Base de dados : MEDLINE
Pesquisa : N02.421.325 [Categoria DeCS]
Referências encontradas : 74 [refinar]
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[PMID]:29211415
[Au] Autor:Ehrenfeld J; Gridley S
[Ti] Título:Education Creates Welcoming Environment for Transgender Patients.
[So] Source:ED Manag;28(8):90-3, 2016 Aug.
[Is] ISSN:1044-9167
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The ED often is the access point of choice for transgender patients who may be reluctant to interact with providers. Experts say there is a need for training and education of how to present a gender-affirming healthcare environment. Recommended steps include a review of policies, along with corresponding changes to electronic and paper intake forms to ensure that the language used is inclusive of all genders. While blanket discrimination may be declining, experts note that some providers are uncertain about how to interact with a transgender patient. It's always best to ask patients for their preferred name and pronoun and to repeat this exercise every three to six months for return patients, as gender identify can be fluid. To ease anxiety for transgender patients, consider developing a navigator program that will pair any transgender patient who requests the service with a trained advocate who can support and guide the patient through the system.
[Mh] Termos MeSH primário: Serviço Hospitalar de Emergência/organização & administração
Serviços de Saúde para Pessoas Transgênero/organização & administração
Apoio Social
Pessoas Transgênero/psicologia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Capacitação em Serviço
Masculino
Preconceito/psicologia
Discriminação Social/psicologia
Estigma Social
Estresse Psicológico/psicologia
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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[PMID]:29226450
[Au] Autor:Gonzales G; Henning-Smith C
[Ad] Endereço:Vanderbilt University School of Medicine.
[Ti] Título:Barriers to Care Among Transgender and Gender Nonconforming Adults.
[So] Source:Milbank Q;95(4):726-748, 2017 Dec.
[Is] ISSN:1468-0009
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Policy Points: Transgender and gender nonconforming (GNC) adults may experience barriers to care for a variety of reasons, including discrimination and lack of awareness by providers in health care settings. In our analysis of a large, population-based sample, we found transgender and GNC adults were more likely to be uninsured and have unmet health care needs, and were less likely to have routine care, compared to cisgender (nontransgender) women. Our findings varied by gender identity. More research is needed on transgender and GNC populations, including on how public policy and provider awareness affects health care access and health outcomes differentially by gender identity. CONTEXT: Very little population-based research has examined health and access to care among transgender populations. This study compared barriers to care between cisgender, transgender, and gender nonconforming (GNC) adults using data from a large, multistate sample. METHODS: We used data from the 2014-2015 Behavioral Risk Factor Surveillance System to estimate the prevalence of having no health insurance, unmet medical care needs due to cost, no routine checkup, and no usual source of care for cisgender women (n = 183,370), cisgender men (n = 131,080), transgender women (n = 724), transgender men (n = 449), and GNC adults (n = 270). Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for each barrier to care while adjusting for sociodemographic characteristics. FINDINGS: Transgender and GNC adults were more likely to be nonwhite, sexual minority, and socioeconomically disadvantaged compared to cisgender adults. After controlling for sociodemographic characteristics, transgender women were more likely to have no health insurance (OR = 1.60; 95% CI = 1.07-2.40) compared to cisgender women; transgender men were more likely to have no health insurance (OR = 2.02; 95% CI = 1.25-3.25) and no usual source of care (OR = 1.84; 95% CI = 1.18-2.88); and GNC adults were more likely to have unmet medical care needs due to cost (OR = 1.93; 95% CI = 1.02-3.67) and no routine checkup in the prior year (OR = 2.41; 95% CI = 1.41-4.12). CONCLUSIONS: Transgender and GNC adults face barriers to health care that may be due to a variety of reasons, including discrimination in health care, health insurance policies, employment, and public policy or lack of awareness among health care providers on transgender-related health issues.
[Mh] Termos MeSH primário: Assistência à Saúde/organização & administração
Acesso aos Serviços de Saúde/estatística & dados numéricos
Serviços de Saúde para Pessoas Transgênero/organização & administração
Sexismo/estatística & dados numéricos
Pessoas Transgênero/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE
[do] DOI:10.1111/1468-0009.12297


