melhoria do acesso aos serviços de s pós-aborto em angola...
TRANSCRIPT
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Dezembro 2012 !
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Melhoria do acesso aos serviços de cuidado!s pós-aborto em Angola com a introdução do misoprostol para tratamento do aborto incompleto RELATÓRIO FINAL
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Agradecimentos
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2,5.*!F,6A*7?!+,8,.$&!_$..$,67?!>,%8$-&!k*.78*-?!"..$7*-!T*$.&7!
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Resumo Executivo
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Termos Utilizados
"aL"! "77*'$,()*!/*7!a$-&'*.*:$78,7!&!L378&8%,7!/&!"-:*.,!
">hp! "7A$%,()*!>,-5,.!h-/*58&%$-,!
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k22! k&6*%%,:$,!2G7K2,%8*!
J+h! J-78$858*!+,'$*-,.!/&!h78,8D78$',!/&!"-:*.,!
>v"! >*-$8*%$,!&!"=,.$,()*!
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L>0! L%:,-$C,()*!>5-/$,.!/&!0,1/&!
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p0! p-$/,/&!0,-$8M%$,!
I0J! I&-85%&!08%,8&:$&7!J--*=,8$*-7!
!!!! !
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Índice
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#"""!
Lista das Tabelas e Figuras
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1. Introducão
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`?+-'1!/1,;.'1!a?!./#'%1,+)+)#!)!/<-6?6-)!.'!#-1'5+'1,'(!%'!,+),)#/%,'!.'!):'+,'!+/,-.'!';!-%6'#5(/,'8---!-9!9!9-!9--!!b+/-%)+!,'.'1!'1!5+/1,).'+/1!%'!;1'!.'!#-1'5+'1,'(!5)+)!'!,+),)#/%,'!.'!):'+,'!+/,-.'!';!-%6'#5(/,'!)a;.)+?!)!.-#-%;-+!)1!.-<-6;(.)./1!/9-1,/%,/1!%'1!)6,;)-1!1/+8-M'1!'</+/6-.'1!5)+)!'!,+),)#/%,'!5T1=):'+,'!/!)!);#/%,)+!'!)6/11'!)'1!1/+8-M'1!.)1!#;(I/+/1!/#!$%&'()7!!E!5+'a/6,'!5+'5'1,'!<'+%/6/!/8-.c%6-)1!/#5O+-6)1!5)+)!-%<'+#)+!'1!./6-1'+/1!./!5'(O,-6)1!./!1)>./!1':+/!'!;1'!.'!#-1'5+'1,'(!%'!,+),)#/%,'!.'!):'+,'!-%6'#5(/,'7!E!5+'a/6,'!.?!!;#)!T5,-#)!!'5'+,;%-.)./!)'1!5+/1,).'+/1!./!1)>./!%K'!5+/8-)#/%,/!,+/-%).'1!';!I):-(-,).'1!%'!;1'!.)!$15-+)MK'!F)%;)(!"%.';,/+-%)!@$F"LD!%)1!;%-.)./1!1)%-,)+-)1!.)!5+'8O%6-)!./!V;)%.)!./!,+),)+!6)1'1!./!):'+,'!-%6'#5(/,'!';!+/,-.'7!"1,/!5+'a/6,'!;1';!'1!.).'1!+/6'(I-.'1!.)!5+/1,)MK'!./!1/+8-M'!%)1!;%-.)./1!1)%-,?+-)1!/%8'(8-.)1!/!/%,+/8-1,)1!</-,)1!N1!#;(I/+/1!:/%/<-6-).)1*!5)+)!a;%,)+!N1!/8-.c%6-)1!1':+/!'!;1'!
