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Therapists say mental health suffered in COVID-19 pandemic | News, Sports, Jobs

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The ongoing impact of the pandemic is keeping local therapists on their toes as they help clients cope with last year’s losses and get back to normal once COVID-19 restrictions wear off.

“Many of the therapists in Maui I spoke to reported an increase in psychiatric symptoms in people with and without a history of mental illness during the COVID-19 pandemic in 2020, and this has both financial and emotional well-being , “ said Dr. David Wittenberg of Behavioral Health Services at Maui LLC. “I saw an increase in fear of the future, poverty, as several family members worked for resorts and certain people left the island.”

Maui Behavioral Health Resources includes three facilities – Aloha House, Malama Family Recovery Center, and Maui Youth and Family Services.

Wittenberg, who shares responsibility for the crisis services, case management services, Maui Counseling Group, and intensive home therapy services for adolescents, said he was working with many psychiatrists and psychologists, as well as other licensed and unlicensed providers, on the problem.

They spearheaded an overall surge in anxiety, depression, substance abuse, insomnia, weight gain, and other medical conditions over the past year, some of which could continue as the pandemic wears off.

Maui Counseling Group’s therapists served 1,067 clients in April, up about 10 calls a month since February. The crisis team makes about 100 mobile outreach calls per month over the state crisis line, and the case management staff has over 400 clients with severe mental illness who are offered services.

Crisis calls from adults increased each month during the pandemic, with calls in February and March being the highest in those months in the four years. Calls about youth crises decreased, in part because many of the calls Aloha House would handle were from the state education department. Since the DOE schools were closed, the calls were dropped.

However, the calls are increasing again and “We fear that these numbers could increase a little” Wittenberg said last month.

“The nature and extent of this unprecedented pandemic has affected so many people in Maui County,” he said. he added. “There are still a lot of families who have remained in a kind of prolonged isolation.”

Customers who have had a therapist before the pandemic are “Generally better” because they could use the already existing support, “Which underlines the importance of starting and maintaining therapy for people at risk” Wittenberg said.

Fortunately for some, the mental health effects of the pandemic have been mitigated through government support programs such as stimulus checks, eviction moratoriums and mortgage deferrals.

“If and when these programs are lifted, we anticipate that the mental health landscape could change again.” he said.

Many families are still recovering from last year’s struggles as parents return to work and students prepare for daily face-to-face lessons.

The pandemic took its toll on teenagers who endured online classes and missed social and extra-curricular activities.

Students who previously got A fell back to Ds during distance learning, what “Became a blow to their self-esteem and the process of losing faith in their abilities”, Wittenberg said.

Heather Long of Maui Youth and Family Services, who is also a counselor for Baldwin High School and other children in the Wailuku and Hawaiian Homes area, noticed a decline in the mental wellbeing of some of her clients.

“Children complained that they hated virtual learning and wanted to go back to school.” Long said last month. “Some of my clients put on a lot of weight from sitting and being online for over six hours a day.”

Long has reached out to Baldwin students and homeless youth in Wailuku for the past 15 months, offering personal support services or telemedicine counseling to 14-18 year olds and clients who graduate in 2020.

“I felt that the children felt separated from their support community” She said.

Long believes the community will have a lasting impact on the youth.

“I think when teenagers learn in person again, they have to get up every day and wear different clothes than their pajamas.” She said. “Teens need to get back on a schedule they haven’t had in the past 16 months.”

According to Barry Taghavi, a psychiatrist with the Maui Counseling Group, these age groups are more “emotionally vulnerable to the effects of limited social interactions.”

While many welcome a return to the classroom or to work, returning can also cause a degree of discomfort that can prolong mental illness or substance use disorders.

Despite the increase in social interactions, the move to work or school can sometimes change the mood due to the lower “Stress of uncertainty and having to make new decisions that you are no longer used to or that you did not have to make before” Wittenberg said.

There were also many families who had to balance multiple responsibilities during the pandemic, such as: B. returning to work or finding a job, finding childcare, raising young children in virtual learning, maintaining relationships, and so on. This balancing act may persist or worsen once the regular schedules resume.

