Manuals for Educators, Parents and Physicians  A Consensus Manual for the Primary Care and Management of Chronic Fatigue Syndrome Suggested Reading Educational A PARENT'S GUIDE TO CFIDS--How to Be an Advocate for Your Child with Chronic Fatigue Immune Dysfunction Syndrome, written by David S. Bell, MD, FAAP, Mary Z. Robinson, MSEd; Jean Pollard, AS; Tom Robinson, MS, CAS; Bonnie Floyd, MA
This is a book that explains the disease and its impact on a child's life. A portion of it deals with educational difficulties, and rights and needs of the children with this disability. Negotiating the Special Education Maze: A Guide for Parents and Teachers by Winifred Anderson, Stephen Chitwood and Deidre Hayden.
________________________ _______________________________ Personal FACES OF CFS, written by David S. Bell, MD, FAAP
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Medical A DOCTOR'S GUIDE TO CHRONIC FATIGUE SYNDROME,written by David S. Bell, MD, FAAP
A Clinician's Guide to Controversial Illnesses CHRONIC FATIGUE SYNDROME FYBROMYALGIA MULTIPLE CHEMICAL SENSITIVITIES by Renee Taylor, Fred Friedburg and Leonard A. Jason
ME The New Plague by Jane Colby Recovering from Chronic Fatigue Syndrome: A Guide to Self-Empowerment by Williem Collinge, M.P.H., PhD. Facing and Fighting Fatigue: A Pratical Approach by Dr. Benjamin Natelson SSI and SSDI The Chronic Fatigue Syndrome: Qualification for Disability Benefits Providing Medical Evidence to the Social Security Administration for Individuals with Chronic Fatigue Syndrome: A GUIDE FOR HEALTH PROFESSIONALS Massachusetts CFIDS Association's Disability Handbook The Americans with Disabilities Act: CFIDS and Employment State Department of Education Web Sites  Find your state. Click on the web site. Look for Special Education or Exceptional Children links. States in Alphabetical Order Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachussetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Educational Rights of the Children with Invisible Disabilities These children face many educational difficulties. The symptoms vary from child to child. They vary in intensity. The symptoms fluctuate at their own pace. The children themselves cannot predict what task they will be able to accomplish from moment to moment. Some of these children's symptoms are severe enough to need special services from their school system. I have provided some links with information dealing with Special Education Laws.  General Wrights Law Special Education Law IDEA Practices Parent Educational Advocacy Training Center Council for Exceptional Children National Information Center for Children and Youth with Disabilities (NICHCY) American Speech-Language-Hearing Association  Invisible Disability Specific Recommended Eligibility Testing for Children witn CFIDS Educational Rights, Responsibilities and Options for YPWCs and Others Assistive Technology Writing Process Inspiration - helps child work through the writing process. For a free thirty day trial version, Reading Text Books on Tape Recording for the Blind and Dyslexic Other Reading Materials on Tape Math Calculator Math Charts Wheelchairs and Ramps  Accommodations Modifications For the Student with CFIDS Three years ago, I developed a workshop focused on CFIDS and the impact on a child's education. (It can easily be applied to FM or any of the Dysautonomia symptoms that apply) I started out presenting a workshop in my own county. I then took it on the road to other states and counties.The attending staff has included school nurses, administrators, related services, social worker, foreign language teachers, P.E. teachers, psychologists and special and regular ed teachers. After the informational portion, the educators were given the tasks of brainstorming, in teams, over case studies of children with CFIDS. They have all been deliberate in their tasks. They took this endeavor seriously and I applaud their efforts. The information below is a compiled list of ideas and suggestions for all the the workshops I've given up to date. Because CFIDS affects each person differently, use what is useful to your child and then discard the rest. If you have other ideas to add to the list, please email me. Putting the Puzzle of CFIDS Together
