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DEVELOPMENTAL THEORY
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SISTER CALLISTA ROY
Adaptation Model
The changing
environment stimulates
the person to make
adaptive responses. For
human beings, life is
never the same
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BIOGRAPHY
Date of Birth: October 14, 1939
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EDUCATION
1963: BSN Mount St. Marys College, Los
Angeles
1966: Masters Degree in Pediatric Nursing University of California
1973: Masters Degree in Sociology
1977: PhD in Sociology
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WORK HISTORY
Entered the Sisters of Saint Joseph Carondelet
Professor and Nurse Theorist at Boston
College of Nursing
Fellow American Academy of Nursing
Member
Sigma Theta Tau North American Nursing Diagnosis Association
(NANDA)
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INFLUENCING FACTORS
Family
Education
Religious background Mentors
Clinical Experience
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METAPARADIGM IN NURSING
Person
A biopsychosocial being in constant interaction
with a changing environment
Is an open, adaptive system who uses coping skills
to deal with stressors
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METAPARADIGM IN NURSING
Environment
Conditions, circumstances and influences that
surround and affect the development and
behavior of the person
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METAPARADIGM IN NURSING
Health
Is the process of being and becoming an
integrated and whole person
Represented by a health-illness continuum
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METAPARADIGM IN NURSING
Nursing
To promote adaptation for individuals and groups
in the four adaptive modes, thus contributing to
health, quality of life, and dying with dignity byassessing behaviors and factors that influence
adaptive abilities and by intervening to enhance
environmental interactions
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METAPARADIGM IN NURSING
Person
Adaptive system has:
Cognator subsystems
Regulator subsystems
Adaptive system act to maintain adaptation to
four (4) adaptive modes:
Physiologic-physical Self-concept-group identity
Role function
Interdependence
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ROYS ADAPTATION MODEL
Person is an adaptive system in constant
interaction with an internal and external
environment
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ROYS ADAPTATION MODEL
Environment is the source of a variety of
stimuli that either threaten or promote the
persons unique wholeness
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ROYS ADAPTATION MODEL
Categories of environmental stimuli: Focal
Is the internal or external stimulus most immediately
challenging the persons adaptation
Is the phenomenon that attracts the most of ones
attentions
Contextual
All other stimuli existing in a situation that strengthen the
effect of the focal stimulus
Residual
Any other phenomena arising from a persons internal or
external environment that may affect the focal stimulus
but whose effects are unclear
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ROYS ADAPTATION MODEL
Persons Adaptation Level
Integrated
Compensatory
Compromised
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ROYS ADAPTATION MODEL
Categories of Coping Mechanisms:
Regulator subsystem
Occurs through neural, chemical, endocrine processes
Automatic response to stimuli
Cognator subsytem
Occurs through cognitive-emotive processes-perceptual
and information processing, learning, judgment, and
emotion
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ROYS ADAPTATION MODEL
Two Control Processes the Coincide With the
Subsystems:
Stabilizer subsystems
The established structures, values, and daily activitieswhereby participants accomplish the primary purpose
of the group and contribute to common purpose of
society
Innovator subsystems Refers to cognitive and emotional strategies that allow
a person to change to higher levels of potential
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ROYS ADAPTATION MODEL
Four Adaptive Modes:
Physiological
Self-concept
Role function
Interdependence
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ROYS ADAPTATION MODEL
Physiological Adaptive Mode
Refers to the way a person responds as a physical
being to stimuli from the environment
Goal: physiological integrity
5 physiological needs: 4 complex processes:
Oxygenation Senses
Nutrition Fluids and electrolytes
Elimination Acid-base balance
Activity and rest Neurologic function
Protection Endocrine function
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ROYS ADAPTATION MODEL
Self-Concept Adaptive Mode
Refers to psychological and spiritual characteristics
of the person
Goal: psychic integrity
Two components:
Physical self
Incorporates body sensation and body image Personal self
Incorporates self-consistency, self-ideal, and moral-ethical-
spiritual self
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ROYS ADAPTATION MODEL
Role Function Adaptive Mode
Refers to the primary, secondary or tertiary roles
the person performs in society
Goal: social integrity
