DiversityNursing Blog

According to projections from the Bureau of Labor Statistics by 2022 there will be an increase in the number of Registered Nurses of 526,800. That is over half a million! This means lots of nursing jobs for the near future– definitely a career with good prospects. If you are curious about RN salaries this infographic will be helpful.

It is clear that digital technology has a firm grasp on our lives and is advancing daily. We walk around with a computer in our pocket (cellphones) full of endless amounts of information. This technology has changed the way we provide healthcare and with this change there are pros and cons. Specifically, Electronic Health Records (EHRs) or Electronic Medical Records (EMRs). 

An Electronic Health Record according to CMS.gov, is an electronic version of a patient's medical history. It is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that person's care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR automates access to information and has the potential to streamline the clinician's workflow. The EHR also has the ability to support other care-related activities directly or indirectly through various interfaces, including evidence-based decision support, quality management, and outcomes reporting.

Pros

EHRs will save you space and paper. Administrative duties in health systems represent a significant amount of time and costs. Staff can spend a good portion of the workday filling out and processing forms. Because they are paperless, EHRs streamline a number of routine tasks. With less paperwork taking up space there will be less clutter and more room to be efficient.

Patient’s medical files will all be consistent. The medical staff can interact easily with affiliated hospitals, clinics, labs and pharmacies about the patient’s medical history. All of the patient’s files are updated when something is entered or changed in the system. This way the patient’s information is always up to date, leaving less room for errors or miscommunication.

Easy access to all clinical data. Staff can quickly transfer patient data to other departments or providers, while also reducing errors, which yield improved results management. Patients and employees often respond positively to this because it helps keep a health system’s schedule on track.

Cons

Privacy is a major concern when it comes to electronic health records. Using EHR software could put your organization at risk if you don’t follow privacy settings correctly. Paper records also make it easy to violate a patient’s privacy but, electronic records are convenient and timely which makes it easier to violate the patient’s privacy. A common privacy concern is identity theft.

Another disadvantage is data loss. A computer crash could wipe out vital data that you’ve been accumulating over the years. Always have a backup plan. This is imperative.  Many systems backup their data through a cloud program. So if there is an unfortunate event and your system crashes, you will still be able to access the data from the cloud.”

There are high costs involved with implementing an EHR to your system and many smaller health systems might not be able to afford it. The American Action Forum says, “Implementing an EMR system could cost a single physician approximately $163,765. As of May 2015, the Centers for Medicare and Medicaid Services (CMS) had paid more than $30 billion in financial incentives to more than 468,000 Medicare and Medicaid providers for implementing EMR systems. With a majority of Americans now having at least one if not multiple EMRs generated on their behalf, data breaches and security threats are becoming more common and are estimated by the American Action Forum (AAF) to have cost the healthcare industry as much as $50.6 billion since 2009.”

Do you work in a health system that uses Electronic Health Records? If so, how do you feel about them? We want your honest opinion, the good, the bad and the ugly.

It's officially Autumn season and we are sadly saying goodbye to our Summer sandals and pulling out clothes to keep us warm. If you're going to miss Summer like us, hopefully taking a look back at our hottest blogs of the season will help ease the pain. 

1. 14yr old African American Develop A New Surgical Technique To Sew Up Hysterectomy Patients

This incredible young man, Tony Hansberry II, is a 14-year-old student who used an endo stitch in a way no one has ever done before and the results are a game changer.

2. Study Confirms What We Knew All Along: Nurses Are Key to Hospital Success

We all know and love Nurses, but isn’t it wonderful when a research study validates something you already know? We think you’ll enjoy this article.

 3. 5 Things Labor Nurses Want You To Know

 
"As a labor and delivery nurse, here is what I wish I could say to every mother out there, what I'm sure many of us would want to say to the families we care for..."

4. Nurse Practitioners More In Demand Than Most Physicians

 It comes as no surprise that primary care doctors are, and have always been, highest in demand. However, recent data shows that this paradigm is shifting.

5. Empty Pill Bottles Desperately Needed (Take your meds & help others!)

In other parts of the world patients are handed their pills and must use whatever they have to keep the medication safe. In three easy steps you can make a difference for those patients. 

