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Hemming S, Munir F. Using the patient activation measure to examine the self-management support needs of a population of UK workers with long-term health conditions. Chronic Illn 2022; 18:702-707. [PMID: 34569325 PMCID: PMC9397392 DOI: 10.1177/17423953211043492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
OBJECTIVES To examine differences in patient activation and self-management support needs in a population of UK workers with long-term health conditions. METHODS Demographic, health and activation information were taken from the data of participants with long-term conditions, collected via an online cross-sectional survey of workers. The 13-item British patient activation measure measured workers knowledge, skills and confidence towards self-managing. RESULTS Three hundred and seven workers with mental health, musculoskeletal and other conditions completed the patient activation measure. Mental health conditions were most prevalent (36.8%). Workers were higher activated, however workers with mental health conditions were significantly less activated (p = 0.006). Differences in activation by condition severity and age were revealed. DISCUSSION This study provides insight to the activation of UK workers with long-term conditions. Whilst workers with mental health conditions need more training and education to self-manage, workers are variably activated indicating broader support needs. There is a gap for workplace self-management support. The patient activation measure is used in healthcare to improve people's self-management and should be considered to be included in the workplace, and could form part of interventions to support workers self-management. More rigorous studies, including the patient activation measure, are needed to identify the best approaches to identifying workers self-management support needs.
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Affiliation(s)
- Sally Hemming
- School of Sport, Exercise and Health Sciences, 152602Loughborough University, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, 152602Loughborough University, UK
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Wang R, Zhou C, Wu Y, Sun M, Yang L, Ye X, Zhang M. Patient empowerment and self-management behaviour of chronic disease patients: A moderated mediation model of self-efficacy and health locus of control. J Adv Nurs 2021; 78:1055-1065. [PMID: 34643959 DOI: 10.1111/jan.15077] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 08/18/2021] [Accepted: 09/26/2021] [Indexed: 11/28/2022]
Abstract
AIMS To explore the role of self-efficacy (SE) in the effect of patient empowerment on self-management behaviours among patients with chronic illness and to investigate the moderating effect of three types of health locus of control (HLC) in this moderated mediation model. DESIGN Cross-sectional design. METHODS Data were collected in a general tertiary hospital, and a sample of 254 patients was recruited between August and October 2020. The effect of moderation and mediation was tested by the PROCESS macro (Model 4 and Model 8) for SPSS 25.0 by Hayes using 5000 bootstrap samples. RESULTS Self-efficacy significantly mediated the relationship between patient empowerment and self-management behaviour with a 95% confidence interval excluding zero. The chance HLC demonstrated a moderating effect, and the interaction effect on SE and self-management behaviour was significant. CONCLUSION Patient empowerment may improve confidence and adherence to self-management among people with chronic illness, and such benefits were conditional on the HLC of patients. IMPACT This study addresses the relationship between patient empowerment and self-management behaviour in patients with different personality characteristics. This result indicated that classifying the type of HLC may enable the identification of subgroups of patients who may subsequently benefit from patient empowerment. In a patient-centred programme, nurses and other healthcare professionals correctly identifying patients' HLC type and understanding the implications and then providing appropriate health care plans for patients with different health beliefs may be useful to tailor the decision-making process.
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Affiliation(s)
- Run Wang
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China.,School of Nursing, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Chunlan Zhou
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Yanni Wu
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Meihua Sun
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Lixiao Yang
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Xiaoling Ye
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Mi Zhang
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
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Crawford JO, Berkovic D, Erwin J, Copsey SM, Davis A, Giagloglou E, Yazdani A, Hartvigsen J, Graveling R, Woolf A. Musculoskeletal health in the workplace. Best Pract Res Clin Rheumatol 2020; 34:101558. [DOI: 10.1016/j.berh.2020.101558] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Francis H, Carryer J, Wilkinson J. The complexity of food for people with multiple long-term health conditions. J Prim Health Care 2019; 10:186-193. [PMID: 31039931 DOI: 10.1071/hc18020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The prevalence of long-term health conditions (LTCs) continues to increase and it is normal for people to have several. Lifestyle is a core feature of the self-management support given to people with LTCs, yet it seems to fail to meet their needs. From a larger study exploring the experiences of this group, this paper reports on the role of food and mealtimes, and the effect of the nutritional advice on the lives of people with several LTCs. METHODS The experiences of 16 people with several advanced LTCs were explored using multiple qualitative case studies. Over an 18-month period, contact with participants included monthly conversations, two longer, semi-structured interviews and one interview with their primary care clinicians. The data were analysed inductively using thematic analysis. RESULTS There was profound social, psychological and cultural significance of food to the participants. These aspects of food were then described using the Whare Tapa Wha model of health. The approach to food and nutrition participants experienced in health care was closely associated with conventional weight management. They found this advice largely irrelevant and therefore ineffective. DISCUSSION The pressure people with several LTCs experience during clinical encounters has perverse effects on wellbeing and reinforces an overall sense of failure. This research challenges the assumption that all people have the will, agency and income to follow the advice they receive about nutrition and exercise. Considering people's needs using the Whare Tapa Wha model of health offers clinicians a framework to re-conceptualise the core features of self-management support and provide realistic, compassionate care that will optimise the quality of life for people with multiple LTCs.
