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Learning Resources.

Assignment: Practicum – Week 1 Journal Entry

As a future advanced practice nurse, it is important that you are able to connect your classroom experience to your practicum experience. By applying the concepts you study in the classroom to clinical settings, you enhance your professional competency. Each week, you complete an Assignment that prompts you to reflect on your practicum experiences and relate them to the material presented in the classroom. This week, you begin documenting your practicum experiences in your Practicum Journal.

Note: Be sure to use the Practicum Journal Template, located in this week’s Learning Resources.

Learning Objectives

Students will:

· Analyze nursing and counseling theories to guide practice in psychotherapy*

· Summarize goals and objectives for personal practicum experiences*

· Produce timelines for practicum activities*

In preparation for this course’s practicum experience, address the following in your Practicum Journal:

· Select one nursing theory and one counseling theory to best guide your practice in psychotherapy.

· Explain why you selected these theories. Support your approach with evidence-based literature.

· Develop at least three goals and at least three objectives for the practicum experience in this course.

· Create a timeline of practicum activities based on your practicum requirements.

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healthcare policy and regulatory

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate.

To Prepare:

  • Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.
  • Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).
  • Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (1 page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

  • Briefly and generally explain the policy or regulation you selected.
  • Address the impact of the policy or regulation you selected on system implementation.
  • Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.
  • Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.

By Day 7 of Week 11

Submit your completed Policy/Regulation Fact Sheet.

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diabetes in adults or children.

Identify a research or evidence-based article that focuses comprehensively on a specific intervention or new diagnostic tool for the treatment of diabetes in adults or children.

In a paper of 750-1,000 words, summarize the main idea of the research findings for a specific patient population. Research must include clinical findings that are current, thorough, and relevant to diabetes and the nursing practice.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center. Only Word documents can be submitted to LopesWrite.

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: Coaching and Teaching

Module 10: Clinical case: Coaching and Teaching

Mrs. E. is 69 years old and was admitted for extremely high blood pressure which caused her to be dizzy and fall at home. She sprained her wrist and had multiple bruises and complained of some chest pain. She is a widow and lives with her two dogs. Her children live in the next state and try to visit her often. She does have one sister and brother-in-law who live in the same city. Mrs. E. has been relatively healthy during her life but since her husband passed away from a massive heart attack last year she has not been as active as she had been. She also has found it difficult to make meals only for herself. As a result, she has lost 15 pounds in the last year, she was already quite thin. Mrs. E. is a devout Christian and was born in India and emigrated to the United States when she was married due to her husband’s profession. She misses her husband and her children and does not like to visit her doctor hence the untreated hypertension. During her hospital stay amlodipine 2.5 mg/day was prescribed.

Submit an individual assignment. You may use any books or other resources or references to complete this assignment. Use APA Editorial Format for all citations and references.

  1. List the goal for this teaching/coaching plan
  2. Describe three teaching resources
  3. Identify the teaching strategies that can be used
  4. List the specific instructions that may be needed      regarding her medication and what adverse reactions to be aware of/and      what to do
  5. Identify two factors that may negatively influence      adherence to the medication and how they can be overcome
  6. Describe how to include the family
  7. Provide information on how and when she should seek      support and help

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Case Study

Read the “Resource 1: Case Study.”

Answer the questions at the end of the case study in a paper of 750-1,000 words.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. References please

A 22-year-old woman reports being “sick with the flu” for the past 8 days. She is vomiting several times every day, having difficulty keeping liquids or food down, and has been using more than the recommended dose of antacids in an attempt to calm the nausea. She has become severely dehydrated. After fainting at home, she was taken to a local hospital. An arterial blood gas sample was drawn and then an IV was placed to help rehydrate her. The arterial blood gas revealed the following:

Test  Result  Normal levels

pH  7.5  7.35 – 7.45

PaCO2 40 mm Hg 35-45 mm Hg

PaO2 95 mm Hg 80-100 mm Hg

SaO2  97% 95-100%

HCO3-  32 meq/liter 22-26 meq/liter

How would you classify the patient’s acid-base disturbance and explain why?

Given the case study, what are the possible factors causing this acid-base

disturbance? Explain the pathophysiology created by these factors.

How would the renal and respiratory systems try to compensate for this acid-base disturbance?

What pharmacologic intervention is commonly used to correct this acid-base disturbance? Describe the pharmacological actions.

