Thursday, August 15, 2019
Personal and professional development Essay
ââ¬Å"The most successful nations in the future will be those which develop high quality, skilled and motivated workforces and make good use of them. â⬠Government White Paper (1994) This object of this assignment is to identify what personal and professional development is, if there is any difference between personal and professional development and what opportunities there are, how this benefits both staff and Lancashire Care Foundation Trust (LCFT) as an organisation. I will consider how motivation affects people and their desire for development both personally and within the workplace Briefly I will be looking at qualifications: how these are obtained, utilised as a means to recognise stages of development and as evidence to demonstrate competencies of staff. As the theories show, people learn in many different ways and so I will discuss further 2 examples of these ââ¬â Behaviourism and Humanistic learning theories. Delving into experiential and reflective learning styles and strategies and how these link into the theories of how people learn and what resources are available to aid learning. How to plan for personal and professional development Personal development can be described as self-improvement, or development of skills and knowledge on a personal level not related to a specific job role but are personal goals. Adair and Allen categorise this as self-development and feel that these ââ¬Å"Transferable skills are the key to improved prospectsâ⬠(Adair and Allen 2003 p64). Improvement of these personal skills can be taken to any job and will be beneficial no matter which role is undertaken. In the same context, Wade (1996) suggests in addition to professional qualifications, employers also demand abilities that are considered as personal transferable skills such as communication, leadership, decision making and teamwork. Professional development is learning or enhancing necessary skills to carry out specific job functions effectively or improving practice and is aimed at the team/service/ organisational goals. This often defines where a role fits within an organisation or hierarchy and indicates promotion opportunities or employment prospects for career enhancement. Although viewed by many as separate agendaââ¬â¢s, Morrow states that she ââ¬Å"does not believe there is a significant difference between personal development and professional development. Learning is learning. Personal development is professional development ââ¬â what is learnt at home is taken to work and experience at work is implemented at home. â⬠(Morrow, 2008). Whether personal or professional, development encourages staff to focus on their present circumstances, evaluate career progression and plan for the immediate and long term future. In order to put a strategy in place, current skills are identified, competencies and achievements recognised, goals clarified and then the difference between to the two assessed to outline the development required. Within the workplace, staff need to be motivated to achieve good results and engage with the development process. Abraham Maslow believed that people are motivated by a number of different needs and grouped them into 5 areas (see appendix 1 ââ¬â Maslowââ¬â¢s Hierarchy of Need). Maslow (1943) theorised everyone is capable of moving up the levels in the hierarchy ââ¬â once one need is satisfied, the next arises. Failure to meet each of the lower levels will prevent the ability to reach highest level of self-actualisation. ââ¬ËIt is quite true that man lives by bread alone ââ¬â when there is no bread. But what happens to manââ¬â¢s desires when there is plenty of bread and when his belly is chronically filled? At once other (and ââ¬Å"higherâ⬠) needs emerge and these, rather than physiological hungers, dominate the organism. And when these in turn are satisfied, again new (and still ââ¬Å"higherâ⬠) needs emerge and so on. This is what we mean by saying that the basic human needs are organized into a hierarchy of relative prepotencyââ¬â¢. (Maslow, 1943, p. 375) Within the workplace the very basic ââ¬Ëbiological and physiological needsââ¬â¢ along with ââ¬Ësafety needsââ¬â¢ are governed by law in the UK and so the higher three needs (Social, Esteem and Self Actualisation) may be realised through learning and development leading to increased motivation and confidence If invested in and developed, employees are more likely to feel their social needs are met by being part of a team are well regarded and appreciated for their skill set and therefore motivated to work harder to reciprocate which leads to higher production and efficiency. People are able to realise their abilities and potential, take on more responsibility or variety of tasks which improves versatility and prevents boredom leading to demotivation. Staff feel happier if they feel valued and are likely to stay within the organisation. Learning can be the result of many activities which can include formal classes and training sessions, on the job training and mentoring or self-study. Every time we encounter something new, there is an opportunity to learn and improve skills. As a result of increasing and honing skills and gaining qualifications, people tend to develop a greater sense of self-worth, dignity and well-being as they become more valuable to their employer and to society. These factors give a sense of satisfaction and motivation through improving performance, achieving personal and company goals which can also give them physical rewards such as increased remuneration and benefits. Qualifications are evidence of the level of knowledge gained and the competencies developed. The type of qualification i. e. Degree or NVQ dictates the characteristics and context of the learning and the learning outcomes are measured or assessed and qualifications awarded based on the results. The Office of Qualifications and Examinations Regulation (Ofqual) (2009) states that the 5 main purposes of qualifications are: â⬠¢Recognise personal growth and engagement in learning â⬠¢Prepare for further learning or training and/or develop knowledge and/or skills in a subject area â⬠¢Prepare for employment â⬠¢Confirm occupational competence and/or ââ¬Ëlicence to practiceââ¬â¢ â⬠¢Updating and continuing professional development (CPD) Every post in LCFT has a profile of requirements to fulfil the role including which qualifications are required e. g. a midwife must be a qualified nurse and have a degree in Midwifery, a secretary must have RSA3 typing. Proof of qualifications obtained (certificates and professional registrations) must be shown prior to job offers to evidence the level of competency and skills of potential employees to fulfil the requirements of the job. Within LCFT, staff learning and development is viewed as being an integral part of fulfilling the needs of the business as well as the growth and motivation of staff. Within the organisation, Learning Needs Analysisââ¬â¢ (LNA) are carried out to ensure learning provision is in alignment with the business strategy and so that employees have the capabilities to deliver the organisationââ¬â¢s strategy. The root of the LNA is the gap analysis ââ¬â an assessment of the gap between the knowledge, skills and attitudes currently possessed and the knowledge, skills and attitudes that are required to meet business objectives The core of training in LCFT is ââ¬ËMandatory Trainingââ¬â¢ which is any training deemed necessary by law for safe and effective function in the NHS and then training and development to meet the business needs is then prioritised. Every member of staff in LCFT has an annual Personal Development Review which is updated every 3 months to adjust objectives and monitor progress. A Personal Development Plan is written as part of this process which outlines training requirements and skill enhancement for the following 12 months. Staff are required to continue their professional development to build their professional skills and competencies which then improves their performance at work. LCFT also provides training opportunities to support staff to develop and manage their careerà benefitting LCFT by retaining staff with the aptitude and ability to meet the future organisational needs and adjust to the ever changing environment within the NHS. Management Development programmes are also in place to enable leaders to foster this learning environment and motivate staff to embed the learning culture within the organisation. This benefits the NHS as they are assured of the level of staff they are employing and helping t o sustain the future of their workforce. Staff feel they are valued and invested in which in turn leads to job satisfaction and potential career advancement. This all ultimately benefits service users and patients of the NHS in that it gives them confidence they are being treated by qualified staff and they received the best care possible by all employees from administrators to surgeons. Development and training comes in many different guises which benefit different learning preferences. On the job training may include acting up into a role, shadowing or being mentored which are very effective methods to develop skills or enrolling on an NVQ course which would be suited to kinaesthetic learners. Many training sessions for Mandatory Training within LCFT and most external courses follow a pedagogy approach utilising traditional learning methods using a classroom setting with a lead or tutor giving information with some interaction from attendees. This can be beneficial to all if the programme is tailored to every learning need including images, audio and hands on tasks and by having a person on hand to ask questions of and explain points although this is often time consuming and costly as staff have to travel to a central location to join a training session Due to the low costs involved and ease of adapting or amending training templates and resources, e-learning is now a favoured approach to training staff within the NHS. Whilst this is good for people who are visual learners and are office based within LCFT buildings, it can be very difficult for staff with no IT connectivity or only one PC between 10 people on a ward for example. E- learning is also very inadequate for staff who have a kinaesthetic learning style, especially for those with additional learning needs such as dyslexia. ? LO2 ââ¬â How people learn Reece and Walker (2004) state that learning is about change brought about by developing a new skill and understanding something new. Many academics have studied learning theories such as Behaviourism or Humanistic Learning and use these models to explain the principles of how people adopt new skills and understanding. The methodology of how the learning is carried out is directly linked to the theory and so as hypothesised by Pavlov and Skinner, a person that tends to follow a Behaviouristic theory would learn by changing their behaviour in response to an external stimuli. This was proven when Nobel Prize winner Ivan Pavlov carried out ââ¬ËClassical Conditioningââ¬â¢ experiments by ringing a bell when giving food to a dog. The dog would salivate at the food but eventually the dog would respond in the same way to the bell ringing as it had been conditioned to expect food at the sound of the bell. In the adult learning context, psychologist Burrhus Skinner developed the ââ¬ËOperant Conditioningââ¬â¢ methodology by repeating actions and reinforcing or promoting the desired outcome and punishing or supressing negative outcomes. A pedagogy approach is required to deliver these conditioning methods but this often means there is little input from the learners themselves. Humanistic Learning theory recognises that all humans are inherently good and have unlimited potential for their own growth. Maslow believed that people learn from experience but are