Diversity and Inclusion should be a top priority at Hospitals and Health Systems across the country. Why? Because your workforce should reflect your patient population. Your patients may come from your local communities. Others may have traveled from another country to have access to the specific illnesses you are noted for treating. It is imperative that your Nursing and medical team is culturally sensitive to their patients in order to provide the best care possible. Different cultures have different customs including: mannerisms such as not looking you in the eye; family members in attendance around the clock; the way  they dress; language/communication; the food they eat;  etc.

Understanding Diversity and Inclusion helps your team provide culturally responsive care. It also enhances the quality of life for your team. If your Nursing team is culturally aware, your patients and their families will be more comfortable and trusting of your hospital and staff. This makes the entire hospital experience a more positive experience for the patient, which in turn makes a smoother work environment. Imagine becoming ill and hospitalized in another country that doesn’t speak your language and doesn’t understand your subtle cultural differences. You’d most likely be scared and do whatever possible to get home immediately to a hospital where you feel safe and comfortable communicating with your medical team. A hospital you trust.

Hospitals and Health Systems use all types of approaches to monitor and educate their staff about Diversity and Inclusion. Many have Chief Diversity Officers or programs in place to educate and enhance this important factor of health care. Diversity can foster and drive excellence in patient care, research, and education. Here’s what some Hospitals and Health Systems are doing to improve Diversity and Inclusion in the workplace.

Chief Diversity Officers

The Chief Diversity Officer at the AAMC (Association of American Medical Colleges), Marc Nivet, Ed.D., defines a CDO’s role “It’s using the concept of diversity and inclusion to promote a stronger, better organization. Before, it was primarily about representational diversity, focusing on bringing in diverse faces. That remains critically important, but now we also are thinking about how to make use of that diversity to improve health.”

If your organization doesn’t have a Diversity and Inclusion Initiative, do they need one? Nivet goes on to say, “There are still some doubters who do not see the value of a diversity initiative. They don’t see the microinequities of how staff or patients are treated. The pressure is on the CDO to illuminate those inequities, bring them to the surface, and encourage conversations about them.”

Leadership Programs

Boston Children’s Hospital provides leadership development programs for professionals of color. One of their programs is called Conexión. “Conexión was created to advance Latino leadership to meet the changing needs in business, education, and government organizations in an increasingly culturally complex world.”

The Partnership Program is another great opportunity Boston Children’s Hospital provides. The Partnership’s mission is to “develop professionals of color, increase their representation in Boston area businesses and institutions, enhance opportunities for advancement and influence, and thereby extend the region’s economic competitiveness. The Partnership program consists of two levels depending on experience.”

Diversity and Inclusion Team

Yale-New Haven Hospital has a 16 person team dedicated to carrying out their Diversity and Inclusion initiatives. The initiative is based on 6 key factors.

• Recruiting a diverse workforce that is sensitive to and inclusive of people's differences
• Providing an excellent patient experience by understanding patient diversity and the needs of the many different people the hospital serves
• Working with a wide variety of groups and individuals in the community to improve people's health and access to care
• Ensuring the hospital is the employer of choice by creating an environment that encourages the talents and recognizes the uniqueness of each employee
• Supporting the hospital's efforts to use diverse vendors and suppliers
• Educating staff on working with diverse team members and caring for diverse patient populations

Do you have Diversity and Inclusion initiatives in place at your organization? Does your workforce reflect you patient population? Feel free to contact us below to learn more about addressing some of these very important issues!

You don't know when an emergency is going to happen. You don't know if the emergency is going to happen to you. But you can prepare for a medical emergency by downloading the Apple Health app and creating a Medical ID. 

People should keep their information and medical history with them in case they cannot communicate during an emergency. We aren't saying you should carry your entire medical file to the grocery store. But what if we asked you to carry your smart phone?

Some people wear their information on jewelry like bracelets or dog tags. Other people have it written down and kept in their wallet. Now most people have a smart phone and can download apps like the Apple Health app. 

This health app allows you to store and update all your important medical information. Information including your name, date of birth, medical conditions, medical notes, allergies and reactions, medications, emergency contacts, blood type, organ donor status, weight, height, and photo can all be stored and accessed from a touch of a button on your lock screen.

