{"id":1849,"date":"2020-12-15T09:43:46","date_gmt":"2020-12-15T09:43:46","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=1849"},"modified":"2025-11-04T14:13:40","modified_gmt":"2025-11-04T14:13:40","slug":"helping-pregnant-women-quit-smoking-sharing-best-practice-from-the-uk","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/lv\/2020\/12\/helping-pregnant-women-quit-smoking-sharing-best-practice-from-the-uk\/","title":{"rendered":"K\u0101 pal\u012bdz\u0113t gr\u016btniec\u0113m p\u0101rtraukt sm\u0113\u0137\u0113\u0161anu: labas prakses piem\u0113ri Apvienotaj\u0101 Karalist\u0113"},"content":{"rendered":"<p><strong>F\u0113likss Nautons (Felix Naughton), Austrumanglijas universit\u0101te, Apvienot\u0101 Karaliste<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><span style=\"font-weight: 400;\">25\u201350\u00a0% sm\u0113\u0137\u0113jo\u0161u sievie\u0161u p\u0101rtrauc sm\u0113\u0137\u0113\u0161anu p\u0113c tam, kad uzzina, ka ir st\u0101vokl\u012b. Bet k\u0101p\u0113c p\u0101r\u0113j\u0101s sm\u0113\u0137\u0113t\u0101jas turpina sm\u0113\u0137\u0113t visu gr\u016btniec\u012bbas laiku?\u00a0<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">Vai vi\u0146as nezina, ka sm\u0113\u0137\u0113\u0161ana gr\u016btniec\u012bbas laik\u0101 ir kait\u012bga?<\/span><\/i><span style=\"font-weight: 400;\"> Parasti zina. Apvienotaj\u0101 Karalist\u0113 veikt\u0101 <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22311960\/\"><span style=\"font-weight: 400;\">p\u0113t\u012bjum\u0101<\/span><\/a><span style=\"font-weight: 400;\">, kur\u0101 piedal\u012bj\u0101s gr\u016btnieces, kuras bija gan motiv\u0113tas, gan nemotiv\u0113tas p\u0101rtraukt sm\u0113\u0137\u0113\u0161anu, tika konstat\u0113ts, ka 99\u00a0% no vi\u0146\u0101m vair\u0101k vai maz\u0101k piekr\u012bt apgalvojumam, ka \u201csm\u0113\u0137\u0113\u0161ana gr\u016btniec\u012bbas laik\u0101 var nopietni kait\u0113t manam b\u0113rnam\u201d, un aptuveni 75\u00a0% piekr\u012bt apgalvojumam, ka sm\u0113\u0137\u0113\u0161ana \u201cvar \u013coti kait\u0113t\u201d vai \u201c\u0101rk\u0101rt\u012bgi kait\u0113t\u201d. Ta\u010du p\u0113c 12 ned\u0113\u013c\u0101m sm\u0113\u0137\u0113\u0161anu bija p\u0101rtrauku\u0161as maz\u0101k nek\u0101 10\u00a0% responden\u0161u. Lai ar\u012b ar sm\u0113\u0137\u0113\u0161anas p\u0101rtrauk\u0161anu saist\u012btu uzved\u012bbu bie\u017e\u0101k uzs\u0101k <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5695489\/\"><span style=\"font-weight: 400;\">sievietes, kur\u0101m ir sp\u0113c\u012bga p\u0101rliec\u012bba<\/span><\/a><span style=\"font-weight: 400;\"> par sm\u0113\u0137\u0113\u0161anas kait\u012bgumu gr\u016btniec\u012bbas laik\u0101, \u0161\u0137iet, ka \u0161\u012b p\u0101rliec\u012bba <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5896485\/\"><span style=\"font-weight: 400;\">nepaaugstina izredzes<\/span><\/a><span style=\"font-weight: 400;\"> sasniegt stabilu attur\u012bbu.<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5896485\/\"><span style=\"font-weight: 400;\">\u00a0<\/span><\/a><\/p>\n<p><!--more--><\/p>\n<p><span style=\"font-weight: 400;\">Kopsavilkums: uzskatiem par sm\u0113\u0137\u0113\u0161anas kait\u012bgumu gr\u016btniec\u012bbas laik\u0101 ir pavisam neliela noz\u012bme.<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">Vai sieviet\u0113m nav motiv\u0101cijas p\u0101rtraukt sm\u0113\u0137\u0113\u0161anu?