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1.
Objective: To establish the mental health needs of homeless children and families before and after rehousing. Design: Cross sectional, longitudinal study. Setting: City of Birmingham. Subjects: 58 rehoused families with 103 children aged 2-16 years and 21 comparison families of low socioeconomic status in stable housing, with 54 children. Main outcome measures: Children’s mental health problems and level of communication; mothers’ mental health problems and social support one year after rehousing. Results: Mental health problems remained significantly higher in rehoused mothers and their children than in the comparison group (mothers 26% v 5%, P=0.04; children 39% v 11%, P=0.0003). Homeless mothers continued to have significantly less social support at follow up. Mothers with a history of abuse and poor social integration were more likely to have children with persistent mental health problems. Conclusions: Homeless families have a high level of complex needs that cannot be met by conventional health services and arrangements. Local strategies for rapid rehousing into permanent accommodation, effective social support and health care for parents and children, and protection from violence and intimidation should be developed and implemented.

Key messages

  • Homeless children and their mothers have a high level of mental health problems
  • Homeless families experience many risk factors, such as domestic violence, abuse, and family and social disruption
  • In two fifths of children and a quarter of mothers, mental health problems persisted after rehousing
  • In contrast with a comparison group of families of low socioeconomic status, a substantial proportion of homeless families remained residentially and socially unstable
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2.
School-aged children suffer the most from schistosomiasis infection in sub Saharan Africa due to poverty and limited sanitary conditions. Mapping of disease burden is recommended and there is a need of updating prevalence data which is as old as 20 years in the Democratic Republic of Congo. An epidemiological and parasitological study was carried out in 2011 in the health zone of Kasansa. Six health areas (HA) were included in the study. In each health area, one primary school was selected. School-aged children were screened for S. mansoni infection using parallel Kato-Katz and direct microscopy techniques. A total of 335 school-aged children were screened. The average prevalence was 82.7% and ranged between 59.5–94.9%. Four of the six HAs had a prevalence level over 91%. Of all infected children, about half 112 (43.2%) had light parasite density. These results demonstrate that Schistosoma mansoni infection is a bigger problem than anticipated and there is an urgent need to implement effective control measures.  相似文献   

3.
Environmental parameters influencing the distribution of parasite species in three neighbourhoods of differing socioeconomic conditions in La Plata, Argentina were analysed. Coproparasitological screenings were performed in children up to 14 years old from a marginal zone (100), a suburban neighbourhood (101), and an urban area (91) in 1999--2000. The presence of parasite species in environmental samples (water and soil) and the degree of association among parasite communities was documented and evaluated. The prevalence of infection in each population was 73.0%, 54.4% and 35.2%, respectively. The frequencies of helminths and pathogenic protozoa were both higher in the marginal zone, where sanitary and environmental conditions were significantly inferior compared with the other zones. The high prevalence of intestinal parasites in this infantile population was related to parasitic contamination of the soil and water sources in addition to deficient sanitary and sociocultural conditions. Calculation of an equitability index revealed that the specific richness was less equitable once socioeconomic conditions and hygienic practices were improved. This study demonstrates the need to implement management practices for the control of intestinal parasitoses in accordance with the environmental and sociocultural characteristics of a given ecosystem.  相似文献   

4.
《Chronobiology international》2013,30(6):1259-1270
Residing at northern latitudes for long periods of time is associated with sleep disturbances and internal desynchronization, which are considered to be causes of chronic diseases in old age. In children and teenagers, they result in a poor school achievement, psychological problems, and increase in consumption of stimulants. In this paper, we analyze the relationship between both chronotype and sleep length and the variables of age, sex, place of residence, type of settlement (village/city), latitude and longitude of residence, and school achievement of young inhabitants of northern European Russia. We surveyed 1101 children and teenagers between 11 to 23 yrs of age living in four settlements located between 59° and 67° North latitude and 33° and 60° East longitude. The Munich chronotype questionnaire (MCTQ) was used in the study, and all participants were also required to answer a question about their school achievements. An analysis of covariance (ANCOVA) was used to assess the influence of the analyzed factors on sleep length and chronotype. Self-reported sleep length of teenagers depended moderately on age, whereas the place of residence, latitude, and type of settlement only had a weak effect. Chronotype strongly depended on place of residence and longitude; it moderately depended on latitude and age; and it weakly depended on sex and type of settlement. The sleep length of village teenagers was 46?min longer than that of urban teenagers. The authors found a 1?h and 18?min phase delay of the sleep-wake rhythm (as a marker of chronotype) in teenagers moving in the East-West direction and a 16-min delay moving in the South-North direction within one time zone. There was a weak, but significant, positive correlation between chronotype and time of sunrise. There was about a 2-fold stronger influence of chronotype than sleep length on achievement of school children and college students. We conclude that socioeconomic factors exert a significant influence on sleep length and that climatic conditions exert a significant influence on the chronotype of teenagers in the northern latitudes. (Author correspondence: )  相似文献   

