Research Rotations
CPHR students are expected to complete two different research rotations during their first year of study and then to select a mentor and project with which to work on a qualifying paper and dissertation. Research rotations are 2 days a week September-December, January-April, and May-August.
The following descriptions provide examples of the type of projects students can join for rotations and research areas from which dissertation research will be defined. Final selection of rotations and dissertation placements are worked out with the student’s faculty advisor, are limited by the number of slots available at each research site, and can be dependent on funding. For further information, please contact the faculty member identified or the Program Director.
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Commonwealth Medicine - Center for Health Policy and Research
Department of Family Medicine and Community Health
Department of Medicine
Department of Medicine - Division of Cardiovascular Medicine
Department of Medicine - Division of Preventive and Behavioral Medicine
Department of Orthopedics
Department of Pediatrics
Department of Psychiatry - Center for Mental Health Services Research
Meyer's Primary Care Institute
Commonwealth Medicine-Center for Health Policy and Research
The UMass Center for Health Policy and Research was established in 1997 as a part of Commonwealth Medicine's unit at the University of Massachusetts Medical School, to provide resources to health policy research activities on the UMass campus, to promote collaborative evaluation and policy development efforts between UMass and state agencies, to support innovations and quality initiatives in the UMass Memorial Health Care Clinical system, and to enhance and develop educational programs at the undergraduate and graduate level.
Sample Prior Research Rotations
Identifying children with special health care needs: Using previously collected data from large administrative data sets, parent surveys and medical records, the student will explore the accuracy and policy implications of different methods for identifying children with special needs. An expanded project might focus on developing an improved method for policy makers to consistently identify special needs children.
Organizational structure and quality of depression care: The student will explore the quality of care delivered by different models of primary care organization: individual physician practice, large group practice, community health centers and hospital outpatient departments. The focus will be on patient and practice factors that predict differences in quality of care by site of care.
Predictors of “best practice” in asthma primary care: The student will be guided in the analysis of data, primarily from medical records but supplemented by administrative information, to answer the question of what predicts good quality asthma care for publicly insured Massachusetts residents.
Understanding barriers to healthcare access for Medicaid beneficiaries: Using data from a survey of barriers to health care access, supplemented by administrative data, the student will identify patient characteristics associated with reported barriers to health care as well as the specific types of under use that occur (e.g. under use of preventive care or follow-up care).
Disparities in diabetes care: The student will analyze data from over 1,000 medical record reviews to identify factors associated with disparities in screening for diabetes complications, i.e. screening for retinopathy, cardio-vascular disease and nephropathy. The data set includes information about the patient’s health status, co-morbidities, race and language, as well as data about diabetes treatment.
Predictors of poor compliance with diabetes care: Using data collected for the 2004 HEDIS review and supplemented with additional medical records and claims data, the student will identify patient and practice factors associated with poor control of glucose among publicly insured Massachusetts residents.
Cross-state comparison of mental health care and substance abuse treatment for Medicaid beneficiaries in six states: The student will work with a senior researcher to identify a subpopulation (e.g., children, adults with severe mental illness, ethnic groups, people over age 65), to understand differences in Medicaid and behavioral health policy in the different states and to explore the impact of those policies on access to behavioral health treatment using a database of complete Medicaid claims from six states located in each geographic region of the country.
For more information, contact Dr. Robin Clark: robin.clark@umassmed.edu
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Department of Family Medicine and Community Health
The Department of Family Medicine and Community Health has a variety of ongoing and developing research studies funded by the National Institutes of Health, other federal agencies, private foundations, and state government. These studies include primary and secondary data collection and analysis, and qualitative and quantitative methods. Examples are management of chronic illness; treatment of depression, alcohol problems and trauma; patient-centered care innovations in the treatment of chronic pain; patterns of addiction to tobacco among youth; health disparities and access; and community-based interventions for young children and their families with behavior problems.
Sample Prior Research Rotations
Patient’s views of their treatment for chronic pain: The student will have access to an extensive qualitative data set in NVIVO based on 16 focus groups with Worcester area patients with histories of chronic pain. The student will be trained in using this qualitative software and will be able to explore research questions of interest to the research team using the focus group transcripts.
