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F912 A02 Completed Rebecca

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Promoting good health
Rebecca Tomlin
In A02 I will be showing a comprehensive description of job
roles of two key workers who are involved in promoting good
health, there will be justifications of skills and qualities for
each key worker. I will also give two preventive measures
including these being applied. I will show an in depth
understanding of the implications of current health promotion
Promoting good health
Rebecca Tomlin
Firstly I will be looking at the job roles and skills of a care
assistant within a residential home.
Their job roles are to be part of the nursing team, whose aims
are to ensure that resident’s nursing, personal and psychological
needs are met on a daily basis, to help promote as much personal
and physical independence and choice as possible, in the activities
of daily living undertaken by the residents within the Nursing
To help maintain a stimulating and attractive environment for the
residents, to assist residents in washing, dressing and undressing,
to participate in the basic nursing care of the residents, under
the supervision of trained staff, e.g. bed-bathing, pressure area
care, mouth care, eye care, to assist the residents with their
toileting needs, including continence promotion, to change beds,
tidy resident’s rooms and do light cleaning.
To help in the serving of meals and drinks, feeding those
residents who are unable to feed themselves and ensuring that
each resident receives the meal or diet that he/she has
requested and is suitable for his/her needs, maintain
confidentiality regarding resident’s particulars. Assist in
activities within the Home, Undertake any other duties as
required in order to keep the Nursing Home running smoothly, as
delegated by the trained nursing staff or Home Manager.
Promoting good health
Rebecca Tomlin
Care assistant improve the lives of vulnerable people.
Within this job you will work with people on a weekly or daily basis
assisting them in practical activities such as going to the shops or
helping people to bed. You could be working in a care home or
visiting people in their own homes depending on the job and
assisting care workers in their activities.
According to the care assistant I am studying she said “It is a
very rewarding career and can be done on a contract, permanent
or temporary basis and there are specific day and night care
assistant jobs available. Being a care assistant involves, caring for
you clients, who can include: children, the elderly, people with
disabilities and families; by assisting with medications to helping
with household chores. I love doing this job it is so fulfilling.”
Promoting good health
Rebecca Tomlin
You may be liaising with people from other departments such as;
social services, housing officers and GP’s, so you will need to have
good communication skills. You will need to be sensitive to people
of different backgrounds and be able to listen and communicate
well with your clients. This will include the amount of eye contact
given, facial expressions, angle of head, and tone of voice, body
language, gestures, posture, muscle tension, touch, and proximity
and so on. All these skills will make up to how the service user is
going to feel all these skills can be used negatively and positively
but the service provider has to make sure they use it in a positive
A second language may be required in some cases; the reason for
this is because every health and social care setting has multi
cultural people, for example Punjab, Slovakian, Polish and so on.
The reason for this is that they may not speak English so to have
a second language it is important and very helpful. A care
assistant must be able to speak good English and communicate
Care assistants need to be enthusiastic, good team players,
caring, patient, and also enjoy caring and helping people. Patience,
compassion, tact and a sense of humour are vital qualities,
especially if you work with people who do not like to admit that
they need help. For example if a service user is feeling upset
because they have just come back from the doctors and they
have had some kind of treatment it’s the care assistants job to be
Promoting good health
Rebecca Tomlin
patient and calm with them. They must give them the support and
You must understand that every resident has the right to keep as
much independence as they can. You will need to treat each
resident as an individual, with different physical and emotional
needs. You should be able to talk and listen to people from all
You will need to be discreet, and able to ease people's
embarrassment when you help them with personal tasks for
example washing or using the toilet. You must be able to give help
and support with residents' concerns or emotional problems. You
must be prepared to learn and develop new knowledge and skills.
Promoting good health
Rebecca Tomlin
Unlike individuals who wish to become healthcare professionals,
potential healthcare assistants do not need to hold any specific
qualifications or have a scientific background. However, individuals
will need to pass a medical check and, because of the amount of
close contact with vulnerable patients of all ages, a Criminal Records
Bureau check will also have to be carried out. Furthermore, a driving
license is useful, since healthcare assistants often need to visit
patients in their own homes throughout the day.
Once healthcare assistants have started work, they can study for
NVQ qualifications in Health or Health and Social Care. These
qualifications will allow employees to learn more about patient care
and, once they have been completed, individuals will often be allowed
to perform tasks which require a greater level of responsibility.
