Healthy Living in the North

Emotional regulation – why I’m pretty sure I’m a cat person

Puppy

Although hard to believe that anyone could get frustrated by this adorable face, Nick found grounding techniques really helpful when dealing with the frustrations of housebreaking his puppy, Keto. Grounding is a great tool to shake off negative thoughts before they get out of hand.

I’ve just gotten home for what used to be my lunch break. I’m standing outside in the rain. I’m tired, stressed, and I was already irritable before I got home. I am repeating a phrase loudly and evenly. A phrase that apparently only has meaning to me.

KETO, COME!

The puppy looks at me long enough for me to decide that she has heard me, decided that she wants to make me angry and waste my time, and then resume her attempts at inhaling the pine cone in front of her.

KETO, COME!!

I don’t have time for this. I have a bunch of emails to return, education to plan, and an errand to run before I scramble back to work. Keto has now approached me slowly, but right before she mounts the couple of stairs leading back to the house, she suddenly prances into the thicket in my backyard and starts to roll in what I’m sure will be an aromatic pleasure to remove from her fur and my carpet.

KETO, COME!!

It is decided. I already know the picture that my wife will choose for the “Missing Puppy” poster. I’m kidding, of course!

Here’s the thing: when Keto finally does listen and come to the doorstep, I need to be able to greet her and praise her and use positive reinforcement to help her learn to associate coming back to me with a positive memory. I need to be able to separate my busy schedule, work and life stressors, and frustration from the fact that this is a puppy just being a puppy. She is not deliberately trying to get on my nerves. In fact, most things in my life have not been set in place just to get on my nerves.

When it comes to maintaining my wellness and dismissing negative thoughts, generalizations, and distortions, I often find it helpful to use a tool called grounding. At its core, grounding helps to reorient me to the present and keeps me fixed in reality. It lets me shake off some of the negative thinking before it gets out of hand and I end up acting on thoughts that aren’t helpful to me.

My personal favorite way to do it is a simple exercise where I work my way through my five senses (sight, hearing, smell, touch, and taste) and list 3 things that I perceive with each sense. I deliberately focus on each item for a couple of seconds before moving to the next. I can work my way through this exercise in just a minute and nobody around me would have any indication of what I’m doing. When I’m done, I find that it helps me come back to reality and lets me be effective. Sometimes, I need to do the exercise a couple times in a row.

The great thing about grounding is that there are many different ways to do it. Some people like the exercise I described, other people will do things like run their hands under cold water for a few seconds. Others will keep a smooth rock in their pocket and run their fingers over it, focusing on the way that it feels, the weight, whether it is warm or cool. Essentially, you are interrupting yourself before you get carried away with unhelpful thoughts. By choosing an exercise and practising it before you’re in the midst of a really stressful event, you can add another tool to your coping skills that will help keep you well.

So, on days where the housebreaking is failing and Keto has decided to try to eat the only bee stupid enough to be outside this early in the season, I remind myself to be thankful for all this practice I get to have with my grounding and coping skills.

If you would like to try grounding, I would recommend looking at the links below or inquiring at a Northern Health Mental Health and Addictions office. I hope you find it as effective as I have!

Grounding info and exercises:

Nick Rempel

About Nick Rempel

Nick Rempel is the clinical educator for Mental Health and Addictions, northwest B.C. Nick has lived in northern B.C. his entire life and received his education from the University of Northern BC with a degree in nursing. He enjoys playing music, going to the gym, and watching movies in his spare time.

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Devote time and energy to mental wellness

Graphic reading: How do you really feel?

Like physical wellness, it is important to devote time and energy to developing your mental wellness. What can you do to foster mental wellness each and every day?

For me, one of the exciting things I’ve seen when we’re talking about health is the increased attention on wellness and protective factors, instead of solely on disease and symptoms.

It’s no surprise that this extends to the field of mental health and mental wellness.

This year, for Mental Health Week (May 4-10, 2015), I would encourage you to give some thought to the things that keep you healthy mentally. Similar to physical wellness being more than the absence of disease, mental wellness is a state of well-being. What it looks like for you might be different than what it looks like for me, but the important part is that we dedicate time and energy to keeping ourselves well.

