• Title/Summary/Keyword: Nurses

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A Study Analyzing Nursing Diagnoses and Nursing Interventions used in a Demonstration Home Care Project (가정간호 시범사업 간호진단 및 간호중재 분석 연구)

  • Suh, Mi-Hae;Lee, Hae-Won;Chun, Choon-Young
    • The Korean Nurse
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    • v.34 no.5
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    • pp.52-67
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    • 1996
  • As home care in developing and becoming part of the health care delivery system in Korea, it is necessary to examine the use of nursing diagnoses and related nursing interventions with a view to increasing the standardization of nursing recording. This study was done to examine the nursing diagnosis and related nursing interventions used in home care. Data were collected using a chart review of the nursing notes written for the home care given to 38 patients who had pulmonary diseases or traumatic brain or spinal cord injuries and who had received home care as part of a demonstration home care project in a college of Nursing in Seoul. Early on in the project discussions as to format and use to nursing diagnosis was done and a tool was developed based on Gordon's eleven functional catergories with the addition of categories to cover family and environment. This tool was used in the data collection. Data included nursing diagnosis, etiologies and interventions. Real numbers and percentages were used in the analysis. The results show that the most frequently used diagnoses were in the category of physical function (75.6%), followed by the category of emotional and social function (21.8%). The least frequently used category was the one for family and environment (2.6%). The order of the frequency of recorded nursing interventions was the same, 82.3% for physical function, 16.2% of emotional and social function and 1.5% for family and environment. Under the category of physical functioning the most frequently used nursing diagnoses were related to mobility (62.2%), nutrition (23.6%) and elimination (11.9%). The frequencies of nursing interventions for these three diagnostic categories were 69.8%, 16.0% and 10.8% respectively. For emotional and social functioning, the most frequently used diagnoses were for cognition-perception (37.1%), self-perception (30.6%) and perception of health (23.7%). The ordering of the frequency of nursing interventions varied slightly. The most frequently used interventions were for the category of self-perception (31.7%) followed by cognition-perception (24.1%) and perception of health (22.9%). Looking at individual diagnoses, it was found that within the categroy of physical functioning, the most frequently used diagnosis was "impaired physical mobility" (29.5%) and this diagnosis involved 43.9% of the interventions. This was followed by "ineffective breathing pattern" (19.4%) with 17.7% of interventions, and "alteration in nutrition, less than body requirements" (11.2%) with 8.1% of the interventions. For the emotional social category, noncompliance was the most frequently used nursing diagnosis (18.2%) with 19.2% of the interventions. This was followed by "anxiety" (13.4%) with 13.6% of the interventions and by "knowledge deficit" (13.4%) but with only 5.5% of the interventions. The other diagnoses and interventions did not follow this pattern of frequency. Although there were a large number of diagnostic and intervention events, the number of actual diagnoses and interventions used were relatively small ranging from six interventions for "knowledge deficit" to 40 interventions for "imparied physical mobility". From this it can be concluded that the results of this study could be used as basic data for the development of standardized charts with respect to nursing diagnosis and interventions for clients with pulmonary disease and clients with traumatic brain or spinal cord injuries. Interventions that were direct care activities (1178) were much more frequent that education (430), and assessment and observation (148). There were also few diagnoses or interventions related to the family and the environment. This suggests two areas that need to be developed in home care and that need to be considered in the development of standardized records for use in home care.