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2. Descricão do Projecto
2.1 METAS E OBJECTIVOS >!4,#1)"!0"&#!)"+&"!7,*8"$&*!?!#!"@7#1+9*A!"0!&*)*!*!7#3+!)*!#$"++*!#*+!+",-%.*+!)"!BC>A!7"(#!%1&,*)2.9*!)*!2+*!)*!0%+*7,*+&*(!7#,#!*!&,#�"1&*!)*!#'*,&*!%1$*07("&*!"!,"&%)*!#!&*)*+!*+!13-"%+!)*!+%+&"0#!)"!$2%)#)*+!)"!+#=)"5!6!+"2!*'8"$&%-*!7,%1$%7#(!?!#-#(%#,!#!7,#$&%$#'%(%)#)"A!+"42,#1.#!"!"/%$;$%#!)#!#)0%1%+&,#.9*!)*!0%+*7,*+&*(!7*,!"1/",0"%,#+!"!7#,&"%,#+!$*(*$#)#+!1#+!-;,%#+!21%)#)"+!+#1%&;,%#+!7",%/?,%$#+!+"0!$#7#$%)#)"!)"!*/","$",!*!&,#�"1&*!$*0!>DEF!7#,#!*!&,#�"1&*!)*!#'*,&*!%1$*07("&*5!!6+!,"+2(&#)*+!)"+&"!7,*8"$&*!+",-%,9*!)"!'#+"!7#,#!#!"(#'*,#.9*!"!,"-%+9*!)"!1*,0#+!7#,#!*!&,#�"1&*!)*!#'*,&*!%1$*07("&*!"0!>14*(#5!!6'8"$&%-*+!"+7"$3/%$*+!)*!7,*8"$&*G!
H5 I"0*1+&,#,!#!#7(%$#'%(%)#)"!)*!2+*!)"!0%+*7,*+&*(!7#,#!*!&,#�"1&*!)*!#'*,&*!%1$*07("&*J!K5 L*,1"$",!"-%)M1$%#!"073,%$#!7#,#!*!"+&#'"("$%0"1&*!)"!20!7,*&*$*(*!7#,#!*!&,#�"1&*!)*!
#'*,&*!%1$*07("&*!"0!>14*(#J!N5 O)"1&%/%$#,!#+!'#,,"%,#+A!(*43+&%$#+!"!*2&,#+!%07(%$#.P"+!)"!4"+&9*!1#!"@7#1+9*!)*!2+*!)*!
0%+*7,*+&*(!7#,#!*!&,#�"1&*!)*!#'*,&*!%1$*07("&*!1#+!21%)#)"+!+#1%&;,%#+!)*!+"$&*,!7='(%$*J!!Q5 I"&",0%1#,!:2#(!#!0"(R*,!"+&,#&?4%#!7#,#!*+!+",-%.*+!BC>!"0!>14*(#J!S5 E1&"1)",!:2"+&P"+!+*',"!*!2+*!)*+!$*1&,#$"7&%-*+!7T+U#'*,&*A!#!"+$*(R#!)*!0?&*)*A!#+!
'#,,"%,#+!7#,#!*!2+*!)*!0?&*)*A!$#,#$&",3+&%$#+!"!"+$*(R#+!)#!2&"1&"!"!#!:2#(%)#)"!)*+!+",-%.*+!*/","$%)*+J!
V5 I*$20"1&#,!#+!7",+7"$&%-#+!)*W#!7,"+&#)*,W#!+*',"!#!%1$(2+9*!)*!0%+*7,*+&*(!1*+!+",-%.*+5!!2.2 LOCAL DO PROJECTO E PARTICIPANTES X,M+!D21%$37%*+!7#,&%$%7#,#0!1*!7,*8"$&*J!*+!021%$37%*+!)#!Y#0'#A!D#%#14#!"!Z%#1#A!)#!C,*-31$%#!)"![2#1)#5!!>!&#'"(#!H!0*+&,#!#!"+&%0#&%-#!7*,!021%$37%*A!21%)#)"+!+#1%&;,%#+!"!#!7*72(#.9*!#(-*!'"1"/%$%;,%#!)*!7,*8"$&*5!C#,&%$%7#,#0!1*!7,*8"$&*!02(R","+!:2"!7,*$2,#,#0!#+!21%)#)"+!+#1%&;,%#+!+"("$$%*1#)#+!$*0!+%1#%+!"!+%1&*0#+!)"!#'*,&*!%1$*07("&*!*2!,"&%)*!"!:2"!&"1R#0!)#)*!*!$*1+"1&%0"1&*!%1/*,0#)*!7#,#!7#,&%$%7#.9*!1"+&"!7,*8"$&*5!!!