5.
Objective: To evaluate the 4‐year outcome of a school‐based health promotion on weight status as part of the Kiel Obesity Prevention Study (KOPS). Research Methods and Procedures: Within a cluster‐sampled quasi‐randomized controlled trial, 1764 children at 6 and 10 years of age were assessed between 1996 and 2005 in 32 primary schools in Kiel, North Germany. Six nutrition units followed by 20‐minute running games were performed within the first year at school. Prevalence, incidence, and remission of overweight were main outcome measures. Results: The 4‐year change in BMI was +11.6%, with increases in prevalence of overweight and obesity from 5.2% to 11.1% and 3.9% to 5.1%, respectively. Cumulative 4‐year incidence of overweight and obesity was 9.2% and 3.1%, respectively. Intervention had no effect on mean BMI. The effect on prevalence was significant in children from families with high socioeconomic status [odds ratio (OR), 0.35; 95% confidence interval (CI), 0.14 to 0.91] and marginally significant in children of normal‐weight mothers (OR, 0.57; 95% CI, 0.33 to 1.00). Cumulative 4‐year incidence of overweight was lower only in intervention children from families with high socioeconomic status (OR, 0.26; 95% CI, 0.07 to 0.87). Remission of overweight was most pronounced in children of normal‐weight mothers (OR, 5.43; 95% CI, 1.28 to 23.01). Prevalence of underweight was unchanged. The intervention had minor but favorable effects on lifestyle. Discussion: A school‐based health promotion has sustainable effects on remission and incidence of overweight; it was most pronounced in children of normal‐weight mothers and children from families with high socioeconomic status. There was no effect on obesity. The data argue in favor of additional measures of prevention.  相似文献   

6.
The area of Walikale in North Kivu, Democratic Republic of Congo, is intensely affected by conflict and population displacement. Médecins-Sans-Frontières (MSF) returned to provide primary healthcare in July 2012. To better understand the impact of the ongoing conflict and displacement on the population, a retrospective mortality survey was conducted in April 2013. A two-stage randomized cluster survey using 31 clusters of 21 households was conducted. Heads of households provided information on their household make-up, ownership of non-food items (NFIs), access to healthcare and information on deaths and occurrence of self-reported disease in the household during the recall period. The recall period was of 325 days (July 2012–April 2013). In total, 173 deaths were reported during the recall period. The crude mortality rate (CMR) was of 1.4/10,000 persons/day (CI95%: 1.2–1.7) and the under-five- mortality rate (U5MR) of 1.9/10,000 persons per day (CI95%: 1.3–2.5). The most frequently reported cause of death was fever/malaria 34.1% (CI95%: 25.4–42.9). Thirteen deaths were due to intentional violence. Over 70% of all households had been displaced at some time during the recall period. Out of households with someone sick in the last two weeks, 63.8% sought health care; the main reason not to seek health care was the lack of money (n = 134, 63.8%, CI95%: 52.2–75.4). Non Food Items (NFI) ownership was low: 69.0% (CI95%: 53.1–79.7) at least one 10 liter jerry can, 30.1% (CI95%: 24.3–36.5) of households with visible soap available and 1.6 bednets per household. The results from this survey in Walikale clearly illustrate the impact that ongoing conflict and displacement are having on the population in this part of DRC. The gravity of their health status was highlighted by a CMR that was well above the emergency threshold of 1 person/10,000/day and an U5MR that approaches the 2 children/10,000/day threshold for the recall period.  相似文献   

