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Andersson-Watz A, Nygren-Bonnier M, Bergdahl E, Eriksson Crommert M, Svantesson M. Introducing Mechanically Assisted Cough for Patients With Progressive Neurological Disease: Patient-Physical Therapist Interaction and Physical Therapist Perspective. Phys Ther 2024; 104:pzae012. [PMID: 38302072 PMCID: PMC11140267 DOI: 10.1093/ptj/pzae012] [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: 11/16/2022] [Revised: 09/29/2023] [Accepted: 12/20/2023] [Indexed: 02/03/2024]
Abstract
OBJECTIVE The goal of this study was to explore the patient-physical therapist interaction and the physical therapist's experience of the introductory session for mechanical insufflation-exsufflation (MI-E) device treatment for patients with progressive neurological disease. METHODS Qualitative content analysis of participant's observation of interaction between patients and physical therapists during 9 MI-E introduction sessions in different clinical care settings and 10 follow-up interviews with 6 physical therapists. RESULTS The introduction of MI-E emerged as a process of instilling a sense of security in the patient. The process can be described in 4 steps: (1) gain understanding by being responsive to the person's whole life situation; (2) share knowledge and expectations in a respectful and permissive way; (3) introduce the device in a gentle and reciprocal interactivity; and (4) adapt to home use in an inclusive dialog with the patient and their significant others. Physical therapists described a need for assurance to instill a sense of security in the patient, implying a need for confidence, competent peers, guiding yet flexible routines, and emotional support. CONCLUSION Physical therapists have a need to foster assurance in employing a person-centered approach to make a patient feel secure in the process of introducing MI-E treatment. Multiple modes of professional knowledge were used together with action-based and relational-based ethics to facilitate a person-centered care approach. This seems to be a promising approach for providing good care when introducing MI-E to patients. Further research is needed to explore this from the patient's perspective. IMPACT This study added to the body of knowledge regarding MI-E treatment in relation to patients. This has direct implication, particularly for inexperienced physical therapists, for informed care for the patient during introduction. Our study also supports that person-centered care should be implemented at all levels of health care to make it possible for physical therapists to practice person-centered care.
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Affiliation(s)
- Anna Andersson-Watz
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Malin Nygren-Bonnier
- Medical Unit Occupational Therapy and Physiotherapy. Women’s Health and Allied Health Professionals Theme, Karolinska University Hospital, Huddinge, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden
| | - Elisabeth Bergdahl
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Martin Eriksson Crommert
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Mia Svantesson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
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Ahmed Pihlgren S, Johansson L, Holmes EA, Kanstrup M. Exploring healthcare workers' experiences of a simple intervention to reduce their intrusive memories of psychological trauma: an interpretative phenomenological analysis. Eur J Psychotraumatol 2024; 15:2328956. [PMID: 38533843 PMCID: PMC10977018 DOI: 10.1080/20008066.2024.2328956] [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: 12/07/2023] [Accepted: 03/02/2024] [Indexed: 03/28/2024] Open
Abstract
ABSTRACTBackground: Many healthcare workers (HCWs) endured psychologically traumatic events at work during the coronavirus disease 2019 (COVID-19) pandemic. For some, these events are re-experienced as unwanted, recurrent, and distressing intrusive memories. Simple psychological support measures are needed to reduce such symptoms of post-traumatic stress in this population. A novel intervention to target intrusive memories, called an imagery-competing task intervention (ICTI), has been developed from the laboratory. The intervention includes a brief memory reminder cue, then a visuospatial task (Tetris® gameplay using mental rotation instructions for approximately 20 min) thought to interfere with the traumatic memory image and reduce its intrusiveness. The intervention has been adapted and evaluated in a randomized controlled trial (RCT) with Swedish HCWs (ClinicalTrials.gov identifier: NCT04460014).Objective: We aimed to explore how HCWs who worked during the COVID-19 pandemic experienced the use of a brief intervention to reduce their intrusive memories of work-related trauma.Method: Interpretative phenomenological analysis was used for in-depth understanding of the lived experiences of HCWs who used the intervention. Seven participants from the RCT were interviewed by an independent researcher without prior knowledge of the intervention. Interviews were conducted via telephone and transcribed verbatim.Results: Four general themes were generated: 'Triggers and troublesome images', 'Five Ws regarding support - what, when, why, by/with who, for whom', 'Receiving it, believing it, and doing it' and 'The intervention - a different kind of help'; the last two included two subthemes each. The results reflect participants' similarities and differences in their lived experiences of intrusive memories, support measures, and intervention impressions and effects.Conclusion: HCWs' experiences of the novel ICTI reflect a promising appraisal of the intervention as a potential help measure for reducing intrusive memories after trauma, and gives us a detailed understanding of HCWs' needs, with suggestions for its adaption for future implementation.Trial registration: ClinicalTrials.gov identifier: NCT04460014.
