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Alcohol "Overprovision"


Colin
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6th. "A short section of the report summarises the views of users with an alcohol dependency. Some of them said restricting licensing hours so that sales were not permitted until the late afternoon or evening rather than from 10am could help them overcome their alcohol struggles."

 

Its the alcohol talking when anyone with alcohol dependency issues talks, but like everyone else, they're still capable of telling their audience what they think their audience wants to hear, or at worst blaming something/one else to get themselves out of accepting any responsibility or obligation to deal with what is solely their own problem.

 

Folk talking to a Medic about their alcohol "problem", even if they know and accept alcohol is an issue for them that they'd prefer not to have, want the Medic to wave their magic wand, pop them a pill and the "problem" is gone. What they don't want to hear is that its up to them to train themselves, along with suffering whatever withdrawal symptoms they may experience, to have the will power to have only one drink, or two drinks or whatever, then walk away, or be able to stand and stare a full bottle for hours on end and resist the urge to touch it. That's hard painful work, its much easier and more comfortable to point to some obscure and largely irrelevant "reason" instead, and so hopefully move the conversation forward from for them a rather uncomfortable aspect of the subject.

 

Only one person is responsible for someone being a "problem" drinker, and only one person can successfully stop someone being a "problem" drinker, and that's the "problem" drinker themselves. If the NHS has a role to play, its to provide any possible medical solutions that may assist a "problem" drinker who has come to them seeking assistance and has already begun and made measurable progress in addressing their "problem" on their own, and leave the rest of us the hell alone.

 

Don't you just love it, that yet one more time, the "solution" to what the Goverment decides should be a "problem" for an individual ends up in the vast majority being shafted in the name of "helping" a minute few. Many people who the powers that be would consider a "problem" drinker, don't consider it any "problem" at all, they have no interest in living their life ay other way, and don't care what price they pay to continue. Likewise many more "want to have their cake and eat it", and are stuck in this perpetual dilemma of not wanting to be subject to the grip alcohol has over them, but equally enjoying far too much what alcohol does for them, to ever choose one over the other permanently. Neither of those are going to be changed by whatever the NHS says or does, and that doesn't leave just all that many to "benefit" from whatever they do do.

 

 

 

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The report:-
 

Assessing the overprovision of Alcohol Licences in Shetland, and recommendations with regard to protecting and improving public health: Report to Shetland Islands Council Licensing Board

 

Authors:       Elizabeth Robinson, Andy Hayes, Lucy Ward, Karen Smith

Public Health Team, NHS Shetland

 

 

 

Contents:

Introduction

How many licensed premises are there in Shetland?

What statistics are of interest?

a.     Alcohol consumption and dependence

b.     Alcohol related deaths and alcohol related hospital admissions

c.      Police data

What does the academic literature say?

How have other Boards tackled over provision?

What are the views of dependent users of alcohol?

What powers do Licensing Boards have?

Conclusion

Recommendations

 

Introduction

 

The Licensing (Scotland) Act 2005 provided a new emphasis on public health in setting out the five licensing objectives:

(a) preventing crime and disorder,

(B) securing public safety,

© preventing public nuisance,

(d) protecting and improving public health, and

(e) protecting children from harm.

The UK Chief Medical Officers have just published updated alcohol consumption guidelines, following a two year, expert review of the scientific evidence.  https://www.drinkaware.co.uk/alcohol-facts/alcoholic-drinks-units/alcohol-limits-unit-guidelines/

Their guidance makes it clear for the first time that there is no “safe” level of alcohol consumption. Any level of drinking raises the risk of developing a range of cancers including breast, bowel and mouth cancer. Although we have known that alcohol is a carcinogen (cancer causing substance) since the 1980s, the full extent of the link was not recognised in the previous recommended limits which were set out in 1995. There is also now no justification for recommending drinking on health grounds as previous evidence is likely to have over-estimated the protective effects of alcohol for the heart.

Organisations that are concerned about alcohol and public health have welcomed the new guidelines and in particular that attention has been drawn to alcohol-related cancer. Alcohol is responsible for around 12,500 cancer cases a year in the UK, yet only around half of us are aware of the link.  