Improving patient compliance with cancer screening tests: Students will have access to data on various interventions to improve pateient follow-up with mammography, colorectal cancer and prostate screening. Research on quality improvement and healthcare are being developed.
Investigating health disparities using administrative and other large scale data sets: The student will be guided in completing data analysis to address specific questions concerning health access and outcome disparities by ethnicity, age, geography etc. using nationally representative data sets.
Early childhood behavior problems: The student will be asked to explore important research questions on characteristics of children exhibiting behavior problems in child care centers using data collected from a Worcester-area study of a pilot behavioral health intervention.
For more information, contact Dr. Carole Upshur: carole.upshur@umassmed.edu
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Department of Medicine
The mission of the Department of Medicine is to improve medical care through better education and research into the causes and treatment of diseases of adults. The goal of improving health care and health care delivery is achieved by teaching Internal Medicine to healthcare personnel and the general public and by research which enhances our understanding of the causes of diseases so new treatments can be developed.
The department is divided into 15 divisions which include a division of general medicine and primary care, and a separate division of community internal medicine (comprised of physicians throughout central Massachusetts), preventive medicine, gene therapy and 11 subspecialty divisions including cardiovascular medicine, dermatology, endocrinology and metabolism, diabetes, digestive diseases and nutrition, hematology, infectious disease and immunology, oncology, pulmonary, allergy and critical care medicine, renal medicine, and rheumatology.
Department of Medicine - Division of Cardiovascular Medicine
The Division of Cardiovascular Medicine has a variety of ongoing clinical and epidemiological research projects involved with the primary and secondary prevention of coronary heart disease, acute coronary syndromes, heart failure, peripheral arterial disease, and venous thromboembolism.
Sample Prior Research Rotations
Community surveillance for coronary heart disease: Using data from the population-based Worcester Heart Attack Study, the student will be able to examine data from an ongoing community-wide registry of greater Worcester residents hospitalized with independently validated acute myocardial infarction as well as data on out-of-hospital deaths due to coronary disease. Information is available to describe long-term trends (1975-2003) in the incidence rates, hospital and post-discharge death rates, and changing therapeutic practices of over 12,000 greater Worcester residents hospitalized with acute myocardial infarction during 13 annual study periods.
Community surveillance for heart failure: Interested students will be able to explore a variety of research questions utilizing a comprehensive community-based registry of inpatients and outpatients from the greater Worcester area with newly diagnosed heart failure during calendar years 1995 and 2000. Data are available to systematically explore changing disease trends and practice patterns of this emerging clinical syndrome.
Global Registry of Acute Coronary Events: The student will be guided in the use of data from this large multinational coronary disease registry which involves the collection of data from patients hospitalized with acute coronary syndromes at 100 hospitals in 14 countries. Data have been collected on a regular basis since 1999. Opportunities exist for the publication of a variety of important clinical and epidemiological research projects.
Heart Attacks and Air Pollution: In collaboration with investigators from the Harvard University School of Public Health, interested students would be able to analyze data from a large community survey that is examining the relation between air pollution, primarily from traffic, and the incidence rates of acute myocardial infarction in the Greater Worcester population.
For more information, contact Dr. Robert Goldberg: goldbergr@ummhc.org
Diagnosis and treatment of venous thromboembolism in the community setting: The student will utilize a large SPSS-based data set including patient demographics, clinical variables, health care utilization and treatments, and clinical outcomes to further explore and characterized the changing epidemiology of deep vein thrombosis and/or pulmonary embolism.
For more information, contact Dr. Frederick Spencer: spencerf@ummhc.org
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Department of Medicine - Division of Preventive and Behavioral Medicine
The Division of Preventive and Behavioral Medicine has a wide range of ongoing and developing research in the areas of health promotion, disease prevention and adaptation to illness. The division has an outstanding record of research in behavioral intervention for chronic disease treatment and management, cardiovascular disease prevention, nutrition, tobacco prevention and treatment, cancer treatment and screening, women’s health, community-based intervention, and physician-delivered intervention. Ongoing studies are funded by the National Institutes of Health, other federal agencies, private foundations, and state Departments of Public Health. They are at various stages of implementation and involve a variety of quantitative and qualitative methods.
