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Tag Archives: Healthcare

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How telemedicine is the future of healthcare

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The COVID-19 pandemic changed the way we do a lot of things and, even with many countries finally opening back up, there are some changes that are sure to last far beyond the pandemic. One of these changes is the advancement of telemedicine.

Telemedicine has been on the rise for many years. In fact, it may surprise you to know that the earliest telemedicine was as far back as the 1920s, when ship clinicians used to receive medical advice via radio. Of course, we’ve come a very long way since then, and this method of practicing medicine has advanced at a rapid rate, with the most recent development being veterinarians offering virtual visits in 2020.

In early 2020, at the start of the pandemic, physicians performed 1,629,000 telemedicine visits. Sixty-nine percent of patients have now had at least one virtual visit and they’re eager to keep this “new normal” moving forward. In fact, studies show that telehealth increased patient satisfaction and retention by 81.5%.

Find out why telemedicine is the future of medicine in the infographic below.

Infographic courtesy Online Medical Services

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Infographic: Pandemic digital health trends you should know

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The COVID-19 pandemic brought a rapid acceleration in digital health services and telemedicine. Much of the digital transformation in healthcare has been driven by patient expectations and has little to do with doctors’ age or level of experience.

Today, physicians are more likely to recommend health-related smartphone apps, fitness wearables and other technology to their patients. Many use social media to engage with and educate patients. In fact, 87% of doctors who are high digital adopters share educational videos with patients regularly.

One of the true driving forces behind digital healthcare is patients. Many patients who embrace digital tools feel empowered to take control of their own healthcare. Those with rare, chronic conditions are more likely to embrace telemedicine, conduct their own health research online, and interact directly with pharmaceutical companies.

The digital transformation in healthcare is just beginning. Patients and doctors alike expect use of digital tools to continue to grow.

Infographic courtesy Real Chemistry

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Optometrist discovers cannabinoids as means to identify use of marijuana

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Unlike for alcohol, there is no breathalyzer or in-the-field measure of performance such as the Standard Field Sobriety Test.

Impairment Measurement Marijuana and Driving (IMMAD), based in Quincy, Massachusetts, is a bioscience company working to fill the gap of limited technology to detect impairment to drive with marijuana use. IMMAD is collaborating with the Boston University School of Medicine’s Biomedical Forensics (BMFS) Program to do something about the risk of marijuana impaired drivers contributing to fatal crash rates.

HPLC-MS/MS technology in the forensic science lab at Boston University.

The BMFS team have found that tears are an excellent matrix from which to identify active and inactive cannabinoids. Further research is expected to demonstrate tears as being a more sensitive and specific measure than either breath or saliva. The science abstract discussed the early findings at a major forensic science conference this April. The paper will be at the Midwest Association for Toxicology and Therapeutic Drug Monitoring Virtual Conference.

Professor Sabra Botch-Jones spent the fall and winter working with one of her master’s-level graduate students, Allen Mello, to demonstrate efficacy of using the eye’s tears as a measure of marijuana cannabinoids in the body. Professor Botch-Jones and Mello worked on the hypothesis that because the tears have a large quantity of lipophilic/fat components and because cannabis/THC/marijuana adheres very well to fat, that the tears will be a more efficient and a better objective measure of cannabinoids with marijuana use than saliva or breath. Saliva and breath have very few lipid/fat components and do not adhere well or for long to marijuana cannabinoids. Breath as a water vapor is not likely to be capable of measuring cannabis consumption if the route of use was in edible form.

Bench work set up for the analysis of THC/marijuana at BU

IMMAD and Boston University measured the tears of volunteers having used their own legal adult use marijuana at the IMMAD research site in Quincy during the months of November, December and January.

“With the legalization of marijuana, there is a perception that it is safe to perform normal activities such as driving or working. This is not true, decades of research on marijuana’s impairing effects demonstrates that it is not safe to operate a motor vehicle, or other safety sensitive function, while using marijuana. Therefore, it is paramount that we conduct research and develop ways in which we can detect marijuana use and assess impairment,” said Professor Botch-Jones.

