little variation is observed for the high-income persons. For the men living in the San Francisco, New York Detroit, Dallas, California and Texas the range of life expectancy among men was 72.3 years -78.6 years in the lower income regions while those in the top income regions ranged between 86.5-87.5 years (Gapminder, 2015).
85 Life expectancy
Women men
80
75
70
0 5 10 15 20 (House hold income quartile)
The above graph shows the trend in increase in life expectancy as the level of income increases among the various incomes quartiles. The level of increase is higher among women is higher among women than men for both the lower income earners and higher income earners. The figure can also explain the level of income among the variations across the various regions or cities where life expectancy increases with as households’ income increase across the quartiles. For those people occupying the lower income quartile, life expectancy differed by around 5 years among the men and 4 years among the women between the bottom and top longevity community zones (Woolf, et. al 2015). Similar to life expectancy levels, temporal trends differ substantially across geographical areas.
As aforementioned, income-based differences in longevity of life can also be seen across various communities. Counties such as Fairfax in Virginia which is among the richest and McDowel County which is among the poorest are separated by a small distance but the difference in life expectancy is quite huge.
Life expectancy, by Income, 1988–98
Life expectancy after age 25
49.2
51.2
53.8
55.7
Income - percentage
Less than 100 percent
101-200 %
201-400 %
Over 400 %
At 25 years old, people in highest income group are expected to live over 6 years more than those in the lower income groups. This data correlates with reports by Social Security Administration that people retiring at 65 are living longer but from 1970s people with earnings at the highest income distribution have experienced improved life expectancy by over 6 years than those at the bottom with 1.3 years (Gapminder,n.d).
Conclusion
Poverty in United States relates with deprivation in areas related to health and thus individuals’ life expectancy. The eye-opening disparities is indicated by the widening gap shown over a period of 15 years since 2001- 2015 , with the highest earning people being able to afford and access best health benefits while the lower income earners are struggling. Life expectancy and mortality rates are good indicators of such disparities. Life expectancy improved by about 2.34 years among men and around 2.91 years among women for top income earners and about 0.3 and 0.4 among men and women respectively for lower income earners. The difference results from the percentage of income whose expenditure is purely on health with rich people spending more than poor people.
There are many factors which influence healthcare utilization, these includes socio-economic status, policies and beliefs of a nation. The Socio-Economic Status (SES) of a given community is a complex measure which is centered on factors which include demographic characteristics, education and income (Kronenfeld, 2011). SES has very important influence on healthcare utilization behavior, simply because of the effects that it has on aspects such as need, response to symptoms and recognition. The policies of a government can either have direct and indirect effect on the utilization of healthcare. This is so because, when a country decides to increase usage of healthcare through the population, it can only do so through creating policies.
Socio-economic status has very many both positive and negative effects on the access of healthcare. This depends on the living standards of the people in a given country, that is, if the living standards are very poor in the country, then it means the access of healthcare becomes very difficult. On the other hand, if the education in a country is good, then it means that access to healthcare will also be good (Sun, 2015). This is so because, the country will be able to produce medical practitioners, who will cater for medical care, thus reducing the cost of healthcare. Government policies can really help in improving the access of healthcare, since policies such as free healthcare to all, help in improving the access of healthcare in the country.
Lack of or delayed healthcare can really affect individual’s life negatively, this is because, a person may die due to poor or lack of healthcare, when the situation can be controlled (Yan et al 2016). Moreover, an individual’s condition may worsen due to delayed medical attention, thus making the person to contract a terminal disease. Thus healthcare should never be delayed since it can really affect an individual’s life negatively (Kronenfeld, 2011).
Reference
Kronenfeld, J. J. (2011). Access To Care and Factors That Impact Access, Patients As Partners In Care and Changing Roles of Health Providers. Bingley, U.K.: Emerald Group Publishing Limited.
Yan-Ning, L., Dong-xiao, N., Bo, W., Qi-Ming, F., & Hong-ye, L. (2016). The impact of predisposing, enabling, and need factors in utilization of health services among rural residents in Guangxi, China. BMC Health Services Research, 161-9. doi:10.1186/s12913-016-1825-4
Sun, L., Lee, E., Zahra, A., & Park, J. (2015). Original Research: Should non-citizens have access to publicly funded health care? A study of public attitudes and their affecting factors. Public Health, 1291157-1165. doi:10.1016/j.puhe.2015.07.033
In today’s society, most industries have been tasked with the responsibility of incorporating the use of technology in their day to day activities. Advancements in technology have been so beneficial that most industries are opting to leave their traditional methods of operation and adopt the use of technology to improve their quality of service. Technological devices such as computers have been incorporated by various organizations due to the advantage they bring to the industry. One field that has not been left behind is the medical industry which is slowly embracing the use of technology so as to offer better care to patients and make work easier for care givers. A new trend that is seen in the health care industry is the replacement of paper records with more convenient electronic medical records. While paper records have been used for a long period and were somewhat effective, electronic medical records are now the most preferred due to the advantage that they have over paper records.
