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1.
Health Care Manage Rev ; 48(1): 52-60, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-35713571

RESUMEN

ISSUE: Health care management is faced with a basic conundrum about organizational behavior; why do professionals who are highly dedicated to their work choose to remain silent on critical issues that they recognize as being professionally and organizationally significant? Speaking-up interventions in health care achieve disappointing outcomes because of a professional and organizational culture that is not supportive. CRITICAL THEORETICAL ANALYSIS: Our understanding of the different types of employee silence is in its infancy, and more ethnographic and qualitative work is needed to reveal the complex nature of silence in health care. We use the sensemaking theory to elucidate how the difficulties to overcoming silence in health care are interwoven in health care culture. INSIGHT/ADVANCE: The relationship between withholding information and patient safety is complex, highlighting the need for differentiated conceptualizations of silence in health care. We present three Critical Challenge points to advance our understanding of silence and its roots by (1) challenging the predominance of psychological safety, (2) explaining how we operationalize sensemaking, and (3) transforming the role of clinical leaders as sensemakers who can recognize and reshape employee silence. These challenges also point to how employee silence can also result in a form of dysfunctional professionalism that supports maladaptive health care structures in practice. PRACTICE IMPLICATIONS: Delineating the contextual factors that prompt employee silence and encourage speaking up among health care workers is crucial to addressing this issue in health care organizations. For clinical leaders, the challenge is to valorize behaviors that enhance adaptive and deep psychological safety among teams and within professions while modeling the sharing of information that leads to improvements in patient safety and quality of care.


Asunto(s)
Liderazgo , Cultura Organizacional , Humanos , Atención a la Salud , Personal de Salud/psicología , Seguridad del Paciente
2.
Rev. urug. enferm ; 17(2): 1-10, dic. 2022.
Artículo en Español | LILACS, BDENF - Enfermería | ID: biblio-1393223

RESUMEN

El clima organizacional constituye uno de los elementos a considerar en los procesos organizativos y la calidad de los servicios públicos de salud. En este artículo se realiza una valoración sobre el tema, con el objetivo de caracterizar el trabajo de nuestros Centros de Diagnóstico Integral (CDI). Entre varios argumentos se analizan las técnicas propuestas por Letwin y Stinger. Se enfatiza en las técnicas de exploración del clima organizacional a través de cuatro dimensiones básicas: motivación, liderazgo, reciprocidad y participación. Se realizó análisis de contenido de documentos, que incluyó artículos originales y de revisión publicados desde el año 2001 al 2021, se identificaron y revisaron artículos que fueron útiles para el desarrollo de la revisión, así como monografías de varias revistas y tesis doctorales actualizadas que permitieron el análisis histórico lógico de la evolución de la definición del clima organizacional. La sistematización de los términos relacionados con el clima organizacional permitió definirlo con sus características, dimensiones e importancia, sin embargo se hace necesario su conocimiento para el mejoramiento de la calidad en las instituciones laborales.


The organizational climate constitutes one of the elements to be considered in the organizational processes and the quality of public health services. In this article an assessment is made on the subject, with the aim of characterizing the work of our Comprehensive Diagnostic Centers (CDI). Among several arguments, the techniques proposed by Letwin and Stinger are analyzed. Emphasis is placed on the techniques for exploring the organizational climate through four basic dimensions: motivation, leadership, reciprocity, and participation. Document content analysis was carried out, which included original and review articles published from 2001 to 2021, identifying and reviewing articles that were useful for the development of the review, as well as monographs from various journals and updated doctoral theses that allowed the logical historical analysis of the evolution of the definition of organizational climate. The systematization of the terms related to the organizational climate, allowed to define it, with its characteristics, dimensions and importance, however its knowledge is necessary for the improvement of quality in labor institutions.


