Alcohol use among Italian University students: the role of sensation seeking, peer group norms and self-efficacy.
This study investigated the role of sensation seeking, peer group
drinking and self-efficacy in refusing to drink alcohol in influencing
alcohol consumption of a sample of 588 Italian university students.
Results confirmed that heavy drinkers are typically males living in
university residences. Alcohol use is more frequent among students with
higher sensation seeking. Moreover, students whose friends drink alcohol
and who report lower self-efficacy in refusing to drink alcohol tend to
drink themselves to a higher rate and to be involved in drunkenness
episodes. The impact of sensation seeking on drinking behaviors appears
to be partly influenced by perceived group drinking and perceived
self-efficacy. Results emphasise the importance of preventative
interventions targeted to group norms and enhancing students'
Keywords: alcohol use, university students, sensation seeking, peer group norms, self-efficacy
Drinking of alcoholic beverages
Universities and colleges
|Publication:||Name: Journal of Alcohol & Drug Education Publisher: American Alcohol & Drug Information Foundation Audience: Academic; Professional Format: Magazine/Journal Subject: Health; Psychology and mental health; Social sciences Copyright: COPYRIGHT 2011 American Alcohol & Drug Information Foundation ISSN: 0090-1482|
|Issue:||Date: August, 2011 Source Volume: 55 Source Issue: 2|
|Product:||Product Code: 8220000 Colleges & Universities NAICS Code: 61131 Colleges, Universities, and Professional Schools SIC Code: 8221 Colleges and universities|
Entering and being in university tend to be particularly related to heavy alcohol use (Bachman, O'Malley, Schulenberg, Johnston, Bryant, & Merline, 2002; O'Malley & Johnston 2002; Schulenberg & Maggs 2002; Johnston, O'Malley, Bachman, & Schulenberg, 2004). Epidemiological studies conducted in several countries and especially in the USA (Wechsler, Lee, Kuo, & Lee, 2000) found that most students drank alcohol, and almost half of them engaged in binge drinking. Drinking typically begins in high school and escalates upon college entry, and gradually decreases toward the end of college years (Schulenberg, O'Malley, Bachman, Wadsworth, & Johnston, 1996; Vik, Cellucci, & Ivers, 2003; Bewick, Mulhern, Barkham, Trusler, Hill, & Stiles, 2008). Male college students are more likely to engage in this type of drinking (Wechsler et al., 2000; Nolen-Hoeksema, 2004; Kuo, Adlaf, Lee, Gliksman, Demerse, & Wechsler, 2002; O'Malley & Johnston, 2002). Those college students who live on campus (vs. with parents) (Kuo et al, 2002; Larimer, Anderson, Baer, & Marlatt, 2000) and those who belong to fraternities and sororities tend to be the heaviest drinkers (Cashin, Presley, & Meilman 1998; Wechsler, Lee, Kuo, Seibring, Nelson, & Lee, 2002; McCabe, Schulenberg, Johnston, O'Malley, Bachman, & Kloska, 2005).
University students' distinctive patterns of drinking has been tied to a host of negative consequences, such as poor school performance, physical and sexual assaults, vandalism, legal problems with authorities and interpersonal difficulties (Presley, Meilman, & Cashin 1996; Wechsler et al., 2002). Therefore, alcohol use among this group is currently considered a major public health concern.
In Italy, alcohol use and related problems among college students have not been examined extensively. Most existing surveys, conducted on representative samples of the Italian population (e.g., IPSAD, 2007), have found that alcohol consumption among 15 to 24 year olds is increasing with over 90% of young people having tried alcohol, and 35% of youth having been drunk at least once in the last year. The few existing studies focusing on university students as a distinctive group (e.g., Di Grande, Perrier, Lauro, & Contu, 2000; D'Alessio, Baiocco, & Laghi, 2006; Scacchi, Monaci, & Trentin, 2006) indicated that alcohol use is widespread, and that male youth and students living away from home are more frequent consumers of alcoholic drinks. As a consequence, the attention toward this group from both a theoretical and prevention perspective has steadily increased over the last decade.
A considerable amount of research has focused on risk factors for drinking among university students, ranging from sociodemographic characteristics, personality, developmental and psychosocial variables, to environmental and contextual factors.