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Affiliation(s)
- Sara Ahmed Pihlgren
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lotta Johansson
- The Neurosurgical Intensive Care Unit, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Health and Caring Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emily A. Holmes
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Marie Kanstrup
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Theme Women’s Health and Allied Health Professionals, Medical Unit for Medical Psychology, Karolinska University Hospital, Solna, Sweden
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Kanso A, Homsi N, Chaitou AR, Farfour I, Wehbe H, Tarabay L, Abou-Mrad F. Professional and Psychological Influence of the COVID-19 Pandemic on the Training of Medical Residents. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241262685. [PMID: 38868680 PMCID: PMC11168050 DOI: 10.1177/23821205241262685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 05/31/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVES Coronavirus disease 2019 (COVID-19) has profoundly impacted residency and fellowship training and education. However, how and to what extent the COVID-19 pandemic in Lebanon compromised the daily involvement of trainees on the clinical and ethical levels is currently unknown, which this study will shed light on. METHODS We conducted a cross-sectional survey (30 questions) targeting medical residents delivering healthcare services in Lebanon. Residents from different specialties were included in the study to assess the effect of the pandemic on their education and the ethical obstacles they faced when dealing with patients. RESULTS A total of 221 postgraduate medical students participated in our study. Results showed that about half of the residents (52.1%) were only able to do a basic physical examination rather than a full examination as a mandatory requirement in the residency curriculum. The majority (60%) agreed that the doctor-patient relationship is contravened. In addition, almost all residents suffered from fear and emotional distress that affected their education (83.7%). CONCLUSION The findings of this study identify the effect of COVID-19 on residents' training, which affects treatment outcomes and greatly impacts the mental well-being of both healthcare workers and patients.
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Affiliation(s)
- Ali Kanso
- Department of Medical Ethics, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Department of Internal Medicine, Rafik Hariri University Hospital, Beirut, Lebanon
| | - Natasha Homsi
- Department of Medical Ethics, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Department of Family Medicine, Rafik Hariri University Hospital, Beirut, Lebanon
| | - Ali R. Chaitou
- Department of Internal Medicine, Rafik Hariri University Hospital, Beirut, Lebanon
| | - Imadeddine Farfour
- Department of Medical Ethics, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Department of ENT Surgery, Al Zahraa Hospital University Medical Center, Beirut, Lebanon
| | - Hussein Wehbe
- Department of Medical Ethics, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Department of Orthopedic Surgery, Bahman Medical Center, Beirut, Lebanon
| | - Lubna Tarabay
- Department of Medical Ethics, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Fadi Abou-Mrad
- Department of Medical Ethics, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Department of Neurology, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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Månsson Sandberg H, Landstad BJ, Tjulin Å, Brulin E. COVID-19- related work, managerial factors and exhaustion among general practitioners in Sweden: a cross-sectional study. BMC PRIMARY CARE 2023; 24:269. [PMID: 38087223 PMCID: PMC10717449 DOI: 10.1186/s12875-023-02228-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION A significant number of international studies show that general practitioners (GPs) suffered from burnout when working during the COVID-19 pandemic. A Swedish study found that more than 16% of GPs had exhaustion in spring 2021. Exhaustion can be regarded as an initial stage of burnout. A knowledge gap remains on GPs´ working conditions, the impact of management during the pandemic and how it was associated with exhaustion. This study aims to explore the association between severe symptoms of exhaustion and COVID-19 pandemic-related work and managerial factors among Swedish GPs and whether managerial factors have an impact on the association between exhaustion and COVID-19-related work factors. METHODS Cross-sectional data was drawn from the Longitudinal Occupational Health survey in Health Care Sweden (LOHHCS), which included a representative sample of practicing doctors in Sweden. The sample consisted of 6699 doctors with a response rate of 41.2%. This study constitutes a sample of doctors who reported working in primary care facilities at the time of data collection, i.e. 1013 GPs. The Burnout Assessment Tool (BAT) was used to assess severe symptoms of exhaustion. Questions were also asked about pandemic-related work and managerial factors. The data was analysed using descriptive statistics and multivariate logistic regression to identify the association between exhaustion, work and managerial factors. RESULTS The multivariate analysis showed that GPs who managed COVID-19 patients were about twice as likely to report severe symptoms of exhaustion. Further, GPs who reported that management was unsupportive, provided unsatisfactory working conditions and unsatisfactory policies for patient prioritisation were between two and four times more likely to report severe symptoms of exhaustion. CONCLUSIONS COVID-19-related work and managerial factors had a significant impact on the mental health of GPs. Furthermore, the potentially protective effect that satisfactory management actions had on mental health was limited. In the aftermath of the COVID-19 pandemic and in preparation for future major crises that have a high impact on healthcare, there is a need to investigate the measures that can be taken to enable GPs to carry out their work, while maintaining their wellbeing.