O clima organizacional constitui um dos elementos a serem considerados nos processos organizacionais e na qualidade dos serviços públicos de saúde. Neste artigo é feita uma avaliação sobre o assunto, com o objetivo de caracterizar o trabalho de nossos Centros de Diagnóstico Integral (CDI). Entre vários argumentos, são analisadas as técnicas propostas por Letwin e Stinger. A ênfase é colocada nas técnicas de exploração do clima organizacional por meio de quatro dimensões básicas: motivação, liderança, reciprocidade e participação. Foi realizada análise de conteúdo documental, que incluiu artigos originais e de revisão publicados de 2001 a 2021, identificando e revisando artigos que foram úteis para o desenvolvimento da revisão, além de monografias de diversos periódicos e teses de doutorado atualizadas que permitiram a análise histórica lógica da evolução da definição de clima organizacional. A sistematização dos termos relacionados ao clima organizacional, permitiu defini-lo, com suas características, dimensões e importância, porém seu conhecimento é necessário para a melhoria da qualidade nas instituições trabalhistas.


Asunto(s)
Humanos , Atención Primaria de Salud , Calidad de la Atención de Salud , Venezuela , Condiciones de Trabajo , Planificación Estratégica , Cultura Organizacional , Compromiso Laboral , Satisfacción en el Trabajo , Liderazgo , Motivación
3.
BMC Health Serv Res ; 22(1): 1376, 2022 Nov 19.
Artículo en Inglés | MEDLINE | ID: mdl-36403010

RESUMEN

BACKGROUND: An increase in the number of older adults has highlighted the important issue of the safety of residents in nursing homes. This review aimed to review previous studies on patient safety of older adults living in nursing homes, analyze the tools used to measure it, and identify factors affecting patient safety of older adult residents in nursing homes. METHODS: A literature search was conducted using EMBASE, PubMed, CINHAL, and COCHRANE. The main search terms were "nursing home" or "skilled nursing facility" or "long-term care facility" and "patient safety." In total, 13,586 articles were identified. Two authors independently assessed the quality of each selected study using the Crowe Critical Appraisal Tool. RESULTS: Twenty-five studies were included in the analysis. There were a total of seven tools used to measure patient safety in nursing homes: the Nursing Home Survey on Patient Safety Culture (10 studies) and Hospital Survey on Patient Safety Culture (nine studies). Furthermore, the Nursing Home Survey on Patient Safety Culture-China, Safety Attitudes Questionnaire, Safety Attitudes Questionnaire in a Skilled Nursing Facility, Safety Attitudes Questionnaire-Ambulatory Version, and Modified Stanford Patient Safety Culture Survey Instrument were used in one study each. The most used tool among them was the Nursing Home Survey on Patient Safety Culture. Most tools used to measure patient safety in nursing homes were related to patient safety culture and employee attitudes. CONCLUSION: Organizational factors, such as the staff education system and the composition of appropriate personnel, should be strengthened to establish a patient safety culture in nursing homes, for which policy support is crucial.


Asunto(s)
Cultura Organizacional , Seguridad del Paciente , Humanos , Anciano , Casas de Salud , Administración de la Seguridad , Encuestas y Cuestionarios
5.
Artículo en Ruso | MEDLINE | ID: mdl-36385054

RESUMEN

The purpose of the article is to study approaches to the development of corporate culture of healthcare workers in terms of forming a tolerant attitude towards patients belonging to various ethno-cultural and confessional groups. Among the measures of managerial influence is the further development of the foundations of the corporate culture of employees of medical organizations, which can contribute to solving the problem of attracting patients belonging to a variety of national and religious groups. The results of the analysis (systematization of scientific literature and sociological survey in the form of interviews conducted by the authors of the article) of the main problems, the solution of which is associated with the development of corporate culture, showed that the attitude of patients and medical personnel to euthanasia, termination of pregnancy, death (including suicide); methods of reproduction of life (artificial conception, surrogacy); obstacles to religious rituals during the treatment of patients.This article presents conclusions on the analysis of these problems and possible approaches to their solution: the authors propose measures for the formation of new competencies in corporate culture (as a set of formal and informal requirements in a medical organization imposed on its employees) aimed at preventing and overcoming conflict situations arising from misunderstandings in relationships between patients and medical staff.


