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5 things that your Granny might find difficult that you don’t..

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It is hard to imagine life in 40 years time. What we often forget with the elderly is that at one point they were all our age, experienced growing up, being fit, feeling strong. The thought of growing old scares me slightly and chatting to my Granny helps me understand some of the problems she faces on a day to day basis. The purpose of this article is to increase awareness and so that we as daughters, sons, grandchildren and friends can change our behaviour, use our experience of technology to improve the quality of life of the ones we love.  It also gives some information on those little things in life that make everything a bit easier.

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Please do not read this and go and buy everything available for your loved one. No one wants to feel that they are losing their independence and sometimes material home aids can be seen to be patronizing and may disempower them. Instead discuss possible solutions to every day problems in a non threatening, non intrusive manner. No one person is the same so try to work out problems that they face and provide useful solutions.

Life’s little challenges….

  1. Unscrewing jars/Unpeeling packaging:  As we grow older there is a natural process of degeneration (wear and tear/osteoarthritis) and gripping, particularly around small objects can become difficult. There are many things available on the market which help when opening jars and larger jars are easier to open.  If helping your granny/granddad shop try to choose jars that are fairly light (if they struggle holding something heavy) and ones with easy grip lids ie good depth.
    • Small jars usually are preferable and hopefully the contents is less likely to go off. Something I’ve learnt from my Gran is she cant bear to waste food and this causes her unnecessary stress if I buy her big jars (thinking they will last longer). She eats less than me so whereas I would get through all that jam in a week it may last her a month!


    • If buying jars suggest that perhaps you could unscrew the lid then place cling film over the top and the place the lid back on lightly twisted so that it is easily removed. Obviously this is only appropriate if they wish to eat that food at that time and best to leave it the fridge.


    • Look out for packaging, which is easy to open. Sliced ham has to be the worst! A pincher grip (holding thumb and first finger together) is something we take for granted. Choose packaging where you can use scissors to open it or that has a large ‘tab’ to peel back.


    • If yours or your love ones hands are getting stiff and sore visit a physiotherapist who can provide you with gentle exercises. Don’t know where to go? Sign up with to find a physio near you.


photo credit: martinak15 via photopin cc

2.  Getting up from a chair.  As we grow older we tend to be less active and can lose underlying muscle bulk and strength.  Many will begin to feel unsteady on their feet and fear of falling can further reduce activity. To some extent this can be trained and utilizing a physiotherapist or personal trainer who can help target areas of weakness and improve overall exercises tolerance.

This is an excellent Birthday/Christmas present for your loved one (particularly as its often difficulty to think of appropriate presents). When your loved one (you) has consulted a clinician they will advise them on what training regime they might benefit from (they will assess any health conditions and adjust their program accordingly). Programs are likely to involve things like sit to stand, steps ups, balance exercises and strengthening exercises.

3. Walking:  Walking is something we all take for granted. Imagine trying to get from your kitchen to your living room and not feeling like you have the strength or stability to get there without losing your balance. This is the barriers faced by many elderly people.

There are several walking Aids available to provide support for people, sometimes as a short time measure whilst they undergo a rehabilitation program to improve strength and exercise tolerance.  Some may find that they regain independence with a walking AID, which allows them to walk in the garden around shops and out to see friends.

4. Keeping entertained throughout the day. As mobility reduces so does confidence and it can be harder for older people to get out to socialise and get involved in sports teams. As people begin to slow down it is important to remain active, both physically and mentally. IPADs are a great source of games and can be used even with moderate arthritis whereas some puzzle/chess pieces may become too difficult. Where as we have grown up with technology you will have to spend time to explain how it works and keep this up once a week until they have fully got to grips with how to turn it on and activate games.

5. Cooking food. This can be extremely hard work and difficult with heavy pans. There are now good quality ready meals (Waitrose/Marks and Sparks) available which can make life easier for those struggling to make meals. Don’t forget to check out the nutrition information to choose healthy options. Making meals can be good exercise in itself so its good for people cook where possible but keep a supply of quick and easy meals for those days that they may be feeling a little tired.


