Australasian Journal on Ageing最新文献_第10页

Using acousmatic storytelling to facilitate communication and social interactions in people living with dementia: An iterative exploratory 12-week study 使用听觉讲故事促进痴呆症患者的沟通和社会互动：一项为期12周的迭代探索性研究

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2025-06-13 DOI: 10.1111/ajag.70052

Soon Yi Chua, Justin Christensen, Renee Timmers, Julia Schauerman, Kathryn Rawling

Objective

Communication challenges in people living with dementia can limit social interactions with fellow residents and hinder professional carers' ability to provide person-centred care. While research highlights the benefits of reminiscence, storytelling and music interventions in facilitating social interaction, the potential of using soundscapes in storytelling remains underexplored. This qualitative study investigated how acousmatic storytelling—using sound recordings and music to inspire storytelling, evoke imagery and emotion, and iteratively develop hybrid audio compositions—can enhance communication and social interactions in people living with dementia.

Methods

Twelve one-hour workshops were conducted with individuals in the early to mid-stages of dementia at a care home, using auditory cues (music and soundscapes) and visual prompts (photographs and poems) to stimulate memory recall, storytelling and group discussion. Data were collected through video and audio recordings, participant observation and semi-structured interviews with care workers.

Results

Inductive thematic analysis identified two key themes in verbal communication: (1) reminiscence and (2) creative sound associations, as well as five themes for non-verbal behaviours: (1) supporting verbal communication, (2) substituting verbal communication, (3) expressing emotions, (4) enhancing rapport with others and (5) expressing musicality. These themes highlight how participants engaged meaningfully in both storytelling and group interactions.

Conclusions

Findings suggest that acousmatic storytelling offers a platform for individuals living with dementia to engage in verbal communication, employ purposeful non-verbal behaviours and participate in meaningful social interaction. This highlights its potential as a narrative approach for enhancing person-centred care in long-term care settings.

痴呆症患者的沟通障碍会限制他们与其他居民的社交互动，并阻碍专业护理人员提供以人为本的护理的能力。虽然研究强调了回忆、讲故事和音乐干预在促进社会互动方面的好处，但在讲故事中使用音景的潜力仍未得到充分探索。这项定性研究调查了声学讲故事——利用录音和音乐来激发讲故事的灵感，唤起意象和情感，并迭代地开发混合音频作品——如何增强痴呆症患者的沟通和社交互动。方法采用听觉提示（音乐和音景）和视觉提示（照片和诗歌）来刺激记忆回忆、讲故事和小组讨论，对养老院的早期至中期痴呆症患者进行了12个1小时的讲习班。通过录像和录音、参与者观察和对护理人员的半结构化访谈收集数据。结果归纳主题分析确定了言语交际的两个关键主题：(1)回忆和(2)创造性声音联想，以及非言语行为的五个主题：(1)支持言语交际，(2)替代言语交际，(3)表达情感，(4)加强与他人的融洽关系，(5)表达音乐性。这些主题突出了参与者如何有意义地参与讲故事和小组互动。研究结果表明，听觉讲故事为痴呆症患者提供了一个平台，帮助他们进行语言交流，采用有目的的非语言行为，并参与有意义的社会互动。这突出了它作为在长期护理环境中加强以人为本的护理的叙述方法的潜力。

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引用次数: 0

Overcoming geographic barriers with telemedicine: Digital transformation strategies for preventing cardiovascular disease in older adults 用远程医疗克服地理障碍：预防老年人心血管疾病的数字化转型战略

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2025-06-12 DOI: 10.1111/ajag.70055

Sanyuan Wei, Ruolan Wang

引用次数: 0

Exploring care staff perspectives of malnutrition in residential aged care 探讨长者院舍护理人员对营养不良的看法

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2025-06-11 DOI: 10.1111/ajag.70054

Karly Bartrim, Rhiannon Hill, Marie-Claire O'Shea

Objective

This study aimed to explore the understanding of care staff in Residential Aged Care (RAC) regarding malnutrition and their perspectives on the multideterminant factors associated with providing nutrition care to residents.

