ons fundamentals of chemotherapy immunotherapy administration post test

1 / 59. To receive 3.9 nursing contact hours, you must achieve an 80% or higher on the post-test and complete the course evaluation within 180 days. ONS/ONCC Chemotherapy Immunotherapy Certificate 1 hours ago Ons.org Show details . Which of the following classes of agents would you not anticipate to be a part of Mr. Rylan's orders for premedication to prevent CINV? Consider flow of air over the plate with segmented electrical strip heaters as shown in the mentioned example. The Oncology Nursing Society (ONS) is a professional association that represents 100,000 nurses and is the professional home to more than 35,000 members. Pharmacist, Pharmacy tech, MD/DO, qualified RN, Registered Nurses with specialized education, prep and training. Touching any surface that is potentially contaminated with HD residue. What PPE is required for IV Chemotherapy? physics. -breast CA Answer: Resource utilization requires the oncology nurse to evaluate, critique, and mobilize the most appropriate resources to maximize patient outcomes. -only FDA approved for prostate, -identify/attack specific cancer cells, less harm to normal 44 terms. The nurse is reviewing the plan of care with the patient and the palliative care team. All antineoplastic agents used to treat cancer, given through oral and parenteral routes or other routes as specified in the standard, not including hormonal therapies. I am a new-to-oncology nurse and am required to take the ONS/ONCC chemotherapy immunotherapy certification for work. All attempts must be completed before the course closes. Which of the following is of utmost importance to include in your education to Mr. Patterson since he will be receiving HDs at home (continuous 5-FU)? We develop field research tools that enhance productivity and optimize market research values via the use of up to date consumer- oriented technology, in-built strict quality control ONS's position is that nurses who care for patients receiving immunotherapy agents are determined by their respective practice sites to be competent in immunotherapy administration after receiving a fundamental knowledge of principles such as mechanism of action, side effects and management, safe handling, administration considerations, and . The book details the molecular biological aspects of ovarian cancer. Target Audience This course is limited to nurses who took the ONS/ONCC Chemotherapy Immunotherapy Certificate Course and presently hold and desire to maintain a current . Active throughout the cell cycle: Rationale: An example of adaptive or specific immunity is cell-mediated immunity. Fundamentals of Chemotherapy Immunotherapy Administration Reference: Polovich, M., Olsen, M., & LeFebvre, K. The minority of patients with an inadequate response after two vaccinations might benefit from a third vaccination. -ORAL ONLY (Ed.). actually has cancer. -surgery may remove gland that produces hormone Learn how to care for patients with cancer by starting at the beginning. The post test questions are created from course content, which does not include the Recommended Readings. Cancer nursing: Principles and practice (8th ed.). The BMTCN Certification Review Manual is an essential resource for RNs preparing to take the blood and marrow transplant certified nurse (BMTCN) examination. Cancer rehabilitation and survivorship: Transdisciplinary approaches to personalized care. Einnahme your ONS Chemotherapy Immunotherapy Vendor Card and a certificate of added qualification! The answer key follows the set of questions. Mrs. Kearns is receiving her first dose of paclitaxel and about 20 minutes into the infusion, you notice that she begins to start clearing her throat a lot. OCN Study Cards: Test Questions and Oncologic, ONS/ONCC Chemotherapy Immunotherapy Certifica, ONCC Practice Tests (OCN - Treatment Modaliti, ONCC Practice Tests (OCN - Oncologic Emergenc, OCN Practice Questions 2018 (Test-Questions.c, ONCC Practice Tests (OCN - Symptom Management, ONCC Practice Tests (OCN - Psychosocial Dimen, ONCC Practice Tests (OCN - Care Continuum), Julie S Snyder, Linda Lilley, Shelly Collins, Medical Terminology: Learning Through Practice. The UK Oncology Nursing Society Registered Address: First Floor, 10 Queen Street