Skip to main content

Tagged With "Post Traumatic Stress"

Blog Post

12 Myths of the Science of ACEs

Jane Stevens ·
The two biggest myths about ACEs science are: MYTH #1 — That it’s just about the 10 ACEs in the ACE Study — the CDC-Kaiser Permanente Adverse Childhood Experiences Study . It’s about sooooo much more than that. MYTH #2 — And that it’s just about ACEs…adverse childhood experiences. These two myths are intertwined. The ACE Study issued the first of its 70+ publications in 1998, and for many people it was the lightning bolt, the grand “aha” moment, the unexpected doorway into a blazing new...
Blog Post

2019 Beyond Paper Tigers Conference Series - Why Take Course One and Course Two?

Tara Mah ·
Community Resilience Initiative is officially launching a new series of blog posts, building to our 2019 Beyond Paper Tigers conference on June 25th - 27th. We’ll cover a range of topics relevant to conference material, events, and inspirations. In addition to the regular conference, CRI is offering two training add-on options on Tuesday June 25, 2019 prior to the conference: Resilience-Based Trainings, Course One and Two . https://criresilient.org/beyon...re-conference-event/ “A group of...
Blog Post

How a natural disaster led one town to do something about its ACEs, past and future

Jane Stevens ·
Tracy Franke, principal of Darrington Elementary School, a K-8 school with 300 students, had heard about CLEAR, and called Dr. Christopher Blodgett, who runs the program, to arrange a visit from Turner. “We were hurting,” says Franke. “Our students and staff needed some tools to get through the trauma.”
Blog Post

How Parents and Teachers Can Calm Kids' Getty Fire Anxiety [latimes.com]

By Sonali Kohli and Nina Agrawal, Los Angeles Times, October 29, 2019 During this Santa Ana wind season, 12-year-old Nicholas Ladesich tends to go to bed worrying about what might burn overnight. He often has dreams of waking up in his old house that burned down in the Woolsey fire last year. But he awakens instead in the living room of the one-bedroom guest house he shares with his brother and parents. He demands that his mom turn on the news to monitor possible fires while his 15-year-old...
Blog Post

How the Mental Health Community Is Bracing for the Impact of Climate Change “Eco-anxiety” and trauma from natural disasters will be on the rise along with sea levels

Bob Doppelt ·
Rolling Stone, May 16, 2019 By Andrea Marks When San Francisco broke heat records in 2017, with 106-degree temperatures in September, psychiatrist Robin Cooper didn’t hear until after the fact that one of her patients had been feeling dizzy and feverish. One day, he’d fainted in his poorly ventilated workspace. Emergency room doctors had surmised he’d had a virus. But Cooper warned him it could actually be a drug she’d prescribed him interacting with the extreme heat. Certain antipsychotic...
Blog Post

How to help children recover from the trauma of disaster [theconversation.com]

Alicia Doktor ·
In any culture, children hit by a natural disaster will see family members undergo huge amounts of stress and worry. They may be forced to live in temporary accommodation, and experience many changes to their usual routines and social circles. And on top of all this, many treasured possessions – including family pets – may be lost or damaged forever. For many children, this can result in high levels of anxiety and emotional trauma . This can inevitably lead to changes in a child’s behaviour,...
Blog Post

Hurricane Florence first responders receive free trauma/resilience training

Carey Sipp ·
In a webinar offered this morning by Elaine Miller Karas , executive director of the Trauma Resource Institute in Claremont, CA, leaders from several North Carolina ACEs Connection communities affected by flooding and other damage by Hurricane Florence learned more about trauma response and how to better help their communities find resilience. Karas, who was delivering her Community Resiliency Model (CRM) training at Duke University in Durham, NC, offered the free training and provided...
Blog Post

Hurricane Michael: Children Face Stress Of Upended Lives [health.wusf.usf.edu]

Alicia Doktor ·
When Tiffany Harris and her two children emerged from their hotel after Hurricane Michael roared past, her 3-year-old son pointed to a sea of fallen trees and shattered buildings. "It's broken. It's broken, Mommy, fix it," she recalls her little boy Amari begging. Harris, who lives with her boyfriend, two children, plus her sister and her four children near Panama City, soon learned their town house was uninhabitable. Everything was a total loss after Michael powered inland across the...
Blog Post

