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Liu G, Xin H, Lin J, Li X, Zhang Y, Wang X, Liao J, Hu R. Analysis of the survival journey and post-traumatic growth process of children and their families following paediatric intensive care unit admission: A grounded theory study. Aust Crit Care 2024:S1036-7314(24)00116-4. [PMID: 38969541 DOI: 10.1016/j.aucc.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 06/04/2024] [Accepted: 06/10/2024] [Indexed: 07/07/2024] Open
Abstract
OBJECTIVES Advances in critical care technology have lowered mortality rates among critically ill individuals. Nonetheless, survivors and their families may develop new physical, mental, cognitive, and social challenges due to paediatric intensive care unit (PICU) treatments, impacting their quality of life. The aim of this study was to investigate the survival journey and post-traumatic growth process of children and their families following PICU admission within the Chinese cultural context. METHODS Twenty-six children who have been or are currently admitted to the PICU, alongside their parents and three PICU nurses, were chosen through purposive and theoretical sampling. Data collection involved face-to-face interviews and observations, with data analysis conducted through continuous comparison, open coding, and selective coding techniques. FINDINGS A model outlining the survival journey and post-traumatic growth process of critically ill children and their families post PICU admission has been established. This model encompasses two central trajectories: an upward trajectory consisting of confusion, charging, action, and sublimation phases and a downward trajectory comprising confusion, doubt and fear, inhibition (including confrontation and avoidance), and drowning phases. CONCLUSIONS Critically ill children and their families encounter diverse survival experiences and psychological journeys following traumatic events in the PICU. The survival experience has alternative upwards or downwards trajectories that are flexible/adaptable. Hence, offering timely psychological support can alter their developmental trajectories and foster post-traumatic growth.
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Affiliation(s)
- Guihua Liu
- Department of Child Health Care, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian 350001, China; The School of Nursing, Fujian Medical University, Fuzhou, Fujian 350000, China
| | - Huining Xin
- Department of Neurosurgery, Fujian Provincial Hospital, Fujian Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001, China.
| | - Jinling Lin
- The School of Nursing, Fujian Medical University, Fuzhou, Fujian 350000, China
| | - Xiaoting Li
- The School of Nursing, Fujian Medical University, Fuzhou, Fujian 350000, China
| | - Yuhong Zhang
- The School of Nursing, Fujian Medical University, Fuzhou, Fujian 350000, China
| | - Xiaojuan Wang
- The School of Nursing, Fujian Medical University, Fuzhou, Fujian 350000, China
| | - Jinhua Liao
- The School of Nursing, Fujian Medical University, Fuzhou, Fujian 350000, China
| | - Rongfang Hu
- The School of Nursing, Fujian Medical University, Fuzhou, Fujian 350000, China.
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Tang MT, Chui PL, Chong MC, Zhang HY, Li XM, Wang T. Translation, cross-cultural adaptation, reliability, and validity of the Chinese version of the intensive care unit environment stress scale for pediatric patients. J Pediatr Nurs 2024; 77:e511-e519. [PMID: 38782669 DOI: 10.1016/j.pedn.2024.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE There is currently a lack of understanding of children's experience in the pediatric intensive care unit (PICU) environment. Additionally, pediatric patients may experience post-PICU syndrome following discharge. Thus, we aimed to adapt and evaluate the psychometric properties of a tool specifically for use with children in the PICU. DESIGN AND METHODS According to Brislin's Model, the Intensive Care Unit Environment Stress Scale (ICUESS) was translated both forward and backward and adapted cross-culturally. A total of 210 PICU patients were selected from four hospitals in XXX to analyze the final translated version of the questionnaire, the Pediatric Intensive Care Unit Environmental Stress Scale (PICUESS). Content validity, exploratory factor analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to assess the validity, while reliability was assessed using Cronbach's alpha and split-half reliability analysis. RESULTS For PICUESS, seven of 42 items were modified. Content validity was high (overall = 0.96, item validity = 0.8 to 1.0). Exploratory factor analysis revealed eight common factors (Kaiser-Meyer-Olkin = 0.857, significant Bartlett's test). The results of the CFA indicate that the scale model fits well across the 8 factors. The entire scale demonstrated excellent internal consistency (Cronbach's alpha = 0.934). The overall split-half reliability was 0.935. CONCLUSIONS The Chinese version of PICUESS demonstrates good reliability and validity, making it suitable for assessing pediatric patients' perceptions of the PICU environment. PRACTICE IMPLICATIONS The PICUESS can assist healthcare professionals in providing personalized environment care for PICU patients. It has the potential to serve as a tool for further testing and international comparisons of pediatric patients' perceptions of the PICU environment.
