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Kurihara R, Nagao T, Tanemura R. Work-support techniques used by occupational therapists to facilitate support after acquired brain injuries: A qualitative study. Hong Kong J Occup Ther 2024; 37:10-20. [PMID: 38912099 PMCID: PMC11192432 DOI: 10.1177/15691861231225754] [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: 07/16/2023] [Accepted: 12/24/2023] [Indexed: 06/25/2024] Open
Abstract
Background Ensuring effective return to work following acquired brain injuries is crucial from the perspectives of both quality of life and the economy. However, techniques of occupational therapy support for return to work remain relatively unelucidated. Aims/Objectives To clarify the specific contents of occupational therapy required for work and work support for clients with acquired brain injuries. Material and Methods An interview-based survey was conducted with participants who had >10 years of occupational therapy experience and had provided work support. We selected participants via snowball sampling. Data were analyzed using thematic analysis. Results A total of 20 participants (15 women and 5 men; 6, 12, 1, and 1 in their 30s, 40s, 50s, and 60s, respectively) were included. Six concepts were generated on reviewing the support for work items considered important by the occupational therapist as follows: "Support for vocational life," "Support for interpersonal skills," "Support for work," "Support for illness, disability, and awareness," "Support for utilization of compensation measures," and "Support for goal setting." Conclusions We clarified the specific contents of work support, including support for vocational life and support for work, that is administered by occupational therapists who provide work support for clients with acquired brain injury. The insights from the study improve understanding of OTs' roles and contributions in supporting clients with acquired brain injuries in returning to work.
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Affiliation(s)
- Ryoko Kurihara
- Teikyo Heisei University, Japan
- Doctoral Program, Graduate School of Health Sciences, Kobe University, Japan
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Karkon S, Bennett KE, O'Shea F, Doran M, Connolly D. Testing the effectiveness of a Fatigue and Activity Management Education for Work (FAME-W) intervention for individuals with inflammatory arthritis: Study protocol for a randomized control trial. Musculoskeletal Care 2023; 21:1629-1638. [PMID: 37937322 DOI: 10.1002/msc.1839] [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: 10/12/2023] [Accepted: 10/18/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND A work-focused fatigue management intervention, Fatigue and Activity Management Education for Work (FAME-W) programme was developed for individuals with inflammatory arthritis (IA) to manage fatigue in order to maintain demands of their work activities and tasks. This paper presents the protocol for a randomized control trial that will test the effectiveness and acceptability of FAME-W in improving work performance. METHODS This protocol presents a multisite randomized control trial and mixed methods process evaluation. Eligible participants will be aged 18-65 years with a diagnosis of inflammatory arthritis and will be in paid employment. The primary outcome of the study will be Work Role Functioning (WRF) questionnaire, and the secondary outcomes will be fatigue, mood, health-related quality of life (HRQOL) and pain. Data will be collected immediately pre- and post-intervention and at 3 months of follow-up. The process evaluation will consist of focus groups and individual interviews to explore participants' experiences of FAME-W. Occupational therapists delivering the programme will complete a facilitator log to assess the fidelity and quality of intervention implementations. Facilitators will participate in individual interviews to explore intervention delivery and acceptability. RESULTS Results will be expected to show that FAME-W will improve work performance by helping participants gain self-management strategies around managing fatigue and other symptoms related to fatigue. CONCLUSION It is hoped that FAME-W will be an effective and acceptable intervention for individuals with IA in improving work performance by helping them manage their symptoms. TRIAL REGISTRATION ClinicalTrials.gov: NCT05138445, Registered on 30 November 2021.
