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- •Acknowledgements
- •Foreword
- •Contents
- •Preface
- •Recognition of the Sick Patient
- •Shock and Organ Perfusion
- •Outcomes of Resuscitation
- •Investigations
- •Fluid and Electrolyte Replacement
- •Haematological Therapy
- •Coagulopathy
- •Antibiotics
- •Emergency Laparoscopic Surgery
- •Approach to Traumatic Abdominal Pain
- •Ancillary Investigations in the ED
- •Indications for Referral
- •References
- •Risk Factors for Surgery
- •Postoperative Care
- •Intensive Care/High Dependency
- •Sepsis Syndromes
- •Acute respiratory distress syndrome(ARDS)
- •Blood transfusion and blood component therapy
- •Postoperative Oliguria
- •Renal Replacement Therapy (RRT)
- •Abdominal compartment syndrome (ACS)
- •Nutrition
- •Pros and cons of TPN
- •Introduction
- •Initial Management
- •Rockall score
- •Glasgow–Blatchford score
- •Medical Therapy
- •Endoscopic Therapy
- •Timing of endoscopy
- •Epinephrine injection
- •Thermal therapy
- •Argon plasma coagulation
- •Endoscopic clipping
- •Failure of endoscopic therapy
- •References
- •Introduction
- •Management of Variceal Bleeding
- •Medical Management and Resuscitation
- •Endoscopic Management
- •Variceal band ligation
- •Cyanoacrylate glue
- •Endoscopic sclerotherapy
- •Subsequent endoscopy
- •Portosystemic shunts: TIPS and surgery
- •References
- •Introduction
- •Management Options
- •Catheter Angiography
- •CT Angiography
- •Embolic Agents
- •Complications of Angiography
- •Indirect Bleeding
- •References
- •I. Indications
- •II. Preoperative Preparation
- •B. Over-Sewing a Bleeding Ulcer
- •Pyloroplasty/gastroenterostomy
- •Truncal vagotomy
- •Ensure safe duodenal stump closure
- •Dealing with problems related to the posterior duodenal ulcer penetratinginto the pancreas
- •Mobilisation of distal stomach
- •Billroth II gastroenteral anastomosis
- •Surgical Techniques for BleedingGastric Ulcer
- •F. Local Excision of Gastric Ulcer
- •Key Points in Billroth I Gastrectomyfor Bleeding Gastric Ulcer
- •Incisional wound closure
- •Postoperative care
- •References
- •Indications
- •Preoperative Preparation
- •Operative Treatment
- •A. Benign Duodenal Ulcer Perforation
- •B. Benign Gastric Ulcer Perforations
- •References
- •2. Preoperative Preparation
- •3. Surgery
- •Open Appendectomy
- •Introduction
- •General Complications
- •Thromboembolism
- •Atelectasis
- •Nausea and Vomiting
- •Wound Complications
- •Acute Abdominal Complications
- •1. Bleeding
- •2. Leaks
- •Treatment options for GJ leak
- •Managing sleeve leak
- •3. Stenosis and Stricture
- •4. Gastric Band Slippage and IntestinalObstruction
- •5. Other Complications
- •Gastric banding
- •Gastric bypass
- •Nutritional problems
- •1. Indications
- •Operative Strategy of Acute Appendicitis
- •Laparoscopic Appendectomy
- •4. Postoperative care
- •Special Situations
- •Introduction
- •Management of Acute Sigmoid Colonic Diverticulitis
- •A. Preoperative Management
- •B. Indications for Surgery
- •C. Options of Surgical Procedure
- •Two-stage approach
- •Single-stage approach
- •Role of laparoscopic surgery in acute perforative sigmoid colonic diverticulitis
- •E. Position of Patient for Surgery
- •Intra-Operative Surgical Techniques
- •A. Incision and Laparotomy
- •Tips and tricks to help locate the ‘difficult’ left ureter
- •Common sites of left ureteric injury during anterior resection
- •D. Splenic Flexure Take Down
- •Tips and tricks to tackle difficultsplenic flexure
- •E. Vascular Control
- •Ligation of the inferior mesenteric artery (IMA)
- •How to identify the IMA?
- •On-table colonic lavage
- •When is it not safe to anastomose?
