N.P vs MD/DO ?

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It's great to postulate about improving programs in the future, but the nursing establishment is advocating for independent practice rights with the current curriculum. That's (i think) what many have issue with.
This was the crux of the very long DNP thread in this forum. My main objections involved the actual implementation and delivery of the training (mostly online) and the multitude of "fluff" courses: a bit of business theory, a dash of nursing theory, a watered down stats course, a research project, etc. If it was another 4+ years of specialized clinical training, combined with solid lectures and labs...THEN you'd have some substance for a degree that is supposed to be representative of the highest level of learning in a particular field (doctoral). The current itteration seems to be some online MS classes trying to pass for doctoral-level training.

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If it was another 4+ years of specialized clinical training, combined with solid lectures and labs...THEN you'd have some substance for a degree that is supposed to be representative of the highest level of learning in a particular field (doctoral).

A program like this already exists. It's called medical school.
 
The AACN's Essentials of Doctoral Education for Advanced Nursing Practice specify that programs provide "a minimum of 1,000 hours of practice post-baccalaureate as part of a supervised academic program".

Eeek. So a new grad BSN prepared RN can get their DNP with only 1,000 clinical hours?! I guess that is why they are equivalent to a physician :confused:
 
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Exactly. With the aging population, we're going to be seeing even more patients needing chronic and palliative care.
You just cannot "cure" some (many) of the diseases out there.
They have to live with the disease, and we can facilitate them in normalization with their current status and their journey.

What on earth are you talking about-- can you translate what "facilitate them in normalization with their current status and their journey?" Do you mean help them get better, because I'm pretty sure that's what physicians try to do everyday.
 
What on earth are you talking about-- can you translate what "facilitate them in normalization with their current status and their journey?" Do you mean help them get better, because I'm pretty sure that's what physicians try to do everyday.

"Normalizing" in this context means living life as though it were normal. When you're talking about most chronic medical conditions, of course, this is basically bull****.

Believe it or not, it's possible to hold somebody's hand and kick 'em in the butt at the same time. As a matter of fact, that's what most people with self-inflicted chronic diseases need more than anything else.

The "fat acceptance" movement is an example of "normalization" at its worst.
 
"Normalizing" in this context means living life as though it were normal. When you're talking about most chronic medical conditions, of course, this is basically bull****.

Believe it or not, it's possible to hold somebody's hand and kick 'em in the butt at the same time. As a matter of fact, that's what most people with self-inflicted chronic diseases need more than anything else.

The "fat acceptance" movement is an example of "normalization" at its worst.

It may be bull to you, but it may not for the patients in those situations.

People being educated in the public health and health promotion are just wasting their time because everything can be treated medically right?

My point exactly. It is a degree without a true purpose, as it seems to want to be many things to different people: psuedo-MBA/MPH/Ph.D./etc.....without doing any one of those things effectively.

Shared theory
 
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People being educated in the public health and health promotion are just wasting their time because everything can be treated medically right?

Of course not.

I'm not even sure we're talking about the same thing.

Perhaps you need to explain what "facilitate them in normalization with their current status and their journey" means in plain English.
 
My point exactly. It is a degree without a true purpose, as it seems to want to be many things to different people: psuedo-MBA/MPH/Ph.D./etc.....without doing any one of those things effectively.

I thought the info I posted from Rush's DNP program stated exactly what the purpose of the degree was.
 
It may be bull to you, but it may not for the patients in those situations.

People being educated in the public health and health promotion are just wasting their time because everything can be treated medically right?

I think you're operating under the misconception that "Medicine" is somehow just prescribing drugs, and that physicians are shackled to their prescription pads. In my admittedly limited experience, this is not the case.
 
Perhaps you need to explain what "facilitate them in normalization with their current status and their journey" means in plain English.

I've already been over this earlier in the thread. It's basically terms that a nursing program would use to try to make themselves sound intellectual and useful. If they said "we give renal failure patients diet and lifestyle advice" then people would respond with "but doctors already do that, why do we need a nurse to do the same thing?" That's the mode of operation for these ridiculous DNP programs to justify their existence. They don't provide "medical care," they provide "comprehensive care." They don't treat "chronic disease," they "facilitate normalization."