In the past, prescriptions and any other vital information regarding a patient, their condition and required treatment method were noted down in paper. The records were then kept in a place that was accessible to ensure that the health institution had a systematic way of keeping track of all its patients (Hoyt, 2017). While this was the most favored method, it was greatly flawed in that the accuracy of the information kept in these paper records were determined by the legibility of the written information. As is common with most doctors, the hand writing used to make and update the paper records was difficult to read as doctors rarely took the time to ensure that what they were writing was clear and easily understood by a third party. This made it difficult for the patient and even for other nurses who had to review the patient’s records (Hoyt, 2017). With electronic medical records however, legibility is not an issue since the information is stored in a font that is clear and easily read by anyone who reads the files. Better records allow for better treatment as doctors and patients can read the records and learn the accurate procedures to be followed on the journey to recovery.
Another advantage that electronic medical records have over paper records is that they are relatively hard to be damaged. In the case of paper records, factors such as fire and water could easily destroy the records with no hope of recovery (Hoyt, 2017). Time was also a challenge as the paint would disappear from the records over time thus making paper medical records very vulnerable. However, electronic medical records are more durable and therefore safe. The records are saved in electronic devices such as computer hard drives or even through the cloud services offered through the internet. Multiple copies of the medical records can be made to further enhance the security of the patients’ information. In case of a fire or contact with water, the only damage caused will be to the computers but not the records themselves. The data can be retrieved by using other computers thus ensuring that the records kept are always safe and secure (Hoyt, 2017).
Electronic medical records also help to enhance the quality of care offered at health institutions by ensuring that the information regarding a patient is easily available and in real time. Since the records are updated automatically every time a health practitioner treats the patient, the information is always accurate and up to date (Kawasumi et al, 2005). Doctors viewing the records before treating a patient will therefore have reliable and accurate information to ensure that the treatment offered is necessary and will not lead to any medical errors. The records also help in ensuring that patients get the correct prescriptions. The physicians are able to communicate with physicians in real time through a method that is clear and the medication is easily read to ensure that the patient receive the correct medication. In advanced systems, the technology is able to check the medication being prescribed to a patient to assess whether there will be any danger for the patient in using the prescribed drugs (Bisk, 2017).
Before electronic medical record keeping, doctors found it difficult to track the medical history of a patient such as the medication the patient was currently using, any medical procedures that the patient had undergone and other information especially when multiple doctors were working on one patient (Bigelow et al, 2005). While this may have been a challenge when relying on paper medical records, electronic medical records are more convenient as they allow multiple doctors to read and update a patient’s record, regardless of their location within the health facility in actual time thereby allowing them to batter treat the patient. The information is not only accessible by doctors but also by other departments such as the physicians who rely on this up to the minute information so as to give the recommended medication to the patient (Hoyt, 2017).
Another advantage that electronic medical records have over paper records has to do with storage where the latter tends to occupy more space. Electronic medical records are easier to store as one only need the storage space found in hard drives of computers (Kobeissi, 2015). Rather than relying on shelves as is the case in paper medical records, electronic medical records are easily stored in hard drives which not only reduce the space accounted for storage but also the time taken to access the information stored. Accessing patients records is at the click of a button unlike is the case with paper records where the doctor has to go through various files before finding the required file. The ease of access also makes accessing the files faster and in cases where time is an issue, electronic medical records could save a life (Kobeissi, 2015).
