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Karthigesu SP, Chisholm JS, Coall DA. Do grandparents influence parents' decision to vaccinate their children? A systematic review. Vaccine 2018; 36:7456-7462. [PMID: 30420037 DOI: 10.1016/j.vaccine.2018.10.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/14/2018] [Accepted: 10/03/2018] [Indexed: 10/28/2022]
Abstract
The global reduction in childhood infectious diseases since the 1960s is primarily due to the success of extensive worldwide immunisation campaigns. However, the universal vaccination coverage program appears to have lost momentum in the wake of negative, unfounded claims about the safety of vaccines. While parents of the 21st century have little first-hand knowledge of devastating childhood diseases, grandparents are more likely to remember family and community members who were afflicted. In the current age of vaccine hesitancy and science scepticism, where research-informed arguments are not always persuasive, grandparents, through their experience of the diseases, may positively influence paediatric vaccine uptake. This paper reviews the literature investigating potential direct or indirect influences of grandparents on parents' decisions to vaccinate their children. A database search using the keywords immunisation, vaccination, children and grandparents resulted in 1988 articles. Titles were screened for relevance and seventy-seven results were retained. After the abstracts were read, only five articles that either explored paediatric vaccines, factors promoting and/or inhibiting paediatric vaccine use and decision-making strategies were reviewed. One paper located through Google Scholar, which failed to show up on database searches, was also retained for a total of six papers. While none of the six papers set out to explore the impact of grandparents on vaccine uptake, they found that grandparents were involved to varying degrees in paediatric vaccine uptake within young families. The research clearly showing that grandparents, and older people more generally, promote vaccination uptake is not currently available. The dearth of literature shows the need for research exploring the perceived and real influences of grandparents on childhood vaccination. This will establish whether grandparents' memory and knowledge of preventable childhood infectious diseases could be harnessed as a public health measure to counteract the current, ill-informed, negative attention on paediatric vaccines.
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Affiliation(s)
- Shantha P Karthigesu
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - James S Chisholm
- School of Human Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - David A Coall
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia; School of Medicine, University of Western Australia, Crawley, WA 6009, Australia
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Bekondi C, Zanchi R, Seck A, Garin B, Giles-Vernick T, Gody JC, Bata P, Pondy A, Tetang SM, Ba M, Ekobo CS, Rousset D, Sire JM, Maylin S, Chartier L, Njouom R, Vray M. HBV immunization and vaccine coverage among hospitalized children in Cameroon, Central African Republic and Senegal: a cross-sectional study. BMC Infect Dis 2015; 15:267. [PMID: 26164361 PMCID: PMC4499446 DOI: 10.1186/s12879-015-1000-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 06/26/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Hepatitis B is a major health concern in Africa. The vaccine against hepatitis B virus (HBV) was introduced into the Expanded Programme on Immunization (EPI) of Cameroon and Senegal in 2005, and of CAR (Central African Republic) in 2008. A cross-sectional study was conducted to assess HBV immunization coverage following the vaccine's introduction into the EPI and factors associated with having been vaccinated. METHODS All hospitalized children, regardless of the reasons for their hospitalization, between 3 months and 6 years of age, for whom a blood test was scheduled during their stay and whose condition allowed for an additional 2 mL blood sample to be taken, and who provided the parent's written consent were included. All children anti-HBs- and anti-HBc + were tested for HBsAg. Vaccination coverage was assessed in three different ways: immunization card, maternal recall and serologic anti-HBs profile. RESULTS 1783 children were enrolled between April 2009 and May 2010. An immunization card was only available for 24 % of the children. The median age was 21 months. Overall HBV immunization coverage based on immunization cards was 99 %, 49 % and 100 % in Cameroon, CAR and Senegal, respectively (p < 0,001). The immunization rate based on maternal recall was 91 %, 17 % and 88 % in Cameroon, CAR and Senegal, respectively (p < 0,001). According to serology (anti-HBs titer ≥ 10 mUI/mL and anti-HBc-), the coverage rate was 68 %, 13 % and 46 % in Cameroon, CAR and Senegal, respectively (p < 0,001). In Senegal and Cameroon, factors associated with having been vaccinated were: mother's higher education (OR = 2.2; 95 % CI [1.5-3.2]), no malnutrition (OR = 1.6; 95 % CI [1.1-2.2]), access to flushing toilets (OR = 1.6; 95 % CI [1.1-2.3]), and < 24 months old (OR = 2.1; 95 % CI [1.3-3.4] between 12 and 23 months and OR = 2.7; 95 % CI [1.6-4.4] < 12 months). The prevalence of HBV-infected children (HBsAg+) were 0.7 %, 5.1 %, and 0.2 % in Cameroon, CAR and Senegal, respectively (p < 0.001). CONCLUSIONS Assessing immunization coverage based on immunization cards, maternal recall or administrative data could be usefully reinforced by epidemiological data combined with immunological profiles. Serology-based studies should be implemented regularly in African countries, as recommended by the WHO. Malnutrition, lack of maternal education and poverty are factors associated with vaccine non-compliance. The countries' vaccination programs should actively address these problems.