Sample Prior Research Rotations
Nutrition research with adults with obesity, diabetes, metabolic syndrome, and cardiovascular disease: The student will be part of a team development for interventions that target specific populations in innovative ways. The student will be trained in research nutrition concepts (such as utilizing the glycemic index) and will assist with the development of an array of materials necessary for successful delivery of nutrition information to the targeted population.
Feasibility and Structure of a Systems-based Intervention to Prevent and Treat Pediatric Obesity: The student will be part of a team to assess the needs of pediatric practices and their multicultural population of families with regard to obesity prevention and treatment, develop an intervention, and test the intervention and data collection protocol in a pilot study. Data being collected includes qualitative data from focus groups, patient exit interview data regarding fidelity to intervention protocol, feasibility and satisfaction regarding the intervention and evaluation protocols, and short-term changes in dietary and physical activity behavior.
Adherence and Coronary Heart Disease: The student will be guided in the use of clinical trial data to evaluate the effects of a pharmacist-mediated program designed to improve adherence to lipid-lowering pharmacologic therapy for patients with known coronary heart disease. Data methods are still under development in which the student can participate.
Diabetes Prevention for Low-Income Hispanics: The student can explore research questions involving a diabetes prevention program for Latino patients at high risk for developing diabetes using data collected in a randomized clinical trial. Data methods are still under development.
Diabetes Management for Low-income Hispanic Patients: This randomized clinical trial is testing the efficacy of a culturally- and literacy-tailored cognitive-behavioral intervention designed to enhance adherence to diabetes self-management behaviors and thus improve glycemic control among low-income Hispanic individuals with type 2 diabetes mellitus. Opportunities for students include participation in the development of intervention materials and assessment tools and database development. Under the guidance of the principal investigator, opportunities also exist for developing a research question of interest to the study using data collected from the intervention and control arms.
Self-Management of Early Stage Heart Failure: Using data collected from a pilot intervention of a nurse-delivered, patient-centered counseling intervention to promote medication adherence and dietary and physical activity change, the student will have the opportunity to participate in the development of a large randomized controlled trial, which includes literature review and methodological development. Opportunities for analysis of the pilot study also exist.
Longitudinal Relationships of Psychosocial Factors and Behavior in Female Relatives of Breast Cancer Patients: Using a large longitudinal dataset, the student will have the opportunity to develop data analysis and scientific writing skills on important research questions related to the psychosocial and behavioral adjustment of first degree relatives of women recently diagnosed with breast cancer.
Step Ahead - Activity and Diet Steps by Hospital Employees to Promote Health: This randomized controlled trial will test the effectiveness of an environmental worksite intervention to reduce overweight and obesity, targeting change in physical activity among hospital employees. The student will have an opportunity to be part of a multidisciplinary team and gain experiences in study implementation, measurement development, and data collection using various research methods.
Massachusetts Comprehensive Cancer Control Program Evaluation: The student will have the opportunity to work with a team to evaluate the process used to implement a new cancer control coalition and state cancer control plan in Massachusetts. The student will be involved in administering process evaluation instruments and in the analysis of the data collected.
QuitWorks: A Proactive Quitline: QuitWorks is a public health initiative sponsored by the Massachusetts Department of Public Health and major health plans in Massachusettslinking healthcare providers and their patients to tobacco treatment services. The student will have the opportunity to assist with the design and implementation of phone surveys to primarycare provider practices and community health centers to evaluate the impact of activities designed to promote the adoption of QuitWorks in these settings.
Massachusetts Tobacco Treatment Programs Study (MassTTPS): Sustainability of Tobacco Treatment Services: This study examined the effect of Massachusettspolicies to fund tobacco treatment programs in healthcare settings, including the effect of statewide de-funding on these programs’ ability to sustain tobacco treatment services. The student will conduct telephone interviews using an established telephone survey protocol to collect and analyze data regarding the sustainability of tobacco treatment services following de-funding.
