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Whitehead IO, Moffatt S, Warwick S, Spiers GF, Kunonga TP, Tang E, Hanratty B. Systematic review of the relationship between burn-out and spiritual health in doctors. BMJ Open 2023; 13:e068402. [PMID: 37553194 PMCID: PMC10414094 DOI: 10.1136/bmjopen-2022-068402] [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: 09/16/2022] [Accepted: 05/03/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE To investigate the relationship between burn-out and spiritual health among medical doctors. DESIGN Systematic literature review and narrative synthesis of cross-sectional studies. SETTING Any setting, worldwide. DATA SOURCES Five databases were searched from inception to March 2022, including Medline, Embase, PsycINFO, Scopus and Web of Science. ELIGIBILITY CRITERIA Any study design that involved medical doctors (and other healthcare staff if assessed alongside medical doctors), that measured (in any way) both burn-out (or similar) and spiritual health (or similar) medical doctors. DATA EXTRACTION AND SYNTHESIS All records were double screened. Data extraction was performed by one reviewer and a proportion (10%) checked by a second reviewer. Quality was assessed using the Appraisal of Cross-sectional Studies tool. Due to the heterogeneity of the included studies, a narrative review was undertaken without a meta-analysis. RESULTS Searches yielded 1049 studies. 40 studies met eligibility criteria and were included in this review. Low reported levels of spirituality were associated with high burn-out scores and vice versa. Religion was not significantly associated with lower levels of burn-out. Few studies reported statistically significant findings, few used validated spiritual scores and most were vulnerable to sampling bias. CONCLUSIONS Published research suggests that burn-out is linked to spiritual health in medical doctors but not to religion. Robust research is needed to confirm these findings and develop effective interventions. PROSPERO REGISTRATION NUMBER CRD42020200145.
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Affiliation(s)
| | - Suzanne Moffatt
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Stephanie Warwick
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Gemma F Spiers
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Eugene Tang
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Barbara Hanratty
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Skalski-Bednarz SB, Konaszewski K, Toussaint LL, Büssing A, Surzykiewicz J. Positive religious coping acts through perception of nature and silence in its association with well-being and life satisfaction among Polish Catholics. Front Public Health 2022; 10:1020007. [PMID: 36420015 PMCID: PMC9678048 DOI: 10.3389/fpubh.2022.1020007] [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: 08/15/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Abstract
Previous studies indicate that perceptions of nature and thought-provoking silence can have positive consequences for individual functioning. The purpose of the present study was to assess the relationships between religious coping (assessed with the Brief RCOPE), perceptions of nature and silence (a subscale of the Perception of Change Questionnaire), well-being (the World Health Organization's five-item Well-Being Index) and life satisfaction (the Brief Multidimensional Life Satisfaction Scale). An online questionnaire was completed between 2021-2022 by 1,010 Polish Catholics ages 18 to 73, 61% of whom were women. Structural equation modeling showed that positive religious coping was positively related to well-being (β = 0.08, p = 0.011) and life satisfaction (β = 0.22, p < 0.001). In contrast, negative religious coping was related to reduced well-being (β = -0.07, p = 0.040) and life satisfaction (β = -0.25). In addition, more frequent perceptions of nature and reflective times of silence partially mediated the associations of positive religious coping with well-being (β = 0.04, p = 0.011) and life satisfaction (β = 0.04, p = 0.008). The data might suggest that interventions that help people develop an ability or awareness for nature as an exceptional encounter and may help to strengthen the ways they can utilize their religiosity as a resource and thus contribute to well-being and life satisfaction among Catholics.
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Affiliation(s)
- Sebastian Binyamin Skalski-Bednarz
- Faculty of Philosophy and Education, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany,Faculty of Education, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland,*Correspondence: Sebastian Binyamin Skalski-Bednarz
| | | | | | - Arndt Büssing
- Professorship Quality of Life, Spirituality and Coping, Witten/Herdecke University, Herdecke, Germany
| | - Janusz Surzykiewicz
- Faculty of Philosophy and Education, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany,Faculty of Education, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
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Hvidt NC, Curlin F, Büssing A, Baumann K, Frick E, Søndergaard J, Nielsen JB, Lawrence R, Lucchetti G, Ramakrishnan P, Wermuth I, Hefti R, Lee E, Kørup AK. The NERSH Questionnaire and Pool of Data from 12 Countries: Development and Description. JOURNAL OF RELIGION AND HEALTH 2022; 61:2605-2630. [PMID: 34599478 DOI: 10.1007/s10943-021-01428-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 06/13/2023]
Abstract
Modern healthcare research has only in recent years investigated the impact of health care workers' religious and other values on medical practice, interaction with patients, and ethically complex decision making. So far, only limited international data exist on the way such values vary across different countries. We therefore established the NERSH International Collaboration on Values in Medicine with datasets on physician religious characteristics and values based on the same questionnaire. The present article provides (a) an overview of the development of the original and optimized questionnaire, (b) an overview of the content of the NERSH data pool at this stage and (c) a brief review of insights gained from articles published with the questionnaire. The pool at this stage consists of data from 17 studies from research units in 12 different countries representing six continents with responses from more than 6000 health professionals. The joint data pool suggests that there are large differences in religious and other moral values across nations and cultures, and that these values contribute to the observed differences in health professionals' clinical practices-across nations and cultures!
