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Sandman, Per-Olof
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Publications (10 of 84) Show all publications
Vassbø, T. K., Kirkevold, M., Edvardsson, D., Sjögren, K., Lood, Q., Sandman, P.-O. & Bergland, Å. (2019). Associations between job satisfaction, person-centredness, and ethically difficult situations in nursing homes: A cross-sectional study. Journal of Advanced Nursing, 75(5), 979-988
Open this publication in new window or tab >>Associations between job satisfaction, person-centredness, and ethically difficult situations in nursing homes: A cross-sectional study
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2019 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 5, p. 979-988Article in journal (Refereed) Published
Abstract [en]

AIM: To explore the associations between job satisfaction and perceived person-centredness and ethically difficult situations among staff in nursing homes (NHs).

BACKGROUND: Previous studies have indicated that person-centredness and few ethically difficult situations can contribute positively to NH staff's job satisfaction. However, empirical evidence of these associations is lacking.

DESIGN: Cross-sectional survey design.

METHOD: Nursing home staff (N = 341) in six NHs in Australia, Norway, and Sweden completed the questionnaire measuring job satisfaction, person-centredness, and ethically difficult situations. Data were collected between April - June 2016. Univariate analysis was used to describe the sample, one-way analysis of variance examined differences between variables. Bivariate correlation tested the relationships between variables and hierarchical multiple regression explored the extent to which person-centredness and ethically difficult situations could explain job satisfaction among staff.

RESULTS: After controlling for socio-demographic variables in a regression model, three variables of person-centredness and "ethically difficult situations" were significantly associated with job satisfaction. A "climate of community" contributed the most, followed by the "amount of organizational and environmental support," "a climate of everydayness," and few "ethically difficult situations."

CONCLUSION: The results support the theoretical foundation and previous findings suggesting that establishing NHs organizations based on person-centredness will increase staff job satisfaction. However, this is a cross-sectional study and the causality may go in both directions and should be further explored.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
cross-sectional study, ethical difficult situations, nursing home staff, person-centred care, person-centred climate
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-158317 (URN)10.1111/jan.13890 (DOI)000465107000007 ()30375019 (PubMedID)
Available from: 2019-04-23 Created: 2019-04-23 Last updated: 2019-09-05Bibliographically approved
Lood, Q., Kirkevold, M., Sjögren, K., Bergland, Å., Sandman, P.-O. & Edvardsson, D. (2019). Associations between person-centred climate and perceived quality of care in nursing homes: a cross-sectional study of relatives' experiences. Journal of Advanced Nursing
Open this publication in new window or tab >>Associations between person-centred climate and perceived quality of care in nursing homes: a cross-sectional study of relatives' experiences
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2019 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIMS: To explore the extent to which a more person-centred climate could explain the variation in quality of care, as rated by relatives to nursing home residents in three countries.

DESIGN: A cross-sectional, correlational, anonymous questionnaire study.

METHODS: Questionnaires were administered to 346 relatives to residents in six nursing homes in Australia, Norway and Sweden between April-June 2016. Relatives (N = 178) agreed to participate. Data were analysed using descriptive statistics and hierarchical multiple regression.

RESULTS: The results showed that the relatives' experiences of a more person-centred climate were associated with higher ratings of the quality of care. A person-centred climate of safety had the strongest unique association with the quality of care, explaining 14% of the variance in quality of care. In addition, the results indicated that the relatives in general were satisfied with the quality of care and that children to the residents rated the quality of care higher than partners or other relatives.

CONCLUSION: This study advances the understanding of the relationship between person-centredness in nursing homes and quality of care, showing that person-centred climate aspects of safety and hospitality have a significant role in the quality of care as perceived by relatives.

IMPACT: Person-centredness in nursing homes is often mentioned as a quality of care indicator, but the empirical evidence for this suggestion is limited. This study expanded the evidence-base for person-centredness as a significant aspect of relatives' experiences of the quality of care in nursing homes.