CFIDS: The Impact of Chronic Fatigue Syndrome on a Child’s Education The student’s disability affects his/her performance in the following areas: Written work (expression, spelling, speed, legibility, copying) Reading skills (decoding, comprehension) Math skills (computation, reasoning) Listening comprehension skills Oral expression skills Attention/concentration for extended time Gross and/or fine motor skills Peer and/or social behaviors Organizational skills Emotional/Behavioral Setting Preferential Seating (easy access to door) Small Group (prevents sensory overload) Homebound services (immune system dysfunction,pain, fatigue) Modified school day (full day, half day, homebound) This is dependent on the severity of the symptoms of the child. Assignments Shortened assignments (focused on mastery, not quantity of problems) Reduced pencil/paper tasks (due to pain in small muscles and joints in hands) Extended Time (fluctuations in disease contradict time limitations) Opportunity to respond orally (when pain in hands is too severe. . . per request) Instruction/Methods Assignment Notebooks (filled out and/or checked by teacher and parents daily) Highlight key words on handouts, notes and study guides Peer Tutor/Helper (to assists with disorientation problems) Frequent/Immediate feedback (necessary to be certain the student is on the right track) Repetition of instruction Student responses on tape (when manual responding is too painful or fatigue too severe ) Additional directions (clarify, repeat, reword) Supplement with visual cues Other
Tape record all lessons (assists in recall and processing deficits) Recorder/Scribe (daily notes provided) Video recorded classes Email assignments to home Materials/Technology Taped Text Books/Materials (visual dysfunction, short-term memory, comprehension) Highlighted Text/Materials (key points on handouts, notes and study guides) Large Print/Magnification (at least 14pt for visual dysfunction) Calculator/Math charts (dyscalcula) Spell Check on assignments (memory) Access to keyboard/word processor (reduces pain from writing) Augmentative Communication Device (when symptoms too severe too speak) Study guides Book with pictures, names, highlighted school map,condition explanation, address and phone number for disorientation issues Yellow sheet (break the glare from fluorescent lights) Assignment Notebook Other Course syllabus (provided so student has plenty of time to work on upcoming projects. Student can also take advantage of up time to get ahead of the down times) Provide ruler or index card (to keep place when reading) Behavior Frequent Breaks (scheduled rest breaks to prevent “crashes”) Quiet Time EXTRA SUGGESTIONS FOR NEEDS RELATED TO CFIDS Study carol (minimize distractions) Second set of books for home (eliminates added pain and fatigue) Laminated hall pass Ice chips or cold water (temperature fluctuations) Wheelchair/Scooter at door Release from classes five minutes early (minimizes sensory disturbances) Eye drops (dry, scratchy eyes) Jacket kept in class (temperature fluctuations) Elevator privileges Classrooms in same area Snack breaks when necessary (nausea, digestive disorders) Mints/gingerale (nausea) Highlighted map (disorientation issues) PE modification, exemption or Physical therapy substituted for P.E. Change of clothing in nurse’s office (abdominal issues) Allowed to have water at desk (throat and orthostatic intolerance issues) NO Cafeteria (sound,motion, odor sensitivities) Allow student to have lunch in a quiet area with a few friends Dim lighting (allow use of sun glasses or brimmed hat) Minimize usage of overhead projector Caution with sciences, cologne usage, cleaning products (chemical sensitivity) Laminated Nurse’s Pass (unlimited usage) Referrals to Related Services (Occupational Therapist, Physical Therapist, Dietitian, Speech-Language Therapist or Assistive Tech for evaluation.) Consider available community resources Alert school nurse in reference to the student Allow to use comfort measure (ice pack, analgesic rub, heat patches) HAVE A CRISIS PLAN IN PLACE FOR THE WORST CASE SCENARIO HOMEBOUND NEEDS Special education teacher preferred. Instruction scheduled at best time of day for child Web cam in classroom to enable the student to have contact with others on regular basis. EVERY STAFF MEMBER WHO COMES IN CONTACT WITH THE CHILD MUST BE INFORMED ENTIRELY ABOUT THE CHILD’S DISEASE. THIS INCLUDES TEACHERS, NURSES, BUS DRIVERS, CUSTODIANS, PARA PROFESSIONALS, OFFICE STAFF AND ADMINISTRATORS. (Because they look fine unless they’re wheelchair bound, they are often overlooked until a crisis arises.) TESTING ACCOMMODATIONS Timing/Scheduling flexible schedule, time, breaks, multiple settings Setting group size: small groups, individual testing, natural lighting Environmental modifications lighting, adaptive furniture, location, preferential seating, hospital/home Presentation visual aids, magnifying glass, templates, masks or markers, by sections not chapters, word banks, multiple choice Font Large print test or increased size answer bubble Directions Assistance with directions reading, simplifying, interpreting, repeating Tape recorder Audio tape version of test items Response mark in booklet or student responds verbally Math aids abacus, math tables, calculator Writing instruments large diameter or pencil grip Word Processor/Typewriter any other assistive tech they use regularly for academic work Spelling aids spell checker, spelling dictionary
