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Thi Bui DH, Nguyen BX, Søndergaard J, Gammeltoft TM, Bygbjerg IC, Nielsen J, Meyrowitsch DW. Informal caregiving among people supporting a person with type 2 diabetes in rural communities of Northern Vietnam: A cross-sectional study of caregiver burdens. PLoS One 2024; 19:e0304821. [PMID: 38820495 PMCID: PMC11142696 DOI: 10.1371/journal.pone.0304821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 05/18/2024] [Indexed: 06/02/2024] Open
Abstract
OBJECTIVE The prevalence of type 2 diabetes mellitus (T2DM) in Vietnam has doubled from 3% to 6% over the last decades, with potential consequences for persons with diabetes and their caregivers. This study aimed to assess caregiver burdens and factors associated with caregiver burden. METHOD A cross-sectional study was conducted in 2019, using data from 1,241 informal caregivers (ICGs). Caregiver burden was scored from 0-32 using 8 questions from the Zarit Burden Interview (ZBI). Quantile regression analysis was used to identify factors associated with caregiver burden. RESULTS The median score of the ZBI was 7.0 (Q1-Q3: 2.0-10.0), indicating that the burden among caregiver of persons with T2DM is not high. Quantile regression showed that the higher the monthly income, the lower the burden among caregivers (50% quantile and 75% quantile of burden: -0.004). Lower educational level (25%Q: 4.0, 50%Q; 3.0, 75%Q: 2.16), being a farmer (25%Q: 2.0) and providing care to other people besides the person with T2DM (25%Q: 2.0, 50%Q; 2.54, 75%Q: 1.66) were associated with higher burden on caregivers. CONCLUSION The study found that caregivers facing additional life stressors, such as low income or other caregiving responsibilities, reported higher levels of burden. These findings could inform the development of interventions targeted at supporting informal caregivers in rural areas in low- and middle-income countries.
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Affiliation(s)
| | - Bai Xuan Nguyen
- Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Jens Søndergaard
- The Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Tine M. Gammeltoft
- Department of Anthropology, University of Copenhagen, Copenhagen K, Denmark
| | - Ib Christian Bygbjerg
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen K, Denmark
| | - Jannie Nielsen
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen K, Denmark
| | - Dan Wolf Meyrowitsch
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen K, Denmark
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Ilaghi M, Gharib F, Pirani A, Vahabie AH, Grafman J, Shariat SV, Shariati B, Jahanbakhshi A, Mirfazeli FS. The burden of traumatic brain injury on caregivers: exploring the predictive factors in a multi-centric study. BMC Psychol 2024; 12:150. [PMID: 38491536 PMCID: PMC10941615 DOI: 10.1186/s40359-024-01652-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 03/07/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is a significant cause of mortality and morbidity worldwide. With survivors often exhibiting degrees of function loss, a significant burden is exerted on their caregivers. The purpose of this study was to explore the predictive factors of caregiver burden among caregivers of patients with TBI. METHODS Sixty-eight family members of individuals with a TBI who had been admitted to three hospitals were assessed in terms of caregiver burden using the Zarit Burden Interview. The association of caregiver burden with patients' baseline cognitive function according to the Montreal Cognitive Assessment (MoCA) test, as well as caregivers' sociodemographic characteristics, were evaluated using multiple regression analysis. RESULTS Based on the multiple regression model, the MoCA score of the patients (std β=-0.442, p < 0.001), duration of caregiving (std β = 0.228, p = 0.044), and higher education of the caregivers (std β = 0.229, p = 0.038) were significant predictors of caregiver burden. CONCLUSION Overall, our findings highlight the importance of taking caregivers' psychosocial needs into account. Long-term caregivers of TBI patients with cognitive impairment should be viewed as vulnerable individuals who could benefit from psychosocial intervention programs, to improve their well-being and enabling them to enrich their care of the TBI patient.