Keywords
care home, caring environment, family members, nursing, older people, person-centered care, person-centred care, residential aged care
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-158653 (URN)10.1111/jan.14011 (DOI)30937934 (PubMedID)
Available from: 2019-05-06 Created: 2019-05-06 Last updated: 2019-05-07
Gustafsson, M., Lämås, K., Isaksson, U., Sandman, P.-O. & Lövheim, H. (2019). Constipation and laxative use among people living in nursing homes in 2007 and 2013. BMC Geriatrics, 19, Article ID 38.
Open this publication in new window or tab >>Constipation and laxative use among people living in nursing homes in 2007 and 2013
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2019 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 19, article id 38Article in journal (Refereed) Published
Abstract [en]

Background: Constipation is a common condition among older people, particularly among people living in nursing homes, and the use of drugs such as opioids is one of many factors that contribute to its high prevalence. The aim of this study was to compare the prevalence of constipation and the use of laxatives between 2007 and 2013, to analyze constipation and laxative use among people who are prescribed opioids, and to identify factors associated with constipation. Methods: In 2007 and 2013, two surveys were performed in the county of Vasterbotten in Northern Sweden, comprising all those living in nursing homes. The Multi-Dimensional Dementia Assessment Scale was used to collect data regarding laxative, opioid and anticholinergic drug use, functioning in activities of daily living (ADL), cognition and symptoms of constipation. A comparison was made between 2820 people from 2007 and 1902 people from 2013. Results: The prevalence of symptoms of constipation among people living in nursing homes increased from 36% in 2007 to 40% in 2013. After controlling for age, sex, ADL, cognitive impairment and use of opioid and anticholinergic drugs, this difference was found to be statistically significant. When controlled for demographic changes, there was a statistically significant difference in the regular use of laxatives between the respective years, from 46% in 2007 to 59% in 2013. People prescribed opioids and anticholinergic drugs were at increased risk of constipation, while people with a higher ADL score were at decreased risk. Further, among people prescribed opioids and rated as constipated, 35% in 2007 and 20% in 2013 were not prescribed laxatives for regular use, a difference that was found to be statistically significant. Conclusions: The prevalence of symptoms of constipation increased between 2007 and 2013. Although there was a decrease between the years, there were still a number of people being prescribed with opioids and rated as constipated who were not treated with laxatives. This study therefore indicates that constipation remains a significant problem among people in nursing homes and also indicates that those prescribed opioids could benefit from an increased awareness of the risk of constipation and treatment, if required.

Place, publisher, year, edition, pages
BMC, 2019
Keywords
Constipation, Laxatives, Dementia, Nursing homes
National Category
Gerontology, specialising in Medical and Health Sciences Geriatrics
Identifiers
urn:nbn:se:umu:diva-162507 (URN)10.1186/s12877-019-1054-x (DOI)000458136800002 ()30736737 (PubMedID)
Available from: 2019-08-21 Created: 2019-08-21 Last updated: 2019-11-19Bibliographically approved
Baxter, R., Sandman, P.-O., Björk, S. & Lood, Q. (2019). lluminating Meanings of Thriving for Persons Living in Nursing Homes. The Gerontologist
Open this publication in new window or tab >>lluminating Meanings of Thriving for Persons Living in Nursing Homes
2019 (English)In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background and Objectives: Thriving has been described as a multidimensional concept that can be used to explore place-related well-being; however, there has been limited research into the meaning of thriving in aged care. This study aimed to illuminate meanings of thriving as narrated by persons living in nursing homes.

Research Design and Methods: Narrative interviews were conducted with 21 persons residing in a rural Australian nursing home. The interviews were audio-recorded, transcribed, and interpreted using a phenomenological hermeneutic approach.

Results: Meanings of thriving could be understood as: Striving toward acceptance of being in a nursing home while maintaining a positive outlook; Feeling supported and cared for while maintaining a sense of independence; Balancing opportunities for solitude and company while living with others; and, Feeling a sense of home while residing in an institutional environment. The meanings of thriving, as presented through the interpretive lens of Gaston Bachelard’s “Poetics of Space,” encompassed having access to literal, metaphorical, and symbolic doors, as well as having the freedom to open, close, and use these doors however the person wishes.

Discussion: Exploring meanings of thriving in nursing homes could contribute towards understanding and implementing positive life-world constructs in research and practice. These findings could be used to inform and enhance person-centered care practices by maximizing opportunities for persons residing in nursing homes to have options and choices, and the agency to make decisions where possible, in relation to their everyday care and living environment.

