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Examining Children's Experiences of Visiting Their Pediatrician: Insights into Communication, Actions, and Emotions. 研究儿童看儿科医生的经历:洞察交流、行动和情感。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2024-11-01 Epub Date: 2024-02-19 DOI: 10.1080/10410236.2024.2318130
Michele Capurso, Chiara Pazzagli

The way children experience a medical visit lays the groundwork for their health education and fosters trust and comfort in healthcare relationships. This study employed a retrospective and narrative-based design to analyze how children perceived their experiences of visits to their doctor, how they describe their emotions, and how they portray the different relationships within the doctor-caregiver-patient triad. Three hundred fifty students (50.75% female, 8-13 years, Mage = 10.5, SD = 5.93, 77.95% from primary school) completed a booklet comprising different narrative activities. The booklet underwent quantitative content analysis according to gender and school level. Children reported that the doctors primarily addressed their caregivers when asking for and delivering health-related information, while their role was mostly passive. Meeting with friendly doctors and being in a welcoming environment were associated with a positive medical experience, while negative emotions and encounters with unsympathetic practitioners contributed to negative experiences. Most respondents wanted to talk privately with their doctors at their next visit. Some examples and practices are discussed to enable healthcare practitioners to create an environment where children are heard and valued, and their involvement during consultation processes is enhanced.

儿童看病的经历为他们的健康教育奠定了基础,并培养了他们对医疗保健关系的信任和舒适感。本研究采用回顾性和叙事性设计,分析儿童如何看待自己的就医经历,如何描述自己的情绪,以及如何描绘医生-护理人员-患者三者之间的不同关系。350 名学生(50.75% 为女性,8-13 岁,Mage = 10.5,SD = 5.93,77.95% 来自小学)完成了由不同叙事活动组成的小册子。根据性别和学校级别对小册子进行了定量内容分析。儿童报告说,医生在询问和提供与健康有关的信息时,主要是向他们的看护人询问,而他们的角色大多是被动的。与友好的医生见面和身处热情的环境与积极的就医体验有关,而负面情绪和遇到不近人情的医生则会导致消极的就医体验。大多数受访者希望在下次就诊时与医生私下交谈。本报告讨论了一些实例和做法,以帮助医疗从业人员营造一个能倾听儿童心声、重视儿童的环境,并提高儿童在就诊过程中的参与度。
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引用次数: 0
Toward Multidimensional Message Tailoring to Address COVID-19 and Influenza Vaccine-Hesitancy: A Latent Profile Analysis Approach. 针对 COVID-19 和流感疫苗致病性的多维信息定制:潜在特征分析方法。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2024-11-01 Epub Date: 2024-02-26 DOI: 10.1080/10410236.2024.2321763
Lijiang Shen

Vaccines remain the best strategy as the COVID-19 pandemic enters into later stages and governments begin to shed pandemic-control measures. Vaccine hesitancy continues to be a major obstacle in efforts to end the pandemic. This study reports formative evaluation research that adopted a multidimensional approach using latent profile analysis to audience segmentation and message targeting. Within the framework of the integrated behavioral model, data were collected from a US national survey to explore the dimensions in which vaccine-confident vs. -hesitant individuals differed significantly across the topics of COVID-19 and influenza. Latent profile analyses were performed to identify subgroups and establish measurement invariance between COVID-19 and influenza vaccines. Matching message strategies were proposed for the distinctive characteristics of the subgroups for both topics and to be tested in future research.

