- Posted byon April 1, 2013 at 1:29 PM EDT
This is a cross-post from the USA.gov blog. The original post can be found here.
What is the value of a strong public health system? The answers are quite literally all around us: in the air we breathe, the water we drink, the food we eat, and the places where we live, learn, work and play.
Today marks the beginning of National Public Health Week, an annual celebration organized by the American Public Health Association every April. This year’s theme, “Public Health is ROI: Save Lives, Save Money,” highlights the return on investment, or ROI, that public health programs and services deliver in protecting our health and reducing medical costs from diseases that could be prevented.
Did you know that investing $10 per person each year in community-based public health activities could save more than $16 billion within five years? That’s $5.60 returned for every dollar invested. And that’s just the tip of the iceberg:
Routine childhood immunizations save $9.9 million in direct health care costs, save 33,000 lives and prevent 14 million cases of disease.
Every $1 invested in the nation’s poison center system saves $13.39 in medical costs and lost productivity, saving a total of more than $1.8 billion every year.
From 1991 to 2006, investments in HIV prevention averted more than 350,000 infections and saved more than $125 billion in medical costs.
The benefits of tobacco cessation programs nearly always outweigh the costs, with a benefits-to-cost ratio reaching more than $2.50 for every $1 invested.
Substance abuse treatment has an ROI of $4-7 for every $1 invested.
Lowering health care spending and curbing disease rates is possible — and opportunities to do so are all around us. But most people may not know what public health is and how it impacts their lives.National Public Health Week is an opportunity to raise awareness about the value of public health and its benefits on our lives and our pocketbooks. Each day carries a new theme, including health at home, at school, in the workplace, outdoors and in communities.You can make the key difference. Make your mark during National Public Health Week by:
Together, we can shape a healthier future for all.
- becoming a partner and making a difference;
- attending or organizing events that promote value of public health and prevention; or
- driving the conversation at NPHW activities including the national prevention road tour and Twitter chat (follow along at #nphwchat).
- Posted byon March 29, 2013 at 3:44 PM EDT
Newtown. Today, the name of the town itself immediately conjures many images and emotions for people throughout our country. After visiting Newtown myself yesterday I am left with the memory of two words specifically -- perseverance and character.
I was privileged to visit the Newtown Prevention Council, a drug free communities coalition dedicated to reducing substance abuse in Newtown, Connecticut. The Council has been in existence since 1986 and seeks to help young people and families make decisions in support of healthy and substance-free lifestyles. But as with all prevention focused coalitions they also strengthen family and build resiliency and self-reliance for a community.
I asked them if the presence of their Coalition had helped them since the tragedy that rocked their community on December 14. To a person, they agreed it had. Coalition members include faith leaders, the chief of the Newtown police department, public and private school principals, counselors, health care professionals including a school nurse and emergency room doctor, high school students and several other community members.
In the face of unspeakable tragedy, the strength of this community has come through. Community members and members of this coalition support one another and cultivate the core characteristics of a town that will be known not just for the tragedy it has been through but for its resilience and character. The community coalition has done great work in Newtown to reduce underage drinking and substance use. Using evidence based techniques they work to give parents and young people the tools they need to lead healthy lives. And they build trusting relationships among the participants, relationships that pay huge dividends when tragedy strikes.
- Posted byon March 29, 2013 at 9:55 AM EDT
Drug overdoses persist as a major cause of preventable death. Calling 911 during an overdose can mean the difference between life and death, but witnesses sometimes do not call because they perceive that they may be arrested. Proponents of drug overdose Good Samaritan laws aim to address this concern by providing limited immunity to overdose witnesses and victims. Opponents argue that immunity will provide a “get-out-of-jail-free card” and interfere with the work of police and prosecutors.
Drug overdose Good Samaritan laws are in effect in 10 states and the District of Columbia and are being actively considered by at least a half-dozen state legislatures as of March 2013. In 2010, Washington State became the second state to pass a law incorporating a Good Samaritan provision providing immunity from drug possession charges; immunity applies to a person who seeks medical aid during an overdose (e.g., by calling 911 or taking someone to the ER), and to a person having an overdose.
I evaluated the development and implementation of the law and remain involved in spreading awareness of the law, providing overdose education, researching interventions, and encouraging broader availability of the opioid antidote naloxone (Narcan).
