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Sjögren, Karin
Publications (10 of 25) 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
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)31441533 (PubMedID)
Available from: 2019-08-27 Created: 2019-08-27 Last updated: 2019-08-30
Backman, A., Sjögren, K., Lövheim, H. & Edvardsson, D. (2018). Job strain in nursing homes: exploring the impact of leadership. Journal of Clinical Nursing, 27(7-8), 1552-1560
Open this publication in new window or tab >>Job strain in nursing homes: exploring the impact of leadership
2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. 1552-1560Article in journal (Refereed) Published
Abstract [en]

Aims and objectives: To explore the association between nursing home managers' leadership, job strain and social support as perceived by direct care staff in nursing homes.

Background: It is well known that aged care staff experience high levels of job strain, and that aged care staff experiencing job strain are exposed to increased risk for adverse health effects. Leadership styles have been associated with job strain in the literature; however, the impact of perceived leadership on staff job strain and social support has not been clarified within nursing home contexts.

Design: This study had a cross‐sectional design.

Methods: Participating staff (n = 3,605) completed surveys which included questions about staff characteristics, valid and reliable measures of nursing home managers' leadership, perceived job strain and social support. Statistical analyses of correlations and multiple regression analysis with interaction terms were conducted.

Results: Nursing home managers' leadership were significantly associated with lower level of job strain and higher level of social support among direct care staff. A multiple regression analysis including an interaction term indicated individual and joint effects of nursing home managers' leadership and social support on job strain.

Conclusions: Nursing home managers' leadership and social support were both individually and in combination associated with staff perception of lesser job strain. Thus, nursing home managers' leadership are beneficial for the working situation and strain of staff.

Relevance to clinical practice: Promoting a supporting work environment through leadership is an important implication for nursing home managers as it can influence staff perception of job strain and social support within the unit. By providing leadership, offering support and strategies towards a healthy work environment, nursing home managers can buffer adverse health effects among staff.

Keywords
aged care, leadership, long-term care, management, nursing home care, stress, support
National Category
Nursing
Research subject
omvårdnadsforskning med samhällsvetenskaplig inriktning
Identifiers
urn:nbn:se:umu:diva-146494 (URN)10.1111/jocn.14180 (DOI)000430825100062 ()29148598 (PubMedID)2-s2.0-85040863850 (Scopus ID)
Funder
Vårdal FoundationForte, Swedish Research Council for Health, Working Life and WelfareSwedish Research Council
Available from: 2018-04-11 Created: 2018-04-11 Last updated: 2018-09-25Bibliographically approved
Edvardsson, D., Sjögren, K., Lood, Q., Bergland, A., Kirkevold, M. & Sandman, P.-O. (2017). A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial. BMC Geriatrics, 17, Article ID 22.
Open this publication in new window or tab >>A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial
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2017 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, article id 22Article in journal (Refereed) Published
Abstract [en]

Background: The literature suggests that person-centred care can contribute to quality of life and wellbeing of nursing home residents, relatives and staff. However, there is sparse research evidence on how person-centred care can be operationalised and implemented in practice, and the extent to which it may promote wellbeing and satisfaction. Therefore, the U-Age nursing home study was initiated to deepen the understanding of how to integrate person-centred care into daily practice and to explore the effects and meanings of this.

Methods: The study aims to evaluate effects and meanings of a person-centred and thriving-promoting intervention in nursing homes through a multi-centre, non-equivalent controlled group before-after trial design. Three nursing homes across three international sites have been allocated to a person-centred and thriving-promoting intervention group, and three nursing homes have been allocated to an inert control group. Staff at intervention sites will participate in a 12-month interactive educational programme that operationalises thriving-promoting and person-centred care three dimensions: 1) Doing a little extra, 2) Developing a caring environment, and 3) Assessing and meeting highly prioritised psychosocial needs. A pedagogical framework will guide the intervention. The primary study endpoints are; residents’ thriving, relatives’ satisfaction with care and staff job satisfaction. Secondary endpoints are; resident, relative and staff experiences of the caring environment, relatives’ experience of visiting their relative and the nursing home, as well as staff stress of conscience and perceived person-centredness of care. Data on study endpoints will be collected pre-intervention, post-intervention, and at a six-month follow up. Interviews will be conducted with relatives and staff to explore experiences and meanings of the intervention.

Discussion: The study is expected to provide evidence that can inform further research, policy and practice development on if and how person-centred care may improve wellbeing, thriving and satisfaction for people who reside in, visit or work in nursing homes. The combination of quantitative and qualitative data will illuminate the operationalisation, effects and meaning of person-centred and thriving-promoting care.

Keywords
Person-centred care, Thriving, Residential aged care, Long-term care, Residents, Relatives, Staff, Job tisfaction, Satisfaction with care, Intervention studies
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-132026 (URN)10.1186/s12877-016-0404-1 (DOI)000392024300001 ()
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-4016
Available from: 2017-03-29 Created: 2017-03-29 Last updated: 2018-06-09Bibliographically approved
Backman, A., Sjögren, K., Lindkvist, M., Lövheim, H. & Edvardsson, D. (2017). Characteristics of highly rated leadership in nursing homes using item response theory. Journal of Advanced Nursing, 73(12), 2903-2913
Open this publication in new window or tab >>Characteristics of highly rated leadership in nursing homes using item response theory
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2017 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2903-2913Article in journal (Refereed) Published
Abstract [en]