7.
This study examines socioeconomic conditions, psychosocial stress, and health among 264 infants, children, adolescents, and young adults aged 2 months to 18 years residing in a rural Caribbean village. Fieldwork was conducted over a 9 year period (1988–1996). Research methods and techniques include salivary cortisol radioimmunoassay (N = 22,438), systematic behavioral observations, psychological questionnaires, health evaluations, medical records, informal interviews, and participant observation. Analyses of data indicate complex relations among socioeconomic conditions, stress, and health. Household income, land ownership, parental education, and other socioeconomic measures are weakly associated with child illness. There is no evidence that apparent material benefits of high socioeconomic status—such as improved housing, diet, work loads, and access to private healthcare—have important direct effects on child health in this population. However, social relationships, especially family environment, may have important effects on childhood psychosocial stress and illness. Abnormal glucocorticoid response profiles, diminished immunity, and frequent illness are associated with unstable mating relationships of parents/caretakers and household composition. We suggest that family relationships and concomitant stress and immunosuppression are important intermediary links between socioeconomic conditions and child health. Am J Phys Anthropol 102:33–53, 1997. © 1997 Wiley-Liss, Inc.  相似文献   

8.
The objective of this study was to investigate the relationship between health conditions in childhood (ages 4–11), and health and socioeconomic outcomes in adulthood (ages 21–33). This study takes advantage of a new linkage between the National Longitudinal Survey of Children and Youth (NLSCY) and administrative tax data from the T1 Family File (T1FF) from Statistics Canada. The NLSCY includes rich longitudinal information on child development, while the T1FF includes administrative tax information on each child in adulthood (e.g., income, social assistance). The primary measures of child health relate to the diagnosis of a chronic condition, affecting the child’s physical or mental/developmental health. The results suggest that mental/developmental health conditions in childhood more negatively influence adult health and socioeconomic conditions, compared to physical health conditions. Interaction models reveal modest heterogenous effects; for example, there is some evidence of a cushioning effect from higher household income in childhood, as well as an exacerbating negative effect from lower birth weight for mental/developmental health conditions. Using a covariate decomposition approach to explore underlying pathways, the results reveal that associations between health in early life and outcomes in adulthood are partially explained by differences in cognitive skills (i.e., mathematics test scores) in adolescence (ages 16–17). Results may encourage policy investments to mitigate the occurrence of health conditions in childhood and to ensure timely access to educational supports and health services for children with chronic conditions.  相似文献   

9.
The region of Grobnik, in the north west of Croatia, 15 km away from the Adriatic coast and 400 meters above the sea level, used to be known as a centre of endemic goitre. Iodine prophylaxis of 10 mg KJ added per kilo salt started in Croatia during the year 1953 and it was increased to 25 mg KJ per kilo in 1996. During 1961, the prevalence of goitre among Grobnik school children was 63%, while in the adult population it was 34%. In 1981, 18% of goitrous school children and 11% of goitrous adults were found in the same region, which shows the fall in goitre prevalence in the twenty-year period, from a severe to a mild one. The aim of this study was to estimate the effectiveness of iodine prophylaxis in goitre eradication and to compare the obtained results to those found in the same region 20 and 40 years ago, namely, in 1961 and 1981. The research was conducted in 2001. We examined 472 Grobnik inhabitants, 378 children (196 girls and 182 boys, aged 7-15 years) and 94 adults. Regarding their size thyroid glands were graded according to WHO and PAHO classification. Data regarding lifestyles and health conditions were collected by individual and family questionnaires. The prevalence of goitre in 2001 was 6.6% in school children and 6.4% in adults. In relation to 1981, we found a statistically significant fall of goitre in school children at the level of p < 0.01 (chi2 = 23.65), but the prevalence change was not statistically significant in adults (p > 0.01, chi2 = 1.419). The frequency of thyroid gland hereditary diseases in native inhabitants was high, 11.7%. There were no statistically significant differences in the prevalence of goitre or thyroid hereditary diseases between groups of native and newcomers' children. According to our results, in the year 2001 the area of Grobnik was still was a region of a mildly expressed endemic goitre. This study presents final results of a 40-year long follow up of endemic goitre eradication, demonstrating the long-term effectiveness of iodine prophylaxis.  相似文献   

