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Iyamu I, Gómez-Ramírez O, Xu AXT, Chang HJ, Watt S, Mckee G, Gilbert M. Challenges in the development of digital public health interventions and mapped solutions: Findings from a scoping review. Digit Health 2022; 8:20552076221102255. [PMID: 35656283 PMCID: PMC9152201 DOI: 10.1177/20552076221102255] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background “Digital public health” has emerged from an interest in integrating digital technologies into public health. However, significant challenges which limit the scale and extent of this digital integration in various public health domains have been described. We summarized the literature about these challenges and identified strategies to overcome them. Methods We adopted Arksey and O’Malley's framework (2005) integrating adaptations by Levac et al. (2010). OVID Medline, Embase, Google Scholar, and 14 government and intergovernmental agency websites were searched using terms related to “digital” and “public health.” We included conceptual and explicit descriptions of digital technologies in public health published in English between 2000 and June 2020. We excluded primary research articles about digital health interventions. Data were extracted using a codebook created using the European Public Health Association's conceptual framework for digital public health. Results and analysis Overall, 163 publications were included from 6953 retrieved articles with the majority (64%, n = 105) published between 2015 and June 2020. Nontechnical challenges to digital integration in public health concerned ethics, policy and governance, health equity, resource gaps, and quality of evidence. Technical challenges included fragmented and unsustainable systems, lack of clear standards, unreliability of available data, infrastructure gaps, and workforce capacity gaps. Identified strategies included securing political commitment, intersectoral collaboration, economic investments, standardized ethical, legal, and regulatory frameworks, adaptive research and evaluation, health workforce capacity building, and transparent communication and public engagement. Conclusion Developing and implementing digital public health interventions requires efforts that leverage identified strategies to overcome diverse challenges encountered in integrating digital technologies in public health.
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Affiliation(s)
- Ihoghosa Iyamu
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Oralia Gómez-Ramírez
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- CIHR Canadian HIV Trials Network, Vancouver, BC, Canada
| | - Alice XT Xu
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Hsiu-Ju Chang
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Sarah Watt
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Geoff Mckee
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Mark Gilbert
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
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Zakerabasali S, Ayyoubzadeh SM, Baniasadi T, Yazdani A, Abhari S. Mobile Health Technology and Healthcare Providers: Systemic Barriers to Adoption. Healthc Inform Res 2021; 27:267-278. [PMID: 34788907 PMCID: PMC8654335 DOI: 10.4258/hir.2021.27.4.267] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 07/23/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives Despite the growing use of mobile health (mHealth), certain barriers seem to be hindering the use of mHealth applications in healthcare. This article presents a systematic review of the literature on barriers associated with mHealth reported by healthcare professionals. Methods This systematic review was carried out to identify studies published from January 2015 to December 2019 by searching four electronic databases (PubMed/MEDLINE, Web of Science, Embase, and Google Scholar). Studies were included if they reported perceived barriers to the adoption of mHealth from healthcare providers’ perspectives. Content analysis and categorization of barriers were performed based on a focus group discussion that explored researchers’ knowledge and experiences. Results Among the 273 papers retrieved through the search strategy, 18 works were selected and 18 barriers were identified. The relevant barriers were categorized into three main groups: technical, individual, and healthcare system. Security and privacy concerns from the category of technical barriers, knowledge and limited literacy from the category of individual barriers, and economic and financial factors from the category of healthcare system barriers were chosen as three of the most important challenges related to the adoption of mHealth described in the included publications. Conclusions mHealth adoption is a complex and multi-dimensional process that is widely implemented to increase access to healthcare services. However, it is influenced by various factors and barriers. Understanding the barriers to adoption of mHealth applications among providers, and engaging them in the adoption process will be important for the successful deployment of these applications.
