Which stressors increase the odds of college binge drinking?
At the same time that college binge drinking has made it into the spotlight as a national concern (U.S. Department of Health and Human Services, 2000, 2012), so too has college stress (Mahmoud et al., 2012; Regehr, Glancy, & Pitts, 2013). More students than ever--about 80%- report stress on a daily basis (ADAA, 2015; Brougham et al., 2009), and many report feeling stressed to the point of burnout (Anderson & Cole, 2001). Students who are preparing to enter college and newly enrolled freshmen already feel "overwhelmed by obligations" (Pryor et al., 2012). Indeed, recent cohorts of students report the lowest recorded level of emotional and mental health (Pryor et al., 2010), a finding that is echoed by the staff that help them in counseling centers and student health organizations (Newbury-Birch, Lowry, & Kamali, 2002; Raj et al., 2000).
Moreover, these two primary concerns related to the college years are connected. Although binge drinking is often a recreational behavior, woven into college culture (Borsari & Carey, 2001), it is also a documented response to stress (Grzywacz & Almeida, 2008; White & Hingson, 2014). Empirical studies have shown that the burden of stress is related to heavy alcohol consumption and binge drinking (Ham & Hope, 2003; O'Hare & Sherrer, 2000). Among college students, drinking to cope is a fairly common behavioral response, emerging as both a short-term reaction to situational stress and a long-term coping style that remains a strong predictor of heavy alcohol use even when other influences on drinking are controlled for (Park & Levenson, 2002). In the current study, four research questions related to college student stress and binge drinking are asked. First, which academic (RQ1), interpersonal (RQ2), and developmental (RQ3) stressors are associated with college binge drinking? Finally, of academic, interpersonal, and developmental stressors, which is most strongly associated with binge drinking? (RQ4)
Pearlin's (1989) work on the nature of stress is helpful in understanding these potential relationships. Pearlin argued that because well-being is associated with people's access to resources and their patterned experiences within institutions, stress is an inherently sociological problem. As an occupant of various social roles - student, friend, employee, boy/girlfriend, family member--undergraduate students face routine demands on their time, energy, and other resources. When these role demands are perceived as being too burdensome or threatening, or the relationships connected to role performance are problematic or conflictual, stress is the likely outcome. Individual college students feel this stress in varying magnitudes and degrees of intensity (Lunney, 2006), but all must learn to effectively cope with it in order to succeed (Hojat et al., 2003).
From a developmental-contextual perspective, the increased likelihood of stress among college students is a predictable outcome of role change. College students face a number of developmental tasks that are related to the loss or modification of old social roles and adoption of new ones that may challenge their resilience (Arnett, 2004). Students often move away from family and friends to attend university, and must learn to function in a new environment that includes not only intellectual but also relational challenges (Blackmore, Tucker, & Jones, 2005; Howard et al., 2006). Many are newly responsible for their income and finances, and in addition to living expenses must find a way to pay for tuition and fees. Students must learn to set priorities and schedule their time, and face uncertainty about the future. Although these changes present a series of relatively enduring stressors during the college years that are inherent to the role of student (McGrath, 2006) and thus relatively routine in nature (Pearlin, 1989), they require significant reorganization and adaptation, as well as psychosocial change at the individual level (Aseltine & Gore, 1993).
Bronfenbrenner (1979) referred to these periods of role transition, involving changes at the individual and multiple systemic levels, as ecological transitions. Such transitions can permanently change an individual's trajectory of well-being (Schulenberg & Maggs, 2002). Indeed, this combined set of burdens and the experience of multiple concurrent transitions, from the perspective of an overload model (Schulenberg & Maggs, 2002), means that the college years are among the most stressful during a person's life (Hales, 2009). Undergraduates have higher stress levels than their same-age peers who are working rather than attending university (Cotton, Dollard, & de Jonge, 2002; Vaez, Kristenson, & Laflamme, 2004). Stress is also much higher among college students than the general population (Adlaf, Demers, & Gliksman, 2005; Stewart-Brown et al., 2000).
