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Sun M, Scherffius A, Sun M, Chen C, Wang D. Insomnia symptoms as a mediator between school connectedness and suicidal ideation in Chinese adolescents: A three-wave longitudinal model. Early Interv Psychiatry 2024. [PMID: 38783351 DOI: 10.1111/eip.13579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 04/02/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024]
Abstract
AIM School connectedness is related to suicidal ideation (SI) in adolescents. However, little is known about the mediating role of insomnia symptoms in the school connectedness-SI link. This study aimed to examine the longitudinal mediating effect of insomnia symptoms on the relationship between school connectedness and SI as well as the moderating effect of sex using a three-wave longitudinal design. METHODS A total of 3110 adolescents completed three online surveys. Data were collected over the course of 1 year, in three waves 6 months apart. Participants completed the School Connectedness Scale, Youth Self-Rating Insomnia Scale, Self-rating Idea of Suicide Scale, Beck Depression Inventory and a self-compiled demographic questionnaire. Linear regressions and mediation analyses were performed to examine the associations between school connectedness, insomnia symptoms and SI. RESULTS School connectedness had a significant mediating effect on SI through insomnia symptoms (βa×b = -.03, 95% confidence interval = -0.04, -0.02) after controlling for demographics and depressive symptoms. Mediation analyses showed that insomnia symptoms accounted for 23.1% of the total effects in the entire sample, with 13.3% in males and 27.3% in females. Sex had no significant moderating effect on the school connectedness-SI link association. CONCLUSIONS The association between school connectedness and SI appears to be mediated by insomnia symptoms. Assessing and promoting school connectedness, as well as intervening and treating distress associated with insomnia, may have important clinical implications for reducing the risk of SI in adolescents.
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Affiliation(s)
- Mingze Sun
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Andrew Scherffius
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Chunping Chen
- Institute of Education, Xiamen University, Xiamen, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
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Welty CW, Bingham L, Morales M, Gerald LB, Ellingson KD, Haynes PL. School Connectedness and Suicide Among High School Youth: A Systematic Review. THE JOURNAL OF SCHOOL HEALTH 2024; 94:469-480. [PMID: 38383772 DOI: 10.1111/josh.13445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Suicide is a leading cause of death for adolescents, and school connectedness is a potential, modifiable protective factor for suicide. We sought to examine if school connectedness protected against suicide among high school students and if potential moderators affected the relationship between school connectedness and suicide. METHODS We searched online databases (PubMed, EMBASE, CINAHL, and PsycINFO) on December 12, 2021, for studies that examined the effects of school connectedness on suicide among high school students. RESULTS This systematic review identified 34 studies that examined the effects of school connectedness on adolescent suicidality. Results indicated mixed findings of school connectedness on suicidality. Among studies that assessed a suicide ideation outcome, 73.3% found that school connectedness protected against suicide. Among studies that assessed a suicide attempts outcome, 50% found that school connectedness protected against suicide. Most included studies did not control for notable variables in their final models, such as sleep, impulsivity, substance use, or depression. No studies examined moderators of school connectedness and suicide. CONCLUSIONS School connectedness is somewhat protective of suicidality, and more protective of suicidal ideation than suicide attempts. Researchers should examine the construct of school connectedness among modern youth to better understand school connectedness and suicide.