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Affiliation(s)
- Mehran Ilaghi
- Institute of Neuropharmacology, Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Farhad Gharib
- Mental Health Research Center, Psychosocial Health Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Pirani
- Mental Health Research Center, Psychosocial Health Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Abdol-Hossein Vahabie
- School of Electrical and Computer Engineering (ECE), College of Engineering, University of Tehran, Tehran, Iran
- Faculty of Psychology and Education, University of Tehran, Tehran, Iran
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Jordan Grafman
- Shirly Ryan AbilityLab, Departments of Physical Medicine and Rehabilitation, Neurology, Cognitive Neurology, and Alzheimer's Center, Chicago, IL, USA
- Department of Psychiatry, Feinberg School of Medicine, Department of Psychology, Weinberg College of Arts and Sciences, Northwestern University, Chicago, IL, USA
| | - Seyed Vahid Shariat
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Behnam Shariati
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran.
| | - Amin Jahanbakhshi
- Skull Base Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sadat Mirfazeli
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran.
- National Brain Centre, Iran University of Medical Sciences, Tehran, Iran.
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Patrick KS, Gunstad J, Martin JT, Chapman KR, Drost J, Spitznagel MB. Specific agitation behaviours in dementia differentially contribute to aspects of caregiver burden. Psychogeriatrics 2022; 22:688-698. [PMID: 35853570 PMCID: PMC9544824 DOI: 10.1111/psyg.12871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/26/2022] [Accepted: 06/06/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Agitation is a common symptom in dementia and linked to caregiver burden, but both agitation and burden are multidimensional constructs. The current study sought to determine whether specific presentations of agitation differentially relate to aspects of caregiver burden. METHODS Medical record data from an outpatient memory clinic were extracted for 609 persons with dementia, including caregiver-reported burden and care recipient agitation. RESULTS Exploratory factor analysis yielded three domains of agitation on the Cohen Mansfield Agitation Inventory ('Physically Aggressive', 'Physically Non-Aggressive', 'Verbally Agitated') and four domains of burden on the Zarit Burden Interview ('Impact on Life', 'Guilt/Uncertainty', 'Embarrassment/Frustration', 'Overwhelm'). Regression analyses demonstrated all domains of agitation positively predicted overall burden. Regarding specific aspects of burden, Physically Aggressive behaviours predicted Embarrassment/Frustration. Physically Non-Aggressive behaviours predicted Impact on Life and Guilt/Uncertainty. Verbally Agitated behaviours predicted all burden dimensions. CONCLUSIONS Results suggest specific aspects of agitation may differentially contribute to facets of caregiver burden.
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Affiliation(s)
- Karlee S Patrick
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - John Gunstad
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - John T Martin
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Kimberly R Chapman
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Jennifer Drost
- Summa Health System Department of Geriatrics, Akron, Ohio, USA
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Yuan Q, Tan GTH, Wang P, Devi F, Goveas R, Magadi H, Ng LL, Chong SA, Subramaniam M. Combining a variable-centered and a person-centered analytical approach to caregiving burden - a holistic approach. BMC Geriatr 2021; 21:286. [PMID: 33931027 PMCID: PMC8086073 DOI: 10.1186/s12877-021-02238-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 04/20/2021] [Indexed: 11/24/2022] Open
Abstract
Background Informal caregivers of persons with dementia often experience elevated levels of caregiving burden. However, existing studies tend to use a variable-centered approach to explore it. This study aims to understand the caregiving burden of informal caregivers of persons with dementia in Singapore through a combination of variable-centered and person-centered analytical approaches, and explore the correlates of identified factors and latent classes of caregiving burden. Methods Zarit Burden Interview was used to gauge the caregiving burden of 282 primary informal caregivers of persons with dementia recruited through convenience sampling in Singapore. Factor analysis and latent class analysis were conducted to identify the latent factors and the latent classes of Zarit Burden Interview, followed by multiple linear regression and multinomial logistic regression to explore their significant correlates. Results The analyses suggested a 17-item 3-factor structure for Zarit burden interview and three mutually exclusive caregiving burden classes. Regression analyses found that caregiving related variables especially care recipients’ memory and behaviour problems were correlated with both the factors and latent classes of caregiving burden. Conclusions The combination of these two approaches suggests that caregivers experiencing higher burden on one domain are likely to experience higher burden on the other two domains. This further supports the point that more attention should be given to caregivers who experience an overall high burden. Future research could explore the generalizability of our findings among caregivers elsewhere and explore the type of support needed by caregivers, especially those experiencing high burden.