For undergraduates, high levels of stress are of concern because of their connection to negative coping behaviors. Among those whose friends are heavy drinkers, especially those affiliated with the Greek system, binge drinking is often a learned behavior and may be perceived as a feasible coping mechanism (Chauvin, 2012; LaBrie, Hummer, & Pedersen, 2007). Binge drinking is used by students--more men than women (Pedersen, 2013)--to cope with stress, shyness, anxiety, and depression (Eshbaugh, 2008; Stewart, Zvolensky, & Eifert, 2001). When it is used, drinking becomes a patterned behavior like any other that is marked by considerable continuity, increased use, and application to a variety of problems--even when it may not be situationally appropriate (Hersh & Hussong, 2006; Pearlin, 1989; Wills et al., 2001). And to be sure, use of a coping mechanism does not guarantee the reduction of stress. Some strategies used to cope, including binge drinking, may actually increase the likelihood that individuals feel overwhelmed and stressed (Giancola, 2002; Hyman & Sinha, 2009).
To summarize, college students represent a subset of the population experiencing developmental transition and heightened vulnerability to stress. Common stressors faced by undergraduates are academic, interpersonal, and developmental in nature (DeRoma, Leach, & Leverett, 2009; Disch et al., 2000; Ross, Niebling, & Heckert, 1999). Some students learn to deal with these stressors using positive means of coping, such as time management and effective study skills (Larson, 2006; Ross et al., 1999). Others engage in avoidant means of coping such as substance use and abuse, and when they do, these negative means of coping tend to increase rather than decrease feelings of stress (Hyman & Sinha, 2009). Which of the common stressors faced by university students are related to the use of binge drinking as a means of coping? The following research questions are posed:
RQ1: Which, if any, academic stressors are associated with college binge drinking?
RQ2: Which, if any, interpersonal stressors are associated with college binge drinking?
RQ3: Which, if any, developmental stressors are associated with college binge drinking?
In the subsequent analyses, the following are examined as potential correlates of college binge drinking: academic stressors including (a) academic concerns, (b) unrealistic course expectations, and (c) concern about grades; interpersonal stressors including (d) relationships, (e) interpersonal conflicts, and (f) conflict in a living situation; and developmental stressors including (g) separating from family, (h) balancing academic demands with other priorities and demands, and (i) making decisions about the future. The final research question asks:
RQ4: Are academic, interpersonal, or developmental stressors more strongly associated with college binge drinking?
The association between each stressor and binge drinking was tested using data from a sample of undergraduate students, detailed in the following section of this paper.
Data for this study were taken from a survey of college undergraduates enrolled at the University of North Dakota, a doctoral-granting Midwestern university serving approximately 15,000 students. The University of North Dakota is located in the northern Great Plains and enrolls a high proportion (75%) of its students from two of the states with the highest binge drinking rates in the nation: Minnesota and North Dakota (CDC, 2015). Grand Forks County, in which the university is located, also has one of the highest underage drinking rates in the nation (SAMHSA, 2014). The student body at the University of North Dakota is largely white (81%), the largest minority group being Native American students (2.5%). Past work indicates that higher drinking rates are present in Midwestern states (Wechsler et al., 2000b), and more white than minority young adults and students engage in heavy drinking (Orcutt & Schwabe, 2012; Vogt Yuan, 2011).
Instrumentation and Measures
An online questionnaire was distributed to students, and included a number of measures related to college students' health, academic life, and stress. For the current analysis, a measure of binge drinking was used as the dependent variable, taken from the annual Behavioral Risk Factor Surveillance System (BRFSS) (CDC, 2011). Students were asked "Considering all types of alcoholic beverages, how many times during the past 30 days did you have 4 (women) / 5 (men) or more drinks in one sitting?" Respondents selected the appropriate number of days ranging from 0-30. Responses were then recoded for some of the analyses so that a student reporting having not binged in the last month was coded (0), and those who reported binging one or more times in the last month were coded (1).
Nine stressors were considered as independent variables, three representing academic demands, three interpersonal in nature, and three related to developmental tasks of emerging adulthood. Students were asked to indicate which of the following caused them stress: "(a) Academic concerns, (b) Unrealistic course expectations, (c) Concern about grades, (d) Relationships, (e) Interpersonal conflicts, (f) Conflict in a living situation, (g) Separating from family, (h) Balancing academic demands with other priorities and distractions, and (i) Making decisions about the future." Responses were coded so that 0 = no and 1 = yes.
