Presbyterian Health Plan, Inc. P.O. Box 27489 Albuquerque, NM 87125-7489 www.phs.org Important plan information TC Standard U.S. Postage PAID Presbyterian Health Plan INSIDE New! NeuroFlow aids in well-being 2 Tips for a healthy pregnancy 6 Your Winter 2024 for Turquoise Care members En español: Si usted desea obtener este boletín en español, llame al (505) 923-5200 o al 1-888-977-2333. 1. Track your spending Financial stress can put a damper on the holidays. Set a realistic budget and track your spending with a daily list. Scale back instead of straining your budget. Talk to your kids or family members about setting realistic expectations and remind them that the holidays are about making memories, not expensive gifts. 2. Take it a step further No time to exercise? Exercise while you shop. Add more activity to your busy days by taking a few quick laps around the mall before going into any stores, by taking the stairs, and by parking farther from the shopping center entrance. 3. Take time to recharge while staying active Amid all the holiday hustle and bustle, treat yourself to some downtime with yoga or a workout — Continued on page 2 It’s that “most wonderful time of the year” again. You’ve got happy visions of cozy times with family and friends and perfect meals and presents, right? In reality, you’ve got more to do than ever. There are cards to send; cookies to bake; and kids, relatives, friends, and teachers to shop for. And what about all that decorating? All while dealing with cold weather and darker, shorter days. With so much going on during the holidays, it can be hard to enjoy the season. The winter holiday season can be extra difficult for managing mental health. Added stress can worsen other mental health conditions like depression, anxiety, and substance use disorder. It can also affect your physical health with raised blood pressure and increased risk for a heart attack or stroke. But take heart — the following holiday tips can help you stress less and increase your enjoyment. Downsize holiday stress 5ways to put the wraps on holiday overload and enjoy the season
2 class. Or take a quiet walk at your local park or around your neighborhood to see the lights and sights. 4. Load up on healthy food choices During the holidays, food isn’t always just food; it can be an indulgence loaded with delicious tradition. You don’t have to completely deny yourself. Keep your plate healthier at holiday parties by filling it with fruit and vegetables first. Reserve a small portion for anything else you may want, even if it’s less healthy. Be sure to sit down to savor each and every bite. 5. Keep the conversation light Family tensions can rise during the holidays, but this is a time to find neutral ground. If you’re concerned about tension at family gatherings and differences of opinion, steer the conversation away from controversial topics. Focus on happy memories and common ground. Enhance your health and well-being with NeuroFlow Take control of your health and well-being this winter with NeuroFlow. NeuroFlow is a tool that connects you to health information, self-guided exercises, tailored resources, and support services. It is offered through Presbyterian Health Plan. It is available at no cost, easy to use, and offered online or by mobile phone app to eligible members. With NeuroFlow, you can get unique content and support services to help you meet your goals. Below are some ways the tool can help you on your journey. • Receive health content on topics such as healthy living, emotional well-being and mental health, recommended screenings, and more • Manage your overall health with unique wellness journeys on topics such as: » Navigating mental health » Lifelong health and wellness » Women’s health » Pregnancy » Smoking cessation • Track and monitor your progress and health patterns in focus areas like: » Mood » Sleep » Stress » Pain • Achieve your goals and feel your best through daily tools and activities Get started and sign up for NeuroFlow today! Use the QR code at left to access NeuroFlow and sign up or visit neuroflow.app.link/PHP123. For assistance with signing up or technical questions, please email NeuroFlow at support@neuroflow.com or call 1-855-296-7711. Downsize holiday stress — Continued from front page Get help Don’t let stress wreck your holiday season! Presbyterian Health Plan (PHP) has services to help you. Talking to a professional can be a good way to lighten your mental load. Go to www.phs.org/virtualcare to schedule a virtual behavioral health visit. If you or a loved one are having an emergency or any kind of emotional crisis or mental health or substance use concern, you can find help 24 hours a day, seven days a week. Please do one of these things to get help right away: •Call or text the 988 Suicide & Crisis Lifeline at 988 or chat online at www.988lifeline.org/chat. •Go to the nearest emergency facility. • Call 911. Sources: Academy of Nutrition and Dietetics; American Psychological Association; Centers for Disease Control and Prevention; U.S. Department of Agriculture