In todays disgustingly politically correct society, everyone has to feel important or else they run home crying to mommy and daddy. Now janitors are in the field of "janitorial engineering" and garbagemen are "sanitation engineers." We need to hire people to play with children in the hospital and designate them "child life specialists." The list goes on and on.

On a side note, I've seen at some hospitals that child life specialists write notes in the chart, such as "played _____ game with child, child was receptive, will return tomorrow." Come on, gimme a break. How long until janitors start writing in charts "mopped patient xxx's room and emptied garbage - pt tolerated procedure well."

Addendum: I have nothing against nurses or NPs that work within their scope of practice. This is all in reference to the DNP stuff.
 
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Wow, I'd leave child life out of this. As a med student who used to work in child life I have to say it's not fair to compare it to being a janitor. There is a lot of research that the hospital is pretty terrifying to kids and if you don't have someone worrying about how the kids are adjusting they can get pretty traumatized. Is having a little comment in the chart on how the kid is doing so bad?

Most child life specialists have a masters in their field, so as professionals I think they deserve a bit more respect than garbage men. Saying they are hired to play with kids is like saying that first grade teachers are just random people who like to use blocks. Or a nutritionist is just someone who likes to cook. And child life at least isn't trying to get anyone call them doctor.
 
Unintentional comment of the day.

:laugh: Fixed


Wow, I'd leave child life out of this. As a med student who used to work in child life I have to say it's not fair to compare it to being a janitor. There is a lot of research that the hospital is pretty terrifying to kids and if you don't have someone worrying about how the kids are adjusting they can get pretty traumatized. Is having a little comment in the chart on how the kid is doing so bad?

Most child life specialists have a masters in their field, so as professionals I think they deserve a bit more respect than garbage men. Saying they are hired to play with kids is like saying that first grade teachers are just random people who like to use blocks. Or a nutritionist is just someone who likes to cook. And child life at least isn't trying to get anyone call them doctor.

Geez, settle down. I wasn't comparing fields. I was noting how everyone has to feel important about themselves in this day and age and you more or less just proved my point. I just said I didn't think it was necessary to have "child life specialists" writing notes in a patients medical chart. But that's a completely different topic.
 
I came across this discussion a few days ago and posed a few questions to a colleague of mine at hospital. I'm still not particularly clear on the matter, however.

I am in PGY-2 of a general surgery residency here in America but was educated in Ireland at RCS. This is a somewhat new issue for me. It certainly was not a subject of discussion at university. Most of my personal with non-physician providers was last year during my internship. We had physician assistant students rotate in with us and I found them all to be very well-prepared. One of our attending surgeons has a physician assistant working with him as a first assistant and she is brilliant- a true asset. I also worked with a nurse practitioner briefly last year in the NICU and she seemed very competent That is the limit of my experience. I don't have any stories about how I see a nurse practitioner for my own medical care or anything like that. And given what I have read, there won't be any stories like that in the future for me either.

Yesterday a nurse practitioner approached me to countersign an order for an opiate for a patient on our service. The typical discussion of where I am from led to a discussion about my education. He actually suggested that because my training resulted in a baccalaureate, his education was superior as it resulted in a Masters degree.

I was mortified beyond belief. I have NEVER had my qualifications questioned by other doctors. Naturally I had to go do a bit of my own research and ran across this forum. How do my fellow medics feel about me using the post-nominal letters "M.D."? Please bear in mind that my degrees are MB, BCh, BAO as well as licentiates L & LM, RCSI..... etc., not M.D. or D.O.

Second, is it true that a nurse practitioner can be qualified through an online program or is this claim only made in jest?

This nonsense about a "nursing model" vs. "medical model" is absolute rubbish. The "nursing model" smacks of quackery and it is beyond me why any profession would develop a rationale for its existence that puts it more in league with reflexologists than any legitimate scientific discipline. We may as well reverse more than a hundred years of medical progress and return to the pre-scientific era of health care. I took the opportunity to look at some charts and repeatedly came across this genius "diagnosis": failure to thrive. If that is the type of "diagnosis" this nursing model comes up with, those who subscribe to the nursing model should only be able to prescribe bed baths and the contents of a 1500 calorie diet. The very idea assaults the senses.

