We Make (Therapy) House Calls!

Medicare Part B in-home physical therapy, occupational therapy, speech rehabilitation therapy

October is National Physical Therapy Month, highlighting the vital role physical therapy (PT) plays in improving lives. Physical therapy aids recovery after surgery or injury, improves mobility and independence, helps manage chronic pain, and supports overall health.

RVNAhealth offers physical therapy, as well as occupational and speech therapies, in the home and at our RVNAhealth Therapy Center. While many understand the difference between in-home and outpatient therapy, here we highlight a unique in-home option that many are unaware of—Medicare Part B In-Home Therapy (sometimes referred to as “in-home-outpatient” therapy).

What is Medicare Part B In-Home Therapy?

Medicare Part B covers outpatient rehabilitative therapy services when they are medically necessary and prescribed by a doctor or qualified healthcare provider. However, these benefits extend beyond outpatient clinics, like our RVNAhealth Therapy Clinic—Part B can also cover therapy in the home.

Therapy at home (including physical, occupational, and speech therapies) may be provided for conditions such as post-surgery recovery, managing chronic conditions (e.g., arthritis, Parkinson’s), or improving mobility. The therapy must be medically necessary, meaning it is needed to diagnose or treat a condition, illness, or injury. Basic requirements for Medicare Part B In-Home Therapy include:

  • You have Medicare Part B coverage, and
  • Your doctor has certified the medical necessity of physical, occupational, or speech therapy, and
  • You are not eligible for Medicare Part A home health benefits

Situations where Part B In-Home Therapy Services may help:

  • Transitioning from Home Health to outpatient therapy care
  • Chronic conditions or continuation of care not covered by Medicare Part A
  • Transportation challenges or concerns about leaving home for appointments
  • Strength and conditioning support
  • Recovery from orthopedic injuries or surgeries
  • Neurological conditions

For More Information or to Inquire About Medicare Part B In-Home Therapy Services

Call RVNAhealth at 203.438.5555 and ask to speak with someone about Medicare Part B therapy or fill out our contact form here.

 

About RVNAhealth

RVNAhealth is a private, 501c(3) non-profit organization which provides a continuum of care to people in 35+ towns across Fairfield, Litchfield, and New Haven Counties. RVNAhealth depends on financial support from individuals like you who believe that healthy communities improve the quality of life for everyone. Every gift — no matter the size — is critical to upholding our mission and sustaining our important work. If you would like to support RVNAhealth’s mission to deliver unmatched, compassionate healthcare when and where it is needed, please click here.

Walking BIG for Parkinson’s Disease

Walking BIG for Parkinson's Disease Event

Join RVNAhealth for our first annual ‘Walking BIG for Parkinson’s’ walk on Saturday morning, September 7th in downtown Ridgefield.  We’ll be walking to raise money, spread awareness, and celebrate RVNAhealth Parkinson’s Center’s first full year supporting individuals and families affected by Parkinson’s in our community.  Funds raised by the walk will help bring continued Parkinson’s education, therapy, and support to the community and help subsidize treatment and programs for those needing financial support.

This event is a great opportunity to honor and support those living with Parkinson’s disease and is a great outing for the whole family to participate in. Grab your friends, family, and co-workers, and come out to support a great cause.

Register by August 30th

Registration is $40 per adult, with kids ages 12 and under free. All participants will receive a T-shirt, lunch, refreshments, and dessert.  Music will be provided by Big Daddy.

Register by scanning or clicking on the QR code below:

Event Schedule

9:00 – 10:00am:            Check-in at RVNAhealth main parking lot and get your t-shirt

10:00 – 10:30am:         Opening ceremony

10:30am – 11:15am:    Walk begins!  Two options – a 0.5 mile and a 1.5 mile planned route through Ridgefield downtown

11:15 – 12:00pm:        Join us back at RVNAhealth’s parking lot for lunch, refreshments, meet with vendors, and enjoy our DJ

 

About RVNAhealth

RVNAhealth is a private, 501c(3) non-profit organization which provides a continuum of care to people in 35+ towns across Fairfield, Litchfield, and New Haven Counties. RVNAhealth depends on financial support from individuals like you who believe that healthy communities improve the quality of life for everyone. Every gift — no matter the size — is critical to upholding our mission and sustaining our important work. If you would like to support RVNAhealth’s mission to deliver unmatched, compassionate healthcare when and where it is needed, please click here.