- •J. Completion of Surgery
- •K. Postoperation Care
- •References
- •Introduction
- •I. Preoperative Management
- •II. Management Options
- •III. Endoscopic Colonic Stenting
- •Indications
- •IV. Defunctioning Stoma
- •Indications
- •Postoperative Considerations
- •References
- •Definition
- •Risk Factors for DifficultLaparoscopic Cholecystectomyin Acute Cholecystitis
- •Preoperative preparation
- •Surgical Treatment
- •Laparoscopic approach
- •References
- •Pre- ERCP Preparation
- •ERCP for Choledocholithiasis
- •ERCP in Bile Duct Injuries
- •Difficult Biliary Cannulation
- •Post- ERCP Care
- •References
- •A) Acute Cholangitis
- •C) Bile Duct Injuries During Surgery
- •D) Pancreatic Trauma
- •E) ERCP Perforation
- •I. Introduction
- •IV. Postoperative Management
- •Special situations
- •Final Note
- •Introduction
- •Disadvantages of Radiological Drainage
- •Radiological Evaluation of the Abscess
- •1) Diagnosis of Abscess
- •2) Identify a Potential Cause for an Abscess
- •3) Determine Drainability of an Abscess
- •4) Identifying the Complications from an Abscess
- •5) Aid Drainage Planning
- •Role of RadiologicalIntervention
- •Contraindications
- •Technique
- •Imaging Guidance
- •Insertion of the Drain
- •Drainage Catheter
- •Site Specific Comments on Radiological Drainage of Intra-Abdominal Abscess
- •Liver Abscess
- •Subphrenic and Lesser Sac Abscess
- •Percutaneous Cholecystostomy
- •Pancreatic Collection/Abscess
- •Pelvic Abscess
- •Enteric Abscess
- •Others
- •Conclusion
- •References
- •I. Ectopic Pregnancy
- •Operative procedures
- •II. Ruptured Tubo-Ovarian Abscess
- •Preoperative
- •Operative procedures
- •Postoperative
- •III. Haemorrhage or LeakingOvarian Cyst and Adnexal Torsion
- •A. Adnexal torsion
- •Preoperative — Benign Ovarian Cyst
- •Laparoscopic intervention
- •2. Laparoscopic ovarian oophorectomy
- •3. Open Cystectomy
- •Introduction
- •Repair of Bladder Injuries
- •Boari Flap
- •Other Manoeuvres
- •Post-Operative Care
- •Conclusion
- •II. Perioperative Care
- •IV. Mycotic Aneurysms
- •VI. Post-Surgery Follow-up
- •I. Introduction and Indications
- •II. Preoperative Management
- •III. OT Preparation
- •IV. Operative Procedure
- •Damage Control Mode
- •Splenic Injuries
- •Bowel Injuries
- •Kidney Injuries
- •Pancreatic Injuries
- •Liver Injuries
- •VI. Postoperative Care
- •V. Wound Closure
- •Introduction
- •Preoperative Planning
- •Choice of Surgical Technique
- •Operative Procedure
- •1. Component Separation Technique
- •3. Bilateral Skin Flap Advancement
- •5. Use of Alloplastic Materials
- •Postoperative Management
- •References
- •Laparotomy
- •Laparoscopy
- •Interventional Radiology
- •Air Enema
- •Neonatal Intestinal Obstruction
- •Duodenal Atresia
- •Duodenoduodenostomy
- •Malrotation with Volvulus
- •Intestinal Atresia
- •Hirschsprung’s Disease (HD)
- •Anorectal Malformations
- •Inguinal Hernia in Children
- •References
- •Introduction
- •Benefits of Laparoscopy in Emergency
- •Indications of Emergency Laparoscopy
- •Instrumentation
- •Instruments for Removal of Specimen
- •Instruments for Port Closure
- •Patient Position and O.T. Setup
- •Suggested Reading
- •Index
- •Uploaded by [StormRG]
- •Contents

based on income and always been some psychopathic, corrupt, and
big-I-am police officers. This was different. Wholesale change was
unfolding in the collective dynamic; it was less about money and far
more about position and perceived power. An us-and-them was
emerging. Noses were lied skyward by government administration
and law enforcement and their aitude to the public they were
supposed to be serving changed to one of increasing contempt,
superiority and control. The transformation was so clear and
widespread that it had to be planned. Collective aitudes and
dynamics do not change naturally and organically that quickly on
that scale. I then came across an organisation in Britain called
Common Purpose created in the late 1980s by Julia Middleton who
would work in the office of Deputy Prime Minister John Presco
during the long and disastrous premiership of war criminal Tony
Blair. When Blair speaks the Cult is speaking and the man should
have been in jail a long time ago. Common Purpose proclaims itself