Two control variables were included in regression analyses. Sex was coded 0 = male and 1 = female. Class level was an ordinal measure: freshmen = 0 to 30 credits (1), sophomores = 31 to 60 credits (2), juniors = 61 to 90 credits (3), and seniors = 91 or more credits (4). Sixty-three percent of the sample was female, and 37% was male. Freshmen made up 21.4% of the sample, sophomores 20.2%, juniors 23.0%, and seniors 35.5%. Thus, there were more women than men and a fairly even distribution by class level.
The online survey was distributed to students roughly two-thirds of the way through the fall semester, after midterm exams but before the final exam period. This time frame was optimal for capturing routine drinking patterns because estimates of how prevalent binge drinking is among students vary based on the timing of surveys: the lowest rates are reported during midterm and final exam periods (Tremblay et al., 2010). Students were not identified individually for participation in this study. Rather, a list of all courses for the fall semester was obtained from the Registrar's Office. All independent study, practicum, professional, and part-term courses were removed from the sampling frame. Then, every tenth course was selected for inclusion. Instructors of these 73 courses were contacted via email to enlist their help in announcing the study to their students. The link for the questionnaire was provided to instructors to share with their students. Instructors were encouraged to distribute the link through electronic means in order to reduce user error. The questionnaire was made available for four weeks, and a total of 295 students participated for whom full data were available. For the purposes of the current analysis, the sample was restricted to include only undergraduate students between the ages of 18 and 29, resulting in a final subsample consisting of 250 students. Compared to the undergraduate student body as a whole, the sample consisted of a similar proportion of students in each class level, and a higher proportion of female students.
To answer the research questions posed in this study, a series of chi square statistics was first estimated. These allowed for determination of whether any academic (RQ1), interpersonal (RQ2), or developmental (RQ3) stressors are associated with college binge drinking, as well as which type of stressors is more strongly associated with binge drinking (RQ4). Then, to test the robustness of these findings, logistic and multiple regression equations were estimated while holding control variables--sex and class level--constant. These models regressed the likelihood of binge drinking and frequency of binge drinking on significant stressors.
Among undergraduates in the sample, 58.5% binged in the last month. This is higher than the approximately 50% of college students known to binge drink nationwide (NIAA, 2015b). Among those who reported binging at least once, the average number of days they binged in the last month was 4.38 (SD = 4.08). Descriptive statistics for the independent variables can be found in Table 1. The stressors most commonly reported were (listed by frequency of reporting), academic concerns (70.8%), concern about grades (60.4%), balancing academic demands with other priorities and distractions (54.4%), and making decisions about the future (54.0%). Although three of these stressors directly reference academics, the first two are considered academic stressors and the third is a developmental task as it focuses on the ability to prioritize and balance competing obligations, including demands that arise outside of the classroom (Arnett, 2004). Although measuring experiences in similar domains, the bivariate correlations (available upon request) indicated that although some stressors were significantly associated (e.g., academic concerns and concern about grades), none of the correlations were strong enough to be of concern when used together in multivariate models.
In Table 1, the chi square outcomes for binge drinking by each stressor are also noted. To answer the first research question, which, if any, academic stressors are associated with college binge drinking, none of the academic stressors was statistically significantly associated with the outcome variable. Among the interpersonal stressors (RQ2), although not the most commonly reported, relationships ([chi square] = 5.03, df= 1 ,p< .05), interpersonal conflicts ([chi square] = 4.02, df= 1 ,p< .05), and conflict in a living situation ([chi square] = 6.38, df = 1, p < .05) were significantly associated with binge drinking. Research Question 3 asked which developmental stressors are associated with binge drinking, and results showed that only separating from family ([chi square] = 6.08, df = 1, p < .05) was statistically significantly associated with having binged. Among respondents, 73.1% of those who reported conflict in a living situation binged in the last month, 73% of those who experienced interpersonal conflicts binged, 68.5% of those who reported relationship stress binged, and 61.9% of those who reported separating from family to cause them stress did not binge. Thus, in reference to the last research question, which asks whether academic, interpersonal, or developmental stressors are most strongly associated with college binge drinking, it appears that stressors that are primarily interpersonal in nature are correlates of binge drinking.
