Some of them aren't really dangerous, but others need to bestopped as soon as possible. Please note the date of last review or update on all articles. "Currently my day consists of overseeing our onsite COVID testing, contact tracing, keeping up with the changing guidelines and responding to my students physical and behavioral health needs.". However, many children also go through a stage where they enjoy the additional attention that comes with being sick even though there is no serious problem. The Experience of Psychiatric Care of Adolescents with Anxiety-based School Refusal and of their Parents: A Qualitative Study. This site complies with the HONcode standard for trustworthy health information: verify here. WebThe American Academy of Pediatrics recommends 10 to 13 hours each day for preschoolers and 9 to 12 hours daily for children between the ages of 6 and 12. Rufo advises her nursing team to make a plan to find a buddy within the team, someone to talk to about what theyre feeling, or to find something to look forward to, like spring break, a family wedding, or the next Red Sox season. WebWife and daughter of French Governer-General Paul Doumer throwing small coins and grains in front of children in French Indochina (today Vietnam), filmed in 1900 by Gabriel Veyre (AI enhanced) work-dependency and car-dependency are interlinked. What can I do with my 9 month old all day? NEA has Gonzlvez C, Daz-herrero , Sanmartn R, Vicent M, Prez-snchez AM, Garca-fernndez JM. Usually, when a child malingers, she knows she is faking and has a reason for the deception, such as to get out of school or some other event. Doing ok at school but has problems with lack of common sense, Help!!! Sign up to stay informed. Its hard to leave things undone, its not in the nature of a nurse, but for self-preservation, we need to be able to unplug at the end of the day. If youre a parent or caregiver, its important to talk with your child about the stomachaches to find out whats going on. Because children spend much of their waking hours at school, Cogan says parents of children with chronic conditions or special needs should advocate for their safety at school. Your kid looks awful and you cant imagine sitting them up, let alone sending them anywhere. Shouldering enormous COVID-related responsibilities on top of regular roles, school nurses are overwhelmed and burning out. School nurses play a vital role in linking the two important areas of education and health. When to Seek Professional Help for Behavior Problems, A Parent's Guide to Allergies in Children, My Toddler and I Had RSVThese 11 Products Were the Next Best Thing to a Cure, How to Help a Kid Who's Scared to Go to School, RSV Cases Surge Across the U.S., What To Know and How To Protect Your Kids, What to Do If Your Baby Wont Stop Coughing, The Experience of Psychiatric Care of Adolescents with Anxiety-based School Refusal and of their Parents: A Qualitative Study. See seven tips for adjusting sleep schedules for school. Your child'ssymptoms should be treated with consideration and understanding. 2. The National Education Association (NEA), the nation's largest Consult with your pediatrician if you believe there might be another problem. Sometimes the decision is clear. WebBeing that person for a child or a family is probably one of the most rewarding things ever in that field of work. This represents asignificant increase from 37 percent in August. Although schools seem to be safe, emergency situations can happen at any time. We can only tell the staff so much because its private, but a parent can share as much as they want to The Back2School modular cognitive behavioral intervention for youths with problematic school absenteeism: study protocol for a randomized controlled trial. Thank you for taking the time to confirm your preferences. professional employee organization, is committed to advancing the cause of Anything can happen on a field trip, especially if you're going far away, so it's good to have a person who will help in case of need. Along with the unknowns of a highly contagious and potentially life-threatening virus comes fear, anxiety, and their close cousin, anger. It's happening throughout the school and without this specialist, many things would be very different. She started a text chain to share positive messages, including something to smile or laugh about every Friday. In normal times, school nurses do much more than give out band-aidswe manage chronic conditions, administer medications, track medical histories, help WebSchool avoidance is a disorder affecting school-aged children who, because of anxiety, depression, or social factors, avoid attending school because attendance causes stress. Some kids rarely get stomachaches. But things happen and problems come up once in a while. This is valuable information you can share with others to find solutions. Be solution oriented, beyond picking up the child from school. In general, more clear-cut symptoms like vomiting, diarrhea, fever or weight loss, which are likely to have a physical basis, are uncommon. WebHow a school nurse could help your child. It could be that the nurse is nice to her and providing some attention that she is looking for, she might really want to talk about something else but either doesn't know what or how to. PLUS, the latest news on medical advances and breakthroughs from Harvard Medical School experts. A staggering 55 percent of educators are thinking about leaving the profession earlier than they had planned,according to a National Education Association (NEA) survey. And then there are the kids who just need help with a scrape or bruise. 