Previous experience in any caring role will be invaluable for
individuals hoping to become healthcare assistants. Previous medical
experience is useful but not essential. Volunteer work of any kind
will look good on a CV as well.
Promoting good health
Rebecca Tomlin
Secondly, I am looking at the job roles of a nurse.
The job roles of a nurse consist of assessing, observing and
reporting on the condition of patients; preparing patients for
operations and procedures. Recording pulse, temperature and
respiration and keeping accurate records of these observations. To
set up drips and blood transfusions, Maintaining and checking
intravenous infusions, Administering drugs and injections, To assist
with tests and evaluations, Respond quickly to emergencies,
Explaining treatment and procedures to parents or guardians,
Supporting, advising and educating patients and close relatives.
engaging in and promoting teamwork, including working alongside
specialist doctors and nurses, health visitors, social workers,
radiographers and physiotherapists.
Observing strict hygiene and safety rules and ensuring that visitors
also observe any rules on the ward or unit.
Writing reports and updating records before completing a shift.
Adult nurses provide care too, and support the recovery of, patients
suffering from acute (short-term) and long-term illnesses and
diseases or those requiring surgery. They focus on the needs of the
patient rather than the illness or condition.
They also promote good health and well being through education.
Nurses plan and carry out care within a multidisciplinary team but
are the main point of contact for patients. Adult nurses work mainly
in hospitals and the community, attached to a health centre or
general practice and in residential homes, specialist units, schools
and hospices. Many nurses work with patients in their own homes.
Promoting good health
Rebecca Tomlin
As a nurse you need to have these skills:
Excellent people skills - You will be providing care for people of all
ages and backgrounds. You should be able to put people at their
ease, gain their confidence and deal sympathetically with their
problems and fears.
Good communication and observation, these are crucial to good
nursing. You need to be a good at listening as well as talking and you
have to be constantly alert to changes in patients' conditions and
the implications in terms of care. As a nurse is more frequently in
contact with the patients, he/she should have excellent
communication skills. These include speaking as well as listening
skills. The nurse should be able to openly talk with the patients and
their family members in order to understand their needs and
expectations. He/she should be able to explain the treatment given
to the patient.
Ability to answer questions and offer advice, Nurses are the most
frequent point of contact for patients, so you must be able to
answer their questions, share your knowledge and skills with
patients, their families and friends and make sure their needs are
recognised by the rest of the care team.
Happy to work as part of a team as a nurse you will be part of a
multi-disciplinary team that includes doctors, physiotherapists,
anaesthetists, pharmacists, dieticians’ and many more.
Promoting good health
Rebecca Tomlin
Dealing with emotionally charged situations, nursing can sometimes
involve managing distress. You'll play a key part in helping patients
and families come through their crises.
A good nurse should be highly
qualified and trained. She/he should
have a sound knowledge of the nursing profession, obtained from a
reputed institute. He/she should always be ready to learn more.
Watchfulness is an important quality of a good nurse. He/she should
be alert every moment about the condition of a patient. He/she
should be able to notice a minor change in the patient’s health
A good nurse should have an emotional stability. Nursing is a very
stressful job. Everyday the nurses witness severe traumatic
situations, surgeries and deaths. The nurse should be mentally
strong and should not get disturbed by such incidences.
Good presence of mind is crucial in the nursing profession. In any
critical condition or medical emergency, if the doctor is not there,
then the nurse should not get confused. He/she should be confident
enough to take the correct decisions. Kindness and empathy are the
qualities that every nurse should possess. The nurse should be calm
and kind to the patients, even if they are aggressive. The nurse
should understand the pains and suffering of patients. He/she
should provide comfort and sympathy to the patients, instead of
getting angry with them.
A good nurse should be flexible about his/her working hours and
responsibilities. Nursing is a time demanding profession. It’s not like
that to work for specific hours. Medical emergencies can occur at
any time. Nurses often have to extend their duty hours, work in
overnight shifts, or work on weekends too. They should not complain
about that.
