Friday, April 5, 2019

Relationship Between Staff Motivation and Performance

Relationship Between Staff Motivation and PerformanceINTRODUCTIONShortages give notice be a symptom of de motive, scummy management and lack of transcriptional support (Zurn et al., 2005). Shortages argon resulting in heavy take onload, which is a precursor to chisel form, and burnout, which live excessively been linked to low line of business motif. Nurses craft motif is an knotted concept, which is be deep down its extrinsic and intrinsic values (Cowin, 2002). Extrinsic values encompass the tangible aspects of the job including wages, benefits and bonuses, whereas intrinsic values include status, recognition, personal and professional development opportunities, and other similar factors (Cowin, 2002). Reasons for reserve deindigence suck up been well documented in the breast feeding literature. Such reasons include lack of conflict in decision- reservation, scant(p) relationship with management, low salaries and poor benefits, lack of job security, poor recogni tion and lack of flexibility in scheduling (Albaugh,2003). Nurse de penury has been also linked to emotional exhaustion and burnout,Which can affect patient outcomes (Aiken et al., 1997). much(prenominal) than thanover Shields Ward (2001) and Tzeng (2002) has also state that improper motivation is a primary predictor of nurses invention to commit (Shields Ward, 2001 Tzeng, 2002). A need conducted in the United States presented evidence showing that demotivated nurses were 65% more akinly to suck in intent to leave compargond to the motivated counter theatrical roles (Shields Ward, 2001). Other predictors of intent to leave vary from other motivation factors like low salaries and fringe benefits, inflexible bunk schedule (Coomber Barriball, 2007 Hayes et al, 2006), cathexiser advancement prospects (Tzeng, 2002, Rambur et al., 2003), in summing up to poor management and job stress (Rambur et al., 2003). Nurses turnover is linked to situational factors (Larrabee et al. , 2003) much(prenominal) as low aims of motivation (Tzeng, 2002). It is worth noting that improper motivation has also been name to be a better predictor of intent to leave as compared to the availability of other employment opportunities (Shields Ward, 2001 Purani Sahadev 2007). A shoot by El-Jardali et al. (2007) also set a negative correlation amongst motivation and heading to leave in Lebanese nurses. Their topics briny objective was to examine the tinct of motivation as a predictor variable on purport to leave used as dependent variable in the study. The finding of the study reveals that the main experience of the dis ecstasy and because intention to leave was negatively associated with hospitals motivation schemes such as compensation and incentives (extrinsic rewards). Purani and Sahadev (2007) used motivation with multi-faceted construct as predictor variable and examine its impact on intention to leave among the nurses in India. Assuming one of the role as int eraction and communication with clients and patient of both profession is common, their study also used experience as moderating variables to examine how working experience could affect motivation and intention to leave relationship. Purani and Sahadev (2007) found that employees with long stay at workplace had high level of motivation and would not incline to quit. Their finding also suggested that motivation and intention to leave relationship framework must also fork out other demographic variables consideration into the model of motivation and intention to leave. Pearson and Chong (1997) also examined the impact of job content and job information on motivation among Malaysian nurses in large prevalent sector hospital. They found that job information is stronger predictor to nurses motivation and consequently argued that intrinsic factors such as job information and organisation commitment also influence nurses motivation. However, they did recommend that motivation with in formation cues operable to nurses are crucial to determine nurses motivation which whitethorn lead to intent to leave or higher job burnout, if not available. Tzeng (2002) examined the impact of working motivational factors as well as job enjoyment factors as independent variables on nurses intention to leave in cross-sectional study in Taiwan. He found that low levels of motivation, emotional exhaustion and burnout and to the poor social image of the breast feeding profession influenced nurses intention to leave in Taiwans hospitals. This study therefore, suggested that motivation is a multi-faceted construct and should name both intrinsic as well as extrinsic factors to measure job comfort (Tzeng, 2002).HOW MOTIVATION AFFECTS EMPLOYEE PERFORMANCEThe termination to which employees are motivated in their work depends on how well those employees are able to provide output in their job. Motivation is evaluate to have a domineering execution on lineament surgical procedure. E mployees who are characterized by a high level of motivation show a higher work and life satisfaction. Having a high level of motivation is therefore in itself valuable for employees and a decrease in motivation might affect employees negatively. The motivation leads to high level of initiative and creativity from the employee and where monitoring is heavy, motivation is therefore extremely important for ensuring high quality surgical process. In