Latest Professionals

Evidence Based Practice for Health and Fitness Professionals

Evidence Based Practice for Health and Fitness Professionals

Ask the well being and health specialist if they have "evidence" and the probabilities are good, you possibly can awaken: "Yes!" Perhaps even indignant. In any case, everyone makes use of evidence … some kind of. However should you consider that evidence-based follow solely applies to what "research says," you do it improper. On this article, we'll present you the fitting means to make use of proof that will help you educate and enhance your teaching – and enhance customer outcomes.

++++

Right here in precision food we love science.

In truth, no one loves science more than us!

However is it attainable to rely too closely on scientific literature?

Perhaps

Have you ever seen someone:

  • Reject the coach's profitable technique just because a few of its elements usually are not "research proven?"
  • Refuse to vary the vitamin plan – even if the client hates it – "because science?"
  • Name a respected healthcare professional "Quack" as a result of they mention years of medical expertise as an alternative of ultimate medical analysis?

in all probability gained't spend much time on Fb feedback.)

In each case, an individual's bloated respect for research might restrict their means to study and develop as a coach. They could additionally have an effect on others to comply with their slender mindset, in order that they miss. And that is typically achieved with "proven practice".

Now evidence-based follow or EBP is all the craze in certain well being and health environments, which is an enormous deal. We know our hearts, keep in mind? Not solely is there one drawback…

Many coaches, albeit good, get the EBP mistaken. Particularly, they emphasize that "what research says", besides for different relevant info, resembling their professional expertise and private preferences and the values ​​they work for.

And it's not good for clients, businesses

To ensure you get the EBP proper, use this guide to know what the tactic really is, why it's necessary, and how it can be carried out successfully in your coaching apply.

When used correctly, the EBP is a strong software that may make you a better coach, so you possibly can assist more and extra individuals with sustainable change and deep health.

And we love even more than science.

+++

What is "proof"?

There’s Evidence of On a regular basis Life

Our actual vitamin training program and certificates inform our clients and coaches that you’re using result-based decision-making (OBDM)

Very merely this means you determine what to do subsequent based mostly on the knowledge you simply made

two weeks after a vacation lunch? It's info that claims, "Welcome home, maybe call back a little."

Did your blood strain drop after four months of coaching? This info says, "Keep up the good work!"

We informed our coaches and clients as many knowledge factors as potential and search for progress in all places, including:

  • physique measurements
  • and other medical exams
  • sporty efficiency, similar to stronger or quicker
  • how garments fit [19659028] restoration
  • sleep
  • temper and well-being
  • belief
  • consistency
  • ] And so on. [Tässä muutamia ideoita.]

    All these knowledge points provide evidence that we will use knowledge-based decisions

    Then there’s scientific proof

    . research, primary research (for example, learning culture cells) and rather more.

    This proof can differ drastically in high quality, subject to investigation and how properly the outcomes and results are for you and your clients.

    Basically, scientific evidence is likely one of the greatest methods we have to know concerning the nature of actuality.

    And whereas it might be apparent, we should say it anyway: Do you need to share these insights immediately with prestigious, peer-reviewed scientific articles – no occasional websites, articles in magazines, or footage of sunsets with phrases.

    Finally, there are belongings you study at work.

    We name this "expertise." coach intuition, senior physician talent di agnosis, the best way a carpenter can inform if one thing is 1 / 4 inch from a square just by wanting.

    After you have worked with over 100,000 clients, you begin with a database of collected wisdom. And there are sometimes things which are troublesome to elucidate or defend – you’ve gotten just seen it sufficient that you understand it's a thing.

    Once we convey together experiences, analysis and expertise, we have now quite good work hypotheses about what is more likely to be efficient

    . That is, it isn’t just a medical research.

    EBP is a systematic mindset and software that combines scientific information with medical expertise and the person wants and preferences of each shopper or patient.

    Sure, it's official, specifying eyeglasses, however you may find the Instagram model even more enlightening. (See figure under)

    All three elements are equally essential.

    It’s because:

    1. You are not getting ready for the research averages. Getting ready individuals

    Most studies report average outcomes for interventions. (This is especially true of their titles.)

    Nevertheless, if we take a look at the actual knowledge of most research, we discover that individual outcomes fall into some kind of clock curve

    ]

    Take this instance, James Krieger and Bret Contreras .