to be one of the biggest ‘leadership development’ organisations in
the world while functioning as a charity with all the financial benefits
which come from that. It hosts ‘leadership development’ courses and
programmes all over the world and claims to have ‘brought
together’ what it calls ‘leaders’ from more than 100 countries on six
continents. The modus operandi of Common Purpose can be
compared with the work of the UK government’s reframing network
that includes the Behavioural Insights Team ‘nudge unit’ and
‘Covid’ reframing specialists at SPI-B. WikiLeaks described
Common Purpose long ago as ‘a hidden virus in our government
and schools’ which is unknown to the general public: ‘It recruits and
trains “leaders” to be loyal to the directives of Common Purpose and
the EU, instead of to their own departments, which they then
undermine or subvert, the NHS [National Health Service] being an
example.’ This is a vital point to understand the ‘Covid’ hoax. The
NHS, and its equivalent around the world, has been uerly reframed
in terms of administrators and much of the medical personnel with
the transformation underpinned by recruitment policies. The
outcome has been the criminal and psychopathic behaviour of the

NHS over ‘Covid’ and we have seen the same in every other major
country. WikiLeaks said Common Purpose trainees are ‘learning to
rule without regard to democracy’ and to usher in a police state
(current events explained). Common Purpose operated like a ‘glue’
and had members in the NHS, BBC, police, legal profession, church,
many of Britain’s 7,000 quangos, local councils, the Civil Service,
government ministries and Parliament, and controlled many RDA’s
(Regional Development Agencies). Here we have one answer for
how and why British institutions and their like in other countries
have changed so negatively in relation to the public. This further
explains how and why the beyond-disgraceful reframed BBC has
become a propaganda arm of ‘Covid’ fascism. They are all part of a
network pursuing the same goal.
By 2019 Common Purpose was quoting a figure of 85,000 ‘leaders’
that had aended its programmes. These ‘students’ of all ages are
known as Common Purpose ‘graduates’ and they consist of
government, state and local government officials and administrators,
police chiefs and officers, and a whole range of others operating
within the national, local and global establishment. Cressida Dick,
Commissioner of the London Metropolitan Police, is the Common
Purpose graduate who was the ‘Gold Commander’ that oversaw
what can only be described as the murder of Brazilian electrician
Jean Charles de Menezes in 2005. He was held down by
psychopathic police and shot seven times in the head by a
psychopathic lunatic aer being mistaken for a terrorist when he
was just a bloke going about his day. Dick authorised officers to
pursue and keep surveillance on de Menezes and ordered that he be
stopped from entering the underground train system. Police
psychopaths took her at her word clearly. She was ‘disciplined’ for
this outrage by being promoted – eventually to the top of the ‘Met’
police where she has been a disaster. Many Chief Constables
controlling the police in different parts of the UK are and have been
Common Purpose graduates. I have heard the ‘graduate’ network
described as a sort of Mafia or secret society operating within the
fabric of government at all levels pursuing a collective policy

ingrained at Common Purpose training events. Founder Julia
Middleton herself has said:
Locally and internationally, Common Purpose graduates will be ‘lighting small fires’ to create
change in their organisations and communities … The Common Purpose effect is best
illustrated by the many stories of small changes brought about by leaders, who themselves
have changed.
A Common Purpose mission statement declared:
Common Purpose aims to improve the way society works by expanding the vision, decisionmaking ability and influence of all kinds of leaders. The organisation runs a variety of
educational programmes for leaders of all ages, backgrounds and sectors, in order to provide
them with the inspirational, information and opportunities they need to change the world.
Yes, but into what? Since 2020 the answer has become clear.