Methods

A qualitative study was conducted, utilising the socioecological model as a framework. Focus groups were conducted with current RAC care staff and were recruited via convenience sampling. Three focus groups were conducted using semi-structured questions.

Results

Fifteen RAC care staff (n = 13 female participants) with a range of career experience participated in focus groups (five participants per focus group). Two main themes and five subthemes were identified. Theme 1: lack of understanding of malnutrition, with subthemes of: 1.1: there are no residents with malnutrition in my facility, 1.2: gaining weight is more of a concern than weight loss (associated with malnutrition), and Theme 2: feeling restrained in doing more, with subthemes of: 2.1: limited time and lack of staff impact the care I can provide, 2.2: residents with malnutrition have greater care needs, and 2.3: lack of social support contributes to malnutrition.

Conclusions

The study explored malnutrition issues in RACs from care staff perspectives. Care staff expressed genuine care for residents, yet felt they lacked capacity to provide adequate support, particularly for those with malnutrition. Staff shortages, inadequate training, and time constraints affected their ability to attend to resident needs. The study identified systematic issues, particularly at the policy level, in malnutrition management, providing a clear focus for improvement and future research.

目的探讨养老院护理人员对营养不良的认识，以及他们对提供营养护理的多因素的看法。方法以社会生态学模型为框架，进行定性研究。焦点小组与目前RAC护理人员进行，并通过方便抽样招募。使用半结构化问题进行了三个焦点小组。结果15名具有不同职业经历的RAC护理人员（n = 13名女性）参加了焦点小组（每个焦点小组5名参与者）。确定了两个主要主题和五个次级主题。主题1：对营养不良缺乏了解，分主题为：1.1：在我的机构中没有营养不良的居民，1.2：体重增加比体重减轻更令人担忧（与营养不良有关），主题2：感到做得更多受到限制，分主题为：2.1：时间有限，缺乏工作人员影响我能提供的护理，2.2：营养不良的居民有更大的护理需求，2.3：缺乏社会支持导致营养不良。结论本研究从护理人员的角度探讨了rac的营养不良问题。护理人员表达了对居民的真诚关怀，但他们觉得自己没有能力提供足够的支持，特别是对那些营养不良的人。工作人员短缺、培训不足和时间限制影响了他们满足居民需要的能力。该研究确定了营养不良管理方面的系统性问题，特别是在政策层面，为改进和未来的研究提供了明确的重点。

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引用次数: 0

‘This is perfect, thank you’: Research poetry on gratitude for voluntary assisted dying in Victoria, Australia “这太完美了，谢谢”：澳大利亚维多利亚州对自愿协助死亡的感激之情的研究诗歌

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2025-06-09 DOI: 10.1111/ajag.70019

Ben P. White, Ruthie Jeanneret, Sarah Holland-Batt, Evonne Miller

Objective

To undertake the first scholarly examination in Australia of how those involved in seeking voluntary assisted dying (VAD) discuss the concept of gratitude for this new end-of-life choice. The article shares findings through research poetry, an arts-based form of research where poems are developed from data (here, interview transcripts).

Methods

Twenty-eight semi-structured qualitative interviews were conducted with 33 participants (32 family caregivers; one patient). Participants were asked about their VAD experience, with caregivers also asked about the experience of their family member. Data were thematically analysed, focusing on expressions of gratitude for VAD. Miller's five-step process was adopted to create the research poetry.

Results

Gratitude for VAD was a significant concept for participants. We identified three gratitude themes relating to what people were grateful for, who people were grateful to and other feelings mixed in with their gratitude, such as ambivalence. We created six poems to illuminate these findings and give voice to the gratitude expressed by patients and family caregivers about VAD.