Armco wellness Center, the quality of employee performance is measured by three individual measures of employee performance. The first measure of the individual performance items is a self-rating measure of employee performance by with(predicate) a program called SAP. The performance of the employee asks to indicate eight-points scale how well the employee is doing the job. The second measure of the performance of the Armco Health Center is the extent to which the nurses are willing to conduct tasks that are not part of their job descr iption. The employees are asked to report on the SAP about their willingness to perform additional tasks that are not expected from them on a regular basis and to think constructively about how the organization they work for could be proved. Last item that measure the performance of the nurses are the number of days they were absent. authority AND STAFF MOTIVATIONNursing is increasingly broad in scope and encompasses an ever widening range of work behaviors and role responsibilities. However, they work inside a mood of perplexity and dis authorizement along with high organizational demands placing them under considerable stress (1,2). This condition threatens both fleshly and emotional wellbeing of nurses and the profession itself and may results to low nurses commitment which in turn may sum up to separation or withdrawal of nurses from their organizations (3,4). Consequently, threatens organizational functioning and the quality care, since low nurses commitment leads to absen teeism or poor performance (5). However, the nurses low commitment is being a conundrum in many countries, Aiken et al(6) have cautioned that the health care work outcome faces the serious risk of losing one in five registered nurse for reasons other than retirement. Supportively, some(prenominal) other studies revealed that the turnover ramble for hospital registered nurse is among the highest rates found for professional and technical occupational groups (7,8). In addition, in 2002 the Joint Com perpetration on Accreditation of Health Care Organizations (JCAHO) recorded that current one- stratum registered nurse turnover rates range from 18% to 26% (9). Moreover, Victorian Governmental Department of gentleman Services Research suggests that at low levels of job satisfaction and organizational commitment, belongings of nurse supply is difficult and this in turn increases absenteeism (10).The Kingdom of Saudi Arabia, like many other countries is also pitiful from care for low commitment which evidenced by registered nurses high turnover rate and resignation(11). However, some case studies and articles highlighted that governmental sectors in Riyadh city were suffering for many years from high turnover rate of nurses that reached to 70% in some hospitals and resulted in high nurses shortage (12,13) . Along with working condition, salary, nurse disem powerment and uncertainty being cited to explain why the nurses exhibit poor work performance or uncommitted to their organization. In a research conducted by Attree (17)that studies the relationship amidst nurses acquaintance regarding their control and governance , revealed that registered nurse were disgruntled with their governance, perceived lack of control over their everyday practice and commented on a popular perception that they had reach dissceptered , lacked influence and asserted that they have fairly little power. Its the managers and physicians who have the power, not nurses. Both manag ers and physicians decided, told andexpected from the nurse to just get on with it, without discussion, or negotiation. As Salvage (18), nurses may see themselves as skilled practitioners, merely the public inactive clings to its old image of the nurse as the doctors handmaiden. This indicates that nurses are not powerless due to lack in competence, motivation, and/or information, but because lack of awareness and enabling clay and structure. Foser and Hoggett (19) termed this situation as a Do more with less culture where rhetoric is designed to empower the exhausted workers by emphasizing their commitment to organizational goals . However, disparity between the nurses desired and perceived indecorum and control over daily job activities interferes with nurses attempts to perform according to their expectations as professionals and may contribute to disengagement and withdrawal from the profession of nursing (17). Parallel to this is the national view of nursing in Saudi culture . Abu- Zinada (11,20) stated in many articles that the nurses were disempowered, and have a feeling of uncertainty. In contrast, she saw that the nurse has the right to hire decisions that are separate of the physician ones. Moreover, Al-morshed (21) considered that the nurses were not assistants to the physician or that their role is limited to giving pellet or helping a patient, since the nursing is a science before everything. Thus, creating conditions that foster a sense impression of authority in healthcare scopes are critical to both employee wellbeing and organizational success(22) . For employee well-being, mandate offers opportunities for learning, development, and contend a more active role in operational decisions through the personal development and involvement in decision making. As a result, employees can sense their feelings of self-worth, meaningfulness, job satisfaction and morale that result from their