Describe the educational needs for this patient and what your approach will be.

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narcotic drugs

Question 1 A patient has been prescribed a Scheduled 5 drug, an example of this drug is

Question 2 A nurse has just completed a

Question 1 A patient has been prescribed a Scheduled 5 drug, an example of this drug is

Question 2 A nurse has just completed a medication history on a newly admitted patient. In order to complete medication reconciliation for this patient the nurse will

Question 3 A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a

Question 4 A nurse works in a private hospital and needs to administer some narcotic drugs to one of her patients. Which of the following should the nurse consider when administering narcotics to patients in a hospital setting?

Question 5 Drugs have a valid medical use but a high potential for abuse, both psychological and physiologic. In an emergency, a Schedule 2 drug may be prescribed by telephone if a written prescription cannot be provided at the time. However, a written prescription must be provided within 72 hours with the words authorization for emergency dispensing written on the prescription. These prescriptions cannot be refilled. A new prescription must be written each time. Examples include certain amphetamines and barbiturates. This is scheduled drug

Question 6 A nurse receives an order to administer a critically ill patient two drugs immediately (stat). The nurse begins the process by

Question 7 A nurse working for a drug company is involved in phase III drug evaluation studies. Which of the following might the nurse be responsible for during this stage of drug development?

Question 8 Federal legislation dictates a lengthy and rigorous process of testing for new drugs. What is the primary purpose of this testing process?

Question 9 These drugs have a potential for abuse, but the potential is lower than for drugs on Schedule 2. These drugs contain a combination of controlled and noncontrolled substances. Use of these drugs can cause a moderate to low physiologic dependence and a higher psychological dependence. A verbal order can be given to the pharmacy and the prescription can be refilled up to five times within 6 months. Examples include certain narcotics (codeine) and nonbarbiturate sedatives. This is scheduled drug

Question 10 Which of the following patients should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?

Question 11 Drugs have a high potential for abuse. There is no routine therapeutic use for these drugs and they are not available for regular use.They may be obtained for “investigational use only” by applying to  the U.S. Drug Enforcement Agency. Examples include heroin and LSD. Which scheduled drug is this?

Question 12 A patient has taken an overdose of a vitamin/mineral supplement containing magnesium. The nurse will be sure to assess

Question 13 A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply.

Question 14 A nurse is caring for a 46-year-old patient of Chinese origin who has bipolar disorder. The physician has prescribed lithium carbonate (Eskalith) to treat the disorder. The nurse is aware that the lithium dose will likely be given in a

Question 15 The nurse practitioner orders Amoxicillin 250 mg/5 ml tid for 10 days? The nurse practitioner would expect the pharmacist to fill the prescription bottle with how many ml?

Question 16 A patient will begin three new medications as part of her treatment plan. The nurse practitioner understands that proper disposal of medications is key when the nurse practitioner states

Question 17 A nurse is providing a patient with a list of drugs as a part of the patient’s plan of care. Which of the following drug nomenclatures should the nurse use to list the drugs?

Question 18 A nurse is providing care for a 71-year-old woman who was sponsored to emigrate from Mexico to the United States 6 months ago. Earlier this week, the woman slipped while getting off a bus and fractured  her hip. How should the woman’s nurse best exemplify cultural competence in the care of this patient?

Question 19 Which of the following serves to protect the public by ensuring the purity of a drug and its contents?

Question 20 A nurse is admitting a Mexican woman to the hospital who cannot speak or understand English. The patient is alone, and there is no interpreter available. When trying to communicate with the patient the nurse will

Question 21 A patient comes to primary clinic for strep throat. A throat swab culture is sent to lab. What information is required for the nurse practitioner to disclose on lab transmittal?

Question 22 A Native American man who lives a traditional lifestyle is scheduled to have heart surgery. The tribal chief has requested that the tribe’s medicine man perform a ritual before the patient goes to surgery. The nurse’s response to this request should be

Question 23 A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that

Question 24 A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive

Question 25 A nurse is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called

on a newly admitted patient. In order to complete medication reconciliation for this patient the nurse will

Question 3 A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a

Question 4 A nurse works in a private hospital and needs to administer some narcotic drugs to one of her patients. Which of the following should the nurse consider when administering narcotics to patients in a hospital setting?