Massachusetts Tobacco Treatment Programs Study (MassTTPS): Effect of De-funding on Tobacco Treatment Specialists: This study conducted a telephone survey of tobacco treatment specialists (TTSs) after the loss of funding to the treatment programs which examined the impact of de-funding on the TTS current job functions and their perceptions of the usefulness of the state- funded training that they received. The student will have the opportunity to assist with the revision, implementation and analysis of a 2 year follow-up survey with the TTSs.
Tobacco Prevention and Cessation Education at US Medical Schools: In this project twelve medical schools throughout the United Statesare developing and integrating new teaching modules for tobacco control/smoking cessation training into their curricula and educating medical school faculty in their objectives. Several opportunities for students exist: 1) The student can participate in designing implementation strategies to test the new modules in the twelve schools; 2) S/he also can contribute to the development and implementation of a faculty development workshop and process evaluation tools to monitor implementation of the project objectives in the study schools; and 3) Under the guidance of the principal investigator, the student can develop a qualitative research project to enhance one of the research questions.
Evaluation of Online Course Satisfaction and Student Characteristics: The student will be guided in analyzing data from an online tobacco education course to evaluate the relationship between participant satisfaction with the course and student characteristics such as profession, work setting, amount of time spent online, and final posttest score.
Certified Tobacco Treatment Specialist Satisfaction with Training Program: The student will have the opportunity to revise an existing telephone survey instrument, administer the survey to a representative sampling of Certified Tobacco Treatment Specialists, and analyze the data to ascertain student satisfaction with the program, perceived effectiveness of the training, and how they are using their training in their current responsibilities with respect to tobacco treatment.
Effectiveness of a Community Health Center-Targeted Tobacco Intervention for Cultural and Linguistic Minority Populations: The student will assist with the evaluation of a public health initiative intended to increase smoking cessation counseling and materials development for 10 Community Health Centers (CHCs) in Massachusetts. The student will be guided in the development and implementation of a follow-up survey for the 10 demonstration sites to determine systems changes to support routine tobacco use identification and treatment, maintenance of these clinical systems, and the degree to which the process for developing materials for cultural and linguistic minorities was effective and beneficial to the CHC.
Provider and Peer Delivered Youth Smoking Intervention: The student will have the opportunity to analyze data from a randomized clinical trial conducted to evaluate the effectiveness of a provider-delivered and peer counseling intervention for smoking cessation and prevention in adolescents seen within pediatric practice. Data sets available include prevalence of smoking, adolescents’ attitudes, beliefs, and smoking-related behavior, depression scores, ADHD status, and providers’ knowledge, attitudes, and practice behaviors.
School Nurse Delivered Smoking Intervention: The student will be part of a multidisciplinary team to implement a large randomized controlled school-based trial to evaluate the effectiveness of a school nurse-delivered smoking cessation intervention in increasing abstinence rates among high school students who smoke. Opportunities will be available to assist in the development of evaluation measures and intervention protocols, data collection, and data analysis.
Women's Health, the Post-Menopausal Years: The student will be involved in the Women's Health Initiative (WHI) Extension Study, WHI Memory Study (WHIMS), and WHIMS MRI Collaborative Study. The WHI is a study of women who are post-menopause and the effects of diet, hormones and calcium and vitamin D on heart disease, breast and colon cancer, osteoporosis, and dementia and memory. The student will be guided in the recruitment, consenting, and follow-up of 3860 participants in the WHI and the recruitment of 125 women for the WHIMS MRI Study. The WHIMS MRI study's objective is to establish whether the prevalence of silent cerebral infarctions is increased among women who had been assigned to hormone therapy (HT), relative to placebo therapy during the WHIMS clinical trials. The student will be involved in study implementation, development of ancillary studies, and in the writing of papers.
For more information, contact Dr. Judith Ockene judith.ockene@umassmed.edu
or Dr. Stephenie Lemon: Stephenie.lemon@umassmed.edu
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Department of Orthopedics
The Department of Orthopedics has a variety of ongoing and developing research studies funded by the Robert Wood Johnson Foundation, National Institutes of Health, and private foundations. These studies use primary and secondary data collection, including population-based web surveys and disease registries. Clinical and outcomes research are natural extensions of the inter-disciplinary, chronic-care (Total Joint Replacement, Spine Care) and ambulatory clinics (Sports Medicine, Hand.)
