Engaging Communities to Strengthen Research Ethics in Low-Income Settings: Selection and Perceptions of Members of a Network of Representatives in Coastal Kenya
There is wide agreement that community engagement is important for many research types and settings, often including interaction with ‘representatives’ of communities. There is relatively little published experience of community engagement in international research settings, with available informati...
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Published in | Developing world bioethics Vol. 13; no. 1; pp. 10 - 20 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
England
Blackwell Publishing Ltd
01.04.2013
Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
ISSN | 1471-8731 1471-8847 1471-8847 |
DOI | 10.1111/dewb.12014 |
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Abstract | There is wide agreement that community engagement is important for many research types and settings, often including interaction with ‘representatives’ of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members (‘KEMRI Community Representatives’, or ‘KCRs’) linked to a large multi‐disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self‐administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. |
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AbstractList | There is wide agreement that community engagement is important for many research types and settings, often including interaction with 'representatives' of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members ('KEMRI Community Representatives', or 'KCRs') linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. Adapted from the source document. There is wide agreement that community engagement is important for many research types and settings, often including interaction with 'representatives' of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members ('KEMRI Community Representatives', or 'KCRs') linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. [PUBLICATION ABSTRACT] There is wide agreement that community engagement is important for many research types and settings, often including interaction with 'representatives' of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members ('KEMRI Community Representatives', or 'KCRs') linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential.There is wide agreement that community engagement is important for many research types and settings, often including interaction with 'representatives' of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members ('KEMRI Community Representatives', or 'KCRs') linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. There is wide agreement that community engagement is important for many research types and settings, often including interaction with 'representatives' of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members ('KEMRI Community Representatives', or 'KCRs') linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. There is wide agreement that community engagement is important for many research types and settings, often including interaction with 'representatives' of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members ('KEMRI Community Representatives', or 'KCRs') linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self‐ ;administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. Reprinted by permission of Blackwell Publishers |
Author | Marsh, Vicki Molyneux, Sassy C. Kombe, Francis K. Kamuya, Dorcas M. Geissler, P. Wenzel |
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Copyright | 2013 Blackwell Publishing Ltd 2013 Blackwell Publishing Ltd. Copyright © 2013 Blackwell Publishing Ltd Copyright © 2013 Blackwell Publishing Ltd 2013 |
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References | R.R. Sharp & M.W. Foster. Grappling with groups: protecting collective interests in biomedical research. J Med Philos 2007; 32: 321-327 V.M. Marsh, et al. Working with Concepts: The Role of Community in International Collaborative Biomedical Research. Public Health Ethics 2011; 4: 26-39. C. Gikonyo, et al. Taking social relationships seriously: lessons learned from the informed consent practices of a vaccine trial on the Kenyan Coast. Soc Sci Med 2008; 67: 708-720. P.W. Geissler & R. Pool. Editorial: Popular concerns about medical research projects in sub-Saharan Africa - a critical voice in debates about medical research ethics. Trop Med Int Health 2006; 11: 975-982 C. Weijer & E.J. Emanuel. Ethics. Protecting communities in biomedical research. Science 2000; 289: 1142-1144 O.K. Doumbo. Global voices of science. It takes a village: medical research and ethics in Mali. Science 2005; 307: 679-681. D.A. Diallo, et al. Community permission for medical research in developing countries. Clin