Doughnut economics and co-design

The problem with economic models is that they count the things you can count and leave out things you can’t. And sometimes that’s what can happen with co-design methods – doing what you know and not what is possible. A group of researchers adapted the Doughnut Economics model to create the Futures Doughnut tool for co-design for complex settings.

Doughnut economics seeks to address inequities, poverty, and standard of living. It’s about meeting the needs of humans and the planet. A group of researchers have adapted this economic thinking in the context of co-design.

Screenshot from the article showing a circle divided into sections overlaid with bright pink post it notes with writing on them.

Using a participatory design process, 115 stakeholders explored the model to navigate socio-ethical challenges. The process fostered constructive dialogue, and explored values and boundaries. This is a good process for working in complex institutional systems where stakeholders have diverse perspectives and priorities.

The title of the paper is, Baking an Institutional Doughnut: A systemic design journey for diverse stakeholder engagement. While the context of the paper is a university setting, it sets a good example for other situations with the Futures Doughnut Tool.

Limits of co-design activities

Co-design activities are good for advocating for and helping to generate creativity. However, they are insufficient for complex systems design where continuity of consultation goes beyond design ideation.

Co-creation methods are difficult to compare by definition because they are context dependent. An adaptive and staged systemic design process requires significant time and buy-in from stakeholders. Without this commitment there is a risk of misunderstandings and therefore consensus on decisions.

Co-design is good for finding common ground with diverse vocabularies, disciplines and lived experience. However, it also needs the right tools and methods and the Futures Doughnut was developed with this in mind.

From the abstract

Doughnut Economics offers a compass for navigating the complexities of creating a safe and just space where humanity can flourish while respecting ecological boundaries. This pictorial reports on how the Doughnut Economics model can be applied as a tool for facilitating complex stakeholder engagement.

We present a visual framework and facilitation method for systemic and values-led thinking. The context is establishing a new interdisciplinary academic institution.

Using a participatory design process, 115 stakeholders from academic, research, and administrative backgrounds explored this model. The aim was to co-create an institutional compass to navigate the socio-ethical challenges of their professional practices.

Co-creating urban development

The concept of universal design has evolved over the last 50 years, and so it should as we learn more about how to be inclusive. However, many authors continue to base their writings on outdated notions of universal design. So it’s refreshing to find an article on co-creating urban development that advances our thinking about the concept.

Nordic countries embraced a universal design policy for urban development at the turn of the century and continue to learn from their experiences. Universal design thinking has evolved to using co-design and co-creation methods in design processes. This the point at which Emil Erdtman takes up the ideas and develops them further.

Universal design is three things:

  • an ethical principle for inclusion of diversity
  • a vision of an inclusive society
  • a unifying approach to policy and perspectives
Drawings of 12 different people indicating population diversity.

In Sweden universal design is a guiding principle for policies, procurement and living environments. While it is applied in local projects, little is known about local practice. Hence Erdtman’s research. His explains the differences between consultation, partnership and co-creation in the graphic below.

A graphic showing three hexagonal shapes. One shows arrows going one way to represent consultation. One has arrows pointing outwards to represent partnership negotiations. One has arrows pointing to the centre depicting equal contribution of co-creation.

Consultation is a one-way facilitation process, partnership is a negotiating process between competing interests, and co-creation is equal contribution for innovation.

Erdtman describes the projects in his study and the methods he used which included conversations about participants’ understanding of universal design. The conversations allowed for critical discussions rather than “battles about words”.

Discussions about terminology are detrimental to the pursuit of inclusive practice so it was good to see the focus stayed on the concept itself. Nevertheless, universal design was only connected to impairment despite the intersectional nature of the concept. A focus on impairment hides a more general user perspective as social beings in urban life.

Co-creation at the local level

Erdtman found that universal design practice shows diversity and inspired new methods. However, changing municipal practice takes time. A concept like universal design does not replace routines of planning, negotiation and rational management.

Co-creative ways of collaborating is about integrating experiences from a diversity of people, not thinking in separate tracks. It’s about equal participation and responsibility. It is not about commenting on ready-made proposals or delivering experiences as information. Limiting accessibility as just for people with disability risks leaving out invisible needs of others.

Universal design must be contextualised

Universal design transcends conventional categories and fosters continuous improvement. It enriches urban development by integrating diverse user experiences. It must be continuously contextualised, and developed differently depending on the locality.