Educational Issues for Children with Invisible Disabilities On this page, I have tried to compile a list of sites to aid you in the quest to find methods to help children learn in spite of the disease. Please send any new ideas to me and I'll add it to the document section. CFIDS: Educational Rights, Responsibilities and Options Guidelines for Schools A School's Guide for Students with CFS TEACH-ME: A Sourcebook for Teachers of Children with M.E./CFS/FM Educational Resources for Parents and Educators Learning Disability Educational Ideas Alternative Assessments for Students with Disabilities | This is the resume I use with the school systems for the workshops I give for the education of children with CFS, Lyme, Dysautonomia, and Fibromyalgia. If you are considering approaching your school system about the possibility of me coming to train your staff, you may copy this resume to eliminate an extra step. | | Shanon H. McQuown | | 2005 Harnessing the Wind: Chronic Fatigue Syndrome and My Son, Authorhouse Publishing | | | 1996 - Present Stafford County Public Schools Stafford, VA 22554 Special Education Paraprofessional · Assist students in general education and special education resource room settings ensuring necessary modifications, modifications and adaptations are made to their work and environments to encourage academic success. · Have experience working with children with Learning Disabilities, Traumatic Brain Injuries, Cerebral Palsy, Mild and Moderate Mental Retardation, Autism, Tourettes Syndrome, Attention Deficit and Hyperactivity Disorder, Emotional Disturbances and Deafness. | | | 2002 – present Accessibility Ministry Core Leader/Sign Language Interpreter, Mt Ararat Baptist Church, Stafford, VA 22556 · Insured accessibility to all people with disabilities who had the desire to participate in corporate worship. Helped facilitate special programs to coincide and blend with the functions of the general population in a religious setting · Worked with children and adults with Mental Retardation, Deafness, Blindness, Cerebral Palsy, Autism, and ADHD | | | 1996 – Present Stafford County Public Schools Professional Development: Introduction to Sensory Integration and School Function, Autism Spectrum Disorder Training, Supporting Children with Autism, Behavioral Strategies and Interventions, Handle with Care, Managing the Aggressive Child, PRIDE Level System, Positive Behavior Support, Managing Aggressive Behavior, Crisis Intervention and Functional Behavior Assessment, Learning Disabilities and Social Skills, Strategies to Improve Student Reading, Helping the Struggling Mathematics Learner, Making it Work for the Child with Special Needs, Math and Handwriting Strategies, Assisting Students who Lack Organizational Skills, Accommodations and Modifications for Diverse Student Needs, Organizing the Disorganized Learner, Reasonable and Effective Accommodations, Modifying Curriculum for the Special Needs Child in the Regular Classroom, Working with Students with ADD/ADHD, IEP Procedures, Medical Issues in the Classroom, Independence in Middle and High School, Supported Educational Assistants’ role in the classroom, First Person Language in Special Education, The Twelve Gifts of Self-Esteem, Student Success Begins with Me, Power Point, Power Point Applications 2001 Special Education Coach: Parent Education Advocacy Training Center: Regulations Governing Special Education Programs for Children with Disabilities in Virginia, Methods of Influence, Cultural Perceptions of Disability, Barriers and Bridges to Communication, TEAMS Responsibility, Steps to a Solution 2002 Partners in Policymaking: History of the Disability Movement, Independent Living/Self-Advocacy Movement, Introduction to State Legislature and Advocacy, The Medicaid Maze, IDEA Authorization, Ethical Issues in Advocacy, PATHS, Circles and Person Centered Planning, Creativity and Creative Problem Solving, Special Education Law, Inclusive Education and Media Relations 2002 - 2004 Accessibility Leadership Forum: Structuring for Success, Breaking Down the Barriers, Deaf Ministry – A Ministry of Diversity, Sensory Integration, How to Survive in A Toxic World, Helping Kids Include Kids with Disabilities, Accessing Social Security Benefits to Provide Vocational and Educational Opportunities for People with Disabilities, Managing the Challenging Child in the Classroom 2003- Present Special Education Advisory Committee: Special Education Overview, Transportation as a Related Service, Special Education Rights, The ABC’s of Behavior, Communication Through Visual Supports, IDIEA Overview, Pervasive Developmental Disorder | | | Upon request | | | Shanon's Presentations: CFIDS: The Impact on a Child's Education Visual and Cognitive Dysfunction in CFIDS A Physicians Role in the Education of the Child with CFIDS Invisible Disabilities in Children: CFIDS, FM and Dysautonomia CFIDS and Children  By the year 2000, most