    The research on resistance coaching and muscle progress discovered:

    ”Beforehand educated individuals who have been coaching resistance 3 times every week for 9 weeks increased their muscle mass by 6%. ”

    Based on this, chances are you’ll anticipate a customer to realize comparable leads to your three-day week program.

    However for those who take a look at the individual knowledge within the research, muscle progress ranged from -2.5% to 20%. That's right: minus 2.5 %. As Krieger and Contreras level out, 5 of the 53 individuals lost muscle!

    This does not mean that the research results are misleading. The truth is, in most studies, members experienced muscle mass between 5 and 10 % and some even more. Nevertheless, it exhibits that the overall findings don’t necessarily apply to all individuals. So don't wait for them.

    One other example is broccoli.

    But if a broccoli will get a gaggy or gass, it isn’t the healthiest meals for them, no matter what the research says it reduces the danger of the illness.

    Such models happen over and over once more: Some get good outcomes from the appliance of the research, some get little or no (or destructive) results, and most get results someplace in between.

    That is actuality.

    Analysis might be extremely useful once we give our start line to most individuals. But individuals are totally different – typically wild -.

    They differ from their habits, considering, physiology, setting and personal preferences. Additionally they differ in their capacity to comply with this system first. And even if they stayed completely in the plan, they could differ from one another.

    A singular human coach in entrance of you, not on common.

    This not only improves the results of your clients (since you work with their practical reality), it also improves the retention of your clients (since you take heed to yourself and attempt to perceive them as people, not as a collection of knowledge).

    When a shopper suffers, they are unlikely to have to apply for PubMed for more evidence.

    They typically want you to offer a strong, reliable teaching experience and in fact your teaching expertise. This mix might help you ease your clients' resistance, be artistic and flexible when typical solutions don't work, and be compassionate and supportive once you wrestle with dark stuff.

    2.

    In case you are an fascinating, growth-oriented coach or practitioner, it’s inconceivable to develop a specific amount of expertise and experience.

    bucket: courses and packages you've taken; the books you learn; the lectures you participated in; the mentoring relationships you have got had; and all the sensible experiences you’ve gained from monitoring or teaching shoppers or patients.

    The accumulation of data and experience provides you a sort of "intuition" that can make it easier to practice more effectively

    This "intuition" exhibits up once you see that a customer runs a foolish squat, shortly determine what is improper, and make repairs to improve type.

    It seems whenever you run on the shopper's entry and responses (Only child! Perfectionism!), You possibly can anticipate what points of the program they will struggle, and how you may help them.

    Or it appears once you do a postural analysis and you recognize instantly what workouts are prevented and which could be useful

    A lot of the time, that is the knowledge you possibly can by no means have discovered just by reading the research. It takes time to work with individuals and reveal new ideas and methods, including people who haven’t yet been studied.

    However that is also a challenge. The information we’ve gathered is very vulnerable to human error: Our reminiscences are unreliable, we see patterns that will not exist, and we scale back info that doesn’t match what we now have already believed.

    How We Can Scale back

    • First, discover that bias and error exist… yes, even for you.
    • Take notes during or after shopper periods, and use quite a lot of validated measurement instruments corresponding to weight, physique measurements, photographs, mood scales and sleep high quality monitor to watch your effectiveness.
    • Get mentoring and suggestions in your follow. Coaches need coaches. Or look for an analogous group of execs with whom you need to collaborate. (That is why we developed the precision food regimen degree 2 certification.)

    In case you are conscious of the errors you’re more likely to make and take action to curb them, chances are you’ll begin to see some dependable, widespread models. 19659002] Like very inflexible meals don’t work for individuals in the long run. Or that folks can solely practice for so lengthy and so onerous earlier than they return.

    Or hundreds of other opportunities for skilled coaching announcement, however it might not have been absolutely validated by publication.

    In case you are just beginning out and haven’t any experience in teaching many people for a few years, you’ll be able to borrow insights from mentors or other coaches with extra rips beneath their belts.

    Based on the background (or colleague's) experience, an important part of a superb career

    three. Science by no means comes out.

    Evidence is all the time evolving. Especially vitamin analysis is a relatively new area, and there’s still much to study.