Infect Dis 2005; 41: 255-259 S.F. Morin, et al. Building community partnerships: case studies of Community Advisory Boards at research sites in Peru, Zimbabwe, and Thailand. Clin Trials 2008; 5: 147-156 P. Reddy, et al. The role of community advisory boards in health research: Divergent views in the South African experience. SAHARA J 2010; 7: 2-8. C. Molyneux, et al. The role of community-based organizations in household ability to pay for health care in Kilifi District, Kenya. Health Policy Plan 2007; 22: 381-392. D.F. Ragin, et al. Defining the 'community' in community consultation for emergency research: findings from the community VOICES study. Soc Sci Med 2008; 66: 1379-1392. L.W. Green & S.L. Mercer. Can public health researchers and agencies reconcile the push from funding bodies and the pull from communities? Am J Public Health 2001; 91: 1926-1929. A. Nyika. Ethical and practical challenges surrounding genetic and genomic research in developing countries. Acta Trop 2009; 112 Suppl 1: S21-S31 P.W. Geissler. 'Transport to Where?'. Journal of Cultural Economy 2011; 4: 45-64. K. Shubis, et al. Challenges of establishing a Community Advisory Board (CAB) in a low-income, low-resource setting: experiences from Bagamoyo, Tanzania. Health Res Policy Syst 2009; 7: 16 J.A. Scott, et al. Profile: The Kilifi Health and Demographic Surveillance System (KHDSS). Int J Epidemiol 2012. V.M. Marsh, et al. Experiences with community engagement and informed consent in a genetic cohort study of severe childhood diseases in Kenya. BMC Med Ethics 2010; 11: 13. V. Marsh, et al. Beginning community engagement at a busy biomedical research programme: experiences from the KEMRI CGMRC-Wellcome Trust Research Programme, Kilifi, Kenya. Soc Sci Med 2008; 67: 721-733. L.F. Ross, et al. Nine key functions for a human subjects protection program for community-engaged research: points to consider. J Empir Res Hum Res Ethics 2010; 5: 33-47 L.F. Ross, et al. Nine key functions for a human subjects protection program for community-engaged research: points to consider. J Empir Res Hum Res Ethics 2010; 5: 33-47. S. Molyneux, et al. Community members employed on research projects face crucial, often under-recognized, ethical dilemmas. Am J Bioeth 2010; 10: 24-26. F. Tekola, et al. Impact of social stigma on the process of obtaining informed consent for genetic research on podoconiosis: a qualitative study. BMC Med Ethics 2009; 10: 13. L.F. Ross. 360 Degrees of human subjects protections in community-engaged research. Sci Transl Med 2010; 2: 45cm23 R.P. Strauss, et al. The role of community advisory boards: involving communities in the informed consent process. Am J Public Health 2001; 91: 1938-1943. C.S. Molyneux, et al. Understanding of informed consent in a low-income setting: three case studies from the Kenyan Coast. Soc Sci Med 2004; 59: 2547-2559 A. Davies, et al. Seeing 'With my Own Eyes': Strengthening Interactions between Researchers and Schools*. IDS Bulletin 2012; 43: 61-67. S. Molyneux, et al. Benefits and payments for research participants: Experiences and views from a research centre on the Kenyan coast. BMC Med Ethics 2012; 13: 13. D. Brieland. Community advisory boards and maximum feasible participation. Am J Public Health 1971; 61: 292-296 C. Rotimi, et al. Community engagement and informed consent in the International HapMap project. Community Genet 2007; 10: 186-198. D.M. Kamuya, et al. Evolving Friendships and Shifting Ethical Dilemmas: Fieldworkers' Experiences in a Short Term Community Based Study. Developing World Bioethics 2012; in press. 2001; 91 2010; 11 2010; 10 2009 2009; 112 10 2007 2010 2010 2010; 32 2 5 5 1971; 61 2012 2000 2001; 289 91 2009 2008; 7 2004 2006 2008; 59 11 67 2008; 67 2008; 66 2011; 4 2005 2005; 41 307 2012; 13 2007; 10 2007; 22 2010; 7 2012; 43 |
References_xml | – reference: V. Marsh, et al. Beginning community engagement at a busy biomedical research programme: experiences from the KEMRI CGMRC-Wellcome Trust Research Programme, Kilifi, Kenya. Soc Sci Med 2008; 67: 721-733. – reference: C.S. Molyneux, et al. Understanding of informed consent in a low-income setting: three case studies from the Kenyan Coast. Soc Sci Med 2004; 59: 2547-2559, – reference: R.R. Sharp & M.W. Foster. Grappling with groups: protecting collective interests in biomedical research. J Med Philos 2007; 32: 321-327, – reference: C. Rotimi, et al. Community engagement and informed consent in the International HapMap project. Community Genet 2007; 10: 186-198. – reference: D.A. Diallo, et al. Community permission for medical research in developing countries. Clin Infect Dis 2005; 41: 255-259, – reference: V.M. Marsh, et al. Experiences with community engagement and informed consent in a genetic cohort study of severe childhood diseases in Kenya. BMC Med