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Published in: Pediatric Rheumatology 1/2014

Open Access 01-12-2014 | Research

Health related quality of life and parental perceptions of child vulnerability among parents of a child with juvenile idiopathic arthritis: results from a web-based survey

Authors: Lotte Haverman, Hedy A van Oers, Heleen Maurice-Stam, Taco W Kuijpers, Martha A Grootenhuis, Marion AJ van Rossum

Published in: Pediatric Rheumatology | Issue 1/2014

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Abstract

Background

A chronic illness, such as Juvenile Idiopathic Arthritis (JIA), has an impact on the whole family, especially on parents caring for the ill child. Therefore the aim of this study is to evaluate parental Health Related Quality of Life (HRQOL) and parental perceptions of child vulnerability (PPCV) and associated variables in parents of a child with JIA.

Methods

Parents of all JIA patients (0–18 years) in Amsterdam, the Netherlands, were eligible. HRQOL was measured using the TNO-AZL Questionnaire (TAAQOL) and PPCV using the Child Vulnerability Scale (CVS). The HRQOL of parents of a child with JIA was compared to a norm population, and differences between parents of a child with JIA and active arthritis versus parents of a child with JIA without active arthritis were analyzed (ANOVA). For PPCV, parents of a child with JIA were compared to a norm population, including healthy and chronically ill children (Chi2, Mann-Whitney U test). Variables associated with PPCV were identified by logistic regression analyses.

Results

155 parents (87.5% mothers) completed online questionnaires. JIA parents showed worse HRQOL than parents of healthy children on one out of twelve domains: fine motor HRQOL (p < .001). Parents of children with active arthritis showed worse HRQOL regarding daily activities (p < .05), cognitive functioning (p < .01) and depressive emotions (p < .05) compared to parents of children without active arthritis. Parents of children with JIA perceived their child as more vulnerable than parents of a healthy child (p < .001) and parents of a chronically ill child (p < .001). Parents of children with active arthritis reported higher levels of PPCV (p < .05) than parents of children without active arthritis. A higher degree of functional disability (p < .01) and shorter disease duration (p < .05) were associated with higher levels of PPCV.

