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Wang LYT, Lua JYH, Chan CXC, Ong RLL, Wee CF, Woo BFY. Health information needs and dissemination methods for individuals living with ischemic heart disease: A systematic review. PATIENT EDUCATION AND COUNSELING 2023; 108:107594. [PMID: 36563574 DOI: 10.1016/j.pec.2022.107594] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES This review aimed to identify the health information needs and preferred approaches to receive health information of individuals with Ischaemic Heart Disease (IHD). METHODS A systematic review was conducted. Relevant literature, published in English (January 2011 to October 2021), was identified across six databases. Guided by Coulter et al.'s framework for developing patient information materials, thematic analysis was performed. The findings were presented in tables and prose. RESULTS Fifty-nine studies were included. Eleven themes summarised the information needs of individuals with IHD. Each theme was supported with subthemes. Forty-five studies included information on preferred methods of dissemination. CONCLUSIONS Our review has characterised the diverse information needs of individuals living with IHD and dissemination methods for outreach to this population. Such insights inform healthcare providers in formulating patient-centred educational interventions to empower patients to undertake successful behavioural modification. PRACTICE IMPLICATIONS Patient education should be personalised and delivered according to individuals' risks for IHD and modifiable risk factors. The use of web-based dissemination of patient education has gained popularity among healthcare providers but sub-optimal adherence to these web-based interventions limits behavioural modification. Adding elements of in-person patient education session to complement web-based interventions may be more propitious to effecting behavioural modification.
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Affiliation(s)
- Laureen Y T Wang
- Alexandra Hospital, National University Health System, Singapore; National University Heart Centre, Singapore, National University Health System, Singapore
| | | | - Cassandra X C Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rachel L L Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Caitlin F Wee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Brigitte F Y Woo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Siewert-Markus U, Ulbricht S, Gaertner B, Zyriax BC, Dörr M, Tobschall S, Baumann S, John U, Freyer-Adam J. Behavioral Health Risk Factors and Motivation to Change among Cardiovascular General Hospital Patients Aged 50 to 79 Years. Nutrients 2022; 14:nu14091963. [PMID: 35565928 PMCID: PMC9105822 DOI: 10.3390/nu14091963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 02/01/2023] Open
Abstract
Little is known about the (co-)occurrence of smoking, alcohol at-risk drinking, physical inactivity and overweight, and the motivation to change these behavioral health risk factors (HRFs) in older general hospital patients with cardiovascular disease. Between October and December 2016, all consecutively admitted patients aged 50 to 79 years were proactively recruited on 3 cardiology wards and asked to participate in a survey on HRFs and behavior change motivation. Of the eligible patients, 80.4% participated in the survey (n = 328). The mean age was 66.5 years (standard deviation 9.0), and 65.5% were male. At least 1 HRF was present in 91.8% (n = 280), at least 2 HRFs in 54.4% (n = 166), and 3 or 4 HRFs in 12.1% (n = 37) of participants. The proportion of older adults who contemplated or were changing or planning to change their behavior to meet health behavior recommendations ranged between 66.0% (smoking) and 93.2% (alcohol consumption). The results indicate a notable co-occurrence of behavioral HRFs in older patients with cardiovascular disease. The majority of older adults were at least considering changing the respective behavior. To prevent and treat diseases efficiently, hospitalization may be a suitable moment for systematic multiple HRF screening and intervention.
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Affiliation(s)
- Ulrike Siewert-Markus
- Institute for Medical Psychology, University Medicine Greifswald, 17475 Greifswald, Germany; (S.T.); (J.F.-A.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany; (S.U.); (M.D.); (S.B.); (U.J.)
- Correspondence: ; Tel.: +49-(0)3834-86-5610; Fax: +49-(0)3834-86-5605
| | - Sabina Ulbricht
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany; (S.U.); (M.D.); (S.B.); (U.J.)
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | | | - Birgit-Christiane Zyriax
- Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany;
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg, 20251 Hamburg, Germany
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany; (S.U.); (M.D.); (S.B.); (U.J.)
- Department of Internal Medicine B, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Stefanie Tobschall
- Institute for Medical Psychology, University Medicine Greifswald, 17475 Greifswald, Germany; (S.T.); (J.F.-A.)
| | - Sophie Baumann
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany; (S.U.); (M.D.); (S.B.); (U.J.)
- Section Methods in Community Medicine, Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Ulrich John
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany; (S.U.); (M.D.); (S.B.); (U.J.)
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Jennis Freyer-Adam
- Institute for Medical Psychology, University Medicine Greifswald, 17475 Greifswald, Germany; (S.T.); (J.F.-A.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany; (S.U.); (M.D.); (S.B.); (U.J.)