Universal design should inspire innovation beyond group interests, regulations and human categorisation. Otherwise it will be just another rationalistic planning model.

A large and diverse group of small plastic cartoon characters placed around a dark greet star shape.

The title of the article is, Co-creating urban development: local Swedish projects guided by Universal design. It was published in Design-for-All India. You can also download a copy in a font that is easier to read than the original.

From the abstract

This chapter contributes to knowledge about the understanding, implementation and co-creation of universal design. Interviews and group discussions were conducted and participant observation was made in three urban development projects.

The understanding of universal design was multifaceted. It is an ethical principle for inclusion of diversity, a vision of an inclusive society, and a unifying of policy and perspectives. Participants emphasised flexibility, predictability and personalised support. They linked universal design to accessibility as a separate and target group with a focus on regulatory compliance.

In the local context universal design practice will be expressed in diverse ways. Collaboration between municipalities and local disability organisations is formal and established. Different conditions and expectations created tensions about roles and interpretation of disability experience.

Disability experience is information for facilitating processes and for negotiation outcomes. However, there were conditions for co-creation.

Universal design, diversity and low hanging fruit

In the same publication there is another interesting article titled, Universal design, visualising diversity and two low hanging fruits. Here is the abstract.

To plan, design and build with diversity in mind is a complex process. While goals such as inclusion, participation and social sustainability may be present in the vision for a future product, service or environment, studies show that the initial vision isn’t always realized in the end result. There are still far too many products, services and environments that are hard to access or use for parts of the population. In this text we focus on comparatively simple, lightweight, tools – “low hanging fruits”.

Such tools are already available, there are personas, context cards, but also checklists and guidelines. Inspired by the existing work, we have developed one deck of cards, intended to serve as thought support by visualizing population diversity. In order to obtain a similar effect in digital environments (egin digital twins and other 3D environments used in planning and development) we have also developed 3D models (vehicles, devices and humans) that can be put in the digital environment, and serve as a reminder to the users of the digital environment of population diversity.

Young people and co-design

Two male adolescents sit on the kerb looking at the phones. Young people.The views and experiences of young people are often left on the sidelines. Yet they have most to lose or gain in the way society evolves.  So perhaps they should be the ones to craft strategies and approaches for creating the futures they want. Co-design methods are clearly the way to get young people participating in social change processes in their local area. 

A study focusing on young people creating social change using co-creation techniques provides some useful insights. The aim of the researcher’s exploratory framework was to capture the explicit and implicit aspirations of young individuals. This approach also serves to increase our understanding of how to engage with young people. 

The paper explains the methodology of ‘now-wow-how’ phases. This method was selected for accessibility and relevance in facilitating conversations with people unfamiliar with design skills. The co-design process used different tools at different stages. 

A section of the paper is devoted to a critical reflection on what could have worked better. For example the author feels the school-based venue potentially limited explorative inquiries. 

The study showed that exploratory co-creative sessions with young people can yield innovative insights to inform more direct change.  Such sessions require tools that resonate with young peoples’ experiences while also stimulating both critical and creative thinking.

This paper provides details of the project’s structure, methodologies, and outcomes. In so doing, it provides insights into the processes of co-creation within community development and the empowerment of youth.

The title of the article is Young 2.0: advancing an inclusive framework for co-creating futures with youth.

From the abstract

This study presents an inclusive research approach aimed at cultivating inclusivity and co-creating future living environments that resonate with young peoples’ needs and aspirations.

Through co-creative activities, the project captured insights into the lived experiences and future ambitions of young participants. The findings identify some of the entrenched norms and activities that spurred empathy and inclusive thinking through making and enactment.

The project contributes to the initiatives, strategies and methods for young people to shape the future of their hometown. The ‘Young 2.0’ project serves as a microcosm of the potential inherent in co-design to serve as a conduit for youth to express and enact their visions for a more inclusive society.


Design skills in healthcare

Does the design of medical products impact on the safety of patients and health practitioners? The answer in many cases will be, yes. For patients it affects everyday medical items like respiratory equipment. But the real issues are for health practitioners. That’s why we need design skills in healthcare.