A good nurse should have a strong physical endurance. He/she
should be able to perform a number of taxing manoeuvres, stand up
Promoting good health
Rebecca Tomlin
for a long period of time or lift heavy objects/people on a daily
basis. A nurse should have a respect for people and rules. He/she
should be devoted to the professions He/she should be aware of
different cultures and traditions and confidentiality requirements
of the patients. He/she should respect the wishes of the patients.
A nurse should be active and cheerful. Her/his presence should
make the patient relaxed and comfortable. The nurse’s pleasant
appearance can reduce the patient’s stress and pains. His/her voice
should be soft and gentle
Promoting good health
Rebecca Tomlin
Before working on the NHS, you will need to complete a preregistration course. There are many pre-registration courses
available throughout the UK, and at present there is no set minimum
entry qualification across the board. The entry requirements differ
depending on the higher education institution chosen. It is generally
thought that most entry criteria for a diploma course will require
candidates to possess around 5 GCSEs (or equivalent) of Grade C and
above including English literature or language and a science subject.
Nursing degree courses usually require candidates to have gained at
least 2 A-Level qualifications or equivalent.
However, if you're considering changing career and becoming a nurse
you should have good numeracy and literacy skills. You should also be
an excellent team worker and possess good communication skills. You
may also find that you have to work within extremely emotionally
charged atmospheres and situations, so an ability to work and
communicate calmly, sympathetically and efficiently within such
situations is crucial. Observation skills are also vital, as a nurse's
role can often include monitoring a patient's progress, as well as the
possible resulting care routes.
Promoting good health
Rebecca Tomlin
Julia Bryan, a community clinical nurse specialist who has worked
at Saint Francis Hospice for three years, shares her day as a
9 am – The first thing I do is write up notes about the phone calls I
received overnight while on call ready for the morning meeting. I
received calls from hospice staff seeking advice and alerting me to a
man discharged from hospital and needing a visit.
I then prepare for the day I’m going to visit two teams of district
nurses about patients and three patients– two are follow-up visits
and one is a new referral. Each hospice nurse looks after 20 to 30
patients at a time in a set area, mine is Romford and Collier Row.
9.30 am – I attend the team meeting and we hand-over patients and
discuss workloads for the day. Afterwards we can talk to hospice
doctors about patients’ symptoms and medication.
10 am – I drop into the district nurses in Romford for information
about the progress of a patient we are caring for. We work closely
with district nurse teams and GPs to ensure highest standard of
symptom control is given as well as supportive care to patients and
their families.
10.30 am – I visit my first patient of the day a 56-year-old woman
recently diagnosed with a brain tumour. She is nervous about
suffering more fits after being hospitalized following one so we
discuss medicine that may prevent them and keep her out of
hospital, which she wants. I ask how she feels and about her session
with our physiotherapist and she requests another appointment as
she has back pain so I will arrange this. I review her medication as
Promoting good health
Rebecca Tomlin
both she and her husband asked me about it and I liaise with her
hospital specialists to ensure continuity of care. I explain that I will
write to the GP for the new prescription.
11.30 am - I call into the Collier Row district nurse team to learn
about a patient they’ve referred.
12 pm - I visit my second patient a 60-year-old woman with cancer,
who had her care changed after difficulty keeping food down - she
is eating better. I help the district nurse take bloods because she’s
experiencing difficulty and then comfort the patient as she is upset.
12.45 pm – Time for a quick lunch while I write up the mornings’
notes before my next appointment.
1.30 pm – I visit an elderly woman with cancer for the first time,
she doesn’t like to talk about how she is feeling so I learn about her
history and illness from her family. I tell them how the hospice and
I can help them and inform them about available financial support.
Then I let them talk and outline the medication prescribed. I then
introduce myself to the patient and see if she is comfortable and
how she feels. Before leaving I let the family know that she is quite
poorly and that I will be contacting them with a care plan shortly.
My aim is to get her symptoms under control so she is comfortable.
3 pm – Back to the hospice to deal with messages and complete my
notes and letters to the GPs with details of the medication I want
prescribed and district nurses about any changes.
5.30 pm – I go home as someone else is on call tonight - the team is
available 24-hours all year round to give advice to colleagues,
healthcare professionals, patients and their carers.
Promoting good health
Rebecca Tomlin
“I feel privileged to have this job where I meet patients and
families and help make a difference by sorting out their
problems. I’m blessed I’ve got a good team and access to many
services.” Says Julia Bryan.
