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  • 1.
    Bäckström, Britt
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The meaning of middle-aged female spouses' lived experience of the relationship with a partner who has suffered a stroke, during the first year postdischarge2010In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 17, no 3, p. 257-268Article in journal (Refereed)
    Abstract [en]

    Stroke consequences present a great long-term challenge to the spouses of the stroke sufferer. A longitudinal study with a phenomenological hermeneutic approach was used to illuminate the meanings of middle-aged female spouses' lived experience of their relationship with a partner who has suffered a stroke, during the first year postdischarge. Four middle-aged female spouses of stroke sufferers participated in the study. Narrative interviews were conducted 1, 6 and 12 month postdischarge (total of 12 interviews), audio-taped and transcribed verbatim to a text and interpreted by a phenomenological hermeneutic method inspired by Ricoeur. The findings showed a process over time during which spouses come to know, recognize and acknowledge the residual changes in their partners' cognitive and emotional conditions and the impact on their relationship. Spouses showed grief due to the loss of the marital relationship they once had and anxiety that they would not be able to continue in an undesired relationship in the future. Even if the partner is still alive, there is a loss to grieve and to be understood, an important meaning of the transition process in the relationship during the first year after the partner's discharge.

  • 2.
    Bäckström, Britt
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Karin
    Institutionen för omvårdnad, Umeå Universitet, Campus Örnsköldsvik.
    The experience of being a middle-aged close relative of a person who has suffered a stroke - six months after discharge from a rehabilitation clinic2009Conference paper (Other academic)
    Abstract [en]

    Being a close relative brings with it a large number of consequences, with the life situation changing over time. The aim of this study was to illuminate the experiences of being a middle-aged close relative of a person who has suffered a stroke six months after being discharged from a medical rehabilitation clinic. Narrative interviews were conducted with nine middle-aged close relatives and analyzed using a content analysis with a latent approach. The analysis revealed that being close to someone who had suffered a stroke six months after discharge meant; a struggling for control and a renewal of family life in the shadow of suffering and hope. The middle-aged close relatives began to perceive the changed reality. They were struggling to take on something new, become reconciled and find a balance in their family life. Their ability to work, relief from caring concerns and having support and togetherness with others seemed to be essential for the close relatives in their efforts to manage their life situation and maintain their well-being. Having reached the ‘halfway point’ in their lives and still with half of their life in front of them created worries. They felt dejected about their changed relationships and roles, experience a sense of loss of shared child responsibilities, a negative impact on their marital relationships and sexual satisfaction. They felt trapped in a caring role and they worried about how to endure in the future. The middle-aged close relatives’ experiences were of being alone and neglected, in an arduous and complex life situation filled with loss and grief. The findings highlights that health professionals need to see and listen to the close relatives’ experiences of transition in order to provide appropriate support adjusted to their varying needs during a time of renewal.

  • 3.
    Bäckström, Britt
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Karin
    Department of Nursing, Umeå University, Campus Örnsköldsvik..
    The experience of being a middle-aged close relative of aperson who has suffered a stroke – six months after discharge from a rehabilitation clinic2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 1, p. 116-124Article in journal (Refereed)
    Abstract [en]

    The experience of being a middle-aged close relative of a person who has suffered a stroke - six months after discharge from a rehabilitation clinicBeing a close relative brings with it a large number of consequences, with the life situation changing over time. The aim of this study was to illuminate the experiences of being a middle-aged close relative of a person who has suffered a stroke 6 months after being discharged from a medical rehabilitation clinic. Narrative interviews were conducted with nine middle-aged close relatives and analysed using a content analysis with a latent approach. The analysis revealed that being close to someone who had suffered a stroke 6 months after discharge meant; a struggling for control and a renewal of family life in the shadow of suffering and hope. The middle-aged close relatives began to perceive the changed reality. They were struggling to take on something new, become reconciled and find a balance in their family life. Their ability to work, relief from caring concerns and having support and togetherness with others seemed to be essential for the close relatives in their efforts to manage their life situation and maintain their well-being. Having reached the 'halfway point' in their lives and still with half of their life in front of them created worries. They felt dejected about their changed relationships and roles, experience a sense of loss of shared child responsibilities, a negative impact on their marital relationships and sexual satisfaction. They felt trapped in a caring role and they worried about how to endure in the future. The middle-aged close relatives' experiences were of being alone and neglected, in an arduous and complex life situation filled with loss and grief. The findings highlights that health professionals need to see and listen to the close relatives' experiences of transition in order to provide appropriate support adjusted to their varying needs during a time of renewal.