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A Study on the Influence of Positive Psychological Capital of Small and Medium Business Members, Job Burnout, and Organizational Citizen Behavior (중소기업 구성원의 긍정심리자본, 직무소진, 조직시민행동의 영향관계)

  • Choi, Sung Yong;Ha, Kyu Soo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.3
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    • pp.159-174
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    • 2020
  • This study is an empirical study analyzing the effects of positive psychological capital on job burnout. In addition, positive psychological capital played a role in organizational citizenship behavior, and tried to verify the role of organizational citizenship behavior as a black box, or parameter, between job burnout. And then, the sub-factors of organizational citizenship behavior were divided into two: individual-oriented organizational citizenship behavior and organization-oriented organizational citizenship behavior. To this end, a questionnaire survey was conducted for members of small and medium-sized enterprises to compare and analyze the relationship between variables. Positive psychological capital is increasing interest in that it can reduce the job burnout of members and embrace the propensity of young generations represented by millennials because it can improve the effectiveness by developing positive mental states and strengths of the organization. There is a need for research as a keyword. As a result of this study, first, it was found that positive psychological capital of SME(small and medium-sized enterprises) members had a positive effect on organizational citizenship behavior. Second, positive psychological capital was found to have a significant negative effect on job burnout. Third, it was a verification of how positive psychological capital and organizational citizenship behavior affect job burnout. In the relationship between positive psychological capital and job burnout, organization-oriented organizational citizenship behavior was found to play a mediating role. However, it was found that individual-oriented organizational citizenship behaviors among the organizational citizenship behaviors are not valid. In this study, positive psychological capital and job burnout, which have been mainly studied in service workers' emotional workers(crew, nurses, counselors, etc.), nursery teachers, and social workers, were applied to SME members by using the parameters of organizational citizenship behavior. You can put that implication on things. The positive psychological capital and organizational citizenship behavior can be further enhanced through SME members' love for the company, improvement of consideration among employees and resulting organizational commitment and work performance. It could also provide momentum for sustainable management for small and medium-sized enterprises that are relatively short of capital and resources.

Lumbar Puncture in Patients Who Experienced First Seizure with Fever (열이 동반된 첫 경련시의 뇌척수액검사)

  • Kim, Jung;Lee, Jun Su;Lee, Sang Eun;Choi, Wan Suk;Han, Sung Ryoung;Cho, Kyunglae
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.1008-1012
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    • 2003
  • Purpose : We aimed to ascertain whether lumbar punctures should be done to prove febrile seizure, and to study what conditions can delay or abolish lumbar puncture. Methods : This retrospective study was done for four years, from January, 1996 to December, 1999. The subjects were the patients who visited Masan Samsung Hospital for the first convulsion with fever, and whose age ranged from 1-month to 5-years old. The total number of patients was 197. We investigated the rate of meningitis, which was classified by age, season, convulsion type, associated symptoms, and results of blood test. All data were tested chi-square. Results : The diagnosis rate of meningitis among all 197 patients was 7.6%, and of these only one patient was proved to have bacterial meningitis. The rate was high in the young(below 6 month), in males and in summer and autumn. Although the general appearance was good after resolution of the fever, the rate of meningitis was 6.5%. Patients with nausea and vomiting totalled 11%; 9.1% of them were diagnosed with meningitis. The diagnosis rate of meningitis in cases in which additional seizures took place were 33.3%. Conclusion : The ultimate goal of lumbar punctures in seizure patients with accompanying fever is to rule out bacterial meningitis, which, has been demonstrated to be rare. So we think that lumbar puncture can be postponed by close observation of pediatrics specialists and skilled nurses.

Adequacy of Medical Manpower and Medical Fee for Newborn Nursery Care (신생아실 의료인력의 적정성 및 신생아관리료의 타당성 분석)

  • Park, Jung-Han;Kim, Soo-Yong;Kam, Sin
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.4 s.36
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    • pp.531-548
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    • 1991
  • To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1-30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (${\pm}58.6$) minutes; 202.3(${\pm}50.7$) minutes for the university hospitals and 164.2(${\pm}60.5$) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the mar reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430won. Out of the total medical fee, 20,323won(9.3%) was for the newborn nursery care. In case of C-section delivery who stayed six nights and seven days, total medical fee was 732,578won and out of the total fee 76,937won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141won for the tertiary care hospitals and 14,576won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.