随着 COVID-19 大流行进入后期阶段,各国政府开始放弃大流行控制措施,疫苗仍是最佳策略。对疫苗的犹豫不决仍然是终止大流行的主要障碍。本研究报告采用了一种多维方法,利用潜在特征分析对受众进行细分,并确定信息的目标。在综合行为模型的框架内,研究人员从一项美国全国调查中收集了数据,以探索在 COVID-19 和流感主题中,疫苗自信者与疫苗不自信者在哪些方面存在显著差异。我们进行了潜在特征分析,以确定亚群,并建立 COVID-19 和流感疫苗之间的测量不变性。针对两个主题的亚群的不同特征提出了匹配信息策略,并将在未来的研究中进行测试。
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引用次数: 0
Cross-Cultural Adaptation and Psychometric Validation of the Interview Satisfaction Questionnaire (ISQ) to Assess Unmet Health Communication Needs of Iranian Breast Cancer Patients. 访谈满意度问卷 (ISQ) 的跨文化适应性和心理测量验证,用于评估伊朗乳腺癌患者未得到满足的健康交流需求。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2024-11-01 Epub Date: 2023-12-05 DOI: 10.1080/10410236.2023.2288712
Razieh Keikhaee, Zohreh Sanaat, Saeid Mousavi, Abdolreza Shaghaghi

Autonomous and patient-centered health communication (PCHC) between a healthcare provider (HCP) and a client (HCC) is a critical fundament for successful healthcare outcomes. A standard and validated data collection tool for studying the satisfaction of Iranian breast cancer patients (BCPs) with various aspects of their health communication with HCPs does not exist. The current study assessed the application, feasibility, and cultural appropriateness of the Persian-translated version of the interview satisfaction questionnaire (ISQ) in the Iranian context. A standard translation/back-translation procedure was used to prepare a preliminary Persian version of the ISQ (ISQ-P) which was then evaluated for content and face validity by a panel of experts. The study data were collected from 200 breast cancer patients and used to estimate the internal consistency measure of Cronbach's alpha and intra-class correlation coefficient. Confirmatory factor analysis (CFA) was performed to verify the compatibility of the instrument's identified dimensions with the original ISQ's factor structure. The calculated content validity index (CVI = 0.89), content validity ratio (CVR = 0.49), and Cronbach's alpha coefficient (0.79) indicated the appropriateness of the ISQ-P for its intended purpose. The CFA's outputs (root mean square error of approximation (RMSEA) = 0.09, comparative fit index (CFI) = 0.954, Tucker-Lewis index (TLI) = 0.931, standardized root mean square residual (SRMR) = 0.04) affirmed the fitness of the study data to the original 4-factor conceptual model. The study findings supported the suitability of ISQ-P for assessing health communication episodes by Persian-speaking BCPs. However, due to cultural variation, cross-border diversity of health systems, and organizational circumstances, further validity and reliability appraisal of the ISQ-P in distinct sub-samples is recommended.

医疗服务提供者(HCP)与客户(HCC)之间自主的、以患者为中心的健康交流(PCHC)是医疗服务取得成功的关键基础。目前还没有一种标准的、经过验证的数据收集工具,用于研究伊朗乳腺癌患者(BCPs)对其与医护人员进行健康交流的各个方面的满意度。本研究评估了波斯语翻译版访谈满意度问卷 (ISQ) 在伊朗的应用、可行性和文化适宜性。研究采用了标准的翻译/回译程序,编制了初步的波斯语版 ISQ (ISQ-P),然后由专家小组对其内容和表面效度进行了评估。研究数据收集自 200 名乳腺癌患者,用于估算 Cronbach's alpha 和类内相关系数的内部一致性。研究还进行了确认性因子分析(CFA),以验证该工具所确定的维度与原 ISQ 的因子结构是否一致。计算得出的内容效度指数(CVI = 0.89)、内容效度比(CVR = 0.49)和克朗巴赫α系数(0.79)表明,ISQ-P 符合其预期目的。CFA 的输出结果(均方根近似误差 (RMSEA) = 0.09、比较拟合指数 (CFI) = 0.954、塔克-刘易斯指数 (TLI) = 0.931、标准化均方根残差 (SRMR) = 0.04)证实了研究数据与最初的 4 因子概念模型相匹配。研究结果支持 ISQ-P 适用于评估波斯语 BCP 的健康传播事件。然而,由于文化差异、卫生系统的跨境多样性和组织环境,建议在不同的子样本中对 ISQ-P 进行进一步的有效性和可靠性评估。
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引用次数: 0
An Experimental Test of the Effects of Public Mockery of a Social Media Health Campaign: Implications for Theory and Health Organizations' Social Media Strategies. 社会媒体健康运动的公众嘲弄效应的实验检验:对理论和卫生组织社会媒体策略的启示。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2024-11-01 Epub Date: 2023-11-19 DOI: 10.1080/10410236.2023.2282833
Jessica Gall Myrick, Jin Chen, Eunchae Jang, Megan P Norman, Yansheng Liu, Lana Medina, Janine N Blessing, Haniyeh Parhizkar