<\/span><\/i><span style=\"font-weight: 400;\"> Da\u017eos gad\u012bjumos \u2013 nav. M\u016bsu <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5695489\/\"><span style=\"font-weight: 400;\">p\u0113t\u012bjumi<\/span><\/a><span style=\"font-weight: 400;\"> liecina, ka gr\u016btniec\u012bbas s\u0101kum\u0101 gandr\u012bz puse sievie\u0161u ir noska\u0146otas p\u0101rtraukt sm\u0113\u0137\u0113\u0161anu tuv\u0101ko 30 dienu laik\u0101, un to m\u0113\u0123ina ar\u012b izdar\u012bt. Turpinoties gr\u016btniec\u012bbai, motiv\u0101cija p\u0101rtraukt sm\u0113\u0137\u0113\u0161anu samazin\u0101s. P\u0101rsteidzo\u0161i, bet motiv\u0101cijas esam\u012bba <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5896485\/\"><span style=\"font-weight: 400;\">neuzlabo izredzes<\/span><\/a><span style=\"font-weight: 400;\"> g\u016bt pan\u0101kumus c\u012b\u0146\u0101 ar sm\u0113\u0137\u0113\u0161anu. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/21752135\/\"><span style=\"font-weight: 400;\">L\u012bdz\u012bgi rezult\u0101ti<\/span><\/a><span style=\"font-weight: 400;\"> atrodami sm\u0113\u0137\u0113t\u0101ju grup\u0101, kur\u0101 sievietes nebija gr\u016btniec\u012bbas st\u0101vokl\u012b. <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2947553\/\"><span style=\"font-weight: 400;\">Randomiz\u0113tu kontrol\u0113tu p\u0113t\u012bjumu p\u0101rskatos<\/span><\/a><span style=\"font-weight: 400;\"> ir izv\u0113rt\u0113tas intervences, kur\u0101s k\u0101 konsult\u0113\u0161anas pieeja tiek izmantota motiv\u0113jo\u0161a intervija (p\u0101rrunas), kur viens no m\u0113r\u0137iem bija pal\u012bdz\u0113t uzlabot uzved\u012bbas p\u0101rmai\u0146u motiv\u0101ciju. \u0160ie p\u0101rskati liecina, ka t\u0101 nav efekt\u012bva, lai sekm\u0113tu sm\u0113\u0137\u0113\u0161anas p\u0101rtrauk\u0161anu gr\u016btniec\u012bbas laik\u0101.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Kopsavilkums: motiv\u0101cija palielina iesp\u0113jam\u012bbu, ka sieviete m\u0113\u0123in\u0101s p\u0101rtraukt sm\u0113\u0137\u0113\u0161anu, bet ar to vien nepietiek, lai nodro\u0161in\u0101tu notur\u012bgus pan\u0101kumus attur\u012bbai no sm\u0113\u0137\u0113\u0161anas.<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">Vai sievietes nav ieinteres\u0113tas sa\u0146emt atbalstu, lai p\u0101rtrauktu sm\u0113\u0137\u0113\u0161anu?<\/span><\/i><span style=\"font-weight: 400;\"> Ar\u012b \u0161eit ir j\u0101atbild, ka da\u017eos gad\u012bjumos \u2013 nav, bet ne vienm\u0113r. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/31570944\/\"><span style=\"font-weight: 400;\">M\u0113s atkl\u0101j\u0101m<\/span><\/a><span style=\"font-weight: 400;\">, ka gr\u016btniec\u012bbas s\u0101kum\u0101 aptuveni puse gr\u016btnie\u010du v\u0113l\u0113j\u0101s sa\u0146emt atbalstu, lai p\u0101rtrauktu sm\u0113\u0137\u0113\u0161anu. At\u0161\u0137ir\u012bb\u0101 no motiv\u0101cijas, interese par atbalstu saglab\u0101j\u0101s l\u012bdz gr\u016btniec\u012bbas beig\u0101m. Tom\u0113r tikai aptuveni desmit\u0101 da\u013ca sievie\u0161u vis\u0101 gr\u016btniec\u012bbas laik\u0101 izmantoja pieejamo atbalstu sm\u0113\u0137\u0113\u0161anas p\u0101rtrauk\u0161anai. T\u0101s sievietes, kuras izmantoja atbalstu, interesi par to bie\u017e\u0101k pauda gr\u016btniec\u012bbas s\u0101kuma period\u0101. Saruna ar vesel\u012bbas apr\u016bpes speci\u0101listu par sm\u0113\u0137\u0113\u0161anas p\u0101rtrauk\u0161anu bija cie\u0161i saist\u012bta ar interesi sa\u0146emt atbalstu, t\u0101p\u0113c to var uzskat\u012bt par vienk\u0101r\u0161u veidu, k\u0101 palielin\u0101t iesp\u0113ju, ka atbalsts tiks izmantots.