As we do every year, the doctors and editors of KidsHealth have sifted through scores of health issues affecting children and families to choose 10 important trends to keep tabs on in 2009. There are significant trends, but there was one common thread that factored into nearly every aspect of families' lives and so became our focus of attention: The economy.
The financial crunch, here and around the world, will undoubtedly affect the physical and mental health of parents and kids throughout 2009 — and beyond. The basics that families may have taken for granted just a year ago are becoming a real struggle for many. Each of us is feeling the pinch in some way.
So, we've pinpointed a collection of the biggest challenges ― and opportunities ― that lie head. Of course, these aren't the only important issues affecting kids' health ― far from it. But we hope we can offer some insights into what to expect and how to make it all work, despite the setbacks of 2008 and others that might loom ahead.
Dealing With Financial Turmoil
The tanking economy, credit crunch, housing crisis, and rising unemployment rate of 2008 have put money (or, rather, the lack of it) at the very top of parents' minds, especially as we enter a new year, a new recession, and a new administration.
In 2008 an already slow economy practically came to a screeching halt. Seemingly reliable corporate giants and age-old banks collapsed or asked for government rescues to the tune of hundreds of billions of dollars. As the stock market struggled to stay afloat, one major company after another begged for lifelines. Automakers teetered as banks and credit card companies cut back on credit lines, making it tough even for people with good credit to get a car. Companies doled out pink slips in droves, and the worst unemployment rate in decades showed no signs of letting up. House prices plunged and more families faced foreclosure on their mortgages.
No doubt, the economy will continue to take center stage throughout 2009, as families tighten their purse strings further and brace themselves for even more economic setbacks. Even the basics — rent/mortgage, gas, groceries, heating oil, child care, health care — may become a difficult burden for usually financially stable families.
What to Watch:
As countries continue to reel from a global recession, more and more children here and abroad will go hungry or face homelessness. Many families on the brink will resort to buying unhealthy, cheaper foods and put once-routine checkups, medications, and immunizations on the backburner. And less money for charitable giving could mean scarcer resources for those newly in distress. There may be fewer dollars for scientific research and the fight against threats such as measles, tuberculosis, malaria, hunger, and AIDS worldwide.
The fragile economy may get worse before it gets better. Now, it's essential for many (if not most) households to learn how to live with less — and do it within their means, instead of falling back on credit or loans.
Parents have an additional challenge: helping their children through these difficult times. Even if they don't always say so, kids are very aware of the tension felt by their parents. As with many things, the best approach is for parents to talk to kids about what's going on and how their family will cope. Kids may not be interested in the global economy, but they are interested in what is happening to them and their family.
It's OK to say "no," set limits, and tell them that there's a limited amount of money in the family budget. Honesty is key but too many details might be too upsetting, especially for younger children. If nothing else, our collective money crunch is a prime opportunity to teach kids of all ages important lessons about separating "wants" from "needs," delaying gratification, and earning the things they truly want. After all, food, heat, and a roof over their heads come before toys, "in" clothes, or a teen's new car.
Family Money Troubles
The Impact of Keeping in Constant Technological Touch
From a suicide conviction tied to MySpace to a dramatic rise in texting-related injuries, communication technologies (and their hazards) spent time under the microscope in 2008.
Technology continues to change the face of social dynamics — especially how kids keep in touch with each other. And moms and dads are becoming just as addicted to all things technological as their offspring — with super-short notes tapped out in a flash through email, instant messages, text messages, blogs, message boards, and personal pages.
But news about communication technologies wasn't all rosy in 2008. The country saw its very first cyberbullying conviction. A federal jury found a mother guilty of three counts of computer fraud after she and her young daughter created a fake MySpace page, pretending to be a boy and allegedly contributing to a depressed teen girl's suicide.
Also in '08: A group of ER doctors — the American College of Emergency Physicians (ACEP) — warned students to stop texting while in motion (when driving, walking, biking) since reports of texting-related injuries (and even deaths) are on the rise nationwide.
What to Watch:
Modern communication technologies will continue to grow and diversify. But all of this constant keeping in touch begs the question, "Do we need more virtual boundaries?" Now, the legal precedent has been set for putting an end to cyberbullying. And maybe texters of all ages will be more aware of the dangers of typing away while on the go (especially as more and more states crack down on texting while driving).