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[PMID]:28771690
[Au] Autor:Johnson EL; Kaplan PW
[Ad] Endereço:Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A.
[Ti] Título:Caring for transgender patients with epilepsy.
[So] Source:Epilepsia;58(10):1667-1672, 2017 Oct.
[Is] ISSN:1528-1167
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Approximately 25 million individuals older than age 15 identify as transgender, representing about 0.3-0.9% of the world's population. The aim of this paper is to identify and describe important medical and social considerations facing transgender persons with epilepsy. METHODS: We performed literature searches on the following terms: transgender AND epilepsy, transgender AND neurology, gender dysphoria AND epilepsy, gender dysphoria AND neurology. We also performed literature searches for common feminizing or masculinizing treatment regimens, and searched for interactions of those treatment regimens with antiepileptic drugs (AEDs) and with seizures. RESULTS: There are multiple bidirectional interactions between AEDs and the commonly used treatments for aligning external sex characteristics with identified gender. The scope of the transgender population with epilepsy remains to be elucidated. SIGNIFICANCE: Transgender patients with epilepsy face significant social and medical challenges. Interactions between medical gender-affirming treatments and AEDs are common, and management must depend on knowledge of these interactions to provide appropriate treatment.
[Mh] Termos MeSH primário: Androgênios/uso terapêutico
Anticonvulsivantes/uso terapêutico
Epilepsia/tratamento farmacológico
Estrogênios/uso terapêutico
Antagonistas de Receptores de Mineralocorticoides/uso terapêutico
Progestinas/uso terapêutico
Transexualismo/tratamento farmacológico
[Mh] Termos MeSH secundário: Fármacos Anti-HIV/uso terapêutico
Antidepressivos/uso terapêutico
Transtornos de Ansiedade/epidemiologia
Comorbidade
Transtorno Depressivo/tratamento farmacológico
Transtorno Depressivo/epidemiologia
Interações Medicamentosas
Epilepsia/epidemiologia
Epilepsia/fisiopatologia
Estradiol/uso terapêutico
Infecções por HIV/tratamento farmacológico
Infecções por HIV/epidemiologia
Serviços de Saúde para Pessoas Transgênero
Seres Humanos
Medroxiprogesterona/uso terapêutico
Estigma Social
Espironolactona/uso terapêutico
Testosterona/uso terapêutico
Pessoas Transgênero
Transexualismo/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Androgens); 0 (Anti-HIV Agents); 0 (Anticonvulsants); 0 (Antidepressive Agents); 0 (Estrogens); 0 (Mineralocorticoid Receptor Antagonists); 0 (Progestins); 27O7W4T232 (Spironolactone); 3XMK78S47O (Testosterone); 4TI98Z838E (Estradiol); HSU1C9YRES (Medroxyprogesterone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE
[do] DOI:10.1111/epi.13864


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[PMID]:28759117
[Au] Autor:Knudson G; De Sutter P
[Ad] Endereço:Vancouver Coastal Health & Provincial Health Services, Vancouver, BC, Canada.
[Ti] Título:Fertility options in transgender and gender diverse adolescents.
[So] Source:Acta Obstet Gynecol Scand;96(10):1269-1272, 2017 10.
[Is] ISSN:1600-0412
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Fertilidade
Serviços de Saúde Reprodutiva
Comportamento Sexual
Pessoas Transgênero
[Mh] Termos MeSH secundário: Adolescente
Feminino
Serviços de Saúde para Pessoas Transgênero
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170801
[St] Status:MEDLINE
[do] DOI:10.1111/aogs.13188