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ROYS ADAPTATION MODEL
Interdependence Adaptive Mode
Refers to the coping mechanisms arising from
close relationship that result in the giving and
receiving of love, respect, and value
Goal: affectional adequacy
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ROYS ADAPTATION MODEL
Results of Coping Mechanisms:
Adaptive responses
Promotes integrity of the person and goals of
adaptation
Ineffective responses
Neither promote integrity nor contribute to the goals of
adaptation
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ROYS ADAPTATION MODEL
Adaptation
Responding positively to environmental changes
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NURSING PROCESS
Six Steps:
Assessment of behavior
Assessment of stimuli
Nursing Diagnosis
Goal Setting
Intervention
Evaluation
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NURSING PROCESS
ASSESSMENT OF BEHAVIOR
Adaptive Modes
Types:
Observable
Vital signs
Non-observable
Feelings experienced by the person (anxiety)
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NURSING PROCESS
ASSESSMENT OF STIMULI
Focal
Most immediately confronting the person
Contextual
All other stimuli present that are affecting the situation
Residual
Stimuli whose effect on the situation is unclear
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NURSING PROCESS
NURSING DIAGNOSIS
Formulation of statements that interpret the data
about the adaptation status of the person
The diagnostic statement indicates:
Actual
Potential problems
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NURSING PROCESS
GOAL SETTING
Involves the establishment of clear statements of
the behavioral outcomes for nursing care
Done together with the client
Includes:
Behavior
Change expected Time frame
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NURSING PROCESS
INTERVENTION
Management of stimuli
Alter
Increase
Decrease
Remove
Maintain
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NURSING PROCESS
EVALUATION
Observation of behaviors after interventions have
been completed to see if goals have been MET
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APPLICATION OF ROYS THEORY
Pages 147-151
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MADELEINE LEININGER
Transcultural Theory in
Nursing
Cultural Care Diversity
and UniversalityTheory
The purpose of transcultural
nursing is to discover and establish a
body of knowledge and skills
focused on transcultural care,health, and illness in order to assist
nurses giving culturally competent,
safe, and congruent care to people
of diverse culture worldwide
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BIOGRAPHY
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EDUCATION
1948: Diploma in Nursing St. Anthonys
School of Nursing, Denver
1950: BS Biological Science Benedictine
College, Atchinson, Kansas
1953: MSN Catholic University, Washington,
D.C. 1965: PhD in Anthropology University of
Seattle
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ACHIEVEMENTS
Offered 1st course in Transcultural Nursing at
University of Colorado
Major contributor to other schools in
transcultural nursing curriculum
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DEFINITION
Culture
Set of values, beliefs and traditions that are held
by a specific group of people and handed down
from generation to generation Beliefs, habits, likes, dislikes, customs, and rituals
learned from ones family
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DEFINITION
Religion
Set of belief in a divine or super human power to
be obeyed and worshipped as the creator and
ruler of the universe
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DEFINITION
Ethnicity
A consciousness of belonging to a group
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DEFINITION
Race
Classification of people according to shared
biologic characteristics, genetic markers, or
features
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DEFINITION
Cultural identity
The sense of being part of an ethnic group or
culture
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DEFINITION
Culture-universals
Commonalities of values, norms of behavior, and
life patterns that are similar among different
cultures
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DEFINITION
Culture-specifics
Values, beliefs and patterns of behavior that tend
to be unique to designate a culture
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DEFINITION
Material culture
Refers to objects (dress, art, religious artifacts)
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DEFINITION
Non-material culture
Refers to beliefs, customs, languages, social
institutions
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DEFINITION
Diversity
Fact or state of being different
Can occur between cultures and within a cultural
group
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DEFINITION
Cultural shock
State of being disoriented or unable to respond to
a different cultural environment because of its
sudden strangeness, unfamiliarity andincompatibility to the strangers culture
TRADITIONAL CONCEPTS OF HEALTH
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TRADITIONAL CONCEPTS OF HEALTH
AND DISEASE
