Outline

Overview

The unit will develop and understanding of the scope of practice, knowledge, clinical decision making and practical skills for the assessment, design and delivery of evidence-based exercise interventions for target conditions in the cardiovascular and metabolic AEP pathology domains. Clinical scenarios will be used to develop understanding of the pathological and pathophysiological bases for disease, diagnostic procedures, medical and allied health interventions, including surgery and medications. This will require the student to integrate prior knowledge, skills and experiences with new learning in the context of cardiometabolic disease management. Emphasis will be placed on the evaluation of the evidence based for exercise prescription, the fundamental determinants of behaviour change, and how to identify and respond appropriately to contraindications to exercise, or changes in clinical status. By the end of the unit, students will have developed the capacity for appropriate assessment, monitoring, prescription and implementation of exercise for cardiometabolic disease clientele, to ultimately design and deliver safe and effective physical activity management plans that are individualised and evidence-based

Unit details and rules

Academic unit	Movement Sciences
Credit points	6
Prerequisites ?	EXSS3070
Corequisites ?	None
Prohibitions ?	None
Assumed knowledge ?	None
Available to study abroad and exchange students	No

Teaching staff

Coordinator	Yorgi Mavrou, yorgi.mavros@sydney.edu.au
Lecturer(s)	Timothy English, tim.english@sydney.edu.au
	Maria Fiatarone Singh, maria.fiataronesingh@sydney.edu.au
	Yorgi Mavrou, yorgi.mavros@sydney.edu.au
Tutor(s)	Angelo Sabag, angelo.sabag@sydney.edu.au
Tutor(s)	Chloe Trevor, chloe.trevor@sydney.edu.au

Type	Description	Weight	Due	Length
Supervised exam ?	Final exam Final examination	35%	Formal exam period	2 hours
Outcomes assessed:
Small test	ECG Exam ECG exam on the identification of heart rate, rhythm and abnormalities	20%	Week 06 Due date: 04 Sep 2023 at 12:00	90 minutes
Outcomes assessed:
Assignment	Case report: Obesity and metabolic syndrome Synthesise information into SOAP notes, client assessment and report	15%	Week 10 Due date: 13 Oct 2023 at 23:59	5 pages
Outcomes assessed:
Assignment	Case report: Cardiovascular Disease Synthesise information into SOAP notes, client assessment and report	25%	Week 13 Due date: 30 Oct 2023 at 23:59	5 pages
Outcomes assessed:
Skills-based evaluation	ECG placement and clinical skills 12-lead ECG and point of care testing	5%	Week 13	20 minutes
Outcomes assessed:
= group assignment ?

Assessment summary

1. ECG Exam - ECG exam on identification of heart rate, rhythm and abnormalities including but not limited to arrhythmias, ischaemic signs and acute myocardial infarction. Students will be required to make clinical decisions about appropriate exercise intensity and safety to commence/continue exercise.

2. Case report: Obesity and metabolic syndrome - Students will be provided a case scenario with relevant medical information, including subjective history and objective assessments. Students will be required to synthesise information into SOAP notes, make an assessment and write an initial report back to the GP on current status. Students to write a report and management plan.

3. Case report: Cardiovascular Disease - Students will be provided a case scenario with relevant medical information, including subjective history and objective assessments. Students will be required to synthesise information into SOAP notes, make an assessment and write an initial report back to the GP on current status. Students to write a report and management plan.

4. OSCE: ECG placement - Practical assessment of 12-lead ECG placement (the client is a peer)

Students must show clinical competency in this assessment. For students who do not show competency on the first attempt, a remediation session will be held.

5. End-Semester Exam – Written exam that will cover the theory from the whole semester, including all cognitive learning outcomes. Students must achieve 45% in the exam to pass the unit

All assessments must be attempted in order to pass the unit of study

Assessment criteria

Result name	Mark range	Description
High distinction	85 - 100	Awarded when you demonstrate the learning outcomes for the unit at an exceptional standard, as defined by grade descriptors or exemplars outlined by your faculty or school.
Distinction	75 - 84	Awarded when you demonstrate the learning outcomes for the unit at a very high standard, as defined by grade descriptors or exemplars outlined by your faculty or school.
Credit	65 - 74	Awarded when you demonstrate the learning outcomes for the unit at a good standard, as defined by grade descriptors or exemplars outlined by your faculty or school.
Pass	50 - 64	Awarded when you demonstrate the learning outcomes for the unit at an acceptable standard, as defined by grade descriptors or exemplars outlined by your faculty or school.
Fail	0 - 49	When you don’t meet the learning outcomes of the unit to a satisfactory standard.

