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Halonen, J. I., Lallukka, T., Virtanen, M., Rod, N. & Magnusson Hanson, L. (2019). Bi-directional relation between effort‒reward imbalance and risk of neck-shoulder pain: assessment of mediation through depressive symptoms using occupational longitudinal data. Scandinavian Journal of Work, Environment and Health, 45(2), 126-133
Open this publication in new window or tab >>Bi-directional relation between effort‒reward imbalance and risk of neck-shoulder pain: assessment of mediation through depressive symptoms using occupational longitudinal data
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2019 (English)In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 2, p. 126-133Article in journal (Refereed) Published
Abstract [en]

Objectives Bi-directional associations between perceived effort‒reward imbalance (ERI) at work and neck-shoulder pain have been reported. There is also evidence of associations between ERI and depressive symptoms, and between depressive symptoms and pain while the links between ERI, depressive symptoms and pain have not been tested. We aimed to assess whether depressive symptoms mediate the association between ERI and neck-shoulder pain, as well as the association between neck-shoulder pain and ERI.

Methods We used prospective data from three consecutive surveys of the Swedish Longitudinal Occupational Survey of Health (SLOSH) study. ERI was assessed with a short version of the ERI questionnaire, and pain was defined as having had neck-shoulder pain that affected daily life during the past three months. Depressive symptoms were assessed with a continuous scale based on six-items of the (Hopkins) Symptom Checklist. Counterfactual mediation analyses were applied using exposure measures from 2010/2012 (T1), depressive symptoms from 2012/2014 (T2), and outcomes from 2014/2016 (T3), and including only those free of outcome at T1 and T2 (N=2876‒3239).

Results ERI was associated with a higher risk of neck-shoulder pain [risk ratio (RR) for total effect 1.24, 95% confidence interval (CI) 1.02–1.50] and 40% of this total effect was mediated through depressive symptoms. Corresponding RR for association between neck-shoulder pain and ERI was 1.36 (95% CI 1.13–1.65), but the mediating role of depressive symptoms was less consistent.

Conclusions Depressive symptoms appear to be an intermediate factor in the relationship between ERI and neck-shoulder pain.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-362392 (URN)10.5271/sjweh.3768 (DOI)000466177200004 ()30199085 (PubMedID)
Funder
Swedish Research Council
Available from: 2018-10-04 Created: 2018-10-04 Last updated: 2019-06-05Bibliographically approved
Ervasti, J., Airaksinen, J., Pentti, J., Vahtera, J., Suominen, S., Virtanen, M. & Kivimäki, M. (2019). Does increasing physical activity reduce the excess risk of work disability among overweight individuals?. Scandinavian Journal of Work, Environment and Health, 45(4), 376-385
Open this publication in new window or tab >>Does increasing physical activity reduce the excess risk of work disability among overweight individuals?
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2019 (English)In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 4, p. 376-385Article in journal (Refereed) Published
Abstract [en]

Objectives We examined the extent to which an increase in physical activity would reduce the excess risk of work disability among overweight and obese people (body mass index ≥ 25kg/m2).

Methods We used counterfactual modelling approaches to analyze longitudinal data from two Finnish prospective cohort studies (total N=38 744). Weight, height and physical activity were obtained from surveys and assessed twice and linked to electronic records of two indicators of long-term work disability (≥90-day sickness absence and disability pension) for a 7-year follow-up after the latter survey. The models were adjusted for age, sex, socioeconomic status, smoking, and alcohol consumption.

Results The confounder-adjusted hazard ratio (HR) of long-term sickness absence for overweight compared to normal-weight participants was 1.43 [95% confidence interval (CI) 1.35–1.53]. An increase in physical activity among overweight compared to normal-weight individuals was estimated to reduce this HR to 1.40 (95% CI 1.31–1.48). In pseudo-trial analysis including only the persistently overweight, initially physically inactive participants, the HR for long-term sickness absence was 0.82 (95% CI 0.70–0.94) for individuals with increased physical activity compared to those who remained physically inactive. The results for disability pension as an outcome were similar.