Place, London EC4R 1BE Charity Commission Number: 1136972 Companies House Registration Number: 6996552 VAT Registration Number: 290 7685 64. the Oncology Nursing Society Chemotherapy and Biotherapy Course The Oncology Nursing Society's Chemotherapy and Biotherapy Course provides a comprehensive review of the knowledge needed to administer cytotoxic and biothera-peutic agents. Welcome to the Fundamentals of Chemotherapy Immunotherapy Administration Course. Which statement made by a patient indicates the need for additional teaching regarding the coverage provided by the Family Medical Leave Act? Which of the following do you feel will be done with the remaining cycles of chemotherapy to hopefully prevent Mrs. Turner from having additional problems with neutropenia? Just because they are intravenous agents does not mean that a port is required and needing a port has nothing to do with her being older in age. To date, nursing literature on the progression of and tools used to evaluate chemobrain is limited. -drug-drug interaction - TKIs metabolized by CYP, -TKI -checkpoint inhibitor: PD-1 Fundamentals of Chemotherapy Immunotherapy Administration and Renewal - ONS Help Center. (Eds.). Reference: Polovich, M., Olsen, M., & LeFebvre, K. For example, in neoadjuvant clinical trials using trastuzumab and pertuzumab, the incidence of decline in left ventricular ejection fraction (LVEF) was 1.9% in patients treated with trastuzumab and docetaxel, compared to ______ of those treated with trastuzumab, docetaxel, and pertuzumab (Genentech, 2013). Directions: Each question or incomplete statement below is followed by four suggested answers or completions. What do chemo drugs do to target M phase? What is the velocity of the particle when it is a distance 2d above the sheet? Target Audience This course is limited to nurses anybody have the Fundamentals of Chemotherapy Immunotherapy Administration and presently hold both desired to maintain a electricity . The patient must have had no prior exposure to chemotherapy. -HR+ breast CA professional development. Find the WBC, the polys/neutrophils and bands on your CBC (neutrophils can be called many things in a differential including: polymorphonuclear cells or polys, PMNs, granulocytes, segmented neutrophils, or segs). "In most cases, I can take up to 12 weeks of leave." Disposing of HDs and items contaminated by HDs Two of the agents (docetaxel and carboplatin) that Mrs. Turner will receive are categorized as irritants. Transferring drugs from HD vials to other containers using needles, dispensing pins, or syringes Non-DNA-binding solutions remain in the local area of the extravasation, which improves the possibility of drug deactivation. A particle carrying charge q and having mass m is placed at rest at a distance d above an infinite sheet that has been charged to surface charge density \sigma . -adding chemo drug to regimen, Always administer through free flowing IV, 1. ensure safety of pt and contain the spill Tumor-Infiltrating Lymphocytes Activate Immune Response to Metastatic Breast Cancer, News, Views, and Advocacy From the Oncology Nursing Society, Copyright 2023 Oncology Nursing Society, immunotherapy represents an entirely different category of cancer treatment, not everyone can be considered for immunotherapy, side effects and toxicities greatly depend on the form of immunotherapy, immunotherapy agents are associated with fatigue, immunotherapy-induced fatigue may be a sign of immune-related. 3 immune responses. Collaboration (Eds.). -"quality assurance" test that the cell will be ready to synthesis DNA . Fresh fruits and vegetables can and should be eaten as long as they are washed thoroughly. Coordinating a family meeting is a supportive structure to educate family members, answer questions, and promote communication with the professional health team. Since 1975, ONS has provided a professional community for oncology nurses, developed evidence-based education programs and treatment information, and advocated for patient care, all in an effort to improve the quality of life and outcomes for patients with cancer and their families. OCN Sample Test Questions | ONCC - Oncology Nursing Certification Pittsburgh, PA: Oncology Nursing Society, p. 33. Mosbys oncology nursing advisor: A comprehensive guide to clinical practice (2nd ed.). 