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Affiliation(s)
- Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark.
| | - Farr Curlin
- Trent Center for Bioethics, Humanities, and History of Medicine, Duke University, Durham, NC, USA
| | - Arndt Büssing
- Faculty of Medicine, Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany
| | - Klaus Baumann
- Caritas Science and Christian Social Work, Faculty of Theology, Freiburg University, Freiburg im Breisgau, Germany
| | - Eckhard Frick
- Department of Psychosomatic Medicine and Psychotherapy, Research Centre Spiritual Care, The University Hospital Klinikum Rechts der Isar, Langerstr. 3, 81675, Munich, Germany
- Forschungsstelle Spiritual Care, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Munich School of Philosophy, Kaulbachstr. 31, 80539, Munich, Germany
| | - Jens Søndergaard
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jesper Bo Nielsen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Ryan Lawrence
- Department of Psychiatry, Columbia University Medical Center, New York, USA
| | - Giancarlo Lucchetti
- Federal University of Juiz de Fora, Avenida Eugênio de Nascimento s/n - Aeroporto, Juiz de Fora, MG, 36038330, Brazil
| | | | - Inga Wermuth
- Medical Faculty, Ludwig Maximilian University of Munich, Munich, Germany
| | - René Hefti
- Medical Faculty, University of Bern, Bern, Switzerland
- Research Institute for Spirituality and Health (RISH), Langenthal, Switzerland
| | - Eunmi Lee
- Caritas Science and Christian Social Work, Faculty of Theology, Freiburg University Center for Social Cohesion, Daegu Catholic University, Hayang-Ro 13-13, Hayang-Eup, Gyeongsan-Si, Gyeongbuk, 38430, Republic of Korea
| | - Alex Kappel Kørup
- Research Unit of General Practice, Department of Mental Health Kolding-Vejle, Institute of Public Health, University of Southern Denmark, Odense, Denmark
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Prinds C, Paal P, Hansen LB. Characteristics of existing healthcare workforce education in spiritual care related to childbirth: A systematic review identifying only two studies. Midwifery 2021; 97:102974. [PMID: 33714917 DOI: 10.1016/j.midw.2021.102974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 02/03/2021] [Accepted: 02/28/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND It has been argued that the beginning of life is one of the most significant, universally-shared life events, impacting parental health biologically, sociologically, psychologically and spiritually. In maternity care settings, only a few educational initiatives exist focusing on increasing competencies in spiritual care. OBJECTIVE To explore the characteristics of content in existing under- and post-graduate education of healthcare professionals in spiritual care in the field of maternity care. METHODS We conducted an integrative review, searching seven databases for studies describing the content of existing education in spiritual care in maternity care settings. RESULTS From 235 studies assessed eligible and full text screened, only two were included, originating from the same project. The majority of existing studies about spiritual care focus on the perspective of women related to loss, sickness or bereavement, whereas research related to the field of maternity care is sparser. Furthermore, the perspective of the professional seems overlooked. CONCLUSION There is a lack of research exploring the content and structure of educational initiatives related to spiritual care in maternity care. In order to strengthen spiritual care competencies in maternity care, for both women/partners and professionals, future research should investigate how education is planned and evaluated.
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Affiliation(s)
- Christina Prinds
- University College South Denmark, Degnevej 16, DK-6705 Esbjerg, Ø, Denmark; University of Southern Denmark, Faculty of Health Sciences, Department of Clinical Institute, Kløvervænget 10, DK-5000 Odense, C, Denmark.
| | - Piret Paal
- WHO Collaborating Centre for Nursing Research and Education, Institute of Nursing Science and Practice, Paracelsus Medical Private University, Strubergasse 21, 5020 Salzburg Austria.