Sample Prior Research Rotations
Predictors of long-term functional outcome following Total Joint Replacement: The Center for Arthritis and Total Joint Replacement is conducting a series of clinical and outcomes studies evaluating the roles of pre-operative emotional health, co-existing illness, and post-operative rehabilitation exercise adherence on post-operative improvement in long-term physical function. For example, a randomized trial of a behaviorally-based, post-surgical exercise program will evaluate patient adherence and long-term physical function.
Radiostereometric Analysis in Total Hip Replacement: This investigative radiological imaging technology allows early assessment of joint replacement function and wear. Prospective randomized trials will evaluate new prosthetic materials and the associated patient outcomes.
Email and web-based health promotion programs for arthritis and primary prevention: Health promotion via sequential emails and interactive web-based tools is currently being tested in a randomized trial across a network of 20 worksites. The program is designed to enhance adoption of healthy diets and physical activity. Health-related work productivity and health costs will be evaluated. A proposed multi-component email arthritis education program will extrapolate the lessons learned in primary prevention to the early identification and self-care for arthritis symptoms among adult employees.
For more information, contact Dr. Patricia Franklin: patricia.franklin@umassmed.edu
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Department of Pediatrics
The Department of Pediatrics has a portfolio of current research studies funded by the National Institutes of Health, federal and state agencies and private foundations. Major areas of research include quality of care for children’s health services (outreach for adolescents at risk for sexually transmitted diseases, adverse birth outcomes in minority women, coordination of communication between primary and specialty care, mental health services research including system interventions for common mental disorders in primary care populations such as for psychological distress in chronically medically ill patients and adolescent depression, and, in conjunction with the Division of Child Psychiatry, the neurobiology of aggression and depressive disorders, ecological models of risk for these disorders and the design and evaluation of wrap around service delivery for seriously emotionally ill youth. These studies include prospective and retrospective data collection with a special emphasis on analysis using longitudinal hierarchical linear models and other new applications of statistical theory. Topics include, systems of care research for the management of risk of depressive disorders in primary care populations, including adolescents and the chronically medically ill, data analytic strategies for profiling paths to aggressive behavior as well as the emergence of first episode depressive disorders in adolescents, the design and implementation of patient-centered quality improvement interventions in the community, and racial and ethnic disparities in access to health care.
Sample Prior Research Rotations
Evaluation of quality improvement program in primary care for adolescent depression: This student will have access to a SAS or SPSS dataset containing depression screening and assessment data, family history of mood disorders and other risk factors. Skill building in programming of complex data, mixed effects (fixed and random) regression models and other quantitative techniques will be stressed.
Profiling of quality and patient safety indicators among children in the pre-hospital settings: This will be accomplished through use of a multi-site database of over 15,000 children transported to hospital emergency departments by ambulance. This project would allow a student to explore variations in quality of care, analytic methods appropriate to such analysis, the use and misuse of treatment guidelines and identification of barriers to appropriate care.
Depressive and other mental disorders in children: A variety of databases are available that are appropriate for studying biological approaches to depressive and other mental disorders in children, including the neurobiology of depression, identification of diagnostic groups in children with symptoms of emerging psychiatric illness and, in collaboration with researchers from the Department of Psychiatry, the neurobiology of aggression. Available databases allow the design of studies that bridge basic clinical research with mental health services research.
For more information, contact Dr. Thomas McLaughlin: thomas.mclaughlin@umassmed.edu
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Department of Psychiatry - Center for Mental Health Services Research
Research rotations within the Center for Mental Health Services Research will be organized around the Center’s five Cores, each of which corresponds to a major substantive area within mental health services and policy research. These include cores focusing on:
- Mental Health Services and Policy Research
- Research on Children and Families
- Law, Criminal Justice and Mental Health Services
- Psychosocial Rehabilitation
- Methods
In addition to its investigators federally and foundation supported research each core has a relationship with working groups within the Massachusetts Department of Mental Health (DMH). While the investigators working within these cores tend to focus their interest within the core’s principal content area, there is substantial cross-core activity. These cores are described briefly below. Each of the Cores is home to a number of studies and has a series of ongoing projects that welcome participation from doctoral students.