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Mentrup S, Harris E, Gomersall T, Köpke S, Astin F. Patients' Experiences of Cardiovascular Health Education and Risk Communication: A Qualitative Synthesis. QUALITATIVE HEALTH RESEARCH 2020; 30:88-104. [PMID: 31729937 DOI: 10.1177/1049732319887949] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Coronary heart disease (CHD) has no cure, and patients with myocardial infarction are at high risk for further cardiac events. Health education is a key driver for patients' understanding and motivation for lifestyle change, but little is known about patients' experience of such education. In this review, we aimed to explore how patients with CHD experience health education and in particular risk communication. A total of 2,221 articles were identified through a systematic search in five databases. 40 articles were included and synthesized using thematic analysis. Findings show that both "what" was communicated, and "the way" it was communicated, had the potential to influence patients' engagement with lifestyle changes. Communication about the potential of lifestyle change to reduce future risk was largely missing causing uncertainty, anxiety, and, for some, disengagement with lifestyle change. Recommendations for ways to improve health education and risk communication are discussed to inform international practice.
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Affiliation(s)
| | - Emma Harris
- University of Huddersfield, Huddersfield, United Kingdom
| | - Tim Gomersall
- University of Huddersfield, Huddersfield, United Kingdom
| | | | - Felicity Astin
- University of Huddersfield, Huddersfield, United Kingdom
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
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Abstract
PURPOSE Many cardiac patients discontinue heart-healthy eating and physical activity (PA) behaviors in the months following cardiac rehabilitation (CR). Involving the spouse in CR with the patient may be 1 strategy to increase the maintenance of these behaviors after CR. Assisting patients and spouses with the maintenance of healthy eating and PA behavior following CR begins with a better understanding of the couple-focused factors, impacting their experiences with these behaviors. The purpose of this study was to qualitatively examine couple-focused facilitators and barriers to maintaining changes in healthy eating and PA behavior from the perspectives of both cardiac patients and their spouses following phase 2 CR. METHODS A purposive sample of 11 couples (patients undergoing postcoronary artery bypass graft surgery and their spouses) were selected from a larger randomized control trial. Semistructured, in-person interviews were conducted with patients and their spouses separately following CR. Data were analyzed using line-by-line coding to identify facilitator and barrier themes. RESULTS Two couple-focused barrier themes emerged: unnegotiated situations and unshared behaviors. Two couple-focused facilitator themes emerged: supportive exchanges and partnerships. CONCLUSION These findings will help guide interventions targeting changes in diet and PA behavior in both patients and their spouses through minimizing unnegotiated situations, fostering supportive exchanges, and creating a partnership for the couple to work together on shared diet and PA goals. Targeting both patients and their spouses may be an innovative and effective way to intervene to increase adherence to healthy eating and PA behaviors post-CR.
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Abstract
The concept of dietary culture is undefined in the nursing literature. This is problematic due to the significant influence of culture on group eating patterns, which impact cardiovascular health. Cardiovascular disease is the leading cause of death, globally. The purpose of this concept analysis was to define the concept of dietary culture to increase the understanding of the relationship between diet, culture, and cardiovascular health. Walker and Avant's method was employed. This analysis of dietary culture provides insight into the internal structure of the concept for future theory development and promotes the application of the concept to nursing research and practice.
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Steca P, Monzani D, Greco A, Franzelli C, Magrin ME, Miglioretti M, Sarini M, Scrignaro M, Vecchio L, Fattirolli F, D’Addario M. Stability and change of lifestyle profiles in cardiovascular patients after their first acute coronary event. PLoS One 2017; 12:e0183905. [PMID: 28850579 PMCID: PMC5574544 DOI: 10.1371/journal.pone.0183905] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 08/14/2017] [Indexed: 11/29/2022] Open
Abstract
Background Acute coronary syndrome (ACS) is a major cause of morbidity and mortality. Lifestyle and health behavior changes play an important role in the primary and secondary prevention of ACS recurrence. Changes in unhealthy lifestyles after an acute coronary event have been analyzed by considering separate behaviors individually, even though research on the healthy population has demonstrated that unhealthy behaviors tend to co-occur. Purpose The aim of this study was to identify lifestyle profiles of ACS patients and to explore their pathways of change for one year after their first coronary event by adopting a typological approach. Methods Two hundred and twenty-three patients (84% male; mean age = 57.14) completed self-report measures of health-related behaviors at the beginning of cardiac rehabilitation, and six months and twelve months after. At each wave depression, anxiety and heart rate were also evaluated. Cluster analysis was performed to identify lifestyle profiles and to analyze their change over time. Differences in psychological factors and heart rate among clusters were assessed. Results Patients' diet, physical activity, and smoking behavior greatly improved six months after their first coronary event. No further improvements were detected after one year. At each wave specific lifestyle profiles were identified, ranging from more maladaptive to healthier clusters. Patients with multiple unhealthy behaviors experience greater difficulties in maintaining a healthier lifestyle over time. Moreover, the results demonstrated the association between lifestyle profiles at twelve months after the acute coronary event and depression measured six months earlier. Finally, the most maladaptive lifestyle profile had many members with elevated heart rate at twelve months after the cardiac rehabilitation. Conclusions Current findings may have a strong practical impact in the development and implementation of personalized secondary prevention programs targeting lifestyles of ACS patients.