  • 4.
    Bäckström, Britt
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The meaning of being a middle-aged close relative of a person who has suffered a stroke, 1 month after discharge from a rehabilitation clinic2007In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 14, no 3, p. 243-254Article in journal (Refereed)
    Abstract [en]

    The sudden and unexpected impact of stroke may have a stressful affect on close relatives. To illuminate the essential meaning in the lived experience of a middle-aged close relative of a person who has suffered a stroke, narrative interviews were conducted with 10 close relatives of people who had suffered their first stroke where both parties were aged over 18 and under 65. A phenomenological-hermeneutic interpretation of the narratives was then conducted. Three intimately intertwined themes emerged during the analysis: 'being called to mission', 'feeling lost and set adrift' and 'struggling to keep going'. The middle-aged close relatives felt unreflectively duty bound. There was a struggle with suffering and enduring the process of coping with life and overcoming a feeling of helplessness. Life turned out to be a struggle with overwhelming feelings. They felt alienated in a restricted life situation, disconnected from themselves and others, and from a world that supports feelings of being lost and set adrift (i.e. feeling homeless). Strength was found in moments when the situation improved, in being related to oneself and others, and when feelings of normality were regained.

  • 5.
    Bäckström, Britt
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The meaning of being a middle-aged close relative of a person who has suffered a stroke, one month after discharge from a rehabilitation clinic: Muntlig presentation. Nationell konferens - Vårdstämman, Stockholm, Sverige2007Conference paper (Other academic)
  • 6.
    Bäckström, Britt
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The meaning of being a young close relative of a person who has suffered a stroke, one month after discharge from a rehabilitation clinic: Oral presentation. Nurses at the Forefront: Dealing with the Unexpected. ICN International Conference, 27 May - 1 June 2007,Yokohama, Japan2007Conference paper (Other academic)
  • 7. Engström, Birgitta
    et al.
    Nilsson, Roland
    Willman, Aina
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Omvårdnad vid stroke: State of the art2005Book (Other academic)
  • 8.
    Juthberg, Christina
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Eriksson, S
    Norberg, A
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Syn på samvete och upplevelse av samvetsstress i relation till utmattningssyndrom (utbrändhet) hos vårdpersonal i kommunal äldreomsorg: Vårdstämman, Stockholm, Sverige2007Conference paper (Other academic)
  • 9.
    Juthberg, Christina
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Eriksson, S
    Nordberg, A
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Perceptions of conscience in relation to stress of conscience among care providers in elderly care: Oral presentation. International conference, The European Conference in Nursing Science EDCNS 2006,Sept. 29, Berlin, Germany2006Conference paper (Other academic)
  • 10.
    Juthberg, Christina
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Eriksson, Sture
    Umeå University, Umeå.
    Norberg, Astrid
    Umeå University, Umeå.
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Perceptions of conscience in relation to stress of conscience2007In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 14, no 3, p. 329-343Article in journal (Refereed)
    Abstract [en]

    Every day situations arising in health care contain ethical issues influencing care providers' conscience. How and to what extent conscience is influenced may differ according to how conscience is perceived. This study aimed to explore the relationship between perceptions of conscience and stress of conscience among care providers working in municipal housing for elderly people. A total of 166 care providers were approached, of which 146 (50 registered nurses and 96 nurses' aides/enrolled nurses) completed a questionnaire containing the Perceptions of Conscience Questionnaire and the Stress of Conscience Questionnaire. A multivariate canonical correlation analysis was conducted. The first two functions emerging from the analysis themselves explained a noteworthy amount of the shared variance (25.6% and 17.8%). These two dimensions of the relationship were interpreted either as having to deaden one's conscience relating to external demands in order to be able to collaborate with coworkers, or as having to deaden one's conscience relating to internal demands in order to uphold one's identity as a 'good' health care professional.