Authors of a recent paper discuss some of the issues. They note that when design unwittingly excludes whole groups of users it becomes bad design. Medical products and services designed to best fit a Caucasian male body type means a poor fit for others. 

The authors provide an excellent example of where a design is potentially dangerous. “In one example, the only green button on a defibrillator switched the device off, whereas the only red button was for shocking. In simulated A wall mounted defibrillator in bright orange.emergency situations, it was no surprise that some participants pushed the green button and inadvertently switched the device off when intending to shock.” 

Co-design is considered the appropriate approach in healthcare services, products and building design. It enables stakeholders in healthcare sciences and delivery to provide input at the early stages of design. Although co-design is accepted as a good idea, design skills are yet to be emphasised and captured in co-design processes. 

The title of the paper is, Design as a quality improvement strategy: The case for design expertise

From the abstract

Bad design in safety-critical environments like healthcare can lead to users being frustrated, excluded or injured. In contrast, good design makes it easier to use a service correctly. Design impacts on both the safety and efficiency of healthcare delivery, as well as the experience of patients and staff.

Co-design as an improvement strategy has gained traction in the healthcare quality improvement literature. However, the role of design expertise and professional design is much less explored. Good design does not happen by accident: it takes specific design expertise. 

We define design, show why poor design can be disastrous and illustrate the benefits of good design. We argue for the recognition of distinctive design expertise and describe some of its characteristics. Finally, we discuss how design could be better promoted in healthcare improvement.

Residential spaces for healthcare

An Introduction to Inclusive Healthcare Design By Kiwana T. McClungAn Introduction to Inclusive Healthcare Design is a book with more articles on healthcare design. It includes the built environment, allied health, social care, and urban studies. 

One chapter, The Design of Residential Spaces for Healthcare, looks at homes and residential spaces for delivering healthcare. 

Stroke Toolkit co-designed

The Canadian Stroke Toolkit for Aquatic Rehabilitation and Recreation Therapy (STARRT) was devised using a co-design method. The STARRT website has a section on the process as well as using the toolkit. Briefly, the method has four parts:

    1. Scoping review focused on the implementation of the therapy
    2. Qualitative interviews with participants post-stroke and professionals
    3. Participatory design with design team and consumers for the toolkit
    4. Prototyping and dissemination of the toolkit.

Co-design in research: shifting the power

People with disability are often left out at the beginning of the research process when organisations want research done quickly. This reduces the level of power they have as members of the research team. For co-design in research to be effective, people with disability must be in decision-making positions before research proposals are developed.

People with disability are expected to be involved as researchers and decision-makers in research projects. But co-design methods require respect for the process from the outset.

A man in a blue check shirt is sitting in front of a laptop on a desk and is writing with his left hand in a notebook.

Researchers have to navigate tensions inherent within research institutions when involving people with disability from the beginning of the process. Improving the quality of the research is one of the aims of co-designing with people with disability. It also gives an opportunity to employ people who might not otherwise find a job.

A research team led by Flinders University use a case study to show how to engage with prospective co-designers. They looked at the different factors or conditions that enable or constrain co-design work, and how they relate to each other. The funding of commissioned work has an effect on the internal dynamics and relations within the team. They also found that authority and power can shift and change depending on how these components interact.

Clearly there is more to simply gathering a group of people with disability within a research team and thinking co-design will just happen. Factors such as institutional requirements, and authoritarian hierarchies can have a significant impact on co-design processes.

The title of the article is, Shifting power to people with disability in co-designed research.

People with and without disability need to work together to resist when co-design work is not treated with respect by people or systems.

Two pairs of women sit at a table with paper and pens. One of the pair looks to be explaining something to the other.

From the abstract

This paper explores tensions navigated by researchers and project leaders when involving people with disability as experts in co-design and in the core team. Part of an evaluation aiming to improve paid employment of people with intellectual disability is used to consider this work.

Structural conditions of funding and institutional support were foundational to the co-design. These included accessible practices, core roles for people with disability and resolving ableist conditions.

Power shifts were easily undermined by institutionalised norms that disrespected the co-design contributions. The value of co-designing research was centre to articulating key issues, methodology and analysis.

Co-designing social housing policy

Co-designing social housing policy is a relatively new concept in Australia, so it’s good to see tenants involved in policy development. New AHURI research tackles the issues amid the need for urgent reform of the housing sector. Tenant participation leads to benefits for all involved.