As you can see being a nurse is a very demanding job from working
from 9.00am till 5.30pm everyday. Being a nurse involves having a
strong mind and being able to cope with emotional situations, making
sure you maintain a professional view on the situation is important
because this can be used to support families and so on. Within her
life as a nurse she has to do many tasks from day to day which
include – note making, meetings, handling medication, supporting
patients, prescriptions, taking bloods and much more. Being a nurse
is not an easy job it takes a lot of willpower and strength.
Promoting good health
Rebecca Tomlin
Just as there are many models of health, there are many models of
health promotion too.
There are three sections which make up health promotion –
1. Health education – communication to improve health and
prevent ill health by improving peoples knowledge on health,
and changing their aspects on how they view their health.
Health educators include in a wide range of professions
including teachers, social workers, practice nurses, health
visitors, leisure centre staff, and so on.
In some of these jobs it is part of it that you have to make
people aware of risks of certain things and also to enlighten
them on their health for example health visitors and practice
However in some cases, you may have a job which you have to
use initiative and warn people of the risks of certain things
just like a community police officer. If a community police
officer was patrolling a certain area and saw a group of
teenagers who were drinking and intoxicating themselves it
would be beneficial for the community police officer to put
forward the risks of what they were doing.
2. Health protection – population measures to safeguard health
through legislation, financial and social means. This might
include legislation to govern health and safety at work or food
hygiene, and using taxation policy to reduce smoking levels or
car use, by raising the price of cigarettes or petrol.
Promoting good health
Rebecca Tomlin
3. Prevention – reducing or avoiding the risks of diseases and ill
health primarily through medical ‘interventions’.
It is all too easy to see health promotion as solely focusing on
preventing people from becoming ill. But also it has three tiers
of health prevention.
Here is Tannahil’s model of health promotion from health and
social care AS level book.
Health education
Preventative services
Preventative health
Preventative health
Health education for
preventative health
Positive health
Positive health
Health education aimed
at positive health
Immunisation, cervical
Substance use
education in schools
Fluoridation of water
Lobbying for
fluoridation or seatbelt
Work with young people
to develop positive selfesteem
Smoking bans in public
Lobbying for a ban on
tobacco advertising or
smoking bans in pubs
Promoting good health
Rebecca Tomlin
 Primary prevention - which is an attempt to eliminate the
possibility of getting a disease, for example making people
aware of risks that are linked to smoking, poor diet, no
exercise and so fourth. An example of making people aware
of risks of certain health issues is within schooling and
education. By talking to the children, creating poster, leaflets,
hand outs and so on making children aware of the risks of
smoking, drinking, drugs etc and this could make an impact on
the Childs life at a young age.
 Secondary prevention - which addresses those people
identified as being in the early stages of a disease, usually
through early detection and symptoms. The action for this
focuses on addressing the underlying causes, in order to
alleviate any further symptoms. A nurse can carry out a
breast screening which is Secondary prevention because this is
a part of the process where they find out if they have a
disease. The NHS breast screening programme provides free
breast screening every three years for all women in the UK
aged 50 years and over. Around one and a half million women
are now screened in the UK each year. Women aged between
50 – 64 years are routinely invited for breast screening every
three years, and work is being carried out to extend the
programme to women up to and including the age of 70 by
2004. According to Neil Moonies health and social care book.
Women less than 50 years are not offered routine screening.
Mammograms seem not to be as effective in pre-menopausal
women, possibly because the density of the breast tissue
makes it more difficult to detect problems and also because
Promoting good health
Rebecca Tomlin
the incidence of breast cancer is lower. The average age of the
menopause in the UK is 50 years old.
Breast screening is a method of detecting breast cancer at a
very early stage. The first step involves x-raying of each
breast – a mammogram – which is taken while carefully
compressing the breast. The mammogram can detect small
changes in breast tissue, which may indicate cancers that are
too small to be felt either by the women herself or by a
doctor. There are over 90 breast screening units in the UK.
This is a very good service that the NHS offers because it can
detect the sign of cancer in early stages, women can ask for
advice if they think they have cancer or if they have been
diagnosed with it. Nurses support women who may not be able
to talk with family or friends but can talk to someone who
knows the profession and who knows all about breast cancer.