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[PMID]:28704458
[Au] Autor:Spencer S; Meer T; Müller A
[Ad] Endereço:Gender Health and Justice Research Unit, University of Cape Town, Cape Town, Western Cape, South Africa.
[Ti] Título:"The care is the best you can give at the time": Health care professionals' experiences in providing gender affirming care in South Africa.
[So] Source:PLoS One;12(7):e0181132, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: While the provision of gender affirming care for transgender people in South Africa is considered legal, ethical, and medically sound, and is-theoretically-available in both the South African private and public health sectors, access remains severely limited and unequal within the country. As there are no national policies or guidelines, little is known about how individual health care professionals providing gender affirming care make clinical decisions about eligibility and treatment options. METHOD: Based on an initial policy review and service mapping, this study employed semi-structured interviews with a snowball sample of twelve health care providers, representing most providers currently providing gender affirming care in South Africa. Data were analysed thematically using NVivo, and are reported following COREQ guidelines. RESULTS: Our findings suggest that, whilst a small minority of health care providers offer gender affirming care, this is almost exclusively on their own initiative and is usually unsupported by wider structures and institutions. The ad hoc, discretionary nature of services means that access to care is dependent on whether a transgender person is fortunate enough to access a sympathetic and knowledgeable health care provider. CONCLUSION: Accordingly, national, state-sanctioned guidelines for gender affirming care are necessary to increase access, homogenise quality of care, and contribute to equitable provision of gender affirming care in the public and private health systems.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Serviços de Saúde para Pessoas Transgênero/normas
[Mh] Termos MeSH secundário: Serviços de Saúde para Pessoas Transgênero/ética
Seres Humanos
África do Sul
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0181132


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[PMID]:28420361
[Au] Autor:Giblon R; Bauer GR
[Ad] Endereço:Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, K201 Kresge Building, London, ON, N6H 2B1, Canada. rgiblon@uwo.ca.
[Ti] Título:Health care availability, quality, and unmet need: a comparison of transgender and cisgender residents of Ontario, Canada.
[So] Source:BMC Health Serv Res;17(1):283, 2017 Apr 18.
[Is] ISSN:1472-6963
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Evidence suggests that transgender (trans) individuals in Canada are a medically underserved population; barriers range from lack of provider knowledge on trans issues to refusal of care. This paper provides the first formal estimation of health care inequalities between trans and cisgender individuals in Ontario, Canada. METHODS: Weighted statistics from the Ontario-wide Trans PULSE Project (n = 433) were compared with age-standardized Ontario data from the Canadian Community Health Survey (n = 39,980) to produce standardized prevalence differences (SPDs). Analysis was also conducted separately for trans men and trans women, each compared to the age-standardized Ontario population. RESULTS: An estimated 33.2% (26.4,40.9) of trans Ontarians reported a past-year unmet health care need in excess of the 10.7% expected based on the age-standardized Ontario population. Inequality was greatest comparing trans with cisgender men (SPD = 34.4% (23.0, 46.1). While trans Ontarians evaluated health care availability in Ontario similarly to the broader population, they were significantly more likely to evaluate availability in their community as fair or poor. CONCLUSIONS: Trans Ontarians experience inequalities in perception and reported experiences of health care access, with 43.9% reporting a past-year unmet health care need.
[Mh] Termos MeSH primário: Acesso aos Serviços de Saúde/normas
Serviços de Saúde para Pessoas Transgênero/normas
Disparidades em Assistência à Saúde/estatística & dados numéricos
Pessoas Transgênero/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
Acesso aos Serviços de Saúde/estatística & dados numéricos
Necessidades e Demandas de Serviços de Saúde
Inquéritos Epidemiológicos
Seres Humanos
Masculino
Meia-Idade
Ontário/epidemiologia
Médicos/normas
Médicos/estatística & dados numéricos
Prevalência
Qualidade da Assistência à Saúde
Comportamento Sexual
Inquéritos e Questionários
Transexualismo/epidemiologia
Transexualismo/terapia
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170531
[Lr] Data última revisão:
170531
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170420
[St] Status:MEDLINE
[do] DOI:10.1186/s12913-017-2226-z


