Posted: October 27th, 2022
The first assignment of this semester is for you to perform a PRELIMINARY NEEDS ASSESSMENT by performing an evidence-based literature review. Once you identify a need, then you can start creating a solution. This will specifically, later on, assist you in explaining and justifying what the needs are in your target population. Use the following process to PREPARE to do your needs assessment.
*Review Healthy People 2020 documents and the objectives from 2020 Topics and Objectives (Objectives A–Z) Link:
https://www.healthypeople.gov/2020/topics-objectives (Links to an external site.)
. Also Table 1-4 (pg. 26) (Course required textbook).*
REQUIRED COMPONENTS for Assignment #1: THE PRELIMINARY NEEDS ASSESSMENT (PLEASE READ CAREFULLY)
The assignment should be typed out on a word document in APA format. Each paragraph should consist of 5-6 complete sentences. The assignment should consist of 1,500- to 3,000-words. This assignment must be completed and submitted on a Microsoft word document.
APA format is required. 12 font size should be used, font names that should be used are Times New Roman or Cambria (not both), normal margins (no more than 1 inch), double spaced, indentation, etc. Please include a title page that consists of your name (First and Last), Panther ID number, and title of the article (APA format).In addition, include a reference page that consists of three (3) references from creditable resources.
1. Document your targeted Objective and your Health Behavior Change Focus. State your chosen health behavior focus and targeted objective from HP 2020 and the Leading Health Indicator it relates to that you intend to address in your health education and program.
2. Document the need for a program related to your targeted objective. Discuss the rationale or need for your choice to design a program to meet the targeted HP 2020 objective by reporting on the following: a) Report on the documented health risk(s) associated with not meeting this objective. b) State ALL of the HEALTH RISKS AND HEALTH CONDITIONS and DISEASES that are associated with the objective’s corresponding maladaptive health behavior. This is to be done by doing an evidence-based literature review using appropriate sources of secondary data.
Examples of appropriate sources include official statistical databases like National Center for Health Statistics, technical reports, scholarly journal articles, and literature review articles. A practical example of this would be to perform a literature review that provides documentation of all pertinent health risks and conditions and diseases that are associated with one of the Healthy People Objective’s that deal with tobacco use, and that describes each of these health risks and diseases (lung cancer, chronic obstructive pulmonary disease).
3. Report on the incidence and prevalence rates of the health risks and the health conditions and diseases that are associated with your chosen Healthy People 2020/2010 Health Behavior. Report on any pertinent morbidity rates or mortality rates that are directly linked to your chosen Healthy People 2020 health behavior. Report any temporal trends of incidence and prevalence rates of the health risks and health conditions and health diseases that are directly linked to your chosen Healthy People 2020 health behavior. Locate research data and statistics from scholarly literature, trustworthy websites, and statistical evidence. You must provide incidence and prevalence rates on a national level. Examples of appropriate sources of data include official statistical databases like NWCHS and census database at
www.census.gov (Links to an external site.)
, technical reports, scholarly journals, and literature review articles). An example of this would be to expound upon the prevalence AND incidence rates AND TRENDS of INCIDENCE AND PREVALENCE RATES of lung cancer and chronic obstructive pulmonary disease for one of the Healthy People 2020/2010 Tobacco Use Objectives at the national level morbidity and mortality rates associated with lung cancer and chronic obstructive pulmonary disease.
4. Report what the research and literature suggest to minimize the risk that is associated with not performing your chosen health behavior change and thus, to meet the Healthy People 2020 objective. This is also to be done by doing an evidence-based literature review using appropriate sources. Examples of appropriate data sources include evidence base search engines, journals, and resources such as Cochrane, Medline, Trip Database, and any other evidence-driven journals or resources. An example would be to search the literature for “evidence-based” methods and programs that have been most effective to accomplish the desired behavior change (like increase physical activity).