10.
ObjectivesTo describe the health and developmental status of children living in refuges for women victims of domestic violence and to investigate their access to primary healthcare services.DesignCross sectional survey.SettingWomen''s refuges in Cardiff.Participants148 resident children aged under 16 years and their mothers.Results148/257 (58%) children living in refuges between April 1999 and January 2000 were assessed. Child health system data were incorrect (general practitioner and/or address) or unavailable for 85/148 (57%) children. Uptake of all assessments and immunisations was low. 13/68 (19%) children aged <5 years had delayed or questionable development on the Denver test, and 49/101 (49%) children aged 3-15 years had a Rutter score of >10 (indicating probable mental health problems). Concerns were expressed by mothers of 113/148 (76%) children. After leaving the refuge, 22 children were untraceable and 36 returned home to the perpetrator from whom the families had fled.ConclusionsThe children had a high level of need, as well as poor access to services. Time spent in a refuge provides a window of opportunity to review health and developmental status. Specialist health visitors could facilitate and provide support, liaison, and follow up.

What is already known on this topic

A pilot study showed poor uptake of immunisations and surveillance among children who live in refuges for women victims of domestic violenceQualitative studies suggest that these children are at risk of psychological ill health

What this study adds

Baseline health and demographic data show that children in refuges have a high level of unmet health need, particularly in relation to mental health difficultiesTheir families have poor access to health services  相似文献   

11.
While recent developments within the field of global mental health have illuminated the reality of serious mental health difficulties worldwide, particularly in low-income settings, research that focuses on children and adolescents remains underdeveloped. This is especially the case with respect to ethnographic studies of lived experience of adolescents diagnosed with serious mental health conditions. Drawing from an interdisciplinary study of adolescents in New Mexico who were afflicted with a broad range of disorders according to contemporary research diagnostic criteria, this article focuses on anxiety-related conditions with respect to subjective experience and social–ecological contexts of living with such conditions. We offer preliminary observations regarding the value of linking ethnographic and research diagnostic data to address questions of resilience, endurance, capacity and struggle. These observations are intended as the basis for the formulation of more precise hypotheses about adolescent anxiety, kin, and care under conditions of structural violence marked by psychological, residential, and intergenerational adversity.  相似文献   

12.
13.
The Ontario Child Health Study (OCHS) was based on interviews of 1869 Ontario families who were selected by means of a stratified, multistaged sampling method from the 1981 census of Canada. Its primary purpose was to determine the prevalence and distribution of mental health problems in Ontario children aged 4 to 16 years and their families, but it also allowed an estimate of other significant medical conditions and provided an overview of these children''s use of health care, education and social services. Our results are based on questionnaire responses concerning 3294 children. Limitation of function without a chronic illness or medical condition was reported in 1.9%, the converse in 14.0%, and a chronic illness or medical condition with limitation of function in 3.7%. When the three groups are considered together, 19.6% of Ontario children had a chronic health problem. Children of lower socioeconomic status were much more likely to have chronic health problems. Overall, children with chronic health problems were more likely to use physician, special education, social and mental health services. These findings have implications for those who provide services for children, plan community programs or train professionals in caring for children.  相似文献   

14.
Human immunodeficiency virus (HIV) infected adults are at a higher risk of pneumococcal colonisation and disease, even while receiving antiretroviral therapy (ART). To help evaluate potential indirect effects of vaccination of HIV-infected adults, we assessed whether HIV-infected adults disproportionately contribute to household transmission of pneumococci. We constructed a hidden Markov model to capture the dynamics of pneumococcal carriage acquisition and clearance observed during a longitudinal household-based nasopharyngeal swabbing study, while accounting for sample misclassifications. Households were followed-up twice weekly for approximately 10 months each year during a three-year study period for nasopharyngeal carriage detection via real-time PCR. We estimated the effect of participant’s age, HIV status, presence of a HIV-infected adult within the household and other covariates on pneumococcal acquisition and clearance probabilities. Of 1,684 individuals enrolled, 279 (16.6%) were younger children (<5 years-old) of whom 4 (1.5%) were HIV-infected and 726 (43.1%) were adults (≥18 years-old) of whom 214 (30.4%) were HIV-infected, most (173, 81.2%) with high CD4+ count. The observed range of pneumococcal carriage prevalence across visits was substantially higher in younger children (56.9–80.5%) than older children (5–17 years-old) (31.7–50.0%) or adults (11.5–23.5%). We estimate that 14.4% (95% Confidence Interval [CI]: 13.7–15.0) of pneumococcal-negative swabs were false negatives. Daily carriage acquisition probabilities among HIV-uninfected younger children were similar in households with and without HIV-infected adults (hazard ratio: 0.95, 95%CI: 0.91–1.01). Longer average carriage duration (11.4 days, 95%CI: 10.2–12.8 vs 6.0 days, 95%CI: 5.6–6.3) and higher median carriage density (622 genome equivalents per millilitre, 95%CI: 507–714 vs 389, 95%CI: 311.1–435.5) were estimated in HIV-infected vs HIV-uninfected adults. The use of ART and antibiotics substantially reduced carriage duration in all age groups, and acquisition rates increased with household size. Although South African HIV-infected adults on ART have longer carriage duration and density than their HIV-uninfected counterparts, they show similar patterns of pneumococcal acquisition and onward transmission.  相似文献   