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Affiliation(s)
- Somayyeh Zakerabasali
- Clinical Education Research Center, Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mohammad Ayyoubzadeh
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Tayebeh Baniasadi
- Department of Health Information Technology, Faculty of Paramedicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Azita Yazdani
- Clinical Education Research Center, Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahabeddin Abhari
- Amol Faculty of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
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Ruhi U, Chugh R. Utility, Value, and Benefits of Contemporary Personal Health Records: Integrative Review and Conceptual Synthesis. J Med Internet Res 2021; 23:e26877. [PMID: 33866308 PMCID: PMC8120425 DOI: 10.2196/26877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/30/2021] [Accepted: 04/15/2021] [Indexed: 12/30/2022] Open
Abstract
Background Contemporary personal health record (PHR) technologies offer a useful platform for individuals to maintain a lifelong record of personally reported and clinically sourced data from various points of medical care. Objective This paper presents an integrative review and synthesis of the extant literature on PHRs. This review draws upon multiple lenses of analysis and deliberates value perspectives of PHRs at the product, consumer, and industry levels. Methods Academic databases were searched using multiple keywords related to PHRs for the years 2001-2020. Three research questions were formulated and used as selection criteria in our review of the extant literature relevant to our study. Results We offer a high-level functional utility model of PHR features and functions. We also conceptualize a consumer value framework of PHRs, highlighting the applications of these technologies across various health care delivery activities. Finally, we provide a summary of the benefits of PHRs for various health care constituents, including consumers, providers, payors, and public health agencies. Conclusions PHR products offer a myriad of content-, connectivity-, and collaboration-based features and functions for their users. Although consumers benefit from the tools provided by PHR technologies, their overall value extends across the constituents of the health care delivery chain. Despite advances in technology, our literature review identifies a shortfall in the research addressing consumer value enabled by PHR tools. In addition to scholars and researchers, our literature review and proposed framework may be especially helpful for value analysis committees in the health care sector that are commissioned for the appraisal of innovative health information technologies such as PHRs.
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Affiliation(s)
- Umar Ruhi
- Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
| | - Ritesh Chugh
- School of Engineering & Technology, Central Queensland University, Melbourne, Australia
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Al-Shorbaji N, Bellazzi R, Gonzalez Bernaldo de Quiros F, Koch S, Kulikowski CA, Lovell NH, Maojo V, Park HA, Sanz F, Sarkar IN, Tanaka H. Discussion of "The New Role of Biomedical Informatics in the Age of Digital Medicine". Methods Inf Med 2016; 55:403-421. [PMID: 27524112 DOI: 10.3414/me15-12-0005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "The New Role of Biomedical Informatics in the Age of Digital Medicine" written by Fernando J. Martin-Sanchez and Guillermo H. Lopez-Campos [1]. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the paper of Martin-Sanchez and Lopez-Campos. In subsequent issues the discussion can continue through letters to the editor.
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Affiliation(s)
- Najeeb Al-Shorbaji
- Najeeb Al-Shorbaji, Vice-President for Knowledge, Research, and Ethics, e-Marefa (www.e-marefa.net), P.O. Box 2351, Amman 11953, Jordan, E-mail:
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von Thiele Schwarz U. Co-care: Producing better health outcome through interactions between patients, care providers and information and communication technology. Health Serv Manage Res 2016. [PMCID: PMC4887817 DOI: 10.1177/0951484816637746] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The demands on healthcare are shifting, from caring for patients with acute conditions managed in a single-care episode to caring for patients with chronic and often complex conditions. With this shift comes a recognition that healthcare requires an interaction between patients and care providers, and of the interdependencies between these actors for achieving a positive outcome – that the results are co-produced. This paper introduces co-care, which stresses that the role of healthcare providers is to complement people’s own resources for managing their health so that patients’ and healthcare providers’ resources combined leads to the best possible outcome. This is done using tools and artifacts such as information and communication technology that enable knowledge to be created, shaped, shared and applied across the actors. Thus, in co-care, knowledge is not attributed to a single entity but distributed between them in line with the theory of distributed cognition. To put co-care into practice, several challenges must be addressed. This includes moving from profession-centeredness to patient-centeredness and from approaching care as a transformation of input to products to viewing care as linking needs and knowledge, as well as a substantial attitude and behavior change across healthcare stakeholders.
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Affiliation(s)
- Ulrica von Thiele Schwarz
- Procome, Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Hedden EM, Jessop AB, Field RI. An education in contrast: state-by-state assessment of school immunization records requirements. Am J Public Health 2014; 104:1993-2001. [PMID: 25122033 PMCID: PMC4167093 DOI: 10.2105/ajph.2014.302078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We reviewed the complexities of school-related immunization policies, their relation to immunization information systems (IIS) and immunization registries, and the historical context to better understand this convoluted policy system. METHODS We used legal databases (Lexis-Nexis and Westlaw) to identify school immunization records policies for 50 states, 5 cities, and the District of Columbia (Centers for Disease Control and Prevention "grantees"). The original search took place from May to September 2010 (cross-referenced in July 2013 with the list on http://www.immunize.org/laws ). We describe the requirements, agreement with IIS policies, and penalties for policy violations. RESULTS We found a complex web of public health, medical, and education-directed policies, which complicates immunization data sharing. Most (79%) require records of immunizations for children to attend school or for a child-care institution licensure, but only a few (11%) require coordination between IIS and schools or child-care facilities. CONCLUSIONS To realize the full benefit of IIS investment, including improved immunization and school health program efficiencies, IIS and school immunization records policies must be better coordinated. States with well-integrated policies may serve as models for effective harmonization.