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Affiliation(s)
- Claudine Bekondi
- Laboratoire des Virus Oncogènes, Institut Pasteur de Bangui, rue Pasteur, BP 923, Bangui, République Centrafricaine.
| | - Roberta Zanchi
- Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, 25-28 rue du Docteur Roux, 75015, Paris, France.
| | - Abdoulaye Seck
- Laboratoire de Biologie Médicale, Institut Pasteur de Dakar, 36 Avenue Pasteur, Dakar, Sénégal.
| | - Benoit Garin
- Institut Pasteur de Madagascar, BP 1274, Antananarivo, Madagascar.
| | - Tamara Giles-Vernick
- Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, 25-28 rue du Docteur Roux, 75015, Paris, France.
| | - Jean Chrysotome Gody
- Services des soins intensifs, Complexe Pédiatrique, BP 911, Bangui, République Centrafricaine.
| | - Petulla Bata
- Complexe Pédiatrique, BP 911, Bangui, République Centrafricaine.
| | - Angèle Pondy
- Centre Mère-Enfant, Fondation Chantal Biya, Yaoundé, Cameroun.
| | | | | | | | - Dominique Rousset
- Laboratoire de Virologie, Institut Pasteur Guyane, 23 avenue Pasteur, BP 6010, 97306, Cayenne, France.
| | - Jean-Marie Sire
- Département de virologie, Hôpital Saint Louis, Paris, France. .,Institut National de la Santé et de la Recherche Médicale, Faculté de Médecine Paris-Diderot, Paris, France.
| | - Sarah Maylin
- Service de Microbiologie CHU St Louis, 75010, Paris, France.
| | - Loïc Chartier
- Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, 25-28 rue du Docteur Roux, 75015, Paris, France.
| | - Richard Njouom
- Service de Virologie, Centre Pasteur du Cameroun, P.O.Box 1274, Yaoundé, Cameroun.
| | - Muriel Vray
- Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, 25-28 rue du Docteur Roux, 75015, Paris, France.
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Li J, Menzies D, Landry JS, Benedetti A, Rousseau MC. Determinants of Bacillus Calmette-Guérin (BCG) vaccination among Québec children. Prev Med 2014; 66:87-94. [PMID: 24945693 DOI: 10.1016/j.ypmed.2014.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 06/06/2014] [Accepted: 06/07/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To identify determinants of Bacillus Calmette-Guérin (BCG) vaccination among children born in Québec, Canada, in 1974, the last year of the systematic vaccination campaign. METHOD A retrospective birth cohort was assembled in 2011 through probabilistic linkage of administrative databases (n=81,496). Potential determinants were documented from administrative databases and by interviewing a subset of subjects (n=1643) in 2012. Analyses were conducted among subjects with complete data, 71,658 (88%) birth cohort subjects and 1154 (70%) interviewed subjects, then redone using multiple imputation. Determinants of BCG vaccination during the organized vaccination program (in 1974), and after the program (1975 onwards) were assessed separately. Logistic regression with backward elimination was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Overall, 46% of subjects were BCG vaccinated, 43% during the program and 4% after it ended. BCG vaccination during the program was associated with parents' birthplace and urban or rural residence. BCG vaccination after the organized program was only related to ethnocultural origin of the child's grandparents. CONCLUSION Different factors were related to vaccination within and after the organized program. Determinants of BCG vaccination in Québec, Canada, have never been studied and will be useful for future research and vaccination campaigns.