Ethics 2010; 11: 13. – reference: S. Molyneux, et al. Community members employed on research projects face crucial, often under-recognized, ethical dilemmas. Am J Bioeth 2010; 10: 24-26. – reference: C. Molyneux, et al. The role of community-based organizations in household ability to pay for health care in Kilifi District, Kenya. Health Policy Plan 2007; 22: 381-392. – reference: K. Shubis, et al. Challenges of establishing a Community Advisory Board (CAB) in a low-income, low-resource setting: experiences from Bagamoyo, Tanzania. Health Res Policy Syst 2009; 7: 16, – reference: D.F. Ragin, et al. Defining the 'community' in community consultation for emergency research: findings from the community VOICES study. Soc Sci Med 2008; 66: 1379-1392. – reference: A. Davies, et al. Seeing 'With my Own Eyes': Strengthening Interactions between Researchers and Schools*. IDS Bulletin 2012; 43: 61-67. – reference: S. Molyneux, et al. Benefits and payments for research participants: Experiences and views from a research centre on the Kenyan coast. BMC Med Ethics 2012; 13: 13. – reference: P. Reddy, et al. The role of community advisory boards in health research: Divergent views in the South African experience. SAHARA J 2010; 7: 2-8. – reference: L.F. Ross, et al. Nine key functions for a human subjects protection program for community-engaged research: points to consider. J Empir Res Hum Res Ethics 2010; 5: 33-47. – reference: C. Gikonyo, et al. Taking social relationships seriously: lessons learned from the informed consent practices of a vaccine trial on the Kenyan Coast. Soc Sci Med 2008; 67: 708-720. – reference: A. Nyika. Ethical and practical challenges surrounding genetic and genomic research in developing countries. Acta Trop 2009; 112 Suppl 1: S21-S31, – reference: V.M. Marsh, et al. Working with Concepts: The Role of Community in International Collaborative Biomedical Research. Public Health Ethics 2011; 4: 26-39. – reference: R.P. Strauss, et al. The role of community advisory boards: involving communities in the informed consent process. Am J Public Health 2001; 91: 1938-1943. – reference: D.M. Kamuya, et al. Evolving Friendships and Shifting Ethical Dilemmas: Fieldworkers' Experiences in a Short Term Community Based Study. Developing World Bioethics 2012; in press. – reference: F. Tekola, et al. Impact of social stigma on the process of obtaining informed consent for genetic research on podoconiosis: a qualitative study. BMC Med Ethics 2009; 10: 13. – reference: P.W. Geissler & R. Pool. Editorial: Popular concerns about medical research projects in sub-Saharan Africa - a critical voice in debates about medical research ethics. Trop Med Int Health 2006; 11: 975-982, – reference: L.F. Ross. 360 Degrees of human subjects protections in community-engaged research. Sci Transl Med 2010; 2: 45cm23, – reference: P.W. Geissler. 'Transport to Where?'. Journal of Cultural Economy 2011; 4: 45-64. – reference: L.F. Ross, et al. Nine key functions for a human subjects protection program for community-engaged research: points to consider. J Empir Res Hum Res Ethics 2010; 5: 33-47, – reference: S.F. Morin, et al. Building community partnerships: case studies of Community Advisory Boards at research sites in Peru, Zimbabwe, and Thailand. Clin Trials 2008; 5: 147-156, – reference: J.A. Scott, et al. Profile: The Kilifi Health and Demographic Surveillance System (KHDSS). Int J Epidemiol 2012. – reference: O.K. Doumbo. Global voices of science. It takes a village: medical research and ethics in Mali. Science 2005; 307: 679-681. – reference: C. Weijer & E.J. Emanuel. Ethics. Protecting communities in biomedical research. Science 2000; 289: 1142-1144, – reference: D. Brieland. Community advisory boards and maximum feasible participation. Am J Public Health 1971; 61: 292-296, – reference: L.W. Green & S.L. Mercer. Can public health researchers and agencies reconcile the push from funding bodies and the pull from communities? Am J Public Health 2001; 91: 1926-1929. – volume: 13 start-page: 13 year: 2012 article-title: Benefits and payments for research participants: Experiences and views from a research centre on the Kenyan coast publication-title: BMC Med Ethics – volume: 289 91 start-page: 1142 1926 year: 2000 2001 end-page: 1144 1929 article-title: Ethics. Protecting communities in biomedical research Can public health researchers and agencies reconcile the push from funding bodies and the pull from communities? publication-title: Science Am J Public Health – volume: 7 start-page: 2 year: 2010 end-page: 8 article-title: The role of community advisory boards in health research: Divergent views in the South African experience publication-title: SAHARA J – volume: 22 start-page: 381 year: 2007 end-page: 392 article-title: The role of community‐based organizations