'I don't feel real': Mental stress mounting after Michael [wjla.com]

Alicia Doktor ·
PANAMA CITY, Fla. (AP) — Amy Cross has a hard time explaining the stress of living in a city that was splintered by Hurricane Michael . She's fearful after hearing gunshots at night, and she's confused because she no longer recognizes the place where she's spent her entire 45 years. "I just know I don't feel real, and home doesn't feel like home at all," Cross said. Health workers say they are seeing signs of mental problems in residents more than a week after Michael, and the issues could...
Blog Post

ITRC Announces Fall 2019 Free Webinars on Building Transformational Resilience for Climate Traumas

Bob Doppelt ·
To Register for Any of the Webinars Below Go to the Link on ITRC Website: http://www.theresourceinnovationgroup.org/ Introduction to Transformational Resilience for Climate Traumas Date : Thursday, October 31 from 12 noon--1 pm Pacific Time (3-4 pm Eastern Time) Although it is difficult to accept, humanity is in the midst of a civilization changing event. The more frequent and extreme disasters and toxic stresses generated by human-induced climate disruption are aggravating the existing...
Blog Post

ITRC Announces Spring 2020 Free 1 Hr. Webinars

Bob Doppelt ·
Introduction to Transformational Resilience for Climate Traumas, Toxic Stresses, and Other Emergencies Date : Thursday, April 30 from 12 noon--1 pm Pacific Time (3-4 pm Eastern Time) Click here to register for this webinar The Coronavirus pandemic is causing significant stress and disorientation. The adversities provide a glimpse of the personal mental health and collective psycho-social-spiritual problems that will emerge as the climate emergency worsens. Although it is difficult to accept,...
Blog Post

ITRC calls for Universal Resilience Education and Skills Training for Climate Trauma

Bob Doppelt ·
Sneak Preview for ITRC ACEs Connection Members! Next Tuesday, Jan. 8, the ITRC will release a major report Preparing People on the West Coast for Climate Change. The media release about the report is below (and attached). It includes a link to the webpage for the report, where people can download the full report, and find a link to the webpage with examples of resilience programs across the west coast. You can connect with the ITRC CA and PNW Facebook page:...
Blog Post

ITRC Featured in New National Climate Assessment

Bob Doppelt ·
Many thanks for this from ITRC National Steering Committee Advisory Board Member Emily York, Oregon Health Authority. I’m excited to share that the ITRC is featured in the recently released National Climate Assessment … specifically highlighted in a call out box in the Northwest chapter : Box 24.4: Healthcare Partnerships That Increase Resilience A new International Transformational Resilience Coalition (ITRC) has grown out of the Northwest and is engaging cross-sector partners in pilot...
Blog Post

Making the Connections Between Climate Change and Sexual and Relationship Violence

Paul bancroft ·
“Human relations were laid bare and the strengths and weaknesses in relationships came sharply into focus. Thus, socially isolated women became more isolated, domestic violence increased, and the core of relationships with family, friends and spouses were exposed” – written in response to a major flood in Australia (Dobson, 1994, p. 11). Racism. Sexism. Classism. Immigration status. Violence against LGBTQ communities. These are just a few of the various forms of oppression that the...
Blog Post

ONCE THE WATER RECEDES, THE MENTAL-HEALTH PROBLEMS EMERGE [PSMag.com]

Samantha Sangenito ·
Like the storm itself, the impact of Hurricane Harvey on Houstonians' mental health promises to linger. Although specific estimates vary widely, the results of numerous research studies suggest residents who suffered a profound personal loss due to the storm are at significantly elevated risk of post-traumatic stress disorder. "A large body of research conducted after disasters in the past decades suggests that the burden of PTSD among persons who were exposed to disasters is significant," a...
Blog Post

One of the most overlooked consequences of climate change? Our mental health

Bob Doppelt ·
Ecoanxiety. Ecoparalysis. Solastalgia. Call it what you want— when it comes to climate change and mental health, the future is now. By Lawrence A. Palinkas , the Daily Climate Hardly a day goes by where we aren't reminded that the Earth's climate is changing and that we are responsible for much if not most of that change. The findings of one study after another are punctuated by breaking news or the direct experience of wildfires, hurricanes and floods that forced thousands of people to...
Blog Post

Oregon bill takes preventive approach to psycho-social-spiritual impacts of climate change