Conclusion

The HRQOL of JIA parents was comparable to the HRQOL of parents of a healthy child. JIA parents of a child with active arthritis showed worse HRQOL than parents of a child without active arthritis. Parents perceived their child with JIA as vulnerable.
Literature
1.
go back to reference Prince FH, Otten MH, van Suijlekom-Smit LW: Diagnosis and management of juvenile idiopathic arthritis. BMJ. 2010, 341: c6434-CrossRefPubMed Prince FH, Otten MH, van Suijlekom-Smit LW: Diagnosis and management of juvenile idiopathic arthritis. BMJ. 2010, 341: c6434-CrossRefPubMed
2.
go back to reference Moorthy LN, Peterson MG, Harrison MJ, Onel KB, Lehman TJ: Physical function assessment tools in pediatric rheumatology. Pediatr Rheumatol Online J. 2008, 6: 9-PubMedCentralCrossRefPubMed Moorthy LN, Peterson MG, Harrison MJ, Onel KB, Lehman TJ: Physical function assessment tools in pediatric rheumatology. Pediatr Rheumatol Online J. 2008, 6: 9-PubMedCentralCrossRefPubMed
3.
4.
go back to reference Kazak AE, Kassam-Adams N, Schneider S, Zelikovsky N, Alderfer MA, Rourke M: An integrative model of pediatric medical traumatic stress. J Pediatr Psychol. 2006, 31: 343-355.CrossRefPubMed Kazak AE, Kassam-Adams N, Schneider S, Zelikovsky N, Alderfer MA, Rourke M: An integrative model of pediatric medical traumatic stress. J Pediatr Psychol. 2006, 31: 343-355.CrossRefPubMed
5.
go back to reference Murphy NA, Christian B, Caplin DA, Young PC: The health of caregivers for children with disabilities: caregiver perspectives. Child Care Health Dev. 2007, 33: 180-187.CrossRefPubMed Murphy NA, Christian B, Caplin DA, Young PC: The health of caregivers for children with disabilities: caregiver perspectives. Child Care Health Dev. 2007, 33: 180-187.CrossRefPubMed
6.
go back to reference Wolfe-Christensen C, Mullins LL, Stinnett TA, Carpentier MY, Fedele DA: Use of the Behavioral Assessment System for Children 2nd Edition: Parent Report Scale in pediatric cancer populations. J Clin Psychol Med Settings. 2009, 16: 322-330.CrossRefPubMed Wolfe-Christensen C, Mullins LL, Stinnett TA, Carpentier MY, Fedele DA: Use of the Behavioral Assessment System for Children 2nd Edition: Parent Report Scale in pediatric cancer populations. J Clin Psychol Med Settings. 2009, 16: 322-330.CrossRefPubMed
7.
go back to reference Hatzmann J, Heymans HS, Carbonell A, van Praag BM, Grootenhuis MA: Hidden consequences of success in pediatrics: parental health-related quality of life–results from the Care Project. Pediatrics. 2008, 122: e1030-e1038.CrossRefPubMed Hatzmann J, Heymans HS, Carbonell A, van Praag BM, Grootenhuis MA: Hidden consequences of success in pediatrics: parental health-related quality of life–results from the Care Project. Pediatrics. 2008, 122: e1030-e1038.CrossRefPubMed
8.
go back to reference Heaton J, Noyes J, Sloper P, Shah R: Families’ experiences of caring for technology-dependent children: a temporal perspective. Health Soc Care Community. 2005, 13: 441-450.CrossRefPubMed Heaton J, Noyes J, Sloper P, Shah R: Families’ experiences of caring for technology-dependent children: a temporal perspective. Health Soc Care Community. 2005, 13: 441-450.CrossRefPubMed
9.
go back to reference Brandon P: Time away from “smelling the roses”: where do mothers raising children with disabilities find the time to work?. Soc Sci Med. 2007, 65: 667-679.CrossRefPubMed Brandon P: Time away from “smelling the roses”: where do mothers raising children with disabilities find the time to work?. Soc Sci Med. 2007, 65: 667-679.CrossRefPubMed
10.
go back to reference Kirk S: Families’ experiences of caring at home for a technology-dependent child: a review of the literature. Child Care Health Dev. 1998, 24: 101-114.CrossRefPubMed Kirk S: Families’ experiences of caring at home for a technology-dependent child: a review of the literature. Child Care Health Dev. 1998, 24: 101-114.CrossRefPubMed
11.
