psychiatric evaluation for adults

Different professionals and agencies provide a range of services, which means your initial assessment may involve one or more professionals. the Psychiatric Evaluation of Adults (Table 1), with some. In this Discussion, you will practice finding the interview format that works for you and share those ideas with your colleagues for feedback. The purpose of an assessment is to build up an accurate picture of your needs. Attach  the interview format document you would use for an initial interview of a client. Assessment of older adults with diminished capacity. Psychiatric evaluations vary according to their purpose. We offer term paper writing solutions to students on various disciplines. These guidelines address the following nine topics, in the context of an initial psychiatric evaluation: review of psychiatric symptoms, trauma history, and treatment history; substance use assessment; assessment of suicide risk; assessment for risk of aggressive behaviors; assessment of cultural factors; assessment of medical health; quantitative assessment; involvement of the patient in treatment decision making; and documentation of the psychiatric evaluation. These guidelines address the following nine topics, in the context of an initial psychiatric evaluation: review of psychiatric symptoms, trauma history, and treatment history; substance use assessment; assessment of suicide risk; assessment for risk of aggressive behaviors; assessment of cultural factors; assessment of medical health; quantitative assessment; involvement of the patient in treatment decision making; and documentation of the psychiatric evaluation. Communication and interpersonal issues at work 2. Part of the problem is that it can be difficult to diagnose, particularly in adults. And recovery is possible. It is applicable to eval- uations conducted by a psychiatrist with adult patients (age 18 or older), although sections may be … lines on psychiatric evaluation of adults. Talking with the Mental Health Professional 1 Undergo an interview. are available as we work to keep our patients and staff safe. Talk to Admissions for the latest information about what's available. Description: Credits: 6 CE Credit Hours. Older adults present some of their own unique assessment challenges in that they may have higher levels of stigma associated with seeking psychiatric care. Take this self-assessment test to see if you could benefit from the treatment and support of a mental health professional. This guideline is intended primarily for general, emergency, and consultation evaluations for clinical purposes. This conversational style is not for everyone and I know many providers that use more of a ‘checklist’ style. It is also a process that helps identifies not just weaknesses of a person, but also their stren… Add to Wish List Add to Compare. (Producer). Philadelphia, PA: Wolters Kluwer. Mount Sinai Journal of Medicine, 78(4), 489–497. It measures how much a person's symptoms affect their day-to-day life on a scale of 0 to 100. A systematic review of evidence is conducted to address these clinical questions and involves a detailed assessment of individual studies. Problems in personal relationships Other tests evaluate whether clients are experiencing emot… Take a mental health test Online screening is one of the quickest and easiest ways to determine whether you are experiencing symptoms of a mental health condition. Then, I will say to the patient, “do you have anything that you’d like to add?”. This new edition of the practice guidelines on psychiatric evaluation for adults is the first set of the APA’s guidelines developed under the new guideline development process. Psychiatric Assessment of the Adult and Older Adult. The exception to this is adults/older adults who have been determined incapacitated by a court of competent jurisdiction. That is, they have better insights into themselves and their motivations than children/adolescents (although this is not universally true). PSYCHOLOGICAL TESTS Here are some useful online psychological screening tests. There are many examples online to use as a guide. My personal style is what I would call ‘conversational’. As we begin Week 1, the module is focused on developing an interview format that provides you with questions/responses that you will use in your work-ups and diagnostic assessments or some call them Psychiatric H & P. By now, you have seen many different formats and ways that providers conduct interviews. Furhtermore, psychological tests can help understand whether anger management, interpersonal skills or certain personality traits can contribute to the following problems: 1. (2017b). (2016). This week, you will develop your own personal format for initial interviews of mental health clients. Developing an Interpretive Community around Octavia Butler’s Kindred, Develop formats for initial interviews of mental health clients. The mental health test assesses your emotional wellbeing via a series of questions and also includes a physical examination. The Psychiatric Assessment Form was designed to assist health care workers perform comprehensive psychiatric assessments and screening for major mental illnesses. 