I’ve gotten better at recognizing when I am not doing enough to support my wellness: I am quicker to become irritated, I start to notice some physical symptoms from stress, and I am generally not a whole lot of fun to be around. These are indications for me that it might be time to take some affirmative action. Personally, I know that I sometimes need to give myself some extra time on the drive home to process after a difficult day of work. I also need to maintain my healthy sleep habits. Regular exercise is also important for my mental wellness.

Another similarity between mental and physical wellness relates to coping tools or what may be referred to as “resiliency factors.” If we have a large range of these tools, even if we do become unwell, we may be sick for less time or not get as sick as we otherwise would. Visit the Canadian Mental Health Association for a self-assessment and some tips on resilience.

Another way that we can enhance our mental wellness is by opening the dialogue about mental health. By having a week to increase attention on mental health, we can address one of the most pervasive things that impedes mental wellness: stigma. Negative attitudes, beliefs, and actions spread misinformation and fear about mental health issues.

The bottom line is that mental illness may affect any one of us over the course of our lives, so let’s do what we can to support one another and help increase the overall level of knowledge and inclusiveness in our home, work, and social environments. To learn more about reducing stigma, visit the Mental Health Commission of Canada.

Nick Rempel

About Nick Rempel

Nick Rempel is the clinical educator for Mental Health and Addictions, northwest B.C. Nick has lived in northern B.C. his entire life and received his education from the University of Northern BC with a degree in nursing. He enjoys playing music, going to the gym, and watching movies in his spare time.

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Health: There’s an app for that

Nurse in a hallway holding a tablet computer.

Mobile health is creating many opportunities to use smart phones and online tools for health and wellness. With the increasing ease of sharing information, individuals need to exercise caution.

As I finish waiting in line to buy tickets for the show, I have already checked Rotten Tomatoes, read the synopsis, watched the trailer, and read user reviews. I’ve also updated my Facebook status and “checked in” at the movie theatre. Only two likes?! Maybe I should post a selfie? (#catchingaflick)

All of this information and interconnectivity is available to me at the touch of a button or a slide of a finger. These amazing devices make our lives easier and help us to communicate instantly with one another in ways that were not possible even 10 years ago. In my opinion, one of the most exciting prospects about all of this functionality in the palms of our hands is the advancement and increased access to health and wellness support, information, and tools.

A number of app designers have invested in mobile technology for wellness. You can get apps that track your mood, coach you in deep breathing, or can track your immunizations. Separately, YouTube and other social media channels are used by scholarly institutions, health authorities, and health professionals as a way of sharing wellness information that can be accessed in the privacy of your own home, from the bus, or wherever you have the desire (and the data plan) to access it.

Research is demonstrating some of the benefits of the emerging field of “mobile health.” For example, research is following individuals who are quitting smoking and receiving text message encouragements (visit quitnow.ca for details), or setting people with specific medical conditions up with education and reminders through their mobile device.

In the north, where winter roads and lengthy distances can make travel difficult, technology is emerging with some exciting options for people to promote wellness and ownership of their health. Informally, communities of like-minded individuals are gathering on sites like Reddit and Pinterest to share wellness tips and information, as well as links to pertinent research or videos. However, users need to take caution.

Not all health information, sites, or sources are created equally. With the increasing ease of information sharing, it’s important for individuals to exercise caution until an app or information found on the Internet can be verified. For information to be trusted, it should come from a credible source, like a health authority. Check with your family doctor if you are unsure.

The future is bright with touch screens and I’m optimistic we’ll continue to see the benefits and development of this area of health services in the years to come.

This article was first published in A Healthier You, a joint publication of Northern Health and the Prince George Citizen.

Nick Rempel

About Nick Rempel

Nick Rempel is the clinical educator for Mental Health and Addictions, northwest B.C. Nick has lived in northern B.C. his entire life and received his education from the University of Northern BC with a degree in nursing. He enjoys playing music, going to the gym, and watching movies in his spare time.