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A Study Exhaustion Experiences in Adolescents - Samples of 12th Grade Examinees- (청소년의 소진 경험에 관한 연구 -고3 수험생을 중심으로-)

  • Kim, Kyung Hee;Kwon, Hye Jin;Yeoum, Soon Gyo
    • Journal of the Korean Society of School Health
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    • v.10 no.2
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    • pp.241-257
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    • 1997
  • This study identifies a basic framework to analyze specific experiences of examinees so that which nurses are better able to understand reactions of examinees and, further, to provide better nursing treatments to them. This study follows Strauss & Corbin's analysis tool (1990). This basic framework identifies the specific mental reactions in a process away from the "being tightened" state. The main factors explaining this process include the 28 following variables : anxiety, being burdened, being suppressed, lack of agency, being suffocated, term pressure, expectation pressure, grade pressure, firmness, feebleness, helping others, being disturbed, watching others, off ficiousness, staightening on, depending on, getting along with, getting out of, shooting out, giving up, being alone, devoting, bracing up, being industrious, being harassed, being distressed, troubles, and quiting. Twelve variables are factored from the above factors which include pressure, being tighened, terms, expectations, grades, will, friends, family, open-minded confrontation, close-minded confrontation, pursuing, and wandering around. The Examinees' state of being tightened is first developed, watched by others, and finally resolved causing students either to pursue (positive reactions) or to wander around (negative reactions). Based on the theoretical framework, the following sixteen hypotheses are developed : 1. Students are less tightened in the first term. 2. Students are more tightened in the second term. 3. Students with higher grades feel less tightened. 4. Students with lower grades feel more tightened. 5. Students with higher expectations feel more tightened. 6. Students with lower expectations feel less tightened. 7. Students who are less tightened confront open-mindedly. 8. Students who are higher tightened confront close-mindedly. 9. Students with a strong will confront open-mindedly. 10. Students with a weak will confront close-mindedly. 11. Students who have more sincere friends confront open-mindedly. 12. Students who have less sincere frieds confront close-mindedly. 13. Students with family support confront open-mindedly. 14. Students with little family support confront close-mindedly. 15. Students confronting open-mindedly pursue. 16. Students confronting close-mindedly wander. We identify the following four relations from the data analysis : 1. Students with average grades in their first term are more tightened from high expectations and have a tendency to wander if they have less supporting families even if they also have a strong will and sincere friends. 2. Students with low grades in their second term are less tighened because of low expectations and have a tendency to wander if they have a weak will and few sincere friends even if they have strong family support. 3. Students with high grades in their second term are more tightened with high expectations and have a tendency to pursue confrontations open-mindedly if they have supporting families and a strong will even if they have few sincere friends. 4. Students with average grades in their first term are less tightened from fewer expectations and have a tendency to pursue confrontations open-mindedly when they have more supporting families and sincere friends even if they have a weak will. A Student's degree of being tightened are affected by grades, terms, and expectations. Being tightened is resolved positively or negatively based on will, friends, and family. We conclude that will, family support, and sincere friends cause students to confront "being tightened" open-mindedly. We also conclude that practical nursing for students who are tightened have to focus on creating environments in which students are able to confront open-mindedly.

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Analysis of Actual State for Hospice Programs in Korea (호스피스 프로그램 운영 현황 조사)