The role of social factors, and specifically peer influences, in explaining university students' drinking behaviours is also well documented (Perkins, 2002; Andrews, Tildesley, Hops, & Li, 2002; Borsari & Carey, 2003; Neighbors, Lee, Lewis, Fossos, & Larimer, 2007). Alcohol use by peers is the strongest predictor of youths' alcohol use. Some authors have discussed the role of both selection and socialization effects of the peer group (McCabe et al., 2005). Selection effects refer to the influence of individual characteristics in steering an individual toward certain experiences, organizations or environments. Socialization effects refer to the influence of experiences, organizations or environments on the individual. The two effects often work in conjunction: students who like drinking may tend to select specific peer groups who share their own drinking habits; in turn, being a member of these groups serves to increase their heavy drinking.
According to the social norms approach to college student drinking (Perkins, 2003), peers influence alcohol use both directly (i.e., explicit suggestions to drink) and indirectly (i.e., perceived norms) (Borsari & Carey, 2003). There is some evidence that normative perceptions are an individual risk factor for heavy drinking; that is, that higher perceived norms are associated with higher levels of drinking and problems (Perkins, 2002; 2003; Neighbors et al., 2007).
Another potentially important individual differences variable that may affect drinking behavior among college students is self-efficacy for refusing heavy drinking (Young, Connor, Ricciardelli, & Saunders, 2006; Oei & Jardim, 2007). Some individuals may not feel capable of turning down drinks, or drinking a small amount of alcohol, in situations where other people are drinking, and it is the norm. Evans and Dunn (1995) found lower self-efficacy judgments to be related to greater alcohol consumption in a college sample. Lee and Oei (1993) reported that participants who found it difficult to resist drinking, when they were given opportunities to drink, typically reported higher frequency and quantity of alcohol consumption.
To our knowledge, no study has examined simultaneously the relationship among sensation seeking, perceived peer group norms about drinking (frequency of alcohol use by peers), self-efficacy for drink refusal, and drinking behaviors. We may hypothesise that perceived use of alcohol by peers and self-efficacy for refusing drinking mediate the relationship between sensation seeking and drinking in university students. In other words, individuals with higher sensation seeking tendencies may likely seek friends who are more likely to drink to give themselves greater opportunities to drink, as this behavior would be encouraged by shared group norms about drinking, and should perceive friends' drinking behavior as more widespread. In addition, it was expected that individuals with higher sensation seeking do not believe strongly in their ability to resist drinking in group situations and are more likely to engage in heavy drinking.
Finally, in agreement with the literature, we expected that drinking would increase during the first years of university, that male students would drink more than females, and that drinking would be more frequent among students living in student residences than among those living with parents and commuters.
The sample for this research consisted of 588 university students enrolled in six different Faculties of a large University in the North of Italy (mostly covering Humanities and Social Sciences) (2). 159 (27%) were male and 429 (73%) female (3). Age ranged from 19 to 26 years (M = 22.23, SD = 1.74). 118 participants (20.2%) were living in the same city with their families, 177 (30.3) were commuters (coming from surrounding towns mostly within the range of 100 Km.) and living with their families, and 289 (49.5%) came from other parts of Italy or European countries (i.e., Erasmus exchange programs) and were living in student residences or apartments with other students. Students were enrolled in different years, of course, including First-degree courses (24% first year, 20.5% second year, 27.2% third year) and Seconddegree courses or Masters (17.1% first year, 10.7% second year).
Participants completed an anonymous, self-administered questionnaire including different measures.
Alcohol consumption was measured by four items assessing the frequency of consumption of four types of alcoholic drinks (beer, wine, cocktails, high spirits); response alternatives ranged from 1 (= never) to 6 (= every day). Factor Analysis confirmed the unidimensionality of the scale, therefore, an overall score of alcohol consumption was calculated considering the mean of the four separate scores (Cronbach [alpha] = .80) (M = 2.83, SD = 1.14; Skewness = -.05). A further item measured frequency of drunkenness episodes during the preceding 30 days (responses from 1 = never to 4 = over four times) (M = 1.56, SD = .81; Skewness = 1.50).
Frequency of alcohol use by peer group members was measured by one item; response alternatives ranged from 1 (= do not drink alcohol) to 4 (= drink alcohol every day).