References
Bigelow J, Bower A, Girosi F, Hillestad R, Meili R, Scovvile R and Taylor R, (2005) “Can electronic medical record systems transform healthcare? Potential health benefits, savings and costs” Health Affairs
Bisk, (2017) “Benefits of electronic health records” USSF Health,
Kawasumi Y, Pereira J, Poissant L and Tamblyn R, (2005) “The impact of electronic health records on time efficiency of physicians and nurses: A systematic review” Journal of the American Medical Informatics Association
Kobeissi B, (2015) “Examining the difference between the use of electronic medical records and the productivity of patient care in Canada: 2014 national physician survey” Canadian Medical Association
Hoyt E, (2017) “Benefits of switching to an electronic health record” Practice Fusion
This report identifies and explains the causes of sleep deprivation and the consequences that are associated with sleep deprivation. Sleep deprivation is caused by sleep disruption as a result of smart-phone use even during the night. Stress is another cause of sleep deprivation as most of the people have engaged in so many activities that are demanding and thus leaving them stressed up with life issues. This paper will therefore examine the functions of sleep to humans. In the next two weeks we will examine the various consequences and the recommendations to this sleep deprivation situation.
Situation
Sleep deprivation is a common and continuous situation that is affecting about 30% of the people and the percentage is increasing as days go by. Psychologically, sleep is important as it stabilizes the mind and helps the mind to rest and clear off the mind. Sleep has been regularly ignored by most of the people and they hardly think of sleep not until their minds and bodies have shut down. Sleep deprivation has thus occurred regularly as from one day to several nights when the person can no longer function due to brain shut down. According to a various researches, the researchers examined the role of sleep and they found growing evidence that demonstrated that sleep enhances the people to strengthen their memories and thus making them successful in their day to day operations.
Background
Research development in this area has been slow but recently there has been an increase in the sequence of interesting results that are giving potential researchers a new outlook into why people need to sleep and its functions to people. The rates at which most of the people while in business and at class are demonstrating inactiveness while still awake is increasing and this has raised concerns. The previous researches indicate that most of the people who fail to sleep adequately are often associated with poor performance since they are not able to concentrate fully with what they are doing as their minds have fatigue.
Causes
Stress can cause sleep deprivation thus resulting to a person’s inactiveness. Stress causes sleep disruption as one thinks of the various things that are troubling them, hence they spend part of their night trying to think of their troubles rather than sleeping. Most of the people also face the problem of sleep deprivation due to electronics devices such as mobile phones which switched on throughout the night while they are in bed and thus their sleep is disturbed. As they chat and follow the trending news through the various social media, they end up spending a larger part of sleep time on these electronic devices than in sleeping.
Effects
Sleep being one of the basic human needs, when it is deprived there are serious health cost that are associated with sleep deprivation. Lack of sleep makes a person to be bad-tempered as well as clumsy. As people lack sleep, they tend to have no sense of humor as they are tired and thus they tend to be emotionally detached thus causing them to become more awkward socially detached due to their bad temper. Thus, lack of sleep affects a person’s personality and also their sense of humor as they turn into being intolerable and irritable people.
Persistent lack of sleep causes a person to be inactive in most part of the day and they are unable to work normally. As the mind is tired, the body coordination is hard and thus due to lack of sleep a person is unable to rest properly thus causing them to be inactive the following day.
A person may as well start to hallucinate as the persons brains become shut down and thus they fail in giving the rest of the body directions. Going for several days without sleep may cause one to hallucinate as the brain fails to function as expected due to the fatigue that has accumulated over the days as sleep has been deprived.
Considerations
The required time to sleep is approximately eight hours at minimal as this will help to solve the issue of brain shutdown since the mind will be able to rest. It is important to consider the fact that health experts recommend a person to sleep for approximately eight hours. Eight hours of sleep in a total of 24 hours in a day is not much as compared to 16hours of staying awake and this cannot disrupt a person’s schedule as it is just a third of the total hours.
Recommendation
It is thus recommended that sleep should not be ignored but rather it should be equally treated as a basic need and this will make us healthier and even more active. Therefore, people should be able to sleep early at night and ensure that they avoid any form of distraction so that they can get enough sleep before waking up early the following day.
It is caused by weakening of arterial wall due to extreme enlargement of the artery. The condition can remain silent or even rupture which leads to severe problems or death. It can occur in arteries that transmit blood to the brain and the aorta or large artery from left ventricle and passes through one’s chest and abdominal cavities (Salvo, 2009). The rapture can also happen in peripheral arteries. The enlargement of the artery allows the blood to extremely and abnormally extend artery wall. Rupturing of cerebral aneurysms is majorly the cause (Salvo, 2009).
While this condition does not itself cause symptoms, some individuals may report lower back pain or abdominal pain, and others abdominal pulsating sensation. Others include chest pain, difficulty swallowing or wheezing, instant extreme headache, low blood pressure, light headedness and rapid heart-rate. Brain aneurysm may require active treatment or regular monitoring through preventive measures or medication. Where rupturing occurs, surgical treatment may be needed since lack of repair may lead to fatality (Brunner & Smeltzer, 2010).