Below are some possible aids that may benefit yourself or a loved one. If you are unsure which are appropriate book in to see a physio in your local area for an assessment  to discuss which would be appropriate and adjust the size for you. Most will be familiar and can teach you how to use these safely (ie elbow crutches, frame, etc)

Physio Treatment may be useful for those who:

  • Have experienced increased frequency of loss of balance/falls.
  • Find it difficult to grip.
  • Experience pain in a joint- We often out this down to age however just because we are older doesn’t mean that we are not exposed to normal musculoskeletal conditions such as muscle strains/imbalances.
  • Experienced reduced mobility and strength.
  • Find it difficult moving about the bed, getting out of a chair, getting off the toilet.
  • Want to improve exercise tolerance and general fitness (its never to old to be healthy!)


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CSP South Central Meeting 10th September

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South Central Meeting 10th September

An informative, worthwhile South central meeting was held at West Berks Community Hospital, Thatcham this Tuesday (10th September). Always a great opportunity to network and share ideas we started off with Rachel Newton (CSP Public Affairs and Policy Officer) who discussed the new governing bodies and changes occurring within the UK structuring. Rachel dazzled us with a creative new presentation tool which helped to visualise the changes (be sure to check out on the CSP website )

photo credit: Wi2_Photography via photopin cc

The new structuring within the NHS is important for both private practitioners and those working within the NHS to offer a level of understanding on who will be commissioning, opportunities for new roles and the importance of promoting physiotherapy services.  A huge point to come out of the presentation is that decisions will be made locally, perhaps by people who may not necessarily understand the value of physiotherapy. Although we are not normally that vocal these changes will need us, as physiotherapists, to explain the value of our services to those decision makers who may not necessarily know the long term cost effectiveness of physiotherapy. The CSP are working hard from the top however a greater impact will be made if every physiotherapist takes time to deliver this message and spread word, display ‘Physiotherapy works posters ‘ and protect services. On a more positive note Rachel explained that although we need to work hard to protect our services there will be new sources of funding available through some of these new bodies.

We then split into groups to thought shower some ideas on which services we could use to engage differing groups and what outcome measures we could use to try and prove our value and reflect our services.

Outcome measures

  • Family/Friends test.
  • Hospital length of stay
  • Re-admission scores
  • Reduce premature death (Death rates)
  • PPI/satisfaction survey
  • QST


Tea and coffee break was extremely popular and allowed the thirty or so attending time to network and share ideas, a fantastic opportunity to meet others within the area. There was a fair representation of both private and NHS physios however I still felt that some areas were under represented and thought that Junior physiotherapist would have got a lot out of the discussions and experience of more senior voices.

The second presentation came from Jill Gillepsie (talking on behalf of Kirsty Harris) from RBH about an exciting new pre-op screening tool for verso shoulder replacement. The team were finding that some patients had poor outcomes following these surgeries so the team designed a tool to predict whether the patient was appropriate for this type of surgery. The tool consists of 5 indicators which use a traffic like system as to whether surgery is advisable or not. This was my perception of the tool and I would encourage all those interested to contact Kirsty or Jill directly fore full information.

It looks at whether they:

  • Have good deltoid function?
  • Do they have good comprehension of the surgery/rehab regime?
  • Are able to carry out daily post op deltoid rehab programme?
  • Ability to avoid contraindications following surgery (ie dislocation)?
  • Ability to attend physio following surgery?


The benefit of the tool is that it enables any care needs to be identified early and highlights discharge planning where needed. It also identifies the patients that may not be suitable for surgery to allow the patients to be educated in the difficulties they may face following surgery should they not be able to answer yes to the above questions. The traffic light system allows physiotherapist to identify whether the patient is ‘red’ not suitable for surgery ‘amber’ may have some difficulties or ‘yellow’ suitable.

