One Hobby Lobby Story

Emily Gargiulo

Waiting to witness history.

Last Tuesday, the Supreme Court listened to oral arguments in the case of Sebelius v. Hobby Lobby Stores, which will determine if a for-profit company can deny its employees health coverage of contraception based on the religious objections of the company owner. The case represents the latest controversy in the health reform/reproductive justice/religious liberty debate—just how that debate is defined is often an indicator of where one stands.

My story

I grew up in a devout Catholic household in Brooklyn, NY. As a child, I learned early that many of my friends and neighbors did not share my family’s beliefs—the gift and consequence of growing up in one of the most diverse cities in the world. Nevertheless, we recognized that we all enjoyed the same protections to believe and not believe, to practice and not practice a given faith. It is this principle that has most clearly defined my views today, but one that Hobby Lobby appears to question. The store owners and supporters suggest that their religious freedom should trump that of their employees. The court’s definition of this freedom will impact the rights of women across the country to make this choice for themselves.

I decided months ago that I needed to be present for this historic case, but I knew making this a reality would be no easy feat. The Supreme Court contains roughly 400 seats for viewers; of these, many go to friends and colleagues of the justices, groups that have assisted in the counsel of the two legal teams, and the press. The limited numbers of leftover seats are made available to the public. In the days leading up to hearing, forecasts predicted snow, slated to start right in the middle of the night. I enlisted one crazy friend still willing to take a chance to witness history.

As the day finally arrived, we drove from Baltimore to DC, armed with blankets, snacks, and a few vain hours of sleep. Joining the line shortly after 3am we were giddy with the anticipation of the hours ahead. Students of all ages—high school, college, and law school—surrounded us on the street, all attracted to the line by a common spirit. We embodied the hopeful, bushy-tailed energy of the nation’s capital, where policy and society collide in the democratic process. We’ve lived in a time when contraception is legal and not just accepted by our peers, but considered a right. We’re also living in a time where companies have unprecedented power and speech. We knew the collision of these individual and corporate rights may well decide the next period of our lives.

Around 6 am, we were told to pack up and prepare for the first groups to start entering the building. (In reality, the very front of the line would not go in until 7:30am, while others, myself included, waited two more hours to snatch up the last few public seats.) At this point, the protestors started to gather. As we anxiously waited to learn our viewing fate, we watched the physical demonstration of colliding principles. Each side fought to be the loudest, the biggest, and the least able to ignore. Advocates all had their own story of why they came, what they believe, and the result they seek.

After hours of camping, standing, and snow, we were among the final public viewers to make it in the courtroom. The 90 minutes of testimony were among some of the most exhilarating minutes two health policy students/reproductive rights advocates could ask for. There are ample sources across the internet where one might read about the arguments considered, so I will not analyze these here. (A decision is expected in June.) What I do think is worth mentioning is just what that courtroom represented—nine highly esteemed justices, serving life tenures, spent 90 minutes asking questions regarding legal standards and the health and economic costs of these decisions. Hundreds of reporters and legal experts listened for those justices’ tones, signs of opinion, and precedence. Students and other lay public marveled at the judicial process, and the chance to experience history. But outside that courtroom, hundreds of activists withstood snow and opposition to openly declare their principles. They wore shirts and raised signs like scarlet letters, a symbol of solidarity to the views and people they represent.

Beyond that courtroom or the surrounding streets, there are millions of women who stand to feel the impact of this decision. No matter how you define the debate, the answer is monumental for the individual rights to healthcare, religion, and freedom of choice for all Americans. My Hobby Lobby story is just one of the millions that remain to be told.

Emily Gargiulo is a Health Policy graduate student at Johns Hopkins Bloomberg School of Public Health and a Research & Evaluation Assistant at Healthy Teen Network.

Check out a short video of Emily waiting to go inside the Supreme Court.


9 Tips to Create a Safe Space for Teachable Moments

Gina Desiderio

Gina Desiderio

A teachable moment is a situation where opportunity knocks—a time at which a person, especially a child, is likely to be particularly disposed to learn something or to be particularly responsive to being taught or made aware of something. Teachable moments can make initiating conversation about sex and contraception easier and more comfortable for everyone involved.

With accurate information and adequate support, young people can make healthy and responsible decisions about having sex and using contraception. Adults can be most effective by providing the information and support needed to promote responsible decision-making in youth and help ensure transition to adulthood is safe and healthy.