15.
Age of mother and pregnancy outcome in the 1981 Arkansas birth cohort   总被引:1,自引:0,他引:1  
W D Mangold 《Social biology》1983,30(2):205-210
Higher levels of obstetric risk observed among teenage mothers seem to be an artifact of lower socioeconomic status and inferior access to health care rather than biological immaturity. In a study of matched Arkansas birth-infant death records for 1978, the proxy variables for health access (month care started and number of visits) have the strongest association with each of the dependent variables. The indicators of social status (education, race, and marital status) have a weaker association, and there is virtually no age effect observable once the affects of socioeconomic status and health access have been controlled for. A series of stepwise regression analyses shows that the multiple partial for health access indicators and mortality is 0.036, while the same coefficients for social status indicators and age are 0.001 and 0.006, respectively. Similar results are obtained using the other dependent variables. Health consequences of adolescent pregnancy usually include higher rates of malnutrition and prematurity and lower birth weight. It seems that the elevated morbidity and mortality among newborns delivered by teenagers are not a result of biologic factors. After the effects of lower status and health care access have been removed, the apparent biological disadvantages attributed to teenagers disappear, and, in the case of mortality and birth weight, are replaced by a slight advantage. This advantage is observed through the use of statisitical controls and will not be observed in the population at large unless there are changes in the policies governing access to contraception, abortion, and health care by adolescents, especially those at the youngest ages.  相似文献   

16.

Background

Eczema and asthma are common conditions in childhood that can influence children’s mental health. Despite this, little is known about how these conditions affect the well-being of children in school. This study examines whether symptoms of eczema or asthma are associated with poorer social and mental well-being in school as reported by children and their teachers at age 8 years.

Methods

Participants were from the Avon Longitudinal Study of Parents and Children. Measures of child well-being in school were child-reported (n = 6626) and teacher reported (n = 4366): children reported on their enjoyment of school and relationships with peers via a self-complete questionnaire; teachers reported child mental well-being using the Strengths and Difficulties Questionnaire [binary outcomes were high ‘internalizing’ (anxious/depressive) and ‘externalizing’ (oppositional/hyperactive) problems (high was >90th percentile)]. Child rash and wheeze status were maternally reported and symptoms categorised as: ‘none’; ‘early onset transient’ (infancy/preschool only); ‘persistent’ (infancy/preschool and at school age); and ‘late onset’ (school age only).

Results

Children with persistent (OR 1.29, 95% CI 1.02 to 1.63) and late onset (OR 1.48, 95% CI 1.02 to 2.14) rash were more likely to report being bullied, and children with persistent wheeze to feel left out (OR 1.42, 95% CI 1.10 to 1.84). Late onset rash was associated with high teacher-reported internalising behaviours (OR 1.61, 95% CI 1.02 to 2.54), and persistent rash with high externalising behaviours (OR 1.37, 95% CI 1.02 to 1.84). Child sleep and maternal mental health explained some of the associations with teacher-reported mental well-being.