So, it is well recognised that excessive consumption of alcohol can result in a wide range of health problems.  Some may occur after drinking over a relatively short period, such as acute intoxication (drunkenness) or poisoning (toxic effect).  Others can develop more gradually, only becoming evident after long-term drinking, such as damage to the liver and brain.  In addition to causing physical health problems, excessive alcohol consumption can lead to mental health problems, including dependency.

 

Why is NHS Shetland interested in this?

 

The new Government Guidelines are that neither men nor women should drink more than 14 units per week.  If people do drink up to this limit it is best that they spread it evenly across the week.  So NHS Shetland is not, therefore, just interested in actual drunkenness and the associated public disorder/increased risk of suicide, self-harm, injury and death, but also the longer term effects of moderate consumption of alcohol.

 

Many people are unaware that they routinely drink above these limits and are likely to cause long term damage to themselves, mentally, physically and socially.  The more often that daily limits are exceeded, and the greater the amount exceeded by, the greater the risk of harm.

 

 

 

How many licensed premises are there in Shetland?

Table 1: numbers and types of licensed premises in Shetland and Lerwick

Premises type

Shetland

Lerwick

% of total Shetland number based in Lerwick

Public house

14

6

42%

Restaurant

14

11

78%

Nightclub

1

1

100%

Hotel

20

6

30%

Supermarket

3

2

66%

Off sales/local convenience

42

11

26%

Public halls

39

2

5%

 

The list of alcohol licences in place across Shetland show that most areas have access to alcohol, although there is a higher concentration in Lerwick, as would be expected. 

 

 

 

Table 2: Number of alcohol on and off sales licences by area of Shetland at May 2016

 

On sales

Off sales

On & Off sales

Total

Bressay

1

1

0

2

Burra & Trondra

2

1

0

3

Delting (without Brae)

4

2

2

8

Dunrossness

2

3

3

8

Fetlar

1

0

0

1

Gulberwick, Quarff & Cunningsburgh

3

0

0

3

Lerwick

15

13

11

39

Nesting & Lunnasting

2

2

0

4

Northmavine

3

2

2

7

Sandness & Walls

3

1

0

4

Sandsting & Aithsting

3

2

0

5

Sandwick

0

1

1

2

Scalloway

4

2

0

6

Skerries

1

0

0

1

Tingwall, Whiteness & Weisdale (without Scalloway)

3

2

1

6

Unst

3

4

2

9

Whalsay

3

2

0

5

Yell

5

4

1

10

Papa Stour

0

0

0

0

Foula

0

0

0

0

Fair Isle

0

1

1

2

Brae

3

2

3

8

Shetland total

61

45

27

133

 

 

The Scottish Public Health Observatory (ScotPHO) shows that Shetland is statistically significantly worse[1] than the Scottish average for the number of both personal and premises licences that are in force.  (It is worth noting that many of the on-sales licences are for public halls, and the opening times may be very restricted.)

 

Table 3: The capacity of licensed premises across Shetland is shown below:

Premises Name

Premises Address

Off Sale Capacity

Alex Morrison Shop

Lerwick

14.55

Anderson Butchers Limited

Whiteness

9.77

Andrew Halcrows Shop

Burra Isle

8.67

Aywick Shop Limited

East Yell

10.62

Beervana

Lerwick

68.55

Bigton Community Shop

Bigton

6.00

Bixter Shop (The)

Bixter

6.78

Brae Garage (Shetland) Limited

Brae

4.50

Co-operative Food (Brae)

Brae

30.33

Co-operative Group Limited (Lerwick)

Lerwick

78.00

D & G Leslie

Lerwick

23.67

Da Keg

Dunrossness

29.93

Eid Community Co-op Ltd

Aith

5.55

Grantfield Garage Ltd

Lerwick

3.37

H Henderson

Baltasound

15.00

Hillswick Shop

Hillswick

8.50

J I Herculson (Messrs)

Vidlin

6.76

John Goudie (Messrs)