Unlike alcohol, there is no breathalyzer or standard field sobriety test currently in general use roadside by the police to measure an impairment to drive with marijuana. The more reliable means to determine recent use of marijuana is a blood test. The levels of cannabinoids in the blood do not have a linear relationship to functional impairment to drive and cannot, in general, be used effectively to determine if marijuana related impairment contributed to the crash. There are no roadside tests of breath currently in general use or approved by the FDA available to law enforcement to measure marijuana.

While there are tests of saliva in use in Canada, Europe, as well as states such as California and Michigan, they are not in use in Massachusetts. Developing an effective, accurate measure of marijuana in the driver’s system will be essential to understand how its use may or may not have contributed to a fatal crash. IMMAD already has the working prototype of technology to measure vision loss and dysfunction with marijuana use and this is predicted to be an effective means to determine the actual impairment to drive.

Dr. Denise A. Valenti, CEO and owner of IMMAD states, “IMMAD is committed to research and technology in support of the responsible use of marijuana. Use of marijuana temporarily impairs functions critical for safe driving.” The measure of the presence of cannabinoids in body fluids will confirm what is causing the impairment to drive. The use of tears may be an effective means to do this.

The analysis of tears relies on volunteers from the community who have been “opportunistically” dosing with their own legal adult use marijuana or medicinal marijuana after having had an initial intake screening visit without having used any alcohol or marijuana. Volunteers make a preliminary visit, without having dosed, to the IMMAD research facility in Quincy where the process is reviewed and the volunteer signs a research informed consent, standard protocol for human research.

The research coordinator then takes information about when and where the volunteer will be available after having dosed with their own marijuana product. The IMMAD research team then arranges transportation to the research facility by Uber or Lyft. Samples of tears are taken using simple swabs or pipettes, blood is drawn to compare with the tears and then the volunteer is driven to their site of origin by Uber or Lyft. The research has had approval by an accredited Institutional Review Board.

Boston University forensic science intern Allen Mello.

The completed study was part of Mello’s required research as part of the master’s level program. This academic program trains aspiring forensic scientists in a variety of disciplines applicable to both crime scene investigation and evidence analysis, skills crucial to today’s comprehensive forensic investigations. Professionals such as Mello are trained in the basic principles of forensic science with a strong biomedical and chemistry background, providing crucial expertise to forensic investigations.

After graduation, students are prepared to pursue a variety of career options in crime laboratories, medical examiner offices, law enforcement agencies, scientific instrument companies and hospital or biotechnology laboratories. All students complete a program of independent research culminating in a written thesis of publishable quality.

For interns, this type of research provides critical practical experience. Data collection and analysis takes place in the BMFS laboratories, other departments at BU or at internship sites such as crime laboratories or forensically relevant industries such as IMMAD. Mello received funding support for his internship research with IMMAD through the Intern Challenge program at MassLifeSciences. Mello developed analysis procedures for the tears along with his advisor, Sabra Botch-Jones. The analysis was done with the QSIGHT High Performance Liquid Chromatography/Tandem Mass Spectrometer.

IMMAD wishes to remind all adults; enjoy legal adult marijuana responsibility. Do not drive. IMMAD welcomes inquiries about education programs and how legal adult use marijuana consumers can become a research volunteer.

For more info, email Dr. Denise Valenti at deniseavalenti@gmail.com or call 617-320-2997.

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Tech tricks that could prevent future COVID-19 outbreaks in your healthcare organization

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Even as the COVID-19 pandemic finally seems to be showing signs of slowing down, you know as a hospital administrator or physician that you still can’t take your eye off the ball in terms of prevention strategy.

One of your top priorities will be stopping any further coronavirus spread in your facility until herd immunity and/or highly controlled case counts have been reached in your region, so you need up-to-date solutions your staff can swiftly and easily implement. The following cutting-edge techniques can mean simplified and highly effective infection control for your organization. These easy-to-implement procedures, which are also extremely cost-efficient, can protect your patients and staff better than ever before.