For more information see guide to grades.

Late submission

In accordance with University policy, these penalties apply when written work is submitted after 11:59pm on the due date:

Deduction of 5% of the maximum mark for each calendar day after the due date.
After ten calendar days late, a mark of zero will be awarded.

Academic integrity

The Current Student website provides information on academic integrity and the resources available to all students. The University expects students and staff to act ethically and honestly and will treat all allegations of academic integrity breaches seriously.

We use similarity detection software to detect potential instances of plagiarism or other forms of academic integrity breach. If such matches indicate evidence of plagiarism or other forms of academic integrity breaches, your teacher is required to report your work for further investigation.

Use of generative artificial intelligence (AI) and automated writing tools

You may only use generative AI and automated writing tools in assessment tasks if you are permitted to by your unit coordinator. If you do use these tools, you must acknowledge this in your work, either in a footnote or an acknowledgement section. The assessment instructions or unit outline will give guidance of the types of tools that are permitted and how the tools should be used.

Your final submitted work must be your own, original work. You must acknowledge any use of generative AI tools that have been used in the assessment, and any material that forms part of your submission must be appropriately referenced. For guidance on how to acknowledge the use of AI, please refer to the AI in Education Canvas site.

The unapproved use of these tools or unacknowledged use will be considered a breach of the Academic Integrity Policy and penalties may apply.

Studiosity is permitted unless otherwise indicated by the unit coordinator. The use of this service must be acknowledged in your submission as detailed on the Learning Hub’s Canvas page.

Outside assessment tasks, generative AI tools may be used to support your learning. The AI in Education Canvas site contains a number of productive ways that students are using AI to improve their learning.

Learning support

Simple extensions

If you encounter a problem submitting your work on time, you may be able to apply for an extension of five calendar days through a simple extension.  The application process will be different depending on the type of assessment and extensions cannot be granted for some assessment types like exams.

Special consideration

If exceptional circumstances mean you can’t complete an assessment, you need consideration for a longer period of time, or if you have essential commitments which impact your performance in an assessment, you may be eligible for special consideration or special arrangements.

Special consideration applications will not be affected by a simple extension application.

Using AI responsibly

Co-created with students, AI in Education includes lots of helpful examples of how students use generative AI tools to support their learning. It explains how generative AI works, the different tools available and how to use them responsibly and productively.

Weekly schedule

WK	Topic	Learning activity
Week 01	Pre-exercise assessment for Cardioetabolic Dsease	Lecture (2 hr)
Week 01	Pre-exercise assessment and goal setting in cardiometabolic disease	Tutorial (2 hr)
Week 02	Clinical Exercise Testing and Electrocardiography	Lecture (2 hr)
Week 02	ECG practical	Practical (2 hr)
Week 03	Evidence-based practice	Lecture (2 hr)
Week 03	ECG Tutorial I	Tutorial (2 hr)
Week 04	Person-centred care	Lecture (2 hr)
Week 04	ECG Tutorial II	Tutorial (2 hr)
Week 05	Exercise programming in overweight and obesity	Lecture (2 hr)
Week 05	Evidence-based practice	Tutorial (2 hr)
Week 07	Exercise in metabolic syndrome and polycystic ovarian syndrome	Lecture (2 hr)
Week 07	Exercise in overweight/obesity, metabolic syndrome and polycystic ovarian syndrome	Tutorial (2 hr)
Week 08	Exercise in type II and gestational diabetes	Lecture (2 hr)
Week 08	Exercise in diabetes	Tutorial (2 hr)
Week 09	Exercise in CVD I: Exercise in ischaemic heart disease and following an acute MI	Lecture (2 hr)
Week 09	Exercise in diabetes	Practical (2 hr)
Week 10	Background to CHF, valvular heart disease and in arrhythmias	Lecture (2 hr)
Week 10	Case studies of CVD	Tutorial (2 hr)
Week 11	Exercise in CVD II: Exercise in CHF, valvular heart disease and in arrhythmias	Lecture (2 hr)
Week 11	Exercise in CHF and valvular heart disease	Practical (2 hr)
Week 12	Peripheral Arterial Disease	Lecture (2 hr)
Week 12	Peripheral Arterial Disease	Practical (2 hr)
Week 13	Obstructive Sleep Apnoea	Lecture (2 hr)
Week 13	ECG revision and assessment	Practical (2 hr)

Attendance and class requirements

Lectures: Lectures will be live on campus unless otherwise directed. All lectures will be recorded and made available on canvas.