But we also need to ask ourselves, "Is our ever-growing reliance on (and obsession with) communication technology changing how we communicate with each other, especially with our kids?" Are quickly typed messages cutting off meaningful, deeper communications? Are moms and dads less in tune with their kids because everyone in the family is plugged in too often (even at the dinner table)? We aren't getting any less busy and being able to zip a quick message off to say who's going to be where and when is priceless. Not to mention, a lot of these widgets are pretty cool. But helping kids and teens develop well-rounded social skills and learn how to have positive personal interactions with others may boil down to just talking to each other more often.
Keeping the Sex Talks Going
When the pregnancies of a popular teen TV star and a vice presidential candidate's daughter took center stage, premarital sex became an even more pressing topic for parents.
It was practically impossible to avoid all the press about teen pregnancy and premarital sex in 2008. And no doubt many preteens and teens caught wind of a lot of it, too. On the heels of a late 2007 government report showing the first rise in teen pregnancies in 15 years, Jamie Lynn Spears (teen TV star and sister of pop diva Britney) gave birth in '08. Then came the news about Bristol Palin, the pregnant adolescent daughter of Republican VP nominee Sarah Palin. Amidst it all, this jaw-dropping headline: "1 in 4 Girls Has a Sexually Transmitted Disease (STD)." A 2008 study by the Centers for Disease Control and Prevention (CDC) found that a staggering 3.2 million teen girls could potentially have at least one of four common STDs (with human papillomavirus, or HPV, at the very top of the list).
The vaccine against HPV (called Gardasil) also drew attention. More than half of sexually active people get HPV at some point in their lives (about 6.2 million people each year, in fact, and about half of those infected are just 14 to 24 years old). Yet, the CDC also reported in 2008 that just a quarter of preteen and teen girls are getting the recommended HPV immunization — it's pricey and many parents are still worried about its possible impact on teens' sexual behavior.
What to Watch:
Somewhere between dealing with two wars and a tanking economy, preventing teen pregnancies could become a top priority for the new administration (fewer teen pregnancies means fewer abortions). One major way to help reduce unplanned pregnancies: Teach kids about more than just abstaining from sex. On the cusp of 2008, a government study from the outgoing administration found that abstinence-only education might not be the most effective way to go. Federal researchers discovered that it has little to no impact on whether teens have sex or how many sexual partners they have. Though it's a heated debate that shows no signs of ending, sex-ed classes may get a major makeover, with an emphasis on not just abstinence but also birth control and preventing STDs.
On the homefront, parents can keep unplanned pregnancies and STDs at bay by finding out about their kids' sex-ed classes — asking teachers what's in their lesson plans, coordinating discussions with kids around class topics, and filling in any gaps. Also key: Having ongoing, age- and developmentally appropriate discussions as kids grow (instead of in one big awkward "talk"). Another simple way to keep early sex from seeming so appealing: Turn off that TV! A 2008 study suggested that watching racy shows might play a role in upping teen pregnancy rates. Although a cause-and-effect relationship isn't clear, teens who see lots of lewd TV are actually twice as likely to become (or get someone) pregnant before age 20 than those who view very little sexually explicit content on the tube.
About Birth Control: What Parents Need to Know
News - Abstinence-Only Education Inadequate, Says Study
News - A Quarter of Teen Girls in the U.S. Have an STD
Questions and Answers About Sex
News - Teen Birth Rate Sees First Rise Since 1990s
News - Teens Who Watch Lots of Sexually Explicit Shows Have Twice the Risk of Getting Pregnant
When Your Teen Is Having a Baby
The New Challenges of Immunization
As measles cases skyrocketed in 2008 because more parents opted not to immunize, the American Academy of Pediatrics (AAP) unleashed a major push to promote complete and timely vaccination of kids of all ages. But when the economy took a steep dive as new and costly vaccines have continued to be added to the recommended list, doctors, health plans and parents are now struggling to overcome barriers to immunization.