Place, publisher, year, edition, pages
Oxford University Press, 2019
Keywords
Nursing, Phenomenology, Hermeneutics, Thriving, Well-being, Nursing home, Long-term care, Bachelard
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-165627 (URN)10.1093/geront/gnz142 (DOI)
Available from: 2019-12-02 Created: 2019-12-02 Last updated: 2019-12-03
Bölenius, K., Lämås, K., Sandman, P.-O., Lindkvist, M. & Edvardsson, D. (2019). Perceptions of self-determination and quality of life among Swedish home care recipients - across-sectional study. BMC Geriatrics, 19, Article ID 142.
Open this publication in new window or tab >>Perceptions of self-determination and quality of life among Swedish home care recipients - across-sectional study
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2019 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 19, article id 142Article in journal (Refereed) Published
Abstract [en]

Background: It is acknowledged that preservation of self-determination is very important in order for older adults to experience good quality of life, but to what degree and in what areas people receiving help from home care service experience self-determination is unknown. Few studies have examined the perception of self-determination in relation to quality of life among older adults living at home with help from home care services. Thus, the aim of this study was to explore perceptions of self-determination among older adults living at home with the support of home care services, and to test whether older adults who perceive a higher degree of self-determination also feel they have a better quality of life.

Methods: This cross-sectional study was conducted in one municipality in northern Sweden. A total of 134 older adults (≥ 65 years) were included. Data were collected by means of a survey including questionnaires about background characteristics, self-determination, and health-related quality of life. Descriptive statistics regarding background characteristics for groups with high and low self-determination respectively were presented and the differences between the groups were analyzed using the Chi-square test and the Mann-Whitney U test.

Results: Our main finding shows that the majority of older adults with support from home care services experience self-determination in the dimensions use of time, and self-care. However, a wide variation was found in self-reported self-determination in all dimensions. Results also show that the group with higher self-reported self-determination also reported a greater degree of experienced quality of life in comparison with the group with lower self-reported self-determination.

Conclusions: In line with earlier research, our results found a positive relation between self-determination and quality of life. The results are relevant for the care of older adults and indicate a need of further research. The results presented in this paper could serve as a guide when planning for improved self-determination among older adults in home care service.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Aged care, Health, Home care services, Nursing care, Older adults, Older people, Self-determination, Quality of life
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-160298 (URN)10.1186/s12877-019-1145-8 (DOI)000468889900006 ()31126243 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2019-06-17 Created: 2019-06-17 Last updated: 2019-06-17Bibliographically approved
Corneliusson, L., Sköldunger, A., Sjögren, K., Lövheim, H., Wimo, A., Winblad, B., . . . Edvardsson, D. (2019). Residing in sheltered housing versus ageing in place: population characteristics, health status and social participation. Health & Social Care in the Community, 27(4), E313-E322
Open this publication in new window or tab >>Residing in sheltered housing versus ageing in place: population characteristics, health status and social participation
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2019 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 27, no 4, p. E313-E322Article in journal (Refereed) Published
Abstract [en]

Sheltered housing is a housing model that provides accessible apartments with elevated social possibilities for older people, which is expected to increase resident health and independence, reducing the need for care. As previous research on sheltered housing is scarce, the aim of this study was to explore the characteristics, health status and social participation of older people living in sheltered housing, compared to ageing in place. The study utilised baseline data from a matched cohort study survey on a nationally representative total population of residents in all sheltered housings in Sweden, and a matched control group (n = 3,805). The data collection took place between October 2016 and January 2017. The survey assessed functional capability using the Katz ADL and Lawton IADL scale, self-rated health using the EQ5D scale, and depressive mood using the GDS-4 scale. Descriptive statistics, frequencies, mean scores, independent t tests, p-values and effect sizes were utilised to compare the two groups. The results of the study show that older people living in sheltered housing, compared to ageing in place, had lower self-reported health (M = 64.68/70.08, p = <0.001), lower self-reported quality of life (M = 0.73/0.81, p = <0.001), lower functional status concerning activities of daily living (M = 5.19/5.40, p = <0.001), lower functional status concerning instrumental activities of daily living (M = 4.98/5.42 p = <0.001,), and higher probability of depressive mood (M = 0.80/0.58, p = <0.001). The results imply that residents in sheltered housing may have more care needs than those ageing in place. Further longitudinal comparative studies are needed to explore the impact residence in sheltered housing has on resident health and well-being.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
geriatric assessment, health status, housing for the elderly, population characteristics, social participation
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-157108 (URN)10.1111/hsc.12734 (DOI)000471832800013 ()30821865 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-4016Swedish Research Council, 521-2014-2715
Available from: 2019-03-11 Created: 2019-03-11 Last updated: 2019-07-12Bibliographically approved
Sköldunger, A., Wimo, A., Sjögren, K., Björk, S., Backman, A. C., Sandman, P.-O. & Edvardsson, D. (2019). Resource use and its association to cognitive impairment, ADL functions, and behavior in residents of Swedish nursing homes: Results from the U-Age program (SWENIS study). International Journal of Geriatric Psychiatry, 34(1), 130-136
Open this publication in new window or tab >>Resource use and its association to cognitive impairment, ADL functions, and behavior in residents of Swedish nursing homes: Results from the U-Age program (SWENIS study)
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2019 (English)In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 34, no 1, p. 130-136Article in journal (Refereed) Published
Abstract [en]