Oh, and this "Dr. Kara" website is a real gem. I did notice that she claims to provide "medical supervision". Doesn't she mean "nursing supervision"? I don't think you can have it both ways.


jsyk, failure to thrive is a MEDICAL diagnosis, not a nursing one.:laugh:
 
So when are we going to start up the online MD programs? I'll say it again for emphasis - When patients find out their provider was trained online, the busiest part of the office will be the back door all the patients are sneaking out of. Let's have a little common sense here people. I wouldn't mind having my life in the hands of a provider trained online though. Sounds like it could be fun.

My best friend goes to UT Houston and said all of her lectures are streamed online and available for students any time. She goes to class live, but apparently many of her fellow students sleep in and just watch lectures ONLINE on their computer after. Just like (some) NP students. Allow me to cry for the future of medicine. Boohoo.
 
I've already been over this earlier in the thread. It's basically terms that a nursing program would use to try to make themselves sound intellectual and useful. If they said "we give renal failure patients diet and lifestyle advice" then people would respond with "but doctors already do that, why do we need a nurse to do the same thing?" That's the mode of operation for these ridiculous DNP programs to justify their existence. They don't provide "medical care," they provide "comprehensive care." They don't treat "chronic disease," they "facilitate normalization."

In todays disgustingly politically correct society, everyone has to feel important or else they run home crying to mommy and daddy. Now janitors are in the field of "janitorial engineering" and garbagemen are "sanitation engineers." We need to hire people to play with children in the hospital and designate them "child life specialists." The list goes on and on.

On a side note, I've seen at some hospitals that child life specialists write notes in the chart, such as "played _____ game with child, child was receptive, will return tomorrow." Come on, gimme a break. How long until janitors start writing in charts "mopped patient xxx's room and emptied garbage - pt tolerated procedure well."

Addendum: I have nothing against nurses or NPs that work within their scope of practice. This is all in reference to the DNP stuff.


I'm a pediatric nurse and I would say child life is VERY important in our work. Even attendings ask them for help when they need to do a procedure and think the child will be difficult. Children are VERY different than adults; please do not go into pediatrics.
 
I've already been over this earlier in the thread. It's basically terms that a nursing program would use to try to make themselves sound intellectual and useful. If they said "we give renal failure patients diet and lifestyle advice" then people would respond with "but doctors already do that, why do we need a nurse to do the same thing?" That's the mode of operation for these ridiculous DNP programs to justify their existence. They don't provide "medical care," they provide "comprehensive care." They don't treat "chronic disease," they "facilitate normalization."

In todays disgustingly politically correct society, everyone has to feel important or else they run home crying to mommy and daddy. Now janitors are in the field of "janitorial engineering" and garbagemen are "sanitation engineers." We need to hire people to play with children in the hospital and designate them "child life specialists." The list goes on and on.

On a side note, I've seen at some hospitals that child life specialists write notes in the chart, such as "played _____ game with child, child was receptive, will return tomorrow." Come on, gimme a break. How long until janitors start writing in charts "mopped patient xxx's room and emptied garbage - pt tolerated procedure well."

Oh now you are comparing nurses with janitors?

Addendum: I have nothing against nurses or NPs that work within their scope of practice. This is all in reference to the DNP stuff.
That's funny.
I thought you were comparing nurses with janitors.

Don't tell me that you've haven't. The implied meaning is clear.

I actually did well on reading comprehension and verbal section for DAT and MCAT respectively.
I chose nursing because I was in a tight situation where I needed to make money as soon as possible.

Amount of disrespect you guys show for nurses are beyond disgusting.

ps: People like you shouldn't work with children.
 
Oh now you are comparing nurses with janitors?


ps: People like you shouldn't work with children.

:laugh::laugh:

Talk about completely missing the point. I'm outta here.
 
This was the crux of the very long DNP thread in this forum. ....... The current itteration seems to be some online MS classes trying to pass for doctoral-level training.