Question 5 Drugs have a valid medical use but a high potential for abuse, both psychological and physiologic. In an emergency, a Schedule 2 drug may be prescribed by telephone if a written prescription cannot be provided at the time. However, a written prescription must be provided within 72 hours with the words authorization for emergency dispensing written on the prescription. These prescriptions cannot be refilled. A new prescription must be written each time. Examples include certain amphetamines and barbiturates. This is scheduled drug

Question 6 A nurse receives an order to administer a critically ill patient two drugs immediately (stat). The nurse begins the process by

Question 7 A nurse working for a drug company is involved in phase III drug evaluation studies. Which of the following might the nurse be responsible for during this stage of drug development?

Question 8 Federal legislation dictates a lengthy and rigorous process of testing for new drugs. What is the primary purpose of this testing process?

Question 9 These drugs have a potential for abuse, but the potential is lower than for drugs on Schedule 2. These drugs contain a combination of controlled and noncontrolled substances. Use of these drugs can cause a moderate to low physiologic dependence and a higher psychological dependence. A verbal order can be given to the pharmacy and the prescription can be refilled up to five times within 6 months. Examples include certain narcotics (codeine) and nonbarbiturate sedatives. This is scheduled drug

Question 10 Which of the following patients should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?

Question 11 Drugs have a high potential for abuse. There is no routine therapeutic use for these drugs and they are not available for regular use.They may be obtained for “investigational use only” by applying to  the U.S. Drug Enforcement Agency. Examples include heroin and LSD. Which scheduled drug is this?

Question 12 A patient has taken an overdose of a vitamin/mineral supplement containing magnesium. The nurse will be sure to assess

Question 13 A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply.

Question 14 A nurse is caring for a 46-year-old patient of Chinese origin who has bipolar disorder. The physician has prescribed lithium carbonate (Eskalith) to treat the disorder. The nurse is aware that the lithium dose will likely be given in a

Question 15 The nurse practitioner orders Amoxicillin 250 mg/5 ml tid for 10 days? The nurse practitioner would expect the pharmacist to fill the prescription bottle with how many ml?

Question 16 A patient will begin three new medications as part of her treatment plan. The nurse practitioner understands that proper disposal of medications is key when the nurse practitioner states

Question 17 A nurse is providing a patient with a list of drugs as a part of the patient’s plan of care. Which of the following drug nomenclatures should the nurse use to list the drugs?

Question 18 A nurse is providing care for a 71-year-old woman who was sponsored to emigrate from Mexico to the United States 6 months ago. Earlier this week, the woman slipped while getting off a bus and fractured  her hip. How should the woman’s nurse best exemplify cultural competence in the care of this patient?

Question 19 Which of the following serves to protect the public by ensuring the purity of a drug and its contents?

Question 20 A nurse is admitting a Mexican woman to the hospital who cannot speak or understand English. The patient is alone, and there is no interpreter available. When trying to communicate with the patient the nurse will

Question 21 A patient comes to primary clinic for strep throat. A throat swab culture is sent to lab. What information is required for the nurse practitioner to disclose on lab transmittal?

Question 22 A Native American man who lives a traditional lifestyle is scheduled to have heart surgery. The tribal chief has requested that the tribe’s medicine man perform a ritual before the patient goes to surgery. The nurse’s response to this request should be

Question 23 A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that

Question 24 A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive

Question 25 A nurse is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called

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Main Diagnosis

Sample Soap Note:

 

Soap Note # Main Diagnosis ( Exp: H&P Note #3 DX: Hypertension)

Student Name

Miami Regional University

Date of Encounter:

Preceptor/Clinical Site:

Clinical Instructor: Dr. Rafael Camejo

 

Soap Note # Main Diagnosis ( Exp: Soap Note #3 DX: Hypertension)

PATIENT INFORMATION

Name: Mr. DT

Age: 68-year-old

Gender at Birth: Male

Gender Identity: Male

Source: Patient

Allergies: PCN, Iodine

Current Medications: 

· Atorvastatin tab 20 mg, 1-tab PO at bedtime

· ASA 81mg po daily

· Multi-Vitamin Centrum Silver

PMH: Hypercholesterolemia

Immunizations: Influenza last 2018-year, tetanus, and hepatitis A and B 4 years ago.

Preventive Care: Coloscopy 5 years ago (Negative)

Surgical History: Appendectomy 47 years ago.