For the next stage of the analysis, two regression equations were estimated. First, a logistic regression equation in which the control variables and four significant stressors were included tested their combined influence on whether respondents engaged in binge drinking during the past month. Then, an OLS regression equation regressing the frequency of binge drinking the in last month on control and independent variables was estimated. The logistic regression model (see Table 2) indicated that the odds of binge drinking in the last month increased with class level (Exp(B) = 1.56 **), and was more likely to occur among those who reported conflict in a living situation (Exp(B) = 2.87 **). The odds of binge drinking were lower among those who reported separating from family as a stressor (Exp(B) = .25 **). This model was statistically significant ([chi square] = 29.94, p < .000), with 20% of the variance in binge drinking explained by this combination of independent and control variables. In regard to the likelihood of binge drinking, the model provides continued support for its association with interpersonal and developmental stressors.
In Table 3, results from the OLS regression model are presented. Here, the frequency of binge drinking in the last month is considered. The four significant stressors and same control variables were included in the model. Results indicated that frequency of binge drinking was higher among college men ([beta] = -.20 **) and those in the upper class levels ([beta] = .23 ***). Among the stressors, frequency of binge drinking increased among those who reported stress from conflict in a living situation ([beta] = .16 *), and decreased among those who reported separating from family as a stressor ([beta] = -.18 *). This model was also statistically significant (F = 5.70, df= 181,/t < .000), and the explained variance was .14. Variance inflation factors ranged from 1.02 to 1.16, and tolerance statistics were between .86 and .98, indicating that muliticollinearity was not a concern in the model. In regard to frequency of binge drinking, then, interpersonal and developmental stressors remained significantly associated with the outcome. However, when only those students who reported binging in the last month were considered, sex ([beta] = -.25 **) and class level ([beta] = .20 *) were statistically significantly associated with frequency of binge drinking, and stress originating in separation from family approached statistical significance ([beta] = -.17[dagger]) (F = 2.59, df= 105, p < .02). Again, multicollinearity was not a concern in this model as variance inflation factors (1.04 - 1.17) and tolerance statistics (.86-.96) were within acceptable ranges.
The current study seeks to deepen our understanding of the relationship between stress and problem drinking by examining which stressors are associated with binge drinking among university undergraduates. In a time of developmental transition and heightened vulnerability to stress, undergraduates routinely face stressors that are academic, interpersonal, and developmental in nature (DeRoma et al., 2009; Disch et al., 2000; Ross et al., 1999). Whereas some students learn to deal with their stressors using positive means of coping (e.g., time management and study skills) (Larson, 2006; Ross et al., 1999), others adopt avoidant techniques. These negative means of coping, such as binge drinking, generally increase rather than decrease feelings of stress (Hyman & Sinha, 2009). Using data from a sample of undergraduates enrolled at a Midwestern university, findings from the current study indicate that the most commonly reported stressors included: academic concerns, concern about grades, balancing academic demands with other priorities and distractions, and making decisions about the future. Yet, bivariate analyses indicated that it was interpersonal stressors that were associated with college binge drinking. Those who reported stress arising from relationships, interpersonal conflicts, and conflict in a living situation were more likely to binge. Among those who reported stress arising from separation from family, a developmental stressor, binge drinking was less likely. Multivariate analyses confirmed the relationships between conflict in a living situation and separation from family and binge drinking. Consistent with past work (Bewick et al., 2008; White et al., 2006), binge drinking was more commonly reported by undergraduate men and those in higher class levels.
Thus, although binge drinking is a phenomena associated with college life, it does not appear to be linked to the academic stressors considered here. This is an important distinction to recognize. As Pearlin (1989) noted, "the multiplication and contagion of stressors means that studies must cast a wide net to capture the full array of stressors that are present in an individual's life. If we fail to discern all the appreciable stressors that are contemporaneous, we also will fail to interpret correctly the outcomes that we observe" (p. 248). Undergraduates do report that they find academic stressors the most taxing. And it is the perception of excess--in how much material must be learned, time demands, the level of intellectual challenge presented by coursework--that is related to whether an academic demand is considered a stressor (Blackmore et al., 2005). But, binge drinking does not appear to be a commonly used form of coping in response to academic stress and learning to balance academic demands with other priorities and distractions. Pryor and colleagues (2012) found that the busiest students are also the most likely to report willingness to communicate regularly with professors, get tutoring, and seek personal counseling. Those who feel overwhelmed by their academic obligations are also likely to reduce their work and social obligations (Blackmore et al., 2005). Thus, those who are the most overwhelmed by the stressors of academic life appear to be academically motivated and able to use positive coping behaviors to manage their stress. Highly motivated students may be less likely to binge drink because they believe that drinking may interfere with their studies. As well, making decisions about the future was a cause of stress reported by the majority of students in this sample. However, it was not associated with binge drinking. Past work suggests that students find future employment prospects to be a stressor (Guo, Wang, & Johnson, 2011). Yet, this stress does not appear to lead to heavy drinking.