Objectives: We aimed to investigate resource use and its association to cognitive impairment, activities of daily living, and neuropsychiatric symptoms in residents of Swedish nursing homes.

Methods: Data were collected in 2014 from a Swedish national sample of nursing home residents (n = 4831) and were collected by staff in the facility. The sample consists of all nursing homes in 35 of 60 randomly selected Swedish municipalities. Demographic data and data on resource use, cognitive and physical function as well as neuropsychiatric symptoms were collected through proxies. Descriptive statistics and regression modeling were used to investigate this association.

Results: We found that cognitive impairment, activities of daily living, and neuropsychiatric symptoms were associated with 23 hours per week increase in total resource use versus cognitively intact persons. This was also the case for being dependent in activities of daily living. Being totally dependent increased the amount of resource use by 25 hours per week. The sex of a resident did not influence the resource use. Annual costs of resource use with no functional dependency were 359 685 SEK, and in severely cognitive impaired resident, the cost was 825 081 SEK.

Conclusion: Being cognitively impaired as well as functionally dependent increases the resource use significantly in nursing homes. This has implications for differentiation of costs in institutional settings in health economic evaluations.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
ADL, care time, cognitive impairment, neuropsychiatric symptoms, nursing home, resource use, RUD
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-155089 (URN)10.1002/gps.5000 (DOI)000453797600017 ()30246433 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, dnr 2014-4016
Available from: 2019-01-10 Created: 2019-01-10 Last updated: 2019-01-10Bibliographically approved
Baxter, R., Lövheim, H., Björk, S., Sköldunger, A., Lindkvist, M., Sjögren, K., . . . Edvardsson, D. (2019). The thriving of older people assessment scale: Psychometric evaluation and short‐form development. Journal of Advanced Nursing
Open this publication in new window or tab >>The thriving of older people assessment scale: Psychometric evaluation and short‐form development
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2019 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim: To evaluate the psychometric properties and performance of the 32‐item Thriving of Older People Assessment Scale (TOPAS) and to explore reduction into a short‐form.

Background: The 32‐item TOPAS has been used in studies of place‐related well‐being as a positive measure in long‐term care to assess nursing home resident thriving; however, item redundancy has not previously been explored.

Design: Cross‐sectional.

Method: Staff members completed the 32‐item TOPAS as proxy‐raters for a random sample of Swedish nursing home residents (N = 4,831) between November 2013 and September 2014. Reliability analysis, exploratory factor analysis and item response theory‐based analysis were undertaken. Items were systematically identified for reduction using statistical and theoretical analysis. Correlation testing, means comparison and model fit evaluation confirmed scale equivalence.

Results: Psychometric properties of the 32‐item TOPAS were satisfactory and several items were identified for scale reduction. The proposed short‐form TOPAS exhibited a high level of internal consistency (α=0.90) and strong correlation (r=0.98) to the original scale, while also retaining diversity among items in terms of factor structure and item difficulties.

Conclusion: The 32‐item and short‐form TOPAS' indicated sound validity and reliability to measure resident thriving in the nursing home context.

Impact: There is a lack of positive life‐world measures for use in nursing homes. The short‐form TOPAS indicated sound validity and reliability to measure resident thriving, providing a feasible measure with enhanced functionality for use in aged care research, assessments and care planning for health promoting purposes in nursing homes.