 Tertiary prevention - this refers to the control and
reduction of an already established disease. Somebody with
cancer may be given 6 months left to live and no chance of
recovering but tertiary prevention and health related
professionals can help give the support and advice to a cancer
sufferer, helping them to deal with their disease and to make
the next 6 months the most comfortable and happiest.
A care assistant can implement Tertiary prevention. This is
when they know someone who has a disease and they try to
help them deal with it and get on with the daily lives as normal
as possible.
Promoting good health
Rebecca Tomlin
 For example and older person who lives in a care home may
have developed over a period of time pressure ulcers.
 Pressure ulcers are also called decubitus ulcers or bed sores,
are a big problem in hospitals, nursing homes and patient
homes. Pressure ulcers are areas where the skin has broken
down. They can go very deep to the bone. Pressure ulcers can
cause pain and very serious infections that can lead to death.
 You can get pressure ulcers by; Age - The normal aging process
changes the skin and the blood circulation. The old person's
skin can be dry and very fragile. It can get irritated; it can
break open into a sore and can even tear very easily. Older
people may also have poor circulation. Their blood, with oxygen,
may be cut off or very limited. When oxygen is not fed to the
skin, it is hard to keep the skin healthy and without injury.
 Lack of mobility - Pressure ulcers occur when people are not up
and walking. They form when a person stays in the bed, chair or
wheelchair for a long time. Blood is cut off to areas where
bones are close to the skin when a person stays in a chair or in
bed for a long time. The weight of the body pushes against a
bony area to cut off the blood and oxygen to that area.
 Poor diet - Patients and residents with a poor diet are at risk
for pressure ulcers. The skin and other tissue, as well as the
rest of the body, does not get the food and nutrition it needs
to be healthy and without injury if the diet is not good.
 Moisture - Residents and patients who are wet are at risk for
pressure ulcers. Patients that are incontinent of urine or stool,
those that sweat a lot and those that have draining wounds are
at risk for pressure ulcers. Moisture makes the skin soft. This
softness leads to skin breaks.
Promoting good health
Rebecca Tomlin
 Mental or any other psychical problems - When a patient or
resident is confused, very sleepy, or in a coma, they may not
turn like other alert patients normally do even when they are
sleeping. People that do not have a normal sense of pain and the
physical ability to turn will remain in one position for a very
long time unless someone else turns them. If a patient stays in
one position for a long time, they will get a pressure ulcer
 Bed sheets and chairs with wrinkled sheets or hard objects Uneven pressure is created when sheets are wrinkled. This
leads to pressure ulcers. Objects such as spoons, tissue boxes,
eye glasses, food crumbs, hair pins and other hard objects that
are left in the bed or sitting chair also cause pressure and
pressure ulcers.
 Pressure ulcers can lead to pain and even death. Pressure
ulcers are difficult and very costly to cure once they have
formed. It is, therefore, important that care assistants and
other team members prevent pressure ulcers before they
 A care assistant should assess patients for their risk of
developing pressure sores. They also plan care and provide care
that prevents and treats pressure sores and monitor and
coordinate the care of a patient with a pressure ulcer in some
hospitals and nursing homes.
 Both a nurse and a care assistant have big parts of the lives of
patients and residents so they can support, inhibit and
communicate with them. They can help regain their patients
and resident’s confidence and well being.
Promoting good health
Rebecca Tomlin
Health promotion research
In summer 2007, the smoking ban was brought into action by
the government. “This legislation is a huge step forward for
public health” quoted by health secretary Patricia Hewitt. This
smoking ban includes no smoking in all work places, including
restaurants and pubs selling food. Although non food pubs and
private members clubs will be exempt. The government has also
announced that it is planning to consult on how to protect bar
workers in pubs where smoking is allowed. This legislation is a
huge step forward for the public health and will help reduce
deaths from cancer, heart disease and other smoking related
diseases. Did you know? Scotland, Wales and Northern
Ireland have similar bans.
 Anyone who lights up a cigarette illegally could be fined £50
- £30 if it is paid within 15 days.
 The figure rises to £200 if an individual is prosecuted and
convicted by a court.
 Businesses failing to comply with the ban could be hit with
fines up to £2,500.
The government hope the smoking ban will encourage people to
quit smoking and realise how much harm it is doing to
themselves and people around them.