The students who were most likely to engage in binge drinking were those who reported stressors that were interpersonal in nature. For traditional-age college students, social events hold a great deal of significance and undergraduates report spending a lot of time with their friends and peers. They also report having more interpersonal conflicts than non-traditional students (Dill & Henley, 1998). Developmentally, late adolescence and early adulthood continue to be a time of rapid cognitive and emotional change. Increases in cognitive development are coupled with a greater likelihood of rumination and negative emotion (Larson et al., 2002). Adolescents and young adults hold on to negative events for a longer period of time (Muris et al., 2004), and they often have difficulty containing experiences and preventing them from carrying over into other aspects of their lives (Harter et al., 1997). This uneven social and emotional development has consequences for students' behavioral choices and health (Unalan et al., 2008; Vaez & Laflamme, 2008). Poor emotional control, including the inability to control and suppress anger from others, is positively associated with substance use including alcohol consumption (Wills et al., 2001). In turn, binge drinking is associated with interpersonal problems and aggression (Giancola, 2002). In at least one other study, drinking was used by young adults to cope with stress originating from problems in peer relationships (Aseltine & Gore, 2000).
In contrast to the positive association between interpersonal stressors and binge drinking, separating from family appears to reduce the likelihood of binge drinking, even when perceived as a stressor. Millennial students are more emotionally connected and dependent upon their parents than the generations preceding them (Howe & Strauss, 2003). Among college students living away from home for the first time, the loss of regular support networks means that an important buffer to stress is no longer as readily available (Hudd et al., 2000; Thoits, 1995). However, it does not appear that the stress of separation leads to heavy alcohol consumption. Despite separation, when a strong attachment exists, family members remain influential in college students' behavioral choices (Vidourek & King, 2013) and exert a preventive and protective influence on both stress and drinking (Bland et al., 2012).
Findings from the current study have implications for those who work with undergraduates, particularly campus health practitioners and student wellness coordinators. Stress has been cited as the primary barrier to student achievement (American College Health Association, 2009), and is reflected in symptoms that directly affect students' academic proficiency (Morrison & O'Connor, 2005). Thus, providing opportunities for students to learn positive and constructive coping behaviors in response to stress is one way to improve student retention rates (Finn, 1989). The current study highlights that a special focus should be paid to developing healthy relationships and conflict management techniques, as interpersonal stressors were associated with participation in binge drinking. In particular, programming to help students develop good communication skills and protective behavioral strategies is called for (Borden et al., 2011; Regehr et al., 2013), with early intervention in the first year of college being most effective (Scott-Sheldon et al., 2014). This training may be especially important for those living in campus housing and residence halls, or off-campus housing with roommates, to help prevent conflict in a living situation. Evidence has also suggested that routine screening in university counseling centers coupled with brief interventions can reduce the frequency of binge drinking (Denering & Spear, 2012).
This study points to an association between interpersonal stressors and binge drinking, but there are sample and data limitations that should be recognized. The sample is a relatively homogeneous one, composed of undergraduate students from a single campus. Most of these students originated from two states, both known for high rates of heavy drinking (CDC, 2015). Coming from households in which parents may drink heavily, and the possibility of early socialization into these behaviors is a potential confounding issue that cannot be dealt with using the current data set. As well, attention to race and ethnicity were not possible using data from this group of students. Past work has indicated that minority students face unique stressors in the academic environment and experience discrimination from other students, faculty, and staff (Chavez & French, 2007; Hwang & Goto, 2008). These could not be accounted for using the current sample. Furthermore, the directionality of relationships is an issue when using cross sectional data. For instance, past work has indicated that alcohol use is associated with greater interpersonal conflict and aggression (Giancola, 2002). Thus, it is possible that binge drinking causes interpersonal stressors to arise rather than these stressors leading to binge drinking. It is only through the use of longitudinal data that this can be determined, although it is likely that the relationship works in both directions. Nonetheless, this paper is unique in its focus on the variety of stressors - academic, interpersonal, and developmental - that may lead to binge drinking among college undergraduates.