Parents, caregivers, and youth-supporting professionals can take advantage of teachable moments to discuss sex and the use of contraception with young people. National Talk to Your Teen About Sex Month–observed every March–is the perfect time to get the conversation started.

Youth can sometimes be hesitant to talk with adults about sex. When young people are willing to discuss this topic, adults must be prepared to help by providing information and resources. When the interaction is positive, it is more likely that the youth will return to the adult in the future.

Confidentiality is the first step in creating a safe space, but you’ll want to try to build a safe space, to help build an ongoing relationship, in other ways, too.

9 Tips To Create a Safe Space for Teachable Moments

  1. Clarify what is being asked.
  2. Determine why the young person is asking the question.
  3. Affirm the young person for asking. It’s okay to talk about sex!
  4. Be aware of your own boundaries.
  5. Give direct responses.
  6. Use positive body language
  7. Be accessible for future opportunities to interact
  8. Bring it up! Open the door to conversation.
  9. Keep it private: Depending on the situation, a one-on-one conversation may be best.

Opportunity Knocks: Using Teachable Moments to Convey Safer Sex Messages to Young People is a Healthy Teen Network publication provided to help adults use teachable moments to talk to young people about safe sex. In addition to this resource, Healthy Teen Network has made available all the materials you need to conduct your own Opportunity Knocks presentation. The goal of this presentation is to educate and empower youth workers, unfamiliar with the field of sexual and reproductive health, to make the most of teachable moments with the young people they serve regarding safer sex and contraceptive choices.

In your experience, what has been helpful in creating a safe space to foster teachable moments with youth?

What opportunities, such as current events or pop culture, have you found to foster teachable moments with young people?

All EC ≠ All Female Bodies

Alexandra Eisler

Alexandra Eisler

The name of the game is to make “the healthy choice, the easy choice.” And we’re excited women can (finally) buy emergency contraception (EC) over the counter! More options, more resources, and removing barriers = awesome, right?!

Not so fast.

We talk about EC as a workable option for just about anyone who wants it. Seems easy enough. The problem is that research shows not all ECs are good for all female bodies. There are three kinds of EC we hear about in the U.S.: Levonorgestrel (LNG; i.e., Plan B, Next Plan, Postinor), ulipristal acetate (UPA; i.e., ella), and the copper IUD (i.e., Paragard):

  • LNG is available over the counter without a prescription.
  • UPA requires a prescription.
  • The copper IUD must be inserted by a medical professional and accessibility varies widely among clinicians (sometimes taking several visits to be acquired and inserted).

As far as “patient friendly” goes, LNG may be the best choice with no doctor’s visit and no prescription. And everyone knows what Plan B is thanks to its sassy purple-hued commercials (brand recognition goes a long way—just ask teens how they feel about Trojan condoms over other brands). This is why in our field we keep the EC-talk simple: if you unprotected sex within this timeframe, go get EC—the sooner the better!

What we don’t talk about is that LNG is not effective for women whose body mass index (BMI) is over 25. (Check out more information about BMI here.) Now, it’s true that BMI is a somewhat controversial measurement of health, but it’s one that was correlated with EC failure.

LNG works for women whose BMI is 25 and lower, UPA works for women whose BMI is 35 and lower (and can be taken up to 120 hours after unprotected sex—longer than LNG), and the copper IUD works for most women if it can be inserted soon enough after sex. The take away is that the research shows that once a woman’s BMI reaches 26 and above, LNG becomes so ineffective, it’s basically a placebo.

So what does this mean? It means a few things. First, the most accessible methods of EC don’t work for a large portion of Americans who might want to use it. Second, we need to wholly reconsider how we talk about EC being a safe and effective method to prevent pregnancy when other methods fail.

Our clients, our students, and our patients have a low tolerance for “bad” information and by removing the required prescription from Plan B, there’s not a good line of defense to make sure folks are getting a good back-up method. There’s no easy way to explain the intersection of sex, hormones, body composition, and family planning, so how will you talk to young people about handling EC?

(Note: The study found two other covariate of EC failure in addition to BMI: existing probability of conception and the occurrence of further acts of unprotected intercourse after using EC.)