!"#$%"&'()*+,%"-.*/&+*0$123"34&#$1$5$23673*4&$&,138"8$4&"&+"70323+"7&+*7&67$"&8*&+7*9$20*&& :";#"& <"3"1="& >3"1"& !*0"%&)*+,%"-.*&\"+&%0#)#]& NSVASV^! VVVAKQS! HAKQNA^^S! ?/?@@/@AB&CD&8$&,138"8$4&4"130673"4&& N! N! Q! 'E&F403;"03G"&8$&;,%H$7$4&=76G38"4&& _A^K^! NNANHK! VKAH`Q! 'EI/IIJ&F403;"03G"&8$&;,%H$7$4&$;&38"8$&5K703%& _QA^_`! HN`A`HH! KVHAKHV! JL@/EE@&F403;"03G"&8$&"#*70*4&312*;+%$0*4& HA_^K! NAVNH! VAKH`! ''/@I?&CM;$7*&8$&+7$40"8*7$4&07$31"8*4& ^! KN! H^! JA&:,#0*0"%&8"4&+*0$123"34&#$1$5323673"4&& QQS! `a_! HSSS! ?AEL&!
!
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!
2.3 PARCERIA "!U$.,)ML0!S')$0('#!*,!5'G*,!=G6#$)'!K0$!'!Q($*'*,!*,!J00.*,('ML0!*0!/.0N,)&0H!"!B,(&+.,!5&.'&,:$,%!
C((03'&$0(%!7B5C>8!+1'!I.:'($P'ML0!SL0RV03,.('1,(&'#!"1,.$)'('!K0.(,),+!0!'/0$0!&O)($)0!,!
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3. Metodologia
3.1 ESTRATÉGIA E DESENHO DO PROJECTO W,(*0!)010!,%&.'&O:$'!0!'+1,(&0!*0!'),%%0!'0%!)+$*'*0%!*,!%'G*,!.,/.0*+&$3'8!0%!)+$*'*0%!/X%R
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5. Conclusões Gerais
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Ç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ÇÃO DO MISOPROSTOL EXPANDE O ACESSO AOS SERVIÇOS DE CPA <!*+)$%,-5K%!,%!/*4%#$%4)%9!#'$/*)*-!-/!/1*%$!1('44%!1%4!4'$3*5%4!,'!HI<E!(1#1(*)1+,%!%4!#$%F*44*%+1*4!,'!41J,'!2-'!+K%!)*+A1/!$'('8*,%!F%$/15K%!'/!<MNOE!'/!#1$)*(-91$!14!#1$)'*$14!'9'/'+)1$'4E!#1$1!%!)$1)1/'+)%!,%!18%$)%!*+(%/#9')%;!Z1$1+)*$!2-'!%4!#$%F*44*%+1*4!,'!)%,%4!%4!('+)$%4!,'!41J,'!'4)'&1/!'2-*#1,%4!(%/!/*4%#$%4)%9!'!F%$/1,%4!+%!-4%!,%!/',*(1/'+)%!1-/'+)1!%!1('44%!1%4!4'$3*5%4!,'!HI<E!'/!#1$)*(-91$!#1$1!14!/-9A'$'4!2-'!3*3'/!9%+0'!,14!-+*,1,'4!41+*)1$*14!,'!