NLP and the Delphi technique
Common Purpose would seem to be a perfect name or would
common programming be beer? One of the foundation methods of
reaching ‘consensus’ (group think) is by seing the agenda theme
and then encouraging, cajoling or pressuring everyone to agree a
‘consensus’ in line with the core theme promoted by Common
Purpose. The methodology involves the ‘Delphi technique’, or an
adaption of it, in which opinions are expressed that are summarised
by a ‘facilitator or change agent’ at each stage. Participants are
‘encouraged’ to modify their views in the light of what others have
said. Stage by stage the former individual opinions are merged into
group consensus which just happens to be what Common Purpose
wants them to believe. A key part of this is to marginalise anyone
refusing to concede to group think and turn the group against them
to apply pressure to conform. We are seeing this very technique used
on the general population to make ‘Covid’ group-thinkers hostile to
those who have seen through the bullshit. People can be reframed by
using perception manipulation methods such as Neuro-Linguistic
Programming (NLP) in which you change perception with the use of

carefully constructed language. An NLP website described the
technique this way:
… A method of influencing brain behaviour (the ‘neuro’ part of the phrase) through the use of
language (the ‘linguistic’ part) and other types of communication to enable a person to
‘recode’ the way the brain responds to stimuli (that’s the ‘programming’) and manifest new
and better behaviours. Neuro-Linguistic Programming often incorporates hypnosis and selfhypnosis to help achieve the change (or ‘programming’) that is wanted.
British alternative media operation UKColumn has done very
detailed research into Common Purpose over a long period. I quoted
co-founder and former naval officer Brian Gerrish in my book
Remember Who You Are, published in 2011, as saying the following
years before current times:
It is interesting that many of the mothers who have had children taken by the State speak of
the Social Services people being icily cool, emotionless and, as two ladies said in slightly
different words, ‘… like little robots’. We know that NLP is cumulative, so people can be
given small imperceptible doses of NLP in a course here, another in a few months, next year
etc. In this way, major changes are accrued in their personality, but the day by day change is
almost unnoticeable.
In these and other ways ‘graduates’ have had their perceptions
uniformly reframed and they return to their roles in the institutions
of government, law enforcement, legal profession, military,
‘education’, the UK National Health Service and the whole swathe of
the establishment structure to pursue a common agenda preparing
for the ‘post-industrial’, ‘post-democratic’ society. I say ‘preparing’
but we are now there. ‘Post-industrial’ is code for the Great Reset
and ‘post-democratic’ is ‘Covid’ fascism. UKColumn has spoken to
partners of those who have aended Common Purpose ‘training’.
They have described how personalities and aitudes of ‘graduates’
changed very noticeably for the worse by the time they had
completed the course. They had been ‘reframed’ and told they are
the ‘leaders’ – the special ones – who know beer than the
population. There has also been the very demonstrable recruitment
of psychopaths and narcissists into government administration at all

levels and law enforcement. If you want psychopathy hire
psychopaths and you get a simple cause and effect. If you want
administrators, police officers and ‘leaders’ to perceive the public as
lesser beings who don’t maer then employ narcissists. These
personalities are identified using ‘psychometrics’ that identifies
knowledge, abilities, aitudes and personality traits, mostly through
carefully-designed questionnaires and tests. As this policy has
passed through the decades we have had power-crazy, powertrippers appointed into law enforcement, security and government
administration in preparation for current times and the dynamic
between public and law enforcement/officialdom has been
transformed. UKColumn’s Brian Gerrish said of the narcissistic
personality:
Their love of themselves and power automatically means that they will crush others who get
in their way. I received a major piece of the puzzle when a friend pointed out that when they
made public officials re-apply for their own jobs several years ago they were also required to
do psychometric tests. This was undoubtedly the start of the screening process to get ‘their’
sort of people in post.
How obvious that has been since 2020 although it was clear what
was happening long before if people paid aention to the changing
public-establishment dynamic.
Change agents
At the centre of events in ‘Covid’ Britain is the National Health
Service (NHS) which has behaved disgracefully in slavishly
following the Cult agenda. The NHS management structure is awash
with Common Purpose graduates or ‘change agents’ working to a
common cause. Helen Bevan, a Chief of Service Transformation at
the NHS Institute for Innovation and Improvement, co-authored a
document called ‘Towards a million change agents, a review of the
social movements literature: implications for large scale change in
the NHS‘. The document compared a project management approach
to that of change and social movements where ‘people change

themselves and each other – peer to peer’. Two definitions given for
a ‘social movement’ were:
A group of people who consciously attempt to build a radically new social
order; involves people of a broad range of social backgrounds; and deploys
politically confrontational and socially disruptive tactics – Cyrus
Zirakzadeh 1997
Collective challenges, based on common purposes and social solidarities, in
sustained interaction with elites, opponents, and authorities – Sidney
Tarrow 1994
Helen Bevan wrote another NHS document in which she defined
‘framing’ as ‘the process by which leaders construct, articulate and
put across their message in a powerful and compelling way in order
to win people to their cause and call them to action’. I think I could
come up with another definition that would be rather more accurate.