Alexandra Eisler is a Training and Technical Assistance Manager at Healthy Teen Network.

One Third Is Too Much

As most of us in the field know, teen pregnancy rates have hit record lows over the past couple years. The teen birth rate for girls aged 15-19 decreased 9% between 2009 and 2010, from 37.9 births per 1,000 to 34.3 per 1,000. This is the largest decline recorded in a single year since 1946-47, and teen birth rates are now at their lowest levels since National Center for Health Statistics (NCHS) began tracking teenage childbearing .

Guttmacher brief released earlier this year help explains some of the reason for this success in driving down rates: “The majority (86%) of the decline in the teen pregnancy rate between 1995 and 2002 was the result of dramatic improvements in contraceptive use, including an increase in the proportion of teens using a single method of contraception, an increase in the proportion using multiple methods simultaneously and a substantial decline in nonuse.” This finding underscores Healthy Teen Network’s core belief that all youth can make responsible decisions about their sexuality and reproductive health when they have complete, accurate, and culturally relevant information, skills, resources, and support.

Still, with all the strides that have been made in the right direction, one third of American youth currently receive no formal information about contraception. This needs to change: one third is too much.

For more than 33 years, Healthy Teen Network has been building the capacity of professionals and organizations to support and empower adolescents and young adults, including teen parents, to lead healthy sexual, reproductive, and family lives. Accurate education on contraceptive methods is crucial to empower youth to make responsible choices.

For example, as part of our grant with the Centers for Disease Control and Prevention Division of Reproductive Health, Healthy Teen Network provides training and technical assistance to state grantees, supporting the implementation of evidence-based programs to prevent teen pregnancy. Healthy Teen Network member and project grantee Erin Livensparger, of Planned Parenthood of Southern New England, Inc., recently attended a Healthy Teen Network five-day training-of-educators on evidence-based programs, and participated in follow-up technical assistance.

“I really enjoy the high caliber way Healthy Teen Network trains on curricula,” Erin says, adding that it was “really powerful” to attend the training, and that it was “really helpful” to be trained on three curricula, all at once. Erin has found that the Healthy Teen Network trainers have “always been accessible and [are] sort of like our über-trainers whom we aspire to be like.” She continues, “The trainers were really approachable, asking what we were thinking, sharing ideas.”

Healthy Teen Network technical assistance goes beyond a single training, providing both proactive and reactive support to build long-term capacity among youth-serving professionals.

Keeping an Eye on STI in the Age of LARC

Valerie Sedivy

Valerie Sedivy

In case you have been under a rock for the past few years, LARCs (otherwise known as Long Acting Reversible Contraceptives) are all the rage in the teen pregnancy prevention community. While implants and injectable contraception have been promoted for many years in this age group, the resurgence of the IUD (intrauterine device) has refocused our attention on LARCs in a big way. Given what we know about the failure rate of other contraceptive methods among teens, this may well be a good thing.

On the other hand, maybe it’s not as simple as it seems. By promoting LARCs among teens, are we inadvertently discouraging condom use? A recent Journal of Adolescent Health study suggests that this may be the case. Now keep in mind that this study only pointed to an association between the use of LARCs and decreased condom use. We cannot say for sure that the use of LARCs caused the decline in condom use. But it does suggest cause for concern. We all want to help teens avoid pregnancy in the most effective way possible, and clearly LARCs help us achieve that aim—and I would wager that none of us wants to do so at the expense of rising rates of STIs. As we all know, some STIs have consequences far more severe than pregnancy.

So what do we do? Do you have a clear and compelling way to make the case that condoms are still essential, even when a teen has the pregnancy risk covered? Is it realistic that teens will do both? After all, many may choose to use LARCs once they are in an ‘established’ relationship when they perceive the risks of STIs to be low to none. At what point is it OK to say “go ahead and skip the condom”? Is it ever OK?

Do the field a favor and share your thoughts and ideas. We need to address this issue more than ever. While teen pregnancy rates are on the decline, rates of STIs among this age group are still far too high and may climb higher if the use of LARCs increases at the expense of condom use.

Valerie Sedivy is a Senior Program Manager at Healthy Teen Network.