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Affiliation(s)
- Helen Francis
- Massey University, School of Nursing, Palmerston North, New Zealand
| | - Jenny Carryer
- Massey University, School of Nursing, Palmerston North, New Zealand
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Miller J, MacDermid JC, Richardson J, Walton DM, Gross A. Depicting individual responses to physical therapist led chronic pain self-management support with pain science education and exercise in primary health care: multiple case studies. Arch Physiother 2018; 7:4. [PMID: 29340199 PMCID: PMC5759926 DOI: 10.1186/s40945-017-0032-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 04/05/2017] [Indexed: 01/13/2023] Open
Abstract
Background Previous evidence suggests self-management programs for people with chronic pain improve knowledge and self-efficacy, but result in small to negligible changes in function. The purpose of this multiple case studies design was to describe the unique responses of six participants to a new self-management program aimed at improving function, to detail each component of the program, and to explore potential explanations for the varied trajectories of each of the participants. Case Presentation Six participants who had been experiencing chronic pain for at least 5 years were included. All participants were enrolled 6 weeks of ChrOnic pain self-ManageMent support with pain science EducatioN and exercise (COMMENCE). Participants completed an assessment at baseline, 7 weeks (1-week follow-up), and 18 weeks (12-week follow-up). Each participant had a unique initial presentation and goals. Assessments included: function as measured by the Short Musculoskeletal Function Assessment – Dysfunction Index, how much participants are bothered by functional difficulties, pain intensity, fatigue, pain interference, cognitive and psychological factors associated with pain and disability, pain neurophysiology, self-efficacy, satisfaction, and perceived change. The self-management program was 6-weeks in length, consisting of one individual visit and one group visit per week. The program incorporated three novel elements not commonly included in self-management programs: pain neurophysiology education, individualized exercises determined by the participants’ goals, and additional cognitive behavioural approaches. Participants were all satisfied with self-management support received. Change in function was variable ranging from 59% improvement to 17% decline. Two potential explanations for variances in response, attendance and social context, are discussed. Several challenges were identified by participants as barriers to attendance. Conclusions A primary care self-management intervention including pain education and individualized exercise has potential to improve function for some people with chronic pain, although strategies to improve adherence and reduce barriers to participation may be needed to optimize the impact. Electronic supplementary material The online version of this article (doi:10.1186/s40945-017-0032-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jordan Miller
- School of Rehabilitation Therapy, Queen's University, Kingston, 31 George Street, Kingston, Ontario K7L 3N6 Canada
| | - Joy C MacDermid
- School of Rehabilitation Therapy, Queen's University, Kingston, 31 George Street, Kingston, Ontario K7L 3N6 Canada.,School of Physical Therapy, Western University, Room 1440, Elborn College, London, Ontario N6G 1H1 Canada
| | - Julie Richardson
- School of Rehabilitation Therapy, Queen's University, Kingston, 31 George Street, Kingston, Ontario K7L 3N6 Canada
| | - David M Walton
- School of Physical Therapy, Western University, Room 1440, Elborn College, London, Ontario N6G 1H1 Canada
| | - Anita Gross
- School of Rehabilitation Therapy, Queen's University, Kingston, 31 George Street, Kingston, Ontario K7L 3N6 Canada
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Heinrichs K, Angerer P, Loerbroks A. Psychosocial working conditions as determinants of asthma self-management at work: A systematic review. J Asthma 2017; 55:1095-1104. [PMID: 29200315 DOI: 10.1080/02770903.2017.1396469] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Asthma exerts a considerable impact on patients and their employers. While adequate self-management is able to improve patients' prognosis, its actual implementation in everyday life may depend on contextual factors. We aimed to review the literature on the potential determinants of asthma self-management at the workplace. DATA SOURCES We systematically searched Medline and PsycINFO using terms related to the key concepts of interest (i.e., adult asthma, working conditions, and self-management). STUDY SELECTION We included original studies published in peer-reviewed journals in English or German since 1992 addressing any type of asthma self-management behavior as the outcome and any type of working condition as the determinant. RESULTS Upon implementation of a multi-stage selection process, seven articles were included. As those studies showed considerable methodological heterogeneity, a qualitative analysis was applied. A first study identified three different adaptation profiles among employees with asthma with implications for self-management behavior. Another study suggested that concerns about taking time off from work may be associated with the utilization of emergency ambulance services for asthma. Five studies among workers with various chronic illnesses addressed determinants of self-disclosure, coping with acute symptoms (e.g., medication use at work), and the potential effect of practical and emotional support from line managers or colleagues on self-management. CONCLUSION Our review indicates that the evidence for a potential link of occupational factors with asthma self-management at work is relatively sparse. Future research should take a more comprehensive approach by considering multiple types of working conditions and asthma self-management behaviors simultaneously.