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Affiliation(s)
- Patrizia Steca
- Department of Psychology, University of Milan –Bicocca, Milan, Italy
| | - Dario Monzani
- Department of Psychology, University of Milan –Bicocca, Milan, Italy
- * E-mail:
| | - Andrea Greco
- Department of Psychology, University of Milan –Bicocca, Milan, Italy
| | - Cristina Franzelli
- Cardiac Rehabilitation Centre, Istituti Clinici di Perfezionamento Hospital, Milan, Italy
| | | | | | - Marcello Sarini
- Department of Psychology, University of Milan –Bicocca, Milan, Italy
| | - Marta Scrignaro
- Department of Psychology, University of Milan –Bicocca, Milan, Italy
| | - Luca Vecchio
- Department of Psychology, University of Milan –Bicocca, Milan, Italy
| | - Francesco Fattirolli
- Department of Medical and Surgical Critical Care, Cardiac Rehabilitation Unit, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Marco D’Addario
- Department of Psychology, University of Milan –Bicocca, Milan, Italy
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Brinks J, Fowler A, Franklin BA, Dulai J. Lifestyle Modification in Secondary Prevention: Beyond Pharmacotherapy. Am J Lifestyle Med 2017; 11:137-152. [PMID: 30202327 PMCID: PMC6125029 DOI: 10.1177/1559827616651402] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/19/2016] [Accepted: 05/04/2016] [Indexed: 12/17/2022] Open
Abstract
Despite significant advances in medical technology and pharmacology, cardiovascular disease (CVD) remains a major contributor to health care expenses and the leading cause of death in the United States. Patients with established CVD and their health care providers are challenged with achieving cardiovascular risk reduction to decrease the likelihood of recurrent cardiovascular events. This "secondary prevention" can be achieved, in part, through adherence to prescribed pharmacotherapies that favorably modify major coronary risk factors (ie, hypertension, hypercholesterolemia, diabetes, and obesity). However, lifestyle modification can also be helpful in this regard, providing independent and additive benefits to the associated reductions in cardiovascular morbidity and mortality. Accordingly, physicians and other health care providers should routinely counsel their coronary patients to engage in structured exercise and increased lifestyle physical activity, consume a heart-healthy diet, quit smoking and avoid secondhand smoke, and purposefully address psychosocial stressors that may elevate cardiovascular risk. These lifestyle interventions, either as an adjunct to medication therapy or independently in those patients where medications may be poorly tolerated, cost prohibitive, or ineffective, can significantly decrease cardiovascular mortality and the risk of recurrent cardiac events.
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Affiliation(s)
- Jenna Brinks
- Jenna Brinks, MS, Manager, Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Beaumont Health Center, Cardiac Rehabilitation, 4949 Coolidge Highway, Royal Oak, MI 48073, USA; e-mail:
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Schumacher TL, Burrows TL, Thompson DI, Callister R, Spratt NJ, Collins CE. The Role of Family in a Dietary Risk Reduction Intervention for Cardiovascular Disease. Healthcare (Basel) 2016; 4:E74. [PMID: 27706027 PMCID: PMC5198116 DOI: 10.3390/healthcare4040074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 09/13/2016] [Accepted: 09/22/2016] [Indexed: 12/04/2022] Open
Abstract
Diet is an essential strategy for the prevention of primary and secondary cardiovascular disease (CVD) events. The objectives were to examine: how families at increased risk of CVD perceived personal risk, their motivations to make dietary changes, their understanding of diet, and the influence of other family members. Individuals (>18 years) who completed an Australian family-based CVD risk reduction program were invited to a semi-structured telephone interview. Responses were recorded, transcribed verbatim and analysed using a systematic deductive approach with coding derived from key concepts developed as part of the interview structure. Seventeen participants from eight families were interviewed (aged 18-70 years, 47% male, five with CVD diagnosis). Key themes indicated both intrinsic and extrinsic motivations to improve heart health, variations in risk perception, recognition of the role diet plays in heart health, and the extent of family influences on eating patterns. Discrepancies between perceived and actual CVD risk perception impacted on perceived "need" to modify current dietary patterns towards heart health recommendations. Therefore, strategies not reliant on risk perception are needed to engage those with low risk perception. This could involve identifying and accessing the family "ringleader" to influence involvement and capitalising on personal accountability to other family members.