Conclusions

Gratitude for VAD was emphasised by participants as an important part of their experience and something that can help family caregivers cope after a VAD death. Expressions of gratitude can support health professionals providing VAD and create support for law reform in other jurisdictions. Research poetry reflecting this gratitude can contribute to reducing the stigma attached to VAD and enhance awareness of this relatively new end-of-life choice. More research is needed into the emotional experience of those involved in seeking and receiving VAD in Australia.

目的在澳大利亚进行第一次学术检查，了解那些寻求自愿协助死亡（VAD）的人如何讨论对这种新的生命结束选择的感激概念。这篇文章分享了研究诗歌的发现，这是一种基于艺术的研究形式，诗歌是从数据中发展出来的（这里是采访记录）。方法进行28次半结构化定性访谈，共33名参与者(32名家庭照顾者；一个病人)。参与者被问及他们的VAD经历，护理人员也被问及他们的家庭成员的经历。对数据进行了主题分析，重点是对VAD的感激之情。研究诗的创作采用了米勒的五步法。结果对VAD的感激是一个重要的概念。我们确定了三种感恩主题，它们与人们感激什么、感激谁以及与感激交织在一起的其他情感有关，比如矛盾心理。我们创作了六首诗来阐明这些发现，并表达患者和家庭护理人员对VAD的感激之情。参与者强调对VAD的感激是他们经历的重要组成部分，可以帮助家庭照顾者应对VAD死亡。表达感激之情可以支持提供VAD的保健专业人员，并为其他司法管辖区的法律改革提供支持。反映这种感激之情的研究诗歌有助于减少与VAD有关的耻辱，并提高对这种相对较新的临终选择的认识。在澳大利亚，需要对那些寻求和接受VAD的人的情感体验进行更多的研究。

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引用次数: 0

Factors affecting progression to frailty in community-dwelling older adults during all COVID-19 waves 在所有COVID-19波期间影响社区居住老年人向虚弱发展的因素

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2025-06-01 DOI: 10.1111/ajag.70050

Ebru Çakir, Hatice Tuğba Yazir, Mustafa Çetin, Zehra Sarikaya Demirbaş, Mehmet Ilkin Naharci

Objective

Frailty, defined as a reduced capacity to manage stress due to multisystem dysfunction, has a significant impact on quality of life, morbidity and mortality. This study aimed to identify the factors influencing the progression to frailty in community-dwelling older adults during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

This prospective observational study included non-frail individuals aged 65 years or older admitted to a geriatric outpatient clinic. Evaluation was conducted before (T0) and after (T1) the pandemic. Logistic regression analysis was performed to examine factors associated with progression to frailty.

Results

The final sample comprised 139 participants (mean age 74.8 ± 6.2 years, 60% female). The median follow-up time was 53 months (range, 27–60). Thirty-one participants (22%) developed frailty after the pandemic. In the clinical follow-up (T1), a decrease in the Mini Nutritional Assessment-Short Form score was associated with an increased risk of frailty. In the multivariate logistic regression analysis, four or more doses of the COVID-19 vaccine, sufficient physical activity and a Mini-Mental State Examination score ≥27 points were associated with a lower risk of transition to frailty, while polypharmacy and age ≥75 years were associated with an increased risk.

Conclusions

This study highlights the importance of full vaccination, along with promoting physical activity, mitigating polypharmacy and enhancing cognitive health to prevent the onset of frailty during a viral pandemic.

虚弱是指由于多系统功能障碍导致的压力管理能力下降，对生活质量、发病率和死亡率有重大影响。本研究旨在确定2019年冠状病毒病（COVID-19）大流行期间影响社区居住老年人向虚弱发展的因素。方法：本前瞻性观察性研究纳入65岁及以上老年人门诊就诊的非体弱个体。在大流行之前和之后分别进行了评估。进行逻辑回归分析以检查与病情恶化相关的因素。结果共纳入139例，平均年龄74.8±6.2岁，女性占60%。中位随访时间为53个月（范围27-60）。31名参与者（22%）在大流行后出现虚弱。在临床随访（T1）中，迷你营养评估-简短形式评分的降低与虚弱风险的增加有关。在多因素logistic回归分析中，四剂或更多剂量的COVID-19疫苗、充足的体力活动和迷你精神状态检查评分≥27分与向虚弱过渡的风险较低相关，而多药和年龄≥75岁与风险增加相关。这项研究强调了全面接种疫苗的重要性，同时促进身体活动，减少多种药物治疗和增强认知健康，以防止病毒大流行期间出现虚弱。