Ischemic stroke
This is caused by the narrowing or blockage of arteries in the brain leading to extreme reduction in blood flow. One cause is thrombotic stroke which happens when a blood clot is formed inside one of the artiries transmitting blood to the brain. Such a clot may result from fatty deposits in the arteries which lead to low blood flow and various artery conditions. Embolic stroke is another cause which occurs due to blood clot or debris forming in areas such as the heart and is transferred through the blood stream and lodged in brain arteries that are narrow (Brunner & Smeltzer, 2010).
The symptoms if this stroke includes disorientation in speech, numbness or paralysis of legs, arms or the face more so in one side of the body, troubled vision, walking and headache. The length of these symptoms may determine the treatment decisions. Treatment of severe ischemic stroke involves therapy aimed at preserving ischemic penumbra tissue through restoration of blood flow to the affected areas and though optimization of collateral flow. Nero-protective strategy is also used to limit the ischemia duration, protecting, and penumbral tissue and allow more time for revascularization procedures (Brunner & Smeltzer, 2010).
Hemorrhagic stroke
This occurs after blood flow to the brain is cut off or reduced significantly after rupturing of a blood vessel so that there is accumulation of the blood around this rupture. The rupture of the blood vessel is caused by aneurysm and arteriovenous malformation. Aneurysm occurs after a blood vessel section is enlarged due to chronic blood pressure or due to a weak blood vessel that is normally congenital. Arteriovenous malformation happens when veins and arteries are linked abnormally without any capillaries between the two. They are congenital meaning they are present during birth but are not usually hereditary (Ulbricht & Natural Standard (Firm), 2009).
Symptoms differ from one person to another but appear almost always after the stroke occurs. They include loss of consciousness completely or partially, vomiting, severe or sudden headache, nausea lack of balance, disorientation in speech and seizures (Brunner & Smeltzer, 2010). Immediate treatment involves the control of bleeding in the brain and reduction of pressure due to bleeding. In this case drugs are used in emergency treatment. In case small rupture, bleeding and pressure, treatment involve supportive care through rest, IV fluids, physical, occupational or speech therapy. Serious cases may require surgery for repairing blood vessels (Brunner & Smeltzer, 2010).
References
Salvo, S. G. (2009). Mosby's pathology for massage therapists. St. Louis, Mo: Mosby/Elsevier. 184-186
Brunner, L. S., & Smeltzer, S. C. O. C. (2010). Brunner & Suddarth's textbook of medical-surgical nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 1902-1905
Ulbricht, C. E., & Natural Standard (Firm). (2009). Natural Standard medical conditions reference: An integrative approach. St. Louis, Mo: Mosby/Elsevier.
Communicable diseases correspond to a significant amount of challenge to the health care providers in the severe food shortage situations. The increasing economic crisis in the underdeveloped countries has attributed to more cases of malnourishment due to high incidences of poverty. The WHO guidelines need to be regularly updated within 18 months up to two years. However, these guidelines have not been updated for the past six years and hence the recommendations may not be considered as current and viable. There has been a new evolution of epidemiological information as well as new guidance and thus the document requires to be updated so as to be viable in dealing with these undernourished related diseases (World Health Organization 2010).
Some of these recommendations are not entirely practical. This is because they are way too general for their effectiveness to occur. They have no set timeline as to how frequent these systematic and routinely vaccinations ought to be undertaken. Also carrying out of an indoor spraying may not be practical in these underdeveloped countries since they have inadequate health officers and inadequate finances to cater for these sprays that can cater for all the malaria infested environment settings (World Health Organization 2010). Follow up recommendation should be integrated in these programs as well as education on health education should be offered to all people across all age groups so as to create awareness to these people on how they can ensure that they take care of themselves s as to ensure that they are not malnourished and on how to ensure that they do not spread the diseases. Nurses have a role in administering health education and in supporting the improvement of safe and adequate food, water, vaccinations, and immunizations as well as promoting infant feeding practices that are appropriate.
References
World Health Organization (2010). Communicable Diseases and Severe Food Shortage. Retrived from:http://apps.who.int/iris/bitstream/10665/70485/1/WHO_HSE_GAR_DCE_2010_6_eng.pdf
Despite the advantages that Prostate Specific Antigen (PSA) testing has to offer, men not displaying any symptoms associated with prostate cancer do not have to get the PSA test. Although the PSA test is beneficial for men who have a history of prostate cancer in the family or are displaying its symptoms, doing the tests on people that do not meet these criteria is not recommended as it could be a waste of capital and putting the individual under unnecessary stress (Jacobson, 2013).