A hearing will be held on April 3 on a recently introduced bill ( SB 1037 ) to create a task force to determine how to make resilience training available to all Oregonians in response to climate change. Under the bill, an 18-member task force would be created to study aspects of psychological, emotional, and psychosocial resilience education and skills training. The Oregon members of the International Transformation Resilience Coalition (ITRC), including ITRC coordinator, Bob Doppelt, have...
Blog Post

Post Traumatic Growth after Natural Disasters - Communication and Connections Help [sciencedaily.com]

Leslie Lieberman ·
A recent study from researchers at the University of Missouri found more communication among family, friends and neighbors who experienced the devastating and deadly 2011 Joplin Tornado was related to more post-traumatic growth. The 2011 tornado in Joplin, Missouri, was one of the most destructive in U.S. history -- killing 161 people, injuring 1,150 and destroying approximately one-third of the city's homes. Individuals who experience such disasters can exhibit a range of mental health...
Blog Post

Post-wildfire report on nonprofit services: mental health a critical need, services to most vulnerable citizens impacted

Lena Hoffman ·
At the end of 2017, Community Foundation of Sonoma County and Napa Valley Community Foundation enlisted the Center for Effective Philanthropy to conduct a survey of local nonprofit organizations about the impacts of the wildfires on the people they serve and on their organizational capacity to provide services in response. While reading CEP Advisory Services " 2018 Wildfire Response Survey " report through an ACEs and trauma-informed lens, the following findings jumped out at me: 1. Mental...
Blog Post

Preparing People for Climate Change in California: Sonoma County Listens and Shares

Holly White-Wolfe ·
Last summer Bob Doppelt asked me to join a planning committee for a conference on climate change . I was surprised to be asked as my recent professional expertise is tied to addressing childhood adversity. Bob changed my perspective on the relevance by saying, "Adversity and trauma are the social side effects of climate-related disasters. Imagine the social-emotional impacts on Katrina survivors." The connection was a glimmer in my mind, but I agreed to support a California conference .
Blog Post

Public Health Matters Blog Posts: Using trauma-informed care to guide emergency preparedness and response

Holly White-Wolfe ·
"Exposure to a traumatic event or set of circumstances can negatively affect a person’s mental, physical, social, emotional or spiritual well-being for a long time after the initial incident. We know that not all individuals respond to trauma in the same way and we know that individuals with a history of trauma, especially childhood trauma, are more likely to experience psychological distress and are at increased risk for the development of Post-traumatic Stress Disorder (PTSD) with future...
Blog Post

Put down the self-help books. Resilience is not a DIY endeavour (theglobeandmail.com)

Former Member ·
The science of resilience is clear: The social, political and natural environments in which we live are far more important to our health, fitness, finances and time management than our individual thoughts, feelings or behaviors. When it comes to maintaining well-being and finding success, environments matter.
Blog Post

Recommendations for preventing & healing pandemic generated mental health and psychosocial problems

Bob Doppelt ·
Attached is a set of ITRC recommendations for swiftly organizing community-based initiatives to prevent and heal pandemic-generated mental health and psychosocial problems. If you find the recommendations helpful, please initiate the creation of a resilience coordinating council in your community or region. Please also pass the document on to other organizations and individuals that might find it useful. Thanks--and stay healthy during this stressful time, Bob Doppelt
Blog Post

Register now: Free ACEs Connection Webinar on the Human Impact of Climate Change

Carey Sipp ·
A year after 85 people died in the wildfire that swept through Paradise, CA, and nearby towns, one of the town’s survivors will talk about how she and others are using resilience practices in their recovery from the trauma. On Wednesday, Nov. 13, Paradise resident Kelly Doty will have a conversation with Elaine Miller-Karas, who developed the Community Resiliency Model (CRM). Doty, who lost her home in the fire, and Miller-Karas will discuss resilience education skills designed to help...
Blog Post

Rising from the Ashes: How Trauma-Informed Care Nurtures Healing in Rural America [The Rural Monitor]

Clare Reidy ·
By Jenn Lukens April 17, 2019 It was late July 2018 when the Mendocino Complex wildfire broke out in rural Lake County, California. It burned more than 450,000 acres and destroyed 280 structures before it was contained. Ana Santana managed to fill some storage bins with sentimental items – her kids’ blankets, pictures, and art projects – before fleeing her home. Santana is the facilitator of the Lake County Children’s Council and Program Director for Healthy Start Youth and Family Services ,...
Blog Post