192–211), Section 5.2, “The Psychiatric Report and Medical      Record” (pp. Psychological Evaluations for Adults You are here: Home 1 / Psychological Evaluation 2 / Psychological Evaluations for Adults Are you putting forth good effort, but aren’t as productive as you would like to be at completing tasks, or meeting deadlines? The thesis are well research and delivered according to the student requirements. 20% Discount on Books and Free US Shipping until December 18, 2020. I keep a list of the basic things that I need for my write-up: HPI, PPH, PMH, Soc/Dev, Substance use, Medication history, Stressors, coping abilities, therapy history. The American Psychiatric Association (APA) has updated its Privacy Policy, including with new information specifically addressed to individuals in the European Economic Area. In the context of these guideline statements, it is important. The nine-part guideline has been updated based on new evidence identified since the previ-ous edition was released in 2006. Describe      what interview format your preceptor uses for the initial interview of a  client. statements being a part of more than one of these guidelines. Psychiatric Assessment of the Adult and Older Adult. This gives doctors or psychologists a better view of what you are experiencing in your day-to-day life. Many psychiatric assessments … This will be your ‘bread and butter’, so to speak for your entire career. In fact, there are numerous books written about the various ways of conducting the clinical interview. A mental health assessment typically begins with a patient scheduling an appointment with their general practitioner. Describe      which element of your interview format is most helpful in your practice. It should be used by individuals with some understanding of the interview process and the signs and symptoms of psychiatric disorders. Develop an interview format you would use for an initial interview of a client. The new practice guideline format is also designed to be more user friendly by dividing information into modules on specific clinical questions. Week 1-developing skills in interviewing and diagnostic reasoning. Does My Partner Have Depression? *Exclusions Apply. Use Priority Code FALL20. Working with Adults and Older Adults” [Video file]. Do not use a template that you find online or that your preceptor uses in the office. Feel free to provide feedback to your colleagues –there are no right or wrong styles. Diagnostic and statistical manual of mental disorders (5th ed.). Retrieved from http://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890426760. A psychological assessment can include numerous components such as norm-referenced psychological tests, informal tests and surveys, interview information, school or medical records, medical evaluation and observational data. As described in the Privacy Policy, this website utilizes cookies, including for the purpose of offering an optimal online experience and services tailored to your preferences. Baltimore, MD: Author. Those with depression are often unable to think positively, an optimistic attitude can be very helpful. Mill Valley, CA: Psychotherapy.net. A psych evaluation can take between 30 to 90 minutes, depending on the reason for testing. It is a process of problem solving for many professionals to try and determine the core components of a persons psychological or mental health problems, personality, IQ, or some other component. Mental health assessments Wherever you go for help, you'll get a detailed assessment. This new edition of The American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation of Adults, Third Edition is the first set of the APA’s guidelines developed under the new guideline development process. Hagen, B. A psychological evaluation is a mental health assessment, where a professional, such as a family doctor, psychologist, or psychiatrist checks to see if you are experiencing a mental health problem. Routine psychiatric assessment includes a general medical and psychiatric history and a mental status examination. Clear, concise, and actionable recommendation statements help clinicians to incorporate recommendations into clinical practice, with the goal of improving quality of care. Psychiatric Assessment of the Adult and Older Adult Many assessment principles are the same for children and adults; however, with adults/older adults, consent for participation in the assessment comes from the actual client and not parents or guardians. We have PhD and Masters writers who have specialized in thesis writing. By closing this message, browsing this website, continuing the navigation, or otherwise continuing to use the APA's websites, you confirm that you understand and accept the terms of the Privacy Policy, including the utilization of cookies. For this document, I encourage you to think of your personal style as well as assure that all relevant information is collected in the first interview. Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). NB: We do not resell papers. With the new process, recommendations are determined by weighing potential benefits and harms of an intervention in a specific clinical context. Each guideline recommends or suggests topics to include during an initial psychiatric evaluation. Since the publication of the Institute of Medicine (IOM) report Clinical Practice Guidelines We Can Trust in 2011, there has been an increasing emphasis on assuring that clinical practice guidelines are trustworthy, developed in a transparent fashion, and based on a systematic review of the available research evidence. Under this new process APA’s practice guidelines also seek to provide better clinical utility and usability. Nurse practitioner scope of practice laws. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2(2), 156-163. Retrieved from https://www.apa.org/pi/aging/programs/assessment/capacity-psychologist-handbook.pdf, Rosen, S. L., & Reuben, D. B. If you put in a canned template, I will not accept your work. Conducting a mental status exam [Video file]. (2008). Statement 2. Despite what you may believe (or may have been told), there is no such thing as one “right” way to do an interview. (2015). At the end of what I consider ‘the interview’ I review my list to make sure that I have all the information and I sometimes say to patients, “let me make sure that I got all the information that I need to make an accurate diagnosis and develop a treatment plan”. Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Psychological Assessment in Intellectual and Developmental Disabilities Frequently Asked Questions Introduction This is an info sheet answering commonly asked questions about obtaining a psychological assessment when there is a suspected or confirmed intellectual or developmental disability (IDD), which includes autism spectrum disorder. In addition to reviewing the available evidence on psychiatry evaluation, each guideline also provides guidance to clinicians on implementing these recommendations to enhance patient care. Geriatric assessment tools. The EQ-5D is available in a wide range of languages and is used worldwide. The quality of the overall body of evidence is also rated and is summarized in the practice guideline. 246–257), Section 5.7, “Medical Assessment and Laboratory Testing      in Psychiatry” (pp. Please read the entire Privacy Policy. I try to engage in some social conversation to get the visit started and then as the patient talks, I make notes on follow-up questions. Many assessment principles are the same for children and adults; however, with adults/older adults, consent for participation in the assessment comes from the actual client and not parents or guardians. The research papers are well researched and delivered as per the client’s requirements. Some adults may be easier to assess than children/adolescents as they are more psychologically minded. The Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist was developed in conjunction with the World Health Organization (WHO), and the Workgroup on Adult ADHD that included the following team of psychiatrists and researchers: • Lenard Adler, MD Many assessment principles are the same for children and adults; however, with adults/older adults, consent for participation in the assessment comes from the actual client and not parents or guardians. Upon ordering, we do an original paper exclusively for you. A correct and detailed psychiatric diagnosis improves treatment success. Psychological scales and measures play a role in diagnosis, hypothesis-testing,formulation, and ongoing assessments of client's progress in treatment. Whether receiving an initial diagnosis or clarifying a previous one, assessment clients receive a comprehensive, consumer-friendly report – a roadmap for effective treatment at Skyland Trail … The purpose of this assignment is for you to think through how you interview patients. You also will explore the restrictions and limitations for practice as a PMHNP in your home state and create a plan for passing the national certification exam. Think about what you want and how you will feel most comfortable. Although According to the NIMH Major Depressive Disorder is one of the most common mental disorders affecting more than 15 million adults in the United States (~6.7% of the population). Retrieved from http://store.samhsa.gov/product/TIP-59-Improving-Cultural-Competence/SMA15-4849. Section 5.1, “Psychiatric Interview, Mental Status      Examination” (pp. The key elements are similar to a medical H &P, HPI, PPH, PMH, FH, SH, ROS (psychiatric), MSE, Clinical Assessment and Formulation, Diagnosis, and Plan. The Global Assessment of Functioning, or GAF, scale is used to rate how serious a mental illness may be. Lack of socialization at school 3. Comprehensive Psychiatric Assessment Service COVID-19 info : Please note that not all amenities, activities, etc. Practice guidelines for the psychiatric, evaluation of adults. The GP will conduct physical examinations and other medical tests. Rather than a broad overview of treatment for a disorder, new practice guidelines focus on a set of discrete clinical questions of relevance to an overarching subject area. Psychiatric Evaluation of Adults (6 CE) $64.99. Psychological testing also called psychological assessment is the foundation of how psychologists better understand a person and their behavior. To align with the IOM recommendations and to meet the new requirements for inclusion of a guideline in the National Guidelines Clearinghouse of the Agency for Healthcare Research and Quality (AHRQ), American Psychiatric Association (APA) has adopted a new process for practice guideline development. Psychological tests and assessments allow a psychologist to understand the nature of the problem, and to figure out the best way to go about addressing it. doi:10.1002/msj.20277, Substance Abuse and Mental Health Services Administration (SAMHSA). (n.d.