  • Chang, Hyun-Sook;Park, Sylvia;You, Sun-Ju
    • Journal of Hospice and Palliative Care
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    • v.3 no.1
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    • pp.4-17
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    • 2000
  • Purpose : This study aimed to investigate and to evaluate the present conditions of hospice programs in Korea for supplying data useful in making policy in hospice, which is not institutionalized yet. Method : For this purpose we surveyed 59 hospice programs regarding the general characteristics, manpower, patients, services, financial conditions, and facilities. Thirty-seven hospice programs answered the questionnaires. Result : They were 11 tertiary hospitals, 11 other hospitals, 3 clinics, 12 home care hospice, and 1 freestanding hospice. Only 9 hospice programs have all of the essential professionals: physicians, nurses, social workers, clergies, and volunteers. In some hospice programs, volunteers who had not been trained for hospice provided services to terminal patients. More than half of the hospice said they provided services to the patients who lost their consciousness and were not suitable for hospice care. 16% of the hospice said they did not keep the patients' record. Some hospitals including tertiary hospitals provided such intensive care as radiotherapy, TPN, injections to hospice patients. Many hospice programs other than hospitals didn't charge patients for hospice care. 60% of the hospice said they suffered from financial problems. Most of the hospice wards were not built for hospice use at first. So they did not have such supplementary facilities as dayroom, waiting room, special bathing facilities etc. Conclusion : For improving the quality of terminal patients and promoting the cost effective use of health care resources, it is necessary to consider the institutionalization of hospice. The institutionalization of hospice programs can improve the quality of hospice care and the standardization of the hospice program can hasten its institutionalization.

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Database for Hospice Nursing in Electronic Medical Record (호스피스 전자기록을 위한 데이터베이스 개발)

  • Kim, Young-Soon;Lee, Chang-Geol;Lee, Kyoung-Ok;Kim, Ok-Kyum;Kim, In-Hye;Kim, Mi-Jeong;Hwang, Ae-Ran;Lee, Won-Hee
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.200-213
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    • 2004
  • Purpose: The purpose of this study was to create an electronic nursing record form to build a hospice nursing process database to be used in the u-hospital EMR system. Specific aims of the study were: 1. To generate a complete, accurate, and simple electronic nursing record form. 2. To verify its appropriateness following documentation with the standardized hospice protocol. 3. To verify its validity and finalize the hospice nursing process database through discussion among hospice professionals. Methods: Nursing records from three independent hospice organizations were collected and analyzed by five expert hospice nurses with more than 10 years of experience, and a nursing record database was developed. This database was applied to 81 hospice patients at three hospice organizations to verify its completeness. Results: 1. An electronic nursing record form with completeness, accuracy, and simplicity was developed. 2. The completeness of the standardized home hospice service protocol was 95.86 percent. 3. The hospice nursing process database contains 18 items on health problems, 79 items on related causes and major symptoms, and 229 items on nursing interventions. Conclusion: The new nursing record form and database will reduce documentation time and articulate and streamline the working process among team members. They can also improve the quality of hospice services, and ultimately enable us to estimate hospice service costs.

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Survey on Quality of Hospice.Palliative Care Programs in Korea (한국 호스피스.완화의료기관 실태 조사)

  • Yun, Young-Ho;Choi, Eun-Sook;Lee, In-Jeong;Rhee, Young-Sun;Lee, Jung-Suk;You, Chang-Hoon;Kim, Hyun-Sook;Paek, Yu-Jin
    • Journal of Hospice and Palliative Care
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    • v.5 no.1
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    • pp.31-42
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    • 2002
  • Purpose : The purpose of this study was to evaluate the present status of hospice palliative care programs in Korea as a basic database for standardization of hospice palliative care. Method : The data was collected from July to October, 2001. The instrument used for this study was the questionnaires which was consisted of the general characteristics of organization, recipient of service, manpower, contents of service, financial conditions and facilities. Sixty-four hospice palliative care programs answered the questionnaires, confirmed by telephone. Results : They were 40 hospital-based hospice palliative care programs and 24 nonmedical hospice palliative care programs. 11 Hospital-based hospice palliative programs have isolated unit or hospital affiliated free standing hospice. 6 Non-hospital hospice palliative programs have a free standing hospice. Major subjects of hospice palliative program were terminal cancer patients but patients with non-terminal illness were also included. Only 24 of 64 hospice palliative programs had all of the essential professionals : physicians, nurses, social workers, and clergies. Home hospice palliative care programs have a referral system in hospital based (89.7%) and nonmedical programs (73.7%). 24hr hospice are were provided in 26 hospital-based (65.0%) and 9nonmedical programs (37.5%). There were rooms for family in half of hospital-based programs. 73.9% of hospice palliative care programs have financial problems. 62.0% of Hospice palliative care programs need financial support from government. Conclusion : 64 Hospice palliative care programs provided hospice palliative services but had many problems in manpower, quality of care and facility. For improving the quality of terminal patients' life and promoting the cost effectiveness of health care resources, it is necessary to consider the standardization and institutionalization of hospice palliative care.