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Affiliation(s)
- Shalaleh Karkon
- Discipline of Occupational Therapy, Trinity Centre for Health Sciences, St. James' Hospital, Dublin, Ireland
| | - Kathleen E Bennett
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Finbarr O'Shea
- Rheumatology Department, St. James' Hospital, Dublin, Ireland
| | - Michelle Doran
- Rheumatology Department, St. James' Hospital, Dublin, Ireland
| | - Deirdre Connolly
- Discipline of Occupational Therapy, Trinity Centre for Health Sciences, St. James' Hospital, Dublin, Ireland
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AlHeresh R, Simpson E, Allaire S, Keysor J. Workplace barriers among people with rheumatic and chronic back pain: Results from the work experience survey for rheumatic conditions. Work 2023:WOR211147. [PMID: 36683472 DOI: 10.3233/wor-211147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The Work Experience Survey for Rheumatic Conditions (WES-RC) is a prominent feature of an evidence-based intervention to prevent premature job loss among people with arthritis. The WES-RC is used to identify client perceived barriers related to work performance. The degree to which people with arthritis and rheumatic conditions report barriers on the WES-RC has not been reported. OBJECTIVE The purpose of this study was to characterize the barriers reported on the WES-RC. METHODS Data from participants who completed the WES-RC in the Work It study trial were included (N = 143). Descriptive statistics were used to characterize the sample and the frequency with which barriers on the WES-RC were reported. Responses to the top three bothersome barriers to study participants were summed. RESULTS The mean age of the sample was 50.3 years; 73% were female, and 66% white. All WES-RC items were checked as a barrier by at least two participants; less than 10 participants checked 34 items. Barriers in the 'getting ready for work and traveling to and from, or for work' domain, were frequently reported. The most bothersome barriers were 'standing or being on feet too long' and 'prolonged sitting'. CONCLUSION The WES-RC is a self-reported checklist that captures a wide breadth of work-related barriers that could be experienced by people with arthritis who are currently employed.
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Affiliation(s)
- Rawan AlHeresh
- Occupational Therapy Department, MGH Institute of Health Professions, Boston, MA, USA
| | - Elizabeth Simpson
- Department of Gerontology, University of Massachusetts, Boston, MA, USA
| | | | - Julie Keysor
- Physical Therapy Department, MGH Institute of Health Professions, Boston, MA, USA
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Hammond A, Radford KA, Ching A, Prior Y, O’Brien R, Woodbridge S, Culley J, Parker J, Holland P. The Workwell trial: protocol for the process evaluation of a randomised controlled trial of job retention vocational rehabilitation for employed people with inflammatory arthritis. Trials 2022; 23:937. [DOI: 10.1186/s13063-022-06871-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 10/29/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The Workwell trial is a multi-centre randomised controlled trial with the aims of evaluating the effectiveness and cost-effectiveness of job retention vocational rehabilitation for employed people with inflammatory arthritis, who are experiencing work difficulties due to their arthritis. Vocational rehabilitation is delivered by health service occupational therapists, who have received additional training in providing this Workwell intervention. A process evaluation will be undertaken alongside the main trial to investigate implementation fidelity; understand key stakeholders’ perspectives of the intervention and the social and structural context in which the intervention is provided; and explore issues related to future implementation in clinical practice. This protocol describes the aims, objectives, and methodology of the Workwell trial process evaluation.
Methods
This mixed methods process evaluation will follow the Medical Research Council’s Guidance on process evaluations for complex interventions. It will be underpinned by the conceptual framework for implementation fidelity (CFIF) and normalisation process theory (NPT). We will analyse treatment records, work assessments, and treatment notes to ascertain implementation fidelity. Semi-structured interviews with trial participants, their employer/line managers, treating therapists, and their therapy service managers will be undertaken to explore perceptions of the intervention, contextual factors, and potential for future implementation in practice. Interview topic guides will be informed by NPT. Therapists’ views about Workwell training will be explored via questionnaires following training, and interviews and focus groups following treatment delivery to inform future implementation. Quantitative data will be analysed descriptively. Qualitative data will be analysed using thematic analysis. NPT will guide data analysis and interpretation. Findings from the different elements of this embedded design process evaluation will be reported separately and then the elements integrated. The process evaluation data will be analysed independently of the Workwell trial outcome evaluation. The process evaluation data will then be reviewed in the light of the trial findings.