motivated by the need to reach their potential and self-realisation (as previously discussed. See also appendix 1 ââ¬â Maslowââ¬â¢s Hierarchy of Need). Carl Rogers theory is based upon the same foundations as Maslow but believed that the basic motive for all humans is to fulfil their own potential and reach self-actualisation ââ¬â to become who they would like to be. Both Rogers and Maslow endorse learning by experience and an andragogy teaching method which fosters student centred learning (as opposed to teacher centred learning) allowing the students to engage their own learning style and subsequently gain rewards by satisfying their own needs. This follows Kolbââ¬â¢s Learning Cycle (see Appendix 2) which states that after an event, experience should be reviewed, actions revised to produce new theories and then the theories should be tried and tested, The cycle then begins again by reviewing the testing etcetera. Gibbs Learning Cycle (see appendix 3) expands further on Kolbââ¬â¢s theories by encouraging further the human thought processes within these stages, to debrief on the activity and reflect on all the phases of an experience or activity and how the person feels at every stage I feel that I am a reflective learner but adhere to Kolbââ¬â¢s cycle rather than Gibbs as I am more practical and less emotional in my learning. In a classroom situation, I find an andragogy approach with open discussion and practical work or auditory and kinesthetic learning much more stimulating in the first instance but as I am a visual learner, I need this backed up by visual aids (notes or presentations) which I then use to reflect on the knowledge and gain a deeper understanding of the objectives. In conjunction with Kolbââ¬â¢s learning cycle, this supports the thoughts of Itin (1999) who states that experiential learning is the process of making meaning from direct experience to which Moon (2004) adds that reflective learning is a phase of learning resulting from the actions inherent to experiential learning. Dewey (1933) reasoned we have to regard reflection as implying purpose which is in line with Cognitive Theory but Moon (2004) suggests that although we reflect for a purpose, conclusions to complicated issues can just ââ¬Ëpop upââ¬â¢ without our being conscious of their having been a reflective process ââ¬â this is a subconscious event supporting Humanist theory. Experiential learning is based in humanistic theory but Behaviourists believe that it can be influenced by external stimuli which in turn changes behaviour. For highly motivated Humanist learners who are adept at self-directed study, the most readily available is the internet which is available 24 hours a day, 7 days a week and can be accessed by computers, tablets, phone and even via gaming machines and TVs. It enables searching for information virtually and sometimes instantaneously from across the world but not all content found on the World Wide Web is from a reliable source and so may not be accurate. The library at college contains a wealth of validated information around the courses that are delivered there but the number of books is limited and so there may be waiting times for specific items to be returned. There are also restrictions on entering the library as opening hours are limited mainly to daytimes and even close earlier on Fridays which severely limits access to working pupils. Public libraries often do not stock academic books and a charge is often made to order books in which also incur waiting times for the books to arrive. There is also a Library within LCFT but it is many miles away from most workplaces, only open during office hours and generally stock books around clinical subjects. Within the workplace, colleagues are an excellent resource for learning as they can impart the knowledge gained from their own training and experience and are available during the working day Difficulties can arise though if new methodologies contradict what is favoured by the experienced colleague. Learning resources may be used as the basis as the foundation for some learning strategies ââ¬â the way a learner identifies the best way to carry out a task. For those who chose reading as their strategy, the library and the internet are immensely advantageous but is also beneficial to many other strategies for finding out the initial information. Conclusion Learning and development for an organisation improves quality, skills, productivity and motivation which leads to a reduction in overheads and errors. This in turn increases profitability and stability for the organisation which enables them to become successful. An organisation needs to recognise its required outcomes alongside the needs of the workforce and develop them accordingly to ensure they retain staff with the aptitude and ability to meet those future needs. In the NHS, patient outcomes are a main focus of the delivery plan but this must be balanced by the financial implications brought by the cost delivery and so development of staff is the most beneficial and cost effective route to achieving this goal. When it comes to learning, there are no right or wrong answers to how people learn. People may follow a certain theory or use a specific learning strategy in the main but often it is a mixture of theories and strategies that produce the best outcomes and is often dictated by how the information is offered, whether online or classroom based and what resources are available to support the student. I have learned that when I am imparting information to a group I need to try and incorporate a variety of learning styles, allowing kinesthetic learners to interact with the subject matter, the audio learners to listen to information and the visual learners to view pertinent materials individual, On a personal level, I have discovered that I learn using a mixture of theories and styles but I am consistent with my strategies and instinctively know how I learn the best.?