Sonoma County Resiliency Collaborative A Practical Approach to Post-Wildlife Resilience and Wellbeing

Holly White-Wolfe ·
The traumatic events of the North Bay wildfires affect our emotional and physical health, social functioning, and overall well-being, both as individuals and as a community. Unresolved, they can damage our health and limit our potential to rebuild a strong community. Join diverse Sonoma County leaders and representatives to participate in dynamic workshop where you will practice tools for effectively addressing personal and team stress after the fires, network with peers, and learn about an...
Blog Post

Spring Transformational Resilience for Climate Traumas Workshops and Webinars

Bob Doppelt ·
Transformational Resilience Workshop Offered at ICISF World Congress in Baltimore, MD. on Tuesday May 21 ITRC Coordinator Bob Doppelt will lead a half-day introductory workshop on Transformational Resilience at the International Critical Incident Stress Foundation World Congress in Baltimore, Maryland, the morning of Tuesday May 21. To see the workshop description and to register go do: http://icisfworldcongress.org/education/ Register Now Open for Spring 2019 Free 1-Hour Webinars on...
Blog Post

Study: Pennsylvanians who live near fracking are more likely to be depressed

Bob Doppelt ·
The Dailey Climate by Kristina Marusic Jul y27, 2018 Stress and depression are higher among those living closest to more and bigger wells. People who live near unconventional natural gas operations such as fracking are more likely to experience depression, according to a new study. For the study, which is the first of its kind and published today in Scientific Reports, researchers from the University of California at Berkeley and Johns Hopkins University looked at rates of depression in...
Blog Post

Texas Children’s Treating More Affected Children Two Years After Hurricane Harvey [hellowoodlands.com]

By Jenn Jacome, Hello Woodlands, August 12, 2019 Nearly two years after the historic rainfall and flooding of Hurricane Harvey, Texas Children’s Harvey Resiliency and Recovery Program is assessing and treating more children than it did in the six to eight months immediately following the storm. “Currently, we’re seeing about 250 kids per month in our Trauma and Grief Center overall when you look at new assessments and those coming in for return appointments, and many of these children were...
Blog Post

The Capital Region Climate Readiness Collaborative (CRC) first Quarterly Adaptation Exchange in 2018

Grace Kaufman ·
The Capital Region Climate Readiness Collaborative (CRC) conducted our first Quarterly Adaptation Exchange in 2018 on how Adverse Childhood Experiences (ACEs) and trauma can be a detriment to an individual’s physical, social, and mental health that has lasting effects into adulthood. Climate impacts and an individual’s and/or community’s capacity to respond to trauma with resilience is intrinsically tied to access to a support system, resources, and past traumas. The reality is with Climate...
Blog Post

The Case of Juliana v. U.S. — Children and the Health Burdens of Climate Change [NEJM.org]

Clare Reidy ·
Renee N. Salas, M.D., M.P.H., Wendy Jacobs, J.D., and Frederica Perera, Dr.P.H., Ph.D. On June 4, 2019, the Ninth Circuit Court of Appeals will hear oral arguments in Juliana v. United States to determine whether the case will proceed to trial in district court in Oregon. Nearly 4 years ago, 21 children and adolescents between 8 and 19 years of age, including Kelsey Juliana from Oregon, filed suit against the federal government, charging that the government’s inaction on addressing climate...
Blog Post

Transformational Resilience Train the Trainer Opportunities in San Francisco

Holly White-Wolfe ·
Applications Now Open for Nov 15-16 Transformational Resilience Intensive Train-the-Trainer Workshop The ITRC is offering a Train-the-Trainer Workshop on Transformational Resilience for climate change aggravated traumas and toxic stresses workshop. The workshop will be held November 15-16 in San Francisco. This will be an intensive 2-day training offered in cooperation with the SEI Resilient Community Fellows Program. It is open to a maximum of 20 people who want to learn how to apply...
Blog Post