    Plus, some things are actually troublesome (and even unethical) to check your analysis format, so we might not have scientific proof

    Though it’s potential to test, high quality analysis takes a long time. Often one research just isn’t sufficient to "prove" one thing true or false. However waiting for a number of studies on a specific matter or even higher, meta-analyzes (that are sort of like research research) might require numerous endurance. Perhaps for many years

    And but we nonetheless need to help our clients and patients make informed selections.

    There’s evidence-based apply.

    RIGHT approach to make use of EBP

    You’ll be able to formally apply the EBP process to coaching selections that appear notably necessary or unsure.

    EBP presents top-of-the-line instruments that will help you reach a choice that is most probably to be protected and effective, and additionally it is smart in your life.

    Comply with these 6 steps to see EBP in action. 19659003] 1.

    Define their distinctive talents and wants

    • What are their strengths?
    • The place do they need assistance from you?
    • What are their exact objectives? values ​​and beliefs?

    Acquire this info by asking questions, utilizing forms of intake, and taking measurements. It will allow you to create an initial action plan and additionally provide a starting point for evaluating progress.

    Plus, if you gather info from many purchasers, you get sensible proof that can assist in making selections

    Using a hypothetical shopper to accomplish these steps.

    His identify is Nora. His objective is to lose fats and he’s additionally considering intermittent fasting. With the preliminary assessment you will study that he has begun to point out signs of perimenopausal, and his sleep just isn’t nice lately.

    2.

    Before shifting on to the answer, find out the problem you are attempting to assist the client.

    Then turn the difficulty to a question that may aid you isolate the proof you want for your recommendations. This challenge must embrace the problem and the elements which might be relevant to the shopper or patient.

    Nora's primary objective is to lose fat and she is fascinated with intermittent fasting. Necessary Issues: Nora is a lady and she is perimenopausal.

    However you're unsure if intermittent fasting is protected (or efficient) to lose fat. And you're unsure if it's protected (or effective) for a perimenopausal lady.

    So your analysis query may be: "Is immediate fasting safe and effective for fat-killing women?"

    three. Acquire Evidence

    Search for info utilizing an Internet database similar to PubMed or Google Scholar. (In case you don't know the way to use on-line research databases, here is the PubMed tutorial.)

    Using a analysis database guides your hits to get solely unique, peer-reviewed researches (some

    A superb combination of keywords that may be typed into the search field might be " intermittent fasting + fat loss + menopause. "These keywords embrace interventions that you’re all for learning extra about, and information about Nora's distinctive objectives and life cycle. So, the more dependable the knowledge, so begin wanting up.

    In the case of Nora, priority is given to finding a spot, meta-analysis, or systematic assessment of using intermittent fasting when menopausal ladies have fat. This provides you a comprehensive overview of the present proof. In principle, onerous work has already been finished by scientists and / or researchers – by analyzing, evaluating and analyzing out there scientific proof.

    If not, look for randomized control exams comparing properly chosen groups in individuals with a control group (resembling a gaggle that did not get any intervention or a special intervention)

    No luck there? You possibly can solely increase your search to "women" as an alternative of "menopausal women". Depending on what is accessible, chances are you’ll have to proceed increasing your search and shifting the hierarchy of proof.

    Accustomed to learning or learning, it's okay. Likelihood is, should you can't find a meta-analysis or evaluate, or – better of all – drive pre-pyramid research is restricted to you

    In that case, or you possibly can't discover any scientific analysis on the topic – chances are you’ll want to use the opinions of other trusted specialists or Develop a educated speculation based mostly in your information of how physiology and vitamin work are. This is still proof, it's not just as reliable, so you possibly can rely on it.

    All granules within the station.

    In case you are not prepared to navigate and interpret scientific literature, think about the perfect

    Positioning Stands are the official statements of the governing physique on subjects reminiscent of vitamin, exercise physiology, weight-reduction plan or drugs.

    Right here's an instance: the 2017 International Sports Restaurant Affiliation

    In case you have an older buyer and have questioned easy methods to improve their coaching talents (but you don't need to be immersed in the dead of night

    If you want to find your location in your area, take a look at any authorities website where

    For instance, in case you are a private coach licensed by means of ACSM, NASM, ACE or NSCA, please consult the web site of each organization and have a unique matter

    four.

    Once you search, you’ll in all probability find a minimum of some proof, which can be just some small studies or some articles by specialists in the subject

    Now, using the hierarchy of proof, determine how valid and dependable these evidence are. or transfer down the quality hierarchy , the much less confident you’re about your recommendations.