Though some stress is necessary for personal growth and achievement, particular stressors may lead to negative coping behaviors that have serious short- and long-term consequences. This study indicates that interpersonal stressors may result in participation in binge drinking. Thus, targeted efforts to help students develop communication skills and healthy relationships--especially among roommates may help reduce the likelihood of heavy drinking. This study also found that students who reported feeling stress as a result of separating from family were less likely to binge drink, and to do so less frequently. This finding points to the continued importance of parental influence in college students' behavioral choices and protective effects of parental involvement in the lives of their young adult children.
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DR. DAPHNE E. PEDERSEN
University of North Dakota
(1) 'Binge drinking' is a popularized term that is contested by those who work within the field of drug and alcohol abuse. To a clinician, a 'binge' is a pattern of behavior that includes drinking to intoxication, often for several days, and often in isolation (WHO, 1994). In contrast, the U.S. Surgeon General and U.S. Department of Health and Human Services use the term 'binge drinking' to mean the consumption of five or more drinks in one sitting. Because this term is more widely recognized by the public, and by social scientists, it is the term adopted in this manuscript. To note, the definition of binge drinking has also been problematized by those who use it. The terms 'occasion' and 'sitting' may be difficult to define, and 'drink' shares a similar inexactness. The National Institute on Alcohol Abuse and Alcoholism (2004) clarified that for women and men, 4 or 5 drinks, respectively, typically brings blood alcohol content to the level of .08. They refer to this as "binge drinking" (NIAAA, 2015a).
Table 1-Percentage Reporting Academic, Interpersonal, and Developmental Stressors, and Chi Square Results for Binged in Last Month by Stressor (A = 250) % yes [chi square] (df) Academic Stressors Academic concerns 70.8 1.39(1) Unrealistic course expectations 26.4 2.33 (1) Concern about grades 60.4 0.02(1) Interpersonal Stressors Relationships 32.0 5.03* (1) Interpersonal conflicts 16.0 4.02* (1) Conflict in a living situation 22.0 6.38* (1) Developmental Stressors Separating from family 11.2 6.08* (1) Balancing academic demands with 54.4 0.97(1) other priorities and distractions Making decisions about the future 54.0 0.58(1) Note. * p< .05, ** p < .01, *** p<.001. Table 2-Logistic Regression Results for Any Binge Drinking in the Last Month by Independent and Control Variables (A = 250) B S.E. Exp(B) Sex -.34 .35 .72 Class level .45 .15 1.56 ** Relationships .48 .36 1.62 Interpersonal conflicts .78 .46 2.17 Conflict in a living situation 1.05 .40 2.87 ** Separating from family -1.40 .54 .25 ** [chi square] (df) 29.94 p < .000 Note. * p < .05, ** p < .01, *** p < .001. Table 3-OLS Regression Results for Frequency of Binge Drinking in Last Month by Independent and Control Variables (N = 250) All Students B S.K [beta] Sex -1.57 .55 -.20 ** Class level .77 .23 .23 *** Relationships .12 .57 .02 Interpersonal conflicts 1.19 .69 .13 Conflict in a living situation 1.30 .58 .16* Separating from family -1.97 .79 -.18* Constant 2.58 1.24 * Adj. [R.sup.2] .14 p < .000 Binged Once or More B S.K [beta] Sex -2.06 .79 -.25 ** Class level .75 .36 .20 * Relationships -.24 .81 -.03 Interpersonal conflicts .99 .92 .11 Conflict in a living situation .98 .81 .12 Separating from family -2.54 1.45 -17 ([dagger]) Constant 5.17 1.91 ** Adj. [R.sup.2] .08 p < .02 Note. ([dagger]) p < .10, * p < .05, ** p < .01, *** p < .001.
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|Author:||Pedersen, Daphne E.|
|Publication:||College Student Journal|
|Date:||Mar 1, 2017|
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