Conclusions These findings suggest that the excess risk of work disability among overweight individuals would drop by 3–4% if they increased their average physical activity to the average level of normal-weight people. However, overweight individuals who are physically inactive would reduce their risk of work disability by about 20% by becoming physically active.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-390153 (URN)10.5271/sjweh.3799 (DOI)000473173000007 ()
Funder
NordForsk
Available from: 2019-08-06 Created: 2019-08-06 Last updated: 2019-08-29Bibliographically approved
Hanson, L. L. M., Virtanen, M., Rod, N. H., Steptoe, A., Head, J., Batty, G. D., . . . Westerlund, H. (2019). Does inflammation provide a link between psychosocial work characteristics and diabetes?: Analysis of the role of interleukin-6 and C-reactive protein in the Whitehall II cohort study. Brain, behavior, and immunity, 78, 153-160
Open this publication in new window or tab >>Does inflammation provide a link between psychosocial work characteristics and diabetes?: Analysis of the role of interleukin-6 and C-reactive protein in the Whitehall II cohort study
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2019 (English)In: Brain, behavior, and immunity, ISSN 0889-1591, E-ISSN 1090-2139, Vol. 78, p. 153-160Article in journal (Refereed) Published
Abstract [en]

Objective: Inflammation may underlie the association between psychological stress and cardiometabolic diseases, but this proposition has not been tested longitudinally. We investigated whether the circulating inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) mediate the relationship between psychosocial work characteristics and diabetes.

Methods: We used three phases of data at 5 years intervals from the Whitehall II cohort study, originally recruiting 10,308 civil service employees aged 35-55 years. The data included repeat self-reports of job demands, control and social support, IL-6 from plasma samples, CRP from serum samples, and diabetes, ascertained through oral glucose tolerance test, medications, and self-reports of doctor-diagnosed diabetes.

Results: Structural equation models with age, sex and occupational position considering men and women combined, showed that low social support at work, but not high job demands or low job control, was prospectively associated with diabetes (standardized beta = 0.05, 95% confidence interval (CI) 0.01-0.09) and higher levels of IL-6 (beta = 0.03, CI 0.00-0.06). The inflammatory markers and diabetes were bidirectionally associated over time. A mediation model including workplace social support, IL-6 and diabetes further showed that 10% of the association between social support and diabetes over the three repeat examinations (total effect beta = 0.08, CI 0.01-0.15) was attributable to a weak indirect effect through IL-6 (beta = 0.01, CI 0.00-0.02). A similar indirect effect was observed for CRP in men only, while job control was prospectively associated with IL-6 among women.

Conclusions: This study indicates an association between poor workplace support and diabetes that is partially ascribed to an inflammatory response.

Place, publisher, year, edition, pages
ACADEMIC PRESS INC ELSEVIER SCIENCE, 2019
Keywords
Social support, Occupational stress, Psychosocial factors, Inflammation, Mechanism, Pathways, Diabetes mellitus
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-386178 (URN)10.1016/j.bbi.2019.01.017 (DOI)000468256900017 ()30684651 (PubMedID)
Funder
NordForskAcademy of Finland, 311492
Available from: 2019-06-19 Created: 2019-06-19 Last updated: 2019-06-19Bibliographically approved
Bean, C. G., Virtanen, M., Westerlund, H., Berg, N., Hallqvist, J. & Hammarström, A. (2019). Group activity participation at age 21 and depressive symptoms during boom and recession in Sweden: a 20-year follow-up. European Journal of Public Health, 29(3), 475-481
Open this publication in new window or tab >>Group activity participation at age 21 and depressive symptoms during boom and recession in Sweden: a 20-year follow-up
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2019 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, no 3, p. 475-481Article in journal (Refereed) Published
Abstract [en]

Background: Organized group activities (e.g. sports or arts clubs) have long been noted as important developmental settings for youth, yet previous studies on the relationships between participation and mental health outcomes have focused on short-term effects among school-aged adolescents. The subsequent period of life, emerging adulthood, has been largely overlooked despite being another important life stage where individuals face new existential challenges and may benefit from group activity participation. The potential for macroeconomic conditions to modify these relationships has also not been considered.

Methods: Participants (n = 1654) comprise two cohorts, born in either 1965 (n = 968) or 1973 (n = 686), from the same middle-sized industrial town in Northern Sweden. Both cohorts completed detailed questionnaires at age 21 (macroeconomic boom for Cohort 65, recession for Cohort 73) and approximately 20 years follow-up (age 43 for Cohort 65, age 39 for Cohort 73). General linear models were used to assess concurrent and prospective associations between regular group activity participation and depressive symptoms, as well as the potential interaction with boom/recession.

Results: After controlling for sociodemographic factors, regular group activity participation at age 21 was associated with lower depressive symptoms, both concurrently and at follow-up. Those exposed to recession at age 21 reported higher depressive symptoms at the time but there was no interaction between cohort (boom/recession) and group activity participation.