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Affiliation(s)
- Helena Månsson Sandberg
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden.
- Unit of Occupational Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Bodil J Landstad
- Faculty of Human Sciences, Mid Sweden University, Östersund, Sweden
- Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden
| | - Åsa Tjulin
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Emma Brulin
- Unit of Occupational Medicine, Karolinska Institutet, Stockholm, Sweden
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Currie GP, Laing RB. Moral distress in healthcare professionals: Time to reflect. J R Coll Physicians Edinb 2023; 53:237-238. [PMID: 37997844 DOI: 10.1177/14782715231215409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
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Wen Z, Xu J, Yu J, Huang X, Ni Y. Effects of work-family conflict on turnover intention among primary medical staff in Huaihai Economic Zone: a mediation model through burnout. Front Psychiatry 2023; 14:1238315. [PMID: 37817834 PMCID: PMC10561281 DOI: 10.3389/fpsyt.2023.1238315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/29/2023] [Indexed: 10/12/2023] Open
Abstract
Background Countries worldwide face the challenge of how medical personnel manage conflicts between work and family. Especially after the challenge of the COVID-19 epidemic, it is necessary to explore the possible mechanisms of work-family conflict, burnout, and turnover intention among primary medical staff. Objectives This study aims to observe the turnover intention of Chinese primary medical staff and explore the relationship between work-family conflict, burnout, and turnover intention. Methods A cross-sectional study included a turnover intention questionnaire, the Maslach Burnout Inventory-General Survey (MBI-GS), and the Work-Family Conflict Scale (WFCS) to understand turnover intention, burnout, and work-family conflict among primary medical staff in four cities (Xuzhou, Linyi, Huaibei, and Shangqiu cities) within the Huaihai Economic Zone. Spearman correlation analysis and hierarchical multiple regression analysis were used to examine the related factors of turnover intention. Structural equation modeling (SEM) was used to study the mediating role of burnout between work-family conflict and turnover intention. Results In this study, there is a positive correlation between work-family conflict and turnover intention (P < 0.01). Demographic characteristics, work-family conflict, and burnout explained 2.3%, 20.3%, and 8.8% of the incremental variances, respectively. Burnout mediated the association between work-family conflict and turnover intention. Conclusions Burnout can be regarded as a mediator between two different variables: work-family conflict and turnover intention. Improving work-family conflict and alleviating burnout may play a key role in reducing the willingness of primary medical staff to resign. Corresponding measures can be taken to balance the conflict between work and family, alleviate burnout, reduce turnover rates, and build a primary medical staff team with higher medical service quality and stability.
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Affiliation(s)
- Zongliang Wen
- School of Management, Xuzhou Medical University, Xuzhou, China
- School of Public Health, Xuzhou Medical University, Xuzhou, China
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jintao Xu
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Jinxun Yu
- School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Xiaojing Huang
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Yuting Ni
- School of Management, Xuzhou Medical University, Xuzhou, China
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Carter J, Burke H. An Adaptive Healthcare Organization Can Effectively Respond to Medical Crises. Int J Public Health 2023; 68:1605581. [PMID: 37637485 PMCID: PMC10450046 DOI: 10.3389/ijph.2023.1605581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/20/2023] [Indexed: 08/29/2023] Open
Abstract
Healthcare systems are challenged by unexpected medical crises. Established frameworks and approaches to guide healthcare institutions during these crises are limited in their effectiveness. We propose an Adaptive Healthcare Organization (AHO) system as a framework focused on the dynamic nature of healthcare delivery. Based on seven key capabilities, the AHO framework can guide single and multi-institutional healthcare organizations to adapt in real time to an unexpected medical crisis and improve their efficiency and effectiveness.