Some of the risks associated with PSA include putting patients through treatments that expose them to side effects such as bowel dysfunction, urinary incontinence and erectile dysfunction (MFMER, 2015). The test can also make patients anxious and confused about the results forcing them to live in fear that they have contracted Prostate cancer as most people consider it to be a life threatening disease. While PSA test have reduced the number of people who die from Prostate cancer, the number is not high enough to warrant the cost that patients have to incur when undergoing the tests. In the case of families with no history of Prostate cancer or any symptoms associated with the disease, PSA test become a waste of money and this can be seen as a downside (MFMER, 2015). The risks therefore outweigh the benefits and men with no symptoms should not take the PSA test.
PSA tests are ideal for men aged between 40 and 70 years and men prone to contracting prostate cancer (Jacobson, 2013). Since men in this age bracket and those with a history of the disease in the family or display its symptoms are the ones likely to contract the disease, the decision to get the test solely lies on the individual. Patients must therefore discuss their risk factors with registered nurses and their families before deciding whether to take the test. Nurses must therefore ensure that patients know everything they need about PSA tests and its impact on the control of Prostate cancer (Jacobson, 2013).
References
Jacobson, J. (2013). “Navigating the PSA screening dilemma”. American Journal of Nursing, 113(1), 19-21. doi:10.1097/01.NAJ.0000425741.91354.c4
Anecdotal records are observations that are made on the children and are written down. These records are basically involved in recording or writing down on the activities that a child does within the classroom setting. These records are essential as they allow the teacher to be able to examine the child’s development in all the areas of his or her life. This involves the cognitive and social development, physical as well as emotional development. They are also able to learn more on the child as an individual as they help the teacher to realize some of the interests for each individual child and ultimately the entire class (Swain 2013). The teachers are also able to track on the progress of the child and thus share the information with their parents and thus important decisions are made. Writing of these anecdotal notes involves some of the fundamental things such as the child’s name, the date, the time as well as the setting. It also involves the observer’s name, the description on the observation made on the child, some details on the actions that the child is taking.
It is 11.00am on Monday morning, 27th March 2017, in the preschool laboratory. Gaye, a 5 years old boy, is standing at the sensory table with other three children as they all play with beads. Gaye watches at the girl standing at the other side and puts the beads at her bowl. Later he starts picking up his own beads and filling his own bowl where he fills the bowl on his own. He uses his right hand as he sneezes and then returns to fill his jar with the beads from the big bowl (Readleafpress 2013).
Family System Theory by Murray Brown is among the family models which were developed a few decades following World War II by pioneers in the metal health sector. Brown had practiced as in the psychoanalytic model after training as a psychiatrist and in late 1940’s while working at Menninger Clinic, he begun involving parents especially mothers in treatment and investigation of patients with schizophrenic problems (Brown, 2014). After moving to the National Institute of Mental Health, his focus started shifting from individual cases to the families’ dimensions as systems. He started involving individuals in family institutions in his psychotherapy and research with their members suffering from schizophrenic condition. His establishment of Georgetown family center facilitated the extension of the developing theory to emotional problems that were less severe (Bitter, 2013). The 1959-1962 periods saw him engage in detailed research into family institutions across various generations. He placed his focus on what he perceived to be the normal patterns in emotional of humans and this focus on families; qualitative similarities he asserted that everyone has in them little schizophrenia (Boss, 1993).
After publishing his first orderly work of the developing ideas, he applied his concepts to assist in intervention where there was emotional crisis of less intensity among his extended family members, which he was to term as a remarkable breakthrough in practice and theory. In a 1967 conference on family therapy, his presentation was in form of a talk on the experience he had with his family, instead of a formal paper presentation to the surprise of many. He later encouraged students to work to focus on intergenerational patterns and triangles in their families instead of just undertaking individual psychotherapy. From these trainees emerged the present Bowenian Therapy leaders (Boss, 1993). While the basic principles in this theory have been changed slightly over a period of time, considerable expansions have seen attention being placed on stages of life cycle and the integration with a feminine lens. There are about eight intertwined principles of Bowen’s theory based on the family systems and therapy of family field and follows a development sequence or hierarchical orders.