Though the World Health Organization (WHO) reported in 2008 that global measles deaths declined nearly 75%, the United States saw the highest rate of the potentially fatal disease in more than a decade (since 1996). And the Centers for Disease Control and Prevention (CDC) said it was likely tied to the refusal of some parents to immunize their kids (particularly with the measles, mumps, rubella [or MMR] vaccine) because of unfounded fears of a link to the development of autism — often perpetuated by misleading media reports, TV shows, and websites. Study after study has found no link between autism and any single immunization, combination vaccination (like MMR), single vaccinations given at the same time, or the mercury-containing vaccine preservative thimerosal.
And for parents who think their personal choice not to vaccinate couldn't really affect anyone else (particularly babies, the elderly, and kids with compromised immune systems), it can. Consider this: In 2008 federal health officials were able to trace a wave of measles cases among unimmunized US children back to just one 12-year-old boy from Japan who traveled to the United States for the Little League World Series, unaware that he had the highly contagious disease. Yet the current economic downturn is making it harder for such an important public health initiative to stay on course. A late 2008 study found that many doctors are feeling the financial strain of purchasing, storing, and administering vaccines to the point that some are even opting to stop offering them altogether in their offices.
What to Watch:
Immunizations remain a crucial tool for keeping kids — and grown-ups — healthy and free from some historically devastating diseases, like measles, whooping cough, and the flu. That's why in 2008 federal health officials started urging flu vaccinations for all kids 6 months of age and older. And the AAP will likely continue its massive mission encouraging moms and dads to make sure kids are immunized on schedule from infancy through adolescence.
But continuation of the economic downturn in 2009 may have a negative effect on immunization efforts. For example, some vaccines (like Gardisil, which protects against human papillomavirus, or HPV) don't come cheap, which means more and more doctors may find it no longer financially feasible to offer some vaccines in their practices. Plus, as more parents lose their jobs (and their health coverage) it could be even tougher to find the out-of-pocket expenses of having their children immunized.
But, as countless studies show, when fewer people immunize their kids, diseases (like measles) that were practically gone start to gain traction again. That why it's only safe to stop vaccinations for a particular disease once that disease has been totally wiped out worldwide, as in the case of smallpox. So, before deciding to skip or delay any vaccine (for whatever reason) it's wise for parents to give their doctor and health insurance provider a call before every routine check-up — to find out which vaccines are routinely recommended and which will actually be available and covered.
News - CDC: Flu Vaccine Now Recommended for School-Age Kids and Teens, Too
News - CDC: Measles Outbreaks May Be Tied to Parents' Choice Not to Vaccinate
News - CDC Warns of Measles Outbreaks in the U.S.
Frequently Asked Questions About Immunizations
Is the Flu Vaccine a Good Idea for Your Family?
News - Meningitis Vaccine Can Save Kids' Lives
Your Child's Immunizations
A Mobilized Youth Movement
The 2008 presidential race drummed up enthusiasm and involvement among people — young and old — more than any other election in modern history. And President-elect Obama is calling on today's youth to keep the public service movement alive.
Kids of all ages have seen what working together for a cause can accomplish — and they want more. Now, preschoolers to teens feel more empowered than ever to do their part. The president-elect's public service plan calls for a required 50 hours of community service each year for all middle- and high-school students. Plus, new and expanded programs could offer many volunteer opportunities for adolescents. A new Green Job Corps aims to put disadvantaged teens to work weatherizing homes and a YouthBuild Program could get kids busy helping to construct affordable housing. And for the college set: A proposed hefty $4,000 tax credit for students logging 100 hours of community service per year.
What to Watch:
As new in-school programs reach out to young kids and time-honored organizations like AmeriCorps and Peace Corps likely to garner more funding and start drawing more eager applicants, we could see a public service ripple effect that lasts for years. More and more kids may start thinking about their post-graduation time in different, more socially aware ways, too. Of course, when the new administration's proposed goals might go into effect remains to be seen. But one thing's for sure: As kids and teens continue to give their time for worthy causes, these young humanitarians will grow up understanding the power of helping out and knowing that they can make a big difference.
Eye on Obesity, and the Health Problems That Come With It
Government health officials said in 2008 that the childhood obesity rate had actually plateaued instead of continuing to shoot up. But this major public health problem certainly isn't going away, either. And now, more and more kids are developing other risky related conditions, too.