  • 11.
    Juthberg, Christina
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Eriksson, Sture
    Norberg, Astrid
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Stress of conscience and perceptions of conscience in relation to burnout among care providers in older people2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 14, p. 1897-1906Article in journal (Refereed)
    Abstract [en]

    Aims. The aim was to study the relationship between conscience and burnout among care-providers in older care, exploring the relationship between stress of conscience and burnout, and between perceptions of conscience and burnout.Background. Everyday work in healthcare presents situations that influence care-providers' conscience. How care-providers perceive conscience has been shown to be related to stress of conscience (stress related to troubled conscience), and in county council care, an association between stress of conscience and burnout has been found.Method. A questionnaire study was conducted in municipal housing for older people. A total of 166 care-providers were approached, of which 146 (50 registered nurses and 96 nurses' aides/enrolled nurses) completed a questionnaire folder containing the stress of conscience questionnaire, the perceptions of conscience questionnaire and the maslach burnout inventory. Multivariate canonical correlation analysis was used to explore relationships.Result. The relationship between stress of conscience and burnout indicates that experiences of shortcomings and of being exposed to contradictory demands are strongly related to burnout (primarily to emotional exhaustion). The relationship between perceptions of conscience and burnout indicates that a deadened conscience is strongly related to burnout.Conclusion. Conscience seems to be of importance in relation to burnout, and suppressing conscience may result in a profound loss of wholeness, integrity and harmony in the self.Relevance to clinical practice. The results from our study could be used to raise awareness of the importance of conscience in care.

  • 12. Norberg, A
    et al.
    Strandberg, G
    Söderberg, A
    Eriksson, S
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Armgard, LO
    Lutzén, K
    Zingmark, K
    Dahlqvist, V
    Ericson-Lidman, E
    Glasberg, AL
    Juthberg, Christina
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Samvetet - en tillgång eller en börda? Samvetsstress i relation till syn på samvete, moralisk lyhördhet, inre styrka, socialt stöd och utmattningssymtom.: Symposium. Nationell konferens. Vårdstämman, Stockholm, Sverige2007Conference paper (Other academic)
  • 13. Persson, C
    et al.
    Wennman-Larsen, A
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Gustavsson, P
    Assessing informal caregivers' experiences: a qualitative and psychometric evaluation of the Caregiver Reaction Assessment Scale2008In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 17, no 2, p. 189-199Article in journal (Refereed)
    Abstract [en]

    With the aim to evaluate the Swedish version of the Caregiver Reaction Assessment Scale (CRA), informal caregivers (n = 209) to individuals with a malignant disease, dementia or a physical impairment were recruited. The CRA was developed in the USA and is a self-rating questionnaire consisting of five subscales, measuring family members' reactions to the experience of caring for a relative with mental or physical illnesses. Data were analysed using psychometric and qualitative methods. Findings indicated good internal consistency, and a factor analysis confirmed the structure with five subscales; however, an overlap of items between the subscales was found. A content analysis of respondents' comments indicated that there were problems due to presuppositions inherent in the questions and with the meaning of words. Problems regarding inclusion/exclusion aspects in some concepts were also found. Two aspects of caregiver reactions were found to be missing or only partly covered: worrying and positive experiences. Results from this study suggest that the Swedish version is useful for assessment of caregiver reactions but needs further refinement.

  • 14. Persson, Carina
    et al.
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Att vara i situationen som närstående till en person med inoperabel lungcancer: Muntlig presentation, Nordisk konferens Familjefokuserad omvårdnad, Kalmar, Sverige2006Conference paper (Other academic)
  • 15. Persson, Carina
    et al.
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Being In the situation of a significant other to a person with inoperable lungcancer: Poster presentation. Internationell conferens. 14th International Conference on Cancer Nursing, Toronto, Canada2006Conference paper (Other academic)
  • 16.
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Att ha svårt att förstå och göra sig förstådd2004In: Att vara äldre: "- man har ju sina krämpor -", Lund: Studentlitteratur, 2004, p. 221-232Chapter in book (Other academic)
  • 17.
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Förnimmelse viktig del i kommunikationen med patienter med afasi2001In: Vårdfacket, ISSN 0347-0911, no 6, p. 57-Article in journal (Other academic)
    Abstract [sv]

    Att drabbas av afasi efter slaganfall innebär kommunikationshinder som försvårar förståelsen och att bli förstådd. Detta kan öka risken för social isolering och lidande hos personer med afasi. Kommunikationssvårigheter i vården utgör en väsentlig utmaning för vårdpersonalen.