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Affiliation(s)
- Qi Yuan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore, Singapore.
| | - Gregory Tee Hng Tan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore, Singapore
| | - Peizhi Wang
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore, Singapore
| | - Fiona Devi
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore, Singapore
| | - Richard Goveas
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Harish Magadi
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Li Ling Ng
- Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore, Singapore
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Lau JH, Abdin E, Jeyagurunathan A, Seow E, Ng LL, Vaingankar JA, Chong SA, Subramaniam M. The association between caregiver burden, distress, psychiatric morbidity and healthcare utilization among persons with dementia in Singapore. BMC Geriatr 2021; 21:67. [PMID: 33468059 PMCID: PMC7816438 DOI: 10.1186/s12877-021-02014-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 01/06/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Caregivers of persons with dementia (PWD) face high caregiving burden, distress related to responsive behaviours, and psychiatric morbidity. The present paper examines how these are associated with healthcare utilization of the PWD in Singapore. METHODS The data of 399 caregiver-PWD dyads were extracted from a national cross-sectional survey. PWD completed the Client Service Receipt Inventory, which provided information on their healthcare utilization (i.e. emergency service use, hospital admission, length of stay in hospital, and number of outpatient visits) within a frame of 3 months. The Zarit Burden Interview (ZBI), Neuropsychiatric Inventory Questionnaire (NPI-Q), and Self Reporting Questionnaire (SRQ-20) were administered to caregivers. Information on severity of dementia, physical multimorbidity of the PWD, household composition, and caregivers' sociodemographic characteristics such as age, gender, and education were collected. Variables significantly associated with healthcare utilization in the univariate analyses were selected and included in the final regression models. Emergency service use and hospital admission were investigated using logistic regression analyses, whilst negative binomial models were utilized for length of stay in hospital and number of outpatient visits. RESULTS After adjusting for significant correlates such as dementia severity and multimorbidity, only caregiver distress from responsive behaviours was positively associated with emergency room utilization, while caregiver burden was positively associated with length of hospital stay in the final regression model. Psychiatric morbidity was associated with healthcare utilization outcomes at the univariate level but did not reach statistical significance in final models. CONCLUSION The study identifies caregiver variables associated with the healthcare utilization of PWD. Policy makers and healthcare professionals should provide interventions to ease burden and distress amongst caregivers of PWD.