Conclusions: Regular group activity participation during emerging adulthood is associated with lower depressive symptoms uniformly in times of boom and recession. Beneficial effects of such participation may contribute to better mental health over 20 years.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-362022 (URN)10.1093/eurpub/cky201 (DOI)000486962600020 ()30265293 (PubMedID)
Funder
Swedish Research Council Formas, 259-2012-37Västerbotten County Council, VLL-355661
Available from: 2018-09-28 Created: 2018-09-28 Last updated: 2019-10-30Bibliographically approved
Virtanen, M., Magnusson Hanson, L., Goldberg, M., Zins, M., Stenholm, S., Vahtera, J., . . . Kivimäki, M. (2019). Long working hours, anthropometry, lung function, blood pressure and blood-based biomarkers:: cross-sectional findings from the CONSTANCES study. Journal of Epidemiology and Community Health, 73(2), 130-135
Open this publication in new window or tab >>Long working hours, anthropometry, lung function, blood pressure and blood-based biomarkers:: cross-sectional findings from the CONSTANCES study
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2019 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 73, no 2, p. 130-135Article in journal (Refereed) Published
Abstract [en]

Background Although long working hours have been shown to be associated with the onset of cardiometabolic diseases, the clinical risk factor profile associated with long working hours remains unclear. We compared the clinical risk profile between people who worked long hours and those who reported being never exposed to long hours.

Methods A cross-sectional study in 22 health screening centres in France was based on a random population-based sample of 75 709 participants aged 18–69 at study inception in 2012–2016 (the CONSTANCES study). The data included survey responses on working hours (never, former or current exposure to long working hours), covariates and standardised biomedical examinations including anthropometry, lung function, blood pressure and standard blood-based biomarkers.

Results Among men, long working hours were associated with higher anthropometric markers (Body Mass Index, waist circumference and waist:hip ratio), adverse lipid levels, higher glucose, creatinine, white blood cells and higher alanine transaminase (adjusted mean differences in the standardised scale between the exposed and unexposed 0.02–0.12). The largest differences were found for Body Mass Index and waist circumference. A dose–response pattern with increasing years of working long hours was found for anthropometric markers, total cholesterol, glucose and gamma-glutamyltransferase. Among women, long working hours were associated with Body Mass Index and white blood cells.

Conclusion In this study, men who worked long hours had slightly worse cardiometabolic and inflammatory profile than those who did not work long hours, especially with regard to anthropometric markers. In women, the corresponding associations were weak or absent.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-367363 (URN)10.1136/jech-2018-210943 (DOI)000458378700007 ()30327450 (PubMedID)
Funder
NordForsk
Available from: 2018-11-30 Created: 2018-11-30 Last updated: 2019-03-12Bibliographically approved
Halonen, J., Merikukka, M., Gissler, M., Kerkelä, M., Virtanen, M., Ristikari, T., . . . Lallukka, T. (2019). Pathways from parental mental disorders to offspring's work disability due to depressive or anxiety disorders in early adulthood—The 1987 Finnish Birth Cohort. Depression and anxiety (Print), 36(4), 305-312
Open this publication in new window or tab >>Pathways from parental mental disorders to offspring's work disability due to depressive or anxiety disorders in early adulthood—The 1987 Finnish Birth Cohort
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2019 (English)In: Depression and anxiety (Print), ISSN 1091-4269, E-ISSN 1520-6394, Vol. 36, no 4, p. 305-312Article in journal (Refereed) Published
Abstract [en]

Background: Parental mental disorders have been shown to predict offspring's mental health problems. We examined whether pathways from parental mental disorders to offspring's psychiatric work disability in early adulthood are mediated through offspring's mental disorders and social disadvantage in adolescence.

Methods: Study population consisted of the 1987 Finnish Birth Cohort. Data on parents’ psychiatric care or work disability due to mental diagnosis between 1987 and 2000 and the cohort participants’ health and social factors between 2001 and 2005 were derived from administrative national registers. From 2006 through 2015, 52,182 cohort participants were followed for admittance of psychiatric work disability due to depressive or anxiety disorders. First, we applied a pathway analysis to examine the occurrence of each path. We then used mediation analysis to assess the proportion of association between parental mental disorders and work disability mediated by offspring's health and social disadvantage.

Results: The pathway model indicated that the association from parental mental disorders to offspring's work disability due to depressive or anxiety disorder is through mental disorders and social disadvantage in adolescence. Odds Ratio for the total effect of parental mental disorders on offspring's psychiatric work disability was 1.85 (95% confidence interval [CI] 1.46–2.34) in the model including offspring's mental disorders that mediated this association by 35%. Corresponding results were 1.86 (95% CI 1.47–2.35) and 28% for social disadvantage in adolescence.

