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Angelhoff, Charlotte, medicine doktor
Publications (10 of 13) Show all publications
Angelhoff, C., Edéll-Gustafsson, U. & Morelius, E. (2019). The cortisol response in parents staying with a sick child at hospital. Nursing Open, 6(2), 620-625
Open this publication in new window or tab >>The cortisol response in parents staying with a sick child at hospital
2019 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 2, p. 620-625Article in journal (Refereed) Published
Abstract [en]

Aim

To study the cortisol response in parents staying with their child in paediatric wards, to compare the parents’ cortisol levels between the paediatric ward and at home 4 weeks after discharge and to compare the parents’ cortisol levels with data of an adult reference population, reported by Wust et al., as there are few studies investigating parental cortisol.

Design

This study has a descriptive and prospective comparative design.

Method

Thirty‐one parents participated. Saliva samples were collected in the paediatric ward and 4 weeks later at home.

Results

The parents had lower morning awakening cortisol levels in the paediatric ward than at home after discharge. There were no statistically significant differences in postawakening cortisol or cortisol awakening response (CAR). The child's age, diagnosis or previously diagnosed chronic condition did not affect the parents’ cortisol levels. The morning and postawakening cortisol levels were lower than those of the reference population.

Conclusion

The hospital stay with a sick child affects parents’ cortisol levels. Parental stress needs more attention to find interventions to prevent the risk of stress‐related complications that subsequently can affect the care of the child.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2019
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-155717 (URN)10.1002/nop2.245 (DOI)000461835600041 ()30918712 (PubMedID)2-s2.0-85062974527 (Scopus ID)
Projects
What about the parents?: Sleep quality, mood, saliva cortisol response and sense of coherence in parents with a child admitted to pediatric care
Funder
Medical Research Council of Southeast Sweden (FORSS), FORSS‐159681
Available from: 2019-03-25 Created: 2019-03-25 Last updated: 2019-09-24Bibliographically approved
Angelhoff, C., Thernström Blomqvist, Y., Sahlén Helmer, C., Olsson, E., Shorey, S., Frostell, A. & Mörelius, E. (2018). Effect of skin-to-skin contact on parents sleep quality, mood, parent-infant interaction and cortisol concentrations in neonatal care units: study protocol of a randomised controlled trial. BMJ Open, 8(7), Article ID e021606.
Open this publication in new window or tab >>Effect of skin-to-skin contact on parents sleep quality, mood, parent-infant interaction and cortisol concentrations in neonatal care units: study protocol of a randomised controlled trial
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2018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 7, article id e021606Article in journal (Refereed) Published
Abstract [en]

Introduction Separation after preterm birth is a major stressor for infants and parents. Skin-to-skin contact (SSC) is a method of care suitable to use in the neonatal intensive care unit (NICU) to minimise separation between parents and infants. Less separation leads to increased possibilities for parent-infant interaction, provided that the parents’ sleep quality is satisfactory. We aimed to evaluate the effect of continuous SSC on sleep quality and mood in parents of preterm infants born <33 weeks of gestation as well as the quality of parent-infant interaction and salivary cortisol concentrations at the time of discharge.

Methods and analysis A randomised intervention study with two arms—intervention versus standard care. Data will be collected from 50 families. Eligible families will be randomly allocated to intervention or standard care when transferred from the intensive care room to the family-room in the NICU. The intervention consists of continuous SSC for four consecutive days and nights in the family-room. Data will be collected every day during the intervention and again at the time of discharge from the hospital. Outcome measures comprise activity tracker (Actigraph); validated self-rated questionnaires concerning sleep, mood and bonding; observed scorings of parental sensitivity and emotional availability and salivary cortisol. Data will be analysed with pairwise, repeated measures, Mann Whitney U-test will be used to compare groups and analysis of variance will be used to adjust for different hospitals and parents’ gender.