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[PMID]:28385895
[Au] Autor:Chan W; Drummond A; Kelly M
[Ad] Endereço:Department of Opthalmology and Visual Sciences (Chan), Queen Elizabeth II Health Sciences Centre, Halifax, NS; Stettler Medical Clinic (Drummond), Stettler, Alta.; Department of Family Medicine (Kelly); University of Calgary Cumming School of Medicine, Calgary, Alta.
[Ti] Título:Deep vein thrombosis in a transgender woman.
[So] Source:CMAJ;189(13):E502-E504, 2017 04 03.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Estradiol/efeitos adversos
Terapia de Reposição de Estrogênios/efeitos adversos
Estrogênios/efeitos adversos
Imobilização/efeitos adversos
Pessoas Transgênero
Viagem
Trombose Venosa/etiologia
[Mh] Termos MeSH secundário: Adulto
Traumatismos do Tornozelo
Desprescrições
Estradiol/administração & dosagem
Estrogênios/administração & dosagem
Inibidores do Fator Xa/uso terapêutico
Feminino
Serviços de Saúde para Pessoas Transgênero
Seres Humanos
Masculino
Progesterona/efeitos adversos
Progestinas/efeitos adversos
Progestinas/uso terapêutico
Rivaroxabana/uso terapêutico
Entorses e Distensões
Adesivo Transdérmico
Trombose Venosa/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Estrogens); 0 (Factor Xa Inhibitors); 0 (Progestins); 4G7DS2Q64Y (Progesterone); 4TI98Z838E (Estradiol); 9NDF7JZ4M3 (Rivaroxaban)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170408
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.160408


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[PMID]:28141788
[Au] Autor:Fernández Rodríguez M; Guerra Mora P; Martín Sánchez E; Grupo GIDSEEN
[Ad] Endereço:Unidad de Tratamiento de Identidad de Género del Principado de Asturias (UTIGPA). Hospital San Agustín de Avilés. Asturias. España.
[Ti] Título:[Characteristics of Adolescents with Gender Dysphoria Referred to the Gender Identity Treatment Unit].
[Ti] Título:Lesiones mortales de tráfico en España relacionadas con el trabajo según el motivo del desplazamiento y según sexo (2010-2013)..
[So] Source:Rev Esp Salud Publica;91, 2017 Feb 01.
[Is] ISSN:2173-9110
[Cp] País de publicação:Spain
[La] Idioma:spa
[Ab] Resumo:OBJECTIVE: The demand for treatment among people with gender dys-phoria has increased during the last years. The aim of the present research was to carry out an analysis of the demand of the teenagers that requested consultation at the UTIGPA (Gender Identity Treatment Unit of Principality of Asturias) as they presented complains of gender dysphoria. METHODS: The sample included 20 minors that were treated between March 2007 and December 2015. The clinical history was made to collect informa-tion. It was made descriptive analysis and the reason sex/gender was used. RESULTS: The 20 teenagers represented the 14,6% of the whole sample (of 137 demands). The age average was 15,20 years (SD=1,473) and the range of years was between 12-17. The reason sex/gender was 1/1 (10 into the man to woman group and 10 into the woman to man group). At the arrival at the Treatment Unit, 100% of the individuals lived with their nuclear or extended family and in the 60% of the cases, their parents were separated. 70% of the cases were referred from mental health services. 10% hadn´t got any past medical history and 35% had never received any prescription for a psychopharmacological treatment. 95% hadn't done any hormonal self-treatment. 100% defined themselves as heterosexual. 25% requested exclusively for psychological interventions and 75% asked for medical treatments. CONCLUSIONS: The profile of the minor was a teenager of approximately 15 years old that was referred from mental health services. Contrary to the fin-dings of other national and international researches, the rate sex/gender was equated in our research. The minor had got a past medical history and their prio-rity request was for medical treatments, both hormonal and surgical therapies.
[Mh] Termos MeSH primário: Disforia de Gênero
Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos
Serviços de Saúde para Pessoas Transgênero
Pessoas Transgênero
[Mh] Termos MeSH secundário: Adolescente
Criança
Feminino
Disforia de Gênero/diagnóstico
Disforia de Gênero/psicologia
Disforia de Gênero/terapia
Seres Humanos
Masculino
Anamnese
Encaminhamento e Consulta
Procedimentos de Readequação Sexual
Espanha
Pessoas Transgênero/psicologia
Pessoas Transgênero/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170201
[St] Status:MEDLINE