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Kopsavilkums: saruna ar gr\u016btnieci par sm\u0113\u0137\u0113\u0161anas p\u0101rtrauk\u0161anu var palielin\u0101t vi\u0146as interesi par atbalstu, kas savuk\u0101rt var palielin\u0101t vi\u0146as iesp\u0113jas to izmantot.<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">Vai nav neviena \u012bsti efekt\u012bva veida, k\u0101 pal\u012bdz\u0113t gr\u016btniec\u0113m?<\/span><\/i><span style=\"font-weight: 400;\"> Par laimi, ir! P\u0113t\u012bjumi liecina: atbalsts uzved\u012bbas mai\u0146ai, struktur\u0113ti ieteikumi un pal\u012bdz\u012bba p\u0101rvald\u012bt da\u017e\u0101dus sm\u0113\u0137\u0113\u0161anas un t\u0101s p\u0101rtrauk\u0161anas uzved\u012bbas aspektus (lai ar\u012b t\u0101 nav motiv\u0113jo\u0161a intervija), neatkar\u012bgi no t\u0101, vai to realiz\u0113 <\/span><a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD001055.pub5\/full\"><span style=\"font-weight: 400;\">individu\u0101las konsult\u0101cijas<\/span><\/a><span style=\"font-weight: 400;\"> veid\u0101 vai <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18339103\/\"><span style=\"font-weight: 400;\">pa\u0161pal\u012bdz\u012bbas veid\u0101, gan druk\u0101t\u0101<\/span><\/a><span style=\"font-weight: 400;\">, gan <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29912621\/\"><span style=\"font-weight: 400;\">digit\u0101l\u0101<\/span><\/a><span style=\"font-weight: 400;\"> form\u0101, var pal\u012bdz\u0113t gr\u016btniec\u0113m p\u0101rtraukt sm\u0113\u0137\u0113\u0161anu. Nikot\u012bna aizst\u0101jterapija papildus uzved\u012bbas mai\u0146as atbalstam sieviet\u0113m ar m\u0113renu vai augstu atkar\u012bbu no nikot\u012bna <\/span><a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD010078.pub3\/full\"><span style=\"font-weight: 400;\">var palielin\u0101t atbalsta efektivit\u0101ti<\/span><\/a><span style=\"font-weight: 400;\">. Tom\u0113r pier\u0101d\u012bjumu tam ir visai maz, visticam\u0101k, t\u0101p\u0113c, ka daudzos p\u0113t\u012bjumos noskaidrots, ka nikot\u012bna aizst\u0101jterapija m\u0113dz izr\u0101d\u012bties neefekt\u012bva bie\u017ei izplat\u012bt\u0101s lieto\u0161anas nor\u0101d\u012bjumu neiev\u0113ro\u0161anas d\u0113\u013c. Da\u013c\u0113ji tas ir saist\u012bts ar ba\u017e\u0101m, ka nikot\u012bns ir kait\u012bgs mazulim. Tom\u0113r <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32621526\/\"><span style=\"font-weight: 400;\">p\u0101rskat\u0101<\/span><\/a><span style=\"font-weight: 400;\"> par visaugst\u0101k\u0101s kvalit\u0101tes p\u0113t\u012bjumiem ar desmitiem t\u016bksto\u0161u sievie\u0161u un z\u012bdai\u0146u konstat\u0113ts, ka nav pier\u0101d\u012bjumu nikot\u012bna aizst\u0101jterapijas kait\u012bgumam gr\u016btniec\u012bbas laik\u0101. Pamatojoties uz to, sievietes var b\u016bt p\u0101rliecin\u0101tas, ka nikot\u012bna aizst\u0101jterapijas riski ir zemi, sal\u012bdzinot ar turpm\u0101ku tabakas lieto\u0161anu. Maz\u0101k zin\u0101ms faktors ir tas, ka paaugstin\u0101t\u0101s vielmai\u0146as d\u0113\u013c nikot\u012bns gr\u016btnieces organism\u0101 <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11961061\/\"><span style=\"font-weight: 400;\">no\u0101rd\u0101s divreiz \u0101tr\u0101k<\/span><\/a><span style=\"font-weight: 400;\"> nek\u0101 laik\u0101, kad