Asunto(s)
Actitud , Cultura Organizacional , Humanos
6.
Medicine (Baltimore) ; 101(45): e31603, 2022 Nov 11.
Artículo en Inglés | MEDLINE | ID: mdl-36397420

RESUMEN

We conducted a cross-sectional study of patient safety culture aimed at examining the factors that influence patient safety culture in university hospitals under a universal health insurance system. The Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality was used. The survey was distributed to 1066 hospital employees, and 864 responded. The confirmatory factor analysis showed a good fit of the results to the 12-composites model. The highest positive response rates were for "(1) Teamwork within units" (81%) and "(2) Supervisor/manager expectations and actions promoting patient safety" (80%), and the lowest was for "(10) Staffing" (36%). Hayashi's quantification theory type 2 revealed that working hours per week had the greatest negative impact on patient safety culture. Under a universal health insurance system, workload and human resources might have a significant impact on the patient safety culture.


Asunto(s)
Cultura Organizacional , Seguridad del Paciente , Humanos , Estudios Transversales , Hospitales Universitarios , Cobertura Universal del Seguro de Salud , Japón , Administración de la Seguridad
7.
J Korean Acad Nurs ; 52(5): 511-521, 2022 Oct.
Artículo en Coreano | MEDLINE | ID: mdl-36373467

RESUMEN

PURPOSE: This study aimed to examine the moderating effect of organizational justice on the relationship between self-efficacy and nursing performance among clinical nurses. METHODS: In January 2021, a cross-sectional survey was conducted with 224 clinical nurses recruited from a university-affiliated hospital in Suwon, South Korea. Participants completed online-based, self-report structured questionnaires. Collected data were analyzed using multiple regression and a simple model of PROCESS macro with a 95% bias-corrected bootstrap confidence interval. RESULTS: Self-efficacy and organizational justice were found to be significant predictors of nursing performance. These two predictors explained the additional 34.8% variance of nursing performance in the hierarchical regression model, after adjusting the other covariates. In addition, organizational justice moderated the relationship between self-efficacy and nursing performance among the clinical nurses. In particular, at low self-efficacy level, participants with high organizational justice had higher nursing performance compared to those with low organizational justice. CONCLUSION: Enhancing organizational justice can be used as an organizational strategy for improving the organizational culture in terms of distribution, procedure, and interaction. Ultimately, these efforts will contribute to the improvement of nursing performance through a synergistic effect on organizational justice beyond nurses' individual competency and self-efficacy.


Asunto(s)
Personal de Enfermería en Hospital , Cultura Organizacional , Humanos , Justicia Social , Estudios Transversales , Autoeficacia , República de Corea , Encuestas y Cuestionarios , Satisfacción en el Trabajo
8.
Artículo en Inglés | MEDLINE | ID: mdl-36361217

RESUMEN

The perception of the existence of deficits in patient safety, the associated costs and the limitation of resources have made it essential to define improvement strategies. Important concepts have emerged, such as safety climate, which evaluates the perceptions of safety status held by professionals in relation to their organization. The aim of this study is to characterize the safety climate in primary health care (PHC) using the Safety Attitudes Questionnaire (SAQ)-Short Form 2006 PT and to assess associations between SAQ-Short Form 2006 PT scores and demographic and professional characteristics. A cross-sectional study was conducted in all public PHC units in the northern region of Portugal. Data were collected through an online questionnaire shared via institutional emails and by means of a snowball approach. Descriptive and inferential statistical analysis were performed. Statistical significance set at p ≤ 0.05. A total of 649/7427 (8.7%) responses were included in the analyses. The mean and median total SAQ-Short Form 2006 PT scores were 69.23 (SD = 15.73, range 22.22-100.00) and 71.53 [59.03; 79.86], respectively. This is the first study to assess the safety climate in PHC in Portugal. The median obtained total SAQ-Short Form 2006 PT score was 71.53 [59.03; 79.86], which is below the threshold of ≥75, indicating safety deficits.


Asunto(s)
Cultura Organizacional , Administración de la Seguridad , Humanos , Estudios Transversales , Psicometría , Actitud del Personal de Salud , Encuestas y Cuestionarios , Atención Primaria de Salud
9.
Artículo en Inglés | MEDLINE | ID: mdl-36361273