Trial by Fire: MARC Sites Collaborate on Trauma-Informed Disaster Response

Clare Reidy ·
By @Anndee Hochman During a December 2017 convening in Philadelphia, several leaders from Mobilizing Action for Resilient Communities (MARC) realized they had more in common than a passion for building resilience in their communities. They all hailed from places that had recently been scorched or flooded by natural disasters: wildfires in California and the Columbia River Gorge, hurricanes in Florida, the lingering residue of 2012’s post-tropical cyclone Sandy in the Northeast.
Blog Post

UC Berkeley Event: Climate Climate Change: The Defining Health Challenge and Opportunity of the 21st Century

Elizabeth Ferguson ·
This coming Wednesday, The Lancet Countdown will release its first annual report tracking climate change and health indicators across five key domains (including Mental Health) on November 1 ( live in Berkeley , or via Livestream ). (Report attached below.) All of the speakers could and should be invited to the upcoming California Preparing Individuals for Climate Change Conference. Unfortunately, I am unable to attend. Climate Change: The Defining Health Challenge and Opportunity of the...
Blog Post

Using the Climate Crisis as Catalyst to Increase Wellbeing

Bob Doppelt ·
I wrote this article for Meeting of the Minds, which brings urban leaders together. It explains the recommendations of the ITRC for using the climate crisis as a transformational catalyst to enhance personal, social, and ecological wellbeing. Found here: https://meetingoftheminds.org/building-transformational-resilience-to-cope-with-climate-disruption-28559 A year after Hurricane Maria ravaged Puerto Rico in 2017, many residents continue to struggle with mental illness. One suicide...
Blog Post

Webinar: Building Resilient Communities with Elaine Miller-Karas

Alison Cebulla ·
This webinar will explore integrating a biological based model to reduce the impacts of toxic stress for children and adults. It is a model both for prevention and to use in the aftermath of adverse event.
Blog Post

Webinar: Building Transformational Resilience for Climate Change Traumas and Toxic Stresses

Alison Cebulla ·
Live Webinar: Building Transformational Resilience for Climate Change Traumas and Toxic Stresses Monday, October 28 th , 2019 12:00-1:30 PM PDT You will learn: how climate change creates personal, family, and community traumas and toxic stresses; how those traumatic stressors trigger feedbacks that expand and aggravate ACEs and many other person, social, community, and societal maladies; why current approaches are woefully inadequate to address what is already occurring and rapidly steaming...
Blog Post

Webinar Slides and Recording: Transformational Resilience for Climate Change Traumas and Toxic Stresses with Bob Doppelt

Alison Cebulla ·
Recorded live October 28, 2019. Find the slides attached below. The webinar recording: You will learn: how climate change creates personal, family, and community traumas and toxic stresses; how those traumatic stressors trigger feedbacks that expand and aggravate ACEs and many other person, social, community, and societal maladies; why current approaches are woefully inadequate to address what is already occurring and rapidly steaming toward us and why prevention is the only realistic...
Blog Post

Webinar Slides and Recording: Transformational Resilience for Climate Change Traumas and Toxic Stresses with Bob Doppelt

Alison Cebulla ·
Recorded live October 28, 2019. Find the slides attached below. The webinar recording: You will learn: how climate change creates personal, family, and community traumas and toxic stresses; how those traumatic stressors trigger feedbacks that expand and aggravate ACEs and many other person, social, community, and societal maladies; why current approaches are woefully inadequate to address what is already occurring and rapidly steaming toward us and why prevention is the only realistic...
Blog Post

Wildfire Mental Health Collaborative: Help for Those Recovering From The Devastating Fires of 2017 [sonomacountygazette.com]

By Sonoma County Gazette, October 22, 2019 As we reach the second anniversary of the 2017 wildfires, the triggers for those impacted have become more visible: reconstruction challenges, the Camp Fires in Butte County or just a windy night are a few examples. Mental health recovery and resiliency are more important than ever. Our community is really starting to see the long-term effects of wildfire trauma and PTSD on the mental health of our employees, neighbors and customers. Prolonged...
Blog Post

ACEs Science 101 (FAQs)

Jane Stevens ·
What are ACEs? ACEs are adverse childhood experiences that harm children's developing brains so profoundly that the effects show up decades later; they cause much of chronic disease, most mental illness, and are at the root of most violence. ...
Blog Post

After the wildfire: treating the mental health crisis triggered by climate change