Virkie

16.10

John Tulloch (Shetland Products) Ltd t/a Hughson Bros

Lerwick

226.10

JWG Plc t/a J W Gray & Co

Lerwick

179.37

JWJ (Whalsay) Ltd

Whalsay

13.50

Lerwick Brewing Company

Lerwick

21.36

Linkshouse Stores Ltd

Mid Yell

7.40

Lochside Stores

Lerwick

15.68

Mail Shop

Bressay

4.79

Mossbank Shop

Mossbank

2.31

Ollaberry Community Enterprises

Ollaberry

7.50

P&T Coaches

Baltasound

12.2

R S Henderson

Yell,

4.00

Robinson & Morrison Ltd

Weisdale

9.50

Sandwick Baking Company Limited

Sandwick

7.04

Scalloway Meat Company Limited

Scalloway

13.00

Skellister Stores

South Nesting

4.00

Skibhoul Stores

Unst

17.21

Stackhoull Stores

Fair Isle

3.00

Staney Hill Shop

Lerwick

12.29

Tagon Stores

Voe

8.88

Tesco Store

Lerwick

182.00

Tetley & Anderson

Whalsay

7.27

The Checkout

Scalloway

14.3

The Shetland Distillery Company

Unst

1.43

Ulsta Shop

Yell

8.40

Universal Stores

Lerwick

2.03

Valhalla Brewery

Unst

8.00

Walls Shop

Walls

5.30

Wine Shop

Lerwick

56.38

 

A map is being developed to show availability and capacity within each area of Shetland. We will note that figures for Lerwick will be distorted by the two wholesalers and larger supermarkets.

What statistics are of interest?

a.Alcohol consumption and dependence

 

Adults:

Chart 1: the percentages of adults drinking at harmful levels in Shetland, Orkney, Western Isles and Scotland.  The figures are taken from the ScotPHO Alcohol Profiles[ii]

 

 

Shetland appears to be the worst of the island boards on a number of measures, although not as bad as Scotland as a whole. (It should be noted that the UK is amongst the worst in the world for dangerous drinking patterns)[iii].  Alcohol sales in Scotland were 20% higher than in England and Wales in 2015. This was mainly due to higher sales of lower priced alcohol through supermarkets and off-licences, particularly spirits. More than twice as much vodka was sold off-sales per adult in Scotland than in England and Wales.[iv]

 

Chart 2: Units of alcohol sold per adult per week, Scotland and England/Wales, 1994-2015

Children & Young People

National surveys are conducted every three to four years to understand the drinking patterns of school children in Scotland.  We are able to break these figures down into island areas.  The Shetland report is reproduced in full in Appendix 1.  Section 4 covers Alcohol Use.

 

Chart 3: Number of pupils aged 15 in Shetland who report drinking alcohol weekly: The Scottish Adolescent Lifestyle and Substance Use Survey (SALSUS)

 

 

In terms of Scotland wide data, SALSUS 2013 reports the following:

 

Pupils were asked whether they had ‘ever had a proper alcohol drink – a whole drink, not just a sip’.  The majority of 13 and 15 year old pupils who had ever had an alcoholic drink reported that they are more likely to obtain alcohol from a relative or a friend;

·         Thirteen year olds who had drunk alcohol were most likely to say that they usually obtained alcohol from a relative (38%) whilst 15 year olds were most likely to get their alcohol from a friend (46%).

·         Almost four out of ten 13 year olds (39%) and almost six out of ten 15 year olds (58%) who had ever drunk alcohol said they had got someone else to buy alcohol for them in the last four weeks.

·         Thirteen year olds most commonly asked their mother, father or carer (33%) to buy them alcohol, followed by an older friend (18%).

·         Among 15 year olds, the most popular response was an older friend (28%), followed by their mother, father or carer (24%).

 

SALSUS data on the alcohol consumption of teenagers is often interpreted as increasing the need to prevent children from entering pubs or buying alcohol.  It is far more likely that the figures are a sign of the availability and affordability of alcohol, given that most of the alcohol that young people are drinking comes from the off-sales trade (via a legal purchase by an adult).

 

 

 

b.Alcohol related deaths and alcohol related hospital admissions

 

Table 4: Alcohol Related Deaths in Shetland 2004-14 – a total of 48 people died of alcohol related conditions during this time, averaging more than 4 per year.