This study explored how social media users' mocking of a public health campaign can affect other users' emotions, cognitions, and behavioral intentions. Inspired by public mocking of the CDC's "Say No to Raw Dough" campaign aiming to prevent food poisoning caused by eating raw flour-based products, this experiment (N = 681) employed a 2 (Public responses to a PSA: Mocking or serious) x 3 (Organizational response to public responses: Self-mocking, serious, or none) + 1 (control condition) design. Statistical tests revealed that user-generated mocking can lower intentions to avoid the health risk by decreasing perceptions of injunctive norms (that is, seeing others mock a public health campaign resulted in weaker perceptions that others think you should avoid the risky behavior). Mockery of a public health campaign also engender anger at the CDC and at other users, with the target of the anger having differential effects on intentions to avoid eating raw dough. Implications for theory and the practice of social media-based health promotion are discussed.

这项研究探讨了社交媒体用户对公共卫生运动的嘲笑如何影响其他用户的情绪、认知和行为意图。该实验(N = 681)采用了2(公众对PSA的反应:嘲笑或严肃)x 3(组织对公众反应:自我嘲笑、严肃或无)+ 1(控制条件)的设计,其灵感来自于公众对CDC“对生面团说不”运动的嘲笑,该运动旨在防止因食用生面粉产品而引起的食物中毒。统计测试显示,用户生成的嘲笑可以通过降低对禁令规范的感知来降低避免健康风险的意图(也就是说,看到其他人嘲笑公共卫生运动导致其他人认为你应该避免危险行为的认知减弱)。对公共卫生运动的嘲弄也引起了对疾病预防控制中心和其他用户的愤怒,而愤怒的目标对避免吃生面团的意图有不同的影响。讨论了基于社交媒体的健康促进的理论和实践意义。
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引用次数: 0
Patients' Problem Presentation in China's Primary Care. 中国基层医疗机构中患者的问题表现。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2024-11-01 Epub Date: 2024-01-12 DOI: 10.1080/10410236.2024.2303530
Zi Yang, Xueming Wang

Identifying patients' reasons for visiting is the central task at medical openings, the structure of which has been well studied in Western primary care, but much under-researched in China's mainland. Drawing on conversation analysis of 91 audio-recorded primary care consultations in China, this study explores interactional features of patients' problem presentation at medical openings in terms of sequential positions, forms, and contextual contingencies, which has implications for the model of medical service encounters in Chinese primary care openings. Although problem description is commonly solicited by doctors across cultures, Chinese patients' problem presentation often takes forms other than problem description. Nearly two thirds of problem presentation in our data are designed as a request-making action (57/91 cases), being more often self-initiated than solicited. This blurs the boundary between medical visits for new and non-new problems. The analysis of Chinese patients' problem presentation points to a high degree of patient agency in primary care in China, suggesting a strong orientation to the "provider-consumer" (vs. "professional-client") model of service encounters in the opening structure of doctor-patient interaction.

