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Hasselgren, Mikael
Publications (10 of 18) Show all publications
Zakrisson, A.-B., Arne, M., Hasselgren, M., Lisspers, K., Ställberg, B. & Theander, K. (2019). A complex intervention of self-management for patients with COPD or CHF in primary care improved performance and satisfaction with regard to own selected activities: a longitudinal follow-up. Journal of Advanced Nursing, 75(1), 175-186
Open this publication in new window or tab >>A complex intervention of self-management for patients with COPD or CHF in primary care improved performance and satisfaction with regard to own selected activities: a longitudinal follow-up
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2019 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 1, p. 175-186Article in journal (Refereed) Published
Abstract [en]

AIM: To test a self-management intervention in primary health care for patients with Chronic Obstructive Pulmonary Disease or Chronic Heart Failure on self-efficacy, symptoms, functioning and health.

BACKGROUND: Patients with Chronic Obstructive Pulmonary Disease or Chronic Heart Failure experience often the same symptoms such as shortness of breath, cough, lack of energy, dry mouth, numbness or tingling in hands and feet, pain and sleeping problems.

DESIGN: A multicentre randomized control trial.

METHOD: The trial was conducted with one intervention group (n=73) and one control group (n=77). The trial was performed from September 2013 - September 2015 at nine primary health care centres in three county councils in Sweden. At baseline patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure experienced any symptom. Follow-ups were performed after three months and one year. The intervention was structured on Bandura's theory of self-efficacy in six meetings and individual action plans based on personal problems were performed and discussed.

RESULTS: At baseline, there were no differences between the groups except for SF-36 social function. After three months, the intervention group improved performance and satisfaction with regard to own selected activities, otherwise no differences were found.

CONCLUSION: When designing a program, the patient's own difficulties must be taken into consideration if person-centered care is to be established. It is feasible to include both patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure in the same group in primary health care. Health care professionals need supervision in pedagogics during intervention in self-management.

Place, publisher, year, edition, pages
Blackwell Publishing, 2019
Keywords
Chronic heart failure, chronic obstructive pulmonary disease, nurses, patient education, primary health care, self-management support
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-70002 (URN)10.1111/jan.13899 (DOI)000453873300019 ()30375028 (PubMedID)2-s2.0-85057336384 (Scopus ID)
Note

Funding Agency:

Uppsala-Orebro Regional Research Council

Available from: 2018-11-06 Created: 2018-11-06 Last updated: 2019-01-08Bibliographically approved
Lindgren, H., Hasselgren, M., Montgomery, S., Lisspers, K., Ställberg, B., Janson, C. & Sundh, J. (2019). Factors associated with well-controlled asthma: A cross-sectional study [Letter to the editor]. Allergy. European Journal of Allergy and Clinical Immunology
Open this publication in new window or tab >>Factors associated with well-controlled asthma: A cross-sectional study
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2019 (English)In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995Article in journal, Letter (Refereed) Epub ahead of print
Place, publisher, year, edition, pages
Munksgaard Forlag, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-75593 (URN)10.1111/all.13976 (DOI)000479801000001 ()31298735 (PubMedID)
Funder
Swedish Heart Lung FoundationSwedish Asthma and Allergy Association
Note

Funding Agencies:

County councils of the Uppsala-Örebro Health Care region

Bror Hjerpstedts Foundation  

Center for Clinical Research, Dalarna  

Region Örebro County through ALF 

Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2019-11-15Bibliographically approved
Åberg, J., Hasselgren, M., Montgomery, S., Lisspers, K., Ställberg, B., Janson, C. & Sundh, J. (2019). Sex-related differences in management of Swedish patients with a clinical diagnosis of chronic obstructive pulmonary disease. The International Journal of Chronic Obstructive Pulmonary Disease, 14, 961-969
Open this publication in new window or tab >>Sex-related differences in management of Swedish patients with a clinical diagnosis of chronic obstructive pulmonary disease
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2019 (English)In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 14, p. 961-969Article in journal (Refereed) Published
Abstract [en]

Purpose: Women with chronic obstructive pulmonary disease (COPD) have more symptoms, more exacerbations, lower health status scores, and more comorbidity. However, it is unclear whether management of COPD differs by sex. The aim of the study was to investigate differences by sex in the care of patients with COPD.