Finally we received a talk from Cate Leighton (Rep to Council) who explained an exciting opportunity for a physiotherapist to get involved in the 2017 elections.  She discusses the benefits of the role which involved significant reading however have allowed her to have access to the latest government changes and attend meetings with influential healthcare professionals to allow our voices to be heard. The role contributes to CPD, gives a high level of understanding of UK health structuring and CSP corporate planning.

If you have been feeling frustrated at recent changes within the CSP or national changes then perhaps it is time to stand up and correct it from the inside rather than complaining that ‘others aren’t doing enough.’

She discussed some interesting points that the CSP are addressing:

  • Links between Age UK and the CSP
  • Practicalities of physios being able to prescribe pain medication.
  • How to encourage Physios into  AHP roles (ie  8a)
  • Francis report
  • Indemnity arrangements

All in all a very useful meeting and I would encourage others to attend the next one In December. A big thank you to Kim Patterson for her hard work in organising the session and to Rachel, Cate, Jill and Kirsty for preparing the information for us. To sign up to south central please Click here …..




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5 Reasons to turn your phone on silent during meetings

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 A quick observation from a meeting today.

How many times a week do you get a phone going off in clinic? Once/twice maybe? Well how often do you think “Why have they even got it switched on?” Its 30 minutes who could they desperately need to speak to in that time? Do they appreciate my time?

Now lets turn it around….. you’re in a meeting with fellow colleagues. Today, in our meeting, three phones went off. Three?! Not even just a little vibrate but a full on high volume laugh laugh ring tone. So here it is 5 reasons to turn your phone off….

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1. Its rude. By attending the meeting you are committing to give your attention to that group for a set period of time. By allowing your phone to go off and disrupting other people’s thought processes and concentration is not acceptable. If you have an urgent call that you may have to take thats fine.  Notify the meeting lead to give them a heads up, leave your phone on silent and slip out of the room to have that conversation in a private location when you feel it vibrate…… NOT wait for “Hit me baby one more time” to belt out.

2. It promotes poor dynamics of the group. When your phone goes off in a meeting others within that meeting may feel that you do not appreciate their time. It creates a feeling that you have other things and people who are more important or who are higher in your priorities.

3. Its Unprofessional. The CSP guidelines Rule 8 talks about how physiotherapists should adhere to professional standards at all times.  You wouldn’t answer a phone/text in front of a client or a one on one meeting with a senior member.  When comparing ourselves to other professions they would expect the same etiquette. Maintaining high standards in our profession is so important for our reputation to the public and setting examples for those coming through.

4. It never goes unnoticed. Even if the group lead doesn’t spot it others will. One of the biggest motivators is said to be recognition. Do you want to be remembered by your peers and employer for your gentle nature with patients or for your obnoxious ringtone?

5. Career progression. The meeting I was in today had two very influential people and those people that you may want to impress if you hope to achieve and progress through the ranks. As physiotherapists we can sometimes be a little relaxed about high paid, high driven jobs but to be noticed by the right people will set you up in the future if you choose to move roles or be considered for a pay rise.

Something to think about at least ……

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Patient Comments: Resolution

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Question of the day and how I deal with it……


1. Patient :”I’ve seen a chiropracter and osteopath which helps for a few days but my symptoms never resolved. How are you going to help?!”

I’m sorry guys but physiotherapists have a bad press when compared to chiro’s and osteo’s. This is not because they are any necessary any better. There are good/less effective practitioners in every field. The difference is physiotherapists are slightly worse at selling ourselves. Ask anyone off the street what do physio’s do and 8/10 will reply “Run onto a sports field/ massage.” This is not their fault. WE should be educating every single person that walks into our treatment room and ‘selling’ ourselves.

How many patients discuss relatives ‘Oh little Johnny fell over at rugby training and has a very sore knee. Its been 2 months now and its still not better’ Does it hurt to politely ask “Oh that’s interesting. Where are they having their physio then?’ and when they reply ‘Oh, do you treat children/knees as well then?”