Try these “hospital hot spot hacks:”

Use the power of UV light.

Researchers from Tel Aviv University report that COVID-19 can be immediately killed in surfaces through disinfection with ultraviolet light-emitting diodes, or as they’re more commonly known, UV-LEDs. In the study, “UV-LED disinfection of Coronavirus: Wavelength effect,” inexpensive LEDs can easily be installed in hospital rooms and will almost instantly sterilize the air pulled into the room before it can disperse virus.

The team found that a wavelength of 285 nanometers (nm) was almost as efficient in disinfecting the virus as a wavelength of 265 nm. This means COVID can be eliminated in less than 30 seconds from an environment, using a reasonably priced bulb that’s easy to find and purchase.

Also, the LED approach proved to be much more effective in terms of killing the virus than sprayed disinfectant, which has to dry on surfaces to be fully efficient. Eventually, the researchers say that this LED technology can be incorporated into ventilation systems and air conditioners for even more room coverage.

One caveat: patients should not be encouraged to try this technology at home, because it can be hazardous outside of the hospital — let them know that, and have your tech teams thoroughly research the technology to see if it’s right for your facility.

Take carbon dioxide measurements.

A new study published last month by researchers from the Cooperative Institute for Research in Environmental Sciences and the University of Colorado at Boulder finds that simple CO2 monitoring throughout an indoor space can give a real-time measurement of how much virus might be the air and be potentially infectious.

This happens because people exhale COVID-19 at the same time as they exhale carbon dioxide. Zhe Peng and Jose L. Jimenez, in their study “Exhaled CO2 as a COVID-19 Infection Risk Proxy for Different Indoor Environments and Activities,” used currently available carbon dioxide monitors to create a math model that can easily be used by facility staff to determine how inhalation and exhalation, ventilation, and the activity in a space, such as talking loudly or performing heavy physical activity, can determine specific virus levels in that room.

This information can then be used to keep track of elevated risk in virtually any part of a healthcare facility. Take a deeper dive into their research with your hospital’s affiliated physician-scientists and apply relevant findings to your building’s populated areas in real time.

Making easy ventilation switches.

A March 2021 study from Florida Atlantic University scientists, “Aerosol generation in public restrooms,” found that flushing a toilet can disperse a big amount of viral microbes into the air, including from COVID-19. Because of this, patient bathrooms can conceivably become highly infectious areas, as can any other restroom in your hospital.

Infectious COVID droplets escaped into the air when the toilet was flushed most readily if it didn’t have a lid, although aerosolized droplets were also shown to disperse via gaps between the cover and the seat. The simple solution: redirecting the airflow in your facility’s bathrooms so that ventilation is plentiful, which cuts the risk of transmission, and doesn’t require a full overhaul of your room layouts. This, plus education outreach that could involve posting notices instructing patients, staff and the general public to quickly turn and exit after flushing a toilet, are simple fixes that can have great impacts.

The bottom line: cutting current COVID-19 risk for your patients and staff doesn’t have to be complex. Significant protection can result from immediate, low-tech changes — make them wisely, now and for the foreseeable future.

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Bridging the gap: How to reach herd immunity with vaccine confidence

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After a year of COVID-19 significantly affecting our lives, a light at the end of the tunnel to normality is finally here. Three effective vaccines have been distributed throughout the U.S. and hope for herd immunity is in sight. However, there is still a gap between those being vaccinated and those who do not want to be vaccinated.

Approximately 10 to 15% of the U.S. population will need to change their mind about being vaccinated in order to reach herd immunity at 70 to 85%. The main two reasons for vaccine hesitancy are freedom of choice and side effects. Freedom of choice must remain, but with incentives given by the government or companies, many who are hesitant may go ahead with the vaccine.