“Some highly functional people who have welcomed re-entry into the world of work or more social interactions have been overstimulated by changes being made too quickly.” Wittenberg said. “Sometimes they are scared in public situations and feel very uncomfortable and do not know how to proceed in certain cases.”

Psychiatrists and therapists have also identified a gap in community attitudes about COVID-19 that can inspire fear and suspicion.

“Sometimes people don’t know how to approach each other after the pandemic” Wittenberg said. “Some people never bothered about it and others were very attuned to it. Some students have been told to stay away from others, and this message contrasts with asking others for help about what was pre-pandemic. “

The pandemic also exacerbated some long-standing problems, such as substance abuse or addiction. Adults dealing with addiction often feel that they are being stigmatized for treatment, or that they can do it “Take care of it yourself”, said Jud Cunningham, chief executive officer of Maui Behavioral Health Resources.

“The prevailing and scientifically based theory is that addiction is a chronic, relapse-prone disease for many people.” said Cunningham. “There is no shame in seeking professional help to seek or maintain recovery from an addiction. It is said that addiction is ‘a pandemic within the pandemic’ that resorting to substance abuse is an inadequate means of dealing with the negative effects of the COVID pandemic. “

Cunningham said it is very likely that there will be one after the pandemic subsides “Even greater need” for substance abuse and mental treatment.

“For those in need of treatment and in recovery, stay connected with social networks, support groups, and friends who promote healthy alternatives to managing stress.” he added. “The search for professional advice / intervention is a strength, not a weakness.”

Connecting with others, being outside, staying active, setting small goals, limiting screen time, and eating nutritious meals are just a few of the ways to boost your mood and overall wellbeing.

“Remember that many of us are anxious and sometimes awkward in new social situations, and unpacking some of these feelings together and serving their purpose is a great way to deal with the new normal.” Wittenberg said.

While teens and keiki need their peers for development, those who are afraid of being back in crowds should take things slowly as life returns to the new normal.

“Try to take a deep breath in new social situations, perhaps ask open-ended questions and listen.” Wittenberg said. “It’s okay if you’re not ready to spend time – don’t try to take on too much at once. People only have a certain amount of social energy and try to be aware of it so that you don’t burn out and get sick. “

Long suggested parents help their teenagers and Keiki get back into a familiar routine. Families could also involve children in activities they enjoyed before the pandemic and “Expose you to new healthy activities.”

“I think we will see an increase in anxiety due to the demands of attending personal school. Children have developed some bad habits and it will take time for them to change. “ She said. “I also think that children will need really safe adults in their lives so that they can feel connected to their community again.”

Educators can have a challenging time in the 2021-22 school year, but when “We practice true aloha and malama, our keiki, we will see healing in our schools.” She said.

Therapists emphasized the importance of soliciting family and friends for support, doing more wellness check-ins, and searching for resources available in Maui County for those struggling with mental health and / or drug use .

“We need to do more to educate the public that isolation is unhealthy and that being in the parks and beaches outdoors is beneficial to both physical and mental health.” Wittenberg said.

Many people found a silver lining during the pandemic – the opportunity to reassess their purpose in life and place more emphasis on family, friends, hobbies and health.

“There were also some families who were so busy before the pandemic that they realized they weren’t spending enough time together and would not have done that if the pandemic hadn’t occurred.” Wittenberg said. “The pandemic added a healthy perspective to what is really important in life.”

For crisis relief or access to mental health resources, call Hawaii CARES for free 24/7 support at (800) 753-6879 or contact the Crisis Text Line by sending ALOHA at 741741.

To access the 24-hour emergency helpline, call Maui Youth and Family Services at 579-8406 or email Services@MYFS.org.

More information and resources about Aloha House can be found at mbhr.org/about-aloha-house/.

* Dakota Grossman can be reached at dgrossman@mauinews.com.

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Individuals and Families | Georgia Department of Public Health

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prevention

There are several steps you can take to prevent it

Opioid

Abuse and Addiction:

  • Never take more than that



    required

    Dose and always follow the prescribed instructions. If you forget a dose, do not take a double dose to make up for the dose.