So how can you help…

Our strength is our communications skills, caring nature and fairly laid back attitude to life. I’m yet to meet a physio who isn’t caring and is jumping over the next person to make lots of money and retire at 30.  So utilise these skills. Build the rapport, educate the patient and provide information to allow the patient to cope and move forward with their injury.

Explain your treatment plan and do not forget of your manual therapy and electrotherapy techniques where appropriate. Want evidence check out the individual treatments or condition on Physiowizz. Pages are updated regularly but this is a great task and if you have any good articles please tweet/facebook them to us.

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4 Tips to improve your service: Managers

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 4 tips to improve your service: Physio Managers

1. Allocate half an hour per week for each physio to choose a patient and perform a quick literature review on their condition to see if there is any recent evidence. Bullet points should be listed and uploaded to a communal data base (or Physiowizz) for others to benefit and learn. This will allow practitioners to keep up to date with research but also will improve efficiency by using cutting edge treatments which have been proven to be more effective. How many people are still recommending corticosteroid injection for tennis elbow? Too many !

(Ok short term benefit but increases likelihood of reoccurrence long term… Read more here. Plenty of other examples…  Learn. Share. Develop.

photo credit: Victor1558 via photopin cc

2. Two weekly reviews with employees will allow you to get to grips with how they are feeling, performing and whether there are any issues to resolve.  Identifying areas of stress and resolving these will reduce sick leave and allow your staff to work efficiently and provide better quality of care.

The biggest motivators are recognition from a leader and trusting a leader.  People are more likely to be motivated to move forward if they feel their work is recognized and their feel connected with their employer. A meeting provides a great opportunity to give feedback and discuss progress.

3.  Your success depends on the success of your colleagues therefore listen to them, train if needed and allow room for development and individuality as part of the team. 

4. Set a plan. The classic “Rome wasn’t built in a day.”  Break down short and long term goals and which areas of the service you wish to change/grow. Clear guidelines will make this goal more easily achievable.

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5 tips to improve your practice: Physio

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5 tips to improve your practice: Physio

With so much hype in the media at the moment in relation to the NHS it is easier to becomecaught up in the political debates and in some areas heavy criticism of the NHS. With continuing demand and less resources to provide our services, we, as physiotherapists and healthcare professionals, need to dig deep to achieve our goals and continuing to help patients.

photo credit: tnm-photography via photopin cc  


1. Smile, be friendly and polite: This is not usual something physiotherapists struggle with. At Therapy Expo earlier this year a speaker described that people changed physio because they had ‘a difference of attitude’. Not because they were not happy with the treatment or that is was too expensive but because they did not feel they were important to the practitioner. Now how hard is to walk out with a huge smile and greet a patient warmly.

1/3 of treatment effectiveness has been found to be placebo and connection between the practitioner and patient. This is an easy change to implement if you do not do so already.

2.  Build rapport with nursing staff and other healthcare professionals.  Working in a ward scenario is stressful at the best of times. Organise time to have meetings with the nursing staff to improve efficiency and find out systems that will help improve working dynamics. Ie When is it best for me to see Mr. X ? Why don’t I see Mrs Y while Mr. X has a shower with you guys. Try to be diplomatic and make an effort to arrange your day so that it is easier for everyone without being bossy and self-centred. The meeting should not be designed purely around your day, you will also need to compromise.

3. Manage expectation. Clear communication skills are paramount.  Short term goals are useful and will motivate patients. We know that recognition is a powerful motivator so be sure to praise and recognize if patients have completed their exercises so they maintain motivation.

4. Time keeping: This is so easy and simple yet how many times are there patients waiting in the waiting room? Plan your 30 minutes (those working with 20 minute slots talk to your manager – I fail to understand how you can adequately treat someone in this time and must reflect on patient outcomes or sessions needed and stress of the physiotherapist).  This is a skill you need to develop and can be difficult with patients who want to tell you their life story. Some practices/hospitals use a gentle bell system, which is explained to the patient prior to treatment, providing a 5 minute warning so the patient has a cue that the session will be coming to an end.  If you don’t have time for all treatment techniques be sure to write them in your note plan.

