Relapse in drug abuse: A concept analysis
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Person is said to recover from drug dependence if he is free or clean of drugs for at least 2 (two) years.<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">1–3</span></a> Based on data from the National Narcotics Agency for Rehabilitation at the National Narcotics Agency, the recurrence rate of drug abusers reaches 90%.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The concept of relapse has been widely used in various fields of science, especially in the fields of health and nursing. The concept of relapse in Indonesia requires a special definition. Various experts have defined the concept of relapse, but to date, but until now there has been no specific definition.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Research on relapse has been carried out a lot, but until now there has not been a clear definition of relapse that applies in research and prevention in community nursing. Therefore, this study aims to find a definition of the concept of relapse with comprehensive.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">The method used in this study is using Walker and Avant concept analysis approach.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">5</span></a> Concept analysis enables researchers to clarify a concept and is one building block in the theory-building process. Through systematic analysis of scientific literature and cases, the main characteristics of the construct can be synthesized into a theoretical definition, which is precise, understandable to others, and appropriate for the context in which the term will be used: (1) The analysis of a new and immature concept that is not yet grounded in a pre-existing theory can, therefore, be an important step toward theory development (2), one of our predominant aims<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">5</span></a> (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">This concept analysis was carried out with the aid of literature on relapse obtained through the Internet databases of CINAHL, Proquest, Google Scholar, and Science Direct. The keywords of interest were “relapse” and “drug abuse.” The search timeline was adjusted to articles published from 1998 to 2019.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Select a concept</span><p id="par0030" class="elsevierStylePara elsevierViewall">After drug rehabilitation, the abuser returns to the family and community. The abuser feels isolated because his family and the surrounding environment do not care about his existence. After meeting with old friends who are still consuming drugs and given information that there are new types of drugs whose effects are more powerful than those used before. On the other hand, the family does not understand the needs of abusers after rehabilitation. Abusers enjoy their old-world again with friends of drug abuser groups.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">6–9</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Determine the aims of analysis</span><p id="par0035" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">a.</span><p id="par0040" class="elsevierStylePara elsevierViewall">Clarify and perfect the concept of port</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">b.</span><p id="par0045" class="elsevierStylePara elsevierViewall">Obtain operational definitions of relapse attributes</p></li></ul></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Identify all users of the concept (using dictionaries, thesauruses, colleagues and available literature)</span><p id="par0050" class="elsevierStylePara elsevierViewall">A brief review of the literature was undertaken to determine which term was used most consistently. On this basis, the concept of ‘relapse’ has been selected for analysis. The definition concept of relapse is a condition in which the client appears the same symptoms as before and resulted in the client must be treated again<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a>; fall ill again (usually worse than before)<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">11</span></a>; conditions that refer to the inability to sustain changes in behavior over time. Relapse can be seen not only as a return to the pattern of substance abuse or dependence but also as a process in which indicators or warning signs about irregularities or relapse occur before the actual use of an individual drug<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">12</span></a>; the return of a disease after it seems to subside<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">13</span></a>; the return of symptoms of the disease so that it is quite severe and interferes with daily activities and requires unscheduled inpatient and outpatient care<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a>; the reappearance of real psychic symptoms<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a>; and return to consuming drugs after recovering.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">16</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Determine the defining attributes</span><p id="par0055" class="elsevierStylePara elsevierViewall">Relapse is the state of the client's return to taking drugs or the condition of the reappearance of symptoms as before so the client is unable to maintain changes in behavior over time.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Identify a model case</span><p id="par0060" class="elsevierStylePara elsevierViewall">Male clients aged 20 years, after undergoing rehabilitation, regroup with their previous group. The client feels unnoticed by his family. The family considers the return of the client to the house as unexpected anymore, especially the environment around where he lives. As a result of the acceptance of the family and community, the client feels a desire to re-consume drugs, even more so when previously received information from his group that and new types of drugs that are more awesome for the body. Clients feel symptoms appear as experienced before doing rehabilitation in body pain and anxiety. As a result, the client is unable to resist taking more drugs.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Identify borderline cases</span><p id="par0065" class="elsevierStylePara elsevierViewall">Male client aged 17 years, post rehabilitation clients feel he is more cared for and loved by the family. The family considers the client's return home as a gift because the client is the only son in the family. On the contrary, neighbors and the surrounding community do not seem to like seeing clients return to the community. The client thinks it is better to go back to consuming drugs so that he can return to the rehabilitation center rather than go home but the community does not accept his presence. As a result, the client's feelings began to get restless and wanted to find a friend to get drugs, but the client realized with such affection that his family loved him, that the client canceled his intention to go back to consuming drugs again.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Identify contrary cases</span><p id="par0070" class="elsevierStylePara elsevierViewall">Clients 23-year-old man, finished undergoing a period of drug rehabilitation felt incredible happiness. Arriving at home welcomed joy by the family and surrounding community. All of our fellow users are all aware and are back to doing routine activities in the community with their respective professions for the happiness of himself and his family. Clients feel back to life as they were before getting caught in drugs, so the client is determined and promises not to consume drugs again, for the happiness of his family and himself.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Identify antecedents and consequences</span><p id="par0075" class="elsevierStylePara elsevierViewall">Antecedence: external factor; family and community support; and internal factor; emotional symptoms and physical symptoms.