Here's how to access Medical ID on a locked iPhone:

1. Swipe to unlock.

2. Tap Emergency.

3. Tap Medical ID, on the emergency call screen.

Here's how to insert your information in the app:

1. From the iPhone home screen, choose the “Health” application. It is the white app with a pink heart in the top right corner.

2. You will notice a “Medical ID” option in the tool bar along the bottom of the screen.

3. An option to “Create Medical ID” will appear and display a screen with fields for you to enter your information.

As a patient, it can save your life. For medical professionals, try to make it a habit to always check a  patient's phone for a Medical ID. It could help you save their life.

Related Article:

How Health Apps Will Change Nursing

By Sara Seng via www.bartonassociates.com 

The telemedicine market isn't only effecting physicians and other healthcare professionals. Telemedicine has potentially great benefits for patients too. For example, regular office visit expenses will reduce and patients who have a difficult time traveling to appointments, don't have to worry about it anymore.

As the telemedicine market is expected to reach $34 billion by 2020, its impact in the healthcare industry is endless. Telemedicine refers to the use of telecommunication and information technologies in order to provide clinical health care at a distance. From reduced transportation expenses to increased cost efficiency, healthcare organizations are constantly searching for more ways to provide quality care and communication between providers and their patients.

However, do people ultimately trust telemedicine?

TechnologyAdvice recently conducted a nationwide survey of 504 U.S. adults to investigate the way people feel about telemedicine and its services. The infographic below highlights their findings.

Ginger Ail Blog post

Not every patient gets their medication in a pill bottle. In other parts of the world these patients are handed their pills and must use whatever they have to keep the medication safe. In three easy steps you can make a difference for those patients.

Pill bottles: they are those translucent orange soldiers that pile up all around us… in our drawers, bags, cabinets… sometimes I wonder – if I had saved every empty pill bottle since I got sick, what would that look like?

One of the things I have always hated the most about being sick, is you often need more help than you can give. That’s not always true, but there are definitely days or weeks like that for even the most functioning among us. I see those specials on tv and think: I want to build a Habitat for Humanity house or dig wells in Africa (this might be a late night, insomnia induced thought but the general sentiment still stands).

Neither of those will be happening in my lifetime, but that’s okay. There really are other things we can do, all of us, to help other people no matter how sick we are. Here’s one idea that only requires a bit of energy…

“Medicine Bottles for Malawi” is a project with an idea so simple, it’s brilliant. I’ve tried this myself so I can vouch for how easy it is to do and how good it feels to pass on something you know will help others.

Imagine you’ve walked miles to a remote village or hospital to receive any form of medical care you can find. You are given the medication you desperately needed and now you have to start the journey back home. You don’t shake the pill bottle maraca as you walk because there is no pill bottle, heck there’s barely medicine. The pills you received are wrapped in a tiny scrap of newspaper.

A scrap of newspaper is all the protection your precious cargo has. The more I thought about this, the more I realized it’s a bigger problem than it sounds like: no safe way to carry the meds home when you are most likely walking miles, no way to really protect the meds from moisture, loss, damage once you get them home. Apparently those orange bottles do more than you think and so can you…

How to Help:

Step 1: Take your meds and when you finish the bottle, don’t throw it away! This includes bottles you might receive over the counter like for Advil, Motrin, vitamin bottles, supplements – as long as the bottles aren’t large, send them on! (Large bottles just cost too much to ship).

Step 2: Remove the label. I find it’s easiest just to peel them off, takes a few seconds, but you can also save up until you have a pile of the bottles and dump them into a bowl of boiling hot water.

Step 3: Snail Mail Send them off! I used a large flat manila envelope, it’s cheap & easy to mail.

Address it to: The Malawi Project, Inc.
3314 Van Tassel Drive
Indianapolis, IN 46240

Tip: Take a photo of that ^ address on your phone & save it as a contact! When you have enough bottles to send off, you won’t have to log back in here to find the address. I do this often and it definitely saves some energy to take photos of info.

Bonus Benefit: I saw someone online arguing that we shouldn’t send them to Malawi because they won’t be recycled when they are finished being used. I thought this question was silly since they are so desperately needed there but I like the answer all the same: Nothing goes to waste in Malawi. Your medicine bottle, when it’s empty, will be used in 100 other ways. Imagine you have very little and then think of all the ways a bottle with a sealed lid could be helpful.