RESUMEN

INTRODUCTION: Adverse events in hospitals are prevented through risk reduction and reliable processes. Highly reliable hospitals are grounded by a robust patient safety culture with effective communication, leadership, teamwork, error reporting, continuous improvement, and organizational learning. Although hospitals regularly measure their patient safety culture for strengths and weaknesses, there have been no systematic reviews with meta-analyses reported from Latin America. PURPOSE: Our systematic review aims to produce evidence about the status of patient safety culture in Latin American hospitals from studies using the Hospital Survey on Patient Safety Culture (HSOPSC). METHODS: This systematic review was guided by the JBI guidelines for evidence synthesis. Four databases were systematically searched for studies from 2011 to 2021 originating in Latin America. Studies identified for inclusion were assessed for methodological quality and risk of bias. Descriptive and inferential statistics, including meta-analysis for professional subgroups and meta-regression for subgroup effect, were calculated. RESULTS: In total, 30 studies from five countries-Argentina (1), Brazil (22), Colombia (3), Mexico (3), and Peru (1)-were included in the review, with 10,915 participants, consisting primarily of nursing staff (93%). The HSOPSC dimensions most positive for patient safety culture were "organizational learning: continuous improvement" and "teamwork within units", while the least positive were "nonpunitive response to error" and "staffing". Overall, there was a low positive perception (48%) of patient safety culture as a global measure (95% CI, 44.53-51.60), and a significant difference was observed for physicians who had a higher positive perception than nurses (59.84; 95% CI, 56.02-63.66). CONCLUSIONS: Patient safety culture is a relatively unknown or unmeasured concept in most Latin American countries. Health professional programs need to build patient safety content into curriculums with an emphasis on developing skills in communication, leadership, and teamwork. Despite international accreditation penetration in the region, there were surprisingly few studies from countries with accredited hospitals. Patient safety culture needs to be a priority for hospitals in Latin America through health policies requiring annual assessments to identify weaknesses for quality improvement initiatives.


Asunto(s)
Cultura Organizacional , Seguridad del Paciente , Humanos , América Latina , Administración de la Seguridad , Hospitales , Encuestas y Cuestionarios
10.
Adv Health Care Manag ; 212022 Dec 12.
Artículo en Inglés | MEDLINE | ID: mdl-36437620

RESUMEN

There are longstanding concerns about the sustainability of the US health care system. Payment reform has been seen over the last decade as a key strategy to reorienting the US health care system around value. Alternative payment models (APMs) that seek to accomplish this goal have become increasingly prevalent in the US, yet there is a perception that physicians are resistant to their use and that organizations have been slow to adopt such models. The reasons for the limited effectiveness of APM programs are multifactorial and include aspects related to the design and implementation of these programs and lack of alignment and coordination across different payers and health care sectors. Most importantly, however, is that the current organizational structures in US health care serve to dampen the direct impact of these incentives, often because health care delivery organizations face conflicting incentives themselves. Organizations filter and refine the incentives from multiple external payment contracts and develop internal incentive systems that best reflect the amalgamation of the incentives embedded across their contracts, and thus the fragmented nature of the US health care system serves to undermine efforts to transform care under value-based contracts. In addition to organizations having conflicting incentives, there also are fundamental problems with the design and implementation of APMs that hinder their acceptance among physicians and the organizations in which they work. Moreover, much remains to be learned about how organizations can best adapt to succeed under these models, and how organizational culture can be leveraged to transform care.


Asunto(s)
Médicos , Humanos , Organizaciones , Contratos , Cultura Organizacional
11.
Artículo en Inglés | MEDLINE | ID: mdl-36429702

RESUMEN

The implementation of effective workforce safety programmes ought to be linked to an understanding of the specificity of the work in the organisation concerned, taking into consideration the assessment of the level of safety expressed by the professional group representing it at the executive level. The main purpose of the study presented in the paper, which is part of a broader project of researching safety culture in the organisation, is a diagnosis of the safety climate in the Polish branch of an international manufacturing company. The following research question was formulated: Is the examined international manufacturing company a homogeneous organisation from the point of view of assessing its safety culture? The research was exploratory. In total, 203 respondents, which amounts to 35% of the employees, participated in the study. The selection of the sample was representative-in proportion to the number of employees in individual departments and their positions in the examined organisation. The presented paper includes an analysis of the results obtained on the basis of the abbreviated version of the Safety Climate Questionnaire, a self-developed tool to assess ten separate dimensions of safety climate. The results of a single-factor analysis of variance (ANOVA) along with post hoc tests prove that there is a statistically significant difference between the respondents representing different positions in the organisation and different areas of employment. The position held in the company significantly differentiates the employees in a statistically significant way-in eight out of eleven diagnostic areas, including the Summary Safety Climate Indicator (SSCI). In the case of department, statistically significant differences were found in seven out of eleven diagnostic areas. Education proved to be the factor that differentiates the respondents the least in terms of the assessment of workplace safety climate. Statistically significant differences occurred only in three out of eleven diagnostic areas. The observed differences in the assessment of the dimensions of workplace safety climate point to the need for the promotion of more diversified and individualised measures, taking into account the specificity of work and the nature of hazards in a given position, and the creation of practical safety programmes not only in the procedural and technical dimensions but also in social and psychological ones.