To assess self-efficacy, participants were asked to specify, on a five-point Liken-type scale (response alternatives ranging from 1 = not at all to 5 = completely), how much they felt capable to resist peer group pressures toward drinking.
Finally, sensation seeking was measured by the Italian version of the Impulsive Sensation Seeking (Impss) Scale, of the "Zuckerman-Kuhlman Personality Questionnaire (ZKPQ)" (Zuckerman, Kuhlman, Thornquist, & Kiers, 1991) (19 items; response alternatives true/false). A summary score of Sensation seeking was calculated (range 0-19), after reversing the scores of the items so that higher scores indicated higher levels of self-efficacy.
The questionnaire was distributed in Spring 2008 after obtaining the consent of the Deans of the Faculties and of the University Ethical Committee. For each of the Faculties involved, one class per year was randomly selected. Students were approached during classes by two trained researchers; they explained the general purpose of the study and responded to students' clarification questions. Participation was voluntary. The completion of the questionnaire required on average 20 minutes. Students received credits for their participation. None of them refused to take part to the study.
Firstly, a series of three-way ANOVA were conducted to test the differences in alcohol use and the other variables according to adolescent gender, age and residential condition. To this purpose, students were divided into three age groups corresponding to different stages of their University career: 19 to 21 years old (including mostly students enrolled in First-degree courses)(39.5%; 62 males and 170 females), 22 to 23 years old (including students enrolled in Second-degree courses) (33.7%; 59 males and 139 females) and 24 to 26 years old (mostly students who were about to complete their exams or had enrolled later) (26.9%; 38 males and 120 females). The percentages of male and female students in the three age groups was not statistically different ([chi square](2) = 1.49, p = ns).
In order to assess the predictors of drinking frequency and frequency of drunkenness episodes, Hierarchical Regression Analyses were conducted.
A three-way gender (2) x age group (3) x residential condition (3) ANOVA was conducted on the global score of drinking frequency. Results indicated a main effect of gender (F(1,584) = 15.18, p < .001) and of residential condition (F(2,584) = 9.32, p < .001) (Table 1). Alcohol use was more frequent among males (vs. females) and among students living in residences and apartments (vs. other groups). No significant differences were found according to age group (F(2,584) = 1.98, p = ns), and no interaction effect was found (gender x residential condition: F(2,584) =. 15, p = ns; gender x age group: F(2,584) = 1.43, p = ns; age group x residential condition: F(4,584) = 1.88, p = ns; gender x age group x residential condition: F(4,584) = 1.17, p = ns).
A further three-way ANOVA was conducted on the score of frequency of drunkenness episodes. Significant differences were found according to gender (F(1,581) = 12.33, p < .001): males reported more episodes of drunkenness compared to females. Significant differences were found also according to age group (F(2,581) = 3.88, p < .05): drunkenness episodes increased with age, especially from 19-21 yrs to 22-23yrs. Finally, frequency of drunkenness episodes differed also according to residential condition (F(2,581) = 17.38, p < .001), with higher scores amongst students living on student residences vs. the other two groups. Interaction effects were not significant (gender x residential condition: F(2,584) = .17, p = ns; gender x age group: F(2,584) = 1.34, p = ns; age group x residential condition: F(4,584) = .43, p = ns; gender x age group x residential condition: F(4,584) = .02, p = ns).
Sensation seeking, perceived group drinking and self-efficacy in resisting peer pressures
ANOVA on scores of sensation seeking indicated significant differences by gender (F(1,567) = 14.98, p < .001) and age group (F(2,567) = 4.21, p < .05). Males scored higher than females, moreover, sensation seeking was lower in the older group. Also, significant differences emerged according to residential condition (F(2,567) = 9.32, p < .001), indicating higher scores in students living in student residences vs. other groups.
With perceived group drinking, ANOVA showed significant differences according to gender (F(1,581) = 11.65, p <.01): males reported a higher frequency of alcohol consumption by their peer group than females. Further differences were found according to residential condition (F(2,581) = 8.38, p < .001): students living in student residences scored higher than the other two groups. No significant differences emerged according to age group.
Finally, ANOVA on scores of self-efficacy indicated that male students had lower scores than females (F(1,581) = 18.97, p <.001). Significant differences were found by age group (F(1,581) = 3.12, p < .05), indicating an increase in scores of self-efficacy in the older age group. No significant differences were found according to residential condition.