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Affiliation(s)
- Cody W Welty
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
| | - Lindsay Bingham
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
| | - Mario Morales
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
| | - Lynn B Gerald
- Office of Population Health Sciences, University of Illinois Chicago, 1220 S. Wood Street (MC 619), Chicago, 60608, IL
| | - Katherine D Ellingson
- Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
| | - Patricia L Haynes
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
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Bacaro V, Carpentier L, Crocetti E. Sleep Well, Study Well: A Systematic Review of Longitudinal Studies on the Interplay between Sleep and School Experience in Adolescence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4829. [PMID: 36981738 PMCID: PMC10049641 DOI: 10.3390/ijerph20064829] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
Adolescents spend most of their daily time in school and performing school-related activities. Different aspects of their school experiences, such as school performance, psychological factors related to school, and structural factors, consistently impact adolescents' health and are likely to be intertwined with their sleep (i.e., quantity and quality, sleep disturbances). This systematic review aimed to comprehensively summarize the reciprocal and longitudinal associations between adolescents' sleep and multiple aspects of their school experience. Using multiple search strategies and applying a two-step selection process, 25 journal articles matched the eligibility criteria and were thus included in the review. The results highlighted the contribution of poor sleep quality and sleep disturbances in predicting longitudinal school experiences-related outcomes (i.e., decreasing school engagement and performance, and increasing school-related burnout, absenteeism, and bullying). At the same time, the results showed how experiences related to the school's psychological factors (e.g., high levels of school burnout and stressful environment) and structural characteristics (e.g., early school entrance time) affect youth sleep over time (i.e., decreasing sleep quality and quantity). These main findings provided novel insights into the bidirectional relationship between school experience and sleep health, highlighting the importance of more longitudinal research investigating all aspects of healthy sleep, including the size and direction of the association.
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Affiliation(s)
- Valeria Bacaro
- Department of Psychology “Renzo Canestrari”, Alma Mater Studiorum Università di Bologna, 47521 Cesena, Italy
| | - Liesbeth Carpentier
- Faculty of Psychology and Educational Sciences, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Elisabetta Crocetti
- Department of Psychology “Renzo Canestrari”, Alma Mater Studiorum Università di Bologna, 47521 Cesena, Italy
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Li S, Xu X, Lai S, Song S, Liu Q. Depression and sleep disorders among AIDS orphans in an HIV/AIDS high-epidemic area in China. Child Care Health Dev 2022; 48:595-604. [PMID: 35023201 DOI: 10.1111/cch.12964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/19/2021] [Accepted: 01/08/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Liangshan Yi Autonomous Prefecture is home to the largest population of Yi ethnic minority within mainland China. Due to the high HIV/AIDS epidemic, many Yi children become AIDS orphans who lost one or both parents to AIDS-related causes. This study explored the prevalence and correlates of AIDS orphans' depressive symptom, sleep disorders and their comorbidity. METHODS A cross-sectional survey was conducted to collect pertinent information from 467 AIDS orphans and 856 non-orphans of Yi ethnic minority. Depressive symptoms were screened by a two-item Patient Health Questionnaire (PHQ-2). The symptoms of insomnia were assessed by the Insomnia Severity Index (ISI), which was complemented by one item from the Pittsburgh Quality Sleep Index (PSQI) to measure the frequency of nightmare. RESULTS The prevalence of depression (26.8% vs. 20.4%, P = 0.009) and comorbidity of depression, insomnia and nightmare (7.5% vs. 4.3%, P = 0.046) was significantly higher for AIDS orphans than for non-orphans. Risk factors such as ostracization and self-reported poor physical health had stronger effects on depressive symptoms and sleep disorders for AIDS orphans than for non-orphans. On the other hand, peer support, as an important protective factor, was significantly and negatively associated with depressive symptoms and sleep disorders for AIDS orphans. CONCLUSIONS AIDS orphans of Yi ethnic minority reported higher levels of depressive symptoms and comorbidity of depression and sleep disorders than their non-orphan counterparts. These symptoms were exacerbated by ostracization and self-rated poor physical health but lowered by peer support.