sieviete nav st\u0101vokl\u012b. Tas noz\u012bm\u0113, ka gr\u016btniec\u0113m nepiecie\u0161ams vair\u0101k nikot\u012bna aizst\u0101jterapijas l\u012bdzek\u013ca nek\u0101 parasti, lai mazin\u0101tu alkas p\u0113c cigaretes un nikot\u012bna abstinenci. Tom\u0113r visbie\u017e\u0101k gan gr\u016btnieces, gan vesel\u012bbas apr\u016bpes speci\u0101listi <\/span><a href=\"https:\/\/www.journalslibrary.nihr.ac.uk\/hta\/hta21360#\/abstract\"><span style=\"font-weight: 400;\">izv\u0113las lietot maz\u0101k<\/span><\/a><span style=\"font-weight: 400;\"> nikot\u012bna aizst\u0101jterapijas nek\u0101 parasti.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Citi nikot\u012bna aizst\u0101\u0161anas veidi, piem\u0113ram, e-cigaretes, gr\u016btniec\u012bbas laik\u0101 var b\u016bt tikpat efekt\u012bvi k\u0101 p\u0101r\u0113j\u0101 laik\u0101, ta\u010du pa\u0161laik mums nav pier\u0101d\u012bjumu, kas apstiprin\u0101tu e-cigare\u0161u lieto\u0161anas efektivit\u0101ti tie\u0161i gr\u016btniec\u012bbas period\u0101. Visticam\u0101k, e-cigare\u0161u kait\u0113jums b\u016bs iev\u0113rojami maz\u0101ks nek\u0101 tabakas kait\u0113jums. Ja gr\u016btniece v\u0113las izmantot e-cigaretes, lai t\u0101s vi\u0146ai pal\u012bdz\u0113tu p\u0101rtraukt sm\u0113\u0137\u0113\u0161anu, Apvienotaj\u0101 Karalist\u0113 ir <\/span><a href=\"https:\/\/smokefreeaction.org.uk\/wp-content\/uploads\/2019\/08\/2019-Challenge-Group-ecigs-briefing-FINAL.pdf\"><span style=\"font-weight: 400;\">ieteikums vi\u0146u atbalst\u012bt<\/span><\/a><span style=\"font-weight: 400;\">. V\u0113l viena efekt\u012bva pieeja ir nodro\u0161in\u0101t finansi\u0101lus stimulus attur\u012bbas sasnieg\u0161anai, ja tas tiek nodro\u0161in\u0101ts vienlaikus ar atbalstu uzved\u012bbai. <\/span><a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD004307.pub6\/full\"><span style=\"font-weight: 400;\">Pier\u0101d\u012bjumi<\/span><\/a><span style=\"font-weight: 400;\"> liecina, ka stimuli ir visefekt\u012bv\u0101k\u0101 no zin\u0101maj\u0101m pieej\u0101m.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Kopsavilkums: efekt\u012bvi pa\u0146\u0113mieni, kas pal\u012bdz no nikot\u012bna atkar\u012bg\u0101m gr\u016btniec\u0113m, ir atbalsts uzved\u012bbai, it \u012bpa\u0161i kombin\u0101cij\u0101 ar nikot\u012bna aizst\u0101jterapiju, un\/vai finansi\u0101li stimuli.<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">Kam atbalsts nepiecie\u0161ams visvair\u0101k?<\/span><\/i><span style=\"font-weight: 400;\"> Ir <\/span><a href=\"https:\/\/www.researchgate.net\/publication\/321779987_Predictors_of_smoking_cessation_during_pregnancy_a_systematic_review_and_meta-analysis_Predictors_of_smoking-cessation\"><span style=\"font-weight: 400;\">daudz faktoru<\/span><\/a><span style=\"font-weight: 400;\">, kas saist\u012bti ar sm\u0113\u0137\u0113\u0161anas p\u0101rtrauk\u0161anu gr\u016btniec\u012bbas laik\u0101, piem\u0113ram, zem\u0101ka izgl\u012bt\u012bba vai ien\u0101kumi. Bet praks\u0113 nov\u0113rojams, ka b\u016btiska noz\u012bme ir tam, vai gr\u016btniecei ir partneris, kur\u0161 sm\u0113\u0137\u0113, k\u0101 ar\u012b vid\u0113ja vai augsta atkar\u012bba no nikot\u012bna \u2013 tas daudz\u0101m sieviet\u0113m ir noz\u012bm\u012bgs \u0161\u0137\u0113rslis, lai p\u0101rtrauktu sm\u0113\u0137\u0113\u0161anu. Citi noz\u012bm\u012bgi faktori ir depresija un liels stress gr\u016btniec\u012bbas laik\u0101.