Maintain your manual therapy skills and if you are choosing any hands off treatments explain why you are doing so to the patient. “Ie With CRPS the nerves are sensitised therefore we need to adopt this approach to encourage stimulation the parasympathetic nervous system and re-organisation of the brain” – When describing acupuncture/mirror therapy/.   We will gradually progress you to tolerate different tactile stimulus such as… which will involve using different materials etc.

I work in both NHS and the private sector and my biggest compliant from patients who have seen physio’s in the NHS is ‘They didn’t do anything, they didn’t touch me.” Now you and I both know if they had followed they exercises program most probably would have improved.

We know the WAY we give our treatment is important and that it is estimated to attribute 1/3 of a treatment’s effect. Therefore by being positive,  smiling and developing a rapport (easier to achieve in 30 mins than 20!) with your patient you will gain better patient outcomes.

photo credit: FJTUrban (sommelier d mojitos) via photopin cc 

5. Endeavour to be a life long learner. Working in Africa has given me valuable experience in the dangers of practitioners who are qualified but were allowed loose without continual professional development. They were provided with a false confidence and monitored by people who didn’t know if they were talking complete rubbish.  I will never forget the response to a question I had asked a little too bluntly in my frustration “Why are people with shoulder injuries being given squats?”  “Exercise!” he had responded enthusiastically. “We promote exercises! “

Learn. Share. Develop. In any way you can through videos, images, courses, experienced seniors, enthusiastic students. Continue to keep an open mind, absorb like a sponge and realize you can always learn something new.


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Tips for starting your Physio degree

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The follow offers some insights from a fellow physio of her experiences of university and how to survive!

To Learn


Arrive on time:

If you are working in private practice and you turn up 10 minutes late to see a patient they will not come back to you.  Therefore you will lose business and make less money. Get this right from the start. There is no excuse for being late and this is something you should get into the habit of doing from the word go. Placements will mark you down for being late. Why lose marks for not being prompt?

Be organized:

Get notes printed the night before to avoid stress and not having to make half hearted notes the day after when you’ve forgotten most of the stuff talked about in the lecture. Then file it immediately in a file for that specific module. This will save you at least a week of ‘organizing’ your notes before you start revising. Trust me I was a poor student and only grasped this at post graduate level.

Read notes the night before

If you have already looked at the lecture content it will make more sense. Look up words you don’t understand and cast your mind to bloom’s taxonomy of learning. Repetition is key for learning so revisit the content frequently.


To Grow


Enjoy your first year

Party hard in the first year because you won’t get the opportunity in the second or third. Don’t party too hard otherwise second year will be hell (trust me I know). Don’t be disheartened if you aren’t too sure of your new ‘best friends’ they will probably change within a few months.

Take up something new

University is full of opportunities you may never get again. There’s chances to try new things at a fraction of the cost. Immerse yourself in anything you can and enjoy it. Try ‘never saying no’ for a day and you may, like myself, find yourself with friendly strangers surfing as the sunsets and then chilling on beach as the night draws in.

Get fit and get involved in sport

Taking up sport will give you a break from the stresses of uni work and help you meet new people and friends providing a solid social calendar. It will also help keep you slim as often people put on weight with the typical uni lifestyle  (eating rubbish food and drinking)



To Succeed 

Grab every opportunity

Physiotherapy is a fantastic career but it is sometimes hard to get your foot in the door. Potential employers will be looking for people with something extra on their CV.  Get involved even if you aren’t paid, contact local clubs to see if you can get experience, volunteer at events and keep posted with Physiowizz for an opportunities that may be available.



Get projects done a week before due date

The amount of times I found myself a week away and panicking! Just get it done early then you can relax, chill out and won’t feel guilty. If you miss a deadline at uni there are tough consequences and you mark will be capped. Just get it done.


Be safe

Control your beverage intake. Your ‘new best friends’ may not look after you and you may not be familiar will your surroundings yet. Many people feel university is all about drinking. Drinking can be fun but don’t be bullied into it buy a coke and say its got vodka in it if people give you stick!