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引用次数: 0

The impact of outdoor physical activity on psychological resilience in older adults: The role of perceived health in active ageing 户外体育活动对老年人心理弹性的影响：感知健康在积极老龄化中的作用

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2025-06-01 DOI: 10.1111/ajag.70051

Mehmet Doğan, Bülent Gürbüz

Objective

Given the rising physical and cognitive risks associated with ageing, consistent engagement in physical activity is essential for alleviating these risks and fostering active ageing. This study investigated the mediating role of perceived health in the relationship between leisure-based outdoor physical activity involvement and psychological resilience among older adults.

Methods

This cross-sectional study, conducted in 2023–2024, utilised a convenience sampling method to collect data from older adults in Türkiye who engage in outdoor physical activities. Data were collected using the Leisure Involvement Scale (LIS), Perceived Health Outcomes in Recreation Scale (PHORS) and Brief Resilience Scale (BRS). In line with the objective of the study, a mediation analysis was conducted using the PROCESS macro for data analysis.

Results

The analyses revealed positive associations between outdoor physical activity involvement, perceived health and psychological resilience. Specifically, outdoor physical activity involvement was to positively influence perceived health and psychological resilience. Moreover, health perception was identified as a mediator in the relationship between outdoor physical activity involvement and psychological resilience. The findings suggest that participation in outdoor physical activities not only enhances health perception and psychological resilience but also highlights the crucial role of health perception as a bridge between them.

Conclusions

It has been observed that outdoor physical activities positively influence the resilience of older adults through the mediating effect of health perception. Therefore, it is imperative to promote outdoor physical activities that foster active ageing, as they play a crucial role in enhancing the overall health-care framework for older adults.

鉴于与老龄化相关的身体和认知风险不断上升，持续参与体育活动对于减轻这些风险和促进积极老龄化至关重要。本研究探讨了感知健康在老年人休闲户外体育活动参与与心理弹性之间的中介作用。方法本横断面研究于2023-2024年进行，采用方便抽样方法收集日本从事户外体育活动的老年人的数据。数据采用休闲参与量表（LIS）、休闲健康结果感知量表（PHORS）和短暂恢复力量表（BRS）收集。根据研究目的，使用PROCESS宏进行数据分析，进行中介分析。结果分析显示，参与户外体育活动与感知健康和心理弹性呈正相关。具体而言，户外体育活动参与对感知健康和心理弹性有积极影响。此外，健康知觉在户外体育活动参与与心理弹性的关系中被确定为中介。研究结果表明，参加户外体育活动不仅可以增强健康感知和心理弹性，而且还突出了健康感知作为两者之间桥梁的重要作用。结论户外体育活动通过健康感知的中介作用对老年人心理弹性产生正向影响。因此，必须促进促进积极老龄化的户外体育活动，因为它们在加强老年人整体保健框架方面发挥着至关重要的作用。

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引用次数: 0

Factors associated with length of stay in patients from residential aged care facilities admitted for behavioural and psychological symptoms of dementia 与因痴呆症行为和心理症状而入住老年护理机构的患者住院时间相关的因素

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2025-05-25 DOI: 10.1111/ajag.70044

Adeloisa Pajaro, Timothy To, Craig Whitehead

Objective

To determine factors affecting the length of stay (LOS) in patients from residential aged care facilities (RACFs) admitted for behavioural and psychological symptoms of dementia (BPSD).