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Consequences: Physical effects and psychic and social.<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">17,18</span></a></p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Define empirical referents</span><p id="par0085" class="elsevierStylePara elsevierViewall">The concept of relapse can be measured by measuring relapse prevention therapy.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a></p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussions</span><p id="par0090" class="elsevierStylePara elsevierViewall">Several factors can trigger relapse in drug abusers. There are two categories, namely factors originating from within the individual (internal) and from the environment (external). Internal factors that can trigger relapse include self-efficacy, motivation, craving, coping, emotional states, and outcome expectancies. While external factors that can trigger relapse are social situations that suppress and the emergence of interpersonal conflict.<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">19,20</span></a></p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conclusions</span><p id="par0095" class="elsevierStylePara elsevierViewall">Relapse prevention is a prevention and intervention strategy designed to prevent early lapse and provide management skills when lapse occurs. Relapse prevention combines major components of education, such as the restructuring of cognition from misperceptions and maladaptive thinking the cognitive-behavioral model of relapse.</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflict of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres1329567" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1225142" "titulo" => "Keywords" ] 2 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consequences" ] 8 => array:2 [ "identificador" => "sec0060" "titulo" => "Define empirical referents" ] ] ] 5 => array:2 [ "identificador" => "sec0065" "titulo" => "Discussions" ] 6 => array:2 [ "identificador" => "sec0070" "titulo" => "Conclusions" ] 7 => array:2 [ "identificador" => "sec0075" "titulo" => "Conflict of interest" ] 8 => array:2 [ "identificador" => "xack459091" "titulo" => "Acknowledgments" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-08-27" "fechaAceptado" => "2019-12-16" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1225142" "palabras" => array:3 [ 0 => "Concept analysis" 1 => "Drug abuse" 2 => "Relapse" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The purpose of this study is to clarify the concept of relapse in drug abuse.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Concept analysis was examined using the help of various literature obtained through internet databases published from 1998 to 2019.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Identification of attributes, antecedent, and consequences of relapse causes the operational definition of the concept of relapse as the return state of the client consuming drugs or the re-emergence of symptoms such as before, so the client is not able to sustain its behavior change over time.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">This concept analysis is able to demonstrate that the concept of relapse is a self-management therapy that is made to prevent the relapse in the area of addiction behavior and focus on the important problems of help addicts change their behavior to help the developments that addicts have made in the process of treatment or self-change.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Peer-review under responsibility of the scientific committee of the International Conference of Indonesian National Nurses Association (ICINNA 2019). Full-text and the content of it is under responsibility of authors of the article.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Steps \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Explanation \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Select a concept \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Choose a concept that is important and useful to your research program or to further theoretical developments in your area of interest \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Determine the aims of analysis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Focus attention on exactly what use you intend to make of the results of your effort \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Identify all uses of the concept (using dictionaries, thesauruses, colleagues and available literature) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Identify as many users of a concept as you can find, this review of literature helps you support or validate your ultimate choices of the defining attributes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Determine the defining attributes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The effort is to try to show a cluster of attributes that are the most frequently associated with the concept and that allow the analyst the broadest insight into the concept \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Identify a model case \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">A model case is an example of the use of the concept that demonstrates. All the defining attributes of the concept, multiple. Models from different perspectives assist in capturing the wide social construction of the concept. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Identify borderline, related, contrary, invented and illegitimate cases \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The basic purpose for these cases is to help you decide what “counts” as a defining attribute for the concept of interest and what doesn’t count. Invented cases reduce the validity of the analysis and are excluded and are illegitimate cases are not necessary if the concept is not common place. This step contrasts the studied concept with related concepts and contributes in that way to more synergetic theory building and the development of the studied concept as a demarcated area in, e.g., research \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Identify antecedents and consequences \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">These steps may shed considerable light on the social contexts in which the concept is generally used. Antecedents are those events or incidents that must occur prior to the occurrence of the concept. Consequences, on the other hand, are those events or incidents that occur as a result of the occurrence of the concept \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Define empirical referents \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Empirical referents are classes or categories of actual phenomena that by their existence or presence demonstrate the occurrence of the concept itself. In many cases the defining attributes and the empirical referents will be identical. When the attributes are highly abstract, empirical referents are necessary \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2279000.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Steps of concept analysis.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">5</span></a></p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0105" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recovery, reintegration, abstinence, harm reduction: the role of different goals within drug treatment in the European context" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. 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This research did not receive any specific grant from a publicly funded agency, commercial, or non-profit sector.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/11308621/00000030000000S3/v2_202004260744/S1130862120300991/v2_202004260744/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/11308621/00000030000000S3/v2_202004260744/S1130862120300991/v2_202004260744/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130862120300991?idApp=UINPBA00004N" ]
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