Don’t walk home alone, stay in well-lit areas and go to parties with others you know. Safety in numbers! Look out for rape alarms at the freshers fair which can be a great comfort if walking alone.


This is an amazing time in your life and will be so much fun. Just enjoy, absorbed as much information as you can and work hard to ensure you get as much out of it as possible.

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Physio Focus. What can I expect at university?

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What will be expected of me on my first day?

On the first day you usually meet in a lecture theatre and they give you an outline of the course, its structure and how it will be formatted.

Most courses combine:

  • Lectures (where you sit listening to presentations usually by powerpoint)
  • Seminars (Small groups where you discuss and work through tasks)
  • Practicals (Larger groups where you will practice skills, handling and treatment techniques)
  • PBL’s ( Depending on your course problem based learning is where you examine a problem and work as a group to provide a solution to a scenario. For example they may give you a case and you will work through what key points you need to be aware of, what things you need to learn and research and what evidence supports your treatment strategy)
  • Placements (Work based placements in various specialities)
photo credit: Rob Shenk via photopin cc

What will I need to bring?

 photo credit: mugfaker via photopin cc

Make sure you have a note pad and pen to take notes. As time goes on you will usually be given access to online lecture notes. I would strongly recommend printing these out before each lecture so you can annotate and note. This is hugely beneficial for when you come to revise, to organize your notes and find them. Buy a few folders for each speciality (ie cardio/neuro/msk). I didn’t get to grips with this until my finally year and my life would have been so much easier when revising had I done it from the word go.


Will it be hard to meet people?

No. Everyone is in the same boat and social boundaries change at university. Everyone is extremely friendly and there are lots of nights to help you meet people. The best thing is no one knows you so you can let go of any stigma of school and branch out of your usual friends group to meet people from all walks of life.


Will I have to take my clothes off?

In practical sessions you will need to undress occasionally. Get some decent shorts and a sports bra/tank top to make yourself feel more comfortable.


How much should I be working outside of contact hours?

Each university is different ask your lecturers for specifics. The more you do the better you will do in exams/as a physio following uni.

For more info on uni, books to by, tips, what to expect CLICK HERE

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Physio: Five books you can’t do without!

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Off to Uni? Get prepared!

With September drawing closer you may be thinking about the looming start of your physiotherapy degree. Where ever you have chosen to go you are sure to have an amazing time and indulge in both the learning and partying environment! Here’s four books you can’t do without that got me through my university days.

1 . Gray’s anatomy..

is essential and don’t panic when you look at the first paragraph and have to google every single word to find out the meaning. Anatomy is hard but you will get it. Repetition is key with visualisation and using a combination of books and other tools is a great way to start. Something I wished I’d bought in the first year but got as a post grad is a skeleton (Great early christmas present). This has helped me hugely with anatomy and understanding where muscles lie, nerves pass through and ligaments connect. Blue tac and string are great for practicing origins and insertions of muscles or the course of nerves.

2. Cardiorespiratory – Alex Hough

Cardiorespiratory involves a lot of chemistry, understanding blood gases, the lungs and how oxygen is transferred around the body. It is hard going at first but a great reference book which covers a wide range of conditions. I found this book useful for advising on positioning, breathing equipment and other physiotherapy techniques..

3. Emergency physiotherapy

This book is worth its weight in gold. Perfect for placements as a quick reference and my survival guide throughout university.

4. Pocket Guide to Physiotherapy

This book offers a quick reference for muscle origins/insertion, treatment names, nerve roots, special tests, blood gases and much more. a great one to have at practicals and lectures to prompt your memory!

 5.Musculoskeletal Assessment

Great reference for musculoskeletal examination. List of order of examination, special tests and specificity of each test.

6. You should also look into a Neuro physiotherapy book however I would recommend asking you tutors as there are varying opinions of the different books out there.


Want to browse all the books we recommend?

Click here..

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