Triangles
This theory basically focused on fusion and distancing, adequate and inadequate partners. His use of the word triangle instead of triad deliberately to show his particular meaning so that to avoid any misunderstanding with other triangulation principles. Triangles are described as the smallest unit of stable relationship and “triangling” happens after reliving unavoidable anxiety in a dyad through the involvement of another party who neutralizes anxiety or takes sides (Goldenberg & Goldenberg, 2008). Couples undergoing an imbalance in their relationship cannot balance their forces like fusion and distancing and left on their own they swing between closeness and distance. Hence a triangle represents the smallest possible system of relationship that can maintain balance in stressing times (Goldenberg & Goldenberg, 2008). For the relationship to stabilize, a third party must be involved in helping reducing anxiety and hence, maintain closeness. This party takes an outside position which is most desirable and comfortable in stressing times since the inside position has the baggage of anxiety and emotional closeness. Over three people form multiple triangles thereby resoling themselves. Outsiders in the triangles will be involved when there is more stress than a family system can handle (Brown, 2014).
Differentiation
Differentiation and fusion are used by Bowen for describing the degree to which individuals are able to separate their intellectual and emotional spheres. People who are highly fused act automatically and their response to life circumstances involves emotions. On the other hand, individuals who are highly differentiated have intellectual system that is autonomous and which enable them to control their emotions (Titilman, 2014). A person whose response to situations is immediate without thinking through available choices or talking directly with their partner over the relationship invests lot energy to take things personally or distancing oneself. A family that tends to fuse greatly has less flexibility in adapting to stressful situations. Bowen describes differentiated self as solid self and a fused self as pseudo self (Titilman, 2014). The former knows its desires and needs while the later reacts to its surroundings. In marriage, the merging of two pseudo selves leaves the dominant one gaining at the expense of the other. This concept of differentiation is important but there is need to emphasize the description is about thought process control and not behavior manifestation. He developed self-scale differentiation to help in explaining his concept. The whole process may be life-long and total differentiation may not be possible to achieve (Rabstejnek, n.d).
Nuclear Family Emotional System
In this system, Bowen attention is focused on the effect of un-differentiation on how a generational family functions. He postulates that relationship fusion which cases “triangling” is the driving force behind symptom formation and is manifested in spouse illness, couple conflict and a problem being projected onto children (Boss, 1993). The emotional system patterns that has been replicated for various generation will be followed by current parents who will pass them to the children they will bear. According to Bowen, marriage is the starting point for relation in nuclear family and other living planning are disregarded. If an option is available for terminating the relationship, true fusion will not exist. As indicated above, the degree of differentiation is not determined by behavioral termination but how intellectual process will be controlled by emotions (Brown, 2014).
Family projection
The level of adaptation that triad requires is affected by outside influences which includes how a nuclear family relates emotionally to the extended family and the degree of anxiety that is applied externally. Psychopathology is made worse by anxiety and motional differences that have not been resolved. The current relationship either absorbs or resolves any undifferentiated energy existed among grandparents (Titilman, 2014). Failure by a parent to resolve energy imbalance makes that energy to be projected onto their children. A child will be free from the symptom relatively if they are not involved in the emotional field while a single may affected while another one is not. Since the mother is directly involved the process of reproduction and development of primary attachment, the emotional filed of this child revolves around her. A serious manifestation of the systems may not be seen until a child’s later development stage like adolescence or moving away from the comfort of their home (Richardson, 2010).
Multi generational transmission process
The symptoms in a child are intensified over many generations until they resurface as schizophrenia. The impact of the generation to generation transmission will be different for individual child, which depends on level of “triangling” they share with parents (Richardson, 2010). Attention given to this pattern is not for evaluation but for intervening so as to help families to distance themselves as much as possible from present struggles with such symptoms. This way they may impart change in transmitting anxiety over future generations. Learning about one’s family, its history and how they succeeded, failed and their relationships you can actively play a role in interactions that are repetitive (Rabstejnek, n.d).
Sibling positioning
Bowen used Walter Toman’s sibling profiles to assert that the position of sibling could offer information that is useful in understanding the roles taken by individuals in relationships. As such the eldest children are likely to undertake leadership and responsibility while the younger ones may be dependent on decision made by others. Middle children are more likely to be flexible in shifting between dependency and responsibility (Ziegler, 2005). He noted that the above traits are not applicable universally and younger sibling to assume the position of functional eldest. A parent may identify more with a child who occupies similar position with their own or a past cross generational triangle can be repeated. It is possible that a sibling can encounter various challenges such illness similar to the ones a previous-generational child who occupies similar position suffered. One should be helped to understand and think past their sibling position’s limitations (Richardson, 2010).