Sample Prior Research Rotations
Mental Health Services and Policy Research: This Core focuses on aspects of organizational and policy change in the delivery of mental health services, for persons with severe mental and emotional disorders. Research by members of this core has included the evaluation of public hospital closures and the effects of public managed care. Because of the generic nature of the core’s content area there is considerable overlap with the activities of other cores.
Research on Children and Families: As its name suggests, investigators in this Core pursue research in two distinct but highly inter-related areas – systems delivering mental health services to children and adolescents with severe emotional disorders and issues related to parenting by adults with severe mental illness. Because its content area addresses issues pertaining both to mental health services delivery and rehabilitation researchers in this core interact frequently with investigators in other cores.
Law, Criminal Justice and Mental Health Services: This core brings together individuals from multiple disciplines, ranging from law to sociology, who conduct research on issues having to do with legal issues in mental health service delivery, such as civil commitment, as well as the interface between the courts, criminal justice and mental health systems. Research on juvenile populations involved in the justice system are included in this core, but also involve members of the Child and Family Core.
Psychosocial Rehabilitation: Work in this core evaluates systems and programs for enhancing the social functioning of individuals with severe psychiatric disorders. A particular emphasis is placed on issues pertaining to employment of individuals in this population.
Methods: Members of the Methods Core serves as a resource to investigators in other cores and also work on the development of innovative methodological approaches to conducting mental health services research.
Students will have the opportunity to work in a highly interdisciplinary environment using eclectic methods and data sources. Some investigators use large public data sets from DMH, Medicaid and other state agencies, and in some cases actually work with those agencies on projects related to the development and refinement of such. A major focus of work by the Methods core has been the merging and analysis of these data sets in ways that keep investigators in compliance with new federal guidelines regarding confidentiality of patient data. In this regard, members of the Law, Criminal Justice and Mental Health Core have developed significant expertise in the issues raised by this new regulatory environment. Other projects rely on primary data collection, through questionnaires and face-to-face interviews, as well as through the use of focus groups and other less traditional methods for acquiring information regarding health status, service use, and other such critical domains. A number of projects are drawing on multiple sources and types of quantitative and qualitative data to develop more complete pictures of the phenomena under study.
For more information, contact Dr. William Fisher: bill.fisher@umassmed.edu
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Meyers Primary Care Institute
The Meyers Primary Care Institute is a joint endeavor of the Fallon Foundation and the University of Massachusetts Medical School. The mission of the Institute is to promote primary care practice through the development and implementation of innovative programs in research and education.
Sample Prior Research Rotations
Administrative Databases in Cancer Research: These databases, constructed for a series of research studies conducted in the context of an NCI-funded cancer research network, provide an excellent opportunity to acquire experience in population-based research and the use of large HMO administrative databases. Current projects include cancer surveillance, the evaluation of cancer treatments and outcomes, and racial and age disparities in cancer outcomes.
Communication between primary care and specialty physicians: The student will have the opportunity to examine and conduct analyses of a detailed dataset to explore issues surrounding generalist-specialist communication in a sample of 178 pediatric referrals.
Measurement in patient populations: The student will have the opportunity to explore measurement issues in assessments of patient perceptions (e.g., patient satisfaction), patient beliefs (e.g. about medication efficacy) and knowledge (e.g., about appropriate medication usage). Additionally, opportunities for examining novel approaches to surveying (e.g., use of randomly generated factorial questionnaires) and for surveying special populations (e.g., preceptors or medical students) are also potentially available.
Medication problems in older adults: The student will have the opportunity to characterize the problems that older adults face in affording and properly taking prescription medications as captured in nationally-represented surveys and medical claims databases.
Patient safety: The student will have the opportunity to assist in the evaluation of prescription drug use and prescribing or monitoring that is inconsistent with drug labeling or guidelines using automated health plan data files.
Patient trust: The student will have the opportunity to explore whether there is any association between patient trust and self-reported quality of life in middle-aged and older geriatric adults. Available datasets include a national telephone survey of adults; a longitudinal survey of HMO members; and a cross-sectional survey of bladder cancer survivors.
For more information, contact Dr. Jerry Gurwitz: jerry.gurwitz@umassmed.edu
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