$'F'$X+(*1;!!AS ENFERMEIRAS PARTEIRAS E PARTEIRAS ELEMENTARES PODEM PRESTAR A MAIORIA DOS SERVIÇOS DE CPA N4)'!0$-#%!,'!)'(+*(%4!,'!41J,'!#$'4)1!1!/1*%$*1!,%4!4'$3*5%4!,'!HI<!+14!-+*,1,'4!41+*)L$*14!,'!)%,%4!%4!+G3'*4;!O/1!3'.!2-'!1!/1*%$*1!,%4!(14%4!,'!18%$)%!*+(%/#9')%!1(%+)'('!0'$19/'+)'!+%!#$*+(G#*%!,1!0$13*,'.!'!+K%!4K%!(%/#9*(1,%4E!'4)'!0$-#%!#%,'!F1(*9/'+)'!9*,1$!(%/!'4)'4!(14%4!'!)$1)L79%4!(%/!/*4%#$%4)%9;!H%+4'2-'+)'/'+)'E!#1$1!%4!#$%F*44*%+1*4!,'!41J,'!,'!+G3'9!4-#'$*%$!4K%!$'4'$31,14!%4!(14%4!/1*4!(%/#9*(1,%4E!#%-#1+,%!,'4)'!/%,%!$'(-$4%4!A-/1+%4!'!F*+1+('*$%4!1%!4*4)'/1!,'!(-*,1,%4!,'!41J,';!!RÁPIDA ADOPÇÃO DO MISOPROSTOL PARA O TRATAMENTO DO ABORTO INCOMPLETO <+)'4!,1!*/#9'/'+)15K%!,'4)'!#$%&'()%E!%!!<MNO!'$1!%!#$*+(*#19!/Y)%,%!,'!'31(-15K%!-)'$*+1!,*4#%+G3'9;!H%+)-,%E!1!/1*%$*1!,14!/-9A'$'4!2-'!4'!1#$'4'+)%-!(%/!-/!18%$)%!*+(%/#9')%!,-$1+)'!%!)'/#%!,%!#$%&'()%!F%*!)$1)1,1!(%/!/*4%#$%4)%9;!<9Y/!,*44%E!)%,%4!%4!#$%F*44*%+1*4!,'!41J,'!*+,*(1$1/!2-'!'$1!FL(*9!1#$'+,'$!(%/%!-41$!%!/*4%#$%4)%9!'!2-'!4'!4'+)*1/!(%+F*1+)'4!+%!4'-!-4%!#1$1!%!)$1)1/'+)%!,%!18%$)%!*+(%/#9')%;!<+)'4!,'4)'!/Y)%,%E!190-+4!,%4!#$'4)1,%$'4!)*/A1/!4*,%!)$'*+1,%4!
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"#$#!%&#$!'!()*+!'%!,-'!./,0#1!,2,0%1#!3'$1#4-'!21!1#.5$/#!62!.$#.#12,.'!6'!#7'$.'!/,8'1"92.':!621',&.$#,6'!#!&%#!$;"/6#!#62&-'!#'!1/&'"$'&.'9!"#$#!2&.#!/,6/8#4-'<!!!!FORNECIMENTO CONSISTENTE DE SERVIÇOS DE PLANEAMENTO FAMILIAR E CONTRACEPTIVOS COMO PARTE DOS CPA =!#8',&290#12,.'!6'!"9#,2#12,.'!3#1/9/#$!3'/!>%#&2!%,/?2$	<!(!1#/'$!"#$.2!6#&!1%902$2&!.2$1/,#$#1!'!.$#.#12,.'!8'1!#!#82/.#4-'!62!%1!15.'6'!8',.$#82"./?'!@ABCD:!,-'!'7&.#,.2!'!3#8.'!62!82$8#!62!12.#62!6#&!E$#?/62F2&!.2$21!&/6'!62&2G#6#&:!$2&%9.#,.2&!21!#7'$.'!2&"',.H,2'<!(!1#/'$!"#$.2!6#&!1%902$2&!$28272%!8',.$#82"./?'&!'$#/&!'%!/,G28.;?2/&<!!