A 21st Century Pain in the Neck

Text Neck and therapy at RVNAhealth

Technology is a regular part of modern daily life and has, for many, become a literal pain in the neck. The hours spent hunched over technology—cell phones, tablets, and computers—can result in a condition coined Text Neck Syndrome, a stress injury to the neck, shoulders, and cervical spine. Text neck, also known as tech neck or forward head posture, is a modern condition characterized by neck pain and stiffness resulting from excessive or prolonged use of electronic devices, such as smartphones, tablets, and computers. When using these devices, especially for extended periods, people often crane their neck forward and downward, which can strain the muscles, ligaments, and tendons in the neck and upper back.

Physical therapists are inundated with complaints of the syndrome. RVNAhealth Director of Outpatient Rehabilitation Services, Kate Campbell, DPT, provided insight into the phenomenon increasingly seen in patients at the Rehabilitation & Wellness Center.

What are the symptoms of Text Neck Syndrome?

  • Nagging or sharp pain in the upper back or neck that is often triggered when bending the neck in a downward forward motion
  • Excessive discomfort and stiffness in the shoulders, neck, and upper back, particularly at the end of the day
  • Headaches, often frequent, exacerbated by screen time
  • Decreased or painful head mobility

How are symptoms assessed?

A physical examination and medical history are part of evaluating patients with the symptoms of Text Neck Syndrome. Review of discomfort, mobility limitations, and lifestyle are all relevant factors in comprehensive assessment and if more serious injury or diagnoses are suspected, a referral for imaging could be recommended. A treatment plan developed by a physical therapist is often the appropriate course of action for many patients.

How is Text Neck Syndrome treated?

All RVNAhealth patients receive personal assessments and treatment programs to address individual presentation of symptoms. There are strengthening exercises and posture adjustments that can mitigate the discomfort and physical misalignments that accompany the syndrome.

A customized plan is developed to address the needs of each patient based on individual lifestyle and ability which can include time working with a physical therapist at the Rehabilitation & Wellness Center and at-home exercises.

Physical therapy can be accessed through a doctor referral or, for Connecticut residents, through the statewide Direct Access program which enables CT residents to see a physical therapist without doctor referral for up to six visits.

Are there ways to prevent neck strain?

Yes! Starting with proper posture is key. And make sure to align technology with eye level to help alleviate neck pressure. Since the average human head weighs around eleven pounds, a downward and forward-positioned head puts significant strain on the neck, spine, and supporting muscles.

Regular stretching can also help to release muscle strain and strengthen stabilizing muscle groups. We recommend chin tucks and gentle arching/backbends while seated to help. You can view some of these recommended stretches in video included here.

Finally, take frequent breaks from technology whenever possible. Take deep breaths while going on a short walk and remember to stand straight with the shoulders back. Practicing good posture is a worthwhile habit!

Since society’s reliance on technology is not likely to dissipate, mindfulness of body position during use can minimize the negative physical consequences of excessive screen time. If you feel you may suffer from Text Neck Syndrome, or any similar ailment causing discomfort, contact the RVNAhealth Rehabilitation & Wellness Center team at 203.438.7862. For more information about our RVNAhealth Rehabilitation & Wellness Center visit www.rvnahealth.org/rehab.

 

RVNAhealth is a private, 501c(3) non-profit organization which provides a continuum of care to people in 35+ towns across Fairfield, Litchfield, and New Haven Counties. RVNAhealth depends on financial support from individuals like you who believe that healthy communities improve the quality of life for everyone. Every gift — no matter the size — is critical to upholding our mission and sustaining our important work. If you would like to support RVNAhealth’s mission to deliver unmatched, compassionate healthcare when and where it is needed, please click here.

RVNAhealth’s First Annual Parkinson’s Symposium Recap

“Living Well With Parkinson’s” …a name apropos for RVNAhealth’s first annual Parkinson’s Symposium, was held at the RVNAhealth Ridgefield office on Friday, January 26th. With over 60 attendees and nearly 20 healthcare experts presenting or hosting information tables, the three hour event successfully delivered an agenda packed with information for both newly and existing diagnosed Parkinson’s patients, loved ones and care partners.