| | - Line Bruun Hansen
- University College South Denmark, Degnevej 16, DK-6705 Esbjerg, Ø, Denmark
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Shapiro RE, Vallejo MC, Sofka SH, Elmo RM, Anderson AH, Ferrari ND. Hospital Spiritual Care Can Complement Graduate Medical Trainee Well-Being. Adv Med 2019; 2019:8749351. [PMID: 31886315 PMCID: PMC6925940 DOI: 10.1155/2019/8749351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 08/06/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Burnout and depression among physician trainees is increasing at an alarming rate. Promoting well-being is of utmost importance for graduate medical education. The primary objective was to determine if spiritual care staff/chaplaincy can assist in building emotional well-being and resiliency within medical residency education. METHODS For the academic year of July 2017 through June 2018, all graduate medical trainees in our institution were given the option of attending either an individual or group spiritual care session as part of a universal "Call to Wellness" curriculum. A Post-Wellness Survey was administered to measure perceptions about the program. RESULTS 49% (N = 258) of residents chose to participate in a spiritual care session. Prior to the session, 51% (N = 132) rated their overall well-being as neutral and 25% (N = 64) rated their overall well-being as slightly positive, positive, or very positive. After their spiritual care session, significant improvement was seen. 25% (N = 64) rated their overall well-being as neutral, and 51% (N = 132) rated their overall well-being as slightly positive, positive, or very positive (p < 0.001). CONCLUSION Spiritual care staff/chaplaincy can have a positive influence on emotional well-being for physicians during residency training.
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Affiliation(s)
- Robert E. Shapiro
- West Virginia University School of Medicine, Department of Obstetrics & Gynecology, P.O. Box 9186, Robert C. Byrd Health Sciences Center, Morgantown, WV 26506, USA
| | - Manuel C. Vallejo
- West Virginia University School of Medicine, Departments of Medical Education and Anesthesiology, P.O. Box 9001A, Robert C. Byrd Health Sciences Center, Morgantown, WV 26506, USA
| | - Sarah H. Sofka
- West Virginia University School of Medicine, Department of Medicine, 4th Floor HSCN Rm 4086, Morgantown, WV 26506, USA
| | - Rebecca M. Elmo
- West Virginia University School of Medicine, Department of Medical Education, P.O. Box 9001A, Robert C. Byrd Health Sciences Center, Morgantown, WV 26506, USA
| | - Allison H. Anderson
- West Virginia University, Department of Spiritual Care and Education, One Medical Center Drive, P.O. Box 8008, Morgantown, WV 26506, USA
| | - Norman D. Ferrari
- West Virginia University School of Medicine, Department of Medical Education, P.O. Box 9111, Robert C. Byrd Health Sciences Center, Morgantown, WV 26506, USA
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Sens GR, Abdala GA, Meira MDD, Bueno S, Koenig HG. Religiosity and Physician Lifestyle from a Family Health Strategy. JOURNAL OF RELIGION AND HEALTH 2019; 58:628-638. [PMID: 29681006 DOI: 10.1007/s10943-018-0619-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This study examines the association between religiosity and physician lifestyle from a Family Health Strategy perspective. This is a cross-sectional study with 30 physicians, who completed the religiosity and lifestyle questionnaires. Among the participants, 70% (n = 21) had no "focus" on spirituality and health. The average total lifestyle score was 74.1 (SD = 8.1), but the "Physical Activity" subscale score was below average (3.4, SD = 2.37). We found eight significant correlations between religiosity and lifestyle subscales (p < 0.05). Greater religious involvement is associated with better overall and specific areas of physician lifestyle.
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Affiliation(s)
| | | | | | | | - Harold G Koenig
- Center for Spirituality, Theology and Health, Duke University Medical Center, Durham, NC, 27503, USA
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Kienle GS, Mussler M, Fuchs D, Kiene H. On caring and sharing-Addressing psychological, biographical, and spiritual aspects in integrative cancer care: A qualitative interview study on physicians' perspectives. Complement Ther Med 2018; 40:126-132. [PMID: 30219437 DOI: 10.1016/j.ctim.2018.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 04/24/2018] [Accepted: 04/26/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Patients confronted with a cancer diagnosis experience a variety of existential needs encompassing emotional, psychological, and spiritual areas of being. A patient-centered care approach addressing such existential issues is recognized as an essential aspect of health care. The aim of this study is to explore what role psychological, biographical, and spiritual factors play for experienced doctors working in integrative cancer care. METHOD The qualitative study was based on in-depth interviews with 35 purposively sampled doctors, all practicing integrative oncology in the field of anthroposophic medicine in hospitals and/or office-based practices in Germany and other countries. Data were analyzed using structured content analysis. RESULTS Psychological, biographical, and spiritual factors are important issues in integrative cancer care. Prevailing themes identified in this study were enabling patients to participate in life, promoting autonomy and coping, stabilizing patients emotionally and cognitively, overcoming the disease, and-primarily if addressed by patients-integrating spiritual issues. Doctors offered conversation, counseling, and time, but also referred to art, music, literature, and nature, so that patients' ongoing emotional, psychological, and spiritual needs could be explored and addressed. Doctors' attitudes with regard to existential issues were seen as important, as was maintaining an attitude of openness towards existential issues. CONCLUSION Doctors in integrative cancer care utilize different methods to explore the needs of patients and employ a variety of treatment methods that address not just patients' medical issues but their existential concerns as well.