Conclusion

Symptoms of eczema or asthma can adversely affect a child’s social and mental well-being at primary school. This suggests interventions, such as additional support or education of peers, should begin at early stages in schooling.  相似文献   

17.
《应用发育科学》2013,17(3):111-129
This longitudinal study examines the effects of exposure to the terrorist attack of September 11th as well as exposure to other forms of community violence on change in the mental health and social attitudes of youths in New York City. Three quarters of the youths reported some form of direct exposure to the events of September 11th, and 80% reported a lot of exposure to at least 1 form of media coverage of September 11th; these rates were comparable with the citywide survey of public school students in New York City conducted by the New York City Department of Education. Results of a structural equation model that included controls for previous levels of mental health and social attitudes, as well as a range of demographic factors, indicated that direct exposure and family exposure to the event did not predict change in any mental health outcomes, but did predict change in levels of social mistrust; media exposure did predict posttraumatic stress disorder symptoms. In contrast, victimization by other forms of violence was strongly associated with change in or current levels of all of the examined mental health symptoms, whereas witnessing other forms of violence was associated with change in or levels of 3 of 4 mental health symptoms and with increased hostile attribution bias and levels of social mistrust. Implications of the results for applied developmental and public mental health strategies in response to traumatic events are discussed.  相似文献   

18.
Season of birth has been shown to correlate with many aspects of somatic and mental disorders, development and social adaptation (so-called 'birth-date effects'). In a sample of young Swedish men, corresponding roughly to a one-year birth cohort, the results of intelligence tests, psychologists' ratings of psychological function, school achievement, body height, weight and self-reported health during childhood, were found to be correlated with month of birth, and--more strongly--father's socioeconomic status. The results were more favourable for men who were born during March-May (the period of highest birth rate), and whose fathers were of higher socioeconomic status, than for those born in November and December (the period of lowest birth rate), and whose fathers were in the lower socioeconomic group. It seems reasonable to conclude, from this study and previously reported findings, that these so-called 'birth-date effects' are determined by varying and often interacting biological and psychosocial factors. Among these factors, the light-induced entrainment of circadian and annual rhythms in the fetus and/or infant seems to be of pivotal importance. The organization of children into one-year age classes therefore produces an unfair lack of equality of possibilities.  相似文献   

19.
Stools of 646 healthy children between zero and five years of age who live in 3 communities of slightly different economic levels and sanitary conditions were investigated for enteropathogenic Escherichia coli (EPEC), enteroinvasive E. coli (EIEC), Shigella and Salmonella. Cultures were positive for enterophatogens in 82 (12.69%) of the children. EPEC was the most frequent isolate (6.04%) followed by Shigella (4.18%) and Salmonella (2.17%). Invasive E. coli (EIEC) was detected only twice. According to our results, the frequency of isolation of enterophatogenic bacteria decreases where the economic level and sanitary conditions improve. The percentage of 12.69% positive cultures among normal children shows that the healthy carrier plays an important role in the dissemination and maintenance of the agents of the enteric diseases.  相似文献   

20.

Background

Despite a history of conflicts and widespread human rights violation in sub-Saharan Africa, little is known about the prevalence of interpersonal violence among the population in this region. Evidence from high-income countries suggests that exposure to violence has mental health consequences and violence also has associations with experiences of sexual coercion.

Aims

This study sought to investigate the prevalence of physical and perceived threats of violence among university students in Uganda and to assess the possible relationship between such violence, sexual coercion, and symptoms of anxiety, depression, and psychoticism, respectively.

Method

In 2005, 980 Ugandan university students responded to a self-administered questionnaire (response rate 80%) that assessed socio-demographic factors, social capital, importance of religion, mental health, experience of violence and sexual coercion, and sexual behaviour factors. Logistic regression analysis was applied as the main analytical tool.

Results

Of those who responded, 28% reported perceived threats/threats of violence and 10% exposure to actual physical violence over the previous 12 months, with no significant gender differences in exposure history. Exposure to violence was significantly associated with the experience of sexual coercion among both males and females. Sexual coercion and threats/threats of violence were both significantly associated with poor mental health in males and females, but only males showed a strong association between exposure to physical violence and poor mental health.

Conclusion

The current study suggests that in terms of general exposure, both males and females in the study population are equally exposed to sexual coercion and interpersonal violence, and both male and female students show generally similar mental health effects of exposure to such violence. The prevalence of interpersonal violence found in our study population may have long-term negative health implications. Our findings may serve as a baseline for interventions and continuing research aimed at preventing interpersonal violence.  相似文献   

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