The Parkinson’s Symposium was the brainchild of Dr. Kate Campbell, Director of RVNAhealth’s Parkinson’s Center and Outpatient Rehabilitation. “After nearly a year since the launch of ourParkinson's Symposium Quote Parkinson’s Center, I wanted to create an opportunity to bring together some of the best local experts from within RVNAhealth and other healthcare institutions. Our goals was to give the Parkinson’s community an afternoon to gather in one place and immerse themselves in learning and helpful discussion,” said Campbell. Main stage presentations included topics on the benefits of exercise, awake versus asleep deep brain stimulation, the importance of Movement Disorder Specialists, and the role of sleep in Parkinson’s. Breakout sessions gave participants an opportunity to customize their afternoon of PD learning. These options ranged from exercise demos, and cooking and nutrition, to information on clinical trials, mental health tips, and an overview from an organization dedicated to hiking trips for people with PD.

RVNAhealth would like to thank our visiting presenters:  Dr. Zion Zibly and Dr. Sophie Holmes and Sophie Elliott, Yale School of Medicine, Dr. Sarah Buckingham, Stamford Health, and Dr. Leon Meytin, Hartford Healthcare. We would also like to add a tremendous thanks to our RVNAhealth Parkinson’s Center staff who lead presentations, exercise classes, nutrition discussions, and more! Finally, we thank our sponsors who helped to make this event possible: Abbott, Abbvie, APDA of Connecticut, Medtronic, and Supernus.

With a successful first Parkinson’s Symposium complete, there is little downtime for Campbell as she continues with plans for the Parkinson’s Center’s second year in operation. “There’s a lot to be excited about at the Parkinson’s Center – we are taking more of our presentations out into the community, we are testing out new and more exercise class options, and we are soon kicking off our second Parkinson’s Bootcamp cohort, where we’ll work intensely with about 10 individuals over the course of 8 weeks. If you haven’t heard about Bootcamp, you should! We are making real life change and enabling individuals with powerful tools to take control of their Parkinson’s diagnosis–contact us to learn more!” says Campbell. “We are passionate about offering these resources to the Parkinson’s community – we are a place for community, compassion, health and wellness, and a partner in the fight against Parkinson’s disease.”

For more information about the RVNAhealth Parkinson’s Center, check out our webpage, call 203-438-5555 ext 1082 or email ParkinsonsCenterLeaders@rvnahealth.org.

 

Adaptive Equipment on Someone’s Holiday List?

RVNAhealth adaptive equipment recommendations

Okay, so adaptive equipment may not actually be on your loved one’s holiday wish list.  But for those who struggle with strength, mobility, or sensory issues, adaptive equipment can enable independence, enhance quality of life, and boost confidence. So RVNAhealth is here to offer great suggestions that might make someone’s holiday brighter!

Our clinicians are always eager to share suggestions on equipment that can make life easier when it comes to mobility and independence around the home. From kitchen, dressing, bed and bath, to grooming and beauty aids and even clothing — we’ve taken some of our clinicians’ most frequent recommendations and created a new webpage where you can browse these items and link directly through to purchase.

We welcome you to check back frequently as we continue to expand our list of recommended products. If you have questions regarding any of these products or usage, feel free to contact us.

See our RVNAhealth Adaptive Equipment Recommendations here!

Celebrating Our First Parkinson’s Disease Bootcamp Warriors!

RVNAhealth Parkinson's Disease Center Bootcamp 2023

On October 9th six brave Parkinson’s Warriors completed RVNAhealth’s first Parkinson’s disease (PD) Bootcamp program. These six clients spent eight weeks coming to our Ridgefield Center of Excellence twice a week to participate in our innovative PD Bootcamp. An intensive eight-week program, PD Bootcamp only takes six participants at a time, providing Parkinson’s patients with in-depth education about their disease, disease management, and exposing them to over sixteen different types of exercise. This first group of ‘bootcampers’ was funded by a grant from the Connecticut Chapter of the APDA. Graduates they are, but we like to call them “warriors!” Read on learn why…

About the RVNAhealth Parkinson’s Disease Center

Since the Parkinson’s Center launched in April of this year, the response from the Parkinson’s community has been overwhelmingly rewarding. “It’s been an amazing experience creating a formal program to provide vital Parkinson’s disease education, exercise programs, and support and resources. I am grateful to the entire Parkinson’s Center team for their tireless dedication. And of course, my congratulations go out to our first Bootcamp warriors who trusted in us and our program,” said Gigi Weiss, Director of RVNAhealth Rehabilitation Services and the Parkinson’s Center.