Discussion
Few trials of job retention vocational rehabilitation in arthritis have included process evaluations. This process evaluation will assist in understanding factors influencing trial outcomes and identifying potential contextual barriers and facilitators for the potential implementation of Workwell vocational rehabilitation into clinical services.
Trial registration
ClinicalTrials.gov NCT03942783. Registered on 08 May 2019. ISRCTN Registry ISRCTN61762297. Registered on 13 May 2019. Retrospectively registered.
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Ubhi M, Dubey S, Gordon C, Adizie T, Sheeran T, Allen K, Jordan R, Sadhra S, Adams J, Daji R, Reynolds JA, Kumar K. Understanding the impact of systemic lupus erythematosus on work amongst South Asian people in the UK: An explorative qualitative study. Lupus 2021; 30:1492-1501. [PMID: 34092136 PMCID: PMC8283190 DOI: 10.1177/09612033211022816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
SLE has a range of fluctuating symptoms affecting individuals and their ability to work. Although South Asian (SA) patients are at increased risk of developing SLE there is limited knowledge of the impact on employment for these patients in the UK. Understanding ethnicity and disease-specific issues are important to ensure patients are adequately supported at work. Semi-structured interviews were conducted with patients of SA origin to explore how SLE impacted on their employment. Thematic analysis was used to analyse the data which are reported following COREQ guidelines. Ten patients (8 female; 2 male) were recruited from three rheumatology centres in the UK and interviewed between November 2019 and March 2020. Patients were from Indian (n = 8) or Pakistani (n = 2) origin and worked in a range of employment sectors. Four themes emerged from the data: (1) Disease related factors; (2) Employment related factors; (3) Cultural and interpersonal factors impacting on work ability; (4) Recommendations for improvement. Patients’ ability to work was affected by variable work-related support from their hospital clinicians, low awareness of SLE and variable support from their employers, and cultural barriers in their communities that could affect levels of family support received. These findings highlight the need for additional support for SA patients with SLE in the workplace.
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Affiliation(s)
- Mandeep Ubhi
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Shirish Dubey
- University Hospitals Coventry, Coventry, UK.,Warwickshire NHS Trust, Warwick, UK
| | - Caroline Gordon
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,Sandwell and West Birmingham NHS Trust, West Bromwich, UK
| | | | - Tom Sheeran
- Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Kerry Allen
- School of Social Policy, University of Birmingham, Birmingham, UK
| | - Rachel Jordan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Steven Sadhra
- Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK
| | - Jo Adams
- Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | | | - John A Reynolds
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,Sandwell and West Birmingham NHS Trust, West Bromwich, UK
| | - Kanta Kumar
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
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Keysor JJ, LaValley MP, Brown C, Felson DT, AlHeresh RA, Vaughan MW, Yood R, Reed JI, Allaire SJ. Efficacy of a Work Disability Prevention Program for People with Rheumatic and Musculoskeletal Conditions: A Single-Blind Parallel-Arm Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2018; 70:1022-1029. [PMID: 28941189 DOI: 10.1002/acr.23423] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 09/12/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Work disability rates are high among people with rheumatic and musculoskeletal conditions. Effective disability preventive programs are needed. We examined the efficacy of a modified vocational rehabilitation approach delivered by trained occupational therapists and physical therapists on work limitation and work loss over 2 years among people with rheumatic and musculoskeletal conditions. METHODS Eligibility criteria for this single-blind, parallel-arm randomized trial included ages 21-65 years, 15 or more hours/week employment, a self-reported doctor-diagnosed rheumatic or musculoskeletal condition, and concern about staying employed. The intervention consisted of a 1.5-hour meeting, an action plan, written materials on employment supports, and telephone calls at 3 weeks and 3 months. Control group participants received the written materials. The primary outcome was the Work Limitations Questionnaire (WLQ) output job demand subscale. The secondary outcome was work loss. Intent-to-treat analyses were performed. RESULTS Between October 2011 and January 2014, 652 individuals were assessed for eligibility. A total of 287 participants were randomized: 143 intervention and 144 control participants. In total, 264 participants (92%) completed 2-year data collection. There was no difference in the mean ± SD WLQ change scores from baseline to 2-year followup (-8.6 ± 1.9 intervention versus -8.3 ± 2.2 control; P = 0.93). Of the 36 participants who experienced permanent work loss at 2 years, 11 (8%) were intervention participants and 25 (18%) control participants (P = 0.03). CONCLUSION The intervention did not have an effect on work limitations but reduced work loss. The intervention can be delivered by trained rehabilitation therapists.