To date, there is no indication from police or prosecutors in Washington State that the Good Samaritan law is a serious impediment to the conduct of their work. This may be because arrests at overdose scenes are quite rare. In Seattle, we found that while police, paramedics, and heroin users all agreed police were usually at the scene of an overdose, they also all agreed that arrests were rare. This is in agreement with what we heard from representatives of statewide police/sheriffs and prosecutor associations during and subsequent to passage of the law.
We have not been able to determine if there is a positive impact directly related to the law either on increasing calls to 911 or decreasing overdose deaths. This is not because there is no effect, but rather because passage of the law facilitated the unfolding of a chain of events that was much broader than the simple legal immunity clause. Like other states’ legislation, no funding for implementation was included and no state agency was designated to implement (or evaluate) the law. However, during the course of our public health law research evaluation of the law, we surveyed Seattle police officers and found very low awareness of the law. Only 16 percent had heard of the law, and only 8 percent knew it applied to both overdose witnesses who sought aid and overdose victims. We shared these findings with police command staff, and they developed a training video that was shown to all patrol officers in the city. The video features the narcotics captain, a county prosecutor, and the medical director for Public Health - Seattle & King County. In my conversations with command staff and patrol officers, it appears that the video has dramatically increased awareness of the law among police in Seattle and has been shared with other Washington law enforcement agencies and at national conferences. The fact that police have been trained about the law has also been shared with those receiving overdose education. The video is publicly available and may be seen here:
Immunity from a broader set of charges is often a point of contention; in Washington State, the 2009 legislation covered a broader set of drug charges and did not pass. In 2010, the legislation was limited to drug possession, and it passed. Because of the social circumstances of substance use, there is interest by some in providing immunity for sharing controlled substances with others, and because of the personal histories of those with substance use, there is also interest in immunity for those on probation or parole. Immunity for these charges has not been implemented in Washington State but is under consideration in some other states.
In summary, Washington’s Good Samaritan overdose law has coincided with a great deal of progress on overdose education efforts throughout the state without any major negative consequences. We have found that collaboration among diverse stakeholders is critical to spreading the word about overdose prevention and response. The Good Samaritan law in Washington was an important catalyst for this progress, and we encourage other states to involve public health, law enforcement, medical and treatment professionals, and advocacy organizations in spreading the word about the need for overdose education and the protections provided by Good Samaritan overdose laws. Other states also may wish to consider cost-neutral ways of explicitly identifying an agency or standing work group to convene a multi-agency task force to help implement overdose-related laws in their legislation.
Dr. Caleb Banta-Green is a Research Scientist at the Alcohol & Drug Abuse Institute and served as a Senior Science Advisor at ONDCP in 2012. More information online at http://bit.ly/adaistaff_bantagreen
- Posted byon March 28, 2013 at 10:47 AM EDT
In light of the tragedy in Newtown, Connecticut, families and local communities nationwide raised questions about the safety and security of our children. Of course, the vast majority of schools are secure – and our children are safe at school. However, the time is ripe to reassess ways to improve the overall school climate and look beyond simply having more police officers in schools. President Obama’s Plan to Reduce Gun Violence includes tools to create a safer environment at schools across the country and includes a call to put as many as 1,000 new school resource officers and counselors on the job.
School resource officers, or SROs, are members of the law enforcement community who teach, counsel, and protect the school community. When SROs are integrated into a school system, the benefits go beyond reduced violence in schools. The officers often build relationships with students while serving as a resource to students, teachers, and administrators to help solve problems.
For students with a mental illness, use of drugs or alcohol can be a key risk factor for committing acts of violence. Recent research shows that those with a severe mental illness and a substance use disorder have a greatly increased relative risk for violence (more than 11 times) compared to those with neither diagnosis. Since SROs can help infuse substance abuse and violence-prevention messaging in schools and throughout school systems, they can play an important role in school safety plans.
In March, I met with school resource officers in Chantilly, Virginia, to discuss school safety and substance abuse. It was clear from this discussion that we need to look beyond the law enforcement function of SROs and recognize their value in cultivating a safe, supportive environment for our young people.