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Affiliation(s)
- Katherina Heinrichs
- a Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine , University of Düsseldorf , Düsseldorf , Germany
| | - Peter Angerer
- a Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine , University of Düsseldorf , Düsseldorf , Germany
| | - Adrian Loerbroks
- a Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine , University of Düsseldorf , Düsseldorf , Germany
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Eifert EK, Adams R, Morrison S, Strack R. Emerging Trends in Family Caregiving Using the Life Course Perspective: Preparing Health Educators for an Aging Society. AMERICAN JOURNAL OF HEALTH EDUCATION 2016. [DOI: 10.1080/19325037.2016.1158674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Elise K. Eifert
- Department of Exercise Science and Health Promotion, Florida Atlantic University
| | - Rebecca Adams
- Gerontology Program, University of North Carolina at Greensboro
| | - Sharon Morrison
- Department of Public Health Education, University of North Carolina at Greensboro
| | - Robert Strack
- Department of Public Health Education, University of North Carolina at Greensboro
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Miller J, MacDermid JC, Walton DM, Richardson J. Chronic pain self-management support with pain science education and exercise (COMMENCE): study protocol for a randomized controlled trial. Trials 2015; 16:462. [PMID: 26466908 PMCID: PMC4606963 DOI: 10.1186/s13063-015-0994-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 10/02/2015] [Indexed: 11/25/2022] Open
Abstract
Background Previous research suggests that self-management programs for people with chronic pain improve knowledge and self-efficacy but result in negligible effects on function. This study will investigate the effectiveness self-management support with pain science education and exercise on improving function for people with chronic pain in comparison to a wait-list control. A secondary objective is to determine which variables help to predict response to the intervention. Methods/Design This study will be an unblinded, randomized controlled trial with 110 participants comparing a 6-week program that includes self-management support, pain science education and exercise to a wait-list control. The primary outcome will be function measured by the Short Musculoskeletal Function Assessment - Dysfunction Index. Secondary outcomes will include pain intensity measured by a numeric pain rating scale, pain interference measured by the eight-item PROMIS pain interference item-bank, how much patients are bothered by functional problems measured by the Short Musculoskeletal Function Assessment - Bother Index, catastrophic thinking measured by the Pain Catastrophizing Scale, fear of movement/re-injury measured by the 11-item Tampa Scale of Kinesiophobia, sense of perceived injustice measured by the Injustice Experience Questionnaire, self-efficacy measured by the Pain Self-Efficacy Questionnaire, pain sensitivity measured by pressure pain threshold and cold sensitivity testing, fatigue measured by a numeric fatigue rating scale, pain neurophysiology knowledge measured by the Neurophysiology of Pain Questionnaire, healthcare utilization measured by number of visits to a healthcare provider, and work status. Assessments will be completed at baseline, 7 and 18 weeks. After the 18-week assessment, the groups will crossover; however, we anticipate carry-over effects with the treatment. Therefore, data from after the crossover will be used to estimate within-group changes and to determine predictors of response that are not for direct between-group comparisons. Mixed effects modelling will be used to determine between-group differences for all primary and secondary outcomes. A series of multiple regression models will be used to determine predictors of treatment response. Discussion This study has the potential to inform future self-management programming through evaluation of a self-management program that aims to improve function as the primary outcome. Trial registration ClinicalTrials.gov NCT02422459, registered on 13 April 2015.
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Affiliation(s)
- Jordan Miller
- School of Rehabilitation Science, McMaster University, 1400 Main St. W, Hamilton, ON L8S 1C7, Ontario, Canada.
| | - Joy C MacDermid
- School of Rehabilitation Science, McMaster University, 1400 Main St. W, Hamilton, ON L8S 1C7, Ontario, Canada.
| | - David M Walton
- School of Physical Therapy, Western University, London, Ontario, Canada.
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, 1400 Main St. W, Hamilton, ON L8S 1C7, Ontario, Canada.