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Affiliation(s)
- Shiying Li
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, China
| | - Xiaohe Xu
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, China.,Department of Sociology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Shimin Lai
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
| | - Shasha Song
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
| | - Qiaolan Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
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Santini ZI, Pisinger VSC, Nielsen L, Madsen KR, Nelausen MK, Koyanagi A, Koushede V, Roffey S, Thygesen LC, Meilstrup C. Social Disconnectedness, Loneliness, and Mental Health Among Adolescents in Danish High Schools: A Nationwide Cross-Sectional Study. Front Behav Neurosci 2021; 15:632906. [PMID: 33927599 PMCID: PMC8078177 DOI: 10.3389/fnbeh.2021.632906] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/12/2021] [Indexed: 01/19/2023] Open
Abstract
Background: Previous research has suggested that social disconnectedness experienced at school is linked to mental health problems, however, more research is needed to investigate (1) whether the accumulation of various types of social disconnectedness is associated with risk for mental health problems, and (2) whether loneliness is a mechanism that explains these associations. Methods: Using data from the Danish National Youth Study 2019 (UNG19), nation-wide cross-sectional data from 29,086 high school students in Denmark were analyzed to assess associations between social disconnectedness experienced at school (lack of classmate support, lack of teacher support, lack of class social cohesion, and not being part of the school community) and various mental health outcomes, as well as the mediating role of loneliness for each type of disconnectedness. Multilevel regression analyses were conducted to assess the associations. Results: Descriptive analyses suggest that 27.5% of Danish high school students experience at least one type of social disconnectedness at school. Each type of social disconnectedness was positively associated with mental health problems (depression symptoms, anxiety symptoms, stress, sleep problems, suicidal ideation, non-suicidal self-injury, eating disorder, body dissatisfaction, and low self-esteem) and negatively associated with mental well-being. In all cases, loneliness significantly mediated the associations. We found a clear dose-response pattern, where each addition in types of social disconnectedness was associated with (1) stronger negative coefficients with mental well-being and (2) stronger positive coefficients with mental health problems. Conclusion: Our results add to a large evidence-base suggesting that mental health problems among adolescents may be prevented by promoting social connectedness at school. More specifically, fostering social connectedness at school may prevent loneliness, which in turn may promote mental well-being and prevent mental health problems during the developmental stages of adolescence. It is important to note that focusing on single indicators of school social connectedness/disconnectedness would appear to be insufficient. Implications for practices within school settings to enhance social connectedness are discussed.
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Affiliation(s)
- Ziggi Ivan Santini
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Veronica S. C. Pisinger
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Line Nielsen
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Katrine Rich Madsen
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Centro de Investigación Biomédica en Red de Salud Mental, Dr. Antoni Pujadas, 42, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Vibeke Koushede
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Sue Roffey
- Educational Psychology, University College London, London, United Kingdom
- School of Education, Western Sydney University, Penrith, NSW, Australia
| | - Lau C. Thygesen
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Bidirectional Associations Between School Connectedness and Mental Health Problems in Early Adolescence: A Cross-Lagged Model. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09440-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bozzola E, Spina G, Ruggiero M, Vecchio D, Caruso C, Bozzola M, Staiano AM, Agostiniani R, Del Vecchio A, Banderali G, Peroni D, Chiara A, Memo L, Turra R, Corsello G, Villani A. Media use during adolescence: the recommendations of the Italian Pediatric Society. Ital J Pediatr 2019; 45:149. [PMID: 31775828 PMCID: PMC6880642 DOI: 10.1186/s13052-019-0725-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/26/2019] [Indexed: 12/13/2022] Open
Abstract
Background The use of media device, such as smartphone and tablet, is currently increasing, especially among the youngest. Adolescents spend more and more time with their smartphones consulting social media, mainly Facebook, Instagram and Twitter because. Adolescents often feel the necessity to use a media device as a means to construct a social identity and express themselves. For some children, smartphone ownership starts even sooner as young as 7 yrs, according to internet safety experts. Material and methods We analyzed the evidence on media use and its consequences in adolescence. Results In literature, smartphones and tablets use may negatively influences the psychophysical development of the adolescent, such as learning, sleep and sigh. Moreover, obesity, distraction, addiction, cyberbullism and Hikikomori phenomena are described in adolescents who use media device too frequently. The Italian Pediatric Society provide action-oriented recommendations for families and clinicians to avoid negative outcomes. Conclusions Both parents and clinicians should be aware of the widespread phenomenon of media device use among adolescents and try to avoid psychophysical consequences on the youngest.