确定患者就诊的原因是开诊时的中心任务,其结构在西方的初级医疗中得到了很好的研究,但在中国大陆的研究却远远不够。本研究通过对 91 个中国基层医疗咨询录音进行会话分析,从顺序位置、形式和情境偶然性等方面探讨了患者在开诊时陈述问题的互动特征,这对中国基层医疗开诊中的医疗服务接触模式具有启示意义。尽管在不同文化背景下,医生通常会要求患者进行问题描述,但中国患者的问题陈述往往采取问题描述以外的形式。在我们的数据中,将近三分之二的问题陈述是作为请求行为设计的(57/91 个病例),更多的情况下是自发的,而不是被请求的。这就模糊了新问题和非新问题就诊之间的界限。对中国患者提出问题的分析表明,在中国的初级医疗中,患者具有高度的代理权,这表明在医患互动的开端结构中,"提供者-消费者"(相对于 "专业人员-客户")的服务模式具有很强的导向性。
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引用次数: 0
Empathic Communication and Implicit Bias in the Context of Cancer Among a Medical Student Sample. 癌症背景下医学生样本中的移情交流和内隐偏见。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2024-11-01 Epub Date: 2023-10-31 DOI: 10.1080/10410236.2023.2272359
Tara K Torres, Heidi A Hamann, Megan J Shen, Jeff Stone

Oncology clinicians often miss opportunities to communicate empathy to patients. The current study examined the relationship between implicit bias (based on cancer type and ethnicity) and medical students' empathic communication in encounters with standardized patients who presented as Hispanic (lung or colorectal) individuals diagnosed with cancer. Participants (101 medical students) completed the Implicit Association Test (IAT) to measure implicit bias based on cancer type (lung v. colorectal) and ethnicity (Hispanic v. non-Hispanic White). Empathic opportunities and responses (assessed by the Empathic Communication Coding System; ECCS) were evaluated in a mock consultation (Objective Structured Clinical Examination; OSCE) focused on smoking cessation in the context of cancer. Among the 241 empathic opportunities identified across the 101 encounters (M = 2.4), 158 (65.6%) received high empathy responses from the medical students. High empathy responses were most frequently used during challenge (73.2%) and emotion (77.3%) opportunities compared to progress (45.9%) opportunities. Higher levels of implicit bias against Hispanics predicted lower odds of an empathic response from the medical student (OR = 3.24, p = .04, 95% CI = 0.09-0.95). Further work is needed to understand the relationship between implicit bias and empathic communication and inform the development of interventions.

肿瘤学临床医生经常错过与患者交流同理心的机会。目前的研究考察了内隐偏见(基于癌症类型和种族)与医学生在面对被诊断为癌症西班牙裔(肺癌或结直肠癌)个体的标准化患者时的移情交流之间的关系。参与者(101名医学生)完成了内隐关联测试(IAT),以测量基于癌症类型(肺癌与结直肠癌)和种族(西班牙裔与非西班牙族白人)的内隐偏见。移情机会和反应(由移情通信编码系统;ECCS评估)在模拟咨询(目标结构化临床检查;欧安组织)中进行评估,重点是癌症背景下的戒烟。在101次遭遇中发现的241次移情机会中(M = 2.4),158人(65.6%)获得了来自医学生的高度移情反应。与进步(45.9%)机会相比,在挑战(73.2%)和情绪(77.3%)机会中最常使用高移情反应。对西班牙裔的隐性偏见水平越高,医学生产生移情反应的几率就越低(OR = 3.24,p = .04,95%CI = 0.09-0.95)。需要进一步的工作来理解内隐偏见和移情沟通之间的关系,并为干预措施的发展提供信息。
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引用次数: 0
Can Stereotype Threat and Lift Visual Messages Affect Subsequent Physical Activity? Evidence from a Controlled Experiment Using Accelerometers. 刻板印象的威胁和提升视觉信息会影响后续的身体活动吗?来自使用加速度计的受控实验的证据。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2024-11-01 Epub Date: 2023-11-08 DOI: 10.1080/10410236.2023.2277573
Camren L Allen, Enoch Montes, Troy Hoang, Therek Romo, Jorge Peña, Jessica Navarro

This study investigated how visual messages conveying stereotype threat or lift influenced physical activity performance. Participants (N = 380) were exposed to a stereotype threat, lift, or control condition image and then engaged in a running task. Accelerometers recorded forward-backward movement, upward-downward movement, and sideways balance. Stereotype threat exposure increased state anxiety relative to the control condition. In addition, forward-backward movement was linked to state anxiety and participants' sex. Moreover, women exposed to stereotype threat who experienced increased state anxiety showed reduced forward-backward movement. Men exposed to stereotype lift displayed higher forward-backward movement. Additionally, stereotype threat visual message exposure increased sideways balance activity for women but not for men. Upward-downward movement was unaffected by stereotype threat or lift. We discuss theoretical and practical implications of how exposure to visual stereotypes can influence physical activity performance.