Patients and methods: The population included 1329 primary and secondary care patients with a doctor ' s diagnosis of COPD in central Sweden. Data were obtained from patient questionnaires and included patient characteristics and data on achieved COPD care. Analyses included cross-tabulations, chi-squared test and multiple logistic regression using several measures in COPD management as dependent variables, female sex as independent variable, and with adjustment for age groups, previous exacerbations, COPD Assessment Test, level of dyspnea assessed by the modified Medical Research Council scale, comorbid conditions, self-rated moderate/severe disease, level of education and body mass index.

Results: Women were more likely to receive triple therapy (OR 1.86 (95% CI 1.38-2.51)), to have any maintenance treatment (OR 1.82 (95% CI 1.31-2.55)), to be on sick leave (OR 2.16 (95% CI 1.19-3.93)), to have received smoking cessation support (OR 1.80 (95% CI 1.18-2.75)) and to have had pneumococcal vaccination (OR 1.82 (95% CI 1.37-2.43)), all independently of age, severity of disease or other potential confounders.

Conclusion: Management of COPD differs by sex, with women being more actively managed than men. It is unclear whether this is due to patient-or care-related factors.

Place, publisher, year, edition, pages
DOVE Medical Press Ltd., 2019
Keywords
gender, triple inhaled therapy, maintenance treatment, sick leave, smoking support, pneumococcal vaccination
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-74345 (URN)10.2147/COPD.S193311 (DOI)000467097300001 ()
Available from: 2019-05-21 Created: 2019-05-21 Last updated: 2019-05-21Bibliographically approved
Stegberg, M., Hasselgren, M., Montgomery, S., Lisspers, K., Ställberg, B., Janson, C. & Sundh, J. (2018). Changes in smoking prevalence and cessation support, and factors associated with successful smoking cessation in Swedish patients with asthma and COPD. European Clinical Respiratory Journal, 5, Article ID 1421389.
Open this publication in new window or tab >>Changes in smoking prevalence and cessation support, and factors associated with successful smoking cessation in Swedish patients with asthma and COPD
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2018 (English)In: European Clinical Respiratory Journal, ISSN 2001-8525, Vol. 5, article id 1421389Article in journal (Refereed) Published
Abstract [en]

Introduction: Our aim was to investigate changes in smoking prevalence, smoking cessation support and factors associated with successful smoking cessation in patients with asthma and COPD.

Methods: Questionnaires about available smoking cessation resources were completed by 54 primary health-care centers and 14 hospitals in central Sweden in 2005 and 2012. Patient data were collected using record reviews and patients questionnaires for two cohorts of randomly selected asthma and COPD patients in 2005 (n = 2306; with a follow up in 2012), and in 2014/ 2015 (n = 2620). Smoking prevalence, available individual and group smoking cessation support, and factors associated with successful smoking cessation were explored.

Results: Smoking prevalence decreased from 11% to 6% (p < 0.0001) in patients with asthma but was almost unchanged in patients with COPD (28 to 26%, p = 0.37). Smoking cessation support increased from 53% to 74% (p = 0.01). A high cardiovascular risk factor level, including diabetes mellitus and hypertension was associated with improved smoking cessation in patients with asthma (OR (95% CI) 3.87 (1.04-14.4), p = 0.04). A higher magnitude success was observed in men with asthma (OR (95% CI) 27.9 (1.73-449), p = 0.02). More highly educated women with asthma had successful greater smoking cessation (4.76 (1.22-18.7), p = 0.04). No significant associations were found in COPD.

Conclusions: The smoking prevalence in patients with asthma but not in COPD has almost halved in Sweden during a 7-year period. The availability of smoking cessation support has increased. Suggested factors related to successful smoking cessation are higher level of education in women with asthma and cardiovascular risk factors in men and women with asthma.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2018
Keywords
Smoking prevalence, smoking cessation support, primary care, secondary care, cardiovascular risk factors, high educational level
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-64414 (URN)10.1080/20018525.2017.1421389 (DOI)000419510300001 ()29321831 (PubMedID)
Available from: 2018-01-19 Created: 2018-01-19 Last updated: 2018-08-20Bibliographically approved
Giezeman, M., Hasselgren, M., Lisspers, K., Ställberg, B., Montgomery, S., Janson, C. & Sundh, J. (2018). Influence of comorbid heart disease on dyspnea and health status in patients with COPD - a cohort study. The International Journal of Chronic Obstructive Pulmonary Disease, 13, 3857-3865
Open this publication in new window or tab >>Influence of comorbid heart disease on dyspnea and health status in patients with COPD - a cohort study
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2018 (English)In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 13, p. 3857-3865Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim of this study was to examine the changing influence over time of comorbid heart disease on symptoms and health status in patients with COPD.