Promoting good health
Rebecca Tomlin
Parliament sets the maximum penalties for road traffic
offences. The seriousness of the offence is reflected in the
maximum penalty. It is for the courts to decide what sentence
to impose according to circumstances.
The penalty table below indicates some of the main offences,
and the associated penalties. There is a wide range of other
more specific offences which, for the sake of simplicity, are
not shown here. The penalty points and disqualification system
is described below.
Penalty points
*causing death by
dangerous driving
14 years
Obligatory – 2 years
3-11 (if
exceptionally not
2 years
3-11 (if
exceptionally not
*Causing death by
careless driving
under the
influence of drink
or drugs
14 years
Obligatory-2 years
3-11 (if
exceptionally not
Careless and
Driving while unfit
through drink or
drugs or with
excess alcohol: or
failing to provide a
specimen for
6 months
3-11 (if
exceptionally not
Failing to stop
after an accident
or failing to report
an accident
6 months
Driving when
6 months (12 months
in Scotland)
Driving after
refusal or
revocation of
licence on medical
6 months
Driving without
Promoting good health
Rebecca Tomlin
Using a vehicle in
a dangerous
LGV £5,000
PCV £5,000
Other £2,500
Obligatory if offence
committed within 3
years of a previous
conviction for the same
offence - 6 months
3 in each case
Failure to have
proper control of
vehicle or full view
of the road and
traffic ahead, or
using a hand-held
mobile phone
while driving
(£2,500 for
PCV or goods
Driving otherwise
than in accordance
with a licence
(£2,500 for
3-6 or 3 (fixed
Traffic light
No MOT certificate
Seat belt offences
Dangerous cycling
Careless cycling
Cycling on
Failing to identify
driver of a vehicle
These were made by the government to try and stop people for
example drinking and driving. People do not realise the risks of
drinking and driving, they can cause damage to themselves, in some
cases others and people around them. When driving a car you are
always risking your life because you may not know what is going to
happen any minute, I believe that these laws are very good and
informative and list everything from drinking driving to jumping a
traffic light.
Promoting good health
Rebecca Tomlin
Health promotion: CORE COMPETENCIES IN
Raising public awareness
Advice and consultancy
Service development
Policy development
Training and education
Challenging prejudice and discrimination
Direct campaigning within schools, e.g.,
national days such as No smoking day or world
aids day.
The organisations of events such as sex
education conferences or the supporting the
school celebrations of achievements within
the healthy school programme, linking with
and involving the media in these types of
The support by specialist offered to schools
participating in the healthy school programme,
facilitating training and policy
The ‘health promoting school award’ provides
a framework for schools to incorporate health
issues into their development plans in terms of
training, policy development, finance and so
on. The extended schools programme also
provides opportunities for developing schoolbased health services, e.g. school nurse drop in
sessions. The health promotion specialists
would provide a leading role for coordinating
the development of these types of service –
based initiatives.
Supporting schools in the development of a
wide range of specific policies including sex
education, smoking, substance use and
Undertaking research, e.g. health surveys to
establish what young people’s health
behaviours are in the locality or consulting
young people about specific issues.
Providing in service training on health
education, co facilitating classes to offer
models of good practice for health and health
related subjects
Specialists both advise on purchases of new
materials for the resource centre, and
recommend resources and appropriate
methods of use
Specialists encourage the development of
policies and work practices that challenge the
root causes of ill health, e.g. policies around
equal opportunities strategies are included in
all policy documents and subsequent strategy
Promoting good health
Rebecca Tomlin
Specialist health promotion services
These are now usually located with the public health team. They are
small, specialised companies which support the development of new
services and policies which can promote health locally. The role of
these services has grown and developed over time, the flexibility to
do this being largely due to the fact that it is not a profession
governed by a professional body, this enabling local teams to grow
and develop into new areas of practice in response to local need.
However there is a national set of competencies for health
promotion practice, which identifies the degree of overlap with
public health practice which identifies the degree of over lap with
public health practice recognising that health promotion specialists
are a part of the wider public health specialism. Their role is best
illustrated by the example of the activities a service might offer in
the school setting as shown above.
Improving health and preventing disease is also the responsibility
of those working to provide health care – especially those with
community based roles.
Promoting good health
Rebecca Tomlin
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