School resource officers are not armed guards standing sentry at school entrances. These men and women receive training in counseling and other skills that help them be effective in a school setting. Part of a school resource officer’s job is building relationships with students and faculty, and the job often doesn’t end at the close of the school day. They can be present at extracurricular activities and in school hallways, building trust with the students. School resource officers can get involved if they believe a young person may pose a danger to the school community. They can even visit students at home and speak with parents and family.
Keeping our young people safe and healthy is a prime motivator for all of us. And properly trained school resource officers can play an important role in creating a school community where young people thrive and are prepared to meet the challenges of the 21st century.
For more information on SROs, please visit the National Association of School Resource Officers at www.nasro.org.
- Posted byon March 13, 2013 at 9:43 AM EDT
In June 2012, National Drug Control Policy Director Gil Kerlikowske visited the Betty Ford Center, one of the Nation’s oldest and most recognized addiction treatment facilities. There he gave remarks to a crowd of leaders in the field of recovery. In the audience were two special guests—Michael Banyard and Federal District Court Judge Spencer Letts. In his remarks, Director Kerlikowske mentioned Banyard’s improbable—and inspirational—journey from crack cocaine dependence and homelessness, to prison, to a successful sentence appeal, to the chambers of a federal district court judge and completion of his GED.
Read Part 1 of Michael Banyard’s story here.
Although I had no idea what I was doing, studying law brought this inner peace that made me feel that everything was going to be alright.
I filed petitions for a writ of habeas corpus, a writ of coram nobis, and a writ of coram vobis.
I somehow never doubted that God would deliver me, and I continued to pray for approximately nine years before my petition made it through the state courts and to the federal court, where Senior Federal Judge J. Spencer Letts of the California Central District Court ruled in my favor and GRANTED my writ of habeas corpus, ruling and writing an opinion on all four of claims (see Banyard vs. Duncan opinion here.)
Shortly after I was released from prison, around the beginning of 2005, I received what was probably the first email in my life. It was from the Federal Court. They gave me a phone number to call Judge Letts’ chambers. I was nervous when I called, but his clerk, Nancy Webb, made sure I understood that nothing had changed, and I was not in trouble.
On the day I arrived and walked into the chambers of Senior Judge Letts, he and his staff gave me a warm and friendly welcome. I knew I was around people who loved to help people. We talked for some time, and before I left, Judge Letts asked me how I felt about going with him to speak to the teens at L.A. High School to share my experiences in a way that would encourage them to go down the right path in their lives and not make some of the choices that I did.
I said, "Yes."
I had never done anything like that in my life, but it felt more than right, and I never felt so sure about anything before in my life. It felt like all that I had went through in my life, being shot and partially paralyzed, going head first through car windshields, and more, was all for this purpose—to help others avoid being blinded by the outcome of poor choices.
I went to L.A. High with Judge Letts and spoke at the assembly. It was at this event that I first met Kurt Streeter of the L.A. Times.
Michael Banyard and Kurt Streeter
I had some struggles after that. I really could not understand how I could not just stay on the right path, as much as I wanted to do right. I really did not know what my life would become, but I knew I wanted something different. As I would stumble, Judge Letts would encourage me to stand back up, and he would remind me that he would never give up on me and would always be my friend. He would tell me that he could see a man in me who would find his place in life.
Things got better and I began to work with the youth at the Long Beach Soledad Enrichment Action Charter High School.
- Posted byon February 27, 2013 at 11:54 AM EDT
Every individual has a unique life story. Some come from families with significant economic limitations yet experience love, faith, and emotional stability. We encourage these fortunate young people to act as positive role models and help their peers avoid drugs.
The lives of others are marked by abuse, violence, hunger, fatigue. With no one to make sure they attend school, they fall behind. Society labels them as useless. They drop out of school and spiral downward. Some are recruited by drug dealers.
With high rates of unemployment and rampant consumerism in Puerto Rico, too many youth turn to drugs, and some become dealers themselves. This is why keeping young people away from drug hot spots is the primary goal of the Alliance for a Drug-Free Puerto Rico (Alianza para un Puerto Rico sin Drogas), where I have worked as executive director for 20 years. Development Officer Raquel L. Muñiz and Social Worker Melissa Frontera complete our team.
The drug threat in Puerto Rico is substantial, due largely to the island’s strategic location in the Caribbean between the producing countries and the consumer markets. Drug sales generate the income to obtain the goods many young people covet. Drug dealers occupy the top of the social ladder, showing off their wealth and power with cash, guns, cars, expensive jewelry, and women.