  • Do not combine opioids with alcohol.
  • Do not combine opioids with any other medication or medication without your doctor’s approval.
  • Stop taking opioid medications as soon as your doctor agrees they are no longer needed.
  • Always follow the prescribed instructions.
  • When taking liquid doses, use an accurate measuring device and measure only the prescribed amount.
  • Only use the drug in the form in which it was prescribed.
  • Never use someone else’s recipe or share your recipe with anyone.
  • Do not drive or use heavy machinery.

Drug withdrawal

Unwanted prescription drugs should be disposed of at an official drug collection point. This prevents prescription drugs from falling into the wrong hands.

Prescription Drug Abuse Prevention Webinars

Information on prevention for parents, students, educators and coaches can be found here.

Signs of overdose

The # 1 sign of opioid overdose is unresponsiveness

Other signs are:

  • Awake but unable to speak
  • Saggy posture
  • The face is pale or clammy
  • Blue fingernails and lips
  • In fair-skinned people, the skin tone becomes bluish-purple; if the skin is darker, the skin tone becomes greyish or ashen
  • Breathing is very slow and shallow, erratic, or has stopped
  • Pulse is slow, irregular, or not there at all
  • Choking noises or a snoring-like gurgling sound (sometimes called a “death rattle”)

Steps to be taken if a drug overdose is suspected:

  1. Immediately call 911, report a drug overdose, and provide the address and location of the suspected overdose. If more people are available, send someone to wait for the ambulance and guide the emergency services to the person. Georgia has one medical amnesty law protects those who may suffer an overdose and callers who see a doctor about an overdose of alcohol and drugs.
  2. Try to wake the person up by talking loudly, pinching, or vigorously rubbing their ankles on the sternum (the bony part in the center of the chest).
  3. Make sure the person is breathing. If not, try providing emergency mouth-to-mouth ventilation by pinching the person’s nose and blowing into their mouth. After breathing on their own again, lay the person on their side.
  4. Give naloxone when you have it and know how to use it.
  5. Stay with the person until help arrives and act quickly to give rescue breaths if they stop breathing.
  6. Encourage the person to work with the ambulance crew.

Georgia’s Medical Amnesty Act

Although most overdoses occur in the presence of others, fear of arrest and prosecution prevents many people from calling 911. Georgia’s Medical Amnesty Act protects victims and callers who seek medical help during a drug or alcohol overdose. This law provides:

  • Limited liability for possession of small amounts of drugs and / or alcohol; this applies to both the victim and the caller
  • Limited liability for parole, injunction, probation and other violations
  • Naloxone Immunity for Prescribers, Pharmacists, and First Responders

Naloxone administration



Naloxone

is only a short term treatment for overdose. It is important that healthcare professionals are notified as soon as possible.

Naloxone blocks or changes the effects of opioid drugs, including extreme sleepiness, slow breathing, or loss of consciousness. Naloxone is used to treat an emergency in the event of an overdose of narcotics. It should be used until the patient can receive emergency medical care for an overdose.

Learn how to



Administer naloxone

.

Standing order for naloxone

There are two ways to get a naloxone rescue kit from a pharmacy in Georgia:

1. Get a prescription from your prescribing doctor and take it to a pharmacy that stocks naloxone.

2. Go straight to a pharmacy and request a naloxone kit. ON



To stand

order

for naloxone was dispensed to all pharmacies in Georgia on December 14, 2016, and a prescription for naloxone is not required.

Damage minimization

Fentanyl or other stronger opioids are added to many illegal drugs today. People who use illegal drugs can take steps to reduce their risk of overdose, such as: B. to have naloxone on hand and never to use it alone.

In addition to the risk of overdose, injectable drug use can lead to people becoming infected with or transmitting infectious diseases such as HIV or hepatitis. To reduce this risk, people who inject drugs should always use safe injection practices, including never sharing needles and always keeping the injection site sterile. For more information on harm reduction resources in Georgia, visit the Atlanta Harm Reduction Coalition.

Neonatal abstinence syndrome

Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome that occurs when the mother suddenly stops taking medication during pregnancy.