I'm taking a DNP class next quarter (in order to have enough hrs to qualify for fin aide)...a business and financial concepts class...so I'll compare it to my MBA classes. However there is nothing wrong , IMO, about a "generalist" route. I've basically done that with my career, working in many different areas...and you see the results...one of the smartest nurses known to mankind, in my humble opinion. :p

Actually my MBA program was a generalist program. I didn't focus on management or finance, etc, but just a little about a lot.

Also, some of you med students can answer this...how much research do med students do? I looked at a Ph.D. program in nursing and it had 44 hours (quarter hours) of research classes and practicum, not counting dissertation.
 
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Also, some of you med students can answer this...how much research do med students do? I looked at a Ph.D. program in nursing and it had 44 hours (quarter hours) of research classes and practicum, not counting dissertation.

Nobody measures the number of hours spent in the lab or gathering/analyzing data. If it takes 100 hours to get results or 500 hours or 1000 hours, you do it. Many start their research between 1st and 2nd years, others wait until 3rd year or residency if they choose to do clinical research. Some do a single project, others do multiple. We don't do dissertations, we publish in journals (usually second or third author) or at the very least poster presentations at conferences. Some people are very into research, others not so much. A good number of residency programs (besides FP) require a research project eligible for publication before the end.

Do keep us updated on the DNP class. I'm curious if they will actually tie in medicine or teach it as a straight business and finance class.
 
Nobody measures the number of hours spent in the lab or gathering/analyzing data. If it takes 100 hours to get results or 500 hours or 1000 hours, you do it. Many start their research between 1st and 2nd years, others wait until 3rd year or residency if they choose to do clinical research. Some do a single project, others do multiple. We don't do dissertations, we publish in journals (usually second or third author) or at the very least poster presentations at conferences. Some people are very into research, others not so much. A good number of residency programs (besides FP) require a research project eligible for publication before the end.

Do keep us updated on the DNP class. I'm curious if they will actually tie in medicine or teach it as a straight business and finance class.

Ok, thanks. Do you actually have research classes or is it more of a mentoring type process?
 
I'm taking a DNP class next quarter (in order to have enough hrs to qualify for fin aide)...a business and financial concepts class...so I'll compare it to my MBA classes. However there is nothing wrong , IMO, about a "generalist" route.

My issue with that is that the way the DNP was originally conceptualized, it wasn't meant to be a generalist degree.

I too will be curious to see what your DNP class will cover.
 
Ok, thanks. Do you actually have research classes or is it more of a mentoring type process?

At our school we took biostatistics during first year along with scattered classes about searching literature and such, then there's some crap at the begining of the first break between first and second year that refreshes what you learned and throws a few more details at you. After that it's a matter of finding a basic science professor or a doctor who is willing to 'mentor' you (or claim first author on the paper lol). Obviously your research project needs to be funded by the school or the hospital, so 99% of the time you are required to have a PhD or MD listed as first author.
 
Thank God. It's not just me, then. ;)

I've been a nurse for almost 25 years, and I have no idea what that means. Is it Pig Latin? I speak two languages, three if you count my mangled French, but I don't speak "nurse."
 
Research shows that the nurse practitioners and physician assistants have been providing a good care and service to the patients.
In fact, there is no evidence or research showing np or pa as incompetent in providing the medical treatment for the patients.

Our education is sufficient for the role that we are partaking.



I don't know of any NP saying that he or she is equivalent to a physician.

That Mundinger lady (Resigned) does not represent all/most of us or how we feel.



Looks like the physicians don't look at the holistic approach and whole body after all.
You and I both know that there are many diseases in the elderly and other people that cannot be treated.
They have to live with chronic illness.
If they can't find a way to cope with the disease and normalize their current status, they will end up costing the health care system a lot more (example: depression).
You have to find a preventative measure and promote health.
In order to do that, you have to look at the person in a holistic manner.

More mush-mouth nurse-speak to try to make yourself feel relevant. How on earth did patients survive all these years without nurse practitioners? The horror!

If you'd speak in less ethereal terms you might actually be able to make a salient point or two. But with this stuff, you're just ridiculous. You sound like you are quoting chapter and verse from a textbook.
 
I'm taking a DNP class next quarter (in order to have enough hrs to qualify for fin aide)...a business and financial concepts class...so I'll compare it to my MBA classes. However there is nothing wrong , IMO, about a "generalist" route. I've basically done that with my career, working in many different areas...and you see the results...one of the smartest nurses known to mankind, in my humble opinion. :p

Actually my MBA program was a generalist program. I didn't focus on management or finance, etc, but just a little about a lot.