54.6 X 10 = 546 Which of the following is a unique side effect that occurs with the agent oxaliplatin? 8 mg twice daily See specific state laws and statutes, How often is chemo competency reassessed>, Annual continuing ed and competency assessment is recommended, -confirm plan with patient -IV push or rapid infusion (15 min) bone marrow activity is decreased, causing less RBC, WBC and Platelets. Other risk factors for the development of colorectal cancer include: FOLFOX6 The Oncology Nursing Society is accredited as a provider of nursing continuing professional development by the . Achieve 80% or higher on the posttest. Other classes of agents like proton pump inhibitors, H2 blockers, and benzodiazepines are utilized for CINV prevention and control as well and sometimes are included as premedications prior to chemotherapy. This is an example of which phase of a clinical trial? You review with Mrs. Turner what the evidence recommends to prevent infections. Reference: Brant, J.M., & Wickham, R.S. Theyre our promise to those who seek care at our facilities that they will be treated by nurses who have demonstrated the knowledge and expertise to provide care in a safe and effective manner, helping to ensure quality outcomes.. -fewer side effects to other treatments, -tyrosine kinase inhibitors (TKIs) Pittsburgh, PA: Oncology Nursing Society, p. 567. Recommended for Practice: -treats: bladder, testes, ovaries, endometrial, lung, squamous cell of head/neck These are some chemotherapy certification courses you may consider: ONCC Chemotherapy Immunotherapy Certificate Course. Per the NCCN Guidelines (http://www.nccn.org/professionals/physician_gls/pdf/myeloid_growth.pdf), because of Mrs. Turner's age 65 as well as a previous neutropenic episode, she would be a candidate to receive a GCSF. Mrs. Turner's ANC is 546, Restriction of fresh fruits and vegetables is no longer necessary based on the evidence (ONS PEP resource Prevention of Infection https://www.ons.org/practice-resources/pep/prevention-infection/prevention-infection-general). Learn vocabulary, terms, and more with flashcards, games, and other study tools. You should call the doctor to provide the results of the MUGA scan compared to her initial MUGA scan and anticipate that the trastuzumab and pertuzumab will be held for this cycle of chemotherapy. (Note: You will have two [2] attempts to achieve a score of 80% or taller on which post-test.) What is the component of vector a along the direction of Upon diagnosis of an invasive ductal adenocarcinoma of the pancreas, the disease will most likely: A patient has an implanted intrathecal pump for pain management. Certification proves youve mastered a broad body of, Sign Into My Account. The intended learner for the certificate course is a nurse who has knowledge of cancer basics and is in a position to regularly administer chemotherapy and . Answer: Breach of duty is defined as failing to perform one's agreement. . permitted if a professional is not available. Breach of duty -prevents/treats CA cells that cant be reached systemically b/c blood brain barrier, localized allergic reaction along a vein caused by irritating drugs, leaving of IV meds into the surrounding tissue, Leaking of IV vesicant meds into SC or subdermal tissues, systemic-inflammatory reaction occurring after the administration of agents that target the immune system and can be life threatening (Eds.). Lincoln Physicians Concord Ma, Evidence-based practice can have positive effects, such as: Smoking This edition's introduction includes timely information on general strategies for drug usage, the science of drug discovery and development, economic and regulatory aspects of cancer drug development, and principles of pharmacokinetics. Diet high in red and processed meats Based on information from Polovich et al., 2005 and manufacturers' prescribing information. Answer: Since a response rate is the primary endpoint of a phase 2 clinical trial, patients entered into these studies must have a specific diagnosis, a good performance status, and minimal prior exposure to chemotherapy (at most 1 or 2 prior regimens). Implantable Gentamycin Sponge does not have cancer despite a positive test result. While there is no requirement for a registered nurse to be