Conclusions: These findings suggest that intergenerational determination of work disability due to mental disorders could be addressed by actions supporting mental health and social circumstances in adolescence.

Keywords
anxiety, child, adolescent, depression, epidemiology, family
National Category
Occupational Health and Environmental Health Psychiatry Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-367360 (URN)10.1002/da.22847 (DOI)000462881800002 ()30329200 (PubMedID)
Available from: 2018-11-30 Created: 2018-11-30 Last updated: 2019-04-17Bibliographically approved
Halonen, J. I., Virtanen, M., Ala-Mursula, L., Miettunen, J., Vaaramo, E., Karppinen, J., . . . Lallukka, T. (2019). Socioeconomic and health-related childhood and adolescence predictors of entry into paid employment. European Journal of Public Health, 29(3), 555-561
Open this publication in new window or tab >>Socioeconomic and health-related childhood and adolescence predictors of entry into paid employment
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2019 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, no 3, p. 555-561Article in journal (Refereed) Published
Abstract [en]

Background

Most studies on prolonging working careers have explored later career, while less is known about social and particularly health-related determinants of entry into labour market. We examined social and health-related factors from childhood and adolescence as predictors of age at entry into paid employment and early occupational class, and whether own education moderates these associations.

Methods

The Northern Finland Birth Cohort 1986 was followed from birth until the end of 2015. We included 8542 participants (52% male) who had had a minimum of 6-month employment that was defined by registered earning periods. As socioeconomic predictors, we examined low parental education at age 7 and low household income at age 16. Behaviour- and health-related factors at age 16 included smoking, alcohol use, physical inactivity, overweight, length of sleep and not having breakfast, while mental health problems included symptoms of anxiety and depression, attention problems and social problems. The analyses for significant predictors were further stratified by register-based level of completed own education by age 28–29 (low/high).

Results

After adjustments, low parental education, smoking and having been drunk were significant predictors of early entry into paid employment (≤18 vs. ≥24 years), especially among those who later obtained high education. Low parental education and smoking were predictors of low or non-specified (vs. high) occupational class in the first job. Mental health problems were not associated with either outcome.

Conclusions

Socioeconomic background and unhealthy lifestyle contribute to early entry into the labour market and low occupational status in the first job.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-367357 (URN)10.1093/eurpub/cky221 (DOI)000486962600033 ()30351369 (PubMedID)
Funder
Academy of Finland, 287488Academy of Finland, 294096Academy of Finland, 319200Academy of Finland, 268336
Available from: 2018-11-30 Created: 2018-11-30 Last updated: 2019-10-30Bibliographically approved
Airaksinen, J., Ervasti, J., Pentti, J., Oksanen, T., Suominen, S., Vahtera, J., . . . Kivimäki, M. (2019). The effect of smoking cessation on work disability risk: a longitudinal study analysing observational data as non-randomized nested pseudo-trials. International Journal of Epidemiology, 48(2), 415-422
Open this publication in new window or tab >>The effect of smoking cessation on work disability risk: a longitudinal study analysing observational data as non-randomized nested pseudo-trials
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2019 (English)In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 48, no 2, p. 415-422Article in journal (Refereed) Published
Abstract [en]

Background

Smoking increases disability risk, but the extent to which smoking cessation reduces the risk of work disability is unclear. We used non-randomized nested pseudo-trials to estimate the benefits of smoking cessation for preventing work disability.

Methods

We analysed longitudinal data on smoking status and work disability [long-term sickness absence (≥90 days) or disability pension] from two independent prospective cohort studies—the Finnish Public Sector study (FPS) (n = 7393) and the Health and Social Support study (HeSSup) (n = 2701)—as ‘nested pseudo-trials’. All the 10 094 participants were smokers at Time 1 and free of long-term work disability at Time 2. We compared the work disability risk after Time 2 of the participants who smoked at Time 1 and Time 2 with that of those who quit smoking between these times.

Results

Of the participants in pseudo-trials, 2964 quit smoking between Times 1 and 2. During the mean follow-up of 4.8 to 8.6 years after Time 2, there were 2197 incident cases of work disability across the trials. Quitting smoking was associated with a reduced risk of any work disability [summary hazard ratio = 0.89, 95% confidence interval (CI) 0.81–0.98]. The hazard ratio for the association between quitting smoking and permanent disability pension (928 cases) was of similar magnitude, but less precisely estimated (0.91, 95% CI 0.81–1.02). Among the participants with high scores on the work disability risk score (top third), smoking cessation reduced the risk of disability pension by three percentage points. Among those with a low risk score (bottom third), smoking cessation reduced the risk by half a percentage point.