Also, some of you med students can answer this...how much research do med students do? I looked at a Ph.D. program in nursing and it had 44 hours (quarter hours) of research classes and practicum, not counting dissertation.

I've decided to go rogue; I'm taking a music theory course next semester.

Really.
 
I've decided to go rogue; I'm taking a music theory course next semester.

Really.

And it will probably be great for you.

Here's an example of "nurse speak" from me: "The other day a surgeon jerked my wife's gallbladder right out through her belly button."
 
The AACN's Essentials of Doctoral Education for Advanced Nursing Practice specify that programs provide "a minimum of 1,000 hours of practice post-baccalaureate as part of a supervised academic program".

Eeek. So a new grad BSN prepared RN can get their DNP with only 1,000 clinical hours?! I guess that is why they are equivalent to a physician :confused:

Only a few misguided souls (and uneducated/hyperbolic posters) have made that claim. Most NPs in the real world don't consider themselves equivalent to physicians.

Would you please get a nursing diploma/degree or become a PA before you start pontificating about professions you aren't licensed to practice?
 
And it will probably be great for you.

Here's an example of "nurse speak" from me: "The other day a surgeon jerked my wife's gallbladder right out through her belly button."

I have to admit zen; I started reading from behind my hands after the word "jerked."

Come to think of it, that's pretty much what it feels like post-op.:laugh:
 
I think you're operating under the misconception that "Medicine" is somehow just prescribing drugs, and that physicians are shackled to their prescription pads. In my admittedly limited experience, this is not the case.

But much of the time this is true, with the exception of those who actually do procedures. I've been in many a doctor's office where I wasn't even touched. Much of a physicians work is ordering someone else to actually do the work, education, PT, OT, etc.. Pretty kool setup!
 
I have to admit zen; I started reading from behind my hands after the word "jerked."

Come to think of it, that's pretty much what it feels like post-op.:laugh:

Bet you didn't have to ask what it meant, though!
 
Nope. No questions here. And you are never guilty of nurse-speak; that's a compliment. Now, shaman-speak...;)

Ha, ha, well let me try. Let's say a soldier sees the vehicle in front of his blown up by an IED. He runs up and try to pull the driver out but only the top half of his body comes out. At that point, the rescuing soldier feels something leave his body...clear as day. In western medicine we call this dissociation and we don't know what dissociates nor where it goes. Shamans, on the other hand, can journey and find this soul part that has left and bring it back.

How's that? I could probably write it in ivory tower language but it would take me awhile.
 
Shamans...can journey and find this soul part that has left and bring it back...I could probably write it in ivory tower language but it would take me awhile.

Sounds to me like you simply facilitate them in normalization with their current status and their journey. Am I right? ;)
 
I've decided to go rogue; I'm taking a music theory course next semester.

Really.

... My least favorite class.... Is it theory I? Or a survey of theory? I remembered the day I walked out of my theory IV after finishing the final... I felt like a free man.
 
Sounds to me like you simply facilitate them in normalization with their current status and their journey. Am I right? ;)

Couldn't have said it better myself :D
 
... My least favorite class.... Is it theory I? Or a survey of theory? I remembered the day I walked out of my theory IV after finishing the final... I felt like a free man.

Music theory...explain that to me. I only had a music appreciation class.
 
More mush-mouth nurse-speak to try to make yourself feel relevant. How on earth did patients survive all these years without nurse practitioners? The horror!

If you'd speak in less ethereal terms you might actually be able to make a salient point or two. But with this stuff, you're just ridiculous. You sound like you are quoting chapter and verse from a textbook.

:laugh: I hope Dr. Nurse DNPDoctor sees how ridiculous her and her collegues sound. I'm glad other nurses are able to point this out.
 
But much of the time this is true, with the exception of those who actually do procedures. I've been in many a doctor's office where I wasn't even touched. Much of a physicians work is ordering someone else to actually do the work, education, PT, OT, etc.. Pretty kool setup!