 

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Deaths

6

6

6

6

4

3

9

4

0

1

3

 

 

Chart 4: The number of A&E Admissions to the Gilbert Bain Hospital where Alcohol was involved, over a three year period 2012-15

In summary, between 2012 and 2015, there were:

û Almost 2,000 admissions where alcohol was involved

û 4 fatalities

û 556 discharged to an NHS service or hospital ward

û 28 discharged to the Police Station

An audit of suicides and sudden deaths in Shetland over the last 12 years shows that alcohol is almost always a contributing, if not a causal, factor.  This conclusion is based on a complex auditing process, developed from the UK National Confidential Inquiry into Suicide and Homicide; the data is then used by the National Suicide Register for Scotland.  The audit uses information from GP, Psychiatrist, and Social Work records, alongside toxicology and post mortem reports, and is conducted by a multi-agency group comprising the Medical Director of NHS Shetland, Consultant Psychiatrist, Social Work and Police representatives. We know that the chemical composition of alcohol means that it has a depressant effect on human beings and is also a dis-inhibitor, making risky behaviour more likely.

 

 

 

c.Police data

Table 5: Drunkenness and other disorderly conduct recorded by the police, Shetland Islands, 2010-11 to 2014-15

Crime

2010-11

2011-12

2012-13

2013-14

2014-15

Drunk & incapable and habitual drunkenness

18

22

28

15

7

Drunk & attempting to enter licensed premises

0

1

0

0

1

Disorderly on licensed premises

2

0

1

2

3

Refusing to quit licensed premises

0

4

5

9

5

Consumption of alcohol in designated places, byelaws prohibited

7

12

0

7

5

 

 

Over these 5 years, there were 154 offences.  Of these:

û 90 were drunk and incapable and habitual drunkenness offences (58.4%)

û 31 were consumption of alcohol in designated places, byelaws prohibited offences (20.1%)

û 23 were refusing to quit licensed premises offence (14.9%)

û 8 were disorderly on licensed premises offence (5.2%)

û 2 were drunk and attempting to enter licensed premises (1.3%)

There were 203 alcohol and/or drug related driving offences within Shetland over the last 5 years, an average of 40 per year.  We do not have comparative data for the islands or other areas of Scotland, but we do know that driving while under the influence of alcohol or drugs presents a danger to both self and others.

Chart 5: a comparison between Shetland, Orkney, the Western Isles and Scotland in terms of types of alcohol related offences.

 

 

What does the literature say?

The World Health Organisation (WHO) sees the harmful use of alcohol as one of the most significant public health problems of the world.  In 2010, the World Health Assembly approved a resolution endorsing a global strategy to reduce the harmful use of alcohol. This resolution urges countries to strengthen national responses to public health problems caused by the harmful use of alcohol. The WHO recommends restricting access to retailed alcohol as one of the five key measures to reduce alcohol related harm.

 

Rehm et al,[v] conducted analyses to determine the lifetime risk of alcohol consumption for acute injury and chronic disease. International evidence showed that having four standard drinks on a single occasion more than doubles the risk of an injury in the 6 hours afterwards[vi] and the risk of injury increases by approximately 1.3 times for each additional standard drink.[vii] Moreover, drinking more than two drinks per day increases the lifetime risk of death from an alcohol-related disease by more than 5-fold for men and 6-fold for women. Each standard drink on top of this increases the chance of alcohol-related disease and death in a linear fashion.[viii]

 

Licensing has historically tended to focus on the prevention of antisocial behaviour rather than the protection of health.  Its key instruments were developed to regulate public drinking in pubs, clubs and bars rather than address the challenges of a market in which the off-trade is a significant factor.  There is also a significant challenge in effectively merging the perspectives and practices of licensing and public health: public health considerations tend to concern population-level health and long-term trends, whereas licensing tends to be based on case-by-case decision-making.[ix]

 

Research from the universities of Edinburgh and Glasgow showed that across Scotland alcohol-related hospitalisations and deaths were higher in areas with higher alcohol outlet availability.[x] Reducing the density of alcohol outlets (i.e. the number of alcohol outlets in close proximity) has also been shown to decrease alcohol consumption and harm.  There is also strong evidence to suggest that reducing trading hours (i.e. imposing a curfew on licensed venues) results in a reduction in alcohol purchase and consumption and, subsequently, a reduction in alcohol-related harms.[xi] [xii]