go back to reference Wilson LS, Moskowitz JT, Acree M, Heyman MB, Harmatz P, Ferrando SJ, Folkman S: The economic burden of home care for children with HIV and other chronic illnesses. Am J Public Health. 2005, 95: 1445-1452.PubMedCentralCrossRefPubMed Wilson LS, Moskowitz JT, Acree M, Heyman MB, Harmatz P, Ferrando SJ, Folkman S: The economic burden of home care for children with HIV and other chronic illnesses. Am J Public Health. 2005, 95: 1445-1452.PubMedCentralCrossRefPubMed
12.
go back to reference Heyman MB, Harmatz P, Acree M, Wilson L, Moskowitz JT, Ferrando S, Folkman S: Economic and psychologic costs for maternal caregivers of gastrostomy-dependent children. J Pediatr. 2004, 145: 511-516.CrossRefPubMed Heyman MB, Harmatz P, Acree M, Wilson L, Moskowitz JT, Ferrando S, Folkman S: Economic and psychologic costs for maternal caregivers of gastrostomy-dependent children. J Pediatr. 2004, 145: 511-516.CrossRefPubMed
13.
go back to reference Hatzmann J, Maurice-Stam H, Heymans HS, Grootenhuis MA: A predictive model of Health Related Quality of life of parents of chronically ill children: the importance of care-dependency of their child and their support system. Health Qual Life Outcomes. 2009, 7: 72-PubMedCentralCrossRefPubMed Hatzmann J, Maurice-Stam H, Heymans HS, Grootenhuis MA: A predictive model of Health Related Quality of life of parents of chronically ill children: the importance of care-dependency of their child and their support system. Health Qual Life Outcomes. 2009, 7: 72-PubMedCentralCrossRefPubMed
14.
go back to reference Lindstrom C, Aman J, Norberg AL: Increased prevalence of burnout symptoms in parents of chronically ill children. Acta Paediatr. 2010, 99: 427-432.CrossRefPubMed Lindstrom C, Aman J, Norberg AL: Increased prevalence of burnout symptoms in parents of chronically ill children. Acta Paediatr. 2010, 99: 427-432.CrossRefPubMed
15.
16.
go back to reference Waxmonsky J, Wood BL, Stern T, Ballow M, Lillis K, Cramer-Benjamin D, Mador J, Miller BD: Association of depressive symptoms and disease activity in children with asthma: methodological and clinical implications. J Am Acad Child Adolesc Psychiatry. 2006, 45: 945-954.CrossRefPubMed Waxmonsky J, Wood BL, Stern T, Ballow M, Lillis K, Cramer-Benjamin D, Mador J, Miller BD: Association of depressive symptoms and disease activity in children with asthma: methodological and clinical implications. J Am Acad Child Adolesc Psychiatry. 2006, 45: 945-954.CrossRefPubMed
17.
go back to reference Lim J, Wood BL, Miller BD: Maternal depression and parenting in relation to child internalizing symptoms and asthma disease activity. J Fam Psychol. 2008, 22: 264-273.CrossRefPubMed Lim J, Wood BL, Miller BD: Maternal depression and parenting in relation to child internalizing symptoms and asthma disease activity. J Fam Psychol. 2008, 22: 264-273.CrossRefPubMed
18.
go back to reference Lopez WL, Mullins LL, Wolfe-Christensen C, Bourdeau T: The Relation Between Parental Psychological Distress and Adolescent Anxiety in Youths With Chronic Illnesses: The Mediating Effect of Perceived Child Vulnerability. Children’s Health Care. 2008, 37: 171-182.CrossRef Lopez WL, Mullins LL, Wolfe-Christensen C, Bourdeau T: The Relation Between Parental Psychological Distress and Adolescent Anxiety in Youths With Chronic Illnesses: The Mediating Effect of Perceived Child Vulnerability. Children’s Health Care. 2008, 37: 171-182.CrossRef
19.
go back to reference Barlow JH, Wright CC, Shaw KL, Luqmani R, Wyness IJ: Maternal stressors, maternal wellbeing and children’s wellbeing in the context of juvenile idiopathic arthritis. [References]. Early Child Dev Care. 2002, 172: 89-98.CrossRef Barlow JH, Wright CC, Shaw KL, Luqmani R, Wyness IJ: Maternal stressors, maternal wellbeing and children’s wellbeing in the context of juvenile idiopathic arthritis. [References]. Early Child Dev Care. 2002, 172: 89-98.CrossRef
20.