    In Nora, if every part is discovered, there are some Internet guru articles which have by no means seen any real clients, you might need to current your findings as a mere thought, not as a reliable advice.

    However, should you find some systematic critiques of intermittent fasting in menopausal ladies, you’ll be able to go to Nora for more confidence in your recommendations. (FYI: We couldn't discover any reputable systematic critiques of intermittent fasting in menopausal ladies.)

    5. Create a suggestion.

    Most clients don't need to know all of the complicated scientific things until they ask for it. They only need to know what to do.

    Right here is the creativeness of teaching in the artwork of teaching.

    It's time to see should you can actually apply the proven evidence collectively together with your professional expertise – a posh, actual, dwelling human being in entrance of you.

    Observe that the proof does not make a decision in itself. Neither is your expertise and customer preferences.

    Three merely supply a extra holistic perspective on the issue to make sure you find one of the best answer for your customer

    . and the client's unique circumstances interprets it into sensible advice.

    It might work like this: In your research, you will see that that intermittent fasting is efficient for fat loss. Nevertheless, with your personal skilled experience, you have got observed that the majority clients are scuffling with fasting in the long term. (Adapting properly to the teaching experience, the research additionally exhibits a comparatively excessive proportion of intermittent fasting.) shed pounds, however you also know that he has just lately had sleep issues. In your expertise with other clients, sleep deprivation has the additional time to manage your urge for food and shed pounds.

    So… intermittent fasting appears to be efficient, however mixed together with your concern for Nora's hormonal health and sleep high quality. and the fact that intermittent fasting could be troublesome to take care of, you’ll be able to determine to not advocate it to Nora.

    In explaining her reasoning, examine together with her what she is making an attempt to do. In the long run, you could recommend some easy consuming habits, in addition to some brief fasting checks, and some sleep ideas.

    These suggestions embrace the most effective obtainable research, your personal coaching expertise and Nora's distinctive preferences. Objectives and Challenges

    Nora has simply acquired fairly a sensible, tailor-made advice to work as a companion to organize her motion plan.

    It is the artwork of teaching and the sector of science

    6. Monitor Outcomes

    After giving your customer a bit of time to apply what you probably did together, you possibly can consider whether or not these actions work.

    Contemplate the measurements you took in the unique estimates. Examine them to present measurements

    Are things proper?

    And speak to your customer about how the plan works.

    Nora says she has utilized and benefited from uni ideas. quick, even with shorter exams. It turns out that it is troublesome to hurry up when you’ve hassle falling asleep because of your abdomen.

    If you comply with the progress, use what you discover to seek out objectives once more and accurately where the client or patient needs more help. 19659002] Now Nora is asking you about experimenting with Paleo's weight-reduction plan. It seems to be like you have got extra research.

    But take into account that over time you will develop a strong understanding of a number of subjects. It's an excellent part of science that moves slowly: It's not that tough to stay.

    What to do next

    Be empathetic, supportive and flexible.

    It doesn’t matter what you assume is true or "true," your first activity is to work together with your shopper wherever they are.

    Many practitioners know this intuitively, however the relationship between a coach and a shopper (or affected person) is essential and influential.

    known as a "therapeutic union" and refers to the degree of belief and connection between the practitioner and the individual they’re serving to.

    The change is troublesome and typically scary. A robust therapeutic alliance may help an individual feel supportive and comprehensible in a wave of change.

    In truth, some studies present that the remedy results achieved by the shopper or the affected person are up to 85% dependent on the therapeutic alliance. The stronger the relationship, the better the outcomes.

    When you sustain together with your head, tell them: "But research says!" Or "I know best!" Robust Therapeutic Affiliation

    Most of the obstacles your clients face are behavioral and emotional, and not smart and theoretical. So more than the details, your clients typically need compassion, help and creativity to get those robust things.

    Give attention to giant stones.

    Due to the complicated bodies and behavioral modifications, it isn’t shocking that science is "trying to sort things out."