The National Health Service and institutions of Britain and the wider
world have been taken over by reframed ‘change agents’ and that
includes everything from the United Nations to national
governments, local councils and social services which have been
kidnapping children from loving parents on an extraordinary and
gathering scale on the road to the end of parenthood altogether.
Children from loving homes are stolen and kidnapped by the state
and put into the ‘care’ (inversion) of the local authority through
council homes, foster parents and forced adoption. At the same time
children are allowed to be abused without response while many are
under council ‘care’. UKColumn highlighted the Common Purpose
connection between South Yorkshire Police and Rotherham council
officers in the case of the scandal in that area of the sexual
exploitation of children to which the authorities turned not one blind
eye, but both:

We were alarmed to discover that the Chief Executive, the Strategic Director of Children and
Young People’s Services, the Manager for the Local Strategic Partnership, the Community
Cohesion Manager, the Cabinet Member for Cohesion, the Chief Constable and his
predecessor had all attended Leadership training courses provided by the pseudo-charity
Common Purpose.
Once ‘change agents’ have secured positions of hire and fire within
any organisation things start to move very quickly. Personnel are
then hired and fired on the basis of whether they will work towards
the agenda the change agent represents. If they do they are rapidly
promoted even though they may be incompetent. Those more
qualified and skilled who are pre-Common Purpose ‘old school’ see
their careers stall and even disappear. This has been happening for
decades in every institution of state, police, ‘health’ and social
services and all of them have been transformed as a result in their
aitudes to their jobs and the public. Medical professions, including
nursing, which were once vocations for the caring now employ
many cold, callous and couldn’t give a shit personality types. The
UKColumn investigation concluded:
By blurring the boundaries between people, professions, public and private sectors,
responsibility and accountability, Common Purpose encourages ‘graduates’ to believe that as
new selected leaders, they can work together, outside of the established political and social
structures, to achieve a paradigm shift or CHANGE – so called ‘Leading Beyond Authority’. In
doing so, the allegiance of the individual becomes ‘reframed’ on CP colleagues and their
NETWORK.
Reframing the Face-Nappies
Nowhere has this process been more obvious than in the police
where recruitment of psychopaths and development of
unquestioning mind-controlled group-thinkers have transformed
law enforcement into a politically-correct ‘Woke’ joke and a travesty
of what should be public service. Today they wear their face-nappies
like good lile gofers and enforce ‘Covid’ rules which are fascism
under another name. Alongside the specifically-recruited
psychopaths we have soware minds incapable of free thought.
Brian Gerrish again:

An example is the policeman who would not get on a bike for a press photo because he had
not done the cycling proficiency course. Normal people say this is political correctness gone
mad. Nothing could be further from the truth. The policeman has been reframed, and in his
reality it is perfect common sense not to get on the bike ‘because he hasn’t done the cycling
course’.
Another example of this is where the police would not rescue a boy from a pond until they
had taken advice from above on the ‘risk assessment’. A normal person would have arrived,
perhaps thought of the risk for a moment, and dived in. To the police now ‘reframed’, they
followed ‘normal’ procedure.
There are shocking cases of reframed ambulance crews doing the
same. Sheer unthinking stupidity of London Face-Nappies headed
by Common Purpose graduate Cressida Dick can be seen in their
behaviour at a vigil in March, 2021, for a murdered woman, Sarah
Everard. A police officer had been charged with the crime. Anyone
with a brain would have le the vigil alone in the circumstances.
Instead they ‘manhandled’ women to stop them breaking ‘Covid
rules’ to betray classic reframing. Minds in the thrall of perception
control have no capacity for seeing a situation on its merits and
acting accordingly. ‘Rules is rules’ is their only mind-set. My father
used to say that rules and regulations are for the guidance of the
intelligent and the blind obedience of the idiot. Most of the
intelligent, decent, coppers have gone leaving only the other kind
and a few old school for whom the job must be a daily nightmare.