Family History: Father- died 81 does not report information

Mother-alive, 88 years old, Diabetes Mellitus, HTN

Daughter-alive, 34 years old, healthy

Social History: No smoking history or illicit drug use, occasional alcoholic beverage consumption on social celebrations. Retired, widow, he lives alone.

Sexual Orientation: Straight

Nutrition History: Diets off and on, Does not each seafood

Subjective Data:

Chief Complaint: “headaches” that started two weeks ago

Symptom analysis/HPI:

The patient is 65 years old male who complaining of episodes of headaches and on 3 different occasions blood pressure was measured, which was high (159/100, 158/98 and 160/100 respectively). Patient noticed the problem started two weeks ago and sometimes it is accompanied by dizziness. He states that he has been under stress in his workplace for the last month. Patient denies chest pain, palpitation, shortness of breath, nausea or vomiting.

Review of Systems (ROS)

CONSTITUTIONAL: Denies fever or chills. Denies weakness or weight loss. NEUROLOGIC: Headache and dizziness as describe above. Denies changes in LOC. Denies history of tremors or seizures.

HEENT: HEAD: Denies any head injury, or change in LOC. Eyes: Denies any changes in vision, diplopia or blurred vision. Ear: Denies pain in the ears. Denies loss of hearing or drainage. Nose: Denies nasal drainage, congestion. THROAT: Denies throat or neck pain, hoarseness, difficulty swallowing.

RESPIRATORY: Patient denies shortness of breath, cough or hemoptysis.

CARDIOVASCULAR: No chest pain, tachycardia. No orthopnea or paroxysmal nocturnal

dyspnea.

GASTROINTESTINAL: Denies abdominal pain or discomfort. Denies flatulence, nausea, vomiting or

diarrhea.

GENITOURINARY: Denies hematuria, dysuria or change in urinary frequency. Denies difficulty starting/stopping stream of urine or incontinence.

MUSCULOSKELETAL: Denies falls or pain. Denies hearing a clicking or snapping sound.

SKIN: No change of coloration such as cyanosis or jaundice, no rashes or pruritus.

Objective Data:

VITAL SIGNS: Temperature: 98.5 °F, Pulse: 87, BP: 159/92 mmhg, RR 20, PO2-98% on room air, Ht- 6’4”, Wt 200 lb, BMI 25. Report pain 2/10.

GENERAL APPREARANCE: The patient is alert and oriented x 3. No acute distress noted. NEUROLOGIC: Alert, CNII-XII grossly intact, oriented to person, place, and timeSensation intact to bilateral upper and lower extremities. Bilateral UE/LE strength 5/5.

HEENT: Head: Normocephalic, atraumatic, symmetric, non-tender. Maxillary sinuses no tenderness. Eyes: No conjunctival injection, no icterus, visual acuity and extraocular eye movements intact. No nystagmus noted. Ears: Bilateral canals patent without erythema, edema, or exudate. Bilateral tympanic membranes intact, pearly gray with sharp cone of light. Maxillary sinuses no tenderness. Nasal mucosa moist without bleeding. Oral mucosa moist without lesions,. Lids non-remarkable and appropriate for race.

Neck: supple without cervical lymphadenopathy, no jugular vein distention, no thyroid swelling or masses.

CARDIOVASCULAR: S1S2, regular rate and rhythm, no murmur or gallop noted. Capillary refill < 2 sec.

RESPIRATORY: No dyspnea or use of accessory muscles observed. No egophony, whispered pectoriloquy or tactile fremitus on palpation. Breath sounds presents and clear bilaterally on auscultation.

GASTROINTESTINAL: No mass or hernia observed. Upon auscultation, bowel sounds present in all four quadrants, no bruits over renal and aorta arteries. Abdomen soft non-tender, no guarding, no rebound no distention or organomegaly noted on palpation

MUSKULOSKELETAL: No pain to palpation. Active and passive ROM within normal limits, no stiffness.

INTEGUMENTARY: intact, no lesions or rashes, no cyanosis or jaundice.

ASSESSMENT:

Main Diagnosis

Essential (Primary) Hypertension (ICD10 I10): Given the symptoms and high blood pressure (156/92 mmhg), classified as stage 2. Once the organic cause of hypertension has been ruled out, such as renal, adrenal or thyroid, this diagnosis is confirmed (Codina Leik, 2015). Diagnosis is based on the clinical evaluation through history, physical examination, and routine laboratory tests to assess risk factors, reveal identifiable causes and detect target-organ damage, including evidence of cardiovascular disease (Domino et al,. 2017).