本研究调查了传达刻板印象威胁或提升的视觉信息如何影响体育活动表现。参与者(N = 380)暴露于刻板印象中的威胁、提升或控制条件图像,然后从事跑步任务。加速度计记录了前后运动、上下运动和侧向平衡。与对照条件相比,刻板印象威胁暴露增加了状态焦虑。此外,前后运动与状态焦虑和参与者的性别有关。此外,受到刻板印象威胁的女性,如果状态焦虑加剧,则前后运动减少。受刻板印象影响的男性表现出更高的前后运动。此外,刻板印象威胁视觉信息的暴露增加了女性的横向平衡活动,但男性没有。上下运动不受刻板印象威胁或提升的影响。我们讨论了暴露于视觉刻板印象如何影响体育活动表现的理论和实践意义。
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引用次数: 0
Emotional Appeals and Norms: How Normative Perceptions Moderate the Persuasive Impacts of Discrete Emotional Appeals within Tobacco Pictorial Warnings in China. 情感诉求与规范:规范感知如何调节中国烟草图片警告中离散情感诉求的说服影响。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2024-11-01 Epub Date: 2023-11-10 DOI: 10.1080/10410236.2023.2277036
Ran Tao, Xinyi Wang, Yidi Wang, Heyu Yao, Shiwen Wu, Jiaying Liu, Sijia Yang

Tobacco pictorial warnings could employ a variety of emotional appeals to enhance effectiveness; however, little research exists to guide the selection of discrete emotional appeals. Further, it remains unclear how contextual pro-smoking norms might influence the persuasive impacts of discrete emotional appeals within pictorial warnings, especially in China, where the overall smoking rate and social acceptance remain high. To fill these gaps, this study leveraged the largest set of pictorial warnings (K = 510) tested to date. Using a randomized large-K multiple-message design, we evaluated the impacts of disgust, fear, self-anger, contempt, shame, and hope appeals among Chinese adult male smokers (N = 2,306) on perceived message effectiveness (PME). Results showed that fear, self-anger, shame, and hope appeals significantly increased PME, while disgust and contempt appeals appeared less effective. Importantly, the PME of nearly all emotional appeals - except hope appeals - was weakened for Chinese adult male smokers with higher pro-smoking normative perceptions, highlighting the importance of considering local contextual influences when implementing pictorial warnings.

烟草图片警告可以采用各种情感诉求来提高效果;然而,很少有研究来指导离散情感诉求的选择。此外,尚不清楚背景支持吸烟的规范如何影响图片警告中离散情感诉求的说服力,尤其是在中国,那里的总体吸烟率和社会接受度仍然很高。为了填补这些空白,本研究利用了最大的一组图片警告(K = 510)。采用随机大K多重信息设计,我们评估了中国成年男性吸烟者厌恶、恐惧、自愤、蔑视、羞耻和希望诉求的影响(N = 2306)关于感知消息有效性(PME)。结果显示,恐惧、自愤、羞耻和希望诉求显著增加了PME,而厌恶和蔑视诉求的效果较差。重要的是,对于支持吸烟的规范认知较高的中国成年男性吸烟者来说,除了希望诉求之外,几乎所有情感诉求的PME都被削弱了,这突出了在实施图片警告时考虑当地背景影响的重要性。
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引用次数: 0
Reflections on Dementia-Related Stigma and Direct Support Seeking by Family Caregivers as Mediating Associations Between Caregiver Stress, Burden, and Well-Being. 对痴呆症相关的耻辱感和家庭照顾者寻求直接支持作为照顾者压力、负担和幸福感之间中介关系的反思。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2024-11-01 Epub Date: 2023-10-24 DOI: 10.1080/10410236.2023.2270248
Karen E Schlag, Anita L Vangelisti