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[PMID]:28103750
[Au] Autor:Cicero EC; Wesp LM
[Ad] Endereço:1 Duke University School of Nursing, Durham, NC, USA.
[Ti] Título:Supporting the Health and Well-Being of Transgender Students.
[So] Source:J Sch Nurs;33(2):95-108, 2017 Apr.
[Is] ISSN:1546-8364
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Throughout the United States, there has been a rise in public discourse about transgender people and transgender issues. Much of this attention stems from passed and proposed anti-LGBTQ (lesbian, gay, bisexual, transgender, queer or questioning) legislation, including "bathroom bills" that would require transgender people to use public facilities corresponding with the sex designated on their birth certificates. With the recent discussion and legislation impacting school-aged children and adolescents, what does this mean for school nurses and how can they care and advocate for their transgender students? In this article, we aim to empower school nurses to join the discussion, advocate for inclusive and equitable school policies, and deliver gender-affirming care to transgender students. We will explain transgender identities; transgender-related stigma, prejudice, discrimination, and health concerns; gender-affirming approaches in caring for transgender youth; and implications for school nurses. School nurses play a key role in creating a space that is welcoming and affirming where transgender students can thrive.
[Mh] Termos MeSH primário: Promoção da Saúde/organização & administração
Serviços de Saúde para Pessoas Transgênero/organização & administração
Serviços de Saúde Escolar/organização & administração
Serviços de Enfermagem Escolar/organização & administração
Pessoas Transgênero
[Mh] Termos MeSH secundário: Adolescente
Criança
Feminino
Seres Humanos
Masculino
Logradouros Públicos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170121
[St] Status:MEDLINE
[do] DOI:10.1177/1059840516689705


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[PMID]:27779767
[Au] Autor:Shatzel JJ; Connelly KJ; DeLoughery TG
[Ad] Endereço:Division of Hematology/Medical Oncology, Knight Cancer Institute, Portland, Oregon.
[Ti] Título:Thrombotic issues in transgender medicine: A review.
[So] Source:Am J Hematol;92(2):204-208, 2017 Feb.
[Is] ISSN:1096-8652
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Clinicians, including hematologists, are more frequently encountering transgender individuals in practice; however, most lack training on the management and complications of transgender medicine. Hormonal therapy forms the backbone of medical interventions for patients undergoing gender transition. While supplementing an individual's intrinsic sex hormone is associated with a variety of hematologic complications including increased rates of venous thrombosis, cardiovascular events, erthyrocytosis, and malignancy, the risks of supplementing with opposing sex hormones are not well understood. Data on the hematologic complications of these therapies are accumulating but remain limited, and clinicians have little experience with their management. This review highlights the current interventions available in transgender medicine and related potential hematologic complications, and it suggests simple, evidence-based management going forward. Am. J. Hematol. 92:204-208, 2017. © 2016 Wiley Periodicals, Inc.
[Mh] Termos MeSH primário: Serviços de Saúde para Pessoas Transgênero
Terapia de Reposição Hormonal/efeitos adversos
Pessoas Transgênero
Trombose Venosa
[Mh] Termos MeSH secundário: Feminino
Terapia de Reposição Hormonal/métodos
Seres Humanos
Incidência
Masculino
Trombose Venosa/epidemiologia
Trombose Venosa/etiologia
Trombose Venosa/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170704
[Lr] Data última revisão:
170704
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1002/ajh.24593



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