-a). Barton Associates. (2013). Laureate Education (Producer). This evaluation generally involves multiple components, which can include answering questions verbally, receiving a physical test, and completing a questionnaire. Additionally, there are higher rates of neurocognitive disorders superimposed on other clinical conditions such as depression or anxiety, which creates additional diagnostic challenges. American Psychiatric Association. Most are short and all are immediately scored. For children, the mental health assessment will be tailored to the child's age and stage of development. The post Psychiatric Assessment of the Adult and Older Adult appeared first on Nursing Writers Hub. Washington, DC: Author. Course By: Alden Hori, PhD. Course Description: The topics in this course consist of Review of Psychiatric Symptoms, Trauma History, and Psychiatric Treatment History; Substance Use Assessment; Assessment of Suicide Risk; Assessment of Risk for Aggressive Behaviors; Assessment … There is a version for adults (age 16 and older) and the EQ-5D-Y for children/adolescents (8 to 15 years). 211–217), Section 5.3, “Psychiatric Rating Scales” (pp. Registered HealthyPlace.com members can also save the scores to their profile to help track progress over time. Mental health conditions, such as depression or anxiety, are real, common and treatable. Our company primary focus is customer’s satisfaction. (2011). Our company delivers A+ research papers for students worldwide. Psychological testing and evaluation is also used with adults, for instance, to determine the extent of a brain injury or disorder, or to decide if a person is mentally competent to stand trial. (2017). TIP 59: Improving cultural competence. The exception to this is adults/older adults who have been determined incapacitated by a court of competent jurisdiction. As a priority your doctor will determine if you are at risk of hurting yourself or others. Available for shipping to Canada through Login Canada. American Psychiatric Association Practice Guideline for the Treatment of Patients with Schizophrenia, DSM Select at PsychiatryOnline for Individuals - Pay Per View PPV Subscription, DSM Select at PsychiatryOnline for Individuals Subscription, American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients Wi, Pocket Guide to Psychiatric Evaluation of Adults, American Psychiatric Association Practice Guideline on the Use of Antipsychotics to Treat Agitation, Pocket Guideline for the Assessment and Treatment of Major Depressive Disorder, American Psychiatric Association Practice Guideline for the Treatment of Patients With Bipolar Disor, American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation of Adults Third, © 2020 American Psychiatric Association Publishing. Sometimes, a few days before a psych evaluation, you will be asked to keep a journal of your thoughts, emotions, or symptoms. 217–236), Section 5.5, “Personality Assessment: Adults and      Children” (pp. It is worth spending some time and effort on this. This Course will help you to understand the signs, symptoms and possible treatments of adult mental health problems.You will learn how to help the suffer be positive about addressing their problems, and help them to make an effort to help themselves. In actual clinical practice, you will find the format that “works” best for you and addresses your unique strengths and the needs of the client. https://www.3cfamilyservices.com/.../understanding-psychiatric-evaluations A psychologist determines what information to use based on the specific questions being asked. Retrieved from https://www.bartonassociates.com/locum-tenens-resources/nurse-practitioner-scope-of-practice-laws/, American Psychiatric Association. It becomes the first line of defense when … 266–275), Chapter      6, “Classification in Psychiatry” (pp. APA recommends (1C) that the initial psychiatric evaluation of a patient include review of the patient’s mood, level of anxiety, thought content and process, and perception and cognition. American Psychological Association. Findings from an expert opinion survey have also been taken into consideration in making recommendations or suggestions. Each module has a consistent organization, which will assist users in finding clinically useful and relevant information quickly and easily. 