Assignment #1 (Preliminary Needs Assessment)
#31: Older Adults
HEALTH BEHAVIOR CHANGE FOCUS: Mental Health: Dementias, Including Alzheimer’s disease
Austen Brianna Graham West
Panther ID: 6080915
Assignment Number One
Introduction and Objectives
Objective: Increase the proportion of adults aged 65 years and older with diagnosed Alzheimer’s disease and other dementias, or their caregiver, who are aware of the diagnosis
The number of people age 65 and older in the United States group accounted for 14.9 percent of the total population (USCB, 2017). One quarter of these elderly Americans live in one of three states: California, Florida, and New York with Florida having the highest percentage of senior citizens (WorldAtlas.com, 2018). Dementia and Alzheimer’s disease commonly associated with the aging population is one of the most feared diseases of the older people. This disease is an irreversible and progressive brain disorder that essentially destroys the thinking skills, personality and robs the affected patient of his/her personality and independence. While it is certainly not a normal part of the aging process, it is more common as people get older (Bennett, 2007). Among persons 71 and older, roughly 14% of the population suffers from dementia (Bennett, 2007).
Will this become more of a problem in the future? Yes, since this is mainly a disease associated with age, some exceptions will apply, the fact that the “older” population (those aged 65 years or older) in the USA is expected to double from approximately 35 million today to more than 70 million by 2030, makes the need for education and mindfulness a very acute community health need (Blassman et al, 2007). Nothing will ever stop the aging process, except of course dying, so treating the possible underlying catalysts to the disease, such as depression is very important since Alzheimer’s is not a curable disease.
In a 2010 study in the journal ” Neurology”, Dr. Jane Saczynski of the University of Massachusetts found that depression at a younger age is a significant risk factor for dementia. In fact, the conclusions of this study were “
is associated with an increased risk of dementia and AD in older men and women over 17 years of follow-up.” (Scazynski, 2010). What can you do to prevent Alzheimer’s disease? Knowledge is key and providing the ability for the affected population to read the latest evidence for promising prevention strategies, increase physical activity, practice blood pressure control, and engage in other methods of cognitive training will contribute to better mental health overall the ability to develop a “cognitive reserve” to deal with the scourge that is Alzheimer’s and dementia.
Awareness and education are two components of this program. Roughly only 34.8 percent of adults aged 65 or over with a dementia diagnosis, or their caregiver, were aware of the dementia diagnosis in 2007–09. The target is 38.3 percent, and while this might not seem significant, due to other environmental factors it would be tremendous.
Definition and Need
A needs assessment is a process used to determine priorities, make organizational improvements, or allocate resources. It involves determining the needs, or gaps, between where the organization envisions itself in the future and the organization’s current state.
This need assessment will encompass the following design:
The program will serve as a community outreach that will build upon the identification, mental health focus community awareness and education design programs, while taking into consideration the fact that older age often involves a level of isolation and an increasing occurrence of a sedentary lifestyle. A study examining the connection between loneliness and risk of developing AD revealed that lonely persons had higher risk of AD compared with persons who were not lonely (Hsiao YH, 2018). The program is shown on a continuum since neither aging nor dementia/Alzheimer is likely to be curable, at least in the foreseeable future for the latter.
This health initiative will focus on health promotion, wellness and education with an emphasis on networking and community involvement. Further definition of the groups:
a. The target population is age 65+: Increasing age is most identifiable in cases of dementia, after the age of 65, the prevalence and the incidences of dementia double approximately every 5–6 years (Winblad et al, 2016). The use of area surveys as well as census reports will identify this group although the census is performed every 10 years and some of these people have expired or died.
b. Awareness of other Mental Health Problems associated with Dementia: Occasionally, Alzheimer’s and other dementias occur combined with other diseases such as with other mental problems such as depression, personality disorders, and psychotic conditions these problems might in up to 50% of older adults with Alzheimer’s disease (Friedman, 2009).
c. Design of Community Awareness and education: Inherent in this parcel public outreach and education would be information about health care providers, long-term care, home- and community-based services, insurance coverage, financial assistance and planning, legal protections, family communication, caregiving, roles and tasks, caregiver coping, respite, day-to-day symptom management, and self-care (NCIOM,2017).
d. Programs to address the Isolation and Inactivity: Loneliness is correlated with the development of dementia later in life but is not a top cause of this malady (Wilson, 2007). People with dementia can face significant barriers to engaging in the social life of their area. Many find their local communities don’t offer support or understanding for their condition, and so give up things they love to do out of anxiety or fear. In addition, in many cases the elder person has outlived their family members or friends thus rendering them “elder orphans” – people without a natural family, children or friends. This promotes lack confidence or the elder will feel have nothing to contribute leading to depression and other forms of mental health maladies.
e. Services must be continually evaluated for effectiveness. The development of patient-centered measures ensures quality health care as well as cost controls and the identification of clinical quality improvements (Borson, 2014).
HEALTH RISKS AND HEALTH CONDITIONS and DISEASES
Concomitant Medical Outcomes of Alzheimer’s and Dementia
If a suitable initiative is not achieved the according to Alzheimer’s.net (2019), the following will be a probable outcome for the affected population:
Alzheimer’s disease presents itself differently in individuals. No two people will have the same symptoms of this disease. There are, however, two health conditions that most patients share – difficulty swallowing and incontinence. Alzheimer’s cannot be prevented; however, the goal of any study should be to promote incorporating certain lifestyle habits into the patient’s routine: Eating a low-fat diet, including cold-water fish (tuna, salmon and mackerel) that are rich in omega-3 fatty acids; Increasing intake of antioxidants by consuming plenty of dark-colored fruits and vegetables; Maintaining a healthy blood pressure; Staying mentally and socially active throughout life (Kamarow, 2019).
To distinguish: Dementia and Alzheimer disease and other dementias, presents a major public health challenge in the United States. Dementia is characterized by memory impairment and cognitive decline. Alzheimer disease is the most common cause of dementia. Other dementias, including Lewy body dementia, frontotemporal degeneration, vascular dementia, and mixed dementias, are often indistinguishable from Alzheimer disease in their symptoms and outcomes and may coexist with Alzheimer disease (Kramarow, 2019).
In addition to AD (Alzheimer’s Disease) , this needs assessment in referring to “dementia” will include frontotemporal dementia (FTD), Lewy body dementia (LBD), vascular contributions to cognitive impairment and dementia (VCID), and mixed dementias — especially AD mixed with cerebrovascular disease or Lewy bodies. It is often difficult for the medical professional and others to distinguish between AD and ADRDs in terms of clinical presentation and diagnosis. Some of the basic degeneration of the brain is quite similar in nature. People with these forms of dementia and their families and caregivers face similar challenges in finding appropriate and necessary medical care and community-based services. As such, many of the actions described in this plan are designed to address these conditions collectively (Galasko, 1994).
Incidence and Prevalence Rates of the Health Risks
Almost universally, the first symptom that people become aware of is memory impairment, however, other factors such as poor attention to detail, visual or motor disturbances, sleep disorders and the inability to complete tasks are often overlooked but are symptoms as well (Department of Health and Human Services, 2019). Although irreversible, 90 percent of all Dementia, Alzheimer’s and other dementias do not present themselves until after the age of 60. The causes can be attributed to environmental, lifestyle/socio-economic factors and genetic factors (Department of Health and Human Services, 2019).
AD and other dementias resulting from genetic factors are not preventable, however, it must be noted that a recent study published in Alzheimer’s and Dementia, The Journal of the Alzheimer’s Association, concluded that you can reduce the risk of cognitive decline and dementia by making positive lifestyle changes. Challenging your mind has long and short-term benefits through staying active in classes either formal or informal, puzzles and games; avoiding brain injury; diet; sleep; cardiovascular health; remaining socially engaged and treating depression are all factors that contribute to positive changes and reduction of risk involving Alzheimer’s and dementia (Alheimers.net, 2019).
Another risk not often thought of is the incidence of something called “skinny fat”. People who are “skinny fat” have a normal body weight but a higher percentage of body fat. Sarcopenia obesity, aka “skinny fat” , increases the risk of dementia (Alzheimers.net,2019) . A slim body doesn’t offer a free pass from chronic conditions, and growing evidence suggests being so-called skinny fat could be just as damaging as being obese.
Disparities in the population demographics:
a. People residing in metropolitan areas have a better awareness and therefore treatment options than people in rural areas.
b. Although more women than men have Alzheimer’s or other dementias, almost two-thirds of Americans with Alzheimer’s are women, the reality is that of the people over the age of 65 there are more women than men. Adjusting for this fact, however, it appears that this disease occurs in 16 percent of older women compared to 11 percent of men (alz.org, 2018).
c. Numbers aside, older African Americans and Hispanics are more likely, on a per-capita basis, than older whites to have Alzheimer’s or dementia (Dilworth-Anderson, 2008).
d. One benefit of education and study is the fact that several studies indicate that the age-specific risk of Alzheimer’s and other dementias in the United States and other higher-income Western countries may have declined with increasing education, lifelong education and improved heart health (Shrivers, 2012).
The “Do-Nothing” Alternative
What is the risk that is associated with not performing your chosen health behavior?
Alzheimer’s and associated dementias are incurable as well as irreversible. There are several drugs on the market that promise to slow the development , however, only time will tell with this disease as most dementias are begin gradually and then over time get exponentially worse. As with most chronic and progressive diseases, the presence of early detection and treatment become tantamount to the quality of life attainable by the patient. Several doctors have indicated that although the detection and treatment might differ regarding educational attainment, the more educated patient will adapt to his/her situation in different ways. The person with a greater level of education will make notes, excuses and adapt by assuming that they are just “forgetful” or “stressed”. In other words, they will make notes and concessions for the malady rather than assuming or succumbing to it. Having more years of formal education might delay the effects memory loss linked to Alzheimer’s disease, but after the conditions presents itself, the well-educated patient will decline at a faster rate (Dunham, 2007).
The level of “cognitive reserve” accounts for individual differences in susceptibility of dementia and Alzheimer’s in. People with a higher amount of education, wealth, and correspondingly services are more tolerant of cognitive changes than those with limited education and resources (Yaakov,2012). People with bigger heads also have a lower incident of Alzheimer’s and dementia because the bigger brain can simply tolerate more disease or injury before it begins to deteriorate (Katzman, 1988). At this point I am glad that I have a big head.
However, in the absence of a large cranium or higher education and given the reality that Alzheimer’s and other dementias are neither curable nor reversible, it is imperative that we give the brain a chance brain to both actively and perhaps passively cope with the changes that inevitably come with the onslaught of this disease. Dementia and Alzheimer’s disease are terminal. Eventually the body will shut down and people die from complications from the illness, such as infections or blood clots. It must be emphasized, however, that with increased health resources and medical technology there will be an exponential increase in cases of dementia as people approach the possibility of living to the age 100. This proposal of a program of health promotion, wellness and education with an emphasis on networking and community involvement will accomplish that end while enhancing the quality of life of those affected by Alzheimer’s and dementia.
Kashmiragander. (2018, July 13). Why being skinny fat could be just as dangerous as being obese? Retrieved from https://www.newsweek.com/why-being-skinny-fat-could-be-just-dangerous-being-obese-1022856
Which U.S. States Are the ‘Oldest’? (n.d.). Retrieved from https://www.prb.org/whichusstatesaretheoldest/
Bennett, D. A. (2009, May 20). Editorial Comment on ‘Prevalence of Dementia in the United States: The Aging, Demographics, and Memory Study’ by Plassman et al. Retrieved from https://www.karger.com/Article/PDF/109999
Plassman, B. L., Langa, K. M., Fisher, G. G., Heeringa, S. G., Weir, D. R., Ofstedal, M. B., . . . Wallace, R. B. (2007, November). Prevalence of dementia in the United States: The aging, demographics, and memory study. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2705925/
Saczynski, J. S., Beiser, A., Seshadri, S., Auerbach, S., Wolf, P. A., & Au, R. (2010, July 06). Depressive symptoms and risk of dementia: The Framingham Heart Study. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2906404/
Figure 2f from: Irimia R, Gottschling M (2016) Taxonomic revision of Rochefortia Sw. (Ehretiaceae, Boraginales). Biodiversity Data Journal 4: E7720. https://doi.org/10.3897/BDJ.4.e7720. (n.d.). doi:10.3897/bdj.4.e7720.figure2f
Basics of Alzheimer’s Disease and Dementia. (n.d.). Retrieved from https://www.nia.nih.gov/health/alzheimers/basics
Dementias, Including Alzheimer’s Disease. (n.d.). Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/dementias-including-alzheimers-disease
Leading Health Indicators Development and Framework. (n.d.). Retrieved from https://www.healthypeople.gov/2020/leading-health-indicators/Leading-Health-Indicators-Development-and-Framework
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Cognitive Camouflage — How Alzheimer’s Can Mask Mental Illness
By Michael B. Friedman, LMSW; Gary J. Kennedy, MD; and Kimberly A. Williams, LMSW
Vol. 2 No. 2 P. 16
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Urinary tract infections
Dehydration and malnutrition
Identifying the Population 65+
Focus on the Mental Health of Said Individuals
Design Community Awareness and Education
Address Issues of Isolation and Inactivity
Provide Services and Evaluation thereof
Running head: Type 2 Diabetes 1
Type 2 Diabetes 2
Preliminary Needs Assessment
Specific HP 2010 objective: Type 2 Diabetes
Targeted behavior: Increase the awareness of the dangers of diabetes and provide education on preventing type 2 diabetes with diet and exercise.
Specific target population: Individuals over 40 years old.
Purpose of Needs Assessment
What is diabetes? Diabetes is a dangerous condition that causes blood sugar to rise to dangerous levels. When blood sugar gets to dangerous levels it can be life threatening. This topic is extremely important to me because my mother is diagnosed with type 2 diabetes. This means that I am predisposed to the disorder. Since I am
I am at high risk to developing the disorder. Unfortunately, growing up there were never any programs to prevent childhood obesity or programs to provide knowledge on the dangers that obesity can lead to. If these programs were implemented when I was in my teenage years perhaps I would have been able to join a nutrition or fitness program. This could have motivated me to be more physically active. Now here I am in my twenties now getting the proper information and guides to adjusting my lifestyle to prevent this from happening. Since this is so close to home I feel compelled to design and implement a diabetes awareness and prevention program in South Florida. It is crucial to get the knowledge and awareness out in our community so more people can get moving and begin eating better to live a longer and have a quality filled life. This program is critical, this program will be able to provide awareness and prevention simply by sharing valuable information that some individuals may not have access to. This program will teach individuals how to change their current unhealthy lifestyles by changing their eating habits and developing a better exercise routine. Just by doing those two it can prevent you from being diagnosed with a chronic illness such as type 2 diabetes. The program will be for all ages. Diabetes is more common for older individuals but providing the information early on it will implement the right tools to a live a healthy and long life. I want to provide the tools and knowledge that I was not given when I was in my teenage years.
Health Risks of Type 2 Diabetes
Your chances of developing Type 2 diabetes may depend on genetics but also lifestyle. We will be focusing on lifestyle since genetics will predispose you to diabetes. Although, genes play a factor it does not necessarily mean you are automatically going to get it. With hard-work and the right awareness you can prevent from being diagnosed with Type 2 diabetes. According to the National Institute of Diabetes, you are more likely to develop type 2 diabetes if you
· are overweight or
· are age 45 or older
· have a family history of diabetes
· are African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander
· have high blood pressure
· have a history of
· are not physically active
· have a history of
(“Risk Factors for Type 2 Diabetes | NIDDK,” 2016).
This is why it is important to create an awareness program so we can get more individuals physically active and eat healthier so they can better their lifestyle. This will be able to prevent an individual from being prone to the disorder.
Incidence and Prevalence Rates of the Health Risks
According to Diabetes.org, the prevalence of diabetes in a study done in 2015 reported 30.3 million American of the population had diabetes. Approximately, 1.25 million children and adults have type 1 diabetes. There are 1.5 million Americans diagnosed with diabetes every year. In 2015, 84.1 million Americans years 18 and older had prediabetes. Diabetes remains the 7th leading cause of death in the United States. This same report shows that in 2015 there were a reported 79,535 death certificates listing it as the underlying cause of death, and a total of 252,806 death certificates listing diabetes as an underlying or contributing cause of death (“Statistics About Diabetes,” n.d.).
Minimizing the risk
One of the approaches on minimizing the risk would be to work with the community to implement free to low cost physical activities throughout the area. For example, I am aware of a couple hospitals who offer free Zumba, yoga and Pilate classes to the local community. This helps individuals get up and get moving. In our program we will provide the listings for all these local free to low cost classes so that individuals can have more access. We can also start implementing nutrition classes throughout the community or have a general listing on where an individual can go for that. We want our program to have all the information required to help prevent diabetes and create awareness throughout the South Florida community. The more awareness that is spread the better the outcome of individuals getting diagnosed with type 2 diabetes.
Evidence Based- Literature Review
According to the Institute of Medicine (IOM; 2013), obesity is one of the greatest challenges to society and public health. 1 in 3 individuals will develop diabetes during his/her lifetime. Evidence-based programs have shown that healthy lifestyle behaviors reduce risk of obesity as well as development of type 2 diabetes. According to a Diabetes Prevention Program study done in 2004 (Achieving Weight and Activity Goals Among Diabetes Prevention Program Lifestyle Participants, 2004) it showed that intensive lifestyle intervention reduced the risk of diabetes by 58%. This study included 1079 participants. The goal for the participants was to lose 7% weight loss and 150 minutes a week of physical activity. There was an assessment at week 24 and then a final assessment about 3 years later. The results of the study showed that 49% met the weight loss goal and 74% met the activity goal. The criteria for this study included an age of at least 25 years, a Body Mass Index of 24 or greater, a fasting glucose of 95-125 and a glucose value of 140-199 mg 2 hours after a 75grams of sugar load. The lifestyle intervention recommended the participants to brisk walk to reach their activity goal. Other activities similar to brisk walking was also allowed and applied to the goal for the study. The study made sure to get the participants to be mentally prepared and motivated at the start. This helped patients get off to a good start and end with great results and long-term success. Although, this study was more extensive than the program I would like to implement it is great to see the evidence-based literature that lifestyle programs can help prevent patients from being diagnosed with type 2 diabetes.
Another study I want to look at is implementing wellness programs in the workplace by providing a program it can ultimately prevent type 2 diabetes and other diseases related to lifestyle wellness. This study mentions that by implementing a wellness program it actually saves them money on health costs (“Workplace Wellness Programs Can Generate Savings | Health Affairs,” 2017). It is beneficial for the hospital to have a program in place. In this particular study the hospital offered several guides and tools for their employees. They provided fitness programs, smoking cessation, classes, seminars, self-help education, individual counselling and incentives for participation. This wellness program that was implemented engaged a lot of its employees and helped change a lot of lifestyles. The education provided to the employees gave them the right knowledge to prevent type 2 diabetes. It also helped lower health costs for the company. This was an interesting study. One of my previous workplaces offered a similar wellness program. It allowed employees to get incentives if they reached their health and fitness goals. If you were classified under a healthy bracket by your primary care physician then your health insurance would lower by $20-30 a month. It gave the employees motivation to stick to the wellness program in order to benefit from the bonus of saving money monthly.
In conclusion, as mentioned above the implementation a diabetes awareness and prevention program in South Florida is critical. As the numbers for individuals being diagnosed with diabetes each year keep rising, there needs to be something done to address this. This program will be able to educate individuals on what they need to do in order to prevent this life-threatening disease. By spreading the word, providing the right education and tools and working hard to implement more wellness programs in the workplace I believe this will help out community in keeping the number of diagnosed patients down. It will also help save more money on health costs by being healthier and not being on medication and constantly at the doctor’s office for health assessments. By showing individuals that just by being active and eating right will lead to a long and quality filled life it will motivate them to get started and make important and critical changes with their lifestyle.
Institute of Medicine of the National Academies. (2013). Evaluating obesity prevention efforts: A plan for measuring progress. (Author), Retrieved from
Risk Factors for Type 2 Diabetes | NIDDK. (2016, November 30). Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/risk-factors-type-2-diabetes
Statistics About Diabetes. (n.d.). Retrieved from http://www.diabetes.org/diabetes-basics/statistics/
The Diabetes Prevention Program Research Group. (2004). Achieving Weight and Activity Goals Among Diabetes Prevention Program Lifestyle Participants. Obesity Research, 12(9), 1426–1434.
Workplace Wellness Programs Can Generate Savings | Health Affairs. (2017, August 2). Retrieved from https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2009.0626
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