NAS is most commonly caused when a woman takes opioids (e.g., morphine, methadone, oxycodone) during pregnancy, but it can also occur with antidepressants and benzodiazepines. It can also occur when a woman is using illegal drugs such as heroin, methamphetamines, and barbiturates.

NAS has been reportable in Georgia since January 1, 2016. Gathering information about the occurrence of NAS will help DPH develop policies and programs aimed at reducing the number of babies born with NAS. For more information on NAS, see Neonatal Abstinence Syndrome.

Treatment and recreational resources

Georgia Crisis and Access Line for Opioid Addiction and Withdrawal
The longer opioid drugs are used, the greater the risk of addiction. With addiction, withdrawal symptoms occur when the drug is stopped. These include pain, nausea, vomiting, muscle spasms, depression, and anxiety, and they can last a week or more. It is dangerous to go through opioid withdrawal without medical attention. Call the Georgia Crisis and Access Line at 800-715-4225 for assistance.

SAMHSA Treatment Services Locator has resources for finding addiction treatment service providers in Georgia and across the country, and collects information on thousands of government-licensed providers specializing in the treatment of addictions, addictions, and mental illnesses.

The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) Addiction Disorders Office provides information about DBHDD strategic planning and community search resources.

Georgia Overdose Prevention is a grassroots organization made up of parents, health professionals, harm reduction advocates, and friends of people who have lost loved ones to accidental drug overdoses. The group was formed to create and advocate the passage of the Georgia 911 Medical Amnesty Law. Inspired by the lives saved by the passage of the Medical Amnesty Act, Georgia Overdose Prevention is now focused on educating, implementing and developing resources for Georgia’s 911 Medical Amnesty Law.

Dose of Reality GA contains information about the dangers of opioid use, addiction prevention, and safe medication storage.

The Emory Center for Maternal Substance Abuse and Child Development provides information on opioid use during pregnancy.



directory

of Georgia Women’s Treatment and Recovery Services



hope

Home restoration assistance for women

How to Contact Law Enforcement / Reporting a Complaint to the Drugs Agency:

To report an increase in overdose, a potential overdose group, or other unusual drug-related event, call the Georgia Poison Center at 1-800-222-1222.

PDMP

The Georgia Prescription Drug Monitoring Program is an electronic database for monitoring the prescription and dispensing of controlled substances. The PDMP can help avoid duplicate prescriptions and overdoses of controlled substances, provide a prescribing doctor or pharmacist with critical information about a patient’s prescribing history with controlled substances, and protect patients from abuse.

Patients can have copies of their PDMP reports. To do this, please fill out a patient inquiry form and send it to pdmpsupport@dph.ga.gov. Patients will then receive a copy of their report.

Page last updated on 07/28/2021

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Pfizer says vaccine’s power wanes over time. Are you still protected?

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The effectiveness of the Pfizer-BioNTech Covid-19 vaccine waned over six months, but experts say the data still does not indicate an immediate need for booster vaccines.

The study, which has not yet been peer-reviewed or published in a medical journal, found that the vaccine was 97 percent effective at preventing serious Covid illnesses for at least six months – but effectiveness against any symptomatic illness fell from 96 Percent to 84 percent over the same period, every two months by about 6 percent.

Full coverage of the Covid-19 pandemic

“I was generally encouraged by the results of the paper,” said lead study author Dr. Stephen Thomas, a coordinating investigator for the Pfizer vaccine study and director of the SUNY Upstate Institute for Global Health & Translational Science in New York.

He said the expectation is always that the protection of the vaccine would wear off. The big question, he said, was whether protection would wane to the extent that the disease was affecting so-called public health; namely, hospitalizations and deaths. So far this does not seem to be the case.

“Although we saw protection wear off after six months, protection from the serious consequences that really put the disease’s public health burden in place,” said Thomas.

Overall, the study found that within six months, the vaccine was 91 percent effective in preventing symptoms of Covid, which ranged from mild to severe symptoms. Pfizer announced these specific results in a press release in April.

Dr. Paul Offit, a vaccine researcher at Philadelphia Children’s Hospital, said he was “pleasantly surprised” that it was as effective as it was in preventing symptoms.

“These data are all very encouraging and exactly what you would expect,” he said.