contributions and control or self-reliance over their work. Additionally, empowerment is essential for enhancing nurses role, strengthening the professional image, and continuously up the healthcare system. It allows the nurses to perform in a professional manner by being more self-governing, surenessworthy and participative (23).For organizational success, many hospitals uses the concept of empowerment as a safekeeping strategies to improve nurses commitment by fostering the desire not to leave the organization for selfish interests or marginal gains, and increase willingness to work by making personal sacrifice, performing beyond normal expectations , endure difficult times with an organization and increasing acceptance of organizations values and goals . As a consequence, nurses will be less burned-out and more engaged in their work and will contribute to organizational say-so (24). Although, the concept of empowerment is much used in health services and in nursing ,particularly in relation to the quality of care, since the m ission of nursing is to provide safe and quality nursing care thereby enabling patients to achieve their supreme level of wellness(25). Also empowerment play a significant role in the management of job stress and job satisfaction as well as in nurse attraction and retention ( 26). Hence, creating healthy work conditions that empowered nurses and provide freedom to act according to their expectation as a professional, may be a fruitful strategy for nurse managers and administrators to bear on nurses who currently work by promoting their commitment to the organization, especially in a critical care settings.Nowadays, many seek power but few possess it. Nurses are not exception (Marquis and Huston, 2000). In health care settings, an unequal power base exists among administrator, physicians, and nurses as a result of the competing goals of administration and the coexistence of multiple lines of authority (Sabiston and Laschinger, 1995). The rigidity of hierarchical rule-bound structur es has been specifically blamed for nurses inability to sufficiently control the content of their practice (Laschinger and Havens, 1996). Kanter (1993) proposed that an individuals effectiveness on the job is influenced for the most part by organizational aspects of the work environment.This author identified power and access to opportunities to learn and grow, as morphological determinants affecting the behavior of the individual. This power is derived from the ability to mobilize information, support, and resources necessary for getting the job done. Access to these empowering structures is influenced by the degree of formal and informal power an employee has in the organization (Kanter,1993). Formal power evolves from having a defined job that affords flexibility, visibility and centrality to organizational purpose and goals whereas informal power is determined by the extent of employees networks and alliances with sponsors, peers, and subordinates within the organization. Acce ss to these empowering structures has a decreed impact on employees, resulting in increase in their job satisfaction, level of organizational commitment and feelings of autonomy. Consequently, employees are more productive and effective in meeting organizational goals (Dutcher and Adams, 1994 Laschinger et. al., 1999). Nurses autonomy or control over work was seriously limited by unequal power relationships with medical cater, which enhanced physician power and restricted the nurses freedom, and consequently hindered their empowerment (McParland et al., 2000). To achieve excellence in nursing requires empowered staff nurses in order to be effective in their roles, and to be more autonomous (Marquis and Huston, 2000). Nurses who perceive them to be empowered are more likely to enhance client care through more effective work practice. Thus by providing the sources of job-related empowerment and autonomy, work methods and outcomes could be improved (Kanter, 1993 Sabiston and Lasching er, 1995).EMPOWERMENT IMPROVES MOTIVATION authorisation. Thomas and Velthouse (1990) define empowerment as personal power that flows from professional growth, which is correlated with job satisfaction. Klakovich (1995) further states that the empowerment of nursing staff may be the critical variable in achieving haughty organizational outcomes while maintaining the caring values of the nursing profession Klakovich (1996) defines three dimensions of empowerment as reciprocity, synergy, and ownership. sanction is a reciprocal leader-fol cut relationship that advances and aligns strategies, both organizational and individual (Klakovich, 1995). The Reciprocal Empowerment Scale rooster reports in three subscales reciprocity and synergy sub-scales represent the interactive leader/fol degrade process the ownership subscale represents the outcomes . Reciprocity involves a lead behavior pattern of sharing power, support and information. Empowerment Research has shown correlations betwee n nursing lead job satisfaction and empowerment (Laschinger et al., 2003 Mrayyan, 2004). In recent years, the idea of empowerment has become popular in the nursing literature (Kluska et al., 2000 Laschinger Finegan, 2005). The review of the literature reveals empowerment being used in various contexts such as, mental health, chronic care, and health promotion (Dahlgaard Dahlgaard, (2003), Paterson(2001) . In these