Frequency of drinking alcohol positively correlated with frequency of drunkenness episodes (r = .48, p < .001).
Sensation seeking was strongly positively correlated with frequency of drinking (r = .43, p <.001) and with frequency of drunkenness episodes (r = .42, p < .001). Perceived frequency of drinking by friends was also significantly and positively correlated with frequency of drinking (r = .48, p <.001) and with frequency of drunkenness episodes (r = .40, p < .001). Lastly, perceived self efficacy in resisting peer group pressures toward drinking negatively correlated with frequency of consumption (r = -.42,p <.001) and with frequency of drunkenness episodes (r = -.33,p < .001).
Considering correlations between the three psychological variables, sensation-seeking negatively correlated with self-efficacy in resisting group pressures toward drinking (r = -.29, p < .001) and positively with perceived frequency of alcohol consumption by peers (r = .29, p < .001). Self-efficacy was negatively correlated with perceived alcohol consumption by peers (r = -.23, p < .001).
Predictors of alcohol use
In order to test the role of sensation-seeking, perceived frequency of drinking by the peer group and self-efficacy in resisting group pressures toward drinking in predicting students' own drinking behaviour and frequency of drunkenness episodes, Hierarchical Regression Analyses were conducted. Gender, age group and residential condition (4) were introduced in the first step, sensation seeking in the second, and perceived group drinking and perceived self-efficacy in resisting group pressures in the third step.
Results indicated both a direct and an indirect effect of sensation seeking through perceived group drinking and self-efficacy in resisting group pressures (Table 2). Students with higher sensation seeking perceived their peer group as more likely to drink and felt less capable of resisting their pressures toward drinking. It is worth noticing that the effects of gender and residential condition disappeared when perceived group drinking and self-efficacy were entered into the equation.
Regression Analysis on frequency of drunkenness episodes indicated similar results. Residential condition had a stronger impact and remained significant when the other variables were introduced, indicating a specific role of contextual factors in influencing the tendency of students to be involved in drunkenness episodes.
DISCUSSION AND CONCLUSION
Results of this study indicated that alcohol consumption among Italian university students is a widespread phenomenon, and its pattern is becoming increasingly similar to other national contexts as regards gender, trends over the university years and residential condition. In particular, in line with research studies conducted in other countries, alcohol use is higher among males than females; it increases with entry to university and shows a decline as the end of university studies approaches; and it is higher among students living on campus (and particularly among students belonging to fraternities and sororities) and not with their parents (e.g., Cashin et al., 1998; Wechsler et al., 2002; McCabe et al., 2005; Larimer et al., 2000). The latter result is particularly interesting since the role of this contextual variable has not been investigated extensively outside of the North American context. The strong differences emerged in this study according to residential condition (both in patterns of alcohol consumption and in the other variables) confirms the importance of further investigating the role of this variable in order to disentangle the mechanisms that may explain its effect. For example, students who decided to attend university far from home (still a lower number in Italy owing to the importance of family bonds in this cultural context) might be a "special" group of individuals in terms of personality characteristics (e.g., more eager to have new experiences and to become independent from their families), as our data on sensation seeking differences seem to confirm. Alternatively, we should consider the importance and salience of peer group norms for students living far from the family, especially when attempting to construct a supportive network of friends in the absence of perceive parental control. Moreover, this residential condition may increase the availability of alcohol both at home and through the attendance of recreational places where alcohol is commonly used; data on recreational habits of students might help clarify this.
The increase in alcohol consumption at the beginning of university, which confirms the pattern found in studies in other countries (e.g., Schulenberg et al., 1994; Bachman et al., 1997; McCabe et al., 2005; O'Malley & Johnston 2002; Schulenberg & Maggs 2002; Johnston et al., 2004), suggests the importance of developmental factors and psychosocial transitions, as indicated by studies on risk behaviours among adolescents. Studies have also shown a natural decline in drinking toward the end of university, as young people are approaching new roles and responsibilities, and this trend also indicates the partial dependence of this behaviour on contextual and environmental factors.