Ethics and dissemination The study is approved by the Regional Research Ethics Board at an appropriate university (2016/89–31). The results will be published in scientific journals. We will also use conferences and social media to disseminate our findings.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
Keywords
attachment; bonding; kangaroo mother care; neonata care; sleep; Stress
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-152093 (URN)10.1136/bmjopen-2018-021606 (DOI)000446181900144 ()30068615 (PubMedID)2-s2.0-85053045224 (Scopus ID)
Note

Funding Agencies|County Council of Ostergotland [LIO-720151, LIO-663781]; Medical Research of Southeast Sweden [FORSS-661721]

Available from: 2018-10-17 Created: 2018-10-17 Last updated: 2019-05-02Bibliographically approved
Angelhoff, C., Edéll-Gustafsson, U. & Mörelius, E. (2018). Sleep quality and mood in mothers and fathers accommodated in the family-centred paediatric ward. Journal of Clinical Nursing, 27(3-4), e544-e550
Open this publication in new window or tab >>Sleep quality and mood in mothers and fathers accommodated in the family-centred paediatric ward
2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 3-4, p. e544-e550Article in journal (Refereed) Published
Abstract [en]

Aims and objectives

To describe sleep quality and mood in parents accommodated with their sick child in a family‐centred paediatric ward. Secondary aims were to compare mothers’ and fathers’ sleep quality and mood in the paediatric ward and to compare the parents’ sleep quality and mood between the paediatric ward and in a daily‐life home setting after discharge.

Background

Frequent interruptions, ward noise and anxiety affect parents’ sleep quality and mood negatively when accommodated with their sick child in paediatric wards. Poor sleep quality and negative mood decrease the parents’ ability to sustain attention and focus, and to care for their sick child.

Methods

This was a prospective and descriptive study. Eighty‐two parents (61 mothers and 21 fathers) with children (median age 6.25 years) admitted to six paediatric wards participated in the study. Uppsala Sleep Inventory, a sleep diary and the Mood Adjective Checklist were used to measure sleep quality and mood.

Results

The parents had a good sleep quality in the paediatric ward even though they had more nocturnal awakenings compared to home. Moreover, they were less alert, less interested and had reduced concentration, and were more tired, dull and passive in the hospital than at home after discharge. Vital sign checks, noises made by the staff and medical treatment were given reasons influencing sleep. Poor sleep quality correlated with negative mood.

Conclusion

Parents’ sleep quality in family‐centred paediatric care is good. However, the habitual sleep efficacy before admittance to the hospital is lower than expected and needs to be further investigated.

Relevance to Clinical Practice

The healthcare professionals should acknowledge parents’ sleep and mood when they are accommodated with their sick child. Further should care at night be scheduled and sleep promoted for the parents to maintain health and well‐being in the family.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
adolescents, child, child nursing, children’s nurses, family nursing, family-centred care, hospitalised child, paediatrics, parent, sleep
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-143585 (URN)10.1111/jocn.14092 (DOI)000425733600018 ()28960555 (PubMedID)2-s2.0-85037348121 (Scopus ID)
Note

Funding agencies: Medical Research Council of Southeast Sweden [FORSS-159681]; Region of Ostergotland, Sweden

Available from: 2017-12-11 Created: 2017-12-11 Last updated: 2019-05-01Bibliographically approved
Angelhoff, C., Askenteg, H., Wikner, U. & Edéll-Gustafsson, U. (2018). "To Cope with Everyday Life, I Need to Sleep" - A Phenomenographic Study Exploring Sleep Loss in Parents of Children with Atopic Dermatitis.. Journal of Pediatric Nursing: Nursing Care of Children and Families, 43, E59-E65
Open this publication in new window or tab >>"To Cope with Everyday Life, I Need to Sleep" - A Phenomenographic Study Exploring Sleep Loss in Parents of Children with Atopic Dermatitis.
2018 (English)In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 43, p. E59-E65Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The whole family is affected when a child has atopic dermatitis (AD), and parents experience sleep disruption related to the child's condition leading to physical and mental exhaustion, mood swings, loss of concentration and lower job performance. This study aimed to explore and describe perceptions of sleep in parents of children <2 years old with AD, consequences of parental sleep loss, and what strategies the parents used to manage sleep loss and to improve sleep.