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Affiliation(s)
- Gunver S Kienle
- Institute for Applied Epistemology and Medical Methodology at the University of Witten Herdecke, Zechenweg 6, D-79111 Freiburg, Germany; Center for Complementary Medicine, Institute for Infection Prevention and Hospital Epidemiology, Medical Center - University of Freiburg, Faculty of Medicine, Breisacher Str. 115B, 79106, Germany.
| | - Milena Mussler
- Institute for Applied Epistemology and Medical Methodology at the University of Witten Herdecke, Zechenweg 6, D-79111 Freiburg, Germany.
| | - Dieter Fuchs
- Department of Theology, Caritas Sciences, University of Freiburg, Werthmannplatz 3, D-79098 Freiburg, Germany.
| | - Helmut Kiene
- Institute for Applied Epistemology and Medical Methodology at the University of Witten Herdecke, Zechenweg 6, D-79111 Freiburg, Germany.
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Abstract
Zusammenfassung. Dieser Artikel gibt einen Überblick über die aktuelle Diskussion zu Ansätzen ärztlicher Spiritual Care. Der ärztliche Beitrag zu einer interprofessionellen Spiritual Care ist aus drei Gründen wichtig: 1. Für manche Patienten stellen religiös-spirituelle Faktoren im Umgang mit Krankheit und Sterben entweder eine Ressource oder ein Problem dar. 2. Religiös-spirituelle Faktoren können medizinische Entscheidungen beeinflussen, insbesondere am Lebensende. 3. Aufgrund des besonderen Abhängigkeitsverhältnisses im stationären Bereich tragen Ärzte eine Mitverantwortung dafür, dass die Ausübung religiöser Lebensvollzüge unter den Bedingungen des klinischen Alltags gewährleistet bleibt. Eine spezifisch ärztliche Spiritual Care ist deshalb als integrales Moment des ärztlichen Behandlungsauftrags zu verstehen.
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Soto-Espinosa J, Koss-Chioino JD. Doctors Who Integrate Spirituality and CAM in the Clinic: The Puerto Rican Case. JOURNAL OF RELIGION AND HEALTH 2017; 56:149-157. [PMID: 26852419 DOI: 10.1007/s10943-016-0198-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article describes Puerto Rican physicians' personal and clinical utilization of complementary and alternative medicines (CAM), its effects, and use as they identified as either Spiritist, spiritual or religious. Semi-structured interviews were conducted with 74 doctors in Puerto Rico. Major themes and relationships among them were charted using the qualitative data analysis program MAXQDA, open coding and grounded theory. Thirty-one doctors spoke of CAM and its use as related to their spiritual or religious perspectives. Spiritual or Spiritist doctors were more inclined than religious doctors to utilize CAM. Seeking closer relationships with patients was related to a spiritually oriented goal of healing (as distinct from curing) as a reason to recommend CAM.
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Affiliation(s)
- Jesús Soto-Espinosa
- Federal Social Security System, 839 Calle Añasco, Suite 2, San Juan, PR, 00925, USA.
| | - Joan D Koss-Chioino
- Arizona State University, Tempe, AZ, USA
- George Washington University, Washington, DC, USA
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The NERSH International Collaboration on Values, Spirituality and Religion in Medicine: Development of Questionnaire, Description of Data Pool, and Overview of Pool Publications. RELIGIONS 2016. [DOI: 10.3390/rel7080107] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Influence of spirituality on cool down reactions, work engagement, and life satisfaction in anthroposophic health care professionals. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:754814. [PMID: 25694789 PMCID: PMC4324950 DOI: 10.1155/2015/754814] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 10/24/2014] [Indexed: 11/17/2022]
Abstract
This study aimed to analyse whether spirituality is a resource for health care professionals to deal with increasing stress and work burden, specifically to analyse associations between "cool down reactions" (which describe an emotional distancing towards patients and/or reduced engagement as a strategy to protect their own functionality), work burden, and life satisfaction. We specifically focussed on anthroposophic health care professionals because of their unique approach to distinct aspects of spirituality. In a cross-sectional survey using standardized questionnaires, 489 persons were enrolled (66% women, mean age 53 ± 10 years, 41% physicians, 12% nurses, and 47% other health care professionals). They scored very high on all measures of spirituality and moderate to low with respect to "cool down reactions." Significant predictors of "cool down reactions" were low work vigor, perceived work burden, alcohol consumption, low life satisfaction, and religious orientation (R (2) = 0.20). In contrast, their life satisfaction was explained best (R (2) = 0.35) by vigor, with further positive influences of being a physician, conscious interactions, and living with a partner on one hand and negative influences of "cool down reactions," work burden, and transcendence convictions on the other hand. Thus, specific aspects of spirituality have only a small influence on anthroposophic health care professionals' "cool down reactions," but might buffer against a loss of vigor and dedication in their work.
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