www.phs.org/Medicaid 3 As winter weather approaches, the chance of falling increases. In winter months, even the seemingly straightforward tasks, such as taking out the trash or walking to the mailbox, can become riskier. Here are some key tips to prevent winter falls and to help keep you safe. easy steps to help Stay safe this winter with these tips. If you have a fall or get injured, go to urgent or emergency care, or make plans to see your provider. Even if it doesn’t seem serious, you don’t want an untreated injury to get worse. Even if you don’t believe you’ll be outside for very long, dress for the weather. Keep an extra jacket in your car or with you when you go out. Even if it is warm when you leave the house, the weather can change quickly. When performing simple tasks outside, such as checking mail, etc., always have your cellphone with you in case of an accident. Have emergency contact numbers set up on your phone so it is easy to call for help. Ignore the need to be fashionable during winter weather that may put you at risk of falling. Wear shoes and clothes that you can easily move in. Pay attention to your surroundings. Don’t walk distracted or while looking at your phone. When outside, use cleats or nonslip shoes or boots that provide traction and stability. Check the soles of older shoes to make sure they are not worn down. Look into getting new shoes if the treads are too worn. To steady yourself, grab something that is secure when outside. Try to stay close to a handle or railing, especially when going up or down stairs. As you move outside of your home, make sure your walking route is clear and/or place something for better traction on the ground, such as cat litter or sand. Be more cautious and aware of your surroundings. Give yourself extra time when out in bad weather and put on proper attire. If you don’t need to go outside, stay inside during inclement weather. If you need to run errands, see if someone can do them for you. 1 4 7 2 5 8 3 6 9 prevent winter falls 9 Source: Senior Safety Advice
4 Winter is coming: Get your vaccinations! An estimated 31 million cases of the flu were reported for the 2022– 2023 season, according to the Centers for Disease Control and Prevention. In the same season, hospitalizations doubled due to RSV (respiratory syncytial virus) for both adults and children. While a vaccine may not prevent you from getting an illness, it can help your immune system fight infections quicker and more effectively. In addition to the flu and RSV vaccines, it is a good time to check in and make sure you and your kids are up to date on all other vaccines. Ask your provider which vaccinations you might need. Who should get a vaccine? Flu vaccine Use any influenza vaccine appropriate for your age and health status. You should get this vaccine each year. Anyone age 6 months and older can receive the vaccine. RSV vaccine Not everyone may need an RSV vaccine. In most cases, young children and adults over 60 years of age should get the vaccine. This is a one-time vaccine, and you should not have to get a new one each year. Speak with a Presbyterian nurse at any time You have access to PresRN, a nurse advice line, 24 hours a day, seven days a week, even on holidays. PresRN is an easy way to speak with a Presbyterian nurse if you are not feeling well and need advice or just have a general health question. A PresRN nurse will help you and your family whether you require a trip to the emergency room or urgent care, a virtual visit with a provider, or self-care at home. The best part is all you need is a phone. Presbyterian nurses are happy to answer any questions. Please call even if you are healthy but need some advice. As part of your Presbyterian healthcare team, we let your provider, care coordinator, and health coach know of your health concern so that you will have continued care and follow-up. We are here when you need answers! Call PresRN at (505) 923-5677 in Albuquerque or 1-888-730-2300 toll-free. If you are having a medical emergency, please call 911. Infants 19 months and younger can receive the vaccine, depending on their month of birth, age, and maternal vaccination status. Women 32– 36 weeks pregnant from September– January should receive the vaccine. Adults 60 years or older should receive the vaccine.