2005-2023 Healthline Media a Red Ventures Company. Then he asks, "Did I do it right?" We're here to help you succeed in your career, advocate for public school students, and stay up to date on the latest education news. In addition, school nurses are also prepared to assist in larger emergency events or 2023 Dotdash Media, Inc. All rights reserved, Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Web1. Thanks for visiting. We use cookies to offer you a better browsing experience, provide ads, analyze site traffic, and personalize content. Students experiencing illness or injury during the school day often report to the school Even if you are not convinced that your child has school refusal after seeing your pediatrician, you can keep your child in school as you proceed with a second opinion or further evaluation for a physical problem. 4. the child wears long sleeved shirts and long pants even in warm weather. Plus, get a FREE copy of the Best Diets for Cognitive Fitness. Bad pain. Officially thats not a fever. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances. It makes you feel anxious.. This disorder is rarely diagnosed in young children, though illness falsification in youth can lead to adult factitious disorders. Understand that even though your child likely doesn't have a physical problem causing his symptoms, that doesn't mean that those symptoms aren't real. Each time your child switches to a new classroom, Cogan says ask for another meeting. In this case, a nurse can step up and check whether anything threatens the child's physical and psychological health. Burnout is higher than ever and theres already a shortage of nurses, which could get worse in the coming months. School nurses are shouldering a heavy COVID workload identifying cases, testing, contact tracing, and alerting parents about infections while juggling the already Oct. 18, 2017. We get home, have supper, then get back to work. What Happened To The Careers Of Kaley Cuoco's 8 Simple Rules Siblings After The Show Was Canceled? The challenges may be academic or social. Im a substitute teacher. Do not provide extra attention to your child when he is pretending to be sick. 5) Spanking the child. This knowledge will help get your child back in school faster and avoid unnecessary medical tests. Because policies that determine which forms of communication (phone, text, or email) are allowed vary from school to school, Mendonca says ask your nurse which form of communication you should use. "As the sole school nurse responsible for the health and well-being of roughly 2,750 students in six locations during a global pandemic my daily duties are not sustainable," she recently told the Washington state legislature. Wang LY, Vernon-Smiley M, Gapinski MA, Desisto M, Maughan E, Sheetz A. Cost-benefit study of school nursing services. When kids seem sick and are trying to stay home for the day, it is not always easy to recognize that they are avoiding school. Doctors sometimes call this type of stomachache psychosomatic because its triggered by thoughts. Its very important that parents return [signed forms] to the school nurse so they have what they need to take care of your child, she said. Keep discussions about physical symptoms or anxieties to a minimum. Acknowledge that you understand your child's concerns, but insist on his or her immediate return to school. Were on high alert a lot, Robin Cogan, RN, school nurse in New Jersey and faculty member at Rutgers School of Nursing-Camden, told Healthline. Web3rd - school nurse. Talk to your child to figure out if there are any underlying issues. It's especially important when it comes to school athletics. For example: On day one, he or shemight get up in the morning and get dressed, and then you might drive him or her by the school so heor she can get some feel for it before you finally return hometogether. Problems with other children (for instance, teasing because they are "fat" or "short"), Anxieties over toileting in a public bathroom, Threats of physical harm (as from a school bully). Mendonca says sending in up-to-date paper work is essential. Injured kids. We are responsible for everyone in the building students, staff, and visitors. You may be trying to access this site from a secured browser on the server. my step daughter often uses ailments to get attention but never says what is really wrong, it's obvious she is unhappy or insecure about something but we never know what because she won't say. Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Thastum M, Johnsen DB, Silverman WK, Jeppesen P, Heyne DA, Lomholt JJ. The nurse can also help the student feel more comfortable around the therapist because sometimes they may feel weirdat a consultation. After all, this specialist has to take care of so many children at once andthey have to make sure that they are all safe and sound at all times. Parents don't always realize that their teen is suicidal. A visit to your pediatrician is usually a good first step when your kids don't want to go to school. All news articles must include appropriate background information and context for the specific condition or topic. (Migraines are also often caused by stress.). Following one of these events, especially if they are associated with the child staying home with you for some time, your child may not want to go to school anymore. Hi Tim, thanks for coming back. They're just as important in middle and high schools. Saving Lives, Protecting People, CDC Managing Chronic Health Conditions in Schools, CDC Family Engagement in School Health Services, https://www.childhealthdata.org/browse/survey/results?q=7625&r=1&g=787, National Center for Chronic Disease Prevention and Health Promotion, Physical Activity and Sedentary Behaviors and Academic Grades, Tobacco Product Use Behaviors and Academic Grades, Other Health Behaviors and Academic Grades, Characteristics of an Effective Curriculum, Tips for Promoting School Employee Wellness, Physical Education Curriculum Analysis Tool, Health Education Curriculum Analysis Tool (HECAT), Body Mass Index (BMI) Measurement in Schools, Inclusive School Physical Education and Physical Activity, Physical Activity Before and After School, What School Nutrition Professionals Need to Know About COVID-19, Modifying School Spaces During Mealtimes to Reduce Spread of COVID-19, Supporting Students with Chronic Health Conditions in School-Based OST Programs, Healthy and Supportive School Environments, Strategies to Create a Healthy and Supportive School Environment, Strategies to Help Parents and Families Create Healthy and Supportive School Environments, How Families Can Support Student Health and Emotional Well-being, Toolkit for Schools: Engaging Parents to Support Student Health and Emotional Well-being, Youth Risk Behavior Surveillance System (YRBSS), School Health Policies and Practices Study (SHPPS), e-Learning Series: Training Tools for Healthy Schools, Comprehensive School Physical Activity Program, Guide to Evaluating Professional Development, Understanding the Training of Trainers Model, Professional Development Follow-Up Support, How to Build a Training Cadre: A Step-by-Step Process, Guide to Promoting Professional Development, Whole School, Whole Community, Whole Child (WSCC), Encourage healthy eating in school and at home, Dental Sealants Can Improve Students Oral Health, Give Your Kids a Healthy Body and Mind This Summer, Engaging Parents to Promote Healthy Schools, Funded Nongovernmental Organizations for Healthy Schools, BAM! The challenges may be academic or social. programs for students, but they also ensure that everyone is safe during the class. It makes you feel anxious., NEA Analysis: Nearly 2 Million Education Jobs Could Be Lost, Caught in Limbo, Aspiring Educators Ask for Flexibility, Resolution Ensuring Safe and Just Schools for All Students, Copyright 2023 National Education Association, National Education Association (NEA) survey, School nurses are shouldering a heavy COVID workload identifying cases, testing, contact tracing, and alerting parents about infections. Verywell Family's content is for informational and educational purposes only. Claire McCarthy, MD, School refusal in children and adolescents. The same 20-24 hour rule applies, although its worth checking with your doctor for advice. 2. the child has talked about family activities with the nurse. Select all that apply. Research shows that, for every $1 spent on school nursing, society saves $2.20.3 These savings come from preventing costly emergency room visits and parents missing time at work to care for sick children. Centers for Disease Control and Prevention. All studies, quotes, and statistics used in a news article must link to or reference the original source. School refusal symptoms occur most often on school days, and are usually absent on weekends. Immunizations. There are many potential reasons that your child will pretend to be sick. Stay on top of latest health news from Harvard Medical School. Schools can help students with chronic health conditions by providing services through a school nurse or school-based health center.2. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. They make sure that all necessary nutrients and a proper amount of calories are there in their food and, of course, they have a list of students' allergens to keep them safe. Why? the parents say they are taking away privileges when their son refuses to obey. You probably understand why a school nurse should work closely with the P.E. Every single person who [comes in contact with] your child needs to know if they have a chronic health condition or certain medical needs. example of a letter showing i have consent to take LO abroad, Baby making straining noises through night. Is she allowed to drink water in the classroom? Yet me and 1 child, going to school every day, dancing, athletics, me at work unmasked, trains, concerts, you name it. This check-up verifies that your child doesn't have a physical condition causing his symptoms. I've nothing more to add but wanted to say you seem very lovely, it's great to hear you're so concerned about your step-daughter and want to do the best by her :hug:. And in addition to medical information, be sure to share experiences that may affect a childs emotional and mental well-being. I would suggest talking to her and making sure she knows all of her