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Affiliation(s)
- Jue Hua Lau
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore
| | - Esmond Seow
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore
| | - Li Ling Ng
- Department of Rheumatology & Immunology, Singapore General Hospital, SingHealth, Singapore, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore
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Miyashita J, Shimizu S, Azuma T, Takeshima T, Suzuki R, Fukuhara S, Yamamoto Y. Experience as an Informal Caregiver and Discussions Regarding Advance Care Planning in Japan. J Pain Symptom Manage 2021; 61:63-70. [PMID: 32688015 DOI: 10.1016/j.jpainsymman.2020.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 11/28/2022]
Abstract
CONTEXT Advance care planning (ACP) is vital for end-of-life care management. Experiences as informal family caregivers might act as a catalyst to promote ACP. OBJECTIVES We investigated the association between ACP discussions and caregiving experiences. METHODS A nationwide survey in Japan was conducted in December 2016 using a quota sampling method to select a sample representative of the general Japanese population. The responses of 3167 individuals aged 20-84 years (mean age: 50.9 ± 16.8) were analyzed. The outcome was measured by asking if respondents had ever engaged in ACP discussions. The exposure was measured by asking whether and for how long respondents had experience as informal caregivers for family members. We analyzed informal caregiving experience related to the occurrence of ACP discussions using multivariable logistic regression models that adjusted for possible covariates. RESULTS Respondents with informal caregiving experience had significantly higher odds of having ACP discussions than those without caregiving experience (adjusted odds ratio: 1.93, 95% CI = 1.63, 2.29). Stronger effects were identified in younger adults (aged 20-65 years) and those with a higher education level (education duration > 12 years) than in older adults (aged ≥65 years) and those with a lower education level, respectively. CONCLUSION Experiences as informal caregivers for family members may facilitate ACP discussions among Japanese adults, especially younger adults with higher educational attainment. Our findings may help health-care providers screen those at risk for inadequate ACP discussions, and informal caregiving experience should be considered when health-care providers initiate discussions of end-of-life care.
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Affiliation(s)
- Jun Miyashita
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, Shirakawa, Fukushima, Japan; Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan
| | - Sayaka Shimizu
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan
| | - Teruhisa Azuma
- Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, Shirakawa, Fukushima, Japan
| | - Taro Takeshima
- Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, Shirakawa, Fukushima, Japan
| | - Ryuji Suzuki
- Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, Shirakawa, Fukushima, Japan
| | - Shunichi Fukuhara
- Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, Shirakawa, Fukushima, Japan; Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Fukushima, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan; Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan.
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Traumatic stress as a mediator of quality of life and burden in informal caregivers of amputees due to diabetic foot: a longitudinal study. HEALTH PSYCHOLOGY REPORT 2021. [DOI: 10.5114/hpr.2020.101495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Sander AM, Hanks RA, Ianni PA, Boileau NR, Kratz AL, Hahn EA, Tulsky DS, Carlozzi NE. Sociocultural Factors Influencing Caregiver Appraisals Following Traumatic Brain Injury. Arch Phys Med Rehabil 2018; 100:S58-S64. [PMID: 30365926 DOI: 10.1016/j.apmr.2018.08.193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 08/03/2018] [Accepted: 08/30/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To investigate the association of the sociocultural variables race/ethnicity, education, and poverty level to caregivers' positive and negative appraisals following traumatic brain injury. DESIGN Survey. SETTING Community. PARTICIPANTS Caregivers (N=344; 216 white; 69 black; 39 Hispanic) of persons with complicated mild to severe TBI at least 1-year postinjury. INTERVENTION Not applicable. MAIN OUTCOME MEASURES Modified Caregiver Appraisal Scale (M-CAS); Zarit Burden Interview (ZBI). RESULTS Black caregivers reported lower levels of perceived burden on both the M-CAS and the ZBI. Black and Hispanic caregivers reported more traditional caregiver ideology (caregiving as a responsibility) than did whites. Greater poverty was associated with higher burden on the M-CAS, lower caregiver satisfaction, and less mastery. Higher education was associated with higher burden on the ZBI and with lower caregiver mastery. CONCLUSIONS Treatment professionals should be culturally sensitive to the different perspectives that caregivers may have based on sociocultural factors. Sociocultural factors should be considered in research investigating caregiver outcomes, including appraisals.
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Affiliation(s)
- Angelle M Sander
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine & Harris Health System, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX.
| | - Robin A Hanks
- Rehabilitation Institute of Michigan, Department of Psychology and Neuropsychology, Detroit, MI; Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI
| | - Phillip A Ianni
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Nicholas R Boileau
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Anna L Kratz
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Elizabeth A Hahn
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - David S Tulsky
- Center for Health Assessment Research and Translation, and the Departments of Physical Therapy and Psychological and Brain Sciences, University of Delaware, Newark, DE
| | - Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
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