Tutorials and practicals: These are interactive activities that are live on campus.

Attendance: Students are encouraged to attend all learning activities to optimise their engagement and learning experience. Attendance at practical classes is not mandatory but strongly encouraged so students can gain mastery over their skills in preparation for their OSCE examination, which is compulsory.

Study commitment

Typically, there is a minimum expectation of 1.5-2 hours of student effort per week per credit point for units of study offered over a full semester. For a 6 credit point unit, this equates to roughly 120-150 hours of student effort in total.

Learning outcomes

Learning outcomes are what students know, understand and are able to do on completion of a unit of study. They are aligned with the University's graduate qualities and are assessed as part of the curriculum.

At the completion of this unit, you should be able to:

LO1. Understand the pathological and pathophysiological bases for cardiometabolic disease to identify relative and absolute contraindications for exercise, and assess and identify barriers to exercise and physical activity
LO2. Understand management of cardiometabolic disease including; diagnostic procedures (e.g. biochemistry, imaging procedures, 12-lead ECG); therapeutic interventions (e.g. medications, surgery, allied health interventions); exercise testing and prescription, including the scope of practice, core principles of case management, and professional conduct of the AEP in cardiometabolic disease
LO3. Apply existing knowledge of exercise testing and prescription to safely design exercise management plans for cardiometabolic disease, including; safe and appropriate screening and assessment tools (including point of care testing) in order to risk stratify and assess clinical status before, during and after exercise in complex cases with multiple chronic diseases; setting appropriate goals that are SMART; design safe and effective evidence-based exercise and physical activity interventions with appropriate selection of mode, intensity and frequency in cardiometabolic disease using available scientific evidence and guidelines that consider client treatment goals and relevant medical history.
LO4. Show adaptability to changes in clinical status (acute and chronic) such as adverse events (including first aid and emergency responses), co-morbidities, or changes in functional capacity in complex cases with multiple chronic diseases
LO5. Be able to set up a client with a 12-lead ECG (at rest and for an exercise stress test), and be able to identify and describe and appropriately respond to common and aberrant changes in ECG waveforms that are indicative of: changes in heart rate, arrhythmias (benign and malignant), ischaemia/infarction, electrolyte imbalances, digitalis toxicity, conduction blocks etc.

Graduate qualities

The graduate qualities are the qualities and skills that all University of Sydney graduates must demonstrate on successful completion of an award course. As a future Sydney graduate, the set of qualities have been designed to equip you for the contemporary world.

GQ1	Depth of disciplinary expertise Deep disciplinary expertise is the ability to integrate and rigorously apply knowledge, understanding and skills of a recognised discipline defined by scholarly activity, as well as familiarity with evolving practice of the discipline.
GQ2	Critical thinking and problem solving Critical thinking and problem solving are the questioning of ideas, evidence and assumptions in order to propose and evaluate hypotheses or alternative arguments before formulating a conclusion or a solution to an identified problem.
GQ3	Oral and written communication Effective communication, in both oral and written form, is the clear exchange of meaning in a manner that is appropriate to audience and context.
GQ4	Information and digital literacy Information and digital literacy is the ability to locate, interpret, evaluate, manage, adapt, integrate, create and convey information using appropriate resources, tools and strategies.
GQ5	Inventiveness Generating novel ideas and solutions.
GQ6	Cultural competence Cultural Competence is the ability to actively, ethically, respectfully, and successfully engage across and between cultures. In the Australian context, this includes and celebrates Aboriginal and Torres Strait Islander cultures, knowledge systems, and a mature understanding of contemporary issues.
GQ7	Interdisciplinary effectiveness Interdisciplinary effectiveness is the integration and synthesis of multiple viewpoints and practices, working effectively across disciplinary boundaries.
GQ8	Integrated professional, ethical, and personal identity An integrated professional, ethical and personal identity is understanding the interaction between one’s personal and professional selves in an ethical context.
GQ9	Influence Engaging others in a process, idea or vision.