Wednesday, August 14, 2019
Good and Bad Experiences Essay
One of the many memorable scenes in Lac Suââ¬â¢s memoir, I Love Yous Are for White People, takes place in Chapter Four. It is the scene where Lacââ¬â¢s father takes his family out to buy their first restaurant meal. I find it a very interesting and hilarious scene. Pa receives some extra food stamps from Uncle Sam, so he decides to take his family out to the restaurant around the corner of their house. Obviously, this is the first time of them eating in the American restaurant; therefore, everything is kind of new for them. Since the only one who knows English in the family is Lac, it is not quite easy for them to order foods. The family has to order food through Lac, or they point at the pictures on the menu to order. Even when the food arrives at their table, which are hamburgers and French fries, they still do not know what those are and how to eat them. Lacââ¬â¢s father even asks him if they need to use chopsticks to eat the hamburgers, and says the other patrons are sav ages when he sees they eat hamburgers with their bare hands. When they are done eating and the bill comes, the father pays the bill with the stamp foods, and it drives the waitress crazy when she keeps explaining to Lacââ¬â¢s father that the restaurant doesnââ¬â¢t take stamp foods but he doesnââ¬â¢t understand what she says. However, when the manager comes to their table to solve the problem, he accepts it. He takes all the stamp foods and twelve dollars cash and jettison the family out. This is a very hilarious scene in the memoir, and I remember this scene the most throughout the whole book. This memoir also examines the emotional and physical damage Pa causes for Lac Su. First, when he notices that Su steals money from the piggy bank, Pa whips Su as soon as they get home. Second, Pa forces Su to take all his clothes off until Su is completely naked. Next, Pa throws Su out in the crowded street to let him feels ashamed even though he insists Pa not to and cries. Then, Pa yells out to the street to make sure everybody notices Su when heââ¬â¢s naked (117). All the neighbors come out to street and laugh at Su. (117). When Pa finally lets Su go back inside, he still lectures Su for two hours and doesnââ¬â¢t care how tired and shocked Su is. In contrast to Lac Suââ¬â¢s life of minimal support, the most supportive person in my life has been my best friend, Trang. I first met her in tenth grade and we have been bestfriends since. She is the same age as me but she is wiser than me and open-minded. She has helped me so much in myà life. She is like my other sister who I could turn to when I have no one beside me. She has helped me make right decisions every time I have to do something important in my life. When I first came to the United States from Vietnam, it was the hardest time for me and she was the one who encouraged me to not give up. She told me to be happy and be positive. Until now, she still always tells me to be positive and stay happy. She is very good at keeping secrets; therefore, I feel like I can tell her everything in my life and expect no one knows about it but her. She also accepts and supports me for being who I am. Sometimes, I get bored and sad, but later, talking to her makes me feel better. She always helps me feel stronger and confident about myself. She was also the only one who helped me choose my major. My parents always wanted me to be a businessman or an engineer, they still do now, but I have never seen myself as an engineer or a businessman. I always see myself as a nurse working in the hospital. So, Trang talked me into pursuing my dream. There are many great and wonderful ways she has supported me.