If you haven’t already heard about the Parkinson’s Center, check out our website and watch our spotlight video below!

PD Bootcamp…Dedication, Commitment, and Tools for Life

PD Bootcamp is designed as a small, intensive education and exercise program for those affected by Parkinson’s disease. Participants met together, with our RVNAhealth trained Parkinson’s specialists twice per week over the course of eight weeks. Our goal is to create relationships with our participants, deliver personalized education and plans, and equip them with the tools needed to live their best life.

Participants attended two exercise classes each week, with each class introducing them to a new type of exercise. Exercise classes included dance, boxing, Pilates, strength training, high intensity interval training, tai chi, and more! The goal in introducing so many different types of exercises is to help individuals find the exercise they enjoy most. “The only medically proven method of delaying the progression of Parkinson’s disease is exercise. So, what’s the best exercise to do? The one you enjoy and will keep up with!” says Kate Campbell, Doctor of Physical Therapy and Parkinson’s Center Program Manager. “Through our format, we really get to know these individuals and can best educate and guide them toward living their best life and taking control against their Parkinson’s.”

Bootcamp participants also attended a weekly educational session covering topics such as sleep, mental health, medication management, speech and cognition, and nutrition. PD Bootcamp workbooks provided reference materials and worksheets for individualized learning plans.

In the Words of Our Parkinson’s Disease Bootcamp “Warriors”

Thank you and congratulations to our first Bootcamp Warriors. We are grateful to share a few parting words from some of our graduates about their experience. If you have any questions about the Parkinson’s Center or its programs, please visit the RVNAhealth Parkinson’s Center website, join our newsletter subscription list, or email us at PCinfo@rvnahealth.org.

“Over the last year my PD has accelerated rapidly. Perhaps it is not noticed by others, but I can feel the loss of muscle, the exhaustion, each slur of words, every scuff of foot, forgetfulness, constant pain, and confused action. The only hope a Parkinson’s patient has to forestall a total and deliberate, debilitating decline into dependency is exercise. Fortunately, this RVNAhealth Bootcamp program addresses this and more! The RVNAhealth Parkinson’s Center and its PD Bootcamp program demonstrates how to interweave exercise and information into your daily schedule. It is a lot to do – but it gives you control, and a confidence you cannot find elsewhere! This program helps guide those diagnosed with Parkinson’s disease through the myriad of symptoms they must confront and gives them the knowledge and defensive tools needed to continue on and live a purposeful life.” – Barbara

“I just finished the PD Bootcamp at the RVNAhealth Parkinson’s Center. What a great program and what a great experience for someone like me who is relatively newly diagnosed. Kate, Andrea, and Meg led a thorough program that kept me engaged for the entirety of the program. You were so visionary in designing and offering this program. I am now more aware of my disease what I can expect and the things I can do to help me cope with the Curveballs of Parkinson’s. I hope you are able to include this in your regular programming because it is so needed.” – Joe.

 

Congratulations again to all of our first Bootcamp Warriors!

Jan Brown vs. Parkinson’s … Score: 1-0

Nothing seems to stop 74 year old Newtown resident, Jan Brown – not even a Parkinson’s disease diagnosis! With a determined spirit and help from her doctors and the RVNAhealth Parkinson’s Center, Jan is now back to playing national level softball and more! And to celebrate Jan’s completion of RVNAhealth’s LSVT Parkinson’s program, the team decided what better way to celebrate than a surprise game of softball after her final session with RVNAhealth therapists and staff (see photo gallery below). Before the game, we had a chance to catch up with Jan and Parkinson’s Center staff to learn a little more about Jan and her journey.

About Jan & Her Diagnosis

After searching for a reason for progressing physical symptoms, Jan’s neurologist finally ordered a DaTscan. When her Parkinson’s diagnosis was revealed Jan was prescribed a common Parkinson’s disease medication which made significant improvements to her tremors and function. Her medical team also quickly mentioned, “You should check out the new Parkinson’s Center happening at RVNAhealth.”