Asunto(s)
Cultura Organizacional , Administración de la Seguridad , Humanos , Lugar de Trabajo , Encuestas y Cuestionarios , Percepción
12.
Artículo en Inglés | MEDLINE | ID: mdl-36430093

RESUMEN

Psychological hazards within organizational structures of construction sites are difficult to detect and can have significant negative impacts on safety performances when such hazards erupt. At present, most safety performance assessment models for construction sites ignore psychological factors. Therefore, in order to reveal psychological hazards within construction site organizations and to avoid damage caused by psychological hazards to safety performances, this paper evaluates the safety performances of construction sites by focusing on leader-member exchange ambivalence as the main trigger point. The evaluation system and evaluation criteria are established through three aspects: building scale, emotional orientation, and stability factors. The hierarchical analysis method, game theory, and extension cloud model are combined to make evaluation results more objective and credible. Moreover, a construction project with high technical requirements, high investment, and complex construction conditions (defined as a complex project) and an ordinary construction project with low technical difficulty and simple construction conditions (defined as a general project) were selected for analysis. The evaluation results indicate that both complex projects and general projects have safety hazards regarding psychological orientations. Finally, this paper makes some suggestions from three aspects: management system and corporate culture, building site intelligence, and social opinion to improve the safety performances of construction sites. The evaluation results are the same as actual operation results, which verify that models proposed in this paper can be used for safety performance evaluations of actual construction projects and provide help for managers to grasp overall safety levels.


Asunto(s)
Industria de la Construcción , Salud Laboral , Lugar de Trabajo , Cultura Organizacional , Ambiente
14.
Artículo en Inglés | MEDLINE | ID: mdl-36360998

RESUMEN

This study aimed to further understand and compare the phenomenon of workplace bullying (WPB) among clinical nurses in various sociocultural contexts. The study sought to determine appropriate interventions, examining how said interventions should be delivered at individual, work-unit, and institutional levels. Qualitative meta-synthesis was chosen to achieve the study aims. Individual qualitative research findings were gathered, compared, and summarized using the thematic analysis suggested by Braun and Clark. Based on the predefined analytic points, the findings included the following themes: horizontal yet vertical violence, direct and indirect violence on victims, nurses feed on their own, accepting and condoning WPB embedded in ineffective work systems, and rippling over the entire organization. The results showed that the phenomenon of workplace bullying shares quite a few attributes across cultures in terms of the characteristics, types, perpetrators, subjects, and consequences. The findings suggest that interventions to change and improve organizational work culture must be developed and implemented.


Asunto(s)
Acoso Escolar , Enfermeras y Enfermeros , Estrés Laboral , Violencia Laboral , Humanos , Cultura Organizacional , Violencia , Lugar de Trabajo
15.
PLoS One ; 17(11): e0278100, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36441686

RESUMEN

The concept of safety climate has gained attention from safety experts as one of the most efficient and effective ways to deal with occupational accidents and injuries across industries. This paper explores the safety climate and the effect of employees' demographic variables on the safety climate perception in the printing industry. We adopted the Safety Climate Scale (SCS) developed by Ghahramani and Khalkhali to measure the safety climate in the print manufacturing industry of Ghana. Our findings, based on all the dimensions in the scale, revealed an unsafe safety climate. Also, there was a correlation between demographic factors (age, gender, experience, and education) and perception of workplace safety climate. The major contribution of this paper is to extend empirical research that provides a greater understanding of the health and safety environment within the printing industry of Ghana and the personal and collective attitudes and patterns of behaviour that determine the commitment to organisations' health and safety practices. These findings are important for managers in the printing industry because they provide evidence about the current safety climate so that management can take the action to reduce risks and improve performance. To improve the safety climate, we recommend that management and other stakeholders within the printing industry must commit and communicate effectively, embrace safety practices and procedures, and be more accountable and responsible to minimise the effects of a poor safety climate.