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Stormark KM, Fosse HE, Pallesen S, Hysing M. The association between sleep problems and academic performance in primary school-aged children: Findings from a Norwegian longitudinal population-based study. PLoS One 2019; 14:e0224139. [PMID: 31697711 PMCID: PMC6837329 DOI: 10.1371/journal.pone.0224139] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 10/07/2019] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to examine the longitudinal association between concurrent, transitory and persistent difficulties initiating and maintaining sleep (DIMS) on academic performance in children in a. longitudinal child-cohort (N = 3986) targeting school-aged children when they were 7-9 years (T1) and 11-13 years (T2) old, whilst controlling for mental health problems. DIMS were parent-reported at T1 and T2 and academic performance teacher-reported at T2. Mental health was based on child self-report at T2 using the Strength and Difficulties Questionnaire (SDQ). In all, 10.6% (n = 423) of the children had poor school performance at T2. These had more symptoms of externalizing and internalizing mental health problems (p. < 001) compared to their peers at T2. A logistic regression analysis showed that both concurrent DIMS (at T2, but not at T1) and persistent DIMS (at both T1 and T2) was associated with elevated risk of poor academic performance. After controlling for mental health problems, only persistent DIMS was associated with increased risk of poor academic performance. Transitory DIMS (DIMS at T1 but not at T2) did not increase the risk of later poor academic performance. A mediation analysis also revealed that the association between DIMS and poor school performance was mediated by mental health problems, in addition to an overall significant direct relative effect of DIMS on poor school performance in the persistent DIMS group. These findings support the notion that sleep problems in children are associated with impaired academic performance, and extends past findings demonstrating that sleep problems may not increase the risk of poor academic performance unless they persist over time. The negative effects of persistent sleep problems suggest that more emphasis should be put on preventive interventions of sleep problems in school-aged children.
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Affiliation(s)
- Kjell Morten Stormark
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Hedvik Elisabeth Fosse
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Ståle Pallesen
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
- Norwegian Competence Centre for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
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Hsieh YP, Lu WH, Yen CF. Psychosocial Determinants of Insomnia in Adolescents: Roles of Mental Health, Behavioral Health, and Social Environment. Front Neurosci 2019; 13:848. [PMID: 31447642 PMCID: PMC6696979 DOI: 10.3389/fnins.2019.00848] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/30/2019] [Indexed: 12/18/2022] Open
Abstract
The theoretical explanation of human problems is derived from the complex interplay of psychological, social, economic, political, and physical factors.
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Affiliation(s)
- Yi-Ping Hsieh
- Department of Social Work, University of North Dakota, College of Nursing and Professional Disciplines, Grand Forks, ND, United States
| | - Wei-Hsin Lu
- Department of Psychiatry, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chiayi City, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital and School of Medicine, Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Abstract
Background and aims Although smartphone use brings many benefits for adolescents, it is also associated with many serious health problems. This study examined the relationship between problematic smartphone use (PSU) and clinical health symptoms (e.g., body dysfunction) and the mediating effects of sleep quality on this relationship in adolescents. Methods Participants in this cross-sectional survey were 686 middle- and high-school students (girls = 55.7%, Mage = 12.98 ± 1.38 years). Participants completed self-report measures of PSU, sleep quality, and physical symptoms. Correlation analyses and structural equation modeling between adolescents' PSU and the variables of interest were conducted. Results This study indicated that there was a significant positive correlation between PSU and health symptoms. Furthermore, sleep quality mediated the relationship between PSU and health symptoms. Discussion and conclusions Findings suggest that to promote health and wellness in adolescents, individuals should be encouraged to place boundaries on smartphone use, especially at bedtime. Reducing adolescents' exposure to smartphone use in this way may hold promise for improving the efficacy of PSU prevention efforts for adolescents.
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Affiliation(s)
- Xiaochun Xie
- School of Psychology, Northeast Normal University, Changchun, China
| | - Yan Dong
- Department of Psychology, The Center of Internet + Social Psychology, Renmin University of China, Beijing, China,Corresponding author: Yan Dong; Department of Psychology, The Center of Internet + Social Psychology, Renmin University of China, No. 59 Zhongguancun Street, Haidian District, Beijing 100872, China; Phone: +86 135 2028 6732; Fax: +86 108 250 9716; E-mail:
| | - Jinliang Wang
- Faculty of Psychology, Southwest University, Chongqing, China
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