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Affiliation(s)
- Mao Ting Tang
- Department of Nursing Science, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia; Department of Pediatric Intensive Care Unit Nursing, West China Second University Hospital, Sichuan University, West China School of Nursing, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, China
| | - Ping Lei Chui
- Department of Nursing Science, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Hai Yang Zhang
- Department of Pediatric Intensive Care Unit Nursing, West China Second University Hospital, Sichuan University, West China School of Nursing, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, China
| | - Xiao Min Li
- Department of Nursing Science, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Ting Wang
- Department of Pediatric Intensive Care Unit Nursing, West China Second University Hospital, Sichuan University, West China School of Nursing, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, China
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He X, Song Y, Cao Y, Miao L, Zhu B. Post intensive care syndrome: A review of clinical symptoms, evaluation, intervention. Heliyon 2024; 10:e31278. [PMID: 38803859 PMCID: PMC11128526 DOI: 10.1016/j.heliyon.2024.e31278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
Post intensive care syndrome (PICS) is a typical complication of critically ill patients during or after their stay in intensive care unit (ICU), characterized by a high incidence and impairment rate. It significantly impacts the quality of life of patients and their families, as well as consumes a substantial amount of medical resources. Therefore, early intervention and assessment of PICS is crucial. This paper aims to provide clinical professionals with a reference base by focusing on the clinical symptoms, diagnostic assessment, and preventative measures of PICS.
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Affiliation(s)
- Xiaofang He
- Department of Critical Care Medicine, the Third Affiliated Hospital of Soochow University, Changzhou 213000, Jiangsu, China
| | - Yuwei Song
- Department of Critical Care Medicine, the Third Affiliated Hospital of Soochow University, Changzhou 213000, Jiangsu, China
| | - Yuchun Cao
- Department of Critical Care Medicine, the Third Affiliated Hospital of Soochow University, Changzhou 213000, Jiangsu, China
| | - Liying Miao
- Department of Nephrology, the Third Affiliated Hospital of Soochow University, Changzhou, 213000, Jiangsu, China
| | - Bin Zhu
- Department of Critical Care Medicine, the Third Affiliated Hospital of Soochow University, Changzhou 213000, Jiangsu, China
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Micaëlli D, Dauger S, Faye A, Levy M. The pediatric intensive care unit in France: What happens afterwards? Arch Pediatr 2024; 31:202-204. [PMID: 38508912 DOI: 10.1016/j.arcped.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/09/2023] [Accepted: 01/18/2024] [Indexed: 03/22/2024]
Abstract
Although pediatric post-intensive care syndrome is frequent and impacts the child's quality of life in various aspects, there are currently no guidelines regarding post-pediatric intensive care unit (PICU) follow-up. The aim of this study was to describe post-PICU follow-up in France. Among the 37 French PICUs, only 67 % had a consultation service, mostly performed by pediatric intensivists (95 %). Post-intensive care evaluation was the main objective for 46 % of these centers, whereas others focused on specific patient populations. Post-intensive care follow-up is highly heterogeneous and developing such consultation services appears to be a main challenge for PICU teams.
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Affiliation(s)
- Delphine Micaëlli
- Médecine intensive et réanimation pédiatriques, hôpital Robert Debré, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris-Cité, ECEVE, UMR 1123, Inserm, F-75010 Paris, France.
| | - Stéphane Dauger
- Médecine intensive et réanimation pédiatriques, hôpital Robert Debré, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris-Cité, ECEVE, UMR 1123, Inserm, F-75010 Paris, France
| | - Albert Faye
- Médecine intensive et réanimation pédiatriques, hôpital Robert Debré, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris-Cité, ECEVE, UMR 1123, Inserm, F-75010 Paris, France
| | - Michaël Levy
- Médecine intensive et réanimation pédiatriques, hôpital Robert Debré, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris-Cité, Paris, France
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Tang M, Zhang H, Liu X, Li N, Sun X, Zhang X. Quality of Life Among Chinese Child Survivors of Heart Failure After Discharge From Pediatric Intensive Care Unit. J Pediatr Health Care 2024; 38:e1-e6. [PMID: 37855782 DOI: 10.1016/j.pedhc.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/24/2023] [Accepted: 09/14/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION This study investigated the current quality of life (QOL) status and related influencing factors in children with heart failure in the pediatric intensive care unit (PICU). METHOD One hundred eighty-three children admitted to the PICU with heart failure were consecutively sampled. They were assessed 3 months after discharge and compared with a control group of 160 healthy individuals. The Pediatric Quality of Life Inventory (version 4.0) and Children's Revised Impact of Event Scale were completed, and factors influencing QOL were analyzed. RESULTS Three months after discharge, the PICU group reported lower average scores on the overall QOL and the physical and emotional functioning scales than the control group. In particular, posttraumatic stress disorder status, age, and caregiver educational level greatly influenced the PICU children's QOL. DISCUSSION More interventions and attention are needed to improve the QOL for PICU heart failure patients after discharge.