DESIGN AND METHODS: This qualitative interview study had an inductive and descriptive design. Twelve parents (eleven mothers and one father) participated in the study. Data analysis was performed using a phenomenographic approach.

RESULTS: Three categories of description were found: Acceptance and normalization of parental sleep loss; Changed routines and behavior to compensate for sleep loss; and Support is needed to gain sleep and manage daily life.

CONCLUSIONS: Sleep loss due to the child's AD affected the parents' emotional state, mood, well-being, cognitive function, ability to concentrate and take initiative, and sensitivity to stress and sound negatively. The parents managed their sleep loss mainly by changing their behavior and creating new routines, by taking me-time and through support from partners.

PRACTICE IMPLICATIONS: Pediatric nurses should acknowledge sleep loss in parents of small children with AD in time to prevent negative consequences, which affect the well-being of the entire family. Advice on how to improve sleep should be given early to increase the parents' understanding, make them feel safer and strengthen them in their parenthood.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Atopic dermatitis, Family nursing, Family-centered care, Pediatric nursing, Pediatrics
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-152216 (URN)10.1016/j.pedn.2018.07.005 (DOI)000450921100011 ()30037591 (PubMedID)
Available from: 2018-10-22 Created: 2018-10-22 Last updated: 2019-05-02
Edéll-Gustfsson, U., Angelhoff, C., Johnsson, E., Karlsson, J. & Mörelius, E.-L. (2015). Hindering and buffering factors for parental sleep in neonatal care.: A phenomenographic study. In: Joav Merrick (Ed.), Disability, Chronic Disease and Human Development: . Paper presented at The Gerry Schwartz and Heather Reisman 4th International Conference on Pediatric Chronic Diseases, Disability and Human Development: ICCD 2015 Jerusalem Israel, 20- 23 January 2015. Nova Science Publishers, Inc. (5-6)
Open this publication in new window or tab >>Hindering and buffering factors for parental sleep in neonatal care.: A phenomenographic study
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2015 (English)In: Disability, Chronic Disease and Human Development / [ed] Joav Merrick, Nova Science Publishers, Inc., 2015, no 5-6Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Background

Parents experience many stressful situations when their newborn infant is preterm and/or sick. This affects bonding. By developing more family-centered care units with single-family rooms, parents are given the opportunity to stay and care for their newborn infant(s) twenty-four hours a day. Lack of sleep may affect the new parents’ ability to handle the situation.

Aim

To explore and describe how parents of preterm and/or sick infants in neonatal care perceive their sleep.

Methods This is a phenomenographic study with an inductive, exploratory design. Semi-structured interviews were conducted with twelve parents of infants in neonatal care. Data was analysed to describe variations of the phenomenon.

Findings

Four descriptive categories were identified within the phenomenon sleep in parents of preterm and/or sick infants in neonatal care; Impact of stress on sleep, How the environment affects sleep, Keeping the family together improves sleep, and How parents manage and prevent tiredness.

Conclusion

Anxiety, uncertainty and powerlessness have a negative influence on sleep. This can be decreased by continuous information, guidance, and practical support. Skin-to-skin-care is an important source for recovery, relaxation and sleep, and should be encouraged by the nurse. The parents also mentioned the importance of being together. To have a private place where they could relax and take care of themselves and their newborn infant improved sleep. It was also desirable to involve older siblings in order to decrease feelings of loneliness, sadness and isolation. Improved parental sleep in the neonatal care may help the families to cope with the situation, and facilitate problem-solving, emotional regulation, and the transition to parenthood.