contexts, the concept of empowerment incorporates positive and respectful relationships through constant dialog (Ellefsen Hamilton, (2000) Prybil( 2003). Morrison, Jones, and Fuller (1997) performed a non-experimental descriptive study that explored the effects of leadership style and empowerment on nursing job satisfaction. The participants included various nursing force play, such as nurse managers, nursing assistants, nursing clinical leaders, commissioned practical nurses and staff nurses. The researchers examined how staff nurses perceived empowerment The resear chers results in their variance analysis indicated a statistically significant difference in empowerment among diverse job classifications within the organization Empowerment accounted for more variance with job satisfaction for authorise personnel than for unlicensed personnel, as well as, for differing by type of satisfaction. The researchers findings indicate the importance of empowerment to staff nurse job satisfaction. They also show the contribution of empowerment to job motivation and how they vary by personnel. This study gives reason for performing this research study that examined the relationship of nurse empowerment and motivationFurthermore, studies have shown that Indian nurses had a moderate empowerment level and their actual work empowerment perception was significantly lower than their expectation (Huang, Lin, Hsu, Chen, Huang, 2003). The findings also showed that nurses had the lowest score on participation in decision making. Researchers pointed out that the nu rsing leaders tended to use authority and might only consult several members opinions for decision making. The opportunity for nurses to record in decision making is limited. As such, frontline nurses might think decision making is the managers responsibility, not theirs (Mok Au-Yeung, 2002). involvement can be seen as the highest level of empowerment. Nurses level of participation in decision making (PDM) can be used as an important indicator of empowerment. In western health care system, it has been found that the area where nurses prefer to be involved in decision-making is more related to the context of nursing practice, such as nursing unit operation (Blegen et al., 1993). Yet, in Indian nurses PDM is still not well studied. The extent to which nurses prefer to be or are actually involved in decision making is still not clear. Laschinger and Finegan (2005) surveyed 273 medical, surgical and critical care nurses concluding that structural empowerment had a direct effect on org anizational religious belief and respect, job motivation and commitment. An important addition to the understanding of empowerment in nursing education was another finding that empowerment increased motivation level of the nurses (Falk-Raphael, Chinn, Anderson, Laschinger, Rubotzky, 2004)Work empowerment has been linked to many other important organizational outcomes, such as job motivation, organizational commitment, lower levels of job stress and empowering leader behaviors (Spence-Laschinger, Tuer-Hodes, 2003). Hollinger-Smith and Ortigara (2004) stated that nurses perceptions of work empowerment are related to commitment to and trust in the organization, autonomy, participation in organizational decision-making, and job motivation. Increased autonomy and work motivation have been directly linked to nurse retention and increased patient satisfaction (Hollinger-Smith Ortigara, 2004). Empowering work environments can also influence nurses ability to practice in a professional m anner, ensuring excellent patient care and positive organizational outcomes. Organizational changes have a direct effect on the work environment and may contribute to higher rates of demotivation, burnout and absenteeism among staff (Kuokkanen, Savikko Doran, 2007). Factors of empowerment can also provide a right smart to measure the effects of organizational changes (Kuokkanen et al., 2007).To achieve excellence in nursing requires empowered staff nurses in order to be effective in their roles, and to be more autonomous (Marquis and Huston, 2000). Nurses who perceive them to be empowered are more likely to enhance patient care through more effective work practice. Thus by providing the sources of job-related empowerment and autonomy, work methods and outcomes could be improved (Kanter, 1993 Sabistonand Laschinger, 1995). In Sochalskis (2002) survey of nurse empowerment , it was found that 1 out of 3 staff nurse participants (manager and staff level) were disgruntled and hence de motivated in their job. Increasing job satisfaction, as it positively correlates with empowerment and organizational commitment, is a strategy to help retain employees (Laschinger, Finegan, Shamian, Casier, 2000). As patient care becomes more technologically advanced and complex, (requiring greater experience on the part of nursing staff to perform the job correctly), workplace stability and autonomy become invaluable in a hospital setting (Laschinger et al,2000.). Many researchers have reason that building collaborative decision making teams will empower both nursing and managerial staff which boosts morale and work performance (Cowin, 2002 Kluska et al., 2004). Ellefsen and Hamilton (2000) concluded that nurse empowerment encourages nurses in management positions to perform their duties efficiently and with confidence and competence. Research suggests when hospital leadership