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Rahmaty Z, Manning JC, Perez MH, Ramelet AS. Post Intensive Care Syndrome in Swiss Paediatric survivors and their Families (PICSS-PF): a national, multicentre, longitudinal study protocol. BMJ Open 2023; 13:e076023. [PMID: 38011965 PMCID: PMC10685943 DOI: 10.1136/bmjopen-2023-076023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION Paediatric intensive care units (PICUs) survivors and their families often experience widespread morbidity and psychosocial consequences after discharge, known as post-intensive care syndrome in paediatrics (PICS-p). In Switzerland, more than 5000 children are admitted to PICUs each year, and despite the high survival rate, there are no data on post-PICU recovery. This study aims to investigate PICS in children and families and identify its associated factors. METHODS AND ANALYSIS This is a national, multicentre, longitudinal, observational study that includes PICU survivors, main family caregivers and siblings (n=1300) recruited from the eight Swiss accredited PICUs with follow-up at discharge, 1, 3 and 6 months after discharge from the PICU. Data will be collected on the domains of physical, emotional, social and cognitive health, as well as factors affecting the outcome related to demographics, clinical specification, PICU and family environment, as well as community and social resources. Structural equation models and growth mixture models will analyse the outcomes, and the heterogeneity of recovery that shed light on the diverse recovery experiences of children and their families. The study identifies risk and protective factors with a focus on the influence of social and familial resources. It will also explore the mutual impact of the child's recovery and parent/sibling psychosocial health. ETHICS AND DISSEMINATION The protocol is approved by the CER-VD ethics committee. Participants will be provided with verbal and written explanations of the study, and their privacy and anonymity will be protected throughout the process. The results will be presented at local and international conferences. APPROVAL NUMBER Swiss ethics committees ID: 2022-02128, representing the eight cantons for both French and German-speaking parts of Switzerland.
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Affiliation(s)
- Zahra Rahmaty
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- IUFRS, Lausanne University Hospital, Lausanne, Switzerland
| | - Joseph C Manning
- School of Healthcare, College of Life Sciences, University of Leicester, Leicester, UK
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Maria-Helene Perez
- Woman-Mother-Infant Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Anne-Sylvie Ramelet
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Woman-Mother-Infant Department, Lausanne University Hospital, Lausanne, Switzerland
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Sobotka SA, Lynch EJ, Dholakia AV, Mayampurath A, Pinto NP. PICU Survivorship: Factors Affecting Feasibility and Cohort Retention in a Long-Term Outcomes Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1041. [PMID: 35884025 PMCID: PMC9317147 DOI: 10.3390/children9071041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
Our understanding of longitudinal outcomes of Pediatric Intensive Care Unit (PICU) survivors is limited by the heterogeneity of follow-up intervals, populations, and outcomes assessed. We sought to demonstrate (1) the feasibility of longitudinal multidimensional outcome assessment and (2) methods to promote cohort retention. The objective of this presented study was to provide details of follow-up methodology in a PICU survivor cohort and not to present the outcomes at long-term follow-up for this cohort. We enrolled 152 children aged 0 to 17 years admitted to the PICU in a prospective longitudinal cohort study. We examined resource utilization, family impact of critical illness, and neurodevelopment using the PICU Outcomes Portfolio (POP) Survey which included a study-specific survey and validated tools: 1. Functional Status Scale, 2. Pediatric Evaluation of Disability Inventory Computer Adaptive Test, 3. Pediatric Quality of Life Inventory, 4. Strengths and Difficulties Questionnaire, and 5. Vanderbilt Assessment Scales for Attention Deficit-Hyperactivity Disorder. POP Survey completion rates were 89%, 78%, and 84% at 1, 3, and 6 months. Follow-up rates at 1, 2, and 3 years were 80%, 55%, and 43%. Implementing a longitudinal multidimensional outcome portfolio for PICU survivors is feasible within an urban, tertiary-care, academic hospital. Our attrition after one year demonstrates the long-term follow-up challenges in this population. Our findings inform ongoing efforts to implement core outcome sets after pediatric critical illness.