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The Grizzly Truth: Setting a Healthy Sleep Routine

Falling asleep with Netflix isn't a good idea.Happy summer everyone! First, I would like to thank Trent for doing some citation checks last month when I questioned who coined the quote I used as a leading statement in my last blog post. We may make you an honorary member of the Grizzly Truth Internet Sleuthing Department. ;)

I hope you are enjoying the added daylight hours and getting the most out of this time of year, whether that’s fishing, camping, hiking, or any important seasonal rituals you may have. See what I did there?

One drawback to the extra daytime hours is that it may interfere with our sleeping patterns. Sleep is something many of us have occasional difficultly with and research indicates this can impact our overall wellness. Studies have identified that difficulty with sleep is a common issue for people with mental health concerns, but recently it has been questioned whether the difficulty with sleep was one of the contributing factors for an illness or if the sleep problems emerged as part of the illness. Regardless, there is consensus that practicing sleep hygiene is beneficial to our health.

Now, this is something I have set some personal goals around because when you start to look into the tips and practices that are encouraged for healthy sleep habits, I recognize that I have some improvement to do. Areas that pose challenges for me are: having a soothing pre-sleep routine, avoiding night-time clock watching, and being conscientious of nighttime eating and snacking. I can think of a number of nights where I thought I would try to catch up on Game of Thrones right before bed and then found myself lying awake and cursing George R.R Martin and his fondness for killing off beloved characters. Having my phone and iPad close by while I am sleeping also creates issues as I hear my e-mail notification noise and inevitably make the mistake of “quickly checking my e-mail” before calling it a night.

In my research into this, I found a great article offering 12 tips for improving quality of sleep, from the Division of Sleep Medicine at Harvard Medical School. Furthermore, there are some really great resources you can access for free on YouTube around progressive relaxation and guided imagery that help you relax and can become part of a pre-sleep routine (see some resources below). Other tips, like avoiding stimulants such as nicotine in cigarettes or coffee before bed, can cause more of a challenge for those of us with habits, but might give you some food for thought if you are thinking about making other lifestyle changes.

Do you have a pre-sleep routine, or do you have any practices around sleep hygiene that you’ve found particularly helpful? Please share in the comments below, and I hope that by next month we’ll all be feeling well rested and relaxed so we can enjoy our brief but beautiful northern summer!

More resources:

Nick Rempel

About Nick Rempel

Nick Rempel is the clinical educator for Mental Health and Addictions, northwest B.C. Nick has lived in northern B.C. his entire life and received his education from the University of Northern BC with a degree in nursing. He enjoys playing music, going to the gym, and watching movies in his spare time.

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The Grizzly Truth: A good laugh for good health

Nick, with a goatee, holds his cat in a Christmas picture.

Nick’s photo entry into the Northern Health Mr. Movember contest.

“Imagination was given to man to compensate him for what he is not; a sense of humor to console him for what he is.”

I have seen this quote attributed to both Francis Bacon and to Oscar Wilde. To be honest, I don’t have the citation to prove who said what when (if you know, feel free to comment and share as I wasn’t able to find firm evidence for either party). This quote carries a lot of meaning to me, both in my professional life and my personal life. I feel that I have a pretty good sense of humor and that has lent itself to some rich experiences with practical jokes and certain Mr. Movember contests (pictured right).

Wellness research shows that people who laugh regularly are healthier than those who do not. I’m not just referring to mental health either. One study actually found that people who laugh regularly have a lower risk for heart attack and an increased pain threshold! In work environments, the appropriate use of humor can de-escalate tense situations and increase the rapport between staff and clients.

There have been a number of circumstances in which laughing about myself, or my situation, has helped me move past unhelpful and unproductive feelings of stress or frustration. For instance, my hair started thinning at the age of 21. I’m 26 now and that trend is continuing, despite my protests. I will admit that the first time my “bald spot” was pointed out, I didn’t laugh and say “thanks for bringing that to my attention!” In fact, a couple of threats were exchanged before I made my way to the nearest mirror. At first, having a sense of humor about the situation wasn’t easy, but, over time, it made me feel better to have a laugh about it, even cracking a joke or two at my own expense. Humour has helped me come to terms with something that’s completely out of my control.