Contributors: Maria R. Shirey, PhD, MBA, RN, NEA-BC, ANEF, FACHE, FAAN via www.americannursetoday.com

For leadership to be authentic, programs should focus on both external programming and individual improvement. The most important factor of individual improvement is self-awareness. Authentic leadership on an individual level can be measured by an Authentic Leadership Questionnaire (ALQ).

In 2013 alone, U.S. organizations spent more than $15 billion on leadership development activities. Although much of these expenses focus on external programming, including face-to-face workshops, webinars, and e-learning, fewer resources target the internal development of leaders. To maximize sustainable leadership development, emphasis must be given to both external programming and individual improvement.

Experts in the field argue that organizations can more effectively redeploy billions of training resources by focusing on helping leaders mine their regularly scheduled lives for deep insights, feedback, strategies, and solutions. By investing in self-awareness and reflective practices, individuals have a better chance to grow as emotionally capable leaders. This article discusses self-awareness as a means to boost authentic leadership, an emotionally capable positive leadership style, and provides suggestions for enhancing self-awareness.

Self-awareness in authentic leadership

Authentic leadership is a pattern of leader behavior that draws upon and promotes both positive psychological capacities and a positive ethical climate. Elements of this definition are incorporated in the Authentic Leadership Questionnaire (ALQ) developed in 2007 and considered the definitive valid and reliable instrument to measure individual-level authentic leadership.

The ALQ uses four scales to evaluate key components of AL: self-awareness, relational transparency, balanced processing, and internalized moral perspective. (See Components of the ALQ, based on Walumbwa and colleagues.)

Self-awareness, the focus of this article, refers to an individual’s capacity to show an understanding of personal strengths, weaknesses, and impact on others. In addition to being a core element of authentic leadership, self-awareness is a key component of emotional intelligence that contributes to self-regulation and leader effectiveness.

Enhancing self-awareness

Authentic leadership can be developed. To become an authentic leader, however, requires that individuals pursue a journey of self-discovery, self-improvement, reflection, and renewal. The following recommendations offer direction for building self-awareness in your authentic leadership development journey.

Explore personal strengths and fatal flaws.
Understanding personal strengths helps to maximize potential. Although it’s your strengths that likely got you noticed as a leader, it may not be your strengths that will keep you on track. For this reason, it’s important to also recognize your major weaknesses or fatal flaws so you can minimize these and prevent them from derailing your leadership.

Completing the Strengths Finder instrument and reading about Goldsmith’s identified fatal flaws can help emphasize personal strengths without ignoring major weaknesses. Goldsmith defines fatal flaws as bad behaviors and cites examples of career derailing behaviors such as making destructive comments, withholding information, and claiming undeserved credit.

Understand your limitations and seek others to complement you and the team.
Self-awareness includes understanding personal limitations and acknowledging what still needs to be learned. Self-awareness also involves recognizing the strengths and fatal flaws in others to build a high performing team where all members complement each other and maximize the whole.

Examine emotional intelligence.
Emotional intelligence (EI) refers to people’s ability to recognize and understand their emotions and those of others. With EI, individuals can use their emotional awareness to manage personal behavior and relationships. EI has four distinctive components that need development: self-awareness, self-management, social awareness, and relationship management.

To better understand where you rate on the various EI scales, complete the simple and inexpensive Emotional Intelligence 2.0 instrument. Taking into account results of the assessment as well as suggestions for improvement can guide a personal AL development plan to develop EI.

Observe yourself and engage an observational partner.
Taking the time to record your major decisions along with the rationale for those decisions provides for personal analysis. In looking at the outcomes of decisions, you can establish a personal feedback loop that reveals what went well, what could be done better, and what patterns of behavior may be fruitful or counterproductive.

Including a trusted colleague or coach as an observational partner can offer just-in-time advice or retrospective validation with constructive direction. When leaders ask for input, it’s most beneficial for them to listen to feedback without justifying their actions or retaliating against the invited messenger.

Create down time for daily reflection.
Taking planned down time in the course of a busy schedule helps clear the mind and provide balanced perspective. This activity can involve taking a daily walk, engaging in mindfulness meditation, or reading daily scripture. Reflective down time is needed to enhance self-awareness and to cultivate authenticity.