 

Alcohol Focus Scotland tells us that around three-quarters of all alcohol drunk in Scotland is now bought from off-licences – mainly supermarkets. Rather than alcohol being kept for special occasions, it’s become normal to include it as part of the weekly shop and to keep the fridge stocked up. Alcohol has become so embedded in our society that there’s a perception that regular drinking is normal, risk-free, and a good way to de-stress, without the recognition that regularly drinking too much increases the risk of cancer, heart disease and mental health problems. This shift to people drinking at home rather than in the pub has been driven by supermarkets selling alcohol at such low prices that pubs simply can’t compete.[xiii]  The Faculty of Public Health suggests that off-licence sales can potentially increase health related harm due to the fact that home measures are often larger than pub measures and as prices in licensed premises increase, and off-licence prices decrease, more people are drinking at home and therefore potentially drinking a lot more than they think. [xiv]

 

Studies described and reported by Babor et al[xv] consistently show that restrictions on availability are associated with reductions in both alcohol use and alcohol-related problems.

 

How have other Boards tackled over provision?

A legal opinion commissioned by Alcohol Focus Scotland identified overprovision policies as the most obvious control for protecting and improving public health within the legislation.

 

Alcohol Research UK found that, in 2013, ten licensing boards in Scotland had declared overprovision compared to seven in 2010, with five over a large geographical area. However, they noted that almost three quarters of licensing policy statements do not declare overprovision in any areas.[xvi]

 

What are the views of dependent users of alcohol?

 

Research has been undertaken recently with people recovering from alcohol dependency in Aberdeen.  These people recognised arguments about free choice and free-will, but also described the struggles faced daily in trying to overcome alcohol misuse and dependency.  They suggested the following actions as being supportive to people in recovery (and potentially people worrying about their alcohol use):

 

·         Restricting licensing hours would be a big help, if off sales were not permitted until late afternoon or evening rather than from 10 am

·         Most buy alcohol from supermarkets, it is difficult to be in recovery and go about normal daily living tasks if they have to pass the alcohol display. Making it a condition of licences that alcohol is sold in a separate area where people can use the rest of the shop and not enter would be helpful (e.g. the use of aisles at the back of the store away from the tills rather than in the middle of the store)

·         In smaller shops, stopping alcohol from being on display behind the counter

 

 

Conclusion

If we consider that alcohol availability reflects not just the number of outlets selling alcohol but the opening times of outlets, the shelf space dedicated to alcohol (for off-trade) or the capacity (for on-trade)[xvii], there exists a strong argument that there is overprovision of alcohol in Shetland.

In particular we would argue that there is overprovision of off-licences in Lerwick, given the higher risks of harm associated with this type of licence and the density of the outlets.

 

Successful programmes to tackle community and societal drinking have often focused on ‘drinking for the right reasons’; i.e. on special occasions rather than every day, and for quality, taste and enjoyment rather than to drown sorrows or to give confidence.  Venues, (on or off-licences) which demonstrate that they clearly support these aims should be prioritised over those which don’t.

 

We would recommend that the Shetland Licensing Board, over the next 5 years, moves to a clear and well thought out position where a smaller number of off-licences sell limited quantities of alcohol responsibly and at reasonable prices. In particular, consideration should be given to eliminating the availability of low-cost alcohol through local supermarkets.  This may require changes to the law, or it may require brave and challenging conditions to be developed by the Licensing Board.

 

What powers does the Licensing Board have?

 

Section 142 of the Guidance for Licensing Boards, 2007, states that ‘It will not normally be appropriate to arrive at a decision based on one particular factor alone; but rather consideration should be given as to whether aggregated information and evidence from a number of sources points compellingly towards a particular conclusion’.  The information, from a range of sources, presented in this report, points compellingly to the unnecessary and preventable harm associated with the ready availability of alcohol, and its use and misuse in Shetland. In addition, from the 30th September, Licensing Boards can consider the capacity of off sales premises when deciding whether to grant a licence or not.