Tuesday, August 13, 2019
Trends and Challenges Paper Essay Example | Topics and Well Written Essays - 1500 words
Trends and Challenges Paper - Essay Example It is a classic case of finding out where the performance management system competes with the annual performance appraisals because the latter do not give the exact details as far as an employee is concerned whereas the performance management system is more comprehensive than anything else. Since the annual performance appraisals are more aligned towards providing value keeping note of how well the employees have fared over the year, the performance management system is more elaborate since it gives each and every instance of the employeeââ¬â¢s domains and tells the management whether or not the performance bonus or the increments are due for a certain employee (Schoch, 2011). This is a better indicator of how well the employee is faring and what his expectations are from the organization in the long run scheme of things. Also the employees know that they are being judged for each and every act of theirs within the organization which is a significant understanding that once reache d, can have long-lasting effects and consequences on their work realms. This is such an essential comprehension that will eventually make the performance management systems more effective and compatible with any business as compared to the annual performance appraisals due to their limited scope and usability issues. Evaluate the effectiveness of various performance appraisal methods and possible problems affecting performance appraisals The effectiveness of various methods of performance appraisals lies more on the shoulders of the human resources management department within an organization. It is this department that eventually finds out where the problems actually exist and how these could be overcome within the related settings. Having said that it is significant to note that the performance appraisals are effective only when they are being followed to the core, which speaks for their legitimacy issue since they are at times being seen only as a barometer for finding out whethe r or not an employee has been punctual at work or has been able to complete certain tasks within the set timelines. This is a very wrong precedent because the performance appraisals can do much more than they are thought out to be. What it will eventually tell one and all is the fact that these performance appraisals would not be able to derive value if they are being judged on these points alone (Buckley, 1998). The possible problems that affect the performance appraisals are concerning the change in personnel and improper documentation of employees over a period of time. If the employees keep on coming in within an organization and leaving it on a constant basis, then there is a problem that needs to be addressed and more so with the understanding reached upon with regards to the performance appraisals. The performance appraisals are therefore being seen as a thing of the past when such issues come to the surface and it is about time that the employees seriously start searching fo r better alternatives which they can give to the management regimes. One such is the performance management system which can help their course and allow them to pace ahead with the guarantee that each and every task of theirs is being
Monday, August 12, 2019
Unfolding the Secrets to Successful Management Assignment
Unfolding the Secrets to Successful Management - Assignment Example Big problems can result and the blame would obviously be laid on me in the end. So, I made it my responsibility almost from the starting period to create the right kind of environment at my store in order to manage a culturally diverse workforce. Creating the right kind of atmosphere means enabling the workers to understand and respect different cultures and consider all opinions in a manner free of cultural prejudices and biases. Things which might be acceptable in one culture might appear to be truly inappropriate for working coming from a different cultural background. So making the workers realize the subtle and sensitive differences between different cultures by providing them with increased means of intercommunication can help a manager immensely in handling a culturally diverse workforce. 2. What tools do you employ to handle the workplace conflicts which can be disastrous for the work environment? You might have noticed that many times conflicts originate due to every worker appearing to be involved in his/her own world, presenting ideas that antagonize ideas introduced by other workers, and refusing to genuinely collaborate with others. Therefore, for one thing, I try handling workplace conflicts by laying stress on the importance of teamwork and mutual collaboration which is all teamwork actually is about. Conflicts also arise between employers and employees when a low level of creativity is consistently maintained by employees. So I have taken it upon myself to encourage my workers to be innovative and creative in whatever job they do here. I happened to be quite authoritative in my initial days which led to a low level of creativity and less production which is why I changed my management style and became more involved to avoid conflicts. 3. What strategies do you follow to address the confusions and prejudices which result due to less communication between managers and employees? I understand that less communication between managers and employees i s a grave issue and raises serious concern for the organizations. As I mentioned before, many changes came in this store I work as a manager at during the authoritarian management days like workplace-related stress, conflicts due to cultural diversity handled in the wrong way, less communication, and myriad confusions. I could not realize these bad and harmful changes until I became involved with my workers and began to take interest in what issue they were facing and how they could be solved. When there is less communication, workers begin to feel confused about certain orders as they are not explained in a more enhanced way by the managers and certain jobs are left undone consequently.Ã
Sunday, August 11, 2019
Human genome Term Paper Example | Topics and Well Written Essays - 500 words
Human genome - Term Paper Example One of the most contentious issues coming up over the next few years will surely be whether to allow human genomes to be patented. Human rights advocates are concerned that allowing patents will infringe on human dignity by giving permission to certain organizations to keep records of a person's genome records and is an invasion of privacy, sort of (Patrinos & Ansorge, 2005, p. 391). Human genome patents is shaping up as a huge social controversy because of its far-reaching implications on research such as those dealing with genetic defects that can cause inherited diseases. Patents are crucial to give encouragement to researchers so that their efforts will be amply rewarded, similar to the copyrights of authors and artists who want royalties for their creative talents. Patents in the context of medical research has effects on how well human beings can live their lives, whether disease-free or not, for example.