    As an alternative of utilizing "top-of-the-line" protocols comparable to intermittent fast or correct macroeconomic ratios (which ought to actually solely be more refined shoppers), concentrate on "big stones" that provide

    • eating sufficient protein and greens
    • Strikes repeatedly
    • to get enough sleep
    • to regulate stress
    • by decreasing smoking and / or excessive alcohol consumption

    If this sounds boring or too obvious, we ask you: How many individuals have you learnt who are doing all five properly? (For those who're curious, it's solely about three to 5 % of the inhabitants.)

    Solely managing these five things retains most individuals busy.

    Be humble, throw out the principles and study.

    Probably the most intelligent individuals are typically those that are probably the most pleasant questions, saying, "I don't know" and uncertainty.

    It's Klise, however true: the more you recognize something, the more you understand what you don't know.

    Watch out when others declare complete assurance. It might be that they don’t absolutely perceive the complexity of the matter.

    The actual expertise is that it feels snug with limited information – and still wanting for extra and better info – and also by accepting, we will never be completely positive.

    Attempt correctly and study from both successes and failures

    Do you need to see how principle works in follow? Check it your self and measure your experience as objectively as attainable.

    With clients, as long as there isn’t a danger of hurt, attempt well-grounded experiments (with their permission) based mostly on both research or skilled principle. Then, as all the time, comply with and measure their experiences and outcomes for the subsequent steps.

    Know what you don't know and work with different specialists as wanted.

    Particularly in case you're a newbie in apply, it's okay to not know the stuff.

    Give attention to what you realize greatest, whether it's a superb lifting type, healthy meals, or giving help during a sticky coaching session. But in addition know that some things are usually not coated by apply.

    So build a robust professional community that would embrace household docs, dietologists, massage therapists, naturopaths, chiropractors, and psychotherapists, and all the time confer with once you feel uncomfortable or notably inexperienced.

    Creating in-depth skilled lists helps clients get the help they want. And we’re positive that the evidence exhibits that it is good for everybody.

    In case you are a coach or you need to be…

    Studying to train shoppers, sufferers, associates or relations by means of healthy eating and way of life modifications – in a means that is justified and unique to every individual's way of life and preferences – is both artwork and science.

    If you need to know extra about both, think about certification of vitamin degree 1 certification. The subsequent group will start quickly.

    What is it about?

    Precision Vitamin Degree 1 certification is the world's most prestigious vitamin schooling program. It provides you the knowledge, methods and tools you actually need to know how food impacts your health and health.

    Degree 1 curriculum developed over 15 years and confirmed to be more than 100,000 clients and sufferers is solely for the humanities of vitamin and coaching.

    Whether or not you're halfway by means of or just starting, degree 1 certification is your springboard for a deeper understanding of vitamin, the facility to train it and the power to translate what you realize into outcomes [19659002] [Of course, if you’re already a student or graduate of the Level 1 Certification, check out our Level 2 Certification Master Class. It’s an exclusive, year-long mentorship designed for elite professionals looking to master the art of coaching and be part of the top 1% of health and fitness coaches in the world.]

    Are you interested? Add your identify to the preset listing. Save up to 33% and safe your home 24 hours before everybody else.

    Open factors within the subsequent Precision Vitamin Degree 1 certification on Wednesday, April 3, 2019.

    If you would like extra info we have now arrange the following pre-selection record that provides you two benefits.

    • Pay less than everybody else. We need to reward people who are keen to increase their credentials and are ready to commit to the coaching they want. So we provide a discount of up to 33% off the overall worth whenever you enroll in the pre-selection listing.
    • Register 24 hours before the viewers and improve your probabilities of getting a seat. The certification program is just opened twice a yr. As a consequence of excessive demand, the places in this system are restricted and are traditionally bought out within a couple of hours. But if you enroll for a pre-selection listing, we give you the alternative to register full 24 hours before anybody else.

    In case you are ready to deepen your vitamin, empower yourself to coach it and the power to translate what you recognize into a end result… this is your probability to see what the world's greatest professional vitamin teaching system can do for you.

    References

    Click here to view the knowledge sources talked about in this article.

    Balachandran, A. & Schoenfeld, B. (2017, March 2) Licensed Practice in Workouts and Vitamin: Widespread Misunderstandings and Criticism. Retrieved from https://www.lookgreatnaked.com/blog/evidence-bact-practice-in-exercise-and-nutrition-common-misconceptions-and-criticisms/

    Baldwin, SA, Wampold, BE and Imel Z E . (2007). Allianssi-tuloksen korrelaation purkaminen: Terapeutin ja potilaiden vaihtelun suhteellisen merkityksen selvittäminen liitossa. Journal of Consulting ja Medical Psychology, 75 (6), 842 – 852.