Place, publisher, year, edition, pages
Nova Science Publishers, Inc., 2015
Keywords
sleep, parents, neonatal intensive care
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-117699 (URN)978-1-63483-029-4 (ISBN)
Conference
The Gerry Schwartz and Heather Reisman 4th International Conference on Pediatric Chronic Diseases, Disability and Human Development: ICCD 2015 Jerusalem Israel, 20- 23 January 2015
Available from: 2015-05-07 Created: 2015-05-07 Last updated: 2016-05-27Bibliographically approved
Edéll-Gustafsson, U., Angelhoff, C., Johnsson, E., Karlsson, J. & Mörelius, E. (2015). Hindering and buffering factors for parental sleep in neonatal care. A phenomenographic study. Journal of Clinical Nursing, 24(5-6), 717-727
Open this publication in new window or tab >>Hindering and buffering factors for parental sleep in neonatal care. A phenomenographic study
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2015 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 5-6, p. 717-727Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES:

To explore and describe how parents of preterm and/or sick infants in neonatal care perceive their sleep.

BACKGROUND:

Parents experience many stressful situations when their newborn infant is preterm and/or sick. This affects bonding. By developing more family-centred care units with single-family rooms, parents are given the opportunity to stay and care for their newborn infant(s) 24 hours a day. Lack of sleep may affect new parents' ability to cope with the many challenges they face on a daily basis.

DESIGN:

A phenomenographic study with an inductive and exploratory design.

METHODS:

Semi-structured interviews were conducted with twelve parents of infants in neonatal care between January-March 2012. To describe variations in perception of the phenomenon, data were analysed using phenomenography.

FINDINGS:

Four descriptive categories were identified within the phenomenon sleep in parents of preterm and/or sick infants in neonatal care: impact of stress on sleep; how the environment affects sleep; keeping the family together improves sleep; and, how parents manage and prevent tiredness.

CONCLUSION:

Anxiety, uncertainty and powerlessness have a negative influence on sleep. This can be decreased by continuous information, guidance and practical support. Skin-to-skin care was perceived as a stress-reducing factor that improved relaxation and sleep and should be encouraged by the nurse. The parents also mentioned the importance of being together. Having a private place where they could relax and take care of themselves and their newborn infant improved sleep. It was also desirable to involve older siblings in order to decrease feelings of loneliness, sadness and isolation.

RELEVANCE FOR CLINICAL PRACTICE:

Improved parental sleep in neonatal care may help the families cope with the situation and facilitate problem-solving, emotional regulation and the transition to parenthood.

Place, publisher, year, edition, pages
John Wiley & Sons, 2015
Keywords
family nursing; family-centred care; kangaroo mother care; neonatal intensive care; nursing; siblings; skin-to-skin care
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-115549 (URN)10.1111/jocn.12654 (DOI)000350354700010 ()25041598 (PubMedID)
Funder
Medical Research Council of Southeast Sweden (FORSS)Östergötland County Council
Available from: 2015-03-16 Created: 2015-03-16 Last updated: 2017-12-04
Angelhoff, C., Edéll-Gustafsson, U. & Mörelius, E. (2015). Parental mood when staying overnight at hospital with their sick child. In: : . Paper presented at 3rd NUS - NUH International Nursing Conference & 20th Joint Singapore - Malaysia Nursing Conference, Singapore, November 18-20, 2015.
Open this publication in new window or tab >>Parental mood when staying overnight at hospital with their sick child
2015 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Parental mood when staying overnight at hospital with their sick child

Objective

to describe mood in parents, staying with their sick children overnight at the hospital.

Methodology

A descriptive design, including 75 parents staying overnight at hospital with their sick child, was used. The parents filled out Mood-scale the morning after staying overnight at the hospital. The Mood-scale is a validated and reliable self-administered instrument measuring six dimensions of mood; control, calmness, social orientation, pleasantness, activation, and extraversion (Sjöberg L, 1979). The study is a part of a larger project, with focus on mood, stress and sleep in parents staying with their sick children overnight at the hospital.