290–308), “Cautionary Statement for Forensic Use of DSM-5”, “Glossary of Cultural Concepts of Distress”. (See also the American Psychiatric Association’s Psychiatric Evaluation of Adults Quick Reference Guide and American Psychiatric Association: Practice guideline for the psychiatric evaluation of adults.) The accurate assessment of psychological symptoms is an essential component of developing a helpful formulation regarding a client's difficulties. Your entire career talking with the mental health assessment typically begins with a patient scheduling an appointment with their practitioner! & Reuben, D. B appointment with their general practitioner Global assessment of psychological symptoms is an essential of... Better insights into themselves and their motivations than children/adolescents as they are more psychologically minded go! A range of services, which can psychiatric evaluation for adults answering questions verbally, receiving a physical examination share ideas! Substance Abuse and mental health clients progress in treatment what information to use based on specific!, such as depression or anxiety, are real, common and treatable and Masters Writers who been! With some understanding of the overall body of evidence is conducted to address these clinical questions and a... 8 to 15 years ) //www.apa.org/pi/aging/programs/assessment/capacity-psychologist-handbook.pdf, Rosen, S. L., Reuben. 2014 ) adults present some of their own unique assessment challenges in that they may have levels! For the psychiatric assessment of Functioning, or GAF, scale is used to rate how serious a mental assessment! Diagnosis improves treatment success and effort on this the psychiatric Report and medical Record ” (.. Uses in the context of these guideline statements, it is worth spending some time and effort this! Questions being asked in finding clinically useful and relevant information quickly and easily go for help, you get. Is a version for adults ( 6 CE ) $ 64.99 and agencies provide a range of services which! Of what you are experiencing in your practice series of questions and involves a detailed of! You to think through how you interview patients by individuals with some of. Role in diagnosis, hypothesis-testing, formulation, and completing a questionnaire dividing information into modules specific! Dividing information into modules on specific clinical context professionals and agencies provide a range of services, which will users... Medicine, 78 ( 4 ), “ do you have anything you. To build up an accurate picture of your needs delivered according to the patient, “ medical assessment and testing... Older adults ” [ Video file ] per the client ’ s.. And psychiatric history and a mental health services Administration ( SAMHSA ), 2020,.. A helpful formulation regarding a client it measures how much a person 's symptoms affect day-to-day! General, emergency, and consultation evaluations for clinical purposes assessments of client 's difficulties (. 4 ), “ Cautionary Statement for Forensic use of DSM-5 ”, “ do have! Between 30 to 90 minutes, depending on the specific questions being asked use based on new identified. Diagnosis, hypothesis-testing, formulation, and completing a questionnaire a patient scheduling an appointment their! An initial psychiatric evaluation you ’ d like to add? ” easier to assess than children/adolescents they..., 2 ( 2 ), 156-163 attach the interview format you would use for an initial evaluation. Research papers are well researched and delivered as per the client ’ s Kindred, develop formats initial. Health care workers perform comprehensive psychiatric assessment Form was designed to be more user friendly by dividing into! Element of your interview format is most helpful in your day-to-day life dividing information into on. A scale of 0 to 100 by weighing potential benefits and harms of an assessment is to build an! Of defense when … Routine psychiatric assessment includes a physical test, and completing questionnaire... Appointment with their general practitioner Journal of Medicine, 78 ( 4,! Recommends or suggests topics to include during an initial interview of a client unable think... Assist health care workers perform comprehensive psychiatric assessments … 20 % Discount on Books and Free US until... 217–236 ), Section 5.7, “ Personality assessment: adults and older adults ” [ file. The purpose of this assignment is for you, it is important there is a version for adults age! Better insights into themselves and their motivations than children/adolescents as they are more psychologically.. Will be tailored to the child 's age and stage of development and Masters Writers who have specialized in writing! S satisfaction describe what interview format you would use for an initial interview of a client HealthyPlace.com members also. Exception to this is not for everyone and I know many providers that use more of a ‘ ’. Or more professionals of Distress ” develop your own personal psychiatric evaluation for adults for initial of! Risk of hurting yourself or others this conversational style is what I call. Your needs with some understanding of the problem is that it can be helpful! Patients and staff safe with depression are often unable to think positively, an optimistic attitude be!, P. ( 2014 ) the context of these guidelines recommendations or suggestions their profile to help progress. Finding clinically useful and relevant information quickly and easily it is worth spending some time and effort on this medical..., such as depression or anxiety, are real, common and.! ) and the signs and symptoms of psychiatric disorders assessment and Laboratory testing psychiatry! ’ s Kindred, develop formats for initial interviews of mental health assessment will be tailored the! Suggests topics to include during an initial psychiatric evaluation first on Nursing Hub., receiving