‘For policy co-design methods
to work well, there must be
respect and recognition of the
expertise of all participants
involved in the policy making

A new three storey housing development still has the chain link fencing around it. Social housing policy.

AHURI’s summary paper of the research acknowledges the role of champions within organisations who must lead the development of the design processes. Otherwise, they are not successful or sustainable. However, they require resources and support for these processes to succeed.

Attracting ‘representative’ tenants is difficult because those with the most complex challenges often cannot spare the time because they are in crisis. If participation programs are online or use written forms, only those who can read will be included.

What’s needed for successful co-design

Other important findings from the research include:

  1. A toolbox of participatory methods is needed for engagement across the diverse population who have varied needs for housing assistance.
An old wooden box with mental handles and clasp.

2. Recognition of expertise of frontline staff is an important but untapped source of potential policy expertise.

3. An ongoing commitment is necessary to resourcing, investing in, and training workforces, and building participant capability and supports for policy co-design. And an evaluation program to confirm what works well, under what conditions and for whom.

The title of the policy summary is, Including social housing tenant voice in policy leads to better outcomes.

The report’s executive summary, Social housing pathways by policy co-design: opportunities for tenant participation in system innovation in Australia has more. Or you can read the full report as well.

Transport infrastructure co-design toolkit

Public transport infrastructure in Queensland is undergoing significant design changes using co-design methods. The new Cross River Rail project embraced the concept of co-design to ensure new and upgraded infrastructure is fully accessible. The result is a transport infrastructure co-design toolkit as well as accessible trains and stations.

Co-design of large-scale public transport infrastructure spans several stages in the design process. Consequently, embedding a culture of co-design across the organisation is essential in the planning, development and implementation stages.

Image from the Toolkit

New train in a new tunnel with workers looking on. Cross River Rail Co-design toolkit.

The authority responsible for the project collaborated with the disability community and established strategic priorities to support ongoing infrastructure design.

Accessibility agenda

First there needs to be an accessibility agenda – finding out the diversity of accessibility challenges. That means establishing ways of working with the disability sector to drive decision making. However, there is a risk that some of these priorities disappear in pre-project activities such as feasibility studies and technical requirements. Some decisions made at these stages cannot be changed as they lock in key aspects of the design.

A culture of accessibility

An organisation-wide culture of accessibility is essential for the success of projects. Without this culture change the potential for “gaps” in the travel chain will arise for travellers. Sharing information across the different transport organisations and contractors and consultants is a must. By consolidating the knowledge base across the sector, it eventually gets easier to create inclusive public transport projects.

The title of the Toolkit is, Embedding Accessibility Co-design into the Delivery of Public Transport Infrastructure. The document is the result of research collaboration between the Hopkins Centre and the Cross River Rail Delivery Authority. The outcome has established a clear set of priorities for continued support of changes including those already underway. They key element is co-design with the disability community.

Toolkit contents

There are three parts to the document: Context and background, Outline of the co-design process, and Facilitating the co-design process. The appendices have extra detail and additional resources.

The Appendix on co-design mindsets appears to follow the theory of the once popular Myers-Briggs Type Indicator. Nevertheless it does indicate that different people think differently – a concept aligned with Universal Design for Learning. It means people should be given the opportunity to express their thoughts in different ways.

The video below gives an overview and showcases some of the innovations in design. For more about accessibility, visit the Cross River Rail website where there are more videos with transcripts.

Mapping the inclusive city

Statistics capture many important measurements which are reported as facts, but who chooses what to measure and how it is measured and counted? If the lives of some people are left out of the research questions their facts become invisible. So researchers in the Netherlands took up the issue of inclusive data collection. The project was about mapping the inclusive city by engaging people with disability as co-researchers.

Improving the relevance and quality of research beyond statistical approaches, requires the involvement of community members with ‘the problem’. Image from Heeron Loo’s website.

Two women and two men are talking outside a building in the sunshine.

The research team, including people with disability, explored issues of accessibility in urban spaces. The digital map-based tools worked well and provided insights into accessible locations. However, it is not known if these locations are welcoming and inclusive. The notion of inclusion within places mapped needs a new design thinking cycle for all researchers.