go back to reference Wallander JL, Varni JW: Effects of pediatric chronic physical disorders on child and family adjustment. J Child Psychol Psychiatry. 1998, 39: 29-46.CrossRefPubMed Wallander JL, Varni JW: Effects of pediatric chronic physical disorders on child and family adjustment. J Child Psychol Psychiatry. 1998, 39: 29-46.CrossRefPubMed
21.
go back to reference Akikusa JD, Allen RC: Reducing the impact of rheumatic diseases in childhood. Best Pract Res Clin Rheumatol. 2002, 16: 333-345.CrossRefPubMed Akikusa JD, Allen RC: Reducing the impact of rheumatic diseases in childhood. Best Pract Res Clin Rheumatol. 2002, 16: 333-345.CrossRefPubMed
22.
go back to reference Timko C, Stovel KW, Moos RH: Functioning among mothers and fathers of children with juvenile rheumatic disease: a longitudinal study. J Pediatr Psychol. 1992, 17: 705-724.CrossRefPubMed Timko C, Stovel KW, Moos RH: Functioning among mothers and fathers of children with juvenile rheumatic disease: a longitudinal study. J Pediatr Psychol. 1992, 17: 705-724.CrossRefPubMed
23.
go back to reference Lustig JL, Ireys HT, Sills EM, Walsh BB: Mental health of mothers of children with juvenile rheumatoid arthritis: appraisal as a mediator. J Pediatr Psychol. 1996, 21: 719-733.CrossRefPubMed Lustig JL, Ireys HT, Sills EM, Walsh BB: Mental health of mothers of children with juvenile rheumatoid arthritis: appraisal as a mediator. J Pediatr Psychol. 1996, 21: 719-733.CrossRefPubMed
24.
go back to reference Manuel JC: Risk and resistance factors in the adaptation in mothers of children with juvenile rheumatoid arthritis. J Pediatr Psychol. 2001, 26: 237-246.CrossRefPubMed Manuel JC: Risk and resistance factors in the adaptation in mothers of children with juvenile rheumatoid arthritis. J Pediatr Psychol. 2001, 26: 237-246.CrossRefPubMed
25.
go back to reference Gerhardt CA, Vannatta K, McKellop JM, Zeller M, Taylor J, Passo M, Noll RB: Comparing parental distress, family functioning, and the role of social support for caregivers with and without a child with juvenile rheumatoid arthritis. J Pediatr Psychol. 2003, 28: 5-15.CrossRefPubMed Gerhardt CA, Vannatta K, McKellop JM, Zeller M, Taylor J, Passo M, Noll RB: Comparing parental distress, family functioning, and the role of social support for caregivers with and without a child with juvenile rheumatoid arthritis. J Pediatr Psychol. 2003, 28: 5-15.CrossRefPubMed
26.
go back to reference Press J, Neumann L, Uziel Y, Bolotin A, Buskila D: Assessment of quality of life of parents of children with juvenile chronic arthritis. Clin Rheumatol. 2002, 21: 280-283.CrossRefPubMed Press J, Neumann L, Uziel Y, Bolotin A, Buskila D: Assessment of quality of life of parents of children with juvenile chronic arthritis. Clin Rheumatol. 2002, 21: 280-283.CrossRefPubMed
27.
go back to reference Wagner JL, Chaney JM, Hommel KA, Page MC, Mullins LL, White MM, Jarvis JN: The influence of parental distress on child depressive symptoms in juvenile rheumatic diseases: the moderating effect of illness intrusiveness. J Pediatr Psychol. 2003, 28: 453-462.CrossRefPubMed Wagner JL, Chaney JM, Hommel KA, Page MC, Mullins LL, White MM, Jarvis JN: The influence of parental distress on child depressive symptoms in juvenile rheumatic diseases: the moderating effect of illness intrusiveness. J Pediatr Psychol. 2003, 28: 453-462.CrossRefPubMed
28.
go back to reference Forsyth BW, Horwitz SM, Leventhal JM, Burger J, Leaf PJ: The child vulnerability scale: an instrument to measure parental perceptions of child vulnerability. J Pediatr Psychol. 1996, 21: 89-101.CrossRefPubMed Forsyth BW, Horwitz SM, Leventhal JM, Burger J, Leaf PJ: The child vulnerability scale: an instrument to measure parental perceptions of child vulnerability. J Pediatr Psychol. 1996, 21: 89-101.CrossRefPubMed
29.
go back to reference Anthony KK, Gil KM, Schanberg LE: Brief report: Parental perceptions of child vulnerability in children with chronic illness. J Pediatr Psychol. 2003, 28: 185-190.CrossRefPubMed Anthony KK, Gil KM, Schanberg LE: Brief report: Parental perceptions of child vulnerability in children with chronic illness. J Pediatr Psychol. 2003, 28: 185-190.CrossRefPubMed