Opportunity Knocks: Teachable Moments

This blog post is part of a series highlighting Healthy Teen Network’s resources on using teachable moments to reach youth, through our Opportunity Knocks resources, including a fact sheet and pre-packaged, fully designed presentation, ready for you to use.  The Opportunity Knocks series is based on Healthy Teen Network’s belief that with accurate information and adequate support, young people can make healthy and responsible decisions about having sex and using contraception. Adults can be most effective by providing the information and support needed to promote responsible decision-making in youth and help ensure transition to adulthood is safe and healthy.

Gina Desiderio

A “teachable moment” is a general term, but one that I’m sure you’ve come across or used in your experiences working with youth. A teachable moment is a situation where opportunity knocks—a time at which a person, especially a child, is likely to be particularly disposed to learn something or to be particularly responsive to being taught or made aware of something.[1]

Teachable moments offer some advantages when trying to reach youth:

  1. Youth can make healthy and responsible decisions: With accurate information and adequate support, young people can make healthy and responsible decisions about having sex and using contraception.
  2. Adults can promote responsible decision-making: Adults can be most effective by providing the information and support needed to promote responsible decision-making in youth and help ensure transition to adulthood is safe and healthy.
  3. Creating a positive interaction opens the door for future opportunities: A key component for adults is taking advantage of teachable moments to discuss sex and the use of contraception with young people.  Youth are often hesitant to talk with adults about sex.  When young people are willing to discuss this topic, adults must be prepared to help by providing information and resources.  When the interaction is positive, it is more likely that the youth will return to the adult again.

Sometimes, adults are afraid that talking about sex leads to sex, but this is simply not true.  Talking about sex does not lead to sex.  Also, risk-taking can be part of normal adolescent development; adults can be most effective by promoting healthy decision-making during this stage. Talking about sex does not mean an adult is advocating sexual activity. Making the best use of teachable moments can help youth make better choices if and when they do make the decision to become sexually active.  Furthermore, sexual feelings are a part of normal adolescent development.[2]

Teachable moments can make initiating conversation about sex and contraception easier and more comfortable for everyone involved.   There are two kinds of teachable moments—those that spontaneously occur, and those that can be prompted based on a situation.  With spontaneous teachable moments, youth initiate the conversation.  With prompted teachable moments, the adult initiates the conversation, using the current situation or topic as a jumping off point.

Media often provide the opportunity for a prompted or a spontaneous teachable moment.  A television show, movie, or song, for example, may present a storyline or subject that contains an important lesson or example. Youth may bring these topics up, or you may be able to take advantage of this example and use it as a “jumping off point” in your discussion about safer sex and contraception. This type of teachable moment may seem contrived, but it is a great way to begin a conversation that may otherwise be difficult to initiate.

What are some ways you have used media examples or current events to prompt a teachable moment?

A helpful hint is not to limit your teachable moments to media that interests you; take some time to understand what interests the youth you work with. Read their magazines and be aware of popular television shows, movies, and music. These images, storylines, songs, and ads are what they are absorbing all of the time.

Teachable moments may also occur if a young person discloses something to, or confides in, you. As an educator, nurse, social worker, clinician, or other direct service provider, it is important to feel confident in your response if a young person discloses a personal situation or asks for advice. This type of teachable moment may catch you off guard, so it is important that you have the training, resources, and preparation to respond accordingly.

For example, I used to be a high school English teacher, and in my first year of teaching, I did not have any training or preparation in dealing with disclosure.  A student confided in me that she sometimes cut herself.  I was caught off guard; I didn’t know how to respond to her, in the moment, and I didn’t know what I was required to report, legally, or to keep confidential.

Whether the disclosure is spontaneous or prompted, it’s important to know the policy relevant to the situation.  While we aren’t able to review your specific organization’s or agency’s confidentiality and referral policy in just a single blog post, there are some important key points to be aware, in the event of a disclosure.  You should know:

  1.  What must be kept confidential (e.g., HIV status, sexual orientation)?
  2. What must be reported (e.g., abuse, intent to harm self or others)?
  3. What is your professional role expected to be (e.g., referral to counseling/crisis intervention or counseling/crisis intervention)?
  4. What are your professional boundaries?
  5. What  resources and referrals are available locally?

See your supervisor, credentialing organization, state law, etc., to find out more about your relevant confidentiality and reporting policies and laws.

It’s important to let youth know what’s confidential, as well.  This will help create a safe space, building trust, and encourage future opportunities for providing information, resources, and referrals.