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Affiliation(s)
- Jocelyn Carter
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Harry Burke
- Department of Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
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Covelli V, Camisasca E, Manzoni GM, Crescenzo P, Marelli A, Visco MA, Cafagna D, Marsicovetere V, Pesce M, Cantoia M. After the first lockdown due to the COVID-19 pandemic: Perceptions, experiences, and effects on well-being in Italian people. Front Psychol 2023; 14:1172456. [PMID: 37333603 PMCID: PMC10274577 DOI: 10.3389/fpsyg.2023.1172456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/30/2023] [Indexed: 06/20/2023] Open
Abstract
Background Since the COVID-19 pandemic and the subsequent measures of containment, multiple studies have been conducted aimed at assessing the impacts on people's psychophysical well-being; however, few studies have investigated the general population's perceptions, experiences, and effects by adopting a mixed-method approach. Methods A total of 855 Italian participants completed an online survey, conducted in the period following the first lockdown in Italy. Psychological well-being, perceived stress and COVID-19-related fears were assessed by standardized questionnaires (Psychological General Well-Being Index-Short version, Perceived Stress Scale 10, and Multidimensional Assessment of COVID-19-Related Fears). The process of sense-making of the experience during the lockdown period was also evaluated by means of an open-ended question. Results Participants reported a lower level of general well-being, and a higher level of both perceived stress and COVID-19-related fear during the lockdown period compared to the time of the survey (1 month after the resumption of activities). The thematic analysis of responses to the open-ended question revealed two factors and five clusters, which explain the thematic variance among the narratives: the first factor refers to the type of experience (emotional states and feelings vs. objective descriptions of daily activities), while the second concerns positive or negative connotations of the experiences reported. Conclusions This study explored the psychological impact of the first lockdown on people's well-being, and described the process of making sense of the experience during the lockdown 1 month after going back to previous habits. Results highlighted the effectiveness of the mixed-method approach for an in-depth and exhaustive investigation of people's psychological condition during and after the first lockdown.
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Affiliation(s)
| | | | | | - Pietro Crescenzo
- Department of Education, Psychology and Communication, University of Bari Aldo Moro, Bari, Italy
| | | | | | - Dario Cafagna
- Faculty of Psychology, eCampus University, Como, Italy
| | | | - Mario Pesce
- Faculty of Psychology, eCampus University, Como, Italy
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Skogsberg M, Jarl G, Matérne M. Health care workers' need for support from managers during the initial phase of the COVID-19 pandemic. BMC Health Serv Res 2022; 22:1563. [PMID: 36544137 PMCID: PMC9768758 DOI: 10.1186/s12913-022-08937-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic placed great pressure on health care workers and increased the risk of these workers developing mental illness. Effective leadership is essential to prevent mental illness from developing. The study aim was to investigate health care workers' perceptions of the support given by their managers, their need for such support, and their levels of anxiety during the initial phase of the COVID-19 pandemic. METHODS An electronic study-specific questionnaire was sent to health care workers. A convergent mixed-methods design was used, in which data were analyzed with descriptive statistics, t-tests, and qualitative content analysis. RESULTS The majority of the 1074 participants experienced support from a manager who was physically present, caring, and sensitive to their needs, who provided information, and listened to their opinions. Those who did not receive this support experienced more anxiety, and the majority of them expressed a need for this support. A minority of the participants had a manager who scheduled reflection time; few asked for this support, and it was not found to be associated with lower anxiety levels. The qualitative analysis resulted in four themes: 1) A physically present and responsive manager who provides support based on the workers' needs, 2) The workers understand their manager's tough work situation and lack of resources, 3) There is a need for clear dissemination of information and participation in organizing the work, and 4) The care of patients is carried out with good cooperation. CONCLUSIONS The majority of the health care workers received adequate support from their managers. A manager has to be physically present, caring, and supportive to meet the workers' needs and potentially reduce anxiety levels.
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Affiliation(s)
| | - Gustav Jarl
- grid.15895.300000 0001 0738 8966University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden ,grid.15895.300000 0001 0738 8966Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Marie Matérne
- grid.15895.300000 0001 0738 8966University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden ,grid.15895.300000 0001 0738 8966School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
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Practices and Strategies of Health Professionals during the COVID-19 Pandemic—Between Limitations and Opportunities. Healthcare (Basel) 2022; 10:healthcare10101817. [PMID: 36292264 PMCID: PMC9601796 DOI: 10.3390/healthcare10101817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
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