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Affiliation(s)
- Julie J Keysor
- Boston University Sargent College of Health and Rehabilitation Sciences, Boston, Massachusetts
| | | | - Carrie Brown
- Boston University School of Medicine, Boston, Massachusetts
| | - David T Felson
- Boston University School of Medicine, Boston, Massachusetts, and the National Institute for Health Research Manchester Musculoskeletal Biomedical Research Centre, Central Manchester National Health Service Foundation Trust, and Manchester Academic Health Science Centre, Manchester, UK
| | - Rawan A AlHeresh
- Massachusetts General Hospital Institute of Health Professions, Boston
| | | | - Robert Yood
- University of Massachusetts Medical School, Saint Vincent Hospital, and Reliant Medical Group, Worcester, Massachusetts
| | - John I Reed
- University of Massachusetts Medical School, Saint Vincent Hospital, and Reliant Medical Group, Worcester, Massachusetts
| | - Saralynn J Allaire
- Boston University Sargent College of Health and Rehabilitation Sciences, Boston, Massachusetts
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Hammond A, O’Brien R, Woodbridge S, Bradshaw L, Prior Y, Radford K, Culley J, Whitham D, Ruth Pulikottil-Jacob. Job retention vocational rehabilitation for employed people with inflammatory arthritis (WORK-IA): a feasibility randomized controlled trial. BMC Musculoskelet Disord 2017; 18:315. [PMID: 28732491 PMCID: PMC5521067 DOI: 10.1186/s12891-017-1671-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/12/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inflammatory arthritis leads to work disability, absenteeism and presenteeism (i.e. at-work productivity loss) at high cost to individuals, employers and society. A trial of job retention vocational rehabilitation (VR) in the United States identified this helped people keep working. The effectiveness of this VR in countries with different socioeconomic policies and conditions, and its impact on absenteeism, presenteeism and health, are unknown. This feasibility study tested the acceptability of this VR, modified for the United Kingdom, compared to written advice about managing work problems. To help plan a randomized controlled trial, we tested screening, recruitment, intervention delivery, response rates, applicability of the control intervention and identified the relevant primary outcome. METHODS A feasibility randomized controlled trial with rheumatoid, psoriatic or inflammatory arthritis patients randomized to receive either job retention VR or written information only (the WORK-IA trial). Following three days VR training, rheumatology occupational therapists provided individualised VR on a one to one basis. VR included work assessment, activity diaries and action planning, and (as applicable) arthritis self-management in the workplace, ergonomics, fatigue and stress management, orthoses, employment rights and support services, assistive technology, work modifications, psychological and disclosure support, workplace visits and employer liaison. RESULTS Fifty five (10%) people were recruited from 539 screened. Follow-up response rates were acceptable at 80%. VR was delivered with fidelity. VR was more acceptable than written advice only (7.8 versus 6.7). VR took on average 4 h at a cost of £135 per person. Outcome assessment indicated VR was better than written advice in reducing presenteeism (Work Limitations Questionnaire (WLQ) change score mean: VR = -12.4 (SD 13.2); control = -2.5 (SD 15.9), absenteeism, perceived risk of job loss and improving pain and health status, indicating proof of concept. The preferred primary outcome measure was the WLQ, a presenteeism measure. CONCLUSIONS This brief job retention VR is a credible and acceptable intervention for people with inflammatory arthritis with concerns about continuing to work due to arthritis. TRIAL REGISTRATION ISRCTN 76777720 . Registered 21.9.12.