Once a licence has been granted by the Board to premises that licence will remain in place on the same conditions as when granted whilst the fees are paid and unless it is revoked for a licensing contravention. There is, however, provision in section 27A for the Board to vary conditions where that is necessary or expedient for the purposes of any of the licensing objectives. This amendment was introduced in 2015; is there potential that it could be used to limit licensing hours in the interests of public health? And can it be applied retrospectively i.e. to licences that have already been granted?

Recommendations

We recommend that the Shetland Area Licensing Board should explicitly include in its statement of Licensing Policy the following:

·         That Lerwick is overprovided for in terms of alcohol off-sales licences and capacity; any applications to increase the number of off sales premises licences or off sales capacity in Lerwick should be required to rebut a presumption of overprovision.

And that Shetland Area Licensing Board should implement the following model conditions:

·         Restricting licensing hours, so that off sales are not permitted until late afternoon or evening rather than from 10 am

·         That alcohol should be sold in a separate area so that people can use the rest of the shop and not enter the alcohol sales area (e.g. the use of aisles at the back of the store away from the tills rather than in the middle of the store)

·         That alcohol should not be displayed behind the counter in off-licences, except where alcohol sales are the core business of the premises.

We also ask that consideration should be given as to whether these conditions can be applied retrospectively to premise licences that have already been granted.


[1] The term ‘statistically significant’ refers to the fact that the data is valid – i.e. it is based on large enough numbers to be meaningful.


[v] Rehm J, Room R, Taylor B. Method for moderation: measuring lifetime risk of alcohol-attributable mortality as a basis for drinking guidelines. International Journal Methods Psychiatric Research 2008;17:141–51.

[vi] National Health and Medical Research Council. Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Canberra: NHMRC, Commonwealth of Australia, 2009

[vii] Taylor B, Irving H, Kanteres F, et al. The more you drink, the harder you fall: A systematic review and meta-analysis of how acute alcohol consumption and injury or collision risk increase together. Drug Alcohol Depend 2010;110:108–16.

[viii] National Health and Medical Research Council. Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Canberra: NHMRC, Commonwealth of Australia, 2009.

[x] Richardson, E. Et al CRESH, 2014. : Centre for Research on Environment, Society and Health http://www.alcohol-focus-scotland.org.uk/media/65042/Alcohol-outlet-density-and-harm-report.pdf

 

[xi] Babor T, Caetano R, Casswell S, et al. Alcohol: No Ordinary Commodity. Oxford: Oxford University Press, 2010.

[xii] Chikritzhs T, Gray D, Lyons Z, Saggers S. Restrictions on the Sale and Supply of Alcohol: Evidence and Outcomes. Perth: National Drug Research Institute, Curtin University of Technology, 2007.

[xv] Babor T, Caetano R, Casswell S, et al. Alcohol: No Ordinary Commodity. Oxford: Oxford University Press, 2010.

[xvi] Alcohol Focus Scotland. Review of statements of licensing policy 2013 to 2016. Glasgow: AFS; 2014. Available at: http://www.alcohol-focus-scotland.org.uk/

 

[xvii] https://www.healthscotland.com/uploads/documents/26884-Appendix%20E__Licensing%20act.pdf

Scottish Government. Changing Scotland's Relationship with Alcohol: A Framework for Action. Edinburgh: Scottish Government; 2009. Available at: http://www.gov.scot/Resource/Doc/262905/0078610.pdf

 

Beeston C, Robinson M, Craig N and Graham L. Monitoring and Evaluating Scotland's Alcohol Strategy. Setting the Scene: Theory of change and baseline picture. Edinburgh: NHS Health Scotland; 2011. Available at: http://www.healthscotland.com/documents/5072.aspx

 

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Thanks,

 

Read it (not very carefully,,,  It's early) but it does appear to be somewhat biased to the point where the authors even attempt to "teach their grannies to suck eggs" by reminding(?) them of the "powers they already have".

 

I would suggest that the author(s) have an agenda that stretches beyond their immediate remit.

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Amusingly and, totally unverified (unless someone here knows better), I was told this morning that one of the reports authors is more than a little keen of "partaking light refreshments" and has been seen on occasion lying pissed out of *** skull..   

Could this, I wonder, be one of the people who wished that the off-licence was not open until 5pm? :rofl:

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