The Alliance for a Drug-Free Puerto Rico is a private non-profit organization with a mission to reduce drug use and drug trafficking through prevention efforts. One such effort was Prevention Power, a project developed by Alianza in 2011 and sponsored by the Puerto Rico/US Virgin Islands High Intensity Drug Trafficking Area (HIDTA).
Alianza recognizes that early interventions have a positive impact in deterring adolescents from behaviors that can lead to substance use. These interventions focus on strengthening protective factors and reducing high-risk factors, particularly in school settings. Informed by science-based research, Prevention Power addressed key areas such as peer relationships, communication, assertiveness, and drug resistance skills and was designed to keep adolescents fully engaged from the start.
The project’s objectives were to:
- Increase awareness of the negative consequences of violence, illegal drug use, and trafficking;
- Develop life skills that enable participants in the decision-making process; and
- Develop prevention leaders who will promote healthy lifestyles.
Prevention Power was implemented in three Puerto Rican public high schools located in zones of high drug-related activity. In the first stage of the project, students participated in workshops that addressed themes such as Decision Making and Problem Solving; Developing a Sense of Belonging; Dealing with Peer Pressure and Anger Management; and Drug Resistance Skills.
In addition to strengthening protective factors and reducing risk factors, the workshops served as a foundation for the next stage of the project: development of prevention ads for television and radio. The radio ads -- Fruits of My Labor and Lights, Camera, Action – and three television ads (Fruits of My Labor, Pills, and Values) will have a lasting positive impact on local youth as they continue to be broadcast throughout Puerto Rico and the U.S. Virgin Islands.
To prepare for this experience, students attended workshops on script writing and learned about the various stages involved in video production. Together they developed the stories and the dialogue, then took part in the filming process. Some students did the acting, while others worked on the storyline, set design, props, and audio. A private company participated in the filming of the ads.
This year, we have replicated the Prevention Power project in other schools and even added an after-school program that offers positive options as extracurricular activities, including dance, music, painting, and drama, as well as vocational courses such as jewelry-making and barber classes. These activities provide plenty of positive, productive alternatives to young people who might otherwise spend their time on the streets.
- Posted byon February 25, 2013 at 1:30 PM EDT
President Obama believes in the pursuit of an America built to last – a Nation founded on an educated, skilled workforce with the knowledge, energy, and expertise to succeed in a highly competitive global marketplace. Yet, for too many Americans, this vision is hampered by drug use and addiction, which inhibits their ability to live healthy lives and achieve their full potential.
While the harms caused by substance use and substance use disorders may seem obvious, here’s a reminder of what the data show: According to the CDC, drug overdose deaths are the second leading cause of injury death, surpassed only by suicides. Making matters worse, studies show that among the 22 million Americans who need treatment for substance use disorders, only about 2 million—only about one-in-10—receive it [i]. What has caused this disparity? For a start, not all health insurance plans have been required to cover drug treatment on par with other medical problems. That’s unacceptable.
This week, the Obama Administration announced a major milestone in drug policy reform that builds on our record of treating drug use as a public health, not just a criminal justice issue. Through a new rule made possible by the Affordable Care Act, we are requiring insurers to treat substance use disorders in the same way they would any other chronic disease. Specifically, this new rule expands coverage of mental health and substance use disorder services to 62 million Americans. In today’s heated debate over drug policy, it is worth noting that this is one of the most significant pieces of drug policy reform in a generation.
Why does this matter? Practitioners in our health care system historically have not screened for substance use disorders and often have limited knowledge of the nature of addiction. As a result, significant resources are spent treating the symptoms of Americans with undiagnosed substance use disorders. Research shows that treating substance misuse before it develops into a chronic disease is the best course of action. Implementing screening and brief intervention protocols has shown to be effective in reducing problematic substance use and its consequences. For those who have already developed an addictive disorder, only 10 percent of the population who need treatment receive it—often because of insufficient insurance coverage.
Like most chronic diseases, a substance use disorder is progressive. As it progresses, it changes the brain, leading to ever more damaging consequences and making the disease more difficult to treat. If we can ward off problematic substance use before an addictive disorder develops, we can prevent the disease’s most serious consequences. Treatment makes good financial sense as well. Because for every dollar we spend on treatment, we realize a benefit of seven dollars as a result of reduced criminal justice system costs and increased employment earnings. [ii] That means less incarceration, safer communities, healthier citizens, and a stronger workforce.