certified in chemotherapy before she can work in the oncology field, the Oncology Nursing Society advocates Oncology Advanced Practice Nursing Course Cancer genetics, epidemiology, cancer risk reduction and screening techniques are all covered in this graduate-level oncology class. Preoperative Antibiotics, Prevention of Infections: Practice Recommended, Effectiveness Unlikely: lovelyyadi. To receive nursing continuing professional development (NCPD) contact hours, the following requirements must be met prior to the closing date and time of the course: What is normal cell biology? Opening ampules or HDs Arrange the following terms in order of increasing specialization: oligopotency, pleuripotency, unipotency, multipotency. -anaphylaxis, pre-medicate w/pepcid, benadryl, dex, -Plant alkaloids delayed wound healing will demonstrate knowledge of chemotherapy and immunotherapy administration and safe handling by achieving a post-test score of 80% or more. Welcome to the Fundamentals of Chemotherapy Immunotherapy Administration: McKesson Course. -B lymphocytes (B cells) - make antibodies (bacteria and viruses, most common lymphoma. -Gown: disposable, back closed, long sleeved 1 Mitosis Gap 1 Synthesis Gap 2, Oligodendroglial tumors originate . *tumor angiogenesis - new blood vessels tumors need to grow -Eye & Face: face shield/mask, Chemo BEFORE primary treatment (common in breast and colon), Chemo AFTER primary treatment (common in solid tumor). Estimate the rate of heat transfer from the first and the sixth heater. Tracing the tubing from the patient to the pump. (Eds.). Welcome to the Fundamentals of Chemotherapy Immunotherapy Administration Renewal Course. will demonstrate knowledge of chemotherapy and immunotherapy administration and safe handling by achieving a post-test score of 80% or more. Infusion should be initiated within six hours of extravasation. 5 Intro to Work Performa. (Eds.). -Ironetecan, MOA: modifies the relationship between a tumor and the host immune system, -Initiating new therapy (Eds.). The Fundamental Oncology Nursing Course, Cancer Basics, is Now Available in Spanish. (2011). The dose recommended is based on the patients' body A handful of oncology nursing certifications are currently in use and recommended for RNs working in the various specialties. Give examples of both types. Suboptimal dosing from increasing the length of time between cycles or from dose reduction is a serious issue because large, randomized clinical trials have demonstrated that the delivery of lower doses or shorter courses of chemotherapy can reduce overall survival in older patients with breast cancer or lymphoma, Amgen (2007) defines RDI as "is a quantification of how closely an administered course of chemotherapy treatment adheres to a specific regimen." In addition to appropriate pharmacological management, patients should be taught to eat small, frequent meals to decrease nausea. attack all cells. Verification of carboplatin doses can be daunting if institutional policies are not clear regarding which formula to use under what conditions. (2017). leukemia cutis. Burlington, MA: Jones and Bartlett, p. 121. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family Note. The patient reports a brother has recently been diagnosed with prostate cancer. Laramie Fire Department, Which of the following of Mr. Patterson's lifestyle factors put him at the most risk for developing mucositis? 2. put on protective apparel from spill kit and place chemo bag in waste container - 5-FU (Eds.). Cancer nursing: Principles and practice (8th ed.). Calculate the pH of each of the following solutions: -two practitioners verify: drug name, dose, volume, rate, route, expiration date, appearance Guide to cancer immunotherapy. The nurse must administer an oral medication which she is concerned may be hazardous. ONCC is the premier provider of nationally accredited certification for nurses in oncology and related specialties. 3. hyperuricemia traztuzmab (herceptin) I am working through the course right now and at the end have 2 attempts to pass the exam. Lifetime cumulative dose of doxorubicin is 550 mg/m2 except when patient has received prior chest irradiation or when receiving concomitant cyclophosphamide where the cumulative dose decreases to 450 mg/m2. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology. St. Louis, MO: Elsevier Mosby, p. 412. ONS Answers Your Top Questions About Cancer Immunotherapy -consider risks with gout, -treatment that adds, blocks, removes hormones Tv Show About Kidnapping 2020, The patient's ejection fraction should be tested prior to starting doxorubicin. What do chemo drugs do to target S phase? Resource utilization 5-FU 3,000 mg/m2 IV by continuous infusion over 46 hours. (Note that a function may assume a global extremum at more than one point.) Mr. P. has both a poor diet and also uses tobacco (both chewing tobacco and cigarettes) and alcohol. Need an Account? Likely to Be Effective: 4 PPE should be worn whenever there is a potential that hazardous drugs could be released into the environment like in the following situations: When receiving chemotherapy in the home (in Mr. Patterson..'s case he is getting continuous 5-FU) it is recommended to send the patient home with and instruct them on the use of a spill kit (see Figure 13 from the Guidelines). You review Mrs. Turner's most recent MUGA scan and see that her LVEF is 48%. Adherence to General Infection Control Recommendations -IV, oral, peritoneal What is the shortest phase of the cell cycle? Mrs. Turner's chemotherapy is given every 3 weeks so she should have her LVEF evaluated prior to cycle #3. -part of immune system from stem cells in bone marrow , Both inpatient nurses who administer chemotherapy, as well as nurses new to our oncology units, are paired with preceptors, Mellington says. Fundamentals of Chemotherapy Immunotherapy Administration - Quizlet -30min-2hrs after -- up to 7 days, ONS/ONCC Chemotherapy Immunotherapy Certifica, Chapter 10&11: Researching and Writing Reports, Chemotherapy and Biotherapy Guidelines - ONS, Julie S Snyder, Linda Lilley, Shelly Collins, Industrial Psych Ch. Since 1975, ONS has provided a professional community for oncology nurses, developed evidence-based education programs and treatment . Day 3: 500 mg/m, Extravasation Tx: Anthracyclines --- Daunorubicin, That is the most likely reason that Mrs. Turner was given a port for her treatments. Which of the following related to doxorubicin is most important to include in Mr. Rylan's comprehensive care summary due to potential late effects of this agent? f(x)=2x1,0x1f(x)=2 x-1,0 \leq x \leq 1f(x)=2x1,0x1. NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings The use of tobacco products is a big risk factor for development of mucositis. Eggert, J. Kaposi sarcoma. (2018). International leaders in the field address the critical biologic and basic science issues relevant to the disease. -mimic antibodies in immune system cytokines. -Adjuvant treatment: colorectal, testicular, esophageal, pancreatic, gastric, hepatobillary, ovarian, lymphoma Burlington, MA: Jones and Bartlett, p. 230. (select all that apply), Administering HDs by any route (PO, IV, IT, etc.) Colony-Stimulating Factors Including Biosimilars for At-Risk Patients Why use AUC instead of BSA for carboplatin dosing? The Oncology Nursing Society (ONS) offers chemotherapy competency courses that will prepare the registered nurse for the requirements set by their employer. Neoadjuvant therapy does not increase survival when compared to adjuvant therapy. -high N/V minutes four times daily You decide that you will take another set of vital signs. Statement on the scope and standards of oncology nursing practice: Generalist and advanced practice. It gives an example of oncology nurse job descriptions. Which of the following actions best exemplifies a safe practice? ONS ONCC Chemo Renewal Flashcards | Quizlet Answer: Many patients with stage IIIC ovarian cancer will develop a relapse after successful completion of first line therapies. OCN Sample Test Questions. Cancer Biology | ONS This is an example of which phase of a clinical trial? Add the polys and bands (polys = 22%, bands = 4%). (Eds.). Risk factors for mucositis that are not from the agents themselves include the following: dental disease and poor oral hygiene, ill-fitting dentures, advanced age and youth age, history of alcohol and tobacco use, poor nutrition, intake of irritating foods (spicy or acidic foods), and dehydration (Information from the chemo/bio guidelines page 214-215). Teaching is more effective when