www.phs.org/Medicaid 5 Respiratory syncytial virus (RSV) is so common that nearly all children have had it by their second birthday. But what is RSV? And why is it important to recognize when your child has RSV — especially RSV that may be getting worse? RSV is a cold-like illness that affects the lungs, nose, and throat. Most kids who get RSV recover on their own in a week or two. But young children with RSV can sometimes get very sick. They may get bronchiolitis (inflammation of the small airways in the lungs) or pneumonia and need to be hospitalized for a few days. Spot the signs RSV often starts like a mild cold. The symptoms may include a runny nose, a cough, and a fever of 100.4 degrees or higher. Very young babies with RSV may only be cranky, tired, and less interested in feeding. If the RSV gets worse, children may have additional symptoms, like fast breathing or wheezing (a whistling sound when your child breathes). When to call your provider You should call your child’s provider if your child has trouble breathing or other worsening symptoms, trouble drinking, signs of dehydration (such as fewer than one wet diaper per eight hours), or decreased alertness. Caring for a child with RSV There is no cure for RSV. But you may be able to ease the symptoms until the virus runs its course by: • Using nasal saline and a suction bulb to clear a stuffy nose for easier breathing • Giving your child over-the-counter medicines, as directed by your child’s provider • Helping your child drink plenty of fluids to help prevent dehydration Sources: American Academy of Pediatrics; Centers for Disease Control and Prevention Presbyterian’s translation and interpretation services Communication is important to you and to us. That’s why we offer translation services if you need them. We want to make sure you have the information in the language or format you use so you can take charge of your own healthcare. We have bilingual staff and certified translator services if you want to use these services. These services are available to help you talk with providers, nurses, and caregivers; learn about your health plan; and much more. Our translation and interpretation services include: • Language translation • Written materials translation •Telephonic interpreters •In-person interpreters •American Sign Language interpreters •Video remote interpreters It’s easy to request these services. Call the Presbyterian Customer Service Center at the number on your Presbyterian member ID card. RSV How to spot the signs of Plus, tips for easing the symptoms
6 Three simple steps to go paperless 1. Scan the QR code or visit www.phs.org/myPRES to log in to your myPRES MemberConnect account. 2. Go to “My Account” in the drop-down menu under your name. 3. Select “Communication Preferences” and answer each question. It’s that easy! Act today to experience all the benefits of going paperless. Are you planning to become pregnant or you are currently pregnant? Presbyterian Health Plan has you covered! Follow these tips for a healthy pregnancy and delivery. Tip 1 Have a checkup to make sure you don’t have any health concerns. Schedule an early prenatal visit with a midwife or OB-GYN provider. Going to an early prenatal visit within the first trimester (<12 weeks gestation) will help ensure that you and your baby are healthy. It can also find any potential risk factors. Recommended prenatal appointment schedule: • Weeks 4 to 28: One visit every four weeks • Weeks 28 to 36: One visit every two weeks • Week 36 to delivery: One visit per week You may have more visits if you are pregnant with multiple babies or have a high-risk pregnancy. Tip 2 Enroll in the Pregnancy Passport Program for Turquoise Care Medicaid members. Earn incentives for attending your pregnancy visits. • Attend a prenatal visit within the first trimester (<12 weeks gestation): receive $150 reward. • Attend a postpartum visit within 7 to 84 days after delivery: receive $100 reward. Tip 3 Establish a fitness plan during pregnancy. Exercise during pregnancy offers many benefits for you and your baby. If you were active before being pregnant, you normally can continue with those exercises. Even if you were not active prior to pregnancy, you should move your body 15 to 30 minutes per day. Walking is a great way to start. Exercise will boost your mood and help with pregnancy symptoms, like discomfort and tiredness. It will also help with quicker postpartum recovery time. During pregnancy, there are safe exercises that you can do to be active. Listen to your body. If the movement you are doing Tips for a healthy pregnancy Get the myPRES app Presbyterian Health Plan has a myPRES app. You can access myPRES on the go and view important items, like your ID card, during your provider visits. The myPRES app is a great way to stay connected to your resources and access all the information regarding your health. Your account also includes: •Easier access to your healthcare team, including your primary care provider •Simpler ways to schedule appointments using Virtual Care •Streamlined access to Turquoise Care Rewards • Set your communications preferences, such as print or electronic delivery and English or Spanish language In addition, your Health and Wellness Resources are all at your fingertips. This includes transportation, Virtual Care, and Value Added Services. We hope that you find the myPRES platform helpful in managing your care. To get the full benefit of myPRES, download the app on your mobile device. Visit www.phs.org/myPRES to get started. To download the app, go to the Apple store or Play Store on your mobile device and search for “myPRES.”