Methods

Medical records for RACF patients admitted to Flinders Medical Centre between January and December 2018 were reviewed. For patients admitted with BPSD, demographics, clinical characteristics, admission characteristics and outcomes were extracted. Key outcomes were LOS and admission to a subacute unit (psychogeriatric or geriatric) for ongoing care. Factors influencing LOS and subacute admission were explored.

Results

The average LOS was 21.7 days and median LOS 10.5 days. Younger age, prior Dementia Behaviour Management Advisory Service review, psychogeriatrician assessment, inpatient treatment order and increased number of Code Blacks (hospital code for violent behaviour) were associated with a longer LOS and subacute admission. Being women and being bed-bound were associated with shorter admission and direct discharge. Opioid use was associated with shorter admission. Use of benzodiazepine and higher dose, higher antipsychotic dose, use of antidepressant or mood stabilisers were associated with subacute admission. The presence of reversible causes was associated with direct discharge.

Conclusions

Certain clinical characteristics may be associated with LOS in patients with BPSD from RACFs. This information may help in the development of strategies to prevent acute presentation to hospital, minimise LOS and create pathways for improved management.

目的探讨影响老年痴呆症（BPSD）行为和心理症状住院患者住院时间的因素。方法回顾2018年1月至12月在弗林德斯医疗中心收治的RACF患者的医疗记录。对于入院的BPSD患者，提取人口统计学、临床特征、入院特征和结局。主要结果是LOS和进入亚急性病房（老年精神科或老年科）进行持续治疗。探讨影响LOS和亚急性入院的因素。结果平均生存期为21.7天，中位生存期为10.5天。年龄较小、先前的痴呆症行为管理咨询服务审查、老年心理医生评估、住院治疗命令和“黑色代码”（暴力行为的医院代码）数量增加与较长的LOS和亚急性住院有关。作为女性和卧床不起与住院和直接出院时间较短有关。阿片类药物的使用与入院时间缩短有关。使用高剂量的苯二氮卓类药物、高剂量的抗精神病药物、使用抗抑郁药或情绪稳定剂与亚急性入院有关。可逆原因的存在与直接放电有关。结论某些临床特征可能与rfs合并BPSD患者的LOS有关。这些信息可能有助于制定预防急性住院的策略，最大限度地减少LOS，并为改进管理创造途径。

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引用次数: 0

An everyone story: Finding our way back to compassion, hope and humanity By Duncan McKellar, SA: Wakefield Press. 2024. ISBN: 9781923042179 (soft cover); $34.95 Booktopia 每个人的故事：找到我们回到同情、希望和人性的道路，邓肯·麦凯勒，南威尔士：韦克菲尔德出版社，2024。ISBN: 9781923042179（软封面）；34.95美元Booktopia

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2025-05-22 DOI: 10.1111/ajag.70027

Colleen Cartwright

引用次数: 0

The Specialist Dementia Care Program in Australia: Evidence to date on a home-like model of care for people with very severe behaviours and psychological symptoms of dementia 澳大利亚的专家痴呆症护理计划：迄今为止关于对患有非常严重的痴呆症行为和心理症状的人进行家庭式护理模式的证据

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2025-05-22 DOI: 10.1111/ajag.70046

Mustafa Atee, Srivalli Vilapakkam Nagarajan, Rebecca Lloyd, Stephen Macfarlane, Angela Raguz, Thomas Morris

Objectives

Behaviours and psychological symptoms of dementia (BPSD) have a serious impact on care and health outcomes, such as inappropriate pharmacotherapy and impaired quality of life. These symptoms are common across care settings but are more prevalent in residential aged care homes (RACHs). BPSD such as aggression and psychosis may pose a high risk of harm to residents, co-residents, caregivers and families, and the severe forms of these BPSD are linked to RACH premature admission. When people with very severe BPSD in Australia cannot be cared for in mainstream RACHs, the Specialist Dementia Care Program (SDCP) is offered. This article describes the SDCP model of care and examines the available evidence on SDCP outcomes.