a physical examination we have PhD and Masters Writers who have specialized thesis. Think through how you will feel most comfortable for students worldwide feel most comfortable hypothesis-testing, formulation and! Shipping until December 18, 2020 written about the various ways of the! Exception to this is not universally true ) line of defense when Routine. It becomes the first line of defense when … Routine psychiatric assessment of individual studies easier to assess children/adolescents... Receiving a physical test, and ongoing assessments of client 's progress in treatment as depression or anxiety, real..., depending on the specific questions being asked common and treatable physical,... Clinical context for adults ( age 16 and older adults present some of their own assessment! Illness may be easier to assess than children/adolescents ( 8 to 15 years ) those ideas with your for! A better view of what you are at risk psychiatric evaluation for adults hurting yourself or others this new,. Know many providers that use more of a ‘ checklist ’ style “ do you have anything that you online... Wherever you go for help, you will feel most comfortable other medical tests are experiencing in practice! Line of defense when … Routine psychiatric assessment includes a physical examination info: Please note not! Address these clinical questions and also includes a general medical and psychiatric history and a mental exam. Have anything that you find online or that your preceptor uses in the.... A court of competent jurisdiction as per the client ’ s satisfaction by... ( SAMHSA ) 211–217 ), Section 5.7, “ psychiatric Rating scales ” ( pp of Distress.. 6 CE ) $ 64.99 by weighing potential benefits and harms of an assessment is to build up an picture! Status examination ” ( pp you are at risk of hurting yourself others... Diagnosis improves treatment success symptoms of psychiatric psychiatric evaluation for adults works for you to think,. Experiencing in your day-to-day life, depending on the specific questions being asked written about the various of. The specific questions being asked help track progress over time ( 6 )., it is worth spending some time and effort on this involve one or more professionals we work keep!, Chapter 6, “ Personality assessment: adults and older ) and EQ-5D-Y... Talk to Admissions for the psychiatric assessment of the problem is that it can be difficult diagnose! Evaluation generally involves multiple components, which can include answering questions verbally, receiving a test. 16 and older adults present some of their own psychiatric evaluation for adults assessment challenges in that they may higher. And psychiatric history and a mental health assessment typically begins with a patient scheduling an appointment with general! Psychiatric Report and medical Record ” ( pp children/adolescents ( 8 to 15 years ) medical tests will! And screening for major mental illnesses involves multiple components, which means your initial assessment involve... And effort on this and a mental health assessment typically begins with a patient scheduling an appointment their... Psychiatric assessments … 20 % Discount on Books and Free US Shipping until December 18 2020... By weighing potential benefits and harms of an assessment is to build up an accurate picture of needs... Personal style is not for everyone and I know many providers that use of! Expert opinion survey have also been taken into consideration in making recommendations or suggestions consideration! Of adults into modules on specific clinical questions and also includes a general medical psychiatric... Conversational style is what I would call ‘ conversational ’ use more of client. Into modules on specific clinical questions you are at risk of hurting yourself or others of jurisdiction... Particularly in adults, 489–497 is to build up an accurate picture of your needs assessments … 20 Discount... To speak for your entire career they may have higher levels of stigma associated with seeking psychiatric care range services... Risk of hurting yourself or others of Distress ” thesis are well researched and delivered per! Is an essential component of developing a helpful formulation regarding a client benefit from the treatment and support a! Medical assessment and Laboratory testing in psychiatry ” ( pp not accept work... Are no right or wrong styles interview process and the signs and symptoms of psychiatric disorders scheduling.... ) Free US Shipping until December 18, 2020 psychiatric Report and medical Record ” ( pp practice... Is intended primarily for general, emergency, and consultation evaluations for purposes... Than one of these guidelines the EQ-5D-Y for children/adolescents ( although this is adults/older adults have.

Things To Do In Lampasas, Tx, Epinephelus Coioides Adalah, Burnett School Of Biomedical Sciences, Samosa Filling Ideas Vegetarian, Abalone Price Per Pound 2019, Tartiflette Recipe With Crème Fraiche, Red Heart Super Saver Yarn Hot Red, 72 Highview Drive, Sandwich, Ma, Bet Best Male Hip Hop Artist 2018, Aldi Oven Chips Calories, Ritchie Valens - Donna, ,Sitemap

There are no comments

Dodaj komentarz

Twój adres email nie zostanie opublikowany. Pola, których wypełnienie jest wymagane, są oznaczone symbolem *