Gina Desiderio is the Director of Marketing and Communications at Healthy Teen Network.

[1] Teachable Moments. (2009).  Encarta Dictionary. Retrieved online.

[2] Haffner, D. (Ed.). (1995). Facing facts: Sexual health for America’s adolescents. NY, NY: Sexuality Information and Education Council of the United States.

It’s a Feminazi’s World

Slut: A middle English word used around the 1450s to describe an individual who is considered to have loose sexual morals or who is sexually promiscuous. The term is generally pejorative and often applied to women as an insult or offensive term of disparagement, meaning “dirty or slovenly (Oxford Dictionary, 2012).

Prostitute: “Prostitute” is derived from the Latin prostituta. Some sources cite the verb as a composition of “pro” meaning “up front” or “forward” and “situere”, defined as “to offer up for sale”. A person who willingly uses his or her talent or ability in abase and unworthy way, usually for money (Merriam-Webster, 2012).

Feminazi: “an extreme or militant feminist”. An unspecified women whose goal is to allow as many abortions as possible (Merriam-Webster, 2012).

Sandra Fluke: Feminazi (According to the Limbaugh Dictionary) who testified before Democratic members of the House of Representatives on why she believed free contraception is generally essential and should be covered by employer health plans.

Vanessa Geffrard

Wondering why I decided to start off with a little vocabulary lesson? Well, if you do not have the slightest clue what these words refer to, I’m referring to the disgusting, humiliating, misinformed words political commentator Rush Limbaugh used to vilify the testimony of Sandra Fluke. Limbaugh has been known to push the envelope, but this time, his comments take aim at men and women of all political affiliations and backgrounds, and even his advertisers, who are starting to pull ads from his radio talk show. When Limbaugh called Fluke, a Georgetown University law student, a “slut” and a “prostitute” (neither of which accurately describe Fluke) for publicly advocating that employers cover contraception in their health plans, he crossed the line.

Limbaugh concluded his sexist rant by telling the women, also known as feminazis in his dictionary (see definition above), who want their contraception covered by their insurance plans, to post pornographic videos of themselves online in exchange for taxpayers funding contraceptives. When Limbaugh said, “If we are going to pay for your contraceptives and thus pay for you to have sex, we want something. We want you to post the videos online so we can all watch,” he went too far.

What is probably most offensive is that Limbaugh decided to go on a tirade discussing his viewpoint and repeatedly tried to make a connection between Fluke wanting contraceptives covered by insurance companies to women wanting to be “paid” to have sex. See the connection? Yeah, I didn’t either. Limbaugh did not bother to base any of his opinions on fact or conduct any preliminary research in order to formulate an informed and logical opinion about women and contraceptives.

In a November 2011 report, The Guttmacher Institute found that 88% [of women] take oral contraceptive pills for non-contraceptive purposes; most commonly, women used the medication for menstrual regulation (46%) and menstrual pain (40%). Guttmacher also cited that more than half of pill users, 58%, rely on the method at least in part for purposes other than pregnancy prevention; 31% percent use it for cramps or menstrual pain; 28% for menstrual regulation; 14% for acne; 4% for endometriosis. Therefore, many women, as mentioned by Ms. Fluke in her testimony, are using their right to use birth control pills in a non-contraceptive manner to help alleviate health problems experienced by women, and especially young women (Guttmacher, 2011).

Some other good things to know when accusing women of “having so much sex, they can’t afford birth control,” with “no self-control,” is that birth control’s benefits include:

  • Reducing the amount of blood flow during the period. Less blood loss is helpful in preventing anemia.
  • Endometriosis: Occurs when cells from the lining of the womb (uterus) grow in other areas of the body. Most women with endometriosis have cramps or pelvic pain during their menstrual cycle. Birth control pills are often prescribed to treat endometriosis and work by temporarily preventing periods.
  • Menstrual Cramps: When over-the-counter medications don’t help with severe cramps, birth control pills may be the solution because the pills prevent ovulation and lighten periods.
  • Lack of periods (“amenorrhea”) from low weight, stress, excessive exercise, or damage to the ovaries from radiation or chemotherapy: With any of these conditions, the hormone “estrogen” is not made in normal amounts by the body. Birth control pills may be prescribed to replace estrogen, which helps to regulate the menstrual cycle. Normal estrogen levels are important for healthy bones.
  • Reducing the risk of ovarian cysts: The risk of developing ovarian cysts is greatly reduced for birth control pills users because the pills help prevent ovulation. An ovarian cyst is a fluid-filled growth that can develop in the ovary during ovulation (the release of an egg from an ovary).
  • Protection against pelvic inflammatory disease: Birth control pills provide some protection against pelvic inflammatory disease (PID). Pelvic inflammatory disease is a serious bacterial infection of the fallopian tubes and uterus that can result in severe pain and potentially, infertility (, 2010).