Conclusions

Our results suggest an approximately 10% hazard reduction of work disability as a result of quitting smoking.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-390154 (URN)10.1093/ije/dyz020 (DOI)000479285400019 ()30815682 (PubMedID)
Funder
NordForsk
Available from: 2019-08-06 Created: 2019-08-06 Last updated: 2019-09-30Bibliographically approved
Pekurinen, V., Välimäki, M., Virtanen, M., Kivimäki, M. & Vahtera, J. (2019). Work Stress and Satisfaction with Leadership Among Nurses Encountering Patient Aggression in Psychiatric Care: A Cross-Sectional Survey Study. Administration and Policy in Mental Health, 46(3), 368-379
Open this publication in new window or tab >>Work Stress and Satisfaction with Leadership Among Nurses Encountering Patient Aggression in Psychiatric Care: A Cross-Sectional Survey Study
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2019 (English)In: Administration and Policy in Mental Health, ISSN 0894-587X, E-ISSN 1573-3289, Vol. 46, no 3, p. 368-379Article in journal (Refereed) Published
Abstract [en]

We examined the associations between work stress (job strain, effort-reward imbalance), perceived job insecurity, workplace social capital, satisfaction with leadership and working hours in relation to the likelihood of encountering patient aggression (overall exposure, assaults on ward property, mental abuse, physical assaults). We conducted a cross-sectional survey for nurses (N = 923) in 84 psychiatric units. Both work stress indicators were associated higher odds for different types of patient aggression. Poorer satisfaction with leadership was associated with higher odds for overall exposure to patient aggression. These findings were robust to adjustment for several nurse and work characteristics, and unit size.

Place, publisher, year, edition, pages
SPRINGER, 2019
Keywords
Patient violence, Psychosocial work environment, Psychiatric nursing
National Category
Public Health, Global Health, Social Medicine and Epidemiology Psychiatry Nursing
Identifiers
urn:nbn:se:uu:diva-382817 (URN)10.1007/s10488-018-00919-6 (DOI)000464671000009 ()30684111 (PubMedID)
Available from: 2019-05-06 Created: 2019-05-06 Last updated: 2019-05-06Bibliographically approved
Xu, T., Magnusson Hanson, L., Lange, T., Starkopf, L., Westerlund, H., Madsen, I., . . . Rod, N. (2019). Workplace bullying and workplace violence as risk factors for cardiovascular disease: a multi-cohort study. European Heart Journal, 40(14), 1124-1134
Open this publication in new window or tab >>Workplace bullying and workplace violence as risk factors for cardiovascular disease: a multi-cohort study
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2019 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 40, no 14, p. 1124-1134Article in journal (Refereed) Published
Abstract [en]

Aims:

To assess the associations between bullying and violence at work and cardiovascular disease (CVD).

Methods and results:

Participants were 79 201 working men and women, aged 18–65 years and free of CVD and were sourced from three cohort studies from Sweden and Denmark. Exposure to workplace bullying and violence was measured at baseline using self-reports. Participants were linked to nationwide health and death registers to ascertain incident CVD, including coronary heart disease and cerebrovascular disease. Study-specific results were estimated by marginal structural Cox regression and were combined using fixed-effect meta-analysis. Nine percent reported being bullied at work and 13% recorded exposure to workplace violence during the past year. We recorded 3229 incident CVD cases with a mean follow-up of 12.4 years (765 in the first 4 years). After adjustment for age, sex, country of birth, marital status, and educational level, being bullied at work vs. not was associated with a hazard ratio (HR) of 1.59 [95% confidence interval (CI) 1.28–1.98] for CVD. Experiencing workplace violence vs. not was associated with a HR of 1.25 (95% CI 1.12–1.40) for CVD. The population attributable risk was 5.0% for workplace bullying and 3.1% for workplace violence. The excess risk remained similar in analyses with different follow-up lengths, cardiovascular risk stratifications, and after additional adjustments. Dose–response relations were observed for both workplace bullying and violence (Ptrend < 0.001). There was only negligible heterogeneity in study-specific estimates.

Conclusion:

Bullying and violence are common at workplaces and those exposed to these stressors are at higher risk of CVD.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-367354 (URN)10.1093/eurheartj/ehy683 (DOI)000465095500010 ()30452614 (PubMedID)
Funder
NordForsk
Available from: 2018-11-30 Created: 2018-11-30 Last updated: 2019-05-14Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8361-3301

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