Oh. Thanks for letting me know. I'll drop out of med school and become a nurse practitioner now. I forgot that nurses heal the patient while doctors just treat disease. Some of the NP students around here like to remind me of it, but I just forget. Probably 'cause I'm dumb.
 
... My least favorite class.... Is it theory I? Or a survey of theory? I remembered the day I walked out of my theory IV after finishing the final... I felt like a free man.

I'm really going rogue; I'm skipping I and going to II. I figure that after 30+ years of playing one instrument or another, I should have picked up something along the way. But I'm kind of a geek when it comes to music theory--I like it. I may change my mind come January, though.
 
Oh. Thanks for letting me know. I'll drop out of med school and become a nurse practitioner now. I forgot that nurses heal the patient while doctors just treat disease. Some of the NP students around here like to remind me of it, but I just forget. Probably 'cause I'm dumb.

No, you're not dumb, other than making a totally unrelated comment to my post. I was replying to your "admittedly limited experience" with my "non-limited experience."

So much of the time a physician never even touches a patient and just writes a script. Sometimes that's ok, but you should always touch a patient or they go to CAM practitioners who do. The ER physician who saw my wife a couple weeks ago never touched her and she wound up with a lap choley this week. Trust me, it happens.
 
No, you're not dumb, other than making a totally unrelated comment to my post. I was replying to your "admittedly limited experience" with my "non-limited experience."

So much of the time a physician never even touches a patient and just writes a script. Sometimes that's ok, but you should always touch a patient or they go to CAM practitioners who do. The ER physician who saw my wife a couple weeks ago never touched her and she wound up with a lap choley this week. Trust me, it happens.

That doesn't make it the norm. I've never once seen this happen.
 
That doesn't make it the norm. I've never once seen this happen.

What's more important is that you make sure it never happens :) I even remember a CV surgeon telling his patients that he loved them. That might be a bit much for you but I bet they all loved him to.
 
Music theory...explain that to me. I only had a music appreciation class.
Take Music Theory if you have played an instrument, and it should be easy. I made the mistake of taking Music Appreciation....and completely tanked it. I'll never forget because we had to memorize dates of when things were written, etc. I could play all of the pieces (i was classically trained), and I could describe the various music theory behind the music, but damn if I could remember when a piece was written or who belonged to which era. It was one of the only Cs I've ever gotten. :(
 
I'm a nursing instructor (clinicals, associate's RN program)

Among having a clinical group, and teaching skills, I man the skills lab for practice. Last week, a student (who is a practicing chiropractor) told me he will do direct entry into a BSN/FNP program, and wants then to open up his own practice as a solo NP.

I told him I would never recommend anyone to see him (or anyone like him).

I suggested that NPs/PAs should work in a direct supervision model, under a physician. He laughed, stating a couple of "bad doc" stories he'd experienced, and that his chiro experience will give him the foundation he needs.

Now, I know he has no "pro ANA" agenda. He's just plain misguided (and he was a chiro for 25+ years).

I fear he will do this online, never having worked as an RN...

He actually belives he will provide safe accurate care...

And I fear that the DNP movement will attract his kind.

scary stuff

oh, and that Doctor nurse (website) is embarassing...sigh
 
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I'm a nursing instructor (clinicals, associate's RN program)

Among having a clinical group, and teaching skills, I man the skills lab for practice. Last week, a student (who is a practicing chiropractor) told me he will do direct entry into a BSN/FNP program, and wants then to open up his own practice as a solo NP.

I told him I would never recommend anyone to see him (or anyone like him).

I suggested that NPs/PAs should work in a direct supervision model, under a physician. He laughed, stating a couple of "bad doc" stories he'd experienced, and that his chiro experience will give him the foundation he needs.

Now, I know he has no "pro ANA" agenda. He's just plain misguided (and he was a chiro for 25+ years).

I fear he will do this online, never having worked as an RN...

He actually belives he will provide safe accurate care...

And I fear that the DNP movement will attract his kind.

scary stuff

oh, and that Doctor nurse (website) is embarassing...sigh

there are a few direct entry combination fnp/nd(naturopathic) programs out there. 6 yrs straight from high school and you are an independently practicing doctorate level medical professional with full rx rights.....
 
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