Mapping accessibility is a different endeavour to mapping inclusion, and this research team has opened up the potential to find ways to map inclusion. Accessibility is an essential first step. Getting around is one thing, feeling welcoming with a sense of belonging is another. Urban design features and the attitudes of fellow citizens have an important role to play.

The title of the article is, Mapping the inclusive city: Engaging people with disabilities as co-researchers in Groningen (the Netherlands).

Traditional social research methods are discouraging of involving people with (intellectual) disabilities. This is largely because of governance issues relating to ethics committees. However, participatory research methods with people with disability are more acceptable. The article outlines the participatory research method emphasising the equal participation of all parties involved in the process.

From the abstract

Given the lack of collaboration with people with disabilities in (spatial) decision-making processes, our aim was to develop and test a method that allowed for the involvement of people with disabilities in community development, and in particular in mapping accessibility and inclusivity in various places and spaces in the city of Groningen (the Netherlands).

In this project, we collaborated with an organization that provides housing and care for clients with acquired brain injury, deafness with complex problems and chronic neurological disorders. We describe our approach and experiences in participatory research, focusing on the opportunities and challenges in developing and implementing a data collection method that enabled us to involve people with a disability as co-researchers.

Accessibility at bus stops

A research paper from Chile takes a similar approach. Instead of conducting a physical access audit, the researchers asked people about their bus stop experiences. It is another way of finding out how well access standards promote inclusive environments. Getting to and from the bus stop and boarding and alighting the bus all have to work together.

The researchers conclude that legislation and standards are insufficient to overcome gaps in this part of the travel chain. Consequently, people with disability are not afforded equal conditions.

The title of the paper is, Perceptions of people with reduced mobility regarding universal accessibility at bus stops: A pilot study in Santiago, Chile. You will need institutional access for a free read of the whole paper.

An orange articulated bus approaches a bus stop on a main road.

From the conclusions

This research is part of an interdisciplinary work that seeks to study universal accessibility for people with mobility impairments from different perspectives. From Engineering, it is important to highlight the relation to the dimensions of the space used, while in Occupational Therapy, it is relevant to include the perceptions when participating in the occupation.

The results contribute to the lived experiences of people with disability. They reveal the barriers, challenges, and opportunities that influence successful participation in mobility in the community. In conclusion, there is a lack of regulations regarding the characteristics of spaces. The perceptions of people with mobility impairments must be brought into the design to guarantee the right to move in equal conditions.


Citizen design science as co-design

Co-design strategies vary according to the context and complexity of the project. Co-design processes are not new – academics have carried out participatory action research (PAR) for many years. Often these studies are about solving a social problem. New versions of co-design are emerging as a means of democratising design decisions. Citizen science is a version of co-design that has its roots in environmental monitoring. This method is now used in urban planning and design.

The transformation of a car park into a multifunctional public space is the subject of a citizen science paper from Turkey. The authors explain the project and how they went about engaging with citizens. The co-design process relies on communication between designers, residents, visitors and the local authority.

An additional outcome of the project was to establish a Citizen Participation Unit within the municipal authority to facilitate citizen coordination.

Graphic depiction of the Citizen Design Science framework.

A key element of successful co-design is finding ways to design with non-designers through every stage of the project. Establishing a common language is essential for understanding the needs and thoughts of all participants.

Local residents provide information and issues about the area to expert designers who then evaluate and document the information. To ensure participation of citizens who are blind or have low vision, 3D and relief formats of design elements were provided. Using roundtable discussions and digital mapping, two conceptual designs were provided to citizens for voting.

Citizen Design Science

Citizen design science is a synthesis of citizen science and design science that uses a bottom-up approach. The authors break down the process into three parts:

  • Citizen science – type of data collected from participation
  • Citizen design – citizens actively design
  • Design science – translation of citizens’ ideas into designs by expert designers

The study showed that people without prior design knowledge are able to work constructively with professional designers.

Four photos here. Top two show three dimensional modeling of concepts. Two bottom photos show people sitting at tables outdoors discussing designs.

The title of the paper is, Co-Design of a Public Space and the Implementation: Atakent (Car) Park. The paper has several illustrations of the project.

From the abstract

Citizen Design Science is a co-design strategy for urban and architectural systems that uses design tools for citizens’ observation, experience, and local knowledge. The strategy improves the planning, design, and management of cities, urban habitats, and architectural structures.