The most important thing we can do to reform our drug policies is to change the way we think about – and address -- our Nation’s drug problem. A "war on drugs” should not define how we can make America healthier and safer. We cannot arrest our way out of the drug problem. So while smart law enforcement efforts will always play a vital role in addressing drug related crime in America, we must acknowledge that science shows addiction is a disease of the brain that can be successfully prevented and treated.
That is why equal access to drug treatment programs is a priority for this Administration. After all, treatment should not be a privilege limited to those who can afford it, but a right available to all those who need it. That is what real drug policy reform looks like.
[i] In 2010, an estimated 23 .1 million Americans (9 .1 percent ) aged 12 or older needed specialized treatment for a substance use disorder, but only 2 .6 million (or roughly 11 .2 percent of them) received it .
[ii] 37 . Ettner, S . L ., Huang, D ., Evans, E ., Ash, D . R ., Hardy, M ., Jourabchi, M ., & Hser, Y . I . (2006) . Benefit-cost in the California treatment outcome project: Does substance abuse treatment ‘pay or itself’? Health Services Research, 41(1), 192-213
- Posted byon February 22, 2013 at 3:40 PM EDT
The independent, non-partisan fact-checkers at Politifact have tackled another claim frequently made in today’s debate about drug policy. The claim goes something like this:
“Despite laws outlawing certain drugs, young people still find it easier to get marijuana than alcohol.”
If that seems implausible to you, that’s because it is. According to PolifiFact:
“…all the most recent, credible, national studies we found showed that teenagers report it’s easier to get alcohol than marijuana.”
You can read their full reporting here.
This is part of a series of blog posts that address myths about federal drug policy. See also:
- Posted byon February 14, 2013 at 12:14 PM EDT
Please note that this is a co-authored blog post by Gil Kerlikowske, Director, ONDCP and Benjamin Todd Jealous, President and CEO, NAACP. This post also appears on The Huffington Post and the NAACP blog.
In Los Angeles not long ago, a man named Michael Banyard ran afoul of California’s “three strikes” law. After bouts of homelessness, unemployment, suicidal thoughts, and a criminal record driven by an underlying substance use disorder, Michael faced a mandatory 25-year prison sentence.
Fortunately for Michael, Federal District Court Judge Spencer Letts was put in charge of his final sentence appeal. Judge Letts saw Michael not as a hopeless, drug-using criminal, but as an individual with a disease in need of help. The judge then did something highly unusual. He not only reversed Michael’s sentence, he invited him into his chambers to talk.
Here were two men who could not be more different – a white, Yale- and Harvard-educated judge and former corporate vice president, and a shy African American who had spent most of his adult life in prison. And yet, the men found they had more in common than either could have imagined. Judge Letts knew that repeatedly incarcerating Michael wasn’t accomplishing much.
Over the years, Judge Letts became, in Michael’s words, the father he never had. The Judge gained something extraordinary too. Michael, he said, “showed me that my gut feeling was right – that people are basically the same, with the same basic goodness, if you just give them the chance.” Today, Michael Banyard has received his GED degree and spends his time volunteering at the Los Angeles Dream Center, where he graduated from a faith-based program that he credits for his transition away from substance abuse.
Stories like this illustrate the kind of thinking needed to reform our nation’s criminal justice and drug control policies. In 2011, about seven million people were under the supervision of the criminal justice system in the United States. Of these, about two million were behind bars. And nearly one quarter - 500,000 - of those behind bars are there for drug related offenses. America’s incarceration rate – 756 per 100,000 population – is the highest in the world. High rates of incarceration have resulted in prison overcrowding and state governments facing the costs of a rapidly expanding penal system.
In addition, our nation’s historical emphasis on incarceration has significantly affected communities of color. African Americans are disproportionately incarcerated for drug offenses, accounting for almost half (45 percent) of all drug offenders in state prison in 2010. (Whites accounted for 29 percent.) Among prisoners age 18 to 19, African American males are imprisoned at more than 9 times the rate of white males, and African American females are imprisoned at between 2 and 3 times the rate of white females.