    Cabaniss, D. L. (2012, 31. toukokuuta) Terapeuttinen liitto: olennainen ainesosa psykoterapiaan. Haettu osoitteesta https://www.huffpost.com/entry/therapeutic-alliance_b_1554007?fbclid=IwAR1NDl7sNR60OSvNFWmpTUA-GqAV65fMtxsOrOFAQ9fLM5Z5eQlcRR4APbU three,6199002 ]Duke College. (2018). Johdatus näyttöön perustuvaan käytäntöön. Haettu osoitteesta https://guides.mclibrary.duke.edu/ebmtutorial/home [19659002]Erskine, RM, Jones, DA, Williams, AG, Stewart, CE & Degens, H. (2010) Mukautuksen yksilöllinen vaihtelu ihmisen lihasten erityinen jännitys progressiiviseen vastustuskoulutukseen. European Journal of Utilized Physiology, 110 (6), 1117 – 25.

    Todisteisiin perustuva lääketieteen työryhmä. (1992) Evidence-Based Drugs: A New Strategy to Educating the Practice of Drugs. Journal of the American Medical Affiliation, 268(17), 2420-5.

    Frances, A.J. (2013, June 24) What Ought to Docs Do When They Don’t Know What to Do? Retrieved from https://www.psychologytoday.com/us/blog/saving-normal/201306/what-should-doctors-do-when-they-dont-know-what-do?fbclid=IwAR3ce99uT-RDXcp_yvnJ0r2aTfBPWPpngqNUvkIc5a6PBZkyr5d-Z8sgy2Y

    Joyce, A.S. & Piper, W.E. (1998) Expectancy, the Therapeutic Alliance, and Remedy Consequence in Brief-Term Particular person Psychotherapy. The Journal of Psychotherapy Practice and Research, 7(three), 236–248.

    Löfgren, Okay. [Kent Löfgren]. (2013, February 25). What is epistemology? Introduction to the word and the concept [Video File]. Retrieved from https://www.youtube.com/watch?v=lI9-YgSzsEQ

    Ludwig, J. (2018, April 16) Here’s what is going mistaken with ‘evidence-based’ insurance policies and practices in faculties in Australia. Retrieved from https://www.aare.edu.au/blog/?p=2822

    Schoenfeld, B.J., Contreras, B, Krieger, J., Grgic, J., Delcastillo, Okay., Belliard, R. & Alto, A. (2019) Resistance Coaching Volume Enhances Muscle Hypertrophy but Not Power in Educated Men. Drugs & Science in Sports & Exercise, 51(1), 94-103.

    Wampold, B. E. (2001). The good psychotherapy debate:Models, methods, and findings. Mahwah, NJ: Lawrence Erlbaum. NJ: Lawrence Erlbaum.

    Evidence-Based Drugs Toolbox. (2017) Retrieved from https://ebm-tools.knowledgetranslation.net/

    Evidence-based apply. (2018, November 19) Retrieved from https://en.wikipedia.org/wiki/Evidence-based_practice?fbclid=IwAR3ARk06zmx_lJYPIrTGA_chfBa9v_-NsW7HQbC7-rTHaq-Y7AYcSdLAk80

    The well-built medical query: a key to evidence-based selections. (1995). Retrieved from https://mclibrary.duke.edu/sites/mclibrary.duke.edu/files/public/guides/richardson.pdf

!perform(f,b,e,v,n,t,s)if(f.fbq)return;n=f.fbq=perform()n.callMethod?
n.callMethod.apply (n, arguments): n.queue.push (arguments) if (! f._fbq) f._fbq = n;
n.push=n;n.loaded=!0;n.model='2.zero';n.queue=[];t=b.createElement(e);t.async=!zero;
t.src=v;s=b.getElementsByTagName(e)[0];s.parentNode.insertBefore(t,s)(window,
doc, & # 39; script & # 39 ;, & # 39; https: //join.fb.internet/en_US/fbevents.js');

// set _fbq to repair any dependencies downstream
// var _fbq = f.fbq; // this breaks the pixel code

fbq ('init', '399328443574513');
fbq ("track", "PageView");