The ability to also make the vaccine accessible and convenient will also cause an impact for those who aren’t necessarily against it but would rather not go through the hassle of being vaccinated. Changing the dialogue from accusation and guilt to emphasizing the personal and economic benefits while allowing freedom of choice to still exist will also likely help close the gap. There is still progress to be made, but we are closer than ever before to having our lives back.

Check out the following visual deep dive for more on vaccine confidence:

Infographic courtesy Real Chemistry

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Podcast: How to sell packages in a cash-based practice

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Offering discounted multi-treatment packages can be a great way to help fill your clinic’s schedule and minimize drop-offs to maximize the raving fans you create for your practice. However, the higher price tag can scare off those who aren’t totally sold on the value of your services if you don’t frame the “ask” in a way that builds trust, addresses objections, and is timed perfectly.

In this episode, I walk you through how to effectively sell packages to your patients, including the simple analysis that will enable you to predict if offering discounted plans is likely to leave you with regrets down the road. You’ll hear how to position a package in a way that emphasizes the high value, and how packages should be billed if a patient needs documentation to submit for self-claims.

This “highlight” is taken from Q&A calls with my Mastermind Gold group — a highly interactive, supportive group where people who have tons of questions and concerns about how to start, grow, or transition to a cash-based private practice get the answers, resources, and confidence they need to build the practice of their dreams. We have a group coaching call every week, and we occasionally use excerpts of those calls for this podcast.

More specifically, I discuss these topics related to selling packages in your cash-based practice:

  • How your plans for future growth should affect your package offerings if you don’t want to leave money on the table with every package sold.
  • Why understanding the critical role of the patient lifecycle will help you sell more easily and avoid cancelations due to buyers’ remorse.
  • Positioning a package in a way that helps them truly appreciate how it will help them reach their goals as well as saving money.
  • How you can frame patient expectations so they’ll understand why you’re recommending a certain number of visits and what will happen when they reach the end of the plan of care.
  • How to document packaged services on receipts for patients who need to submit self-claims to their insurance for reimbursement.

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Encouraging mental health awareness in the classroom

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Educators teach students about more than math and science. They also establish spaces where kids develop their social skills and learn more about themselves. It’s a critical place for introducing topics surrounding mental health, but that might be tricky to integrate into lesson plans.

If you’re wondering how to encourage mental health awareness in the classroom, try these tips and watch your students thrive.

1. Hang Special Posters

Teachers utilize their classrooms to establish safe environments, so play with your surroundings. You can figure out how to encourage mental health awareness at school by printing new posters.

Hang relevant material that students will see every day. Signs listing symptoms of depression or anxiety will normalize the conditions so they’re easier for kids to recognize and discuss.

2. Increase Their Self-Esteem

You can also discover how to teach mental health awareness through developing your students’ self-esteem. They’ll need more confidence to defeat discouraging thoughts that could morph into depression.

Merge mental health and classroom culture by giving students more responsibility in projects. When they succeed, they’ll gain confidence in their abilities and be better prepared to fight mental health symptoms.

3. Invite a Speaker

Kids might struggle with stress and anxiety because they’re scared. They don’t know much about the world yet, but you can expand their horizons by inviting a speaker. A professional in the mental wellness world will increase your students’ positivity by giving them valuable tools from their life experience. Young people will feel more positive about their future if they can see themselves in others who already achieved success.

4. Teach Healthy Outlets

Teaching about healthy outlets is another way teachers can learn how to encourage mental health awareness in the classroom. Give students more control over their mental health with tools to release pent-up daily anxieties or vent their stress.

They’ll deal with things by dancing, meditating or working on their art instead of relying on unhealthy coping mechanisms. Practicing these outlets even once a week empowers students to build a brighter future, no matter their personal battles.

5. Address Forms of Discrimination

Discrimination in the classroom can lead to symptoms of depression. It can come in the form of lessons that lack diversity or bullying among students. Addressing these issues is another way teachers can figure out how to teach mental health awareness.

Update your lesson plans so they include voices from minority communities and images that reflect people of different backgrounds. Talk about how bullying can take on multiple forms, like verbal or digital harassment. Students will be able to spot negative mental health symptoms if they can identify the situations sparking those issues.