www.phs.org/Medicaid 7 is causing discomfort, try doing an easier exercise. The goal is to move your body and stay healthy. Tip 4 To prepare for baby, you should select a pediatrician (doctor for your baby). You can also enroll in the Baby Benefits Program. Attend the first appointment within one week from birth. These well-child checkups ensure your baby is growing and developing on track. You will also get rewards for these health habits! • Complete six well-child visits from one week of birth to 15 months of age: receive $50 reward. • Complete well-child visits seven and eight from 16 to 30 months of age: receive $25 reward. Tip 5 Enjoy a healthy diet during pregnancy. Getting the right nutrition while you’re expecting is one of the best ways to ensure you’ll have a healthy pregnancy and baby. Eat plenty of the following: A colorful variety of fruits and vegetables Calcium-rich foods Foods with folic acid and healthy fats (omega-3 fatty acids) Avoid: Alcohol Caffeine Drink plenty of water throughout the day. You should drink at least half of your body weight in ounces per day (e.g., 100 lbs./2=50 ounces of water per day) to stay hydrated. Don’t forget to take a prenatal vitamin with folic acid. You can get one over the counter or get a prescription from your provider. Raw foods (like hot dogs, deli meats, raw or undercooked eggs, and fish) Don’t forget to take care of yourself and schedule your postpartum visit within one to six weeks after delivery.
8 Secure Messaging: Get your plan and coverage questions answered Presbyterian Health Plan has a way for members to connect with an expert about their plan and coverage. Secure Messaging is a secure and convenient message center available on myPRES. When members access Secure Messaging, they choose from one of the following topics for discussion: • Benefit and coverage information • Care coordination •Claims and billing • Cost estimation •Account management •Appointment scheduling •Finding a doctor and/ or changing your primary care provider •Healthcare resources The message center is available 24 hours a day, seven days a week. When PHP gets a message, it is sent to an expert who can best answer the question. The expert will respond in one to three business days. The message stays in the member’s myPRES account and stays active until all questions are answered. Please note that the message center is not for medical questions or information. Please do not ask questions related to personal healthcare. It’s holiday season, and treats are all around us. It’s easy to overdo it. Here are some tips for enjoying the holidays and staying on track. Enjoy your favorite homemade treat, but skip food that is available yearround, such as store-bought cookies. Take smaller portions of “treat” foods. The first few bites of food usually taste best. Chances are you will enjoy it just as much as a larger portion. Have a plan for buffets. Look at all your choices first and select three or four special foods that you want most. Smaller plates can also help you with your portion control. Plan activities with friends and family that don’t involve food. Ideas include going for a walk, making holiday crafts, or volunteering for a cause that is important to you. Bring a healthy dish to parties and potlucks. Move away from the food table after eating. You will be less tempted if you do not see it. How to enjoy eating during the holidays — in a healthy way Path for Wellness Prevention Program provides more ideas for healthy eating This program offers healthy weight management and diabetes prevention to eligible Presbyterian Turquoise Care members at no additional cost. It is designed to help members: • Build healthy habits • Lose or manage weight • Be more active • Reduce their risk of Type 2 diabetes It’s easy and fun to participate — the program is available online or by phone. The classes are also available in Spanish. To learn more about the program and get more information about how to sign up, visit www.phs.org/preventionprogram or call 1-855-249-8587.
www.phs.org/Medicaid 9 If you have diabetes, it’s important to get certain tests and exams every year to protect your body from heart disease; stroke; and eye, foot, or kidney problems. Keeping up with diabetes care can help you and your provider find any changes early and take steps to help you keep your diabetes under control. Here are a few important health checks you may need this year. Make sure to talk to your provider about which tests are right for you and how often you should have them. 1 A1C test. Also known as the hemoglobin A1C or HbA1C test, this is a simple blood test that shows your average blood sugar levels over the past three months. This test helps keep track of how well your diabetes is under control. How often you need it: Every three to six months. Your provider will recommend what is best for you. 2 Dilated eye exam. This is to protect your vision. Unlike a routine eye exam, this exam looks for damage to your eyes caused by high blood sugar. Having high blood sugar levels for a long time can hurt the tiny blood vessels in the back of your eyes. This can cause serious eye diseases resulting in cloudy or blurry vision and eventually loss of vision. How often you need it: Once a year. More resources Engage in resources, classes, and events available through Presbyterian Community Health: www.phs.org/community/ committed-to-community-health/programs. Earn $20 in Turquoise Rewards for completing a diabetes retinal eye exam. Centennial Rewards became Turquoise Rewards on July 1, 2024. Check out all the 2024 and 2025 Turquoise Rewards here: www.turquoiserewards.com. Find tips, resources, and more through the American Diabetes Association: www.diabetes.org/about-diabetes/ more-about-diabetes. Self-manage diabetes with routine lab tests and exams 3 Kidney health evaluation. This is a urine test and a blood test done together to check kidney health. Finding and treating chronic kidney disease early can stop or slow kidney damage. How often you need it: Once a year. Healthy living with diabetes requires keeping up with these recommended tests and exams. There are many ways to manage your health every day. Monitor your blood glucose, eat well, engage in physical activity, and take medications as prescribed. You should also get recommended screenings and minimize risk-taking behaviors.