Dig deep to gain insight.
It’s important for current and aspiring leaders to be able to ask and answer important questions such as: Who am I? What are my values? What is my purpose? What drives me? Are my actions consistent with what I value? How do others see me and is this consistent with how I wish to be seen?

Digging deep to honestly explore these questions requires time, dedication, and possibly validation from others. This type of deep reflection represents the inner work of leadership development that someone else cannot do for you.

Keep a reflective journal.
Keeping a journal helps to record personal thoughts that can lead to a higher degree of self-awareness and enhance both writing and emotional fluency. In recording daily reflections, this can help to recognize desirable as well as undesirable patterns of emotions and behavior that could either be repeated or modified for self-improvement.

A reflective journal also helps you begin to compose your individual life story, which can shed light on where you have come from, how you have learned from experiences, and provide direction for the future you wish to pursue.

Incorporate time for personal renewal and celebrate milestones.
Taking time to celebrate milestones is important for closure as well as for personal renewal. Pausing at regular intervals can be both inspiring and energizing for yourself and the team you lead.

Authentic leadership journey

Authentic leadership begins with self-awareness. Growing in self-awareness, however, entails individual responsibility, hard work, and devotion to reflective practices. You can use the suggestions in this article to build self-awareness that in turn enhances a personal authentic leadership development journey.

By Tom Clegg via Nurse.com 

Whistleblowers fear retaliation and the chance that nothing will be done with the information they've provided. An organization's culture should make it's employees feel safe when reporting something. But, there are still times when Nurses refrain from whistleblowing because their work culture has encouraged them not to do so. This delicate area of policy and ethics is a work in progress. As a healthcare worker, what steps do you think would help the process of reporting questionable practices?

A 2015 revision to the ANA Code of Ethics strengthened the wording of its policy that “nurses have a responsibility to assist whistleblowers who identify potentially questionable practices.” Further, New Jersey’s Conscientious Employee Protection Act protects those who report such practices from retribution.

That’s all well and good, but as nurse leaders stressed at the Organization of Nurse Executives New Jersey Research Day Conference in June in Princeton, the best way to ensure nurses and other healthcare workers feel confident they can blow the whistle is by creating the proper work environment.

That was the conclusion of a research committee study at ONE NJ to replicate work done by University of Nevada researcher Lisa Black in 2011, which identified workplace factors that influence nurses’ willingness to report.

“If you have a culture in your organization where people felt safe to report things, they would report it and have less fear of retaliation,” said Patricia Steingall, MS, RN, NE-BC, vice president of patient care services and CNO of Hunterdon Medical Center in Flemington, N.J., and president of ONE NJ.

Steingall said the biggest fears of those considering blowing the whistle are retaliation and that nothing will be done with the information provided. Nurse leaders can alleviate some of those concerns by establishing a culture of openness and by educating “staff on what are the policies about whistleblowing, assure them that there are protections in place for them and let them know what those protections are,” Steingall said.

She also stressed the importance of being sure of the facts, a point echoed by Lucille Joel, EdD, RN, APN, FAAN, Distinguished Professor, Rutgers University School of Nursing, Newark. Joel, who presented “Speaking Up: A Dimension of Professional Practice in an Ethical Context” at the conference, added blowing the whistle never is easy and always has some ambiguity.

“In regards to whistleblowing, it’s an ethical decision that runs contrary to an employer,” Joel said. “You have to be sure of the data. You have to be relatively sure, although you can’t be absolutely positive, that whistleblowing or calling governmental attention to a situation is going to be better for the client than allowing the incident to continue uncontested.”

Attorney and nurse Kathleen Gialanella, RN, JD, LLM, Esq., spoke at the conference on the legal and ethical considerations of blowing the whistle. She encourages anyone considering reporting a potentially unsafe practice to seek guidance, which may include legal counsel. She also said that although certain situations allow whistleblowers to report an incident directly to an outside body, “normally the process needs to unfold within the organization, and the organization needs to be given an opportunity to correct whatever concern the employee has.”

Gialanella said progress has been made by healthcare organizations in making staff feel more comfortable reporting incidents, but not everyone is on board.

“Some organizations are ahead of others in adopting that kind of culture,” she said. “There are many situations where nurses still are not comfortable bringing a concern to the attention of their supervisor, and it’s because of a culture (in which) they’re not really encouraged to do so.”