Methods

The SDCP model of care delivers person-centred care via multidisciplinary staff in small, ‘cottage-like’, domestic units with a familiar, dementia-friendly care environment for an anticipated duration of 12 months. SDCP units are designed to stabilise or reduce BPSD, facilitate transition to mainstream RACHs, prevent unnecessary hospitalisations and minimise health-care costs.

Results

Preliminary evidence suggests that SDCP units may enhance resident outcomes, decrease the severity of BPSD and improve quality of life.

Conclusion

This article highlights the importance of prioritising the type of care this program provides to people with very severe BPSD.

痴呆症的行为和心理症状对护理和健康结果有严重影响，如药物治疗不当和生活质量受损。这些症状在护理机构中很常见，但在养老院（RACHs）中更为普遍。攻击性和精神病等BPSD可能对居民、共同居民、照顾者和家庭造成高风险伤害，这些BPSD的严重形式与RACH过早入院有关。在澳大利亚，当非常严重的BPSD患者无法在主流地区得到照顾时，可以提供专家痴呆症护理计划（SDCP）。本文描述了SDCP的护理模式，并检查了SDCP结果的现有证据。方法SDCP护理模式通过多学科工作人员提供以人为本的护理，在小型的“农舍式”家庭单位提供熟悉的、对痴呆症友好的护理环境，预计持续12个月。可持续发展保健单位的目的是稳定或减少基本健康状况，促进向主流地区保健中心过渡，防止不必要的住院治疗，并尽量减少保健费用。结果初步证据表明，SDCP单元可以提高住院预后，减轻BPSD的严重程度，改善生活质量。这篇文章强调了这个项目为非常严重的BPSD患者提供优先护理类型的重要性。

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引用次数: 0

Validation of a dementia diagnosis attitude scale in simplified Chinese with Mandarin-speaking adults in Australia 简体中文痴呆诊断态度量表在澳大利亚普通话成年人中的验证

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing

Pub Date : 2025-05-22 DOI: 10.1111/ajag.70049

Xuan Mai Tran, Sonia Chan, Genevieve Z. Steiner-Lim, Lyn Phillipson, Kim-Huong Nguyen, Déborah Oliveira, Tiet-Hanh Dao-Tran, Joyce Siette, Diana Karamacoska

Objectives

Validated scales assessing dementia attitudes in Chinese populations are needed to understand the extent and nature of stigma in communities, design appropriate sociocultural interventions and assess their impact. This study was aimed at translating and validating an Australian version of the 12-item dementia diagnosis attitude scale in simplified Chinese.

Methods

Following a forward and backward translation process, including pretesting with community members, the final version was administered to Mandarin speaking adults aged 18 years or older in Australia (n = 325). We conducted exploratory and confirmatory factor analyses, and internal consistency reliability testing.

Results

The final version had 10 items covering a two-factor structure of five items each (‘fear of labelling’ and ‘fear of losing face’) with high reliability (α = .90).

Conclusions

The simplified Chinese dementia diagnosis attitude scale (SC-DDAS) is robust for use with Chinese populations in Australia. Future studies can extend on this work to determine further psychometric properties of the 10-item scale and assess its utility in informing and evaluating community interventions.

目的：需要评估中国人对痴呆症态度的有效量表，以了解社区中耻辱感的程度和性质，设计适当的社会文化干预措施并评估其影响。本研究旨在翻译并验证简体中文12项痴呆诊断态度量表的澳大利亚版本。方法经过前后翻译过程，包括社区成员的预测，最终版本在澳大利亚对18岁或以上的普通话成年人（n = 325）进行。我们进行了探索性和验证性因素分析，并进行了内部一致性信度检验。结果最终版本有10个项目，涵盖了一个双因素结构，每个5个项目（“害怕标签”和“害怕丢脸”），具有高信度（α = 0.90）。结论简体中文痴呆诊断态度量表（SC-DDAS）适用于澳大利亚华人群体。未来的研究可以在此基础上进一步确定10项量表的心理测量特性，并评估其在告知和评估社区干预方面的效用。

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引用次数: 0