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Care Needs of Hospice Patients in Comparison with Those from the Family Caregivers' Perspective: Q methodology (호스피스 환자의 돌봄 요구와 가족이 인지하는 환자의 돌봄 요구 비교: Q 방법론)

  • Yong, Jin-Sun;Hong, Hyun-Ja
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.153-168
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    • 2004
  • Purpose: The purpose of tile study was to identify types of care needs of hospice patients and those from the family caregivers' perspective and to compare these two groups in reporting patients' care needs through Q-methodology. Methods: Twenty three Q-statements concerning care needs were selected through in-depth interviews of hospice patients. Data were collected from 20 hospice patients as well as 20 family caregivers respectively by sorting 23 Q-statements into 9 points standard. Data analysis was performed by using PC QUANL program. Results: Principal component analysis identified four types of care needs of the hospice patients. Overall, the accuracy of family caregiver reports was 48% in all types of care needs. Type 1 was named 'physical care needs type' for those whose greatest need was physical care to be free of pain and comfortable. The accuracy in Type 1 was 62.5%. Type 2 was named 'emotional care needs type' for those who would like to share love and intimacy with their family members. The accuracy in Type 2 was 20%. Type 3 was named 'spiritual care needs type' for those who would like to receive forgiveness from their God and prayers and visitation of clergy. The accuracy in Type 3 was 60%. Type 4 was named 'social care needs type' for those who would like to complete their ongoing work and to give service to others. The accuracy in Type 4 was 50%. Conclusion: There was a great difference between hospice patients and the family caregivers in reporting patients' care needs. Thus, hospice nurses need to educate family caregivers to more accurately assess patients' care needs.

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The Need for Child Hospice Care in Families of Children with Cancer (암 환아 가족의 아동 호스피스 요구도)

  • Kang, Kyung-Ah;Kim, Shin-Jeong;Kim, Young-Soon
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.221-231
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    • 2004
  • Purpose: The purpose of this study was to analyze the need for child hospice care programs in families of children with cancer. Methods: The survey of 104 families who were taking care of children with cancer was conducted. This survey was conducted from February 2004 to July 2004 at two general hospitals in Seoul. The data were collected through a self-reporting questionnaire of 22 items. The items were classified into five areas by factor analysis to identify the construct validity. The reliability of the tool was established by Cronbach's alpha as .94 and the data collected were analyzed by descriptive statistics, t-test and ANOVA. Results: 1) The degree of need for hospice care of the subjects showed a high average of 3.40 (${\pm}3.8$). The need for 'emotional care of children' showed the highest mean (M=3.55), 'management of terminal physical symptoms'(M=3.49), 'control of secondary physical problems' (M=3.41), 'acceptance of the family's difficulty' (M=3.20), 'spiritual care for preparing for death'(M=3.17), respectively. 2) With respect to the demographic characteristics of the subjects, there were statistically significant differences in hospice care needs, according to the child's mother's age (F==4.980, P=.009), whether or not there were cancer patients among their siblings or relatives (t=2.423, P=.017). Conclusion: The family of children with cancer have a heavy burden of ambivalence, especially in relieving the anxiety and fear of their children, communicating about death, and managing physical symptoms. Child hospice care must be provided considering the needs of families of children with cancer. Thus popular needs as well as hospice nurses' higher concern and support for hospice care of children require further education and program development to meet the current demands.

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