The combination of psychopaths and rule-book soware minds has
been clearly on public display in the ‘Covid’ era with automaton
robots in uniform imposing fascistic ‘Covid’ regulations on the
population without any personal initiative or judging situations on
their merits. There are thousands of examples around the world, but
I’ll make my point with the infamous Derbyshire police in the
English East Midlands – the ones who think pouring dye into beauty
spots and using drones to track people walking in the countryside
away from anyone is called ‘policing’. To them there are rules
decreed by the government which they have to enforce and in their
bewildered state a group gathering in a closed space and someone
walking alone in the countryside are the same thing. It is beyond
idiocy and enters the realm of clinical insanity.

Police officers in Derbyshire said they were ‘horrified’ – horrified –
to find 15 to 20 ‘irresponsible’ kids playing a football match at a
closed leisure centre ‘in breach of coronavirus restrictions’. When
they saw the police the kids ran away leaving their belongings
behind and the reframed men and women of Derbyshire police were
seeking to establish their identities with a view to fining their
parents. The most natural thing for youngsters to do – kicking a ball
about – is turned into a criminal activity and enforced by the
moronic soware programs of Derbyshire police. You find the same
mentality in every country. These barely conscious ‘horrified’ officers
said they had to take action because ‘we need to ensure these rules
are being followed’ and ‘it is of the utmost importance that you
ensure your children are following the rules and regulations for
Covid-19’. Had any of them done ten seconds of research to see if
this parroting of their masters’ script could be supported by any
evidence? Nope. Reframed people don’t think – others think for
them and that’s the whole idea of reframing. I have seen police
officers one aer the other repeating without question word for
word what officialdom tells them just as I have seen great swathes of
the public doing the same. Ask either for ‘their’ opinion and out
spews what they have been told to think by the official narrative.
Police and public may seem to be in different groups, but their
mentality is the same. Most people do whatever they are told in fear
not doing so or because they believe what officialdom tells them;
almost the entirety of the police do what they are told for the same
reason. Ultimately it’s the tiny inner core of the global Cult that’s
telling both what to do.
So Derbyshire police were ‘horrified’. Oh, really? Why did they
think those kids were playing football? It was to relieve the
psychological consequences of lockdown and being denied human
contact with their friends and interaction, touch and discourse vital
to human psychological health. Being denied this month aer month
has dismantled the psyche of many children and young people as
depression and suicide have exploded. Were Derbyshire police
horrified by that? Are you kidding? Reframed people don’t have those

mental and emotional processes that can see how the impact on the
psychological health of youngsters is far more dangerous than any
‘virus’ even if you take the mendacious official figures to be true. The
reframed are told (programmed) how to act and so they do. The
Derbyshire Chief Constable in the first period of lockdown when the
black dye and drones nonsense was going on was Peter Goodman.
He was the man who severed the connection between his force and
the Derbyshire Constabulary Male Voice Choir when he decided that
it was not inclusive enough to allow women to join. The fact it was a
male voice choir making a particular sound produced by male voices
seemed to elude a guy who terrifyingly ran policing in Derbyshire.
He retired weeks aer his force was condemned as disgraceful by
former Supreme Court Justice Jonathan Sumption for their
behaviour over extreme lockdown impositions. Goodman was
replaced by his deputy Rachel Swann who was in charge when her
officers were ‘horrified’. The police statement over the boys
commiing the hanging-offence of playing football included the line
about the youngsters being ‘irresponsible in the times we are all
living through’ missing the point that the real relevance of the ‘times
we are all living through’ is the imposition of fascism enforced by
psychopaths and reframed minds of police officers playing such a
vital part in establishing the fascist tyranny that their own children
and grandchildren will have to live in their entire lives. As a
definition of insanity that is hard to beat although it might be run
close by imposing masks on people that can have a serious effect on
their health while wearing a face nappy all day themselves. Once
again public and police do it for the same reason – the authorities tell
them to and who are they to have the self-respect to say no?
Wokers in uniform
How reframed do you have to be to arrest a six-year-old and take him
to court for picking a flower while waiting for a bus? Brain dead police
and officialdom did just that in North Carolina where criminal
proceedings happen regularly for children under nine. Aorney
Julie Boyer gave the six-year-old crayons and a colouring book
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