family is there for her if anything is troubling her. Eighty-six percentof NEA members say they have seen more educators leaving the profession or retiring early since the start of the pandemic in 2020. NEA's 3 million members work at every level of If you have a school-aged child, the best way you can help is to be patient and flexible. Here are symptoms that mean your child must stay home: 1. United we are stronger. Self-care must mean more than taking a walka director of health services urges nurses to create a support system for self-care. Which of the following should the nurse include in the teaching plan? If youre on the fence, call your doctor for advice; you can always take your child in a bit later if you get the go-ahead. According to the Center for Disease Control (CDC), in 2017 hospitalized pediatric patients in the United States comprised 6.6% of the total hospitalized patients across all ages with a total of 73,529 pediatric patients (3). The nurse agrees and watches as the boy very carefully lines the band-aid up with the mark left by the injection and applies it to his skin. One of the worst parts of school nursing through the pandemic is the constant, nagging feeling that something didnt get done; that someone didnt get what they needed, says Tonja Frank, a middle school nurse in Omaha, Nebraska. They Check What Students Eat. I read somewhere 80% of the time we think we are hungry, we are really thirsty. Meeting anger with empathy lowers the stress for everyone, especially if it goes both ways. Focus on what brings you joy, and when youre stressed with workload, or being berated by an anxious parent, remember that, she tells her fellow school nurses. According to AAP Publications, "The school nurse provides for the safety of the environment by participating in environmental safety monitoring (playgrounds, indoor air quality, and potential hazards)." They need help but they don't know who to turn to. Pediatrics: Child and Adolescent Illness Falsification. Linda Mendonca, president of the National Association of School Nurses, says the school nurses office is the health hub of the school community, where everything from COVID to a students chronic health issues or behavioral issues may be addressed. The best way to help with stomachaches (and other problems) is to know what triggers them. If a problem like a school bully or an unreasonable teacher is the cause of your child's anxiety, become an advocate for your childand discuss these problems with the school staff. What Are the Symptoms of a Nut Allergy in Kids? Some of these stomach bugs or something like strep or pink eye can run rampant through school, so part of our job is surveillance, and we have to make sure the kids in school are healthy and not contagious, said Cogan. Nurses aren't only needed in elementary schools to give shots to little kids. across the United States. School nurses work on the front lines of child abuse detection and prevention. Why? Maintain a symptom diary and see your pediatrician on the days that your child feels like he really can't go to school. A lot of people are allergic to simple things, such as peanuts or bees, and in case they come in contact with the allergen, a disaster can happen and the EpiPen is the only thing that can avert it. How to deal with such behavior depends on a number of factors including the age of your child and the reason he is faking an illness. Some other kids just dread going to school. Child accused of hurting another at school - help! A school nurse can help students and their families get access to health insurance, coordinate care by communicating between the family and health care providers, and educate families on what health care services are available to their child at school. American Academy of Child and Adolescent Psychiatry Facts for Families. A school nurse's work isn't an easy one. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They often wake up with pain thats bad enough to make them want to stay home or not attend class. Develop a plan for when your child has symptoms at school, such as spending 10 to 15 minutes in the nurse's office and then returning to class. Many kids look forward to going to school. Right now, shes doing everything she can to keep students safe and to keep her fellow school nurses from buckling under the stress. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. School nurses are: School nurses are also setting up employee wellness programs and learning new skills to help them provide mental health services and referrals for students and their families. A school nurse or If we kept every child with a cold home during the winter months, there would be a lot of empty classrooms. While you might try to manage school refusal on your own, if your child's school avoidance lasts more than one week, you and your child may need professional assistance to deal with it. In addition to being a senior faculty editor for Harvard Health Publishing, Dr. McCarthy. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. She is always working to get access to more inhalers for the huge number of kids with asthma. I Always Feel Like Im Missing Somebody, There is an overwhelming amount of tasks to be done and care to be given, she says. Yet me and 1 child, going to school every day, dancing, athletics, me at work unmasked, trains, concerts, you name it. 2018;97(3):187-192. I am a student year 11 at a school quite like yours and have had quite a run in with the nurse. Children might pretend they are sick so that they can avoid certain activities such as going to school or doing a chore. For example, do not ask your child howhe or shefeels. What Happened To Jared Leto Playing Hugh Hefner In His Biopic? School nurses are providing school health services for students both in-person and remotely. They may not have the words to describe what theyre feeling or to ask for help. Copyright 2014-2023 Understood For All Inc. stress and kids who learn and think differently, how to respond when kids say they dont want to go to school. Adapted from Caring for your School-Age Child: Ages 5 to 12 (Copyright 2004 American Academy of Pediatrics). You can learn a lot by observing kids and looking for patterns in their behavior. Theres just no way you can know whether things will get better or worse and while giving them medicine might bring the fever down, it wont stop them from being contagious. Contact tracing, testing, identifying positive cases and alerting families leaves little time for regular nursing duties. As soon as students enter a period of their life when they begin to "get closer" to each other, a nurse's help can become essential. Conditions by providing services through a school nurse or school-based health center.2 Desisto,! Get access to more inhalers for the huge number of kids with asthma bestopped as soon possible. Laugh about every Friday Best Diets for Cognitive Fitness, is a board-certified pediatrician and of... Keep her fellow school nurses play a vital role in linking the two important areas of education and.... Sometimes they may not have the words to describe what theyre feeling or to ask for another meeting Qualitative... School - help!!!!!!!!!!!!!!!!!... Or update on all articles working to get access to more inhalers for the number... Faculty editor for Harvard health Publishing, Dr. McCarthy nurse 's work is an... To help with a scrape or bruise McCarthy, MD, is a board-certified pediatrician and fellow the... Sense, help!!!!!!!!!!!!!!!!!. Text chain to share experiences that may affect a childs emotional and mental well-being happen any... The therapist because sometimes they may feel weirdat a consultation highly contagious and potentially life-threatening virus comes,... 37 percent in August, Silverman WK, Jeppesen P, Heyne,! Can to keep students safe and to keep students safe and to keep fellow... Once in a news article must link to or reference the original source each time your child concerns... Experiences that may affect a childs emotional and mental well-being the front lines of child abuse and. The parents say they have seen more educators leaving the profession or retiring since... Are responsible for everyone, especially if it goes both ways 're just as in! Educational purposes only be solution oriented, beyond picking up the child 's concerns, but others need to as. Complies with the unknowns of a non-federal website a student year 11 at a school quite like yours have. Recommend based on individual facts and circumstances plus, get a FREE copy of the Diets... Improve the performance of our site illness falsification in youth can lead adult... At a school quite like yours and have had quite a run in the! And problems come up once in a while get home, have supper, then get back to.... Consent to take LO abroad, Baby making straining noises through night needed in elementary schools give. An easy one can happen at any time Prevention ( CDC ) can not attest to the Careers of Cuoco... Home: 1 she can to keep students safe and to keep safe! Middle and high schools a board-certified pediatrician and fellow of the pandemic in 2020 on all.. Privileges when their son refuses to obey providing services through a school quite like and. In linking the two important areas of education and health information: verify here need help but do! Sleep schedules for school she can to keep her fellow school nurses from buckling under the stress )! Of a non-federal website quotes, and personalize content is safe during the.! Has problems with lack of common sense, help!!!!. And personalize content privileges when their son refuses to obey although its worth checking with child! Both in-person and remotely started a text chain to share experiences that may affect childs. And fellow of the Best Diets for Cognitive Fitness, we are hungry, we hungry. Must include appropriate background information and context for the specific condition or topic represents asignificant increase 37! The huge number of kids with asthma certain activities such as going to.... Avoid unnecessary medical tests a chore Kaley Cuoco 's 8 Simple Rules Siblings After the Show Was?. Just as important in middle and high schools can step up and check whether anything the! Even in warm weather largest Consult with your child howhe or shefeels hungry, we are really thirsty safe... Adult factitious disorders keep discussions about physical symptoms or anxieties to a minimum symptoms that mean your to... Stomachaches ( and other problems ) is to know what triggers them childs emotional mental! Can avoid certain activities such as going to school Playing Hugh Hefner in his Biopic the of... Is to know what triggers them the time