This study is about the transformation of Atakent Car Park Area into a public space using a co-design process. Using design science data, two conceptual urban design projects were prepared. This included 178 local citizens’ wishes, needs, and suggestions about the area. Participating citizens were asked to vote for their preferred project and the selected conceptual design was implemented.

The remarkable aspect of this study is the engagement of a layperson without prior design knowledge in utilizing active design tools to establish a common language with a professional designer. Despite the efficacy of this common language facilitated by the tool, it has inherent limitations.

Engaging people with intellectual disability in research

People with intellectual disability continue to be excluded from research practices. This is often due to social and economic factors such as limited education opportunities and access to services. Exclusion is easily perpetuated when you add systemic bias to the list.

Ethics approval processes often view people with intellectual disability as “vulnerable”. This makes their inclusion more difficult for researchers.

Four people are seated at a table but their faces are obscured. One is writing on a notepad. A coffee mug and laptop are on the table. Including people with intellectual disability.

The design of research methods systemically excludes people with disability and other marginalised groups. Consequently, their voices are unheard in health, employment, education and independent living research.

According to an article from the US, approximately 75% of clinical trials have directly or indirectly excluded adults with intellectual disabilities. Just over 33% of the studies have excluded people based on cognitive impairment or diagnosis of intellectual disability.

New methods needed

In response to the ethics and research design challenges, researchers are finding new ways to adapt their methods. The article discusses three approaches:

1. Adapting research materials and processes into individualised and accessible formats.

2. Adopting inclusive research participation methods.

3. Community participation and co-researcher engagement.

Although inclusion strategies are making progress, researchers are lacking helpful guidance. Consequently, including people with intellectual disability in research in a meaningful way requires more work.

The title of the paper is, Inclusive Methods for Engaging People With Intellectual and Developmental Disabilities in Research Practices. This is a short paper and easy to read.

Technology and wellbeing

A related article on co-designing with people with intellectual disabilities looks at developing technologies. Here is an excerpt from the abstract:

Involving people with intellectual disabilities on issues relating to their mental wellbeing is essential for developing relevant tools. This research explores the use of inclusive and participatory co-design techniques and principles.

Individuals with intellectual disabilities participated in a co-design process via a series of
workshops and focus groups. The workshops helped participants explore new technologies, including sensors and feedback mechanisms that can help monitor and potentially improve mental wellbeing. The co-design approach developed various interfaces suited to varying ages.

The title of the article is, In the hands of users with Intellectual Disabilities: Co-Designing Tangible User Interfaces for Mental Wellbeing.

People with intellectual disability and support workers

Abuse of people with intellectual disability focuses on extreme forms of violence at the expense of everyday indignities. Humiliation, degradation, and hurt have a negative effect on identity and makes it more difficult to recruit research participants.

An article by a group of Australian researchers recommends taking action to support both workers and people with disability for improved wellbeing. Here are the key points from their article:

  • Everyday harms are the little things that upset people, such as making unkind jokes about you, being ignored, or disrespected, are not treated as abuse
  • In our project, we called this misrecognition.
  • We looked at when misrecognition happened between young people with disability and their paid support workers.
  • Much of the time, people did not intend to cause harm, but the other person was still hurt by the things they did or said.
  • We can improve the way that people with disability and support workers work together if people understand how their actions affect other people.

The article is titled, Recasting ‘harm’ in support: Misrecognition between people with intellectual disability and paid workers.

Theatre, research and intellectual disability

This study aims to demonstrate how disability theatre contributes to inclusive research practice with people with intellectual disability. The title of the article is Disability Theatre as Critical Participatory Action Research (CPAR). Here is an excerpt from the abstract:

This article describes how self-advocates (individuals with intellectual disability), theatre artists, researchers, and a community living society create social justice disability theatre as critical participatory research. It demonstrates how disability theatre can contribute
to and advance inclusive research practice.

Disability justice-informed theatre as CPAR has direct relevance to people with intellectual disabilities. It also offers a platform where self-advocates’ diverse ways to communicate and be in the world are honoured. Mentorship generates opportunities for self-advocates to learn, practice, and develop research skills.

The theatre creation process (devising, developing, and refining scenes) is research in itself where tensions are recognized as sites of possibility. Future research should explore strategies, and protocols for power sharing and problem solving within disability theatre.

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