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Factors influencing prehospital delay time among patients with peripheral arterial occlusive disease. Eur J Cardiovasc Nurs 2015; 15:285-93. [DOI: 10.1177/1474515114567813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 12/17/2014] [Indexed: 11/15/2022]
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Plat MJ, Frings‐Dresen MHW, Sluiter JK. Impact of Chronic Diseases on Work Ability in Ageing Firefighters. J Occup Health 2012; 54:158-63. [DOI: 10.1539/joh.11-0105-oa] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Marie‐Christine J Plat
- Academic Medical Center, University of AmsterdamDepartment of Coronel Institute of Occupational HealthThe Netherlands
| | - Monique HW Frings‐Dresen
- Academic Medical Center, University of AmsterdamDepartment of Coronel Institute of Occupational HealthThe Netherlands
| | - Judith K Sluiter
- Academic Medical Center, University of AmsterdamDepartment of Coronel Institute of Occupational HealthThe Netherlands
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Schulte PA, Pandalai S, Wulsin V, Chun H. Interaction of occupational and personal risk factors in workforce health and safety. Am J Public Health 2011; 102:434-48. [PMID: 22021293 DOI: 10.2105/ajph.2011.300249] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Most diseases, injuries, and other health conditions experienced by working people are multifactorial, especially as the workforce ages. Evidence supporting the role of work and personal risk factors in the health of working people is frequently underused in developing interventions. Achieving a longer, healthy working life requires a comprehensive preventive approach. To help develop such an approach, we evaluated the influence of both occupational and personal risk factors on workforce health. We present 32 examples illustrating 4 combinatorial models of occupational hazards and personal risk factors (genetics, age, gender, chronic disease, obesity, smoking, alcohol use, prescription drug use). Models that address occupational and personal risk factors and their interactions can improve our understanding of health hazards and guide research and interventions.
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Affiliation(s)
- Paul A Schulte
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH 45226, USA.
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Meier C, Bodenmann G, Mörgeli H, Jenewein J. Dyadic coping, quality of life, and psychological distress among chronic obstructive pulmonary disease patients and their partners. Int J Chron Obstruct Pulmon Dis 2011; 6:583-96. [PMID: 22135491 PMCID: PMC3224653 DOI: 10.2147/copd.s24508] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Successfully coping with a chronic disease depends significantly on social support, particularly that of a significant other. Thus, it depends on the ways of dealing with stress within a couple (dyadic coping). In this study, the relationship between dyadic coping and well-being was investigated among couples in which one partner suffers from chronic obstructive pulmonary disease (COPD). Methods A total of 43 couples participated. They were mailed questionnaires on anxiety and depression (Hospital Anxiety and Depression Scale), quality of life (World Health Organization Quality of Life Questionnaire-BREF), and dyadic coping (Dyadic Coping Inventory). Results Low scores of positive and high scores of negative dyadic coping were associated with poorer quality of life and higher psychological distress among couples. Delegated coping (assistance with daily tasks) was higher among partners. When estimated by patients, high delegated partner coping (frequent provision of support by partners) and low delegated personal coping (low provision of support by patients) were associated with poorer quality of life for both patient and partner. COPD patients suffering from depression were supported more often and attributed deficits in dyadic coping primarily to themselves, whereas partners with higher scores of depression provided higher estimates of both their own negative coping and the negative coping of their partner. Conclusion The higher the patient perceived the imbalance in delegated dyadic coping, the lower the couple’s quality of life. More negative and less positive dyadic coping were associated with lower quality of life and higher psychological distress. Psychotherapeutic interventions to improve dyadic coping may lead to better quality of life and less psychological distress among COPD patients and their partners.
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Affiliation(s)
- Caroline Meier
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Switzerland
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Abstract
BACKGROUND There is limited understanding of the utilization of and perceived need for physical therapy services among middle-aged and older adults with multiple sclerosis (MS). The resulting knowledge gap compromises efforts for physical therapy service planning for this population. OBJECTIVE The purpose of this study was to examine the use of and need for physical therapy services in a sample of adults with MS living in the Midwestern United States. DESIGN This was a cross-sectional, descriptive study. METHODS Data from telephone interviews with 1,065 people with MS, aged 45 to 90 years, were used for the study. A multinomial regression model was used to determine factors associated with use of physical therapy services (never, within the past year, more than a year ago). Logistic regression analysis examined factors associated with unmet needs for these services. RESULTS Thirty-six percent of the sample reported never using physical therapy services, 33% reported using physical therapy services within the past year, and 31% reported using physical therapy services more than a year prior to the interview. Factors associated with recent use of physical therapy services included living in an urban or suburban community, deteriorating MS status, experiencing problems with spasticity (ie, hypertonicity), having difficulty moving inside the house, being hospitalized in the past 6 months, and seeing a family physician. These same factors were associated with unmet needs. Limitations Physical therapy service use was self-reported. Data were collected in 5 Midwestern states from people 45 years of age or older, which may limit generalizability. CONCLUSIONS Factors associated with use of and need for physical therapy services reflect issues of access (geographical, referrals), MS status, and mobility difficulties.
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