Patients and methods: This is a prospective cohort study of 495 COPD patients with a baseline in 2005 and follow-up in 2012. The study population was divided into three groups: patients without heart disease (no-HD), those diagnosed with heart disease during the study period (new-HD) and those with heart disease at baseline (HD). Symptoms were measured using the mMRC. Health status was measured using the Clinical COPD Questionnaire (CCQ) and the COPD Assessment Test (CAT; only available in 2012). Logistic regression with mMRC $2 and linear regression with CCQ and CAT scores in 2012 as dependent variables were performed unadjusted, adjusted for potential confounders, and additionally adjusted for baseline mMRC, respectively, CCQ scores.

Results: Mean mMRC worsened from 2005 to 2012 as follows: for the no-HD group from 1.8 (+/- 1.3) to 2.0 (+/- 1.4), (P=0.003), for new-HD from 2.2 (+/- 1.3) to 2.4 (+/- 1.4), (P=0.16), and for HD from 2.2 (+/- 1.3) to 2.5 (+/- 1.4), (P=0.03). In logistic regression adjusted for potential confounding factors, HD (OR 1.71; 95% CI: 1.03-2.86) was associated with mMRC $ 2. Health status worsened from mean CCQ as follows: for no-HD from 1.9 (+/- 1.2) to 2.1 (+/- 1.3) with (P=0.01), for new-HD from 2.3 (+/- 1.5) to 2.6 (+/- 1.6) with (P=0.07), and for HD from 2.4 (+/- 1.1) to 2.5 (+/- 1.2) with (P=0.57). In linear regression adjusted for potential confounders, HD (regression coefficient 0.12; 95% CI: 0.04-5.91) and new-HD (0.15; 0.89-5.92) were associated with higher CAT scores. In CCQ functional state domain, new-HD (0.14; 0.18-1.16) and HD (0.12; 0.04-0.92) were associated with higher scores. After additional correction for baseline mMRC and CCQ, no statistically significant associations were found.

Conclusion: Heart disease contributes to lower health status and higher symptom burden in COPD but does not accelerate the worsening over time.

Place, publisher, year, edition, pages
DOVE Medical Press Ltd., 2018
Keywords
COPD Assessment Test, CAT, Clinical COPD Questionnaire, CCQ, modified Medical Research Council dyspnea score, mMRC, ischemic heart disease, heart failure
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-70781 (URN)10.2147/COPD.S175641 (DOI)000452171700001 ()
Available from: 2018-12-17 Created: 2018-12-17 Last updated: 2018-12-17Bibliographically approved
Zakrisson, A.-B., Arne, M., Hasselgren, M., Lisspers, K., Sandelowsky, H., Ställberg, B., . . . Theander, K. (2017). A description of requests for self-management support among patients with COPD in Primary Health Care. Paper presented at European-Respiratory-Society (ERS) International Congress, Milan, Italy, Sep. 9-13, 2017. European Respiratory Journal, 50(Sup. 61), Article ID PA1605.
Open this publication in new window or tab >>A description of requests for self-management support among patients with COPD in Primary Health Care
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2017 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 50, no Sup. 61, article id PA1605Article in journal, Meeting abstract (Refereed) Published
Place, publisher, year, edition, pages
European Respiratory Society, 2017
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-67266 (URN)10.1183/1393003.congress-2017.PA1605 (DOI)000431748901343 ()
Conference
European-Respiratory-Society (ERS) International Congress, Milan, Italy, Sep. 9-13, 2017
Available from: 2018-06-14 Created: 2018-06-14 Last updated: 2018-06-14Bibliographically approved
Sundh, J., Åberg, J., Hasselgren, M., Montgomery, S., Ställberg, B., Lisspers, K. & Janson, C. (2017). Factors influencing pharmacological treatment in COPD: a comparison of 2005 and 2014. European Clinical Respiratory Journal, 4, Article ID 1409060.
Open this publication in new window or tab >>Factors influencing pharmacological treatment in COPD: a comparison of 2005 and 2014
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2017 (English)In: European Clinical Respiratory Journal, ISSN 2001-8525, Vol. 4, article id 1409060Article in journal (Refereed) Published
Abstract [en]

Introduction: The aim was to investigate how the pattern of pharmacological treatment in Swedish patients with chronic obstructive pulmonary disease (COPD) has changed over a decade, and to identify factors associated with treatment.