Outcome map

Learning outcomes	Graduate qualities
Learning outcomes

Alignment with Competency standards

Outcomes	Competency standards
	Accredited Exercise Physiologist Professional Standards (2023) - 2.2.1. Integrate knowledge of anatomy, physiology, pathophysiology, and other determinants of health and function and apply these to inform safe and effective movement, physical activity, and exercise-based interventions for individuals and population groups throughout all stages of their life.
	Accredited Exercise Physiologist Professional Standards (2023) - 1.2.1. Practise with integrity within the scope of practice for an AEP, the ESSA Code of Professional Conduct and Ethical Practice, and jurisdictional Codes of Conduct. 1.2.2. Practise in accordance with ethically relevant legislation, regulations, and standards that apply to AEPs including privacy, confidentiality, data security, informed consent, and record-keeping. 1.2.3. Differentiate and select verbal and non-verbal communication strategies that are contextually appropriate, timely, accessible, and respectful to clients, population groups, and relevant others. 1.2.4. Develop effective, concise, respectful, and informative clinical documentation, including case notes and reports, and apply appropriate record keeping practices. 1.2.5. Practise in a culturally safe, inclusive, sensitive, respectful, and responsive way and according to person-centred care principles. 1.2.6. Practise collaboratively and effectively with other professionals, including seeking feedback and input to inform decision-making, delegating tasks, and referring to other professionals and services where appropriate. 1.2.8. Demonstrate leadership and the ability to advocate for client access to AEP services and appropriate health care. 2.2.4. Evaluate the effect of commonly prescribed medications, diagnostic procedures, medical, surgical, and other interventions on both resting and exercise-related physiological responses across the full health spectrum. 2.2.7. Explain national, state, and compensable scheme frameworks across the health care, aged care, and disability sectors, and the requirements for AEPs working in these settings. 3.2.7. Distinguish when client needs are outside of scope or competence and take appropriate, timely actions including engaging effectively with other professionals.
	Accredited Exercise Physiologist Professional Standards (2023) - 1.2.3. Differentiate and select verbal and non-verbal communication strategies that are contextually appropriate, timely, accessible, and respectful to clients, population groups, and relevant others. 1.2.4. Develop effective, concise, respectful, and informative clinical documentation, including case notes and reports, and apply appropriate record keeping practices. 2.2.2. Examine principles of biopsychosocial care, value-based care, person-centred care and social and cultural determinants of health and apply this to promote health and well-being for individual clients and population groups. 2.2.3. Evaluate physiological responses and adaptations to acute and chronic exercise for clients across the full health spectrum. 2.2.5. Evaluate research findings and apply exercise prescription principles to develop recommendations and interventions, including targeted exercise prescription for the purposes of optimising health status, function, recovery, independence, and participation. 2.2.6. Apply clinical, ethical, and evidence-based decision-making to formulate appropriate interventions and recommendations and communicate the expected outcomes. 2.2.8. Evaluate and apply contextual learning principles and behaviour change strategies to improve health outcomes, increase engagement, motivation, and adherence, and empower self-management of health conditions. 3.2.1. Formulate appropriate screening processes to evaluate and stratify risk for participation in assessments and interventions, including consideration of appropriate service modalities for clients. 3.2.2. Formulate safe, effective, and culturally sensitive assessments to collect relevant information, social and cultural determinants of health, client history, and client needs, preferences, barriers, facilitators, and goals. 