Tom Clegg is a freelance writer.

By Debra Wood, RN, contributor via www.americanmobile.com 

It appears there will be a positive future relationship between Nurses and health apps that will benefit the healthcare team and patients. These health apps will cause a shift from reactive to proactive care while providing benefits for healthy and chronically ill patients.

Living services, technology that learns and evolves to meet the needs of the consumer, is fast approaching as consumer expectations converge with increasingly sophisticated sensor and communication devices. Nurses may soon see a time when smartphones warn of impending depression or a stomach-activated patient monitoring sensor lets them and the physician know how the patient is taking a prescribed medication.

“It is something that is changing the way medicine is being practiced,” said David Collins, senior director of HIMSS mHealth Community. Collins said that while much of the technology for connected health care is available today, issues remain in regard to reimbursement, and patient acceptance and engagement. However, with accountable care organizations and other shared-risk programs, reimbursement is based on outcomes, not fee-for-service. 

“[This technology] is a tool to allow accountable care organizations to keep cost at a certain level and have an advantage in the marketplace,” Collins added. “Things are moving toward population health management. It’s more of a team-based approach.” 

The shift from reactive to proactive care

Those teams may form around patients at high-risk for costly hospital care. Nurses may coordinate care and monitor incoming information from sensors, scales or other technologies. The nurse may assess remotely and help with self-care or changes in the medical plan, based on protocols or the advice of a provider. 

“Applications could trigger nurses when a patient shows up in an emergency room, and then information could be delivered to the physician at the point of care,” explained Carolyn Richardson, MSN, MBA, RN-BC, regional nursing officer for Zynx Health based in Los Angeles. The company offers ZynxCarebook, a mobile platform to help identify members of a patient’s health team and communicate health information and coordinate care across settings.

Rick Ratliff, managing director of digital health at Accenture based in New York, reported that Accenture has predicted that Food and Drug Administration-approved internet-connected solutions created for detection and treatment of a medical indication are poised to save the health care industry more than $100 billion by the close of 2018.

“Longer-term, these IOT (Internet of Things) technologies represent a shift from reactive care--centering exclusively on in-person visits with nurses and doctors--to proactively managing a patient’s health with interlinked solutions and services geared to an individual,” Ratliff said. 

Benefits for healthy and chronically ill

Currently, Apple has created much buzz with the health apps on Apple Watch, and FitBit has grown quickly in popularity. People are wearing both and tracking their fitness activities. But self-care is also going mainstream, with the health insurer Health Care Service Corp. (HCSC) releasing the Centered app for the watch and phone. The app takes a holistic approach to stress management by allowing users to track their daily physical activity while providing guidance for meditation exercises to help reduce stress levels and improve overall health. Nurses could use this health app to manage their own stress or teach patients how to meditate with it. 

“Our research indicates that an abbreviated, self-guided, online version of the popular Mindfulness-Based Stress Reduction program can help people recognize stress triggers and gain greater insight in managing their health and well-being,” said Conway McDanald, MD, vice president and chief medical officer, Behavioral Health, HCSC. 

While these types of health apps may be valuable to active individuals interested in promoting self-care, Dean Sawyer, CEO of Sentrian in Aliso Viejo, Calif., believes the greater benefit will come from tracking the chronically ill. This can be done with biometric devices able to pick up trends of deterioration in the patient’s condition before symptoms become noticeable--for instance, with congestive heart failure monitoring thoracic fluid and stroke volume changes. Then the clinician can intervene to prevent costly exacerbations. Sentrian is developing and piloting such a remote patient intelligence platform, using biosensors and a rules-based monitoring program. 

“It’s helping physicians make better decisions,” Sawyer said.

Many local health systems are creating various technologies for collating patient data and monitoring indicators of chronic conditions, Ratliff reported. Internet-connected devices using sensors capture continuous health indicators and can transmit real-time patient monitoring data to health care professions. Medical practices and hospitals must create systems to receive and coordinate the incoming data and allow healthcare professionals to take action. 

“Several hospitals are finding early successes in their ability to improve medication adherence, improving behavioral modifications and preventing emergency room visits,” Ratliff said. “It’s the notion that extending care services beyond the brick and mortar that is today’s health care system allows self-care to follow a continuous cycle of prevention, management and improvement.” 

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