Methods: Data on patient characteristics and pharmacological treatment were collected using questionnaires from two separate cohorts of randomly selected primary and secondary care patients with a doctor's diagnosis of COPD in central Sweden, in 2005 (n = 1111) and 2014 (n = 1329). Cross-tabulations and chi-square tests were used to compare maintenance treatment in 2005 and 2014, and to investigate the distribution of treatment by the 2017 Global Initiative for Obstructive Lung Disease (GOLD) ABCD groups. Multinomial logistic regression was used to analyze associations with the major types of recommended treatments: bronchodilator therapy, combined long-acting beta-2-antagonists (LABA) + inhaled corticosteroids (ICS), and triple inhaled therapy.

Results: The proportion of patients with no maintenance treatment, with only LABA + ICS, and with sole ICS statistically significantly decreased (36 vs. 31%, 16 vs. 12% and 5 vs. 2%, respectively), and the proportion with triple inhaled therapy statistically significantly increased (29 vs. 40%). In 2014, triple inhaled therapy was the most common treatment in all GOLD groups except group A. In 2014, previous frequent exacerbations [OR (95% CI) 2.34 (1.62 to 3.36)], worse COPD Assessment Test score [1.07 (1.05 to 1.09)], female sex [2.13 (1.56 to 2.91)], and access to a specific responsible doctor [1.95 (1.41 to 2.69)] were associated with triple inhaled therapy. Current smoking [0.40 (0.28 to 0.57)] and overweight [0.62 (0.41 to 0.93)] were inversely associated with triple inhaled therapy.

Conclusions: Over the last decade, triple inhaled therapy has increased, and no maintenance treatment, ICS, or LABA + ICS has decreased. Triple inhaled therapy is the most common treatment and is associated with previous exacerbations, higher symptom level, female sex, and having a specific responsible doctor.

Place, publisher, year, edition, pages
Taylor & Francis, 2017
Keywords
LAMA, LABA, ICS, bronchodilator therapy, triple inhaled therapy, symptoms, frequent exacerbations GOLD 2017
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-63422 (URN)10.1080/20018525.2017.1409060 (DOI)000417152400001 ()
Available from: 2017-12-19 Created: 2017-12-19 Last updated: 2018-08-13Bibliographically approved
Sundh, J., Wireklint, P., Hasselgren, M., Montgomery, S., Ställberg, B., Lisspers, K. & Janson, C. (2017). Health-related quality of life in asthma patients: A comparison of two cohorts from 2005 and 2015. Respiratory Medicine, 132, 154-160
Open this publication in new window or tab >>Health-related quality of life in asthma patients: A comparison of two cohorts from 2005 and 2015
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2017 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 132, p. 154-160Article in journal (Refereed) Published
Abstract [en]

Introduction: The aim was to investigate temporal variation in Health-Related Quality of Life (HRQL) and factors influencing low HRQL, in patients with asthma.

Material and methods: Questionnaire data on patient characteristics and the mini-Asthma Quality of Life Questionnaire (mini-AQLQ) scores from two separate cohorts of randomly selected Swedish primary and secondary care asthma patients, in 2005 (n = 1034) and 2015 (n = 1126). Student's t-test and analysis of covariance with adjustment for confounders compared mini-AQLQ total and domain scores in 2005 and 2015. Multivariable linear regression analyzed associations with mini-AQLQ scores.

Results: The mean Mini-AQLQ scores were unchanged between 2005 and 2015 (adjusted means (95% CI) 2005: 5.39 (5.27-5.33) and in 2015: 5.44 (95% CI 5.32 to 5.38), p = 0.26). Overweight (regression coefficient 95% CI) (0.21 (-0.36 to -0.07)), obesity (-0.34 (-0,50 to -0.18)), one or more exacerbations during the previous six months (-0.64 (-0.79 to -0.50)), self-rated moderate/severe disease (-1.02 (-1.15 to-0.89)), heart disease (-0.42 (-0.68 to-0.16)), anxiety/depression (-0.31 (-0.48 to -0.13)) and rhinitis (-0.25 (-0.42 to -0.08)) were associated with lower HRQL. Higher educational level (0.32 (0.19-0.46)) and self-reported knowledge of self-management of exacerbations (0.35 (0.19-0.51)) were associated with higher HRQL.

Conclusions: HRQL in Swedish patients with asthma is generally good and unchanged during the last decade. Overweight, obesity, exacerbations, self-rated moderate/severe disease, heart disease, depression/anxiety and rhinitis were associated with lower HRQL, and high educational level and knowledge on self-management with higher HRQL.