The demanding nature of caring for relatives with Alzheimer's disease and related dementias (ADRD) can lead to family caregiver burden and poor health. The stigmatization of people with ADRD can also impact caregivers' stress, while their support-seeking strategies may mitigate negative impacts of burden on their health. To examine hypothesized relationships, the present study considered whether different dimensions of ADRD family stigma influenced the association between a care recipient's behavioral symptoms and their family caregiver's perceived burden and if direct support seeking explained a connection between caregiver burden and well-being. Family caregivers (n = 375) completed a Qualtrics survey. Path analysis revealed ADRD behavioral symptoms predicted both caregiver and layperson forms of stigma. Layperson stigma also intervened between behavioral symptoms and caregiver burden. Direct support seeking mediated the association between caregiver burden and well-being. Findings underscore the utility of including stigma within ADRD caregiver stress models and studying caregiver health from network and communication perspectives.

照顾患有阿尔茨海默病和相关痴呆症(ADRD)的亲属的要求很高,这可能会导致家庭护理负担和健康状况不佳。对ADRD患者的污名化也会影响照顾者的压力,而他们寻求支持的策略可能会减轻负担对他们健康的负面影响。为了检验假设的关系,本研究考虑了ADRD家庭污名的不同维度是否影响了受照顾者的行为症状与其家庭照顾者感知负担之间的联系,以及直接寻求支持是否解释了照顾者负担与幸福感之间的联系。家庭照顾者(n = 375)完成了Qualtrics调查。路径分析显示,ADRD行为症状可预测照顾者和非专业人员的污名形式。外行的耻辱感也介入了行为症状和照顾者负担之间。寻求直接支持在照顾者负担和幸福感之间起中介作用。研究结果强调了将污名纳入ADRD护理人员压力模型以及从网络和沟通角度研究护理人员健康的效用。
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引用次数: 0
"I Remember Feeling Pretty Darn Lucky": Crafting Family Resilience in Response to a Medical Emergency. "我记得自己感觉非常幸运":打造家庭应对医疗紧急情况的复原力。
IF 3 3区 医学 Q1 COMMUNICATION Pub Date : 2024-11-01 Epub Date: 2023-12-19 DOI: 10.1080/10410236.2023.2296187
Sophie S Downing

Through a combination of autoethnographic reflections and oral history interviews with my parents, I explore the ways in which we enacted resilience throughout my father's unexpected hospitalization, rehabilitation, and his subsequent years of recovery, both individually and communally. Using communication theory of resilience (CTR) as a framework, I identify the ways in which we engaged in the five processes outlined by the theory: crafting normalcy, emphasizing action while backgrounding negative feelings, affirming identity anchors, relying on communication networks, and employing alternative logics. I then propose three additional processes of enacting resilience that emerged from my family's insights: enacting performative resilience, connecting to broader experience, and emphasizing perspective-taking. To conclude, I reflect on the value of these communicative processes and the combination of research practices I engaged in the paper, as well as the practical benefits of CTR and my additions to the theory.

通过自我民族志反思和对我父母的口述历史访谈,我探讨了在我父亲意外住院、康复以及随后几年的恢复过程中,我们个人和社会如何发挥抗逆力。以抗逆力沟通理论(CTR)为框架,我确定了我们参与该理论概述的五个过程的方式:营造正常状态、强调行动同时淡化负面情绪、确认身份锚点、依赖沟通网络以及采用替代逻辑。然后,我从我的家人的见解中提出了另外三个实施抗逆力的过程:实施表演性抗逆力、与更广泛的经验相联系以及强调透视。最后,我反思了这些交流过程的价值和我在论文中参与的研究实践组合,以及 CTR 的实际益处和我对该理论的补充。
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引用次数: 0
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Health Communication
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