Kate Campbell DPT, LSVT BIG, RVNAhealth Parkinson’s Center Program Manager, recalled meeting Jan and evaluating her symptoms and goals. “At the point of diagnosis, the symptoms of her disease had progressed to the point of making simple daily tasks such as getting dressed, washing hair, and putting in contacts difficult,” said Campbell. This sports enthusiast and winner of several National Senior Games in softball and basketball, believed it was time to turn in her sports equipment. But thankfully the active spark in Jan had not fully extinguished and she signed on to participate in RVNAhealth’s LSVT program.

What is LSVT?

LSVT stands for Lee Silverman Voice Treatment. It is a globally recognized therapy program developed in the late 1980s and designed to help individuals with Parkinson’s disease improve their vocal and physical movement abilities. While the acronym LSVT refers to treatment for the effects of diminished or difficult voice/speaking skills, it also refers to an exercise protocol dedicated to improving a person’s physical movements commonly becoming smaller and more tentative as disease progresses. The LSVT programs aim to retrain a patient’s brain so their perception of their speech and movement is BIGGER and more accurate and they become able to speak and move with more amplitude.

RVNAhealth offers LSVT therapy at its Parkinson’s Center in Ridgefield and also in the home. The program is an intensive commitment – 4 weeks, 4 days a week for 1 hour appointments with an LSVT certified therapist – but when done, the results are usually life changing. Graduates of the program will have new habits and exercises to incorporate and continue in their ongoing daily routines. If someone needs a little more ongoing encouragement or prefers a group exercise setting, RVNAhealth also offers ongoing LSVT BIG and LSVT LOUD weekly drop in exercise classes at its Ridgefield office for graduates. “Our goal is to help you live your best life with Parkinson’s. And our new Parkinson’s Center aims to be a lifelong resource for those who need it,” says Campbell.

Jan’s Experience at the RVNAhealth Parkinson’s Center

“I was determined to do what I needed to do to get back to my life. It was a commitment – 4 weeks, 4 days a week, 1 hour each day, plus homework – but with this program, I achieved my goals. I am so grateful!” says Jan. “And I am blown away by how much the RVNAhealth therapists know and have to know about Parkinson’s disease to help me and help other people. Megan [my RVNAhealth Parkinson’s Center physical therapist assistant] listens to all of my questions and she is able to give me the correct answers. Everyone was just great.”

With Jan’s dedication to the LSVT program, its homework, and incorporating new skills and tools into her life to control symptoms, Jan is back to living her life to the fullest – including looking forward to the next softball National Senior Games in Arizona. And we didn’t mention her love of pickleball…or that she’s an instructor…or that she can beat her own grandchildren at the game!

What else can Jan Brown do with Parkinson’s disease? We’re betting on A LOT more! Way to go Jan – we are so proud of you!

For more information about the RVNAhealth Parkinson’s Center, visit our website or call 203.438.5555 ext 1082 or email PCInfo@rvnahealth.org.

See Jan throw!
See Jan jump!
See Jan swing! Go Jan go!

 

 

 

 

 

 

 

 

Megan Laber, Jan Brown, Kate Campbell
RVNAhealth Parkinson’s Center staff with Jan Brown for celebration softball game

Exercise for Two…No Reservations Needed!

While Valentine’s Day has past, it’s never too late to gift yourself time with a friend or loved one! And while you’re at it, why not consider adding a healthy element to your time together? Kate Campbell, DPT, RVNAhealth Rehabilitation & Wellness Outpatient Practice Manager and Physical Therapist, recently shared a special “Valentine’s Day-edition” sample exercise program than can be done with a partner.

Why partner exercise? Partner exercise can be a great way to improve your physical and mental health, while also having fun and building a stronger bond with your partner. It drives benefits such as improved motivation and accountability, better results with partner help and encouragement, a boost in mood and mental health, and exercising with a partner can be more fun and enjoyable than exercising alone!

Campbell emphasizes the physical connection aspect of partner exercise. “Any kind of touch — skin to skin, hugging — anything like that does great things for our body. It lowers negative stress hormones like cortisol and norepinephrine. And it increases your oxytocin levels, which is that bonding hormone that makes moms and babies feel really close together. This in turn stimulates other feel good hormones like dopamine and serotonin and endorphins. Everyone wants those endorphins. It makes you feel good and happy, and it can even reduce pain. All of this can happen in your brain – just by simple touch!”