people had heard of the disease Chronic Fatigue Syndrome (CFS). Unfortunately, most people still are not aware that children can also get this disease. Those who are aware don't realize the severity of the disease or the impact that it makes on a child's life. The young people with CFS (YPWCs) must sometimes face ridicule and disbelief from the people they naturally turn to for help (parents, physicians, educators, and friends). It is my mission to raise awareness about the disease to lighten the load for the children. National Organizations Focusing on CFIDS The CFIDS Association of America Inc. The National CFIDS Foundation Web Sites Devoted to CFIDS Immune Support Co-Cure General Information on YPWCs Kids with CFS Children, Teens and Young Adults CFIDS in Youth CFS/CFIDS/ME Parent/Teacher Connection Young Action Online My Suggestions This page will always be considered under construction. If you have ideas or suggestions, let me know. I will add things as I think of them. If I think of enough, I'll make each section a separate page. Education 1. Document. Document! DOCUMENT!! Keep record of all meetings, phone conversations, written correspondence, messages and face-to-face interactions. 2. Educate yourself as much as you can about your child's disease and the symptoms that are specific to your child. 3. Provide the staff with the opportunity to become informed about the disease. (pamphlets, brochures, web links, books, videos, etc) 4. Keep communication open between you and the people who are responsible for your child's education. 5. Know that your input is as important as anybody else's on the Child Study, Eligibility or IEP committee. 6. When possible and appropriate, allow your child to take part in the meetings. 7. Have notes ready before each meeting so you can stay focused on the issues that need to be addressed for your child. 8. Have someone go with you to meetings who knows your child well. 9. Learn all you can about your and your child's rights in the education process. (See the State Department of Education section) 10. Stay aware about the implementation of your child's IEP. Once you've got it on paper, you need to make sure it's in effect. Your child's future will be impacted one way or the other. 11. If you have questions, call to speak with the teacher, case manager or administrator before things get out of hand. I don't wear rose colored glasses and my name is not Polyanna. I just wanted to give you a place to start. If these things get you nowhere, the IDEA provides a process for complaint. Medical 1. Keep your own copies of all of your child's records. 2. Share information on research findings, medical journals and articles pertinent to your child's disease with the doctor. 3. Remember nobody knows everything. . . this includes doctors. 4. Don't be afraid to look elsewhere. 5. Remember that no matter what, you and your child are entitled to be treated with respect and compassion. 6. Don't be afraid to ask for a second opinion. 7. Remember that even though you may not have your PhD or MD, you do have your M.O.M or D.A.D.  8. Know the effects and the side effects of each medication. (many of our children are hyper sensitive to certain medications) Personal 1. Listen to how your child feels. Ask and then really listen. 2. Encourage your child to continue to look at his/her goals. Then, together, brainstorm about ways to achieve the goals by going around the disability. 3. Encourage some level of social interaction. 4. Reassure the child that your frustration is not his/her fault. 5. Find a source of support and encouragement for yourself. 6. Let the child know that you accept him/her as he/she is now. (don't put so much emphasis on finding a cause or cure that you neglect the blessing that is in front of you) 7. Never give up hope. 8. Have a plan. (example: This is how we're going to do this if you're not well by then) By doing this, they know there is a chance they may improve. They also know the disease won't completely stop them if they don't) Extra 1. Share your experience with others. 2. Share your information with others. 3. Don't be afraid to ask for help from others who have been or are still where you are. 5. Set aside time to do what gives you pleasure. 6. Find humor in some of the symptoms. (sometimes, all we can do is laugh) 7. Don't forget the rest of the family. 8. See what community services may be available. 