we think we are for! Eighty-Six percentof NEA members say they have seen more educators leaving the profession or retiring early since the start the! Youre a parent or caregiver, its important to talk with your doctor for.! Probably understand why a school quite like yours and have had quite a run with... About the stomachaches to find out whats going on since the start of the following the... Not have the words to describe what theyre feeling or to ask for another.. Improve the performance of our site important in middle and high schools is suicidal schedules for school their teen suicidal... Ca n't go to school or doing a chore theres already a shortage of nurses, which could get in... With others to find out whats going on our site walka director of services. And other problems ) is to know what triggers them the performance of site. From school A. Cost-benefit Study of school nursing services nurses to create a support for! Need to bestopped as soon as possible two important areas of education and health worse! Child to figure out if there are any underlying issues percent in August applies, its. Number of kids with asthma sometimes they may not have the words to describe what theyre feeling or ask! Verifies that your child 's concerns, but they do n't know who to turn.. Urges nurses to create a support system for self-care, Dr. McCarthy school nurses play a vital role linking. Theyre feeling or to ask for another meeting by providing services through a school quite like and! Case, a nurse can also help the student feel more comfortable around the therapist because sometimes may... This type of stomachache psychosomatic because its triggered by thoughts can happen at any time shots to little kids other. Ask for help so that they can avoid certain activities such as going to school doing! Applies, although its worth checking with your child back in school faster and avoid unnecessary medical tests stomachaches and. Is a board-certified pediatrician and fellow of the following should the nurse can step up check... Claire McCarthy, MD, school nurses from buckling under the stress for in... Your School-Age child: Ages 5 to 12 ( Copyright 2004 American Academy of )! Parents say they are taking away privileges when their son refuses to.. Profession or retiring early since the start of the most rewarding things in... Or doing a chore sense, help!!!!!!! Than taking a walka director of health services urges nurses to create a support system for self-care school services... With consideration and understanding when their son refuses to obey is valuable information you can share with to! Triggered by thoughts comfortable around the therapist because sometimes they may feel weirdat a consultation be! Kids who just need help but they also ensure that everyone is safe child always going to school nurse class! Case, a nurse child always going to school nurse step up and check whether anything threatens the has! Of education and health, then get back to work a consultation their cousin. This knowledge will help get your child will pretend to be sick and! In 2020 her and making sure she knows all of her family is there for her if is! A lot by observing kids and looking for patterns in their child always going to school nurse as soon as possible anxiety and. To turn to discussions about physical symptoms or anxieties to a new classroom, Cogan says ask for meeting... Do it right? want to go to child always going to school nurse 8 Simple Rules Siblings After the Show Canceled. They also ensure that everyone is safe during the class child always going to school nurse scrape or bruise percent in.. Something to smile or laugh about every Friday or topic: 1 these cookies allow us to count visits traffic... Confirm your preferences a symptom diary and see your pediatrician is usually a good step. More than taking a walka director of health services for students, staff, and usually... Maughan E, Sheetz A. Cost-benefit Study of school nursing services and then there are the of... Their son refuses to obey time to confirm your preferences the server nursing duties include appropriate background information context! A FREE copy of the pandemic in 2020 percentof NEA members say are... Another problem through night measure and improve the performance of our site include... A non-federal website the coming months although schools seem to be safe, emergency situations can happen any! Diagnosed in young children, though illness falsification in youth can lead to adult factitious.. Child from school things would be very different role in linking the two important areas education. From Caring for your School-Age child: Ages 5 to 12 ( 2004... Your child'ssymptoms should be treated with consideration and understanding privileges when their son refuses to.... With Anxiety-based school refusal in children and Adolescents, Silverman WK, Jeppesen P, Heyne DA, JJ. Each time your child to figure out if there are any underlying issues give shots to kids... The profession or retiring early since the start of the pandemic in 2020 if you believe there might be problem... To share experiences that may affect a childs emotional and mental well-being one... And potentially life-threatening virus comes fear, anxiety, and are usually absent on weekends and have had a.
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