30.
go back to reference Thomasgard M, Metz WP: Parental overprotection and its relation to perceived child vulnerability. Am J Orthopsychiatry. 1997, 67: 330-335.CrossRefPubMed Thomasgard M, Metz WP: Parental overprotection and its relation to perceived child vulnerability. Am J Orthopsychiatry. 1997, 67: 330-335.CrossRefPubMed
31.
go back to reference Vrijmoet-Wiersma CM, Egeler RM, Koopman HM, Bresters D, Norberg AL, Grootenhuis MA: Parental stress and perceived vulnerability at 5 and 10 years after pediatric SCT. Bone Marrow Transplant. 2010, 45: 1102-1108.CrossRefPubMed Vrijmoet-Wiersma CM, Egeler RM, Koopman HM, Bresters D, Norberg AL, Grootenhuis MA: Parental stress and perceived vulnerability at 5 and 10 years after pediatric SCT. Bone Marrow Transplant. 2010, 45: 1102-1108.CrossRefPubMed
32.
go back to reference Spurrier NJ, Sawyer MG, Staugas R, Martin AJ, Kennedy D, Streiner DL: Association between parental perception of children’s vulnerability to illness and management of children’s asthma. Pediatr Pulmonol. 2000, 29: 88-93.CrossRefPubMed Spurrier NJ, Sawyer MG, Staugas R, Martin AJ, Kennedy D, Streiner DL: Association between parental perception of children’s vulnerability to illness and management of children’s asthma. Pediatr Pulmonol. 2000, 29: 88-93.CrossRefPubMed
33.
go back to reference Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, He X, Maldonado-Cocco J, Orozco-Alcala J, Prieur AM, Suarez-Almazor ME, Woo P: International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004, 31: 390-392.PubMed Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, He X, Maldonado-Cocco J, Orozco-Alcala J, Prieur AM, Suarez-Almazor ME, Woo P: International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004, 31: 390-392.PubMed
34.
go back to reference Singh G, Athreya BH, Fries JF, Goldsmith DP: Measurement of health status in children with juvenile rheumatoid arthritis. Arthritis & Rheumatism. 1994, 37: 1761-1769.CrossRef Singh G, Athreya BH, Fries JF, Goldsmith DP: Measurement of health status in children with juvenile rheumatoid arthritis. Arthritis & Rheumatism. 1994, 37: 1761-1769.CrossRef
35.
go back to reference Wulffraat N, van der Net JJ, Ruperto N, Kamphuis S, Prakken BJ, Ten CR, Van Soesbergen RM, Van Rossum MA, Raat H, Landgraf JM, Kuis W: The Dutch version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ). Clin Exp Rheumatol. 2001, 19: 111-115. Wulffraat N, van der Net JJ, Ruperto N, Kamphuis S, Prakken BJ, Ten CR, Van Soesbergen RM, Van Rossum MA, Raat H, Landgraf JM, Kuis W: The Dutch version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ). Clin Exp Rheumatol. 2001, 19: 111-115.
36.
go back to reference Bruil J, Fekkes M, Vogels T, Verrips GHW: TAAQOL Manual. 2004, Leiden: LUMC-TNO: Leiden Center for Child Health and Pediatrics: LUMC-TNO Bruil J, Fekkes M, Vogels T, Verrips GHW: TAAQOL Manual. 2004, Leiden: LUMC-TNO: Leiden Center for Child Health and Pediatrics: LUMC-TNO
37.
go back to reference Houtzager BA, Moller E, Maurice-Stam H, Last BF, Grootenhuis MA: Parental perceptions of child vulnerability in relation to chronic illness and health related quality of life in a community based sample. J Child Health Care. 2014, [Epub ahead of print] Houtzager BA, Moller E, Maurice-Stam H, Last BF, Grootenhuis MA: Parental perceptions of child vulnerability in relation to chronic illness and health related quality of life in a community based sample. J Child Health Care. 2014, [Epub ahead of print]
38.
go back to reference Thompson SD, Moroldo MB, Guyer L, Ryan M, Tombragel EM, Shear ES, Prahalad S, Sudman M, Keddache MA, Brown WM, Giannini EH, Langefeld CD, Rich SS, Nichols WC, Glass DN: A genome-wide scan for juvenile rheumatoid arthritis in affected sibpair families provides evidence of linkage. Arthritis Rheum. 2004, 50: 2920-2930.CrossRefPubMed Thompson SD, Moroldo MB, Guyer L, Ryan M, Tombragel EM, Shear ES, Prahalad S, Sudman M, Keddache MA, Brown WM, Giannini EH, Langefeld CD, Rich SS, Nichols WC, Glass DN: A genome-wide scan for juvenile rheumatoid arthritis in affected sibpair families provides evidence of linkage. Arthritis Rheum. 2004, 50: 2920-2930.CrossRefPubMed