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Affiliation(s)
- Sarah A. Sobotka
- Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, The University of Chicago, 950 East 61st Street, Suite 207, Chicago, IL 60637, USA;
| | - Emma J. Lynch
- Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, The University of Chicago, 950 East 61st Street, Suite 207, Chicago, IL 60637, USA;
| | - Ayesha V. Dholakia
- Department of Pediatrics, Boston Children’s Hospital, Boston, MA 02115, USA;
| | - Anoop Mayampurath
- Department of Biostatistics & Medical Informatics, The University of Wisconsin-Madison, Madison, WI 53705, USA;
| | - Neethi P. Pinto
- Division of Critical Care Medicine, Department of Anesthesiology and Critical Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA;
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Ji J, Yang L, Yang H, Jiang Y, Tang P, Qunfeng L. Parental experience of transition from a pediatric intensive care unit to a general ward: A Qualitative Study. J Nurs Manag 2022; 30:3578-3588. [PMID: 35695173 DOI: 10.1111/jonm.13716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/02/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
Abstract
AIM To explore parental experience in transitioning from a pediatric intensive care unit to a general ward and to investigate parental involvement in caring for their critical illness children. BACKGROUND Parents have a major responsibility in caring for seriously ill children, but nursing staff fail to meet the expectations of parents regarding nursing care. Few studies have investigated the challenges and needs of Chinese parents during the transition from pediatric intensive care unit to general ward. METHODS Semi-structured interviews were conducted with 24 parents of children with critical illness in a pediatric hospital in Shanghai, mainland China to explore their views. Transcripts were entered into NVivo. Framework analysis was used to analyze the qualitative data. RESULTS Four themes were identified by data analysis: changes in the child during post pediatric intensive care unit periods; experiencing a wide range of emotions; factors involved in the transition; and suggestions for improving transitional care. CONCLUSIONS Due to the unmet needs of parents, a more flexible visiting policy and social media support were highly desirable. Getting accurate information, establishing family integrated care, and strengthening ward-based critical support services were also listed as important needs of parents caring for critically ill children. IMPLICATIONS FOR NURSING MANAGEMENT A profound understanding of parental experiences during the transitional period can help nursing staff to assess the effects on children and their families, improve ward-based intensive care, support parental participation, and improve visitation policies. Based on these findings, nurse managers can develop reasonable intervention programs in order to improve nursing quality and patient outcomes.
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Affiliation(s)
- Jianlin Ji
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Liling Yang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Hanlin Yang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Jiang
- Neonatal Intensive Care Unit, Children's Hospital of Shanghai, School of medicine, Shanghai Jiao Tong University
| | - Ping Tang
- Emergency Outpatient Clinic, Children's Hospital of Shanghai, School of medicine, Shanghai Jiao Tong University
| | - Lu Qunfeng
- Nursing department, Children's Hospital of Shanghai, School of medicine, Shanghai Jiao Tong University
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Park J, Choi EK. Transfer anxiety in parents of children transferred from pediatric intensive care units to general wards in South Korea: a hybrid concept analysis. CHILD HEALTH NURSING RESEARCH 2022; 28:154-165. [PMID: 35538727 PMCID: PMC9091769 DOI: 10.4094/chnr.2022.28.2.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/02/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose This study aimed to analyze the concept of transfer anxiety in parents of children transferred from pediatric intensive care units to general wards. Methods The hybrid model by Schwarz-Barcott and Kim was used to analyze the characteristics of transfer anxiety in parents of children transferred from pediatric intensive care units to general wards. Results Transfer anxiety was defined by the following attributes: 1) stress concerning the adaptation process, 2) concern about the child’s condition worsening due to the parent’s caregiving, and 3) involuntary changes in daily life due to the treatment. Transfer anxiety has the following antecedents: 1) uncertainty; 2) a lack of knowledge about the illness, medical devices, and caregiving; and 3) a lack of social support. It resulted in 1) caregiver burden, 2) a decrease in the capacity for coping with caregiving, 3) delays in the child’s physical and psychological recovery, and 4) decreased quality of life. Conclusion It is necessary to develop an assessment scale that considers the attributes of transfer anxiety in parents of children transferred from pediatric intensive care units to general wards. Furthermore, an effective nursing intervention should be developed to reduce transfer anxiety.
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Affiliation(s)
- Jisu Park
- Graduate Student, Department of Nursing, Yonsei University, Seoul, Korea
| | - Eun Kyoung Choi
- Assistant Professor, College of Nursing ․ Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
- Corresponding author Eun Kyoung Choi College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea TEL: +82-2-2228-3340 FAX: +82-2-2227-8303 E-MAIL:
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