“You will never be so well protected from an asymptomatic infection or a mildly symptomatic infection, and that’s fine,” he said. “They just want to keep people out of the hospital and keep them from dying. That is the goal.”

The new study examined follow-up data collected as of March 13 from more than 44,000 people who participated in Pfizer’s Phase 3 clinical trial last year. People received either two doses of the vaccine or two doses of placebo three weeks apart. Since the study only looked at data through mid-March, it remains unclear how the shots against the Delta variant, which became the most common strain of the virus in the United States in early July, remains unclear.

The results come as experts continue to consider whether or not booster injections are needed. Pfizer CEO Albert Bourla has long said that a refresher would be needed in the coming months, although federal health officials say there is still no evidence to warrant this.

In a conference call Wednesday morning, Pfizer said a third dose increases antibody levels specific for the Delta variant by five-fold in people ages 18 to 55 and eleven-fold in people ages 65 to 85 have. Although these results suggest better protection against the variant, whether this leads to better protection against disease remains to be explored.

Offit stressed that it was too early to definitively say that booster vaccinations are needed as the vaccine remains very effective in preventing serious illness and hospital admissions.

“If the number of people who are fully vaccinated and still being hospitalized or killed increases to 5, 10, or 20 percent, you can think about a booster, but we’re not there yet,” he said.

Download the NBC News app for full coverage of the Covid-19 pandemic

Dr. Bob Wachter, chairman of the medical school at the University of California, San Francisco, agreed with Offit that the new data does not suggest that it is not yet time to rush and get a booster shot.

“It just goes to show that someone who was injected seven or eight months ago is at a slightly higher risk [for a breakthrough infection] than we thought, and it’s a perfectly good justification for self-vaccinated people to wear masks indoors again, “Wachter said, referring to the Centers for Disease Control and Prevention’s decision on Tuesday to put vaccinated people on wearing masks Recommended indoors in areas with high concentrations of community spread.

However, the dominance of the delta variant, combined with the vaccine’s declining effectiveness over time, suggests that boosters will be needed at some point, he said.

“I don’t think it’s a reason to panic and I don’t think it’s a reason to run out and find a booster today because the overall protection against super sickness and dying remains extremely high,” said Wachter. “But I think it’s part of the puzzle that tells us all that boosters will be in our future.”

Thomas, the study’s author, said more research is needed.

“I believe [the study] says it is possible that if the protective effect of the vaccine continues to wear off over time, we may need booster doses, ”said Thomas. “But that’s still an unanswered question for me.”

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How to stop eye twitching, and why it happens

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Usually the eye twitching is mild and goes away on its own after a few seconds or a few minutes. It is usually not a sign of an underlying disease. However, there are a few things people can try to stop it.

Mild eyelid twitching or eyelid myokymia is common. It has associations with stress, fatigue, and caffeine consumption. Reducing the factors that contribute to eyelid twitching can help reduce the frequency of its occurrence.

This article takes a closer look at eye twitching, what causes it and how to stop it.

A slight twitch occurs when the orbicularis oculi muscle, responsible for closing the eyelids, contracts spontaneously, causing small and uncontrollable twitching movements. The medical term for this condition is eyelid myokymia.

Eyelid myokymia can affect the upper or lower eyelid, but most commonly it affects the lower eyelid. Usually the twitches are light and brief and go away on their own after a few seconds or minutes. In some cases, they can last for hours. Less often they can become chronic.

Learn more about eyelid twitching here.

Other less common types of eyelid twitching include:

Essential blepharospasm

Essential blepharospasm causes the eyelids to close spontaneously. This may be like a blink or a wink, but the eyelids may close for a longer period of time in some cases. Blepharospasm can last a few seconds to a few hours, and some people may not be able to see during this time.

Doctors believe a problem with the nerves around the eyes is causing essential blepharospasm, but aren’t sure why it develops. Sometimes another condition such as Parkinson’s disease can be the cause.

Hemifacial spasm

Hemifacial spasm is a rare condition that causes the muscles on one side of the face to contract. Sometimes this starts near the eye and causes eyelid cramps before other areas of the face are affected.

Hemifacial spasm can occur alone, because something is pressing on the nerves that control the muscles of the face, or as a result of another condition.