39.
go back to reference Zeft A, Shear ES, Thompson SD, Glass DN, Prahalad S: Familial autoimmunity: maternal parent-of-origin effect in juvenile idiopathic arthritis. Clin Rheumatol. 2008, 27: 241-244.PubMedCentralCrossRefPubMed Zeft A, Shear ES, Thompson SD, Glass DN, Prahalad S: Familial autoimmunity: maternal parent-of-origin effect in juvenile idiopathic arthritis. Clin Rheumatol. 2008, 27: 241-244.PubMedCentralCrossRefPubMed
40.
go back to reference Haverman L, Grootenhuis MA, van den Berg JM, Van Veenendaal M, Dolman KM, Swart JF, Kuijpers TW, Van Rossum MA: Predictors of health-related quality of life in children and adolescents with juvenile idiopathic arthritis: results from a web-based survey. Arthritis Care Res. 2014, 64: 694-703.CrossRef Haverman L, Grootenhuis MA, van den Berg JM, Van Veenendaal M, Dolman KM, Swart JF, Kuijpers TW, Van Rossum MA: Predictors of health-related quality of life in children and adolescents with juvenile idiopathic arthritis: results from a web-based survey. Arthritis Care Res. 2014, 64: 694-703.CrossRef
41.
go back to reference van Oers HA, Haverman L, Limperg PF, van Dijk-Lokkart EM, Maurice-Stam H, Grootenhuis MA: Anxiety and depression in Mothers and Fathers of a chronically ill child. Matern Child Health. 2014 van Oers HA, Haverman L, Limperg PF, van Dijk-Lokkart EM, Maurice-Stam H, Grootenhuis MA: Anxiety and depression in Mothers and Fathers of a chronically ill child. Matern Child Health. 2014
42.
go back to reference Rait DS, Ostroff JS, Smith K, Cella DF, Tan C, Lesko LM: Lives in a balance: perceived family functioning and the psychosocial adjustment of adolescent cancer survivors. Fam Process. 1992, 31: 383-397.CrossRefPubMed Rait DS, Ostroff JS, Smith K, Cella DF, Tan C, Lesko LM: Lives in a balance: perceived family functioning and the psychosocial adjustment of adolescent cancer survivors. Fam Process. 1992, 31: 383-397.CrossRefPubMed
43.
go back to reference Stam H, Hartman EE, Deurloo JA, Groothoff J, Grootenhuis MA: Young adult patients with a history of pediatric disease: impact on course of life and transition into adulthood. J Adolesc Health. 2006, 39: 4-13.CrossRefPubMed Stam H, Hartman EE, Deurloo JA, Groothoff J, Grootenhuis MA: Young adult patients with a history of pediatric disease: impact on course of life and transition into adulthood. J Adolesc Health. 2006, 39: 4-13.CrossRefPubMed
44.
go back to reference Weathers FW, Keane TM: The Criterion A problem revisited: controversies and challenges in defining and measuring psychological trauma. J Trauma Stress. 2007, 20: 107-121.CrossRefPubMed Weathers FW, Keane TM: The Criterion A problem revisited: controversies and challenges in defining and measuring psychological trauma. J Trauma Stress. 2007, 20: 107-121.CrossRefPubMed
46.
go back to reference Eccleston C, Palermo TM, Fisher E, Law E: Psychological interventions for parents of children and adolescents with chronic illness. Cochrane Database Syst Rev. 2012, 8: CD009660-PubMedCentralPubMed Eccleston C, Palermo TM, Fisher E, Law E: Psychological interventions for parents of children and adolescents with chronic illness. Cochrane Database Syst Rev. 2012, 8: CD009660-PubMedCentralPubMed
Metadata
Title
Health related quality of life and parental perceptions of child vulnerability among parents of a child with juvenile idiopathic arthritis: results from a web-based survey
Authors
Lotte Haverman
Hedy A van Oers
Heleen Maurice-Stam
Taco W Kuijpers
Martha A Grootenhuis
Marion AJ van Rossum
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Pediatric Rheumatology / Issue 1/2014
Electronic ISSN: 1546-0096
DOI
https://doi.org/10.1186/1546-0096-12-34

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