On a more serious note, I recently read about a nurse who had been struggling with significant depression. He received support to enroll in a stand-up comedy course and, since beginning the course, has found that his outlook, self-esteem, and mood have greatly improved. You don’t have to get on the stand-up comedy stage like the nurse, but, to improve your health, it is important to practise allowing yourself to laugh and to put yourself in an environment where laughter is common practise!

Nick Rempel

About Nick Rempel

Nick Rempel is the clinical educator for Mental Health and Addictions, northwest B.C. Nick has lived in northern B.C. his entire life and received his education from the University of Northern BC with a degree in nursing. He enjoys playing music, going to the gym, and watching movies in his spare time.

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The Grizzly Truth: reflecting on rituals

Reflecting on ritual: eulichan runningWhile attending some educational meetings last week I had the opportunity to listen to a speaker by the name of Dr. Glen Grigg, who is a clinical counsellor and teacher for City University in Vancouver and the Justice Institute of BC.

Glen spoke about rituals and the role they play in our health and wellness. Glen shared a story about a family in a war torn environment where the mother made a point of having the children continue the daily rituals around preparing for and attending school (taught by the mother), having meals together (despite having next to no food), and doing homework.

Glen highlighted that consistency with our rituals, particularly those that are deeply rooted with our identity, can be a protective factor during times of turmoil and stress. He posed the following question:

Can you think of a ritual in your life, and make a story about how it defines a part of who you are?

This led to some deep introspection on my part, as well as a little bit of anxiety when I began to self-diagnose some of my rituals as potentially compulsive behaviors (for example, I have a ritual around the way I enjoy one of my favorite TV shows, Mystery Science Theatre 3000, and I will refuse to start the episode unless everything is prepared accordingly).

The second part of the exercise, looking for a story that explains a part of who I am, has occupied a lot of my thinking lately. I had the opportunity to travel to Prince Rupert this week, and it so happens that the eulichan fish are currently running. I am aware of the significance of the eulichan for the First Nations of this area and that there are a number of rituals tied to the catching and processing of these fish. I am sure many individuals who engage in these rituals would be able to share stories that highlight the personal and cultural significance of the fish and the practices. I took a picture of all of the activity on the water around the running eulichan and took some time to do some personal reflection.

I was reminded that the only fish I’ve brought home since moving to Terrace have been donations from friends (my goal this summer is to go river fishing and come home with my own fish, not just a story of the one that got away!). One ritual that has had significant impact on my life recently is starting to read together with my wife. I think this ritual tells more of a story about our relationship than telling a story about me as an individual. The process of choosing a book to read, settling in and getting comfortable together, and then reading/being read to all have meaning associated with them. The net result has been a protected time to be close as a couple, where neither of us necessarily need to think about the words to say because they’re written for us and we can simply be present with one another.

If anyone is interested in sharing, I would be very interested to hear your responses and thoughts about a ritual that helps you stay well. What story does it tell about who you are? I would also be keen to hear from anyone who does catch and prepare eulichan, as I don’t know as much about the practices and rituals involved as I would like! Your turn – share in the comments below!

Additional reading on rituals:

Nick Rempel

About Nick Rempel

Nick Rempel is the clinical educator for Mental Health and Addictions, northwest B.C. Nick has lived in northern B.C. his entire life and received his education from the University of Northern BC with a degree in nursing. He enjoys playing music, going to the gym, and watching movies in his spare time.

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The Grizzly Truth: Getting help early on

Men and depression: learning to get help early on“Hey man, I’ve got this thing, and I don’t know what it is…”

How many times has a conversation with a buddy started like this? How many times is the advice you give, “You should really get that checked out”? Speaking personally, I know I’ve been given that advice many times and then proceeded to ignore it completely.

Studies have shown that men think denying weakness and rejecting help is a sign of masculinity. I can recall incidents where my wife, out of genuine concern, would point out a cut or injury and ask me, “Why are you bleeding?” to which I would respond, proudly, “I don’t know.” The silliness of that approach might be apparent, but it doesn’t stop us from capitalizing on the opportunity to show how “manly” we are. However, that approach does stop us from getting assistance before it becomes a crisis or before it has significantly affected our quality of life.