Place, publisher, year, edition, pages
Saunders Elsevier, 2017
Keywords
Asthma, Health-related quality of life, Mini-AQLQ, Risk factors
National Category
Cardiac and Cardiovascular Systems Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-63966 (URN)10.1016/j.rmed.2017.10.010 (DOI)000418239100024 ()29229090 (PubMedID)2-s2.0-85032193787 (Scopus ID)
Funder
Swedish Heart Lung FoundationSwedish Asthma and Allergy Association
Note

Funding Agencies:

Uppsala-Örebro Health Care region

Bror Hjerpstedts Foundation  

Center for Clinical Research, Dalarna  

Region Örebro County through ALF 

Available from: 2018-01-09 Created: 2018-01-09 Last updated: 2018-09-13Bibliographically approved
Zakrisson, A.-B., Arne, M., Hasselgren, M., Lisspers, K., Lundh, L., Sandelowsky, H., . . . Theander, K. (2017). Improved quality of care by the PRISMS form in supporting self-management in patients with COPD: A Randomized Controlled Trial (RCT). In: : . Paper presented at IPCRG 5th Scientific Meeting, Ljubljana, Slovenia, May 17-18, 2017.
Open this publication in new window or tab >>Improved quality of care by the PRISMS form in supporting self-management in patients with COPD: A Randomized Controlled Trial (RCT)
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2017 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Patient Report Informing Self-Management Support (PRISMS) could be a useful tool to improve quality of care in supporting self-management. Personal attention is an important part of a person-centered approach.

National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-67447 (URN)
Conference
IPCRG 5th Scientific Meeting, Ljubljana, Slovenia, May 17-18, 2017
Available from: 2018-06-21 Created: 2018-06-21 Last updated: 2019-04-03Bibliographically approved
Sundh, J., Lindgren, H., Hasselgren, M., Montgomery, S., Janson, C., Ställberg, B. & Lisspers, K. (2017). Pulmonary rehabilitation in COPD - available resources and utilization in Swedish primary and secondary care. The International Journal of Chronic Obstructive Pulmonary Disease, 12, 1695-1704
Open this publication in new window or tab >>Pulmonary rehabilitation in COPD - available resources and utilization in Swedish primary and secondary care
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2017 (English)In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 12, p. 1695-1704Article in journal (Refereed) Published
Abstract [en]

Introduction: Pulmonary rehabilitation is effective in all stages of COPD. The availability and utilization of pulmonary rehabilitation resources, and the characteristics of COPD patients receiving rehabilitation, were investigated in primary and secondary care in central Sweden.

Materials and methods: Data on available pulmonary rehabilitation resources were collected using questionnaires, to 14 hospitals and 54 primary health care centers, and information on utilization of different rehabilitation professionals was obtained from questionnaires completed by 1,329 COPD patients from the same centers. Multivariable logistic regression examined associations with having received rehabilitation in the previous year.

Results: In primary care, nurse- based asthma/COPD clinics were common (87%), with additional separate access to other rehabilitation professionals. In secondary care, rehabilitation was more often offered as part of a multidisciplinary teamwork (71%). In total, 36% of the patients met an asthma/COPD nurse in the previous year. Utilization was lower in primary than in secondary care for physiotherapists (7% vs 16%), occupational therapists (3% vs 10%), nutritionists (5% vs 13%), and counselors (1% vs 4%). A higher COPD Assessment Test score and frequent exacerbations were associated with higher utilization of all rehabilitation professionals.

Conclusion: Pulmonary rehabilitation resources are available but underutilized, and receiving rehabilitation is more common in severe COPD. Treatment recommendations need to be better implemented, especially in mild and moderate COPD.

Place, publisher, year, edition, pages
DOVE Medical Press Ltd., 2017
Keywords
multidisciplinary, asthma/COPD nurse, physiotherapist, occupational therapist, nutritionist, counselor
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-58797 (URN)10.2147/COPD.S135111 (DOI)000402968500002 ()28652722 (PubMedID)2-s2.0-85020823895 (Scopus ID)
Funder
Swedish Heart Lung FoundationSwedish Asthma and Allergy Association
Note

Funding Agencies:

County councils of the Uppsala-Orebro Health Care region

Bror Hjerpstedts Foundation  

Örebro Society of Medicine  

Region Örebro County through ALF (Avtal om Läkarutbildning och Forskning) 

Available from: 2017-07-26 Created: 2017-07-26 Last updated: 2018-07-20Bibliographically approved
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