Emotional cutoff
This was added to this theory later since it had not been covered when it was part of other principles. Termination of a past relationship does not guarantee an end to its impacts on future relationships. Emotional attachments to previous generation that remain unresolved will affect future performance. Bowen asserts that an individual who abandons their family of origin becomes emotionally dependent as the one who didn’t leave and running away is copied as a pattern in other relationships in future (Titilman, 2014).
Emotional process in society
Regression in the society extends past triangles the domain of immediate family. There emotional forces in the society that tend to lessen intellectual functioning and fusion will be reinforced by chronic anxiety of the times. The assumption is that societal influences follow the principles of Bowen Family System Theory. Through this concept, Bowen Theory is extended to include the organizations’ and community everyday life. Just like in families, groups operations occur at emotional level with undifferentiated people who make irrational decisions after triangulating (Brown, 2014). This knowledge can be used in development of strategies which will change the groups’ undifferentiated ego mass which reduces frustration through process observation, triangles identification and assessment of differentiation (Rabstejnek, n.d).
The Bowen theory can be compared with other theories such as the Cognitive- Behavioral Family Therapy and Behavioral Theory. Unlike Bowen theory where traits can be passed on from one generation to another, these theories consider behavior as being learnt or resulting from thinking process (Pedersen, 1991). Behavioral theory holds that behavior is learnt through processes such as classic conditioning or operant conditioning. Learnt responses affect ones habit through stimulus and rewards can increase the possibility of certain behavior while punishment decreases the possibility of this behavior occurring (Pedersen, 1991). Cognitive theory on the other hand focuses on how thinking of individuals can influence behavior or feelings. Therapy is normally focused on this theory has its orientation towards solving problems. Therapists have their focus on the present situation of the client and their distorted thinking rather than the past on which Bowen Theory is focused (Beck, 2010). Humanistic approach theory on the other hand focuses on the present with an aim assisting a person in achieving the highest possible potential. Humanist believes on goodness found in everyone and self-actualization or growth is emphasized (Pedersen, 1991). Unlike Bowen’s theory where past generations influence current generations, humanistic approach consider individuals as being able to influence their behavioral outcomes and thus destinies.
These theories have various similarities with the Bowen Theory in terms of solving any conflict or changing behavior of an individual. The need for a third party intervention is indicated to be of great significance so that they can help in neutralizing the ground or in helping an individual to influence on their behavior. Change is also an important aspect identified in these theories more so the need to break away from a past behavior in order to experience better outcome. Moreover therapeutic actions are the basis of assisting in behavioral change and the counselors must first understand the past of an individual and while it may not be important to dwell on, it is essential in imparting the necessary changes in a person or among conflicting individuals.
From the Bowen theory it can be learnt that Murray Bowen was a strong believer in a cogent theory having to be the basis of therapeutic actions. His interest in natural science informed concrete knowledge upon which therapeutic metaphors are mostly based. A therapist has the role of connecting with a family while not becoming emotionally reactive. The therapist must maintain a stance which is differentiated so that he is not drawn into an under responsible or over responsible reciprocity in his attempt to help. Therapist must not lose sight of the part they have to play in the interaction system where they can be required to act as mediators in a family triangle. As per the Bowen theory, the intervention techniques should be focus on an individual rather than the triangles in a family setting. There is also an emphasis on not involving children in settling conflict but dealing with adults who are majorly the cause of the situation (Pedersen, 1991). The Bowenian therapist should take up the role of a coach while teaching clients about the aspect of differentiation.
Part II
From a Christian point of view, one should be mindful of the danger of equating biblical perspective on condition of humanity with the current psychological theories that dominates the counseling field. Approaches that aim at promoting human capacity to be essentially achieve full potential or good by use of personal effort undermines the solutions offered to helplessness state that humanity find itself in. hence, any strategy that attempt to promote the goal of continuous efforts to self knowledge will collide with Biblical call to depend on God with our strength, hear and mind (Banker& Powell, 2014). The family system by Bowen does not show how human should be living but it is attempts to use research observation in the description of human reaction in relationships. This theory provides a description of human patterns that can be identified in relational spheres. It describes what is not clearly defined in the Bible since the Bible explains where disharmony and symptoms come from in human relationships but does not offer detailed description of relationship and emotional aspects that are inherent in human condition. The description by Bowen Theory is about emotional systems and relationship patterns in Christian lives that are also found in non-believers (Banker& Powell, 2014). An objective observation of human actions while undergoing relationship stressors defines the believers and the non-believers. Bowen theory asserts that the main variable is the degree of differentiation of an individual in terms of both relational and emotional maturity.