Checkout Campbell’s partner exercise video sampling here! (Spoiler alert, Kate still looks amazing in her wedding dress!)

 

 

 

 

 

 

In the end, it’s all about getting your body moving and enjoying the enhanced physical and mental health benefits of spending time with another person. And as the spring season and nice weather approach, don’t forget the benefits of a simple walk, hand in hand, of course!

P.S. – Kate would love to see your partner exercise posts on social media (Facebook or Instagram) or via email (kcampbell@rvnahealth.org)!
P.P.S – If you would enjoy receiving weekly communications on fitness topics, such as this, and other nutrition topics, you may subscribe HERE.

Bad Weather? Unexpected Meeting? No Car?…No Problem for Your Rehab!

If we learned two things from the pandemic, it’s the importance of accommodation and flexibility. We all have busy and complex schedules which can make in-person healthcare appointments difficult – especially if they are only offered during work hours. During the pandemic, many practitioners adapted creative ways to still see patients out of necessity. It is these alternative appointment options, such as telehealth visits and extended hours, that keep many of us healthier today – even in a post-pandemic world!

According to the Physical Therapy and Rehabilitation Journal, telehealth, especially for physical therapy, has worked wonders for patients. Gone are the days when you would have to cancel an appointment due to weather challenges, not having a ride to your appointment, or other obstacles preventing you from receiving care. Telehealth appointments have allowed patients to have quicker access to care and have allowed practitioners to treat patients within a larger radius of the office.

Research shows that, on average, patients travel about 34 minutes for a healthcare appointment and, as a result, spend 90 fewer minutes working on appointment days. This can be a burden to some, especially if a practitioner recommends multiple appointments. The addition of telehealth and extended hours not only eliminates these obstacles but can improve a patient’s health outcomes without negatively affecting the quality of care received.

RVNAhealth’s Rehabilitation and Wellness Center offers extended hours Monday through Thursday (open from 8:20 am to 7:00 pm) as well as telehealth and hybrid (both in-person and telehealth) options to help you get well regardless of scheduling obstacles. To schedule an appointment or inquire about therapy services, please call: 203.438.7862 or email: rehabcenter@rvnahealth.org.

Direct Access: What it is and why you want to know about it

Much as a dented car does not get fixed by parking it on the side of the road, nor does a body hindered by injury or pain get healed without attention. Injuries and pain require evaluation, diagnosis, and treatment.  Lucky for us, the State of Connecticut offers a healthcare benefit that simplifies the process of getting treated. It’s called Direct Access and it’s a benefit worth knowing about.

Direct Access is a statewide program that eliminates the need for a primary care physician referral prior to seeing a Rehabilitation Therapist. The streamlined process — which allows up to six visits with an RVNAhealth physical therapist at the RVNAhealth Rehabilitation & Wellness Center without a physician referral — is both cost-effective and allows individuals to enjoy swifter diagnosis and relief. In other words, it helps you get better faster.

This little-known benefit began in Connecticut in 2006 to provide patients more immediate diagnosis and relief.  “Direct Access is an expedited way to get to the root cause and treat, rather than just self-diagnose — or ignore — both of which can prolong the issue but are tempting when the process of getting to a therapist is belabored,” says Gigi Weiss, MSPT, RVNAhealth Director of Rehabilitation Therapies. “Ultimately, Direct Access allows you to get in quickly to increase stability, relieve discomfort, and prevent worsening,”

Weiss encourages those with intermittent pain, mild injury, mobility limitations, or other chronic conditions to leverage the Direct Access program not just for minimization of discomfort but for proper diagnosis and treatment. “Often patients self-treat without success because symptoms are not always representative of the core issue,” says Weiss. “For example, neck issues can present as wrist pain so tending to the wrist won’t address the root cause and won’t provide much relief, especially long term. In many cases, the six visits granted through Direct Access get an individual well on their way to healing.”

Direct access can also benefit individuals with lingering difficulties from a health episode, like swallowing, fine motor skills, or communication. In these cases, Direct Access provides a fast track to restorative visits with an appropriate clinician.

At RVNAhealth, the rehabilitation team also collaborates with insurance providers and primary care physicians to coordinate coverage and treatment so patients can focus on wellness. For more information or to schedule a Direct Access assessment, visit RVNAhealth.org/Rehab or call  (203) 438-7862.

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