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Affiliation(s)
- Erika M Hedden
- Erika M. Hedden and Amy B. Jessopare are with the Department of Health Policy and Public Health, University of the Sciences, Philadelphia, PA. Robert I. Field is with the School of Law and School of Public Health, Drexel University, Philadelphia, PA
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Flaherty D, Hoffman-Goetz L, Arocha JF. What is consumer health informatics? A systematic review of published definitions. Inform Health Soc Care 2014; 40:91-112. [PMID: 24801616 DOI: 10.3109/17538157.2014.907804] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Consumer health informatics (CHI) is an emerging field that utilizes technology to provide health information to enhance health-care decision making by the public. There is, however, no widely accepted or uniform definition of CHI. A consensus definition would be important for pedagogical reasons, to build capacity and to reduce confusion about what the discipline consists of. AIM We undertook a systematic review of published definitions of CHI and evaluated them using five quality assessment criteria and measures of similarity. METHODS Five databases were searched (Embase, Web of Science, MEDLINE, CINAHL and Business Source Complete) resulting in 1101 citations. Twenty-three studies met the inclusion criteria. Definitions were appraised using five criteria (with each scoring out of one): use of published citation, multi-disciplinarity, journal impact, definition comprehensibility, text readability. RESULTS Most definitions scored low on citation (Mean ± SD: 0.22 ± 0.42), multi-disciplinarity (0.15 ± 0.28) and readability (0.04 ± 0.21) and somewhat higher on IF (0.35 ± 0.45) and definition comprehensibility (idea density) (0.87 ± 0.34) criteria. Overall, the quality of the published definitions was low 1.63 ± 0.80 (out of five). CONCLUSIONS The definitions of CHI were variable in terms of the quality assessment criteria. This suggests the need for continued discussion amongst consumer health informaticians to develop a clear consensus definition about CHI.
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Affiliation(s)
- David Flaherty
- School of Public Health and Health Systems, University of Waterloo , Waterloo, Ontario , Canada
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Carrera PM, Dalton ARH. Do-it-yourself healthcare: the current landscape, prospects and consequences. Maturitas 2013; 77:37-40. [PMID: 24287177 DOI: 10.1016/j.maturitas.2013.10.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 10/13/2013] [Indexed: 11/30/2022]
Abstract
The wider availability and increasing use of mHealth tools - covering health applications, smartphone plug-ins and gadgets is significant for healthcare. This trend epitomises broader trajectories in access to and delivery of healthcare, with greater consumer involvement and decentralisation. This shift may be conceptualised as 'do-it-yourself Healthcare' - allowing consumers to monitor and manage their health, and guide their healthcare consumption. Technology that enables data collection by patients informs them about vital health metrics, giving them more control over experiences of health or illness. The information can be used alone as empowered consumers or together with healthcare professionals in an environment of patient-centred care. Current evidence suggests a large scope for do-it-yourself Healthcare, given the availability of technologies, whilst mHealth tools enhance diagnostics, improve treatment, increase access to services and lower costs. There are, however, limitations to do-it-yourself Healthcare. Notably, its evidence base is less well developed than the availability of technologies to facilitate it. A more complex model and understanding is needed to explain motivations for and consequences of engaging in do-it-yourself Healthcare. That said, its introduction alongside existing medicine may improve quality and reduce costs - potentially improving health system sustainability whilst future generations - tomorrow's middle-aged and the elderly, will become more conducive to its spread.
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Affiliation(s)
- Pricivel M Carrera
- Health Technology and Services Research Department, University of Twente, The Netherlands.