Explanations for health and disease are
characterized by many traditional beliefs
about disease causation, treatment, and
general health practices
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METAPARADIGM IN NURSING
Person
Is caring and capable of being concerned about
others
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METAPARADIGM IN NURSING
Environment
Closely related to the concept of culture
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METAPARADIGM IN NURSING
Health
Is culturally defined, valued and practiced
Is universal across all cultures yet defined differently by each
to reflect its specific values and beliefs
It is BOTH universal and diverse
Components
Health systems
Health care practices
Changing health patterns
Health promotions
Health maintenance
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METAPARADIGM IN NURSING
Nursing
Has physical, psychocultural, and social
significance for those being assisted
Uses 3 modes of action to deliver care: Cultural care preservation or maintenance
Cultural care accommodation or negotiation
Cultural care repatterning/restructuring
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APPLICATION OF LEININGERS THEORY
Refer to page 159-161
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MARGARET JEAN WATSON
Philosophy and Science
of Caring
Caring in nursing
conveys physical acts,but embraces the mind-
body-spirit as it
reclaims the embodied
spirit as its focus ofattention
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EDUCATION
1964: BSN Boulder Campus, Univ. of
Colorado
1966: MS in Psychiatric-Mental Health
Nursing Health Sciences Campus,
Univ. of Colorado
1973: PhD in Educational Psychology andCounseling - Boulder Campus,
University of Colorado
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METAPARADIGM IN NURSING
Person
Is a valued person in and of him to be cared for,
respected, nurtured, understood, and assisted
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METAPARADIGM IN NURSING
Environment
Provides values that determine how one should
believe and what goals one should strive toward
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METAPARADIGM IN NURSING
Health
Unity and harmony within the mind, body, and
soul
Three elements: High level of over-all physical, mental, and social
functioning
A general adaptive-maintenance level of daily
functioning
Absence of illness (or presence of efforts that lead to its
absence)
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METAPARADIGM IN NURSING
Nursing
Human science of people and human health-
illness experiences that are mediated by
professional, personal, scientific, aesthetic, andethical human care transactions
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MAJOR ELEMENTS
1. The carative factors
Care with love
Originated from the word caritaswhich means
to cherish, appreciate and give special attention
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MAJOR ELEMENTS
Ten Carative Factors1. Formation of humanistic-altruistic system of
values
2. Instillation of faith-hope3. Cultivation of sensitivity to ones self and to
others
4. Development of a helping-trusting, human
caring relationship (pls refer to the next slide)5. Promotion and acceptance of the expression of
positive and negative feelings
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MAJOR ELEMENTS
Characteristics needed in the helping-trust
relationship
Congruence
Empathy
Warmth
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MAJOR ELEMENTS
Ten Carative Factors
6. Systematic use of a creative problem-solving caring
process
7. Promotion of transpersonal teaching-learning8. Provision of a supportive, protective, and corrective
mental, physical, societal, and spiritual environment
9. Assistance with gratification of human needs (please
refer to the next slide)
10. Allowance for existential-phenomenological-spiritual
forces
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MAJOR ELEMENTS
Watsons Ordering of Needs
Lower order needs (Biophysical Needs)
The need for ventilation
The need for food and fluid The need for elimination
Lower order needs (Psychosocial Needs)
The need for activity-inactivity
The need for sexuality
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MAJOR ELEMENTS
Watsons Ordering of Needs
Higher order needs (Psychosocial Needs)
The need for achievement
The need for affiliation
Higher order needs (Intrapersonal-interpersonal
Needs)
The need for self-actualization
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MAJOR ELEMENTS
2. Transpersonal Caring Relationship
Describes how the nurse goes beyond an
objective assessment, showing concerns toward
the persons subjective and deeper meaningregarding their own health care situation
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MAJOR ELEMENTS
3. Caring occasion / caring moment
The nurse and another person come together in
a such a way that an occasion for human caring is
created Not simply a goal for the cared-for, the nurse,
also needs to be aware of her own consciousness
and authentic presence of being in caring
moment with her patient
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APPLICATION OF WATSONS THEORY
Refer to page 166