10 Cold, dark winter days and holiday events and stress can be hard for those struggling with their alcohol use. It’s not always easy to tell someone they have a problem with alcohol — and it may be even harder to admit that you may have one yourself. However, now is a great time to get help or support loved ones. Alcohol use disorder (AUD) is considered a medical condition. Its hallmark trait is an inability to control the use of alcohol despite the negative effects drinking is having on someone’s life. AUD can be mild, moderate, or severe. No matter how severe it is, though, there are treatments that can help. Warning signs Among the possible signs that someone has AUD: • They’ve had times when they drink more or longer than intended. • They’ve tried more than once to cut back on drinking or stop altogether, but they couldn’t. • They continue to drink even though it’s causing problems with friends, family, work, or school. • They’ve cut back on, or have stopped doing, favorite activities so they can drink more. • They’ve more than once done things while drinking — such as driving, swimming, using machinery, or having unprotected sex — that put them at risk for serious harm. • They find they have to drink more than they once did to get the effects they want. Why AUD is a problem Alcohol use can have serious impacts on someone’s health. It can lead to injuries from accidental falls and traffic crashes. It can cause miscarriage or other problems in pregnant women. Over the long term, chronic alcohol use can cause, among other things: • Heart disease, high blood pressure, and liver disease • Certain cancers • A weak immune system • Cognitive problems • Mental health problems How to stop drinking For many people, the first step is to admit they have a problem with alcohol. And that can be a very difficult thing to do. Take a hard look at the warning signs of AUD. Any of them are a cause for concern if you have them. The second step is to ask for support. That may mean talking to family and friends, as well as to your provider. Your provider can prescribe medications to help you quit drinking. They can also refer you to a mental health therapist who can help you identify any underlying causes for your alcohol use and better ways to deal with them. You may also want to join a mutualsupport group, like Alcoholics Anonymous. These kinds of groups are available in most communities at low or no cost. You also may be able to find a mutual-support group online. Presbyterian Health Plan also has resources to support you. Don’t wait to get help; go to www.phs.org/ virtualcare to schedule services for AUD through virtual care visits. You can also call the number on the back of your member ID card. If you or a loved one are having an emergency or any kind of emotional crisis or mental health or substance use concern, you can find help 24 hours a day, seven days a week. Please do one of these things to get help right away: • Call or text the 988 Suicide & Crisis Lifeline at 988 or chat online at www.988lifeline.org/chat. • Go to the nearest emergency facility. • Call 911. Sources: Centers for Disease Control and Prevention; HelpGuide; National Institute on Alcohol Abuse and Alcoholism When drinking becomes a problem Alcohol use disorder can be mild, moderate, or severe. No matter how severe it is, though, there are treatments that can help.