Other important results of this study concern the role of sensation seeking, perceived frequency of drinking by peers and self-efficacy in resisting peer group pressures in explaining frequency of drinking and drunkenness. On the specific influence of each of these variables there was already supporting evidence in the literature (Brennan et al., 1986; Yanovitzky, 2006; Perkins, 2002; 2003; Neighbors et al., 2007; Lee & Oei, 1993). Sensation seeking has been consistently found as a key factor in increasing risk behaviours in adolescence (Zuckerman, 1971). Similarly, the perception of group norms supporting drinking behaviors is one of the strongest predictors of drinking (Perkins, 2002; Andrews et al., 2002; Borsari & Carey, 2003; Neighbors et al., 2007), whereas self efficacy in refusing peers' proposals to drink has been found as a protective factor (Evans & Dunn, 1995; Lee & Oei, 1993). The important result emerging from this study concerns the indirect effect of sensation seeking on drinking patterns; specifically, students with higher sensation seeking tendencies are also more likely to drink alcohol, because they tend to congregate with peers who drink more frequently, and because they have lower levels of self-efficacy in resisting their pressures. Altogether, these variables explain a considerable portion of the variance in drinking frequency.
The traditional perspective on sensation seeking conceived it as a biologically-based personality dimension, and as such, less amenable to changes as a consequence of preventative interventions. A more recent perspective suggests that this characteristic may show changes increasing across adolescence (being associated with the adoption of reckless behaviors), and decreasing when reaching adulthood (Zuckerman, 2007). The available evidence seems to lend support to both perspectives. For example, a recent longitudinal study (Lynne-Landsman et al., 2011) found that some adolescents show patterns of moderate increase in sensation seeking levels across the adolescent years, whereas others show profiles of stability (low or high). Adolescents showing increases in levels of SS also showed a parallel increase in risk behaviors. Our data indicate a decline in mean levels of sensation seeking across the university years, supporting this second perspective.
Results have different implications for preventative interventions for this population. Some authors (Arnett, 1995) proposed to incorporate sensation seeking into interventions; in particular, partly different approaches may be adopted for students showing patterns of stability as opposed to increases in SS levels. The former might benefit from interventions aimed at modifying the ways SS is expressed (e.g., offering opportunities for healthy and.productive expression of these tendencies). Interventions minimizing unhealthy expression of SS would be useful also for students showing a pattern of increase in sensation seeking; the latter would also benefit from interventions aimed at the factors responsible for the increase (e.g., socialization processes).
Similarly, results suggest the usefulness of preventative interventions targeting peer group norms (e.g., peer education interventions), as well as interventions focused on enhancing students' skills and self-efficacy (e.g., life skills, assertiveness training). These programs should focus on students in the university context (especially those students living in student residences) including also the local community, and should be paralleled with interventions in collaboration with community stakeholders focused on alcohol policies (e.g., collaborations with sellers in pubs and other recreational places attended by students in order to set limits on the amount of alcohol consumed).
We should mention some limitations of this study. Firstly, we did not measure students' drinking patterns prior to entry to university. The literature indicates that drinking behaviors start earlier, during high school, and college entry constitutes for many youngsters a transition event that increases alcohol consumption (Schulenberg et al., 1996; Vik et al., 2003; Bewick et al., 2008).
A further issue concerns measurement of peer influences. Perceived group norms about drinking is a possible indicator that might correspond to actual behavior, however, there is evidence in the literature that students who drink tend to overestimate drinking by their peers (Perkins, Meilman, Leichliter, Cashin, & Presley, 1999). Thus, more information will be needed to clarify whether students with higher sensation seeking are actually congregating with peers who drink more frequently or are more likely to overestimate peers' drinking habits. The use of more objective measurement of drinking by peers might be useful to clarify this point.
Finally, the role of the context where the study was conducted should be considered. The present sample belongs to a large and highly attractive University in Italy, which is located in a city where students may find a lot of recreational opportunities including places to drink. More data should be collected on representative national samples including students attending smaller universities located in less attractive places or differing in terms of recreational opportunities for drinking.
Nonetheless, we think that results of this study contribute to our understanding of drinking in this population and context, confirming the importance of considering the interrelation of demographic, individual and contextual factors in the explanation of this behavior and in the elaboration of preventative intervention programs.