6. Create a Safe Space

Combine your mental health and classroom culture concerns by creating a safe space for conversations. Talk about these issues with nonjudgmental word choices and tones. Encourage your students to come to you with any questions or concerns. They’ll become more open to mental wellness topics if they don’t feel judged or ostracized.

Encourage Mental Health Awareness in the Classroom

Educators can learn how to encourage mental health awareness at school by using these tips to change everything from the classroom environment to your lesson plans. Normalize these discussions and encourage students to come forward with concerns and develop the skills they need to take care of themselves.

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Infographic: How to set work boundaries to avoid burnout

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With remote work being the new professional normal, it can be especially challenging to stay productive and separate job stress from our personal lives. When stress is high and maintained over a period of time, it can lead to burnout or a type of work-related stress that can have a myriad of negative effects on your health and productivity.

Those experiencing burnout can suffer from fatigue and mental exhaustion, and it can also lower work performance and cause job dissatisfaction. Over time, burnout can increase your vulnerability to disease and even potentially cost you lost income because of unpaid sick leave or a missed promotion.

As May is Mental Health Awareness Month, it’s important to create healthy work boundaries whether you work remotely or in-office to help prevent the negative effects of burnout. Setting boundaries can be as simple as having a strict time to end work every day and silencing notifications or planning out your vacation days so that you make sure that you have time to recover from stress.

Check out this infographic from Mint to learn more ways to build healthy boundaries between your professional and personal life.

Infographic courtesy Mint

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What lessons did COVID-19 teach your healthcare organization? Use what you learned to improve

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Every hospital administrator, physician and caregiver has been tested and changed by the COVID-19 pandemic. While the challenges your facility faced were no doubt huge and tremendously difficult, there is a positive side to meeting them: You and your teams can now take the lessons you learned while operating through COVID-19 to improve patient care to its highest degree ever — and you can innovate for the future through key steps that will ensure you’re prepared for anything.

Use the following science-based advice for identifying and implementing the changes you need to offer your very best to your community.

Make contingency plans when it comes to clinical trial completion.

A new study by Penn State College of Medicine researchers Nour Hawila and Arthur Berg, “Assessing the impact of COVID-19 on registered interventional clinical trials,” shows that researchers reported difficulty working with patients from April to October 2020 due to lockdowns and cases to the point where study completion rates dropped 13-23%.

This is the perfect time to set up a constructive strategy with your organization’s affiliated researchers and educational partners so that studies will not be interrupted or delayed in the future. Work out ways that trials can be adapted and adjusted via technology so as many participants can work remotely with your teams as feasibly as possible.

Encourage your researchers to think creatively and be flexible; good brainstorming now will ensure their process stays timely and results are accurate and useful whenever the unexpected occurs.

Consider workshare or shift change models to avoid healthcare worker burnout.

Many of your employees may be reevaluating the way they want to be productive after grappling with the stress and intense workloads the pandemic presented. Could new scheduling models help them recover their equilibrium? Look into ways you might spread out staff responsibility, offer shorter workweek options, and allow professionals with administrative duties to do some of their work from home.

Talk to your employees about what changes they feel would most improve their work-life balance — this will allow them to do their best for your patient population.

Avoid antibiotic overuse at admission.

A study from Michigan Medicine finds that, during the pandemic, many hospitalized COVID patients received antibiotics quickly after admission as a preventative measure in case they also had a bacterial infection. However, researchers found that 96.5% of the patients they looked at did not need antibiotics at all.

As part of your facility’s continuing goal not to overprescribe, this is an excellent time to analyze how your doctors determined antibiotic prescription rates during the pandemic and work on an information campaign to reduce unnecessary usage. Make sure your nursing staff is fully involved in giving you crucial feedback about antibiotics for the best real-time data.

Freshly review patients’ overall lifestyles before discharge.