Eyelid myokymia often goes away on its own. However, if a person wants to stop or reduce this symptom, they can try the following:

  1. With a warm compress: People can use a warm compress and apply it over the eyelid area. This can help relax the muscles around the eye and stop the cramps.
  2. Reduce stress: Eyelid myokymia is linked to stress, so it may help reduce the exposure to stress. People can do this by delegating tasks to others, taking time each day to relax, trying stress relieving hobbies, and practicing stress management techniques like breathing exercises or mindfulness.
  3. Avoid caffeine: Tea, coffee, some sodas, and chocolate can all contain caffeine, which can trigger or worsen eyelid twitching. Try to gradually reduce or eliminate caffeine intake.
  4. Getting enough sleep: Taking a nap can help resolve the eyelid twitching. It’s also good to get enough sleep each day by setting a regular schedule for falling asleep and waking up. If a person is having trouble falling asleep, a doctor, sleep specialist, or other health care provider can provide advice.
  5. Fight dry eyes: Dry, irritated, or gritty eyes can make your eyelids twitch. People can use moisturizing eye drops to relieve dryness.

More severe or persistent eyelid cramps, such as blepharospasm and hemifacial spasms, may require medical treatment.

Scientists aren’t entirely sure what causes eyelid myokymia. It is a common condition that can occur in healthy people for no apparent reason. It seems to be related to lifestyle factors such as:

The side effects of some medications, including topiramate, flunarizine, and clozapine, can also cause eyelid twitching. However, this is unusual.

A 2017 study from Taiwan on chronic eyelid twitching found that around half of the participants had differences in nerve function. This could be due to a nerve conduction defect that explains why some people develop persistent twitching.

Chronic eye twitching also seems to be more common in women, although experts don’t know why.

The authors of the study suspect that this could be due to the fact that women, especially in China, are exposed to higher levels of stress than men due to social or cultural pressure. Overall, however, more research is needed.

Doctors don’t know what causes blepharospasm, but it can sometimes be related to underlying conditions, such as:

The underlying conditions that can cause hemifacial spasm are similar and include:

  • traumatic injury
  • Brain lesions
  • Bell’s palsy
  • Mastoid or ear infections
  • Tumors
  • other structural abnormalities in the posterior region of the cranial cavity

Many of the known triggers for mild eye twitching are lifestyle related, so changing their daily routine may help people avoid this symptom. This can mean:

  • go to sleep earlier
  • Sleep and wake up at similar times each day, including weekends
  • Practice sleep hygiene
  • Switch to decaffeinated drinks
  • Reducing activities or habits that cause stress, such as B. Revision
  • Seek support from a therapist for anxiety or high levels of stress
  • Avoiding tobacco smoking or alcohol consumption

If eye twitching is common, it can be helpful to record when it occurs and note any other contributing factors. This can help someone see a pattern.

However, if the eye twitching is bothersome and doesn’t seem to be related to daily habits, a doctor may be able to offer other treatments to contain or prevent it.

This could include botox injections, which temporarily paralyze the affected muscles to prevent the twitching.

In rare cases, doctors may recommend an eyelid angle myectomy to correct blepharospasm or hemifacial spasm. This procedure removes the muscles that are causing the cramps. Identifying any underlying medical conditions that are causing the convulsions will allow a doctor to manage or control this symptom.

Most of the time, eye twitching is mild and goes away on its own. However, people should see an ophthalmologist if they experience:

  • Twitching that has lasted for more than a few weeks
  • severe twitching that affects vision
  • spontaneous closing of the eyelids
  • Twitching in other parts of the face
  • often dry eyes
  • other new symptoms that could indicate an underlying condition

Many people experience slight, temporary twitches in their eyes. It is usually not a sign of serious health and often does not require treatment.

People may find that twitching occurs less often if they can reduce stress, anxiety, trouble sleeping, or caffeine consumption.

The more bothersome forms of eye twitching include essential blepharospasm and hemifacial spasm. These can affect a person’s eyesight and make activities such as working or driving difficult to perform.

If a person has severe eye twitching, it is important to speak to a doctor.

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