Results

The result will describe how parents report their total mood and how they report the different dimensions when they stay with their sick children overnight at the hospital. A comparison will be made between the parent´s mood and gender and the child´s age. Data is under analysis and will be presented as preliminary data.

 

Conclusion

According to UNICEF Convention on the Rights of the Child, children in hospital have the right to have their parents with them at all times and parents should be offered accommodation and be encouraged to stay. However, the hospital environment, in combination with having a sick child, might affect the parent´s mood, which in turn might affect the ability to handle the situation and the child´s care. Therefore it is of importance to study parental mood and find ways to help the families during their hospital stay.

National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-127473 (URN)
Conference
3rd NUS - NUH International Nursing Conference & 20th Joint Singapore - Malaysia Nursing Conference, Singapore, November 18-20, 2015
Available from: 2016-04-27 Created: 2016-04-27 Last updated: 2016-05-27
Angelhoff, C., Edéll-Gustfsson, U. & Mörelius, E. (2015). Parents´ perception of circumstances influencing their own sleep when living with a child enrolled in hospital-based home care services. In: Kerem, Eitan (Ed.), The Gerry Schwartz and Heather Reisman 4th International Conference on Pediatric Chronic Diseases, Disability and Human Development: ICCD 2015 Jerusalem Israel. Paper presented at The Gerry Schwartz and Heather Reisman 4th International Conference on Pediatric Chronic Diseases, Disability and Human Development. Jerusalem: Paragon Israel
Open this publication in new window or tab >>Parents´ perception of circumstances influencing their own sleep when living with a child enrolled in hospital-based home care services
2015 (English)In: The Gerry Schwartz and Heather Reisman 4th International Conference on Pediatric Chronic Diseases, Disability and Human Development: ICCD 2015 Jerusalem Israel / [ed] Kerem, Eitan, Jerusalem: Paragon Israel , 2015Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Background: Caring for a sick child creates great demands for the parents. Sleep is an important aspect of wellbeing and is strongly related to stress and quality of life. Caring for a child at home gives the family the opportunity to be together in a familiar environment, but includes several sleep disturbances during the night which affects the ability to handle the situation.

Aim: To describe parents’ perceptions of circumstances influencing their own sleep, living with a child enrolled in Hospital-Based Home Care Services.

Method: This is a phenomenographic study with an inductive, exploratory design, using semi-structured interviews with main and follow-up questions. Fifteen parents with children enrolled in Hospital-Based Home Care Services were included.

Findings: The outcome space consists of four descriptive categories: s; Sleep influence mood and mood influences sleep, Support and safeness influence sleep, The child´s needs and routines influence sleep, and Me-time influences sleep.

Discussion: Parents to children in Hospital-Based Home Care Services perceive their sleep differently depending on how safe they feel with the situation. Troubling thoughts, bedtime worries, anxiety and stress affect sleep negatively. Safeness is prerequisite for sleep. Shared responsibility and social support help the parents to cope with the daily life and thus facilitate sleep. The parents adjust their routines after the cild´s needs to find time for sleep and relaxation. Me-time and physical activity was perceived as important tools to improve coping and sleeping.

Place, publisher, year, edition, pages
Jerusalem: Paragon Israel, 2015
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-115552 (URN)
Conference
The Gerry Schwartz and Heather Reisman 4th International Conference on Pediatric Chronic Diseases, Disability and Human Development
Available from: 2015-03-16 Created: 2015-03-16 Last updated: 2015-03-16
Angelhoff, C., Edéll-Gustfsson, U. & Mörelius, E. (2015). Sleep of Parents Living With a Child Receiving Hospital-Based Home Care: A Phenomenographical Study.. Nursing Research, 64(5), 372-380
Open this publication in new window or tab >>Sleep of Parents Living With a Child Receiving Hospital-Based Home Care: A Phenomenographical Study.
2015 (English)In: Nursing Research, ISSN 0029-6562, E-ISSN 1538-9847, Vol. 64, no 5, p. 372-380Article in journal (Refereed) Published
Abstract [en]

Background: Caring for an ill child at home gives the family the chance to be together in a familiar environment. However, this involves several nocturnal sleep disturbances, such as frequent awakenings and bad sleep quality, which may affect parents' ability to take care of the child and themselves.