A second Michigan Medicine study, “Sixty Day Outcomes Among Patients Hospitalized With COVID-19,” reveals that life after discharge can present patients with more significant difficulties than you may expect. Two months after discharge, 39% of the patients followed within this research had not resumed normal activities, including 40% who had not returned to work.

Half of these patients reported struggling emotionally, and 37% of these patients reported suffering financially, to the point where they had to ration their food and medicine and had difficulty paying for housing and heat. For patients with any lasting conditions, monitoring these concerns can play a huge role in recovery.

Drawing up a detailed checklist including these COVID-based factors can help your case managers and physicians make better choices for and with patients. It’s also important to schedule timely follow-ups to get feedback directly from each patient on any ongoing problems or concerns. Don’t let them go it alone.

Shore up your supply chain early and often.

COVID taught every hospital administrator that sufficient PPE, meds, and other crucial supplies must be plentiful at all times. Make stocking your facility in a cost-efficient manner one of your top ongoing priorities.

The bottom line: the toughest experiences are the greatest teachers. Use what you have learned to your patients’ best advantage.

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What does the research say about COVID-19 safety protocols in schools?

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I noticed the other day as I walked the halls of my high school that no one follows all the one-way floor stickers we placed all over the building last summer — no one. The funny thing is, no one has been following them at the Demoulas Market Basket grocery store I shop at either. Maybe that’s why the grocery store got rid of them last week. I just told my head custodian to do the same this summer when they do their annual deep clean and waxing of our school floors.

The floor stickers may be one example of a safety protocol that we won’t need this fall, but we know that COVID won’t be gone. The question is, what protocols will we need?

In a recent article, Education Week’s Sarah Sparks reports on “Masks, Tracking, Desk Shields: How Much Do School Measures Reduce Families’ COVID-19 Risk?

She writes, “The number and kind of protections schools put in place now can make a big difference in the risk that those students will bring the illness home to family members, according to a study published last month in the journal Science. Even as more adults and older students become vaccinated, the study suggests no one safety measure will be a silver bullet when it comes to preventing COVID-19.”

The study, published in April, analyzed data from a large online survey in the United States that found increased risk for COVID for individuals who live with a child who attends school in-person. The study went on to note, “School-based mitigation measures are associated with significant reductions in risk, particularly daily symptoms screens, teacher masking, and closure of extra-curricular activities.”

Furthermore, the authors of the study concluded this: “While in-person schooling is associated with household COVID-19 risk, this risk can likely be controlled with properly implemented school-based mitigation measures.”

So, what exactly are the best school-based mitigation measures for COVID? Here are some suggestions that were pointed out in the study which included data from more than 600,000 families attending 130,000 schools. These strategies were associated with the biggest reductions in the risk of family members developing COVID-like symptoms or testing positive for COVID-19.

Daily symptom screenings: Schools should have a process to perform these daily screenings, and also have procedures to make sure that students with symptoms stay home without penalty.

Teacher masking: One reason that I have found as a principal that teacher masking is effective is one you may not think of — the masks serve as a physical reminder to students to take extra precautions to maintain their personal space and practice good hygiene.

Elimination of extra-curricular activities: It can be an unpopular decision or a school to make, but the research showed lower risk of COVID-19 transmission in schools that put the brakes on extra-curricular activities as they are often much more difficult to monitor and enforce health and safety protocols.

Interestingly, the study found almost no benefit to closing playgrounds or using desk shields. The desk shield topic is of particular interest to me as a principal, especially since I spent a fairly hefty price on plexiglass this past summer so that we could manufacture our own desk shields for classroom and lab spaces at my school.

Teachers in the study reported that the shields actually made them have to get closer to students to hear them. They also restrict air flow, which could make the virus stay around longer in the classroom than if the shield wasn’t there in the first place.

There is no doubt that as we enter the summer months and look to the fall, as school leaders we will still be faced with the reality of needing to implement some COVID-mitigating strategies in schools. We aren’t out of the woods yet, but there is light at the end of the tunnel.

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