encourages subordinate empowerment there is a direct link to increased subordinate job satisfaction and motivation (Laschinger, Finegan, Shamian, Wilk, 2001). Evidence has shown that empowered nurses shift their self-perceived role from that of a subordinate to collaborator which encourages consensus building, improves job ownership, improves trust and the followers motivation, sense of responsibility and organizational commitment( Wagner ,2006 Watson, 2002). Empowerment not only increases job motivation, but sacred and visionary transformational leadership encourages the highest level of staff efficiency and productivity (Keuter, Byrne, Voell, Larson, 2000 Moss Rowles, 1997). Masi (2000) concluded that empowerment provides opportunities for prime(prenominal) and promotes autonomy, which allows subordinates to submit their competencies.The espoused benefits of empowermentThe supposed benefits of empowerment can be broadly divided into two areas benefits for the organization and benefits for the individual. oftentimes of the empirical research into empowerment has focused on o rganizational benefits assuming that these are the driving force behind attempts to engender empowered working (Cunningham et al., 1996). Certainly the motivation for managerial adoption of empowerment is typically driven to help managers manage and improve work organization and job performance, not to primarily piss an environment that is beneficial for the employee (Psoinos and Smithson, 2002). Global competition and a changing business environment have prompted organizational change in response to increased pressures to improve efficiency and performance (Lawler et al., 1992). It has been argued that organizations with higher levels of empowerment have demonstrated improvements in various economic performance areas (Applebaum et al., 1999). The economic benefits of empowerment specifically may be difficult to assess as often it is introduced as part of a broader initiative such as BPR and TQM (Psoinos and Smithson, 2002). Despite the espoused organisational benefits Argyris (199 8) argues that empowerment has still not delivered the promised benefits, remaining a myth rather than reality. While it could be argued that the primary motive for empowerment is initially driven by the need to improve the economic performance of the organisation, benefits to the individual employee have also been identified. Nykodym et al. (1994) found that employees who consider themselves empowered have reduced conflict and ambiguity in their role, as they are able to control (to a certain extent) their own environment. They suggested that this reduces emotional physique on the employee. Similarly, it has been suggested that empowered employees have a greater sense of job satisfaction, motivation and organisational loyalty (Koberg et al., 1999, Spreitzer et al., 1997). Empowerment cannot only impact attitudes but it can also impact on performance, specifically employee productivity (Koberg et al., 1999) and employee effectiveness (Spreitzer et al., 1997). Overall the literatur e points to many potential benefits to both organisations and employees like if the workplace empowerment is successful, then it produces a win-win situation (Lashley, 1999). However, despite the strong support for empowerment in theory, in practice empowerment may exist in rhetoric only and control is the reality for employees (Sewell and Wilkinson, 1992). Although it may be considered that employee empowerment will improve organizational performance but it is possible that empowered employees are not necessarily more motivated or have higher levels of job satisfaction (Collins, 1999). Thus the benefits of empowerment should not be assumed to automatically occur nor should the rhetoric of empowerment be confused with the reality. Measurement of the employee benefits is very difficult to achieve. Unlike organisational benefits which can be measured using objective facts, individual benefits are much more complex. Certain objective measures, such as absence and turnover rates have be en applied in this context (Psoinos and Smithson, 2002). However, it is often considered that softer measures of employees attitudes may provide informative insights omitted by other more tangible measures (Psoinos and Smithson, 2002).FACTORS measurable FOR MOTIVATING EMPLOYEESOne of the most perplexing healthcare retention issues is keeping newly licensed nurses from expiration after just a year or two of employment in the clinical setting (Zucker, Goss, Williams, Bloodworth, Lynn, Denker, et al., 2006). Kovner, Brewer, and Djukic (2007) presented evidence that 13% of newly licensed 1490 RNs had changed principal jobs after one year, and 37% reported that they felt ready to change jobs. Nurses leave the profession mainly because of low pay and poor job satisfaction (DiMeglio, Padula, Piatek, 2005)Hence pay and motivation at workplace are very important factors of retaining the staff. Therefore, nurse leaders are faced with two contests to recruit sufficiently qualified nurses and to establish rewarding work cultures that promote retention. Recruiting a younger generation of nursing staff members and meeting retention demands of cross-generational nurses will be a challenge like no other previously seen in healthcare (Cordinez, 2002). Newly licensed nurses recruitment and retention into the workplace are fundamental strategies for ensuring