The Bowen theory can be used by Christians in good conscience since it does not refer to any strange metaphysic and mythology. It starts by attempting to define factually those discrete symptom and behaviors that happens within an individual and the emotionally significant relations referred to as systems. By not referring to metaphysic and mythology, the theory does not discredit the fact that human beings experience challenges in relationships due to their fallen nature and the solution can only be found in God. Furthermore, aspects provided to define the most common human behavior such as distance, conflict and cut-off are just descriptive but not diagnostic. Bowen theory has no experts since a person cannot just read the materials and start counseling. This can only be done by those individuals who maintain contact with the extended family while they are teaching others on differentiation art. Just as the church pursues sanctification, this theory involves relations, incarnation and is normally a life-long process (Banker& Powell, 2014). The theory touches on behavioral dynamics that are inherent in the creation itself. It would not be appropriate to oppose a theory that brings out observable facts. The idea that Murray is trying to sell to counselors is for them to make their clients experts in their own families (Richardson, 2010). The practitioners of this theory avoid the dependence on a certain authority which is encouraged by personal focus in psychiatry and psychology. The family should be the best manual that can help an individual to learn about themselves and hence the aim of Bowen’s theory is for people to be knowledgeable about their family patterns of empirical behavior. They then use this knowledge in improving functioning in all their relationships.
The virtue of humility appreciated in apostolic counsels are encouraged by this theory, and rather than of looking into the ups and downs of diagnosis, we should embrace couching. In addition, this theory keeps a person a way from being judgmental through perceiving their clients as being sinful but showing the need to the person first before diagnosis. This theory can be termed as proverbial wisdom for believers if it can be used in the same way as literature wisdom is used in leadership and pastoral care. The various aspects explored in this theory can be used to finding solution to challenges and conflicts facing modern day families. The differentiation aspect defines what happens when members of a family become involved and attached to one another to an unhealthy level. Personal evaluation is a valuable therapy whose broadness enables to incorporate many techniques which are family focused (Banker& Powell, 2014). It’s emphasizes on family units and healthy relationships among extended families makes it compatible with the teachings of Christian faith. It has much resource that is useful in settling issues that involve more than members of a family. The focus of Bowen’s Theory was on patterns in which families are developed so as to resolve anxiety. The perception in the family of too much distance and too great closeness in a relationship is a major source of anxiety and the level of anxiety in a given family will be shaped by the present external stress levels together with sensitivities to specific issues that have been passed on among generations (Banker& Powell, 2014).
The theory offers principles that are in line with Christian teachings on role of an individual in minimizing conflict by first changing their behavior before judging others. In case members in a family are unable to solve their conflict they should involve a third party with to make peace by reducing any conflict between them. A family whose members are unable to check their responses to relationship issues but instead react to emotional demands anxiously allows the setting in of chronic reactivity or anxiety. Bowen Therapy has a major goal of reducing chronic anxiety through the facilitation of awareness on the functioning of emotional system and increased differentiation where focus is placed on changing self instead of an attempt to changer others. Spouses should be at par in terms of differentiation level. A lot of fusion in a couple may lead to one or both being anxious, and emotional divorce or distance is the normal way of handling this stress (Banker& Powell, 2014). The above mentioned symptoms are also methods for compensation. The outsiders like ministers, therapist, police and support groups form extend triangles that will moderate tension by having two comfortable sides and another side in conflict. In a normal father-mother-child triangle, there may be tension between parents where father who is weak increases conflict between a mother who is dominant and a kid who is traumatized. According to Bowen, the strong person is over-adequate while the weak one is inadequate in a marriage. Both strength and weakness are not better states since they represent the partners’ states that are equally undifferentiated. The theory practically offers ways of maintaining good relationships in family units which form the foundation of the church.
Reference
Bitter, J.B. (2013).Theory and Practice of Family Therapy and Counseling.166-167
Boss, P., (1993).Sourcebook of family theories and methods: A contextual approach. New York (N.Y.: Springer
Ziegler, S. M. (2005). Theory-directed nursing practice. New York: Springer Pub. Co. 110-113
Goldenberg, H., & Goldenberg, I. (2008). Family therapy: An overview. Australia: Thompson Brooks/Cole.178-179.
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