9. Always have a "plan B" 10. Remember that God knows how strong you are even if you doubt it at times. He may have plans for you to become an advocate, volunteer, counselor or homebound teacher for these children. Chronic Fatigue Syndrome Advisory Committee (CFSAC) Sixth Meeting I introduce myself as Anthony’s mom because he is why I am here. I have been a paraprofessional for several years in special education, working with children with mild or moderate mental retardation, autism, learning disabilities, and emotional disturbances. I am the core leader of the accessibility ministry at our church for all disabilities. I am trained as a special education coach, which empowers parents to advocate for their own children. I am a member of Partners in Policymaking and I am on the Special Education Advisory Committee for our school system. I am an expert in “Anthonyology.” As adults, we know how difficult it is when we are not capable of going to work because we are sick. However, our children are expected to do their job despite debilitating and devastating effects of CFS. Children are subjected to judgment, ridicule, and humiliation by uninformed educational staff or those who have just enough information to make an incorrect assumption, such as the child is not showing any effort or they are just depressed. These are the people who are responsible for the evaluations and observations that determine a child’s eligibility to access services from the school system. Parents must navigate the medical kingdom and must also vigorously battle through the special education maze. No Child Left Behind includes our children with CFS, but they are being left behind. Educators are unsure how to apply special education criteria to a child with CFS. Since CFS covers such a vast spectrum of symptoms, educators become overwhelmed when trying to construct educational plans. They fail to realize that just because something has never been done, it does not mean that it cannot be done. For example, homebound for more than five hours per week is possible and electives on foreign languages can be taught on homebound. School systems expect physicians to make recommendations for the child’s educational plans. However, physicians are not always aware of the most up-to-date strategies or related services, such as occupational therapy, physical therapy, speech language pathology, or visual aids that are available to the school systems. After working for several years in special education, I was surprised to learn that I would one day have to apply the strategies that I had learned to my own son. I thought that it would go smoothly once my son was diagnosed. However, the process did not go smoothly. I was involved in a two-year battle that included the Virginia Department of Education. I knew what documentation to keep and I knew how to fight the system, because I was trained by that system. What happens to the other children? I was distressed that there were not a lot of modifications available in relation to pediatric CFS. As a result, I developed an educational plan specific to my son’s need and I was vigilant over exemplimentation. I am happy to report that my son’s lowest cumulative grade as a senior is 3.75. Seeing that success, I developed a workshop for educators to help other children. The last half hour of the workshop is devoted to brainstorming in groups over case studies and presenting recommendations. These recommendations are given to the parents, who in turn can present them to the child committee. I have seen these children realize educational success. I want the same available to all of our children with CFS. I have driven people crazy at my son’s school and other schools by asking “what if” and “why not.” If the answer was no, I would ask for it in writing. This approach gets results. Some of my suggestions would be that educational workshops should focus more broadly on the entire school staff (including bus drivers, school psychologists, school nurses, librarians, and special education supervisors), with hands-on application of learned materials. The second recommendation is to inform parents and the Department of Education about CFS in children, their educational needs, how to level the academic playing field. The third recommendation is to develop an outline for parents on how the IDIEA applies to children with CFS. Harnessing the Wind Chronic Fatigue Syndrome and My Son by Shanon McQuown  Author House Publishing http://www.authorhouse.com/BookStore/ItemDetail.aspx?bookid=17261 or you can order it from www.amazon.com, www.target.com or www.barnesandnoble.com Free Preview Early, that summer, we tried to visit the local amusement park. We purchased season tickets on a yearly basis. On first, and only, visit that year, Anthony was only able to walk halfway into the park. He was overcome by pain and weakness in his legs. He was so exhausted that he had to be carried out piggyback by my (then) husband. Anthony has not been back to the park again. It grieves my heart because he used to enjoy the park to the fullest. Now, he couldn’t walk the distance, nor could he tolerate being banged around on the rides. He quietly accepted the circumstances.