Differential diagnosis:

Ø Renal artery stenosis (ICD10 I70.1)

Ø Chronic kidney disease (ICD10 I12.9)

Ø Hyperthyroidism (ICD10 E05.90)

PLAN:

Labs and Diagnostic Test to be ordered:

· CMP

· Complete blood count (CBC)

· Lipid profile

· Thyroid-stimulating hormone (TSH)

· Urinalysis with Micro

· Electrocardiogram (EKG 12 lead)

Pharmacological treatment: 

· Hydrochlorothiazide tab 25 mg, Initial dose: 25 mg orally once daily.

· Lisinopril 10mg PO Daily

Non-Pharmacologic treatment:

· Weight loss

· Healthy diet (DASH dietary pattern): Diet rich in fruits, vegetables, whole grains, and low-fat dairy products with reduced content of saturated and trans l fat

· Reduced intake of dietary sodium: <1,500 mg/d is optimal goal but at least 1,000 mg/d reduction in most adults

· Enhanced intake of dietary potassium

· Regular physical activity (Aerobic): 90–150 min/wk

· Tobacco cessation

· Measures to release stress and effective coping mechanisms.

Education

· Provide with nutrition/dietary information.

· Daily blood pressure monitoring log at home twice a day for 7 days, keep a record, bring the record on the next visit with her PCP

· Instruction about medication intake compliance.

· Education of possible complications such as stroke, heart attack, and other problems.

· Patient was educated on course of hypertension, as well as warning signs and symptoms, which could indicate the need to attend the E.R/U.C. Answered all pt. questions/concerns. Pt verbalizes understanding to all

Follow-ups/Referrals

· Follow up appointment 1 weeks for managing blood pressure and to evaluate current hypotensive therapy.

· No referrals needed at this time.

References

Domino, F., Baldor, R., Golding, J., Stephens, M. (2017). The 5-Minute Clinical Consult 2017

(25th ed.). Print (The 5-Minute Consult Series).

Codina Leik, M. T. (2014). Family Nurse Practitioner Certification Intensive Review (2nd ed.).

ISBN 978-0-8261-3424-0

Note:
I need it to be very low deplagiarism index, with at least three updated references, with the main diagnosis, cos reference of some author of the reference.

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HIPAA regulations)

The Assignment
With the client you selected in mind, address the following in a client termination summary (without violating HIPAA regulations):

Identifying information of client (i.e., hypothetical name, age, etc.)
Date initially contacted therapist, date therapy began, duration of therapy, and date therapy will end
Total number of sessions, including number of missed sessions
Termination planned or unplanned
Presenting problem
Major psychosocial issues
Types of services rendered (i.e., individual, couple/family therapy, group therapy, etc.)
Overview of treatment process
Goal status (goals met, partially met, unmet)
Treatment limitations (if any)
Remaining difficulties and/or concerns
Recommendations
Follow-up plan (if indicated)
Instructions for future contact
Signatures

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Code of Ethics.

Nursing paper. 2 pages

Discusses possible outcomes of both positions. Present plans each for resolving the issue (for patient, family and the nurse). 

Supports ideas with 3 scholarly literature nursing peer reviewed not older than 5 years.

APA citation format.

Use this link to take you directly to the ANA website to access the Code of Ethics. When prompted, choose “No I do not wish to register at this time. Take me to the Code now.” https://www.nursingworld.org/practicepolicy/nursing-excellence/ethics/code-of-ethics-for-nurses/

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Musculoskeletal System

Writing and Pronunciation

By the due date assigned you will write 3 reports and use them as your script for your Week 2 Oral Report. Your writing section for this assignment will include 2 paragraphs for each of these:

  • The Department of Orthopedics (Musculoskeletal System)
  • The Department of Pulmonology (Respiratory System)
  • The Department of Gastroenterology (Digestive System)

In order to earn the maximum credit for the written report you need to incorporate at least 10 medical terms for each department, using them in a manner that demonstrates your knowledge of their meaning.

  • Include the major or most common diseases or conditions seen in each department.
  • Include at least three of the principal procedures that are relevant to each department.
  • Highlight pertinent laboratory and radiological diagnostic services relevant to each department.
  • Limit your analysis of each department to two paragraphs.

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