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Affiliation(s)
- J Li
- INRS-Institut Armand-Frappier, Université du Québec, 531 des Prairies, Laval, Québec H7V 1B7, Canada; Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, 1020 Pine Avenue West, Montréal, Québec H3A 1A2, Canada
| | - D Menzies
- Montreal Chest Institute, McGill University Health Centre, 3650 St-Urbain, Montréal, Québec H2Z 2P4, Canada; Respiratory Epidemiology and Clinical Research Unit (RECRU), McGill University, 3650 St-Urbain, Montréal, Québec H2Z 2P4, Canada; Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, 1020 Pine Avenue West, Montréal, Québec H3A 1A2, Canada
| | - J S Landry
- Montreal Chest Institute, McGill University Health Centre, 3650 St-Urbain, Montréal, Québec H2Z 2P4, Canada; Respiratory Epidemiology and Clinical Research Unit (RECRU), McGill University, 3650 St-Urbain, Montréal, Québec H2Z 2P4, Canada
| | - A Benedetti
- Montreal Chest Institute, McGill University Health Centre, 3650 St-Urbain, Montréal, Québec H2Z 2P4, Canada; Respiratory Epidemiology and Clinical Research Unit (RECRU), McGill University, 3650 St-Urbain, Montréal, Québec H2Z 2P4, Canada; Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, 1020 Pine Avenue West, Montréal, Québec H3A 1A2, Canada; Department of Medicine, McGill University, 3655 Sir William Osler, Montréal, Québec H3F 1Y6, Canada
| | - M C Rousseau
- INRS-Institut Armand-Frappier, Université du Québec, 531 des Prairies, Laval, Québec H7V 1B7, Canada.
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An Evaluation of Community Assessment for Public Health Emergency Response (CASPER) in North Carolina, 2003-2010. Prehosp Disaster Med 2013; 28:94-8. [PMID: 23360668 DOI: 10.1017/s1049023x13000071] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Community Assessment for Public Health Emergency Response (CASPER) is a group of tools and methods designed by the US Centers for Disease Control and Prevention (CDC) to provide rapid, reliable, and accurate population-based public health information. Since 2003, North Carolina public health professionals have used CASPERs to facilitate public health emergency responses and gather information on other topics including routine community health assessments. PROBLEM To date, there has been no evaluation of CASPER use by public health agencies at the state or local level in the US. METHODS Local health departments of North Carolina reported when and how CASPERs were used during the period 2003 to 2010 via an online survey. Data on barriers and future plans for using CASPERs also were collected. RESULTS Fifty-two of North Carolina's 85 local health departments (61%) completed the survey. Twenty-eight departments reported 46 instances of CASPER use during 2003 to 2010. The majority of CASPERs were performed for community health assessments (n = 20, 43%) or exercises (n = 11, 24%). Fifty-six percent of respondents indicated they were "likely" or "very likely" to use CASPERs in the future; those who had prior experience with CASPERs were significantly more likely (P = .02) to report planned future use of CASPERs compared to those without prior experience with the tool. Lack of training, equipment, and time were the most frequently reported barriers to using CASPERs. CONCLUSIONS Local public health agencies with clear objectives and goals can effectively use CASPERs in both routine public health practice and disaster settings.