Although the obesity epidemic shows signs of leveling off, it's still a problem of epic proportions that isn't decreasing at all. In fact, about 32% of kids and teens are considered overweight or obese — an astounding and alarming statistic that should give every parent pause. And with many kids now tipping the scales, obesity ranked as the No. 1 children's health concern for most households in 2008, according to the "C.S. Mott Children's Hospital National Poll on Children's Health for 2008."
Yet, a 2008 study found that many parents had no idea — or weren't at all worried — that their kids were considered obese. And that's despite the fact that new research shows kids are also increasingly getting all kinds of typically adult obesity-linked conditions, like type 2 diabetes, hypertension (high blood pressure), unhealthy cholesterol levels, and metabolic syndrome (a combination of obesity-related conditions that lead to the early onset of heart and blood vessel diseases).
More than half of the kids (some as young as 10) in a late 2008 study had cardiovascular systems that looked more like those of middle-aged adults — a major red flag for heart disease, the No. 1 killer of men and women. Now, the American Academy of Pediatrics (AAP) says tracking youngsters' cholesterol levels at an early age — and treating those that are unhealthy — may help fend off future heart disease. In 2008, the group changed its 10-year-old policy on cholesterol, recommending cholesterol-fighting drugs (called statins) for some kids as young as 8 with unhealthy cholesterol levels.
What to Watch:
As the economy keeps spiraling downward and stocking up at the supermarket seems pricier with each trip, parents will need to try even harder to keep kids' diets nutritious. After all, some junk food is cheaper than wholesome fare. But having less money to spend doesn't have to mean buying less healthy foods:
- Opt for canned and frozen fruits and veggies.
- Double recipes and freeze some for later.
- Don't let food go to waste. Plan a full week of meals before grocery shopping — only buy what you need. Make soup from leftovers. Use up veggies, lunchmeat, and cheese before they go bad by making salad or dinner casseroles. Wash and cut up fruits and veggies right away and store them in small containers or bags in the front of the fridge for quick and wholesome snacks.
- Buy only in-season fresh fruits and vegetables. Or go in on a community farm co-op membership with friends. (Farmer's markets usually cost less than grocery store chains, but some may feel the brunt of the economy and either fall by the wayside or start raising prices, too.)
- Stock up on cheaper protein sources like eggs, canned and dried beans, peanut butter, canned chicken and light tuna, frozen shrimp, lean ground beef, chicken thighs or legs (instead of boneless breasts).
While it's not always easy, with a little creativity and planning, parents of all budget levels can do many things to keep nourishing meals from breaking the bank.
Is Dieting OK for Kids?
How Can I Feel Better About My Body?
Type 2 Diabetes: What Is It?
Weight and Diabetes
What "Being Overweight" Means
What's the Right Weight for Me?
Dealing With Feelings When You're Overweight
How Much Food Should I Eat?
Hypertension (High Blood Pressure)
Smart Supermarket Shopping
Type 2 Diabetes: What Is It?
What Is Cholesterol?
What's the Right Weight for My Height?
When Being Overweight Is a Health Problem
News - AAP Takes Aim at Cholesterol in Kids
News - Childhood Obesity Rates High, But Not Rising
Cholesterol and Your Child
High Blood Pressure (Hypertension)
Overweight and Obesity
News - Parents' Perceptions About Kids' Weight Often Off
Poll: Kids' Obesity Tops List of Concerns for 2008
Type 2 Diabetes: What Is It?
Safer Kids' Stuff on the Horizon
Thanks to a groundbreaking new law passed in the summer of 2008, playthings and other kids' products must be deemed safe before they actually make it to the store shelves and, ultimately, children's hands. What's more, lead is being officially phased out of kids' merchandise, once and for all.
Still reeling from millions of unsettling recalls in 2007, many moms and dads spent 2008 wondering what's really safe — and with good reason. But now change is coming, courtesy of the new Consumer Product Safety Improvement Act. The U.S. Consumer Product Safety Commission (CPSC) will be able to: enforce and oversee mandatory testing of products before they ever leave the manufacturing room floor, remove unsafe merchandise from shelves faster, and give hefty fines to companies that don't follow the letter of the law. Plus, companies won't be able to make, import, or sell toys or items for kids under age 12 beyond a new lead limit and phthalates (chemicals used to soften plastics and rubber) in toys and childcare items (like teethers and pacifiers) will be banned.