Asunto(s)
Industrias , Cultura Organizacional , Humanos , Ghana , Accidentes de Trabajo , Industria Manufacturera
17.
J Occup Health ; 64(1): e12373, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36424493

RESUMEN

OBJECTIVES: The present study examined the relationship between health culture evaluated by the Health and Productivity Survey Sheets and the implementation status of infection control measures against COVID-19 in the workplace. METHODS: This was a cross-sectional study using the corporate data (2518 companies) collected for the purpose of selecting the excellent company of health and productivity management by the Japanese government. The explanatory variable was the overall evaluation score, and the outcome was whether or not infection control measures against COVID-19 in the workplace. We used logistic regression analysis and calculated the odds ratio adjusted for the industry sector, the corporation size, and the operating profit ratio by the overall evaluation score category. RESULTS: The odds ratio of all infection control measurements in the workplace increased as the evaluation score increased. CONCLUSIONS: This study revealed a new finding that the presence of a healthy culture in the workplace will lead to the appropriate implementation of infection control measures during a pandemic. The company's ordinary commitment to employee health will be effective even in times of health crisis, such as during the outbreak of the pandemic.


Asunto(s)
COVID-19 , Salud Laboral , Humanos , Lugar de Trabajo , COVID-19/prevención & control , Estudios Transversales , Cultura Organizacional
19.
BMC Health Serv Res ; 22(1): 1342, 2022 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-36371214

RESUMEN

BACKGROUND: Designing implementation programs that effectively integrate complex healthcare innovations into complex settings is a fundamental aspect of knowledge translation. We describe the development of a conceptually grounded implementation program for a complex healthcare innovation and its subsequent application in pediatric hospital settings. METHODS: We conducted multiple case observations of the application of the Phased Reciprocal Implementation Synergy Model (PRISM) framework in the design and operationalization of an implementation program for a complex hospital wide innovation in pediatric hospital settings. RESULTS: PRISM informed the design and delivery of 10 international hospital wide implementations of the complex innovation, BedsidePEWS. Implementation and innovation specific goals, overarching implementation program design principles, and a phased-based, customizable, and context responsive implementation program including innovation specific tools and evaluation plans emerged from the experience. CONCLUSION: Theoretically grounded implementation approaches customized for organizational contexts are feasible for the adoption and integration of this complex hospital-wide innovation. Attention to the fitting of the innovation to local practices, setting, organizational culture and end-user preferences can be achieved while maintaining the integrity of the innovation.


Asunto(s)
Atención a la Salud , Cultura Organizacional , Niño , Humanos , Proyectos de Investigación , Hospitales , Innovación Organizacional
20.
Artículo en Inglés | MEDLINE | ID: mdl-36231165

RESUMEN

Safety voice has become a popular research topic in the organizational safety field because it helps to prevent accidents. A good safety climate and psychological safety can motivate employees to actively express their ideas about safety, but the specific mechanisms of safety climate and psychological safety, on safety voice, are not yet clear. Based on the "environment-subject cognition-behavior" triadic interaction model of social cognitive theory, this paper explores the relationship between safety climate and safety voice, and the mediating role of psychological safety. We collected questionnaires and conducted data analysis of the valid questionnaires using analytical methods such as hierarchical regression, stepwise regression, and the bootstrap sampling method. We found that safety climate significantly and positively influenced safety voice, and psychological safety played a mediating role between safety climate and safety voice, which strengthened the positive relationship between them. From the research results, it was clear that to stimulate employees to express safety voice behavior, organizations should strive to create a good safety climate and pay attention to building employees' psychological safety. The findings of this paper provide useful insights for the management of employee safety voice behavior in enterprises.


Asunto(s)
Cultura Organizacional , Voz , Cognición , Humanos , Organizaciones , Encuestas y Cuestionarios
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