www.phs.org/Medicaid 11 Presbyterian’s Hospice Volunteer Program is a rewarding way to give back to your community by giving time and support to patients. Whether you have a little or a lot of time, volunteers can make a big impact. When you volunteer, you give back to your community and create a positive impact on those around you. Volunteering also has many health benefits. It can improve physical and mental health, provide a sense of purpose, and nurture relationships and social skills. There are chances to volunteer across the state. The hospice volunteer team will provide all the training and information you need to help people. There are many things you can do with patients when you volunteer. This could include: Keep these numbers handy The Presbyterian Customer Service Center (PCSC) is available for members Monday through Friday, 8 a.m. to 6 p.m. Members can reach the PCSC at the following numbers: (505) 923-5200 or 1-888-977-2333, TTY: 711 Children in State Custody: (505) 923-8417 or 1-844-233-4887, TTY 711 Navajo/Diné members: (505) 923-5157 or 1-888-806-8793, TTY: 711 Other important numbers PresRN: (505) 923-5677 or 1-888-730-2300, TTY: 711 Routine transportation (for nonemergency medical transportation): 1-855-774-7737 New Mexico Crisis and Access Line (for a behavioral health crisis): 1-855-662-7474 (1-855-NMCRISIS) 988 Suicide & Crisis Lifeline (available 24/7): 988 or 1-800-273-8255 Presbyterian Turquoise Care Ombudsman: Phone: (505) 923-5780, email: ombudsman@phs.org Volunteer this season with the Hospice Volunteer Program For more information or to apply to become a hospice volunteer, visit us at www.phs.org/doctors -services/healthcare-at-home/ hospice/hospice-volunteer -opportunities. You can also scan the QR code to learn more and apply. • Visit and talk with the patient • Read and discuss books • Take a walk • Help with meals • Provide transportation • Watch TV or movies together • Help care for the patient’s pet • Help with mailings or other hospice office duties We also have a Veterans for Veterans program. This program provides support for hospice patients who are also military service veterans. Sources: Mayo Clinic Health System
Yourstory Your Story is published for members of Presbyterian Health Plan, Inc., and Presbyterian Insurance Company, Inc. P.O. Box 27489, Albuquerque, NM 87125-7489 www.phs.org Managing editor: fluentqc@phs.org Information in Your Story comes from a wide range of medical experts. Models may be used in photos and illustrations. If you have any concerns or questions about specific content that may affect your health, please contact your healthcare provider. Such services are funded in part with the State of New Mexico. Presbyterian complies with civil rights laws and does not discriminate on the basis of protected status including but not limited to race, color, national origin, age, disability, or sexual orientation or gender expression. If you need language assistance, services are available at no cost. Call (505) 923-5420, 1-855-592-7737 (TTY: 711). ATENCIÓN: Si usted prefiere hablar en español, están a su disposición servicios gratuitos de ayuda lingüística. Llame al (505) 923-5420, 1-855-592-7737 (TTY: 711). Díí baa akó nínízin: Díí saad bee yáníłti’go Diné Bizaad, saad bee áká’ánída’áwo’dé̜é̜’, t’áá jiik’eh, éí ná hóló̜, koji̜’ hódíílnih (505) 923-5420, 1-855-592-7737 (TTY: 711). For more information, visit www.phs.org/nondiscrimination. 2024 © Coffey Communications, Inc. All rights reserved. MPC082446 Medicaid #TC7096 Like us on Facebook Facebook.com/PresHealth Makes 4 servings. Ingredients For waffles: 1 cup whole-wheat flour 1⁄ 2 cup quick-cooking oats 2 teaspoons baking powder 1 teaspoon sugar 1⁄ 4 cup unsalted pecans, chopped 2 large eggs, separated* 1 1⁄ 2 cups fat-free (skim) milk 1 tablespoon vegetable oil For fruit topping: 2 c ups fresh strawberries, rinsed, stems removed and cut in half (or substitute frozen strawberries, thawed) 1 c up fresh blackberries, rinsed (or substitute frozen blackberries, thawed) 1 c up fresh blueberries, rinsed (or substitute frozen blueberries, thawed) 1 teaspoon powdered sugar Directions • Preheat waffle iron. • Combine flour, oats, baking powder, sugar, and pecans in a large bowl. • Combine egg yolks, milk, and vegetable oil in a separate bowl, and mix well. • Add liquid mixture to the dry ingredients, and stir together. Do not overmix; mixture should be a bit lumpy. • Whip egg whites to medium peaks. Gently fold egg whites into batter.* • Pour batter into preheated waffle iron, and cook until the waffle iron light signals it’s done or steam stops coming out of the iron. (A waffle is perfect when it is crisp and well-browned on the outside with a moist, light, airy, and fluffy inside.) • Add fresh fruit and a light dusting of powdered sugar to each waffle, and serve. *For pancakes, do not separate eggs. Mix whole eggs with milk and oil, and make pancakes as usual. Nutrition information Serving size: 3 small (2-inch) or 1 large (6-inch) waffle. Amount per serving: 340 calories, 11g total fat (2g saturated fat), 50g carbohydrates, 14g protein, 9g total fiber, 331mg sodium. Source: National Heart, Lung, and Blood Institute Oatmeal pecan waffles (or pancakes) TIP: Swap out berries for your favorites!
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