| | - Andrew R H Dalton
- Department of Primary Care Health Sciences, University of Oxford, United Kingdom
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Olsen J, Baisch MJ. An integrative review of information systems and terminologies used in local health departments. J Am Med Inform Assoc 2013; 21:e20-7. [PMID: 24036156 DOI: 10.1136/amiajnl-2013-001714] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The purpose of this integrative review based on the published literature was to identify information systems currently being used by local health departments and to determine the extent to which standard terminology was used to communicate data, interventions, and outcomes to improve public health informatics at the local health department (LHD) level and better inform research, policy, and programs. MATERIALS AND METHODS Whittemore and Knafl's integrative review methodology was used. Data were obtained through key word searches of three publication databases and reference lists of retrieved articles and consulting with experts to identify landmark works. The final sample included 45 articles analyzed and synthesized using the matrix method. RESULTS The results indicated a wide array of information systems were used by LHDs and supported diverse functions aligned with five categories: administration; surveillance; health records; registries; and consumer resources. Detail regarding specific programs being used, location or extent of use, or effectiveness was lacking. The synthesis indicated evidence of growing interest in health information exchange groups, yet few studies described use of data standards or standard terminology in LHDs. DISCUSSION Research to address these gaps is needed to provide current, meaningful data that inform public health informatics research, policy, and initiatives at and across the LHD level. CONCLUSIONS Coordination at a state or national level is recommended to collect information efficiently about LHD information systems that will inform improvements while minimizing duplication of efforts and financial burden. Until this happens, efforts to strengthen LHD information systems and policies may be significantly challenged.
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Affiliation(s)
- Jeanette Olsen
- Department of Nursing, University of Wisconsin Milwaukee, Milwaukee, Wisconsin, USA
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Abstract
The advent of the electronic health record and numerous mobile, wireless tools with the capacity to capture, store, and transmit prodigious amounts of data, both using and creating evidence-based content and analytics for clinical decision support, requires that all care providers rethink approaches to care delivery. The nursing profession is called to acutely appreciate and support the vision of documentation systems that provide optimal decision support at the point of care, represent nursing knowledge, and are also capable of capturing care delivery outcomes that can be used to inform future care and improve the health of the public.
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Affiliation(s)
- Ida M. Androwich
- Professor and Director, Health Systems Management, Niehoff School of Nursing, Loyola University Chicago
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Hedden EM, Jessop AB, Field RI. Childhood immunization reporting laws in the United States: Current status. Vaccine 2012; 30:7059-66. [DOI: 10.1016/j.vaccine.2012.09.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Revised: 08/13/2012] [Accepted: 09/22/2012] [Indexed: 10/27/2022]
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Marriott LK, Cameron WE, Purnell JQ, Cetola S, Ito MK, Williams CD, Newcomb KC, Randall JA, Messenger WB, Lipus AC, Shannon J. Let's Get Healthy! Health awareness through public participation in an education and research exhibit. Prog Community Health Partnersh 2012; 6:331-7. [PMID: 22982846 DOI: 10.1353/cpr.2012.0041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Health information technology (HIT) offers a resource for public empowerment through tailored information. OBJECTIVE Use interactive community health events to improve awareness of chronic disease risk factors while collecting data to improve health. METHODS Let's Get Healthy! is an education and research program in which participants visit interactive research stations to learn about their own health (diet, body composition, blood chemistry). HIT enables computerized data collection that presents participants with immediate results and tailored educational feedback. An anonymous wristband number links collected data in a population database. RESULTS AND LESSONS LEARNED: Communities tailor events to meet community health needs with volunteers trained to conduct research. Participants experience being a research participant and contribute to an anonymous population database for both traditional research purposes and open-source community use. CONCLUSIONS By integrating HIT with community involvement, health fairs become an interactive method for engaging communities in research and raising health awareness.
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Affiliation(s)
- Lisa K Marriott
- Oregon Health & Science University, Center for Research on Occupational and Environmental Toxicology, USA
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Sarkar IN. Biomedical informatics and translational medicine. J Transl Med 2010; 8:22. [PMID: 20187952 PMCID: PMC2837642 DOI: 10.1186/1479-5876-8-22] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Accepted: 02/26/2010] [Indexed: 11/23/2022] Open
Abstract
Biomedical informatics involves a core set of methodologies that can provide a foundation for crossing the "translational barriers" associated with translational medicine. To this end, the fundamental aspects of biomedical informatics (e.g., bioinformatics, imaging informatics, clinical informatics, and public health informatics) may be essential in helping improve the ability to bring basic research findings to the bedside, evaluate the efficacy of interventions across communities, and enable the assessment of the eventual impact of translational medicine innovations on health policies. Here, a brief description is provided for a selection of key biomedical informatics topics (Decision Support, Natural Language Processing, Standards, Information Retrieval, and Electronic Health Records) and their relevance to translational medicine. Based on contributions and advancements in each of these topic areas, the article proposes that biomedical informatics practitioners ("biomedical informaticians") can be essential members of translational medicine teams.
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Affiliation(s)
- Indra Neil Sarkar
- Center for Clinical and Translational Science, Department of Microbiology and Molecular Genetics, University of Vermont, College of Medicine, 89 Beaumont Ave, Given Courtyard N309, Burlington, VT 05405, USA.
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