3.2.3. Formulate appropriate assessments and outcome measures relevant to treatment and client goals, and evaluate health status, function, capacity, and progress, to inform clinical reasoning and to monitor the delivery and outcomes of interventions. 3.2.5. Evaluate and record assessment outcomes in a timely and accurate manner to inform practice and communicate outcomes and relevance to goals effectively to clients and relevant others. 3.2.8. Choose and use relevant technology and equipment efficiently, effectively, and safely. 4.2.1. Formulate evidence-based exercise prescription, interventions, and recommendations that address health and treatment related client needs, preferences, goals, and abilities, assessment findings, and social and cultural determinants of health. 4.2.2. Design, prescribe, deliver, and monitor safe and effective movement, physical activity, and exercise-based interventions for clients with complex presentations, including those with acute and chronic health conditions and multiple comorbidities. 4.2.3. Formulate and apply strategies to manage risks, evaluate progress, and adapt recommendations and interventions in partnership with clients based on needs and measured outcomes. 4.2.8. Evaluate effectiveness of interventions and their outcomes including the selection, interpretation, and reporting of outcome measures to inform future practice.
	Accredited Exercise Physiologist Professional Standards (2023) - 1.2.4. Develop effective, concise, respectful, and informative clinical documentation, including case notes and reports, and apply appropriate record keeping practices. 1.2.6. Practise collaboratively and effectively with other professionals, including seeking feedback and input to inform decision-making, delegating tasks, and referring to other professionals and services where appropriate. 3.2.4. Distinguish, record, report, and appropriately action changing risk factors and adverse signs and symptoms that may arise before, during, and after assessments and interventions. 4.2.3. Formulate and apply strategies to manage risks, evaluate progress, and adapt recommendations and interventions in partnership with clients based on needs and measured outcomes.
	Accredited Exercise Physiologist Professional Standards (2023) - 1.2.1. Practise with integrity within the scope of practice for an AEP, the ESSA Code of Professional Conduct and Ethical Practice, and jurisdictional Codes of Conduct. 1.2.2. Practise in accordance with ethically relevant legislation, regulations, and standards that apply to AEPs including privacy, confidentiality, data security, informed consent, and record-keeping. 1.2.3. Differentiate and select verbal and non-verbal communication strategies that are contextually appropriate, timely, accessible, and respectful to clients, population groups, and relevant others. 1.2.5. Practise in a culturally safe, inclusive, sensitive, respectful, and responsive way and according to person-centred care principles. 2.2.3. Evaluate physiological responses and adaptations to acute and chronic exercise for clients across the full health spectrum. 3.2.1. Formulate appropriate screening processes to evaluate and stratify risk for participation in assessments and interventions, including consideration of appropriate service modalities for clients. 3.2.3. Formulate appropriate assessments and outcome measures relevant to treatment and client goals, and evaluate health status, function, capacity, and progress, to inform clinical reasoning and to monitor the delivery and outcomes of interventions. 3.2.4. Distinguish, record, report, and appropriately action changing risk factors and adverse signs and symptoms that may arise before, during, and after assessments and interventions. 3.2.7. Distinguish when client needs are outside of scope or competence and take appropriate, timely actions including engaging effectively with other professionals. 3.2.8. Choose and use relevant technology and equipment efficiently, effectively, and safely.