6. Recomendações
(&!8',89%&I2&!6'!"$'G28.'!621',&.$#1!>%2!'&!&2$?/4'&!62!8%/6#6'&!"J&K#7'$.'!"'621!&2$!/,.2E$#6'&!21!.'6'&!'&!,L?2/&!6'!&/&.21#!62!8%/6#6'&!62!&#M62!21!(,E'9#<!!!N28'12,6#1'&!>%2!'!1/&'"$'&.'9!&2G#!/,89%L6'!,'&!&2$?/4'&!62!OP(:!8',3'$12!62&8$/.'!,'!"$'G28.'!"/9'.':!2!>%2!&2G#!2Q"#,6/6'!#!,L?29!,#8/',#9!21!(,E'9#<!!ACTUALIZAR AS DIRECTIVAS DE MODO A INCORPORAR AS CONCLUSÕES DO PROJECTO PILOTO R#6#!#!?/#7/9/6#62!621',&.$#6#!6'&!"$'.'8'9'&!156/8'&!2!6'&!"$'826/12,.'&!62&.2!"$'G28.'!21!S%#,6#:!721!8'1'!#!&%#!8#"#8/6#62!62!#%12,.#$!'!#82&&'!#'&!&2$?/4'&!62!OP(:!#&!6/$28.$/F2&!.58,/8#&!"#$#!'!.$#.#12,.'!6'!#7'$.'!/,8'1"92.'!62?21!&2$!#8.%#9/F#6#&!62!1'6'!#!/,89%L$21!'!1/&'"$'&.'9<!(!6/&&21/,#4-'!62&.#&!6/$28$/F2&!#8.%#9/F#6#&!"'$!.'6'&!'&!"$/,8/"#/&!/,.2$?2,/2,.2&!2!3'$1#4-'!6'&!"$2&.#6'$2&!62!&2$?/4'&!62!OP(!"2$1/./$;!%1#!$;"/6#!2Q"#,&-'!6'&!&2$?/4'&!62!OP(<!!!FORMAR TODOS OS PROFISSIONAIS DE SAÚDE NO USO DO MISOPROSTOL PARA OS CUIDADOS PÓ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ÇÃO À PREVENÇÃO DA GRAVIDEZ INDESEJADA, AOS PERIGOS DO ABORTO INSEGURO E À DISPONIBILIDADE DE SERVIÇOS DE CPA R2?21!&2$!32/.'&!2&3'$4'&!#6/8/',#/&!8'1!?/&.#!#!26%8#$!#&!1%902$2&!2!#&!8'1%,/6#62&!&'7$2!8'1'!"$2?2,/$!#!E$#?/62F:!#&!8',&2>%U,8/#&!6'!#7'$.'!/,&2E%$'!2!#!6/&"',/7/9/6#62!62!&2$?/4'&!62!OP(<!(&!"$'3/&&/',#/&!62!&#M62!62?21!2&.#$!8/2,.2&!6#!/1"'$.H,8/#!6'!&2%!"#"29!,'!3'$,28/12,.'!62!&2$?/4'&!62!OP(!62!1#,2/$#!'"'$.%,#<!!
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GARANTIR O FORNECIMENTO DE PRODUTOS DE SAÚ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7. Referencias Bibliograficas
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""!=<0:!,-JJ!=CF0!
"""!789E!;(1$K&!A6*'%"*(/!F)*6$)!$(3!'&H"*($)!&1%"2$%&1!*K!%B&!"(L"3&(L&!*K!M(1$K&!$6*'%"*(!$(3!$11*L"$%&3!2*'%$)"%+!"(!,--NE!!.%B!&3"%"*(E!F&(&4$/!7*')3!8&$)%B!9'H$("I$%"*(:!,--OE!