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Muhsen K, Abed El-Hai R, Amit-Aharon A, Nehama H, Gondia M, Davidovitch N, Goren S, Cohen D. Risk factors of underutilization of childhood immunizations in ultraorthodox Jewish communities in Israel despite high access to health care services. Vaccine 2012; 30:2109-15. [DOI: 10.1016/j.vaccine.2012.01.044] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 01/15/2012] [Accepted: 01/17/2012] [Indexed: 11/30/2022]
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Horney J, Zotti ME, Williams A, Hsia J. Cluster sampling with referral to improve the efficiency of estimating unmet needs among pregnant and postpartum women after disasters. Womens Health Issues 2012; 22:e253-7. [PMID: 22365134 DOI: 10.1016/j.whi.2012.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 12/28/2011] [Accepted: 01/03/2012] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND BACKGROUND Women of reproductive age, in particular women who are pregnant or fewer than 6 months postpartum, are uniquely vulnerable to the effects of natural disasters, which may create stressors for caregivers, limit access to prenatal/postpartum care, or interrupt contraception. Traditional approaches (e.g., newborn records, community surveys) to survey women of reproductive age about unmet needs may not be practical after disasters. Finding pregnant or postpartum women is especially challenging because fewer than 5% of women of reproductive age are pregnant or postpartum at any time. METHODS From 2009 to 2011, we conducted three pilots of a sampling strategy that aimed to increase the proportion of pregnant and postpartum women of reproductive age who were included in postdisaster reproductive health assessments in Johnston County, North Carolina, after tornadoes, Cobb/Douglas Counties, Georgia, after flooding, and Bertie County, North Carolina, after hurricane-related flooding. RESULTS Using this method, the percentage of pregnant and postpartum women interviewed in each pilot increased from 0.06% to 21%, 8% to 19%, and 9% to 17%, respectively. CONCLUSION AND DISCUSSION Two-stage cluster sampling with referral can be used to increase the proportion of pregnant and postpartum women included in a postdisaster assessment. This strategy may be a promising way to assess unmet needs of pregnant and postpartum women in disaster-affected communities.
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Affiliation(s)
- Jennifer Horney
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina 27599, USA.
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Stefanoff P, Mamelund SE, Robinson M, Netterlid E, Tuells J, Bergsaker MAR, Heijbel H, Yarwood J. Tracking parental attitudes on vaccination across European countries: The Vaccine Safety, Attitudes, Training and Communication Project (VACSATC). Vaccine 2010; 28:5731-7. [PMID: 20558250 DOI: 10.1016/j.vaccine.2010.06.009] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 05/25/2010] [Accepted: 06/01/2010] [Indexed: 11/29/2022]
Abstract
The paper presents the first results from the European project VACSATC which aimed to track parental attitudes on vaccinations across several European countries. We compared five cross-sectional surveys of parents with children less than 3 years of age in England, Norway, Poland, Spain and Sweden carried out during 2008-2009. Data were collected from 6611 respondents. Two countries used face-to face interviews, one used telephone interviews, and two other countries used mail-in questionnaires. In all countries health professionals were indicated as the most important and trusted source of information on vaccination. The study results also show that parental attitudes on vaccinations in the childhood vaccination programs are generally positive. However, there were differences in attitudes on vaccination between the five countries, possibly reflecting different methods of sampling the respondents, context-specific differences (e.g. level of activity of governmental agencies), but also individual-level parental variation in demographic and socioeconomic status variables.
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Affiliation(s)
- Pawel Stefanoff
- Department of Epidemiology, National Institute of Public Health-National Institute of Hygiene, 24, Chocimska Str., 00-791 Warsaw, Poland.
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Falagas ME, Zarkadoulia E. Factors associated with suboptimal compliance to vaccinations in children in developed countries: a systematic review. Curr Med Res Opin 2008; 24:1719-41. [PMID: 18474148 DOI: 10.1185/03007990802085692] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The suboptimal compliance to vaccinations continues to be a major public health problem. SCOPE We conducted a systematic review (PubMed and Cochrane databases) to evaluate factors associated with suboptimal compliance to vaccinations, focusing on children and adolescents in developed countries. We categorized studies according to whether they used an analytical statistical approach. RESULTS We identified 553 potentially relevant articles and evaluated in detail 39 with original data. Factors influencing compliance to vaccinations related to parental-childhood characteristics and healthcare structure-professionals characteristics. Specifically, among the various parental-childhood characteristics studied, non-white race, low socioeconomic status, paying for immunization, lack of health insurance, low parental education, older age of the child, younger maternal age, large family size, late birth order, lack of knowledge about disease and vaccination, negative beliefs/attitudes towards immunization, fear of side-effects/risks/contraindications, not remembering vaccination schedules and appointments, sick child delays, and delayed well child visits were statistically significantly associated with suboptimal compliance. Among healthcare structure-professional characteristics were studied. Skepticism/doubts regarding provided medical information, inadequate support from healthcare providers, lack of available health structures, and problems concerning transportation and accessibility to immunization clinics were statistically significantly associated with suboptimal compliance to vaccination. CONCLUSION By recognizing and understanding factors associated with suboptimal compliance to vaccinations we can better approach the risk populations and target our efforts at stressing and reinforcing the vital importance of immunizations. Methods to enhance compliance to vaccinations may include reminder calls/mail notification of parents, initiation of health education programs for parents and health professionals, and open communication and trust between care takers of children and physicians.