Objectives: The aim of this study was to describe parents' perceptions of circumstances influencing their own sleep when living with a child enrolled in hospital-based home care (HBHC) services.

Method: This is a phenomenographical study with an inductive, exploratory design. Fifteen parents (11 mothers and 4 fathers) with children enrolled in HBHC services were interviewed. Data were analyzed to discover content-related categories describing differences in ways parents experienced sleep when caring for their children receiving HBHC.

Results: Four descriptive categories were detected: sleep influences mood and mood influences sleep; support influences safeness and safeness influences sleep; the child's needs influence routines and routines influence sleep; and "me time" influences sleep.

Discussion: Sleep does not affect only the parents' well-being but also the child's care. Symptoms of stress may limit the parents' capacity to meet the child's needs. Support, me time, and physical activity were perceived as essential sources for recovery and sleep. It is important for nurses to acknowledge parental sleep in the child's nursing care plan and help the parents perform self-care to promote sleep and maintain life, health, and well-being.

Place, publisher, year, edition, pages
Lippincott-Ravn Publisher, 2015
Keywords
children, chronic illness, home care services, parents, qualitative research, sleep
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-121085 (URN)10.1097/NNR.0000000000000108 (DOI)000361361000006 ()26325279 (PubMedID)
Projects
Parents’ stress and sleep quality when their children need medical care
Funder
Östergötland County CouncilMedical Research Council of Southeast Sweden (FORSS)
Available from: 2015-09-07 Created: 2015-09-07 Last updated: 2017-12-04Bibliographically approved
Angelhoff, C., Edéll-Gustfsson, U. & Mörelius, E. (2014). Perceptions of sleep by parents of children in hospital organized home-care. In: Programbok Barnveckan 2014, Malmö, 7-11 april,  2014: . Paper presented at Barnveckan 2014, Malmö, 7-11 april 2014 (pp. 33-33).
Open this publication in new window or tab >>Perceptions of sleep by parents of children in hospital organized home-care
2014 (English)In: Programbok Barnveckan 2014, Malmö, 7-11 april,  2014, 2014, p. 33-33Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Introduction

Caring for a sick child creates great demands for the parents. Sleep is an important aspect of wellbeing and is strongly related to stress and quality of life. Caring for a child at home gives the family the opportunity to be together in a familiar environment. On the other hand it includes several sleep disturbances during the night which affects the ability to handle the situation.

 

Aim

To explore parents’ perceptions of sleep living with a child enrolled in hospital-organized home-care.

 

Material

Fifteen parents with children enrolled in hospital-organized home-care were included.

 

Method

Interviews with open-ended questions, analysed with a phenomenographic method.

 

Results

Four descriptive categories were identified; Anxiety, stress and demands affects sleep negatively’, ‘When I get support I feel safe’, ‘Routines optimizes time for sleep’, and ‘Time for oneself is important for relaxation’

 

Conclusion

Sleep is important for the parents in several aspects. They are in a stressful situation with high demands both from the society and from themselves and there is often a lack of support from relatives and friends. Nurses need to acknowledge and promote parents’ sleep when they care for their sick children at home and support them in the caregiving.

Keywords
Parents, Sleep, Home Care Services, Child, Caregiver, Nursing
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-106056 (URN)
Conference
Barnveckan 2014, Malmö, 7-11 april 2014
Available from: 2014-04-22 Created: 2014-04-22 Last updated: 2014-04-22
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