<o:p></o:p> Anthony began to complain of other symptoms (chest pain, sore throat, muscle and joint pain, headaches and extreme fatigue). He was frequently confused and frustrated when trying to explain his symptoms to his doctor. One day, after the doctor left the examining room, Anthony said to me, “I wish I could go to sleep and never wake up again.” I realized my son was full of despair. When the doctor returned, I told him what Anthony said and was promptly given a referral for Anthony to see a counselor. The counselor was helpful assisting Anthony in facing his fears of medical treatment. Once his digestive problems improved, so did his demeanor. <o:p></o:p> When the new school year rolled around, Anthony attempted to make it to school again. His attendance was suffering. He was too exhausted to make it to school. Yet, he would sleep for an average of anywhere from 13-22 hours in a day. Finally, his teachers, school nurse and school counselor began to get concerned about the things they were observing at school. Anthony was exhausted all of the time. It took extraordinary amounts of time for him to travel between classes. He couldn’t remember to turn in work--even if they had done it together in class. The school nurse would send him home with low-grade fevers and swollen lymph nodes. I was relieved that someone else was seeing that something was wrong. I was truly at my wit’s end. Anthony, at this point, was 5’6” and weighed only appx. 104 lbs. <o:p></o:p> Repeatedly, I took Anthony to Dr. N. (the general practictioner), when the school would send him home. Repeatedly, Dr. N. would berate me for not “making” Anthony go to school. He told me that Anthony “looked fine” to him. I restated the reason that I brought Anthony in. We argued about our difference of opinion. I tried to explain that he didn’t know Anthony. I tried to tell him of the child I knew before he became ill. Again, he told me nothing was wrong with Anthony and I just needed to make him go to school. At this point, I became so angry that tears filled my eyes. Anthony said, “Come on, Mom. Let’s go. I’m fine.” This just made me even madder because I knew Anthony was trying to protect me. I pleaded with God to allow me to “lay hands” on this man. God didn’t allow me to because He knew it wouldn’t have been for the purpose of healing. Instead, I told Dr. N. I did make Anthony go to school and one hour later, they’d call me to come back and pick him up. In what I guess was an attempt at intimidation, Dr. N. announced, “Well, maybe I just need to talk to the school.” I gladly handed him the phone number.<o:p></o:p> Dr. N. never called me after speaking to the school. The next week, after picking Anthony up yet another time from school, we again entered Dr. N’s office. He sneered, I don’t know what devastating disease you think your son has, but he’s fine. I told him that I hoped my son didn’t have a “devastating illness.” By this time, I had become firmly convinced that this man was the spawn of Satan. He mentioned the fact that Anthony had high levels of Ebstein Barr Virus/EBV (virus that causes mono) in his blood. When asked what that meant and if that could have been causing Anthony’s symptoms, he informed me that there was no way to know when Anthony had been infected or how long it would last. Fortunately, I had discovered the Internet. I had entered Anthony’s symptoms into a search engine and was taken to CFS sites. I, then, asked the doctor what he knew about CFS. He told me he’d never heard of a boy Anthony’s age to have it. From the research I’d done, I knew there were others. I just looked at Dr. N. In a condescending tone, he said, “If it will make you feel better, I’ll give him a referral to see an Infectious Disease Specialist. I told him that I would feel better if somebody was doing anything for my child. We were given a referral to see Dr. Bernstein as we left that day. We left the office with limited hope. To Anthony, he was being sent to yet another doctor to poke and prod his body and then tell him nothing was wrong. How do you keep a child from becoming discouraged when those they look to for help ignore what’s happening?<o:p></o:p> When we got home, I talked to Anthony and said something like, “Anthony, you’ve got to learn to be an advocate for yourself. I can’t remember all of your symptoms and you forget by the time we get in the doctors’ offices. We need to make a list of the things that bother you.” We then made a list from head to toe, internal and external. I tried to maintain my composure as that list continued to grow. When we were finally finished, I asked Anthony why he didn’t tell me all of the symptoms before then. He explained that he didn’t know they weren’t normal since some of the symptoms had been with him as long as he could remember. I felt a lump rise in my throat as we addressed his pains. I learned that sometimes, when I hugged my child, I hurt him because his whole body had been hurting (even his skin). <o:p></o:p> 
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