It is clear that we cannot simply arrest our way out of the drug problem. Instead, we need smarter, results-based criminal justice policies to keep our communities safe, including treatment for people with substance use disorders and mental health issues.
To bring about real, meaningful change, we need a fundamental shift in how our Nation discusses drug policy. This begins with the acknowledgement that our drug problem is a public health issue, not just a law enforcement issue. It means acknowledging that an ever-growing body of scientific research clearly demonstrates that addiction – the underlying cause of too much crime in this country – is a disease that can be prevented and treated successfully.
Armed with the indisputable fact that preventing and treating addiction is an effective strategy for reducing substance abuse and crime, the Obama Administration and the NAACP are committed to pursuing evidence-based policies that strengthen families and communities across America.
Already, the Administration has worked to expand specialized courts that divert roughly 120,000 non-violent offenders into treatment instead of prison each year. The President has requested that Congress increase its commitment for drug treatment programs for 2013. And in 2010, President Obama signed into law the Fair Sentencing Act, which made progress in reducing the 100-to-1 disparity between sentences for powder and crack cocaine that disproportionately affected minorities and also eliminated the mandatory minimum sentence for simple possession of crack cocaine.
Significant accomplishments all, yet more must be done, particularly at the state level.
Demonstrating how criminal justice reform can be a bipartisan issue, the NAACP has worked tirelessly with elected officials from both parties to achieve sensible reform. With the support of the NAACP, Republican Governor Nathan Deal of Georgia signed into law the most sweeping criminal justice reform legislation in the country. The NAACP also worked to find common ground with Republican Governor Bob McDonnell of Virginia, who shut down prisons and called for more money to be sent to universities. In Texas, the NAACP helped push Republican Governor Rick Perry to sign 12 progressive reforms that led to Texas scheduling the first prison closure in the state’s history.
Actions by the Obama Administration, the NAACP, and others are vital steps toward reshaping and redirecting our nation’s criminal justice system. These are only the first steps, however, and the road ahead is long. It will take still more action, more time, more work, and more innovative thinking to bring about the reforms that are so urgently needed.
The challenge is immense, but America is up to it. Working together, we can reduce the heavy toll of substance use in our cities, neighborhoods, and families. Combining proven public health and public safety strategies will help break the vicious cycle of drug abuse, crime, and incarceration. This, in turn, will save countless lives and taxpayer dollars, make America stronger and safer, and ensure a more perfect union.
It’s not only the right thing to do—it’s the smart thing to do.
- Posted byon February 13, 2013 at 1:46 PM EDT
Throughout my career as a law enforcement officer specializing in juvenile issues, I have seen first-hand the consequences of drug use on our young people. Drugs can ruin lives and lead to a multitude of other problems, such as school apathy and low self-esteem. This creates an endless cycle.
But I have also seen the success of drug prevention programs in schools. As a former president of Lions Clubs International, former chairman of Lions Clubs International Foundation, and a current member of the Lions Quest Advisory Committee, I have visited classrooms and spoken with teachers who use our materials. Through its programs and materials, Lions Clubs International teaches respect of self, respect for others, and rejection of bullying, and it delivers a strong message to young people about the dangers of drug and alcohol use.
Because drug use knows no age, gender, race, or socioeconomic boundaries, we at Lions Clubs International know we have to share solutions with partner organizations. I have met with elected officials and helped coordinate partnerships with a number of government and non-governmental organizations – including Community Anti-Drug Coalitions of America, the Organization of American States Inter-American Drug Abuse Control Commission, the United Nations Office of Drugs and Crime, and the State Department’s Bureau of International Narcotics and Law Enforcement – in an effort to reach classrooms around the world and in my home State of New York. Today, our materials are used more than 70 countries. Our middle school program is listed on the National Registry of Evidence-Based Programs and Practices, and in the Department of Education's guide to Exemplary & Promising Safe, Disciplined, and Drug-Free Schools Programs. Why? Because it works.
Lions Club International helps turn lives around and lead young people along the path to success. Our educational programs are just one part of Lions Clubs International’s global long-term commitment to youth and drug abuse prevention. If we are not giving our young people the tools they need to succeed and the wherewithal to say “no” to drugs, we are doing them a grave disservice. Education is one of the best tools available for ensuring our youth make intelligent decisions that help them stay happy, healthy, and drug free.
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