Accredited Exercise Physiologist Professional Standards (2023) -

Competency code	Taught, Practiced or Assessed	Competency standard
1.2.1		Practise with integrity within the scope of practice for an AEP, the ESSA Code of Professional Conduct and Ethical Practice, and jurisdictional Codes of Conduct.
1.2.2		Practise in accordance with ethically relevant legislation, regulations, and standards that apply to AEPs including privacy, confidentiality, data security, informed consent, and record-keeping.
1.2.3		Differentiate and select verbal and non-verbal communication strategies that are contextually appropriate, timely, accessible, and respectful to clients, population groups, and relevant others.
1.2.4		Develop effective, concise, respectful, and informative clinical documentation, including case notes and reports, and apply appropriate record keeping practices.
1.2.5		Practise in a culturally safe, inclusive, sensitive, respectful, and responsive way and according to person-centred care principles.
1.2.6		Practise collaboratively and effectively with other professionals, including seeking feedback and input to inform decision-making, delegating tasks, and referring to other professionals and services where appropriate.
1.2.8		Demonstrate leadership and the ability to advocate for client access to AEP services and appropriate health care.
2.2.1		Integrate knowledge of anatomy, physiology, pathophysiology, and other determinants of health and function and apply these to inform safe and effective movement, physical activity, and exercise-based interventions for individuals and population groups throughout all stages of their life.
2.2.2		Examine principles of biopsychosocial care, value-based care, person-centred care and social and cultural determinants of health and apply this to promote health and well-being for individual clients and population groups.
2.2.3		Evaluate physiological responses and adaptations to acute and chronic exercise for clients across the full health spectrum.
2.2.4		Evaluate the effect of commonly prescribed medications, diagnostic procedures, medical, surgical, and other interventions on both resting and exercise-related physiological responses across the full health spectrum.
2.2.5		Evaluate research findings and apply exercise prescription principles to develop recommendations and interventions, including targeted exercise prescription for the purposes of optimising health status, function, recovery, independence, and participation.
2.2.6		Apply clinical, ethical, and evidence-based decision-making to formulate appropriate interventions and recommendations and communicate the expected outcomes.
2.2.7		Explain national, state, and compensable scheme frameworks across the health care, aged care, and disability sectors, and the requirements for AEPs working in these settings.
2.2.8		Evaluate and apply contextual learning principles and behaviour change strategies to improve health outcomes, increase engagement, motivation, and adherence, and empower self-management of health conditions.
3.2.1		Formulate appropriate screening processes to evaluate and stratify risk for participation in assessments and interventions, including consideration of appropriate service modalities for clients.
3.2.2		Formulate safe, effective, and culturally sensitive assessments to collect relevant information, social and cultural determinants of health, client history, and client needs, preferences, barriers, facilitators, and goals.
3.2.3		Formulate appropriate assessments and outcome measures relevant to treatment and client goals, and evaluate health status, function, capacity, and progress, to inform clinical reasoning and to monitor the delivery and outcomes of interventions.
3.2.4		Distinguish, record, report, and appropriately action changing risk factors and adverse signs and symptoms that may arise before, during, and after assessments and interventions.
3.2.5		Evaluate and record assessment outcomes in a timely and accurate manner to inform practice and communicate outcomes and relevance to goals effectively to clients and relevant others.
3.2.7		Distinguish when client needs are outside of scope or competence and take appropriate, timely actions including engaging effectively with other professionals.
3.2.8		Choose and use relevant technology and equipment efficiently, effectively, and safely.
4.2.1		Formulate evidence-based exercise prescription, interventions, and recommendations that address health and treatment related client needs, preferences, goals, and abilities, assessment findings, and social and cultural determinants of health.
4.2.2		Design, prescribe, deliver, and monitor safe and effective movement, physical activity, and exercise-based interventions for clients with complex presentations, including those with acute and chronic health conditions and multiple comorbidities.
4.2.3		Formulate and apply strategies to manage risks, evaluate progress, and adapt recommendations and interventions in partnership with clients based on needs and measured outcomes.
4.2.8		Evaluate effectiveness of interventions and their outcomes including the selection, interpretation, and reporting of outcome measures to inform future practice.

Responding to student feedback

This section outlines changes made to this unit following staff and student reviews.

In response to student feedback from last year , the following changes have been made: - Changes to assessment weighting of the case reports, to reward students for incorporating feedback from Case report 1 into Case report 2 - Content delivered across the unit will better align with EXSS3070

Additional information

Work, health and safety

Students should follow COVID-19 directions from staff or the University for on-campus attendance.

Disclaimer

The University reserves the right to amend units of study or no longer offer certain units, including where there are low enrolment numbers.

To help you understand common terms that we use at the University, we offer an online glossary.

Current students

Overview

Overview

Unit details and rules

Teaching staff

Assessment

Assessment

Assessment summary

Assessment criteria

Late submission

Academic integrity

Learning support

Learning support

Simple extensions

Special consideration

Using AI responsibly

Weekly schedule

Weekly schedule

Attendance and class requirements

Study commitment

Learning outcomes

Learning outcomes

Graduate qualities

Outcome map

Alignment with Competency standards

Responding to student feedback

Responding to student feedback

Additional information

Additional information

Work, health and safety

Disclaimer

On this page

Useful links

Media

Student links

About us

Connect

Current students

EXSS3075: Exercise Physiology in Clinical Cases 1

Semester 2, 2023 [Normal day] - Camperdown/Darlington, Sydney

Overview

Overview

Unit details and rules

Teaching staff

Assessment

Assessment

Assessment summary

Assessment criteria

Late submission

Academic integrity

Learning support

Learning support

Simple extensions

Special consideration

Using AI responsibly

Weekly schedule

Weekly schedule

Attendance and class requirements

Study commitment

Learning outcomes

Learning outcomes

Graduate qualities

Outcome map

Alignment with Competency standards

Responding to student feedback

Responding to student feedback

Additional information

Additional information

Work, health and safety

Disclaimer

On this page

Useful links

Media

Student links

About us

Connect