in household ability to pay for health care in Kilifi District, Kenya publication-title: Health Policy Plan – volume: 32 2 5 5 start-page: 321 45cm23 33 33 year: 2007 2010 2010 2010 end-page: 327 47 47 article-title: Grappling with groups: protecting collective interests in biomedical research 360 Degrees of human subjects protections in community‐engaged research Nine key functions for a human subjects protection program for community‐engaged research: points to consider Nine key functions for a human subjects protection program for community‐engaged research: points to consider publication-title: J Med Philos Sci Transl Med J Empir Res Hum Res Ethics J Empir Res Hum Res Ethics – volume: 10 start-page: 24 year: 2010 end-page: 26 article-title: Community members employed on research projects face crucial, often under‐recognized, ethical dilemmas publication-title: Am J Bioeth – volume: 4 start-page: 26 year: 2011 end-page: 39 article-title: Working with Concepts: The Role of Community in International Collaborative Biomedical Research publication-title: Public Health Ethics – volume: 11 start-page: 13 year: 2010 article-title: Experiences with community engagement and informed consent in a genetic cohort study of severe childhood diseases in Kenya publication-title: BMC Med Ethics – volume: 10 start-page: 186 year: 2007 end-page: 198 article-title: Community engagement and informed consent in the International HapMap project publication-title: Community Genet – volume: 41 307 start-page: 255 679 year: 2005 2005 end-page: 259 681 article-title: Community permission for medical research in developing countries Global voices of science. It takes a village: medical research and ethics in Mali publication-title: Clin Infect Dis Science – volume: 4 start-page: 45 year: 2011 end-page: 64 article-title: Transport to Where? publication-title: Journal of Cultural Economy – volume: 112 10 start-page: S21 13 issue: Suppl 1 year: 2009 2009 end-page: S31 article-title: Ethical and practical challenges surrounding genetic and genomic research in developing countries Impact of social stigma on the process of obtaining informed consent for genetic research on podoconiosis: a qualitative study publication-title: Acta Trop BMC Med Ethics – volume: 61 start-page: 292 year: 1971 end-page: 296 article-title: Community advisory boards and maximum feasible participation publication-title: Am J Public Health – year: 2012 article-title: Evolving Friendships and Shifting Ethical Dilemmas: Fieldworkers' Experiences in a Short Term Community Based Study publication-title: Developing World Bioethics – volume: 91 start-page: 1938 year: 2001 end-page: 1943 article-title: The role of community advisory boards: involving communities in the informed consent process publication-title: Am J Public Health – volume: 7 start-page: 16 147 issue: 5 year: 2009 2008 end-page: 156 article-title: Challenges of establishing a Community Advisory Board (CAB) in a low‐income, low‐resource setting: experiences from Bagamoyo, Tanzania Building community partnerships: case studies of Community Advisory Boards at research sites in Peru, Zimbabwe, and Thailand publication-title: Health Res Policy Syst Clin Trials – volume: 66 start-page: 1379 year: 2008 end-page: 1392 article-title: Defining the ‘community’ in community consultation for emergency research: findings from the community VOICES study publication-title: Soc Sci Med – volume: 67 start-page: 721 year: 2008 end-page: 733 article-title: Beginning community engagement at a busy biomedical research programme: experiences from the KEMRI CGMRC‐Wellcome Trust Research Programme, Kilifi, Kenya publication-title: Soc Sci Med – year: 2012 article-title: Profile: The Kilifi Health and Demographic Surveillance System (KHDSS) publication-title: Int J Epidemiol – volume: 59 11 67 start-page: 2547 975 708 year: 2004 2006 2008 end-page: 2559 982 720 article-title: Understanding of informed consent in a low‐income setting: three case studies from the Kenyan Coast Editorial: Popular concerns about medical research projects in sub‐Saharan Africa – a critical voice in debates about medical research ethics Taking social relationships seriously: lessons learned from the informed consent practices of a vaccine trial on the Kenyan Coast publication-title: Soc Sci Med Trop Med Int Health Soc Sci Med – volume: 43 start-page: 61 year: 2012 end-page: 67 article-title: Seeing ‘With my Own Eyes’: Strengthening Interactions between Researchers and Schools* publication-title: IDS Bulletin |
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Title | Engaging Communities to Strengthen Research Ethics in Low-Income Settings: Selection and Perceptions of Members of a Network of Representatives in Coastal Kenya |
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