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Affiliation(s)
- Tracy L Schumacher
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, NSW, Australia.
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, NSW, Australia.
| | - Tracy L Burrows
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, NSW, Australia.
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, NSW, Australia.
| | - Deborah I Thompson
- USDA/ARS Children's Nutrition Research Centre, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, NSW, Australia.
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan 2308, NSW, Australia.
| | - Neil J Spratt
- Priority Research Centre for Translational Neuroscience and Mental Health & Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, NSW, Australia.
- Hunter New England Local Health District & Hunter Medical Research Institute, New Lambton Heights 2305, NSW, Australia.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, NSW, Australia.
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, NSW, Australia.
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Barolia RI, Clark AM, Higginbottom GMA. Protocol for a qualitative study on promoting dietary change and positive food choices for poor people with low income who experience cardiovascular disease in Pakistan. BMJ Open 2013; 3:e004176. [PMID: 24309173 PMCID: PMC3855597 DOI: 10.1136/bmjopen-2013-004176] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION There is a misconception that cardiovascular disease (CVD) is the burden of wealthy nations, but, in fact, it is the leading cause of death and disability-adjusted life worldwide. Healthy diets are an essential factor in the prevention of CVD. However, promoting healthy diet is challenging, particularly for people with low-socioeconomic status (SES), because poverty is linked with many risk behaviours such as smoking, unhealthy eating and obesity. Multiple factors, cultural values and beliefs interact and make healthy eating very challenging. The effects of these factors in the context of low-SES populations with CVD are largely unknown. To address this gap, this study will examine the factors that affect decisions about consuming healthy diet in Pakistanis with low SES who suffer from CVD. METHODS AND ANALYSIS A qualitative method of interpretive description will be used. 25 participants will be selected from two cardiac rehabilitation (CR) centres in Karachi, Pakistan. Face-to-face interviews using a critical realist framework will be used to understand individual and contextual factors in the food choices of people with low SES and CVD. ATLAS.ti qualitative data analysis software will be used to identify themes and patterns in the interview data. ETHICS AND DISCUSSION Ethical approvals were received from the Ethics Review board of University of Alberta, Canada and Aga Khan University, Karachi Pakistan. The findings will generate new knowledge about which and how factors influence the food choices of Pakistanis with CVD and low SES to provide an insight into the development of an operational framework for designing interventions for prevention of CVD. For knowledge-translation purposes, we will publish the findings in highly accessed, peer-reviewed scientific and health policy journals at the national and international level. This research protocol received IRDC (International Development Research Centre) doctoral award from International Development Research Centre, Ottawa, Canada.
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Affiliation(s)
- Rubina Iqbal Barolia
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alberta, Canada
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A qualitative analysis of coronary heart disease patient views of dietary adherence and web-based and mobile-based nutrition tools. J Cardiopulm Rehabil Prev 2012; 32:203-9. [PMID: 22760245 DOI: 10.1097/hcr.0b013e31825b4e6a] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE Dietary adherence can be challenging for patients with coronary heart disease (CHD), as they may require multiple dietary changes. Choosing appropriate food items may be difficult or take extensive amounts of time without the aid of technology. The objective of this project was to (1) examine the dietary challenges faced by patients with CHD, (2) examine methods of coping with dietary challenges, (3) explore the feasibility of a Web-based food decision support system, and (4) explore the feasibility of a mobile-based food decision support system. METHODS Food for the Heart (FFH), a Web site-based food decision support system, and Mobile Magic Lens (MML), a mobile-based system, were developed to aid in daily dietary choices. Three CHD patient focus groups were conducted and focused on CHD-associated dietary changes as well as the FFH and MML prototypes. A total of 20 CHD patients and 7 informal caregivers participated. Qualitative, content analysis was performed to find themes grounded in the responses. RESULTS Five predominant themes emerged: (1) decreasing carbohydrate intake and portion control are common dietary challenges, (2) clinician and social support makes dietary adherence easier, (3) FFH could make meal-planning and dietary adherence less complicated, (4) MML could save time and assist with healthy choices, and (5) additional features need to be added to make both tools more comprehensive. CONCLUSION Food for the Heart and MML may be tools that CHD patients would value in making food choices and adhering to dietary recommendations, especially if additional features are added to assist patients with changes.
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