that healthcare systems have the continued capacity to deliver patient care (Berliner Ginzberg, 2002). Understanding why newly licensed registered nurses subscribe to to remain in nursing is an essential character of recruitment and retention strategies. Despite a recent four year trend of increasing nursing school enrollment and graduation of qualified nurses (American Association of Colleges of Nursing, 2005), the latest data on the shortage of RNs in the United States is estimated to reach about 500,000 by 2025 (Buerhas, Staiger, Auerbach, 2000.This study shows that nursing shortage is going to increase and hence motivating factors like pay,proper work environment and empowerment are necessary for retaining the experienced nurse staff. Hecker (2005) predicts that more than one million new and replacement nurses will be needed by the year 2014. The problem is that many of the newly licensed nurses will not remain in nursing and will choose to leave the profession within four years of graduation from a nursing program (Sochalski, 2002). In a study by Bowles and Candela (2005), 30% of newly licensed RNs left their first nursing position within one year of employment, and 57% left their first nursing position within two years of employment.This study further provides evidence that adds to the case study done by Kovner, Brewer, and Djukic (2007) which also adds to data and evidence that nurses are leaving their profession due to lack of empowerment and motivation in hospitals.The nursing shortage and the high incidence of turnover among newly licensed nurses within the first year of employment n eed to be investigated. It is well documented that nurses are leaving the profession because they are dissatisfied with current working conditions and not because they are disenchanted with the ideal of nursing, which originally attracted them to the profession (Lynn Redman, 2005 Strachota, Normandin, OBrien, Clary, Krukow, 2003). There is limited research that addresses newly licensed registered nurses career choices post-graduation. The future of nursing rests in the ability to recruit and retain upcoming generations to the profession.Currently, however, there is limited knowledge concerning what influences the decisions of newly licensed registered nurses to remain in nursing. Thus, the objective of this study was to identify factors that influence newly licensed registered nurses decision to remainin nursing. The shortage of people get into professional nursing, nurses dissatisfaction, and high turnover of newly licensed registered nurses are issues of concern. The national s hortage in the nursing workforce highlights the critical importance of encouraging nurses to remain in practice. Evidence suggests that a shortage of nurses is hurtful not only to quality of patient care, but also to staff morale, which in turn affects staff retention (Wilson, 2006). The socialization and assimilation of newly licensed nurses into the healthcare system is a pivotal incident that influences the retention of nurses (Aiken, Clarke, Sloane, Sochalaski, Silber, 2002). Professional socialization and work readiness are contributing factors to the retention of newly licensed registered nurses. The transition from student to new nurse is a vital period in several ways. It is the quality of this transitional experience that is likely to influence new nurse retention (Clare van Loon, 2003 Duchscher, 2001 Ewens, 2003). Professional socialization, a potential buffer to the effects of reality breach, includes the acquisition of knowledge, skills, identity, occupational trai ts, values, norms, and self-concept (Mamchur Myrick, 2003). The process of professional socialization, from career choice to transition to enculturation to the practice setting is influenced by others, especially other nurses (Beck, 2000 Hinds Harley, 2001). It is this initial professional socialization of nurses that will determine the success or failure of retaining new nurses in the healthcare workplace. The increasing complexity of health services and the acuity of patient care create an expectation by the healthcare organization that the new nurse will hit the ground running (Cowin Hengstberger-Sims, 2006, p. 61). Furthermore, Cowin and Hengstberger-Sims believe the workplace expects newly licensed nurses to quickly fulfill their potential as knowledgeable workers, but the health organization remunerates newly licensed nurses at the lowest possible pay scale. These researchers asserted that incongruencies such as high level of stress related to responsibility and high workl oads paired with minimum pay compound the effects of reality shock of nurses new to the field.The healthcare workplace demands work readiness from its newest nurses and the partnership of responsibility for work readiness between nursing education and the workplace can be described as precarious. The strategies of mentorship and preceptor ship have been embraced within many healthcare organizations as a means of increasing work readiness, decreasing the effects of reality shock and lessening the possibility of new nurse attrition (Greenwood, 2000). The period that separates a connoisseur practitioner from an advanced beginner is one which requires support, guidance and constant supervision by experienced individuals to project newly licensed nurses develop competently and safely, b

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