Aim: To identify characteristics of highly rated leadership in nursing homes. Background: An ageing population entails fundamental social, economic and organizational challenges for future aged care. Knowledge is limited of both specific leadership behaviours and organizational and managerial characteristics which have an impact on the leadership of contemporary nursing home care. Design: Cross-sectional. Method: From 290 municipalities, 60 were randomly selected and 35 agreed to participate, providing a sample of 3605 direct-care staff employed in 169 Swedish nursing homes. The staff assessed their managers' (n = 191) leadership behaviours using the Leadership Behaviour Questionnaire. Data were collected from November 2013 - September 2014, and the study was completed in November 2016. A two-parameter item response theory approach and regression analyses were used to identify specific characteristics of highly rated leadership. Results: Five specific behaviours of highly rated nursing home leadership were identified; that the manager: experiments with new ideas; controls work closely; relies on subordinates; coaches and gives direct feedback; and handles conflicts constructively. The regression analyses revealed that managers with social work backgrounds and privately run homes were significantly associated with higher leadership ratings. Conclusion: This study highlights the five most important leadership behaviours that characterize those nursing home managers rated highest in terms of leadership. Managers in privately run nursing homes and managers with social work backgrounds were associated with higher leadership ratings. Further work is needed to explore these behaviours and factors predictive of higher leadership ratings.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
item response theory, leadership, long-term care, management, nursing home care
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-143945 (URN)10.1111/jan.13353 (DOI)000418365200012 ()28556986 (PubMedID)
Available from: 2018-01-15 Created: 2018-01-15 Last updated: 2018-06-09Bibliographically approved
Sjögren, K., Lindkvist, M., Sandman, P.-O., Zingmark, K. & Edvardsson, D. (2017). Organisational and environmental characteristics of residential aged care units providing highly person-centred care: a cross sectional study. BMC Nursing, 16, Article ID 44.
Open this publication in new window or tab >>Organisational and environmental characteristics of residential aged care units providing highly person-centred care: a cross sectional study
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2017 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 16, article id 44Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Few studies have empirically investigated factors that define residential aged care units that are perceived as being highly person-centred. The purpose of this study was to explore factors characterising residential aged care units perceived as being highly person-centred, with a focus on organisational and environmental variables, as well as residents' and staff' characteristics.

METHODS: A cross-sectional design was used. Residents (n = 1460) and staff (n = 1213) data from 151 residential care units were collected, as well as data relating to characteristics of the organisation and environment, and data measuring degree of person-centred care. Participating staff provided self-reported data and conducted proxy ratings on residents. Descriptive and comparative statistics, independent samples t-test, Chi(2) test, Eta Squared and Phi coefficient were used to analyse data.

RESULTS: Highly person-centred residential aged care units were characterized by having a shared philosophy of care, a satisfactory leadership, interdisciplinary collaboration and social support from colleagues and leaders, a dementia-friendly physical environment, staff having time to spend with residents, and a smaller unit size. Residential aged care units with higher levels of person-centred care had a higher proportion of staff with continuing education in dementia care, and a higher proportion of staff receiving regular supervision, compared to units with lower levels of person-centred care.

CONCLUSIONS: It is important to target organisational and environmental factors, such as a shared philosophy of care, staff use of time, the physical environment, interdisciplinary support, and support from leaders and colleagues, to improve person-centred care in residential care units. Managers and leaders seeking to facilitate person-centred care in daily practice need to consider their own role in supporting, encouraging, and supervising staff.

Keywords
Care philosophy, Facilitators, Leadership, Person-Centred Care, Physical environment, Residential care facilities, Social support
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-138754 (URN)10.1186/s12912-017-0240-4 (DOI)000407709500001 ()28808426 (PubMedID)
Available from: 2017-08-29 Created: 2017-08-29 Last updated: 2018-06-09Bibliographically approved
Lood, Q., Björk, S., Sköldunger, A., Backman, A., Sjögren, K. & Edvardsson, D. (2017). The relative impact of symptoms, resident characteristics and features of nursing homes on residents’ participation in social occupations: cross-sectional findings from U-Age Swenis. Journal of Occupational Science, 24(3), 327-337
Open this publication in new window or tab >>The relative impact of symptoms, resident characteristics and features of nursing homes on residents’ participation in social occupations: cross-sectional findings from U-Age Swenis
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2017 (English)In: Journal of Occupational Science, ISSN 1442-7591, E-ISSN 2158-1576, Vol. 24, no 3, p. 327-337Article in journal (Refereed) Published
Abstract [en]

Social occupations have been described as meaningful occupations, and a determinant of health in old age. With ageing populations, and increased need for nursing home care, it is therefore important to support participation in social occupations in nursing homes. However, the limited evidence on factors that may have an impact on nursing home residents’ participation in social occupations makes it difficult to know how and when to support their participation and who to target. Therefore, the aim of this study was to explore the impact of symptoms, resident characteristics and features of nursing homes on residents’ participation in social occupations. In a sample of 4,451 nursing home residents, the average number of social occupations participated in during the week preceding data collection was 5.8. Additionally, participation in social occupations was positively influenced by fewer symptoms of cognitive impairment, female sex, shorter length of stay, and living in a dementia specific care unit. The study thereby contributes with knowledge on populations at risk for occupational deprivation, and implications for understanding who to target with interventions to promote social occupations and when. However, very little is known about how to design interventions to support nursing home residents’ occupational opportunities, and what occupations they desire and need. Further research is therefore needed to identify nursing home residents’ occupational opportunities, wishes and needs in relation to environmental barriers, individual characteristics, and individual choice.

Place, publisher, year, edition, pages
Taylor & Francis, 2017
Keywords
Residential aged care, elderly, meaningful occupation, cognitive impairment, gender
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-133301 (URN)10.1080/14427591.2017.1306721 (DOI)000414755000007 ()
Available from: 2017-04-03 Created: 2017-04-03 Last updated: 2018-06-09Bibliographically approved
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