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PATRICIA BENNER
From Novice to Expert
Nursing is a science
that studies the
relationships betweenmind, body, and human
worlds
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EDUCATION
1964: BSN Pasadena College
1970: MSN Univ. of California
1982: PhD Univ. of California
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ACHIEVEMENTS
Author of nine books
Internationally noted researcher and lecturer
on health, stress, and coping, skill acquisition
and ethics
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METAPARADIGM IN NURSING
Nursing
Enabling condition of connection and concern
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METAPARADIGM IN NURSING
Person
Self-interpreting being
Major aspects of understanding that the person
must deal with as: The role of the situation
The role of the body
The role of personal concerns
The role of temporality
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METAPARADIGM IN NURSING
Health
What can be assessed
Not just the absence of disease and illness
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METAPARADIGM IN NURSING
Environment
situation social environment
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SKILLS ACQUISITION IN NURSING
Novice
Stage where nursing students belong
Advance beginner
Newly graduated nurses
Competent
Proficient
Expert
SEVEN DOMAINS OF NURSING
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SEVEN DOMAINS OF NURSING
PRACTICE
Helping role
Teaching-coaching function
Diagnostic and patient-monitoring function
Effective management of rapidly changing
situations
Administering and monitoring therapeuticinterventions and regimens
Monitoring and ensuring the quality of health
care practices
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PHILIPPINE CONCEPTUAL MODELS
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Dr. LETTY G. KUAN
Has two MA Degree
Nursing
Education, major in Guidance and Counseling
Professor Emeritus UP College of Nursing
Former member of Board of Nursing
G
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Dr. LETTY G. KUAN
Dissertation: Retirement and Role
Discontinuities
D LETTY G KUAN
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Dr. LETTY G. KUAN
Concepts
Physiological age
Role
Change of life
Retiree
Coping approaches
D LETTY G KUAN
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Dr. LETTY G. KUAN
Determinants of positive perceptions inretirement:
Health status
Income
Work status
Family constellation
Self-preparation
CARMENCITA ABAQUIN
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CARMENCITA ABAQUIN
MAN and PhD UPCN
Expertise: MS (Oncologic Nursing)
Chairman of the BON
CARMENCITA ABAQUIN
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CARMENCITA ABAQUIN
Dissertation:
PREPARE ME Intervention and the Quality of
Life of Advance Progressive Cancer Patients
CARMENCITA ABAQUIN
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CARMENCITA ABAQUIN
Concepts
Presence
Reminisce therapy
Prayer
Relaxation-breathing
Meditation
Values clarification
CMO NO 14 S 2009
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CMO. NO. 14 S. 2009
POLICIES AND STANDARDS FOR BSN
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PROGRAM
Art. 1
Sec. 1. A person is a unique bio-psycho-socio-
cultural and spiritual being who is always in
constant interaction with the environment. Theseinteractions affects individuals, family, population
groups and societal health status
POLICIES AND STANDARDS FOR BSN
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PROGRAM
Art. 1
Sec. 1. Within the context of Philippine society,
nursing education, with caring as its foundation,
subscribes to the following CORE VALUES whichare vital components in the development of a
professional nurse and are therefore emphasized
in the BSN program:
POLICIES AND STANDARDS FOR BSN
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PROGRAM
Core Values
Love of God
Caring as the Core of Nursing
Compassion
Competence
Confidence
Conscience
Commitment (to a culture of excellence, discipline,
integrity, and professionalism)
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PROGRAM
Core Values
Love of People
Respect for the dignity of each person regardless of
creed, color, gender, and political affiliation) Love of Country
Patriotism (civic duty, social responsibility, and good
governance)
Preservation and enrichment of the environment andculture heritage
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POLICIES AND STANDARDS FOR BSN
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PROGRAM
The following are the 11 Key Areas ofResponsibility for which the nurse should
demonstrate competence:
1. Safe and quality nursing care2. Management of resources and environment
3. Health education
4. Legal responsibility5. Ethico-moral responsibility
POLICIES AND STANDARDS FOR BSN
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PROGRAM
6. Personal and professional development
7. Quality improvement
8. Research
9. Record management10. Communication
11. Collaboration and teamwork
COMPETENCY STANDARDS
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END
GOODLUCK AND GOD BLESS
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