But government agencies couldn't come to an agreement in 2008 about another worrisome chemical — bisphenol A (BPA), found in polycarbonate plastics (usually clear, hard items like baby and water bottles) and epoxy resins (used in bottle tops, water pipes, and the linings of food and infant formula cans). The U.S. Food and Drug Administration (FDA) said trace amounts migrating into food containers containing BPA aren't hazardous for babies or grown-ups. But the National Toxicology Program (NTP) looked at animal studies and expressed concern that BPA exposure during development could cause changes in behavior and the brain, prostate, mammary gland, and timing of puberty in females.
In other less-than-reassuring news: 2008 brought more questions about China-made products, this time, from items using milk contaminated with the industrial chemical melamine. The FDA did find some melamine in a few select chocolates and coffees sold here. But the bulk of the concern was in China itself, where melamine-contaminated infant formula killed some infants and made tens of thousands of babies and young kids sick with urinary and kidney problems. Luckily, the U.S. supply of formula wasn't affected.
What to Watch:
Although we're making major headway in preventing unsafe kids' items here at home, global oversight of products, in general, still leaves a lot to be desired. The U.S. government will need to garner more worldwide cooperation in demanding much higher standards for the $2 trillion worth of merchandise that comes from beyond our borders. But, much like the recalls of 2007 put the toy industry under the microscope and forced companies to be more careful and step up testing, the world is watching China. The exporting powerhouse country will have to do what it claims it's trying to do — inspecting manufacturers and enforcing major changes in how it makes and regulates products.
Also worth keeping an eye on: A final verdict from the FDA on the chemical BPA. After a federal panel faulted the agency for neglecting to take action, the FDA is taking a closer look at all of the research to decide whether to make an official change. Also, more companies may say "no" to making or selling BPA-containing merchandise and more states may pass or consider laws to ban or limit BPA in toys and kids' products.
News - Behind All the Buzz on the Chemical BPA
Choosing Safe Toys
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Reflecting on Race
Barack Obama's election as the first black president of the United States emphasized the country's ability to overcome deeply embedded racism ... but also brought out the very worst in grown-ups and kids who were outraged at the historic outcome.
Before the election and in the weeks after Nov. 4, hundreds of hate crimes cropped up nationwide as racism reared its ugly head. That the United States — the great "melting pot" of the world — saw a racially motivated backlash wasn't necessarily a surprise but it was often shocking. Obama likenesses hung by nooses from trees. Spray-painted racial slurs surfaced near college campuses. And Obama has the distinction of receiving more death threats than any other president-elect in history (he gave his acceptance speech and took the stage with his family standing behind a wall of bulletproof glass).
The reality of a black president has riled white supremacists and those who've been raised in generation after generation of bigotry. As kids around the country keep a close eye on their parents' attitudes about the election and our new president, the stage is being delicately set for how children will view other people who are different from them.
What to Watch:
Talking to kids about discrimination and the importance of embracing diversity (in appearances, cultures, races, ethnicities, opinions, etc.) is more important now than ever. Without the right perspective, kids — especially the younger set — may distrust someone based solely on how they look. Moms and dads must step up and help their children value diversity, regardless of which candidate they chose on Election Day. We need to provide guidance and education about the wonderfully diverse world we live in, especially for kids growing up in isolated communities with fewer minorities, and emphasize that it's not only OK that we're all different — but that acceptance of differences in beliefs and cultural heritage is one of the principles on which this country was founded. Parents should be mindful of cultural stereotypes they may have learned and make an effort to correct them, and demonstrate an attitude of respect for others. Remember, kids are always listening, so it's important to be aware of how we speak about people who are different from us.
This dawn of a new era can and should be an opportunity for teaching kids, from toddlers to teens, how to respect and learn from others, value differences, bridge cultural gaps, reject unfair stereotypes, discover common ground, create new bonds, and accept people for who they are and what they can offer.
Hoping for Health Care Reform (Finally!)
During the 2008 election the candidates, political pundits, and voters debated the best ways to overhaul a failing health care system that's leaving millions uninsured and countless others being refused care or paying far too much for premiums and medications.
As politicians continue to try come up with a compromise about how much health care coverage is paid for by the government and how much is private, one thing's for sure: If ever there was a time to seriously rethink our health care system, it's now. Lapses in coverage and out-of-pocket medical expenses could spell disaster for families already on the brink of financial catastrophe. With the highest unemployment rate in 15 years, more moms and dads lost their health insurance in 2008, adding to the already astronomical rising rates of uninsured.