I’m not speaking solely about medical issues either. We do this with our mental wellness, too. Not only do we put ourselves through more stress when we don’t get help on board early on, we potentially miss out on putting some protective factors in place that might save us lots of trouble in the long run. Maybe it’s an undiagnosed thyroid problem that is causing the lack of energy and the fluctuation in weight. Maybe taking a look at lifestyle balance and adding some exercise or dedicated social time might make all the difference. The research shows that, when it comes to mental health, the earlier we get some assistance, the better the outcomes are (and the less time we end up spending sick).

There are a number of things you can do now that could help if you feel that something isn’t right. You can try self-help from reliable places like Here to Help. If you’ve got a friend or a family member you can trust, have a conversation about how you’re feeling. Rather talk to a stranger? Many people have access to Employee Family Assistance Programs (EFAP) that they may not even be aware of as part of their employment benefits. If this isn’t a possibility, your local Mental Health and Addictions office or your doctor would be able to connect you to resources and/or offer some options to you. If you’re worried about confidentiality, I’d encourage you to ask the agency you’re talking to what their policy is about confidentiality before you make your appointment. That way you know your information is secure.

Lastly, another way to stay healthy ourselves is to take the opportunity to help others. If a buddy comes to you with an issue, take the opportunity to listen without feeling the need to solve the problem. Being an empathetic ear goes a long way, and it really takes the pressure off if you realize you don’t have to have all the answers either. If it seems appropriate, share some of the resources above, and if you’re worried about safety or feel like the problem is out of your league, get some help! Call the local agency that provides mental health services and get some support or information.

More resources:

Nick Rempel

About Nick Rempel

Nick Rempel is the clinical educator for Mental Health and Addictions, northwest B.C. Nick has lived in northern B.C. his entire life and received his education from the University of Northern BC with a degree in nursing. He enjoys playing music, going to the gym, and watching movies in his spare time.

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The Grizzly Truth: Learning to identify stress

Learning to identify stressI hope that your holiday season went well; it tends to be a stressful time for people regardless of how or if you choose to celebrate it. Icy road conditions, increased family and social events, and the costs can be pretty staggering. Personally, I’ve just recently returned to work and I’ve needed to remind myself about my methods of dealing with stress. Stress, or at least referring to it as that, is something men have a more difficult time identifying or talking about than women. But it’s there.

I can distinctly recall a time where, having just experienced a car accident on the winter highways, I came to a realization about stress. I was navigating my work schedule, ICBC claims, searching for a new mode of transportation, and subconsciously coming to terms with my near miss. At the time, I was on the phone with my wife, and while she was trying to be helpful and supportive, all I could think about was how angry about the whole situation I was. I couldn’t really concentrate, I was exhausted, and if you had asked me if I was feeling “irritable” I probably would have started digging a hole in the backyard to hide the bodies. It was during that conversation I was lucky enough to realize I didn’t really have a reason for being as angry as I was, and that I needed to take a step back and think things over. Retrospectively, I can see all the stress sitting there. In the moment, however, I couldn’t see the forest for the trees (or the sleuth for the bears, to stick with that analogy. Seriously, a group of bears is called a “sleuth”).

As a generalization, men tend to report their stress less and some research has shown that the “stoic and silent” response may have some biological foundations. I took some time, after that conversation, to make some choices. What was I going to do about my stress? Shove it down deep beneath my chest hair where it can incubate and emerge later as a heart attack? Lash out at my family and friends? The challenging part is that we have to do something for ourselves in order to stay healthy in spite of stress. The encouraging part is that we are capable of changing the way we respond to stress and the way we manage it. How do you manage? Exercise, sleep, nutrition, confiding in someone – we know that these things are good for us, but do we make time for them?

If you haven’t made a New Year’s resolution yet, I’m challenging you to give this some thought and commit to doing one thing this month for your own wellness. Feel free to share your challenge in the comments. I’ve decided that this month I am going to focus on what I’m eating, as I’ve really let that slide over the holidays. I know if I eat better I will feel better physically, be more alert, and ready to tackle the bear by the horns! What are you going to do?