"4!F'"2&1!P:!C&(1*(!Q:!R"(HB!R:!S*2&'*!#:!F$($%'$!C:!9D*(*KM$!?:!RB$B!=E!;(1$K&!$6*'%"*(/!%B&!5'&4&(%$6)&!5$(3&2"LE!T$(L&%!,--UV!R&WM$)!$(3!S&5'*3ML%"4&!8&$)%B!R&'4"L&1!X9L%*6&'!,--UYE!
4!>$)"1D$(!0:!&%!$)E!9'$)!#"1*5'*1%*)!K*'!%B&!%B"'3!1%$H&!*K!)$6*'/!$!'$(3*2"I&3!%'"$)E!"#$%&%!'()&*+,!!,--NV!J-J!X.!@%E!JY/!Z,J[\E!
4"!96*'*!]9:!G$6*^&"!G9E!!A!'$(3*2"I&3!L*(%'*))&3!%'"$)!*K!#"1*5'*1%*)!4&'1M1!9W+%*L"(!"(!%B&!AL%"4&!2$($H&2&(%!*K!%B"'3!1%$H&!*K!)$6*M'E!-!"#$%&%!'().&*+,!,--NV!!"#XJY/JN[UE!
4""!&)[S&K$&+!8:!9_C'"&(!@:!#*'$K$!7:!7$)3&'!Q:!S*3&LD!>E!;1&!*K!*'$)!2"1*5'*1%*)!"(!%B&!5'&4&(%"*(!*K!5*1%5$'%M2!B&2*''B$H&E!/0!-!"#$%&%!'().&*+,!JZZOV!$%&/NNU[NZE=>#`?=F9!,--UE!
4"""!C"aM&!>:!;1%$!#:!P&6*'$!C:!>B*(H!0:!7&1%B&"2&'!0:!7"("D*KK!CE!>*25$'"1*(!*K!2"1*5'*1%*)!$(3!2$(M$)!4$LMM2!$15"'$%"*(!K*'!%B&!%'&$%2&(%!*K!"(L*25)&%&!$6*'%"*(E!1)%,!-!'()&*+,+2(!.)3!"#$%&%04*$!,--OV!Z\/!,,,[,,UE!
"W!7&&D1:!AE:!&%!$)E:!A!'$(3*2"I&3!%'"$)!*K!2"1*5'*1%*)!L*25$'&3!^"%B!2$(M$)!4$LMM2!$15"'$%"*(!K*'!"(L*25)&%&!$6*'%"*(E!961%&%!F+(&L*):!,--.E!$%'#XNY/!5E!.b-[OE!
W!RB^&D&'&)$:!CE:!&%!$)E:!54$+60+$%+,!7+0!%0&.%8&)%!+7!4)*+86,&%&!.#+0%4+)!.%!%9&!0&24+).,!9+$64%.,!,&:&,;!0&$<,%$!70+8!=.)>.)4.?!CQ9F/!A(!=(%&'($%"*($)!Q*M'($)!*K!961%&%'"L1!c!F+($&L*)*H+:!,--OE!$$&#XJJY/!5E!JNUN[JNUOE!
W"!P$*:!CE:!&%!$)E:!=1!2"1*5'*1%*)!$!1$K&:!&KK&L%"4&!$(3!$LL&5%$6)&!$)%&'($%"4&!%*!2$(M$)!4$LMM2!$15"'$%"*(!K*'!5*1%$6*'%"*(!L$'&d!S&1M)%1!K'*2!$!'$(3*2"1&3!%'"$)!"(!CM'D"($!?$1*:!7&1%!AK'"L$E!Ce*H:!,--OE!$$&#XJJY/!5E!JNU\[O.E!
W""!C)M2:!QE:!&%!$)E:!=0&.%8&)%!+7!4)*+86,&%&!.#+0%4+)!.)3!84$*.004.2&!@4%9!84$+60+$%+,?!=(%&'($%"*($)!Q*M'($)!*K!F+(&L*)*H+!$(3!961%&%'"L1:!,--OE!((/!5E!RJ\U[RJ\ZE
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