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Kopsavilkums: sieviet\u0113m ar jebkuru vai visiem \u0161iem faktoriem, iesp\u0113jams, b\u016bs nepiecie\u0161ams intens\u012bvs un daudzkomponentu atbalsts.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><b>Praktiski ieteikumi\u00a0<\/b><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Sniedziet vis\u0101m sm\u0113\u0137\u0113jo\u0161\u0101m gr\u016btniec\u0113m inform\u0101ciju par risku, ko sm\u0113\u0137\u0113\u0161ana rada vi\u0146\u0101m pa\u0161\u0101m un vi\u0146u mazulim, un pied\u0101v\u0101jiet atbalstu sm\u0113\u0137\u0113\u0161anas p\u0101rtrauk\u0161anai vis\u0101m sieviet\u0113m, neatkar\u012bgi no t\u0101, vai vi\u0146\u0101m pa\u0161\u0101m ir vai nav motiv\u0101cija p\u0101rtraukt sm\u0113\u0137\u0113\u0161anu. Ja sieviete atsak\u0101s, turpiniet pied\u0101v\u0101t atbalstu vis\u0101 gr\u016btniec\u012bbas laik\u0101.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Sieviet\u0113m, kuras piekr\u012bt, sniedziet struktur\u0113tu atbalstu uzved\u012bbai, kas var tikt realiz\u0113ts gan individu\u0101las konsult\u0101cijas veid\u0101, gan pa\u0161pal\u012bdz\u012bbas veid\u0101, gan druk\u0101t\u0101, gan digit\u0101l\u0101 form\u0101. Ta\u010du nav v\u0113rts pied\u0101v\u0101t motiv\u0113jo\u0161u interviju.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Uzved\u012bbas atbalsta efektivit\u0101te, visticam\u0101k, tiks palielin\u0101ta, pied\u0101v\u0101jot nikot\u012bna aizst\u0101jterapiju sieviet\u0113m, kur\u0101m ir m\u0113rena vai augsta atkar\u012bba no nikot\u012bna. Ta\u010du sieviet\u0113m j\u0101pal\u012bdz to efekt\u012bvi izmantot, inform\u0113jot par nepiecie\u0161am\u012bbu iev\u0113rot lieto\u0161anas nor\u0101d\u012bjumus un nov\u0113r\u0161ot visas nepamatot\u0101s ba\u017eas par nikot\u012bna aizst\u0101jterapijas lieto\u0161anu gr\u016btniec\u012bbas laik\u0101. Ja sieviete v\u0113las izmantot e-cigaretes, lai p\u0101rtrauktu sm\u0113\u0137\u0113\u0161anu, tas vi\u0146\u0101m var to pal\u012bdz\u0113t izdar\u012bt, un \u0161\u012b izv\u0113le b\u016btu j\u0101uzskata par kait\u0113juma mazin\u0101\u0161anas pieeju.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Ja tiek izmantota nikot\u012bna aizst\u0101jterapija, mudiniet sievietes izmantot divas formas (&#8220;kombin\u0113to terapiju&#8221;, piem\u0113ram, pl\u0101ksterus un ko\u0161\u013c\u0101jamo gumiju), lai nodro\u0161in\u0101tu pietiekamu nikot\u012bna aizst\u0101\u0161anu un mazin\u0101tu alkas p\u0113c cigaretes un nikot\u012bna abstinenci.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Ja ir pieejami resursi, pied\u0101v\u0101jiet finansi\u0101lus stimulus par attur\u012bbu, ja t\u0101 pier\u0101d\u0101ma, piem\u0113ram, izmantojot izelpas p\u0101rbaudi ar oglek\u013ca monoks\u012bda (CO) detektoru.<\/span><\/li>\n<\/ul>\n<p><b><i>Intere\u0161u konflikta deklar\u0101cija:<\/i><\/b><span style=\"font-weight: 400;\"> Dr. F\u0113likss Nautons ne finansi\u0101li, ne k\u0101 cit\u0101di nav saist\u012bts ne ar vienu nikot\u012bna aizst\u0101jterapijas vai e-cigare\u0161u ra\u017eot\u0101ju.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Tulkoju\u0161as And\u017eela Ber\u0137e un Krist\u012bne M\u0101rtinsone<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Felix Naughton, University of East Anglia, UK \u00a0Between 25-50% of female smokers quit smoking after they discover they are pregnant. 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