Resources about stress:

 

Nick Rempel

About Nick Rempel

Nick Rempel is the clinical educator for Mental Health and Addictions, northwest B.C. Nick has lived in northern B.C. his entire life and received his education from the University of Northern BC with a degree in nursing. He enjoys playing music, going to the gym, and watching movies in his spare time.

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Men’s mental wellness blog winner

Justin De Medeiros (left) submitted the winning name for the new men's mental wellness blog series. Pictured here with Nick Rempel (right).

Justin De Medeiros (left) submitted the winning name for the new men’s mental wellness blog series. Pictured here with Nick Rempel (right).

At the end of last year, we held a contest to name a men’s mental wellness blog. Starting next week, I’ll begin posting monthly on the topic. We were overwhelmed with the amount and creativity of blog names! Thanks to everyone who contributed!

It’s time to reveal the name for the blog! As determined by our panel of judges, this will henceforth be known as The Grizzly Truth – A Blog about Men’s Wellness. Congratulations to Justin De Medeiros, from Terrace BC, for providing the winning entry, and to Valerie Preston, also from Terrace, with her runner-up entry, The Tackle Box.

Stay tuned next week when our first post of The Grizzly Truth will be published right here on blog.northernhealth.ca.

Nick Rempel

About Nick Rempel

Nick Rempel is the clinical educator for Mental Health and Addictions, northwest B.C. Nick has lived in northern B.C. his entire life and received his education from the University of Northern BC with a degree in nursing. He enjoys playing music, going to the gym, and watching movies in his spare time.

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Shine a light on men’s mental wellness (and win a prize!)

Nick's Movember facial hair

Nick’s Movember effort!

Alright, so who would like to win a Samsung Galaxy Tab 3 8.0 or a 16 GB iPod Touch? I am calling on the creative forces in the north to christen a monthly blog I’m writing about men’s mental wellness. See, the thing is, northern men are some of the most resilient and hardy folk out there. We have a habit of not going to the doctor until things start turning green and falling off. And we don’t use words like “anxiety” or “depression.” A lot of the time we might not have a word for it. Feeling tired all the time, chronic pain, not being able to remember things, lacking a sense of satisfaction. In our culture, we might shrug it off and joke about fist fighting too many grizzly bears or say if a man isn’t irate about something he’s not doing his job.

The reality is that depression affects 840,000 men in Canada each year. That’s a lot of us. Furthermore, 2800 men in Canada commit suicide every year. Now, I don’t want to spend time mired in the problem. I’m starting a monthly blog update, with contributions from men living in the north, about how we stay well mentally. You don’t just walk up and bare knuckle box the bear. You spend time training. You curl some weights, you take some boxing lessons, you eat three chickens a day. Maybe you box a couple of smaller animals like a goat or a bobcat with a limp. Then, when the time comes, you have the tools you need to tackle that bear to the ground and make him tap out with a flawlessly executed guillotine choke hold.

The bear is a metaphor.

I’m calling on you to help me name the blog. Something you think encapsulates northern men’s mental wellness. Send in your submissions to menshealth@northernhealth.ca.

My goal is to be able to share some info and resources in a fun and positive way so that we, the men in the north, can stay as well as possible and have the tools we need to do it. Which brings me back to the Samsung Galaxy Tab 3 8.0 and the 16 GB iPod Touch. I’m calling on you to help me name the blog. Something you think encapsulates northern men’s mental wellness. Send in your submissions to menshealth@northernhealth.ca, and on January 9, 2014, a committee consisting of myself, two men working in the field of mental health and addictions in the north, and two community members will announce a winner, a runner-up, and a name for the blog. The winner will receive the Samsung Galaxy Tab and the runner-up gets the iPod Touch.

I’m looking forward to your submissions, make sure to include your name and contact information! Please share with your friends and colleagues and let’s have some fun!

 

References:

http://ca.movember.com/mens-health/mental-health

http://www.cmha.ca/public_policy/men-and-mental-illness/

 

Nick Rempel

About Nick Rempel

Nick Rempel is the clinical educator for Mental Health and Addictions, northwest B.C. Nick has lived in northern B.C. his entire life and received his education from the University of Northern BC with a degree in nursing. He enjoys playing music, going to the gym, and watching movies in his spare time.

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