Keywords
instrument development, scale reduction, psychometrics, thriving, TOPAS, place‐related well‐being, nursing home residents, long‐term care, nursing
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-162729 (URN)10.1111/jan.14180 (DOI)000485117600001 ()31441533 (PubMedID)2-s2.0-85071953661 (Scopus ID)
Available from: 2019-08-27 Created: 2019-08-27 Last updated: 2019-11-14
Skottheim, A., Lövheim, H., Isaksson, U., Sandman, P.-O. & Gustafsson, M. (2018). Insomnia symptoms among old people in nursing homes. International psychogeriatrics, 30, 77-85
Open this publication in new window or tab >>Insomnia symptoms among old people in nursing homes
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2018 (English)In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 30, p. 77-85Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Insomnia symptoms are common among old people, and hypnotics and sedative drugs are often prescribed in spite of small benefits. The aim of this study was to estimate the prevalence of insomnia symptoms and to analyze the association between insomnia symptoms, cognitive level, and prescription of hypnotics and sedatives among old people living in nursing homes.

METHODS: The study comprised 2,135 people living in nursing homes in the county of Västerbotten, Sweden. Data concerning hypnotic and sedative drugs, cognitive function, and prevalence of insomnia symptoms were collected, using the Multi-Dimensional Dementia Assessment Scale (MDDAS).

RESULTS: The three most common insomnia symptoms were "sleeps for long periods during the day," "interrupted night-time sleep," and "wakes up early in the morning" with 57.8%, 56.4%, and 48.0%, respectively, of the residents exhibiting the symptoms at least once a week. Different insomnia symptoms showed different association patterns with sex and age. Most insomnia symptoms were more common among people with cognitive impairment compared to those with no cognitive impairment and seemed to reach their peak prevalence in people with moderate to severe cognitive impairment, subsequently decreasing with further cognitive decline. Of the study population, 24.0% were prescribed hypnotics and sedatives. Prescriptions were more common among those without cognitive impairment, and among those exhibiting the symptom "difficulty initiating sleep."

CONCLUSIONS: Insomnia symptoms and prescription of hypnotics and sedatives are common among old people living in nursing homes. Considering the risk of adverse effects, it is important to regularly re-evaluate the need for these drugs.

Place, publisher, year, edition, pages
New York: Cambridge University Press, 2018
Keywords
cognitive impairment, dementia, hypnotics and sedatives, insomnia symptoms, nursing homes
National Category
Nursing Geriatrics
Identifiers
urn:nbn:se:umu:diva-139893 (URN)10.1017/S1041610217001703 (DOI)000423081100009 ()28927479 (PubMedID)
Available from: 2017-09-26 Created: 2017-09-26 Last updated: 2019-11-20Bibliographically approved
Hemmingsson, E.-S., Gustavsson, M., Isaksson, U., Karlsson, S., Gustavsson, Y., Sandman, P.-O. & Lövheim, H. (2018). Prevalence of pain and pharmacological pain and treatment among old people in nursing homes in 2007 and 2013. European Journal of Clinical Pharmacology, 74(4), 483-488
Open this publication in new window or tab >>Prevalence of pain and pharmacological pain and treatment among old people in nursing homes in 2007 and 2013
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2018 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 74, no 4, p. 483-488Article in journal (Refereed) Published
Abstract [en]

Purpose: Many elderly people living in nursing homes experience pain and take analgesic medication. The aim of this study was to analyze the prevalence of pain and pharmacological pain treatment among people living in nursing homes in Sweden, in two large, comparable, samples from 2007 to 2013.

Methods: Cross-sectional surveys were performed in 2007 and 2013, including all residents in nursing homes in the county of Västerbotten, Sweden. A total of 4933 residents (2814 and 2119 respectively) with a mean age of 84.6 and 85.0 years participated. Of these, 71.1 and 72.4% respectively were cognitively impaired. The survey was completed by the staff members who knew the residents best.

Results: The prescription of opioids became significantly more common while the use of tramadol decreased significantly. The staff reported that 63.4% in 2007 and 62.3% in 2013 had experienced pain. Of those in pain, 20.2% in 2007 and 16.8% in 2013 received no treatment and 73.4 and 75.0% respectively of those with pain, but no pharmacological treatment, were incorrectly described by the staff as being treated for pain.

Conclusions: There has been a change in the pharmacological analgesic treatment between 2007 and 2013 with less prescribing of tramadol and a greater proportion taking opioids. Nevertheless, undertreatment of pain still occurs and in many cases, staff members believed that the residents were prescribed analgesic treatment when this was not the case.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
pain, elderly, nursing home, analgesic drugs, dementia
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-144537 (URN)10.1007/s00228-017-2384-2 (DOI)000427468600011 ()29260276 (PubMedID)
Available from: 2018-02-06 Created: 2018-02-06 Last updated: 2019-11-25Bibliographically approved
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