  • 18.
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sense of 'understanding and being understood' in the care of patients with communication difficulties2001Doctoral thesis, monograph (Other scientific)
  • 19.
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Understanding and being understood as a creative caring phenomenon - in care of patients with communication difficulties: Muntlig presentation. Nationell konferens - Vårdstämman, Stockholm, Sverige2003Conference paper (Other academic)
  • 20.
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Varying Conditions for Understanding in Communication Between Patients with Aphasia and Care Providers: Poster presentation. 11th Biennial Conference of the Workgroup of European Nurse Researchers (WENR), Geneva, Switzerland2002Conference paper (Other academic)
  • 21.
    Sundin, Karin
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Axelsson, K
    Jansson, L
    Norberg, Astrid
    Suffering from care as expressed in the narratives of former patients in somatic wards2000In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 14, no 1, p. 16-22Article in journal (Refereed)
    Abstract [en]

    To illuminate patients' experiences of suffering from care, ten former patients in somatic wards narrated a desirable care episode (n = 39) and an undesirable care episode (n = 51). The interviews were analysed using a phenomenological hermeneutic method inspired by Ricoeur's philosophy. Four themes were found: having a good rest, suffering through, searching for autonomy and being cared for by attentive and committed staff. The findings were interpreted in light of Eriksson's description of suffering, which describes three kinds of suffering: 'suffering of life', 'suffering of illness' and 'suffering of caring'. Although not mentioned explicitly, it was evident that cases of suffering from care were indicated in the patients' narratives. The themes were related to the patients' states of health, their experience of the care situation and their descriptions of themselves, and could be understood as related to the acts of the 'drama of suffering' described by Eriksson. The study highlights the need for the patient to find a co-actor in the drama of suffering in order to prevent suffering from care, i.e. prevent hindrance to the patient in her/his struggle against the 'suffering of illness' and the 'suffering of life'. The patients must be seen as the directors of their own dramas of suffering.

  • 22.
    Sundin, Karin
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Eurenius, M.
    Relatives' lived experience of support from Registered Nurses during palliative care at home2007In: ICN Conference 2007: Nurses at the Forefront: Dealing with the Unexpected, 2007Conference paper (Other academic)
  • 23.
    Sundin, Karin
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Fahlen, U
    Lundgren, M
    Registered Nurses´ experiences of allocation in the care of patients: Nurses at the Forefront: Dealing with the Unexpected. ICN International Conference, 27 May 1 June 2007,Yokohama, Japan. Oral presentation2007Conference paper (Other academic)
  • 24.
    Sundin, Karin
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Jansson, L
    Norberg, Astrid
    Communicating with people with stroke and aphasia: Understanding through sensation without words2000In: Journal of Clinical Nursing, ISSN 0962-1067, Vol. 9, no 4, p. 481-488Article in journal (Refereed)
    Abstract [en]

    To illuminate the phenomena of 'communicating with people with stroke and aphasia without words', 10 care providers particularly successful at communicating with stroke and aphasia patients who were working at a stroke rehabilitation ward narrated their experiences of communicating with such patients. A phenomenological hermeneutic approach, inspired by Ricoeur's philosophy, was used in the analysis. Two main themes were found: facilitating openness and being in wordless communication. The care providers sensed the feelings of the patients and experienced similar feelings themselves, thus, the communication is guided by the shared feelings between the care provider and the patient, i.e. communion. For this 'communication through sensation' to take place, the following factors were found to be necessary: creative closeness in combination with protective distance; striving for satisfaction and against exhaustion and desperation; meeting the patient halfway to gain understanding; exhibiting attention and accessibility to the patient; and trust and confidence for both care providers and patients. The findings were interpreted and discussed in the light of works by Levinas, Lögstrup and Stern.