Lack of insurance and gaps in coverage caused many families to go completely without preventive health care or to hold off on seeing a doctor until it became a must. That meant more people (including kids) showed up for care when they were sicker and needed pricier medical services. And emergency rooms, already financially strained and experiencing major shortages in doctors and nurses, are bearing the brunt of the burgeoning crowds. Even some families with health insurance decided to skip routine checkups, immunizations, and prescriptions as they tried to make ends meet.
Now, the new administration looks to restructure our ailing health care system as part of a financial stimulus package that could provide affordable health care and make a real economic difference for struggling families.
What to Watch:
The economy and wars in Iraq and Afghanistan will still account for much of the attention and spending in the new administration. But lawmakers will have to move past their political differences to figure out the best way to cover the millions of uninsured kids, especially those of the working poor who don't qualify for Medicaid or can't afford private insurance.
Past attempts at solutions to overhaul our health care system haven't succeeded. But this time the new administration's proposed plan just might get the support it needs. For one, it wouldn't involve the whole-ball-of-wax universal coverage for everyone (a big concern for those worried about too much government control and skyrocketing costs for the taxpayer). However, the plan would include mandatory coverage for kids. Though the State Children's Health Insurance Program (or SCHIP) encountered opposition under President George Bush, the new administration will support expansion of federal funding for the program. The new administration's emphasis on preventing illnesses will be a key feature for controlling costs over the long run — screening and education about healthy lifestyle choices could result in fewer kids getting sick and developing often-avoidable conditions (like obesity and type 2 diabetes).
Whatever happens, kids don't vote and have no say in how or whether they'll be able to get the care they need to stay healthy now and as they grow. So parents — and politicians — must be even more proactive than ever about advocating for kids' health.
Safer Water and Sanitation for the World
The United Nations General Assembly declared 2008 the "International Year of Sanitation," highlighting the crucial need for countries worldwide to have safe drinking water and sanitary places to wash up and use the bathroom.
The initiative came during a year when Zimbabwe endured the largest outbreak in its modern history of cholera, a serious diarrhea-causing disease that's often spread through contaminated food or water. The illness killed hundreds and sickened tens of thousands. Most types of diarrheal infections aren't serious and go away after a few days, but others can be deadly when diarrhea leads to dehydration. According to the United Nations Children's Fund (UNICEF) 5,000-plus tots under age 5 die each day because of diarrheal diseases that many contract because of contaminated drinking water or a lack of fundamental sanitation facilities, like bathrooms with flushable toilets.
In the battle against diarrheal illnesses that are killing 1.5 million kids each year, more than 70 countries in five continents participated in the first ever Global Handwashing Day during the end of 2008. Efforts like these have helped to put the number of people worldwide without improved drinking water below the 1 billion mark for the very first time (with more than half of the people in the world getting piped water in their homes). But a 2008 report by the World Health Organization (WHO) and UNICEF shows that 2.5 billion still don't have access to better sanitation — and 1.2 billion of those don't have any sanitation facilities at all.
What to Watch:
Global health officials still have a long way to go before most countries are able to enjoy safe sanitation facilities and healthy drinking water for all of its communities. But the simple act of washing hands can cut deaths from diarrheal illnesses by as much as 50% (or almost 2 million people). In fact, hand washing is the most effective —and cheapest — way to prevent diarrheal infections. That's because dirty hands carry infectious germs into the body when kids bite their nails, suck their thumbs, eat with their fingers, or put any part of their hands into their mouths.
On the homefront, parents can help keep many infectious illnesses at bay by making sure kids understand how to wash their hands the right way. They need to learn how to use warm soap and water to scrub (both sides of the hands, the wrists, between the fingers, and around the nails), then wash for at least 10 to 15 seconds (about as long as it takes to sing "Happy Birthday" nice and slow). When kids wash is important, too. Kids should always lather up before eating and after using the bathroom, blowing their nose, coughing, touching animals, and playing outside or with other kids. In a pinch, hand sanitizers can help fend off most of these nasty germs, too.
Reviewed by: Steven Dowshen, MD
Date reviewed: December 2008
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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