Bob Doppelt ·
Note from ITRC Coordinator Bob Doppelt: This story illustrates exactly why we organized the ITRC. Post trauma treatment is completely insufficient to address the traumas that lie ahead as temperatures rise. Prevention , by building widespread capacity for Transformational Resilience for all types of climate impacts--is the ONLY viable solution. ----------------------------------------------------------------------------------------------------------- In 2017, thousands of homes in Santa...
Blog Post

An Aboriginal approach to mental health is helping farmers deal with drought (qz.com)

In 2018, a study from the University of Newcastle in NSW found that farmers in rural parts of the state experienced “significant stress about the effects of drought on themselves, their families, and their communities.” Other research suggests that income insecurity related to drought increases the risk of suicide among farmers. Throughout Australia, rates of suicide have increased dramatically for Aboriginal and Torres Strait Islander people over the past 30 years. The rise is due to...
Blog Post

As vast swaths of Australia dry out, a mental health crisis takes shape [washingtonpost.com]

Alicia Doktor ·
ELONG ELONG, Australia — In a community of only about 100 people, Louise Hennessy says, neighbors need to look out for each other. Whenever someone goes quiet for too long, she picks up the phone to check that everything is all right. In recent months, more often than not, the answer has been no. “The stress of not knowing when it’s going to rain creates a lot of anxiety,” Hennessy said. More than two years of extreme drought has hit tiny Elong Elong — about 225 miles from Sydney — and other...
Blog Post

Children are highly vulnerable to health risks of a changing climate [sciencedaily.com]

Alicia Doktor ·
Young children are far more vulnerable to climate-related disasters and the onus is on adults to provide the protection and care that children need. In a paper published in PLoS Medicine, researchers at Columbia University's Mailman School of Public Health and Columbia University Irving Medical Center set out some specific challenges associated with the impacts of climate change on the world's 2.3 billion children and suggest ways to address their under-prioritized needs. "Children and...
Blog Post

Climate Anxiety

Bob Doppelt ·
I worked on David Attenborough’s documentary. The grim reality gave me climate anxiety Liv Grant For the BBC’s Climate Change: The Facts, I met those living on the frontline. I struggled to cope with what I learned Sun 28 Apr 2019 11.56 EDT Last modified on Mon 29 Apr 2019 06.42 EDT W e live in a time of loss. Wild places dwindle, the animals and plants that live in them disappear. Climate change is now a certainty, and it will without a doubt lead to the loss of land, species, and ways of...
Blog Post

Climate Change and Its Impacts on Mental Health

Bob Doppelt ·
Psychiatric Times Oct 12, 2018, By David Pollack (ITRC National and PNW Steering Committee Member) Editor’s Note: One of the most important issues of our time regarding human health and mental health is the impact of climate change. This situation is, of course, not about a new impending ice age but is clearly about global warming. This matter has been discussed mainly in the political arena, and there, mainly as a political football/hot potato (no pun intended). Unfortunately, there has...
Blog Post

Climate change and mental health: risks, impacts and priority actions

Bob Doppelt ·
This is one of the better assessments of the psychological and psychosocial impacts of climate change, though it neglects some key issues. International Journal of Mental Health Systems, October 2018, by Katie Hayes et al. Abstract Background: This article provides an overview of the current and projected climate change risks and impacts to mental health and provides recommendations for priority actions to address the mental health consequences of climate change. Discussion and conclusion:...
Blog Post

Climate Change as ACE

Bob Doppelt ·
To ITRC members: In addition to coordinating the ITRC, for almost a decade I have written a monthly column for my hometown newspaper, the Eugene Register Guard (my wife calls it my weekend job!). Last month I began a three part series on how climate disruption is producing numerous trauma. The column below talks about climate change, ACEs, and violence. Bob Doppelt -------------------------------- Climate Change Increased ACEs and Violence Childhood trauma, mass shootings and climate change...
Blog Post

Climate Change is Bad for Your Mental Health [psmag.com]

Alicia Doktor ·
The world has only a dozen years to act to keep global warming below 1.5 degrees Celsius, and stave off the most catastrophic effects of climate change, according to the latest report from the United Nation's top climate science panel out Monday. Without rapid and drastic action, climate change will expose hundreds of millions more people to heat waves, sea-level rise, more extreme weather events—and, according to a new study published today in Proceedings of the National Academy of...
 
Post
Copyright © 2023, PACEsConnection. All rights reserved.
×
×
×
×