Correspondence concerning this article should be addressed to: Elvira Cicognani, Department of Sciences of Education "G.M. Bertin", University of Bologna, Via Filippo Re, 6, 40126 Bologna (Italy), telephone: +39 051 2091629, fax: +39 051 2091489, email: email@example.com
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(1) The sample is part of a wider national project on substance use among University students, funded by the Italian Ministry of Health, National Centre for Prevention and Disease Control (2007-2009).
(2) Education, Political Sciences, Philosophy, Law, Business, Foreign Languages.
(3) The high percentage of females in the sample is explained bY the gender composition of students in these Faculties, where the percentage of females ranges from 55% to 90%.
(4) Owing to the lack of differences between students in the first two groups (both living with their parents), they were collapsed into one category.
University of Bologna
TABLE 1 Descriptive statistics and differences according to sociodemographic variables. Total sample Gender Male Female Frequency of alcohol M 2.95 3.20 2.72 *** use (+) (SD) (1.14) (1.15) (1.10) Drunkness episodes M 1.55 1.70 1.39 *** (past 30 days) (++) (SD) (1.56) (1.05) (.86) Sensation seeking M 6.58 7.42 5.74 *** ([degrees]) (SD) (3.94) (3.89) (3.82) Perceived group M 2.75 2.89 2.62 *** drinking^ (SD) (.70) (.72) (.68) Self-efficacy in M 3.89 3.62 4.16 *** resisting group (SD) (1.10) (1.21) (1.02) pressures ([section]) Age group 19-21 22-23 24-26 yrs-old yrs-old yrs-old Frequency of alcohol 2.86 3.10 2.88 use (+) (1.16) (1.11) (1.15) Drunkness episodes 1.46 1.68 1.55 * (past 30 days) (++) (.76) (a) (.86) (b) (.82) (a) (b) Sensation seeking 6.63 7.37 5.74 * ([degrees]) (4.27) (a) (b) (3.91) (a) (3.46) (b) Perceived group 2.67 2.78 2.80 drinking^ (.73) (.68) (.68) Self-efficacy in 3.95 3.89 4.17 * resisting group (1.13) (a) (b) (1.16) (a) (.95) (b) pressures ([section]) Student residence of Resident Commuter apartment Frequency of alcohol 2.69 2.89 3.28 ** use (+) (1.14) (a) (1.08) (a) (1.14) (b) Drunkness episodes 1.39 1.39 1.85 *** (past 30 days) (++) (.67) (a) (.55) (a) (.93) (b) Sensation seeking 5.82 6.22 7.71 *** ([degrees]) (3.7) (a) (3.97) (a) (3.86) (b) Perceived group 2.80 2.56 2.89 ** drinking^ (.69) (a) (.70) (b) (.69) (a) Self-efficacy in 3.93 3.89 3.84 resisting group (1.08) (1.10) (1.11) pressures ([section]) *** p<.001 ** p<.O1 * p<.05 Means with the same letters are not significantly different + from 1 (never) to 6 (every day) ++ from 1 (never) to 4 (over four times) ([degrees]) range 1-18 (^) from 1 (does not drink) to 4 (always) ([section]) from 1 (not at all) to 4 (completely) TABLE 2 Predictors of alcohol use: Hierarchical Regression analysis Frequency of alcohol use Model 1 Model 2 Model 3 Gender -.22 *** -.14 *** -.05 Age group .07 .08 .08 Residential condition+ .19 *** .11 ** .07 Sensation Seeking .38*** .23 *** Perceived group drinking .34 *** Self-efficacy in resisting -.27 *** group pressures R2 .09 .23 .42 F 19.54 *** 40.95 *** 66.74 *** DF 3,560 1,559 2,557 F change 19.54 *** 95.32 *** 91.74 *** Rzchange .09 *** .13 *** .19 *** Frequency of drunkness episodes Model 1 Model 2 Model 3 Gender -.17 *** -.10 * -.04 Age group .03 .04 .04 Residential condition+ .26 *** .18 *** .16 *** Sensation Seeking .40 *** .25 *** Perceived group drinking .26 *** Self-efficacy in resisting -.19 *** group pressures [R.sup.2] .10 .22 .33 F 21.51 *** 44.92 *** 49.18 *** DF 3,560 1,559 2,557 F change 21.51 *** 107.80 *** 45.03 *** Rzchange .10 *** .12 *** .10 *** *** p<.001 ** p<.01 * p<.05 1 = with family; 2 = student residence
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