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Affiliation(s)
- Alison Hammond
- Centre for Health Sciences Research (OT), L701 Allerton, University of Salford, Frederick Road, Salford, M6 6PU UK
| | - Rachel O’Brien
- Centre for Health and Social Care Research, Sheffield Hallam University, Montgomery House, 32 Collegiate Crescent, Sheffield, S10 2BP UK
| | | | - Lucy Bradshaw
- Nottingham Clinical Trials Unit, Queens Medical Centre, University of Nottingham, NG7 2UHL, Nottingham, UK
| | - Yeliz Prior
- Centre for Health Sciences Research (OT), L701 Allerton, University of Salford, Frederick Road, Salford, M6 6PU UK
| | - Kate Radford
- Ageing and Disability Research Unit, Queen’s Medical Centre, University of Nottingham, Nottingham, NG7 2UH UK
| | - June Culley
- Derby National Rheumatoid Arthritis Society branch, Derby, UK
| | - Diane Whitham
- Nottingham Clinical Trials Unit, Queens Medical Centre, University of Nottingham, NG7 2UHL, Nottingham, UK
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van Biljon H, du Toit SH, Masango J, Casteleijn D. Exploring service delivery in occupational therapy: The use of convergent interviewing. Work 2017; 57:221-232. [DOI: 10.3233/wor-172557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Hester van Biljon
- Work-link Vocational Rehabilitation practice, South Africa
- Department of Occupational Therapy, Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sanetta H.J. du Toit
- Department of Occupational Therapy, University of the Free State, Bloemfontein, South Africa
- Department of Occupational Therapy, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - July Masango
- Steve Biko Academic Hospital, Pretoria, South Africa
- Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Daleen Casteleijn
- Department of Occupational Therapy, Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Prior Y, Amanna AE, Bodell SJ, Hammond A. A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Patients' views. Br J Occup Ther 2017; 80:39-48. [PMID: 30166772 PMCID: PMC6097118 DOI: 10.1177/0308022616672666] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 09/05/2016] [Indexed: 01/30/2023]
Abstract
INTRODUCTION This qualitative study, nested in a pilot feasibility randomised controlled trial, explored the views of working people with inflammatory arthritis on the impact of a work rehabilitation programme received. METHOD Thirty-two participants, drawn from the 55 participants in the associated randomised controlled trial, were recruited from secondary care in the United Kingdom. Semi-structured telephone and face-to-face interviews were conducted at six (n = 32) and nine months follow-up (n = 31). Interviews were audio-recorded, transcribed, and analysed using a constant comparative approach, under the theoretical framework of critical realism. FINDINGS Three overarching themes emerged: (1) intervention group participants valued the work rehabilitation programme received, and highlighted the benefits of occupational therapy; (2) control group participants reported no benefits in relation to the written work advice pack, and lacked future aspirations to stay employed; (3) the majority of participants reported not reading the written work advice pack provided, which was the only work advice received by the control group. CONCLUSION Working people with inflammatory arthritis highly valued the practical support received from the therapists, and emphasised the value of the therapeutic relationship in the rehabilitation process. A tailor-made work rehabilitation programme, which incorporates cognitive-behavioural strategies into patient education, may help to reduce work instability in people with inflammatory arthritis, and increase their perceived self-efficacy.
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Affiliation(s)
- Yeliz Prior
- Research Fellow, Centre for Health
Sciences Research, University of Salford, UK
- Advanced Clinical Specialist
Occupational Therapist, Mid Cheshire NHS Trust Hospitals, Leighton Hospital, Crewe,
UK
| | | | - Sarah Jane Bodell
- Senior Lecturer in Occupational Therapy,
School of Health Sciences, University of Salford, UK
| | - Alison Hammond
- Professor of Rheumatology,
Rehabilitation, Centre for Health Sciences Research, University of Salford, UK
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Affiliation(s)
- Katharine Norman
- Managing editor, British Journal of Occupational Therapy, previously Editorial Manager, PLOS Biology
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