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Hak E, Schönbeck Y, De Melker H, Van Essen GA, Sanders EAM. Negative attitude of highly educated parents and health care workers towards future vaccinations in the Dutch childhood vaccination program. Vaccine 2005; 23:3103-7. [PMID: 15837208 DOI: 10.1016/j.vaccine.2005.01.074] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2004] [Revised: 01/03/2005] [Accepted: 01/04/2005] [Indexed: 11/28/2022]
Abstract
BACKGROUND It is unknown whether further expansion of the Dutch childhood vaccination program with other vaccines will be accepted and whom should be targeted in educational strategies. AIM To determine attitudes of parents towards possible future vaccinations for their children and the behavioural determinants associated with a negative attitude. DESIGN Questionnaire study. METHODS Parents of children aged between 3 months and 5 years of day-care centres were asked to fill out a questionnaire. Determinants of a negative attitude to comply with possible future vaccinations against example diseases such as pneumonia or influenza, hepatitis B, TBC, smallpox and SARS were assessed using polytomous logistic regression analysis. RESULTS Of the 283 respondents, 123 (43%) reported a positive attitude towards all vaccinations, 129 (46%) reported to have a positive attitude to have their child vaccinated against some diseases and 31 (11%) had no intention to comply with any new vaccination. Determinants of a fully negative attitude were a high education of the parent (odds ratio [OR] 3.3, 95% confidence interval [95% CI]: 1.3-8.6), being a health care worker (OR 4.2, 95% CI: 1.4-12.6), absence of religion (OR 2.6, 95% CI: 1.0-6.7), perception of vaccine ineffectiveness (OR 6.9, 95% CI: 2.5-18.9) and the perception that vaccinations cause asthma or allergies (OR 82.4, 95% CI: 8.9-766.8). CONCLUSION Modifiable determinants for a negative attitude to comply with new vaccinations are mainly based on lack of specific knowledge. These barriers to vaccinations might be overcome by improving health education in the vaccination program, especially when targeted at educated parents and health care workers.
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Affiliation(s)
- E Hak
- University Medical Center Utrecht, Julius Center for Health Sciences and Primary Health Care, HP Str. 6.131, P.O. Box 85060, 3508 AB Utrecht, The Netherlands.
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Abstract
Rapid, small surveys are routinely done in much of the developing world but are less common in the United States. We present as an example a rapid survey of immunization status and other factors in a predominantly Hispanic region in Los Angeles. The survey united county employees, students, and community volunteers, first to enumerate the eligible population and then to conduct in-person interviews. Sampling was done in two stages in a downtown region of Los Angeles. Over the course of two weekends and during clean-up the following week, volunteers and others enumerated 718 eligible children in 30 clusters (i.e. groups of blocks). At the second stage, also in two weekends with midweek clean-up, we selected by simple random sample 10 children per cluster. The parents or legal guardians of 270 children were interviewed about vaccination issues, including home presence of an immunization card. Nearly one fourth of the respondents did not have a home telephone number and thus would have been underrepresented in a telephone survey. Information from such rapid surveys is important for local program planning and evaluation.
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Affiliation(s)
- R R Frerichs
- Department of Epidemiology, School of Public Health, University of California at Los Angeles, Los Angeles, California 90095-1772, USA.
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