Strategic and operation management Essay Example | Topics and Well Written Essays - 2250 words
Strategic and operation management - Essay Example bsequently in 2007, the research and development team of the company developed Crylon fibre, which comprised of all the qualities to be counted as superior to Britlene, especially with its better heat resistant mechanism as compared to other fibres. It is noteworthy in this context that with the development of new products in the market sphere of the industry, the company has been losing its monopolistic positioning. Eventually, the company has been focused on developing new products to regain its leadership positioning, which was already threatened by the expiration of their previous patent on Britlene apart from the rising competition in the market being intruded by local as well as international traders. It is thus expected that the development of Crylon will prove effective in rewarding the organisation with its competitive advantages (Jones, n.d.). The paper particularizes on the critical analysis of the current strategic positioning of the company. Correspondingly, emphasis has been laid on evaluating the implication of change with due regards to resource planning. The options available to the company with the generation of new product, i.e. Crylon have further been assessed on the basis of Ansoff matrix, focused on evaluating its feasibility, suitability and acceptability in the market, as compared to its prior product performance of Britlene. Findings from these analyses have further been summarised to draw upon recommendations for DSF. In general, the strategic positioning of any company is mostly concerned with the impact of its undertaken initiatives in respect with the internal and the external sources persisting in the business environment, observing the influences of the stakeholders and competences of the firm (CIMA, 2008). When marketing a new product, observing the market trends from an overall perspective is essential. It is in this context that a company expanding business in the same product line thus becomes subjected to many speculations to
Saturday, August 10, 2019
Musculoskeletal System Article Example | Topics and Well Written Essays - 1000 words
Musculoskeletal System - Article Example Since this system is comprised of bone and muscle, it is also responsible for giving mass or shape to our body and protecting our internal organs. This system is also responsible for storing calcium in bones and producing red and white blood cells as well as corpuscles (Judge, 2007). There are four common conditions that affect this system and these are osteoporosis, rheumatoid arthritis, osteoarthritis and injuries relating to muscles from strenuous activities such as with sports. Some of the conditions are more related to age and the general degeneration of tendons and ligaments, such as with osteoarthritis that damages tendons and ligaments due to the bearing down of weight on the joints (Judge, 2007). Before diagnosing musculoskeletal conditions, it is important to make a patient assessment first. Taking note of the patients' past medical history, family history and social history need to be taken in consideration because these play an important factor in some musculoskeletal conditions. The medication or drug history of the patient should also be assessed because some drugs cause muscular degeneration. Certain ethnic groups are also predisposed to conditions that affect this system due to their diet, an example of which are Asians who lack Vitamin D in their diets and are at high risk for osteoporosis (Judge, 2007). Next is the pain assessment where the mnemonic PQRST is used. The mnemonic stands for Provoke, Quality, Region, Severity and Timing. These keywords are used in order for the patient to describe the pain, for example if the pain is provoked by sudden movement, or where the pain is localized. Once the description of the pain is noted, physical examination can be done on the affected region where pain is reported. General inspection of the affected region requires the patient and the nurse to assess how much pain or swelling there is and if the patient can move or mobilize the affected part without adding more injury. This inspection may also require assistance especially for those who may find it difficult to move because of the pain or swelling. One of the common methods in managing sprains that affect the musculoskeletal system is to cold or hot compress the affected area. Resting and elevating the affected region is also one of the common methods of management in order to alleviate the pain and swelling. This is for minor conditions that help alleviate the pain and swelling. Monitoring the affected region for possible complication is the next step in the management process if the pain aggravates or the swelling gets worse. In monitoring the pain or swelling, checking the temperature of the swelling is important so that it can be checked for further infections. Taking pain killers like analgesics can help in the management of musculoskeletal conditions. The prescribing of analgesics depend on the gravity of the pain and if it will not counteract with any medication currently taken by the patient. There are non-medication types of pain management such as positioning of the body, distractions or massage of the affected area. Another part of management is immobilization and mobilization. The affected part may need to be rested or immobilized for a few days in order for the swelling to
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