  • 25.
    Sundin, Karin
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Jansson, L.
    Norberg, Astrid
    Understanding between care providers and patients with stroke and aphasia: A phenomenological hermeneutic inquiry.2002In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 9, no 2, p. 93-103Article in journal (Refereed)
    Abstract [en]

    Understanding between care providers and patients with stroke and aphasia: a phenomenological hermeneutic inquiry The present study illuminates the understanding in communication between formal care providers and patients with stroke and aphasia. Five care providers and three such patients participated in the study. Video recordings were made during conversations about pictures (n = 15), and the care providers were also interviewed (n = 15) after the video-recorded conversations. A phenomenological hermeneutic method of interpretation of the interview text was used. The findings showed that a range of conditions for 'understanding and being understood' in the communication on the part of the care providers exists. These different conditions are: lacking both knowledge and understanding; having knowledge but not necessarily accompanied by understanding; and being in understanding. Within the condition 'being in understanding', the care providers create a feeling of at-homeness in a relaxed atmosphere and thus have the opportunity to be in 'understanding and being understood' together with the patient. The condition 'being in understanding' appears in connection with the care providers' creating of a 'calm liturgy of caring' by mediating humility and calm vitality affects to the patients, and further, when needed, being present on the level of mystery, i.e. caring communion.

  • 26.
    Sundin, Karin
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Jansson, Lilian
    Understanding and being understood as a creative caring phenomenon - in care of patients with stroke and aphasia2003In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 1, p. 107-116Article in journal (Refereed)
    Abstract [en]

    Five care providers particularly successful at communicating with patients with communication difficulties were video-recorded together with three patients with aphasia after stroke, during morning care activities. The care providers were then interviewed immediately after the video-recordings, about their experiences of communicating with such patients.The interviews with the care providers were interpreted by means of a phenomenological hermeneutic method.Co-creating was the main theme found.Care providers invite the patient to participate in the creative act of communication. They have a communicative attitude and show interest in the patients' personal desires. The care providers encounter the patient as a presence in a caring communion. In part, care providers communicate by continuously conveying their presence to the patient and even creating availability in a close and open intersubjective relationship.A relaxed and supportive atmosphere facilitates reciprocity between care provider and patient. The communication is not technical or strategic; instead care providers share the patients' experiences in a silent dialogue. This silent dialogue involves sharing the patients' feelings and thus receiving messages from the patient.

  • 27.
    Sundin, Karin
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norberg, Astrid
    Department of Nursing, Umeå University, Umeå.
    Jansson, L.
    Department of Nursing, Umeå University, Umeå.
    The meaning of skilled care providers' relationship with stroke and aphasia patients2001In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 11, no 3, p. 308-321Article in journal (Refereed)
    Abstract [en]

    Little is known about the reciprocal influence of communication difficulties on the care relationship. To illuminate care providers' lived experiences of relationships with stroke and aphasia patients, narrative interviews were conducted with providers particularly successful at communicating with patients. A phenomenological hermeneutic analysis of the narratives revealed three themes: Calling forth responsibility through fragility, restoring the patient's dignity, and being in a state of understanding. The analysis disclosed caring with regard to the patient's desire, which has its starting point in intersubjective relationship and interplay, in which nonverbal communication is essential--that is, open participation while meeting the patient as a presence. Thus, care providers prepare for deep fellowship, or communion, by being available. They described an equality with patients, interpreted as fraternity and reciprocity, that is a necessary element in presence as communion. The works of Marcel, Hegel, Stern, and Ricoeur provided the theoretical framework for the interpretation.

  • 28. Öhlund, Ulrika
    et al.
    Wennman-Larsen, Agneta
    Persson, Carina
    Gutavsson, Petter
    Furst, Carl-Johan
    Wengström, Yvonne
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Longitudinell studie om närstående till personer med lungcancer: hälsa, livssituation, reaktioner och resurser: Nordisk konferens - Familjefokuserad omvårdnad, Kalmar, Sverige2006Conference paper (Other academic)
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