And you know what’s funny? Again, as Guttmacher, The Center for Young Women’s Health, and Ms. Fluke indicate, many of these benefits and necessities to women’s health have nothing to do with a woman’s sex life (which is her business) or that of her partners. Advocating for insurance coverage for contraception has everything to do with a woman’s choice to choose to advocate for herself, her health, and have the right to affordable and reliable resources to help her ensure the health of her body, as recommended by her medical practitioner(s). Contraceptives have been shown to be reliable and critical to the healthcare needs of needs of women—if women need and choose to take them. Limbaugh’s tirade against “feminazis” like Fluke and women’s rights advocates who speak up against the unfair practices to keep women who desperately need their medications from having affordable access minimizes women’s health , turning it into political mockery.

In addition to this widespread denigration of women’s health, we now have Limbaugh attacking the personal sex lives of women in the most degrading sense,calling women sluts and prostitutes for simply accessing basic, standard health care. This topic of women’s health keeps resurfacing as a cornerstone issue in our society, and now is the time to express our opinions and advocate for ourselves. Women of all ages are being attacked, condemned, asked to make pornographic films of themselves, and are having their sexuality and reproductive health spawn out for all to judge, criticize, and testify upon without their permission. So what can we do? How can we express our voices?

  1. Don’t let misogynistic insults such as slut, prostitute, feminazi, etc. define, demonize, and divide us. We are empowered and we know our rights to affordable and reliable medications and health care. Let’s exercise our voices and speak up when we are being treated like second class citizens.
  2. Get involved! Get involved! Get involved! Write an email to your local congress person expressing your views against policies that affect women’s reproductive rights.
  3. Be an advocate and a voice for young women and girls in your community; hold a teach-in at your local community center, host a webcast, post informative articles on your Twitter and Facebook, sign an online petition against policies you see as anti-women, join or start a women’s circle, educate men and women around you on women’s reproductive health issue.
  4. Join the conversation and get information from and connect with us on Twitter and Facebook to keep abreast of the issues!

In conclusion, let’s not give up hope and let’s keep letting our voices be heard above noise of nonsense, hate, and misinformation.

And for you, Rush, in light of your gracious, heartfelt apology; in the words of Mr. Kanye West, “Yo Rush, I’m really happy for you and Imma let you finish your sorry apology and all, but the feminazis are giving the best testimonies of all time!”

Vanessa Geffrard is a Training and Technical Assistance Coordinator for Healthy Teen Network.

Free Will for All?

Shelby Emmett

Under the Affordable Care Act, employers are required to pay for preventative care services—including birth control. The administration announced late January that churches and houses of worship would be exempt from providing free birth control coverage to their employees. The First Amendment of the United States Constitution protects citizens from a government establishment of religion, and also guarantees our free exercise thereof. The exemption upset many members of the religious community, in large part because it required religious hospitals, universities, and charities to still comply with the mandate under the 2010 health care law.

On February 10, 2012, the Administration changed course and amended the regulation. Now, employers who object to providing contraception do not have to pay for it or be involved with it in any way. Instead, insurance companies will be required to reach out to women of these employers, and cover the cost of contraceptives instead of the employer.

Healthy Teen Network supports access to effective contraception for all and believes it is necessary to help people of all ages exercise control over their reproductive choices. We applaud President Obama for finding a compromise that allows for this access. We embrace the faith community as important partners in promoting healthy sexual and reproductive behaviors and hope this compromise will promote partnership on their part as well. We recently met a long-time, progressive Black minister who justifies his pro-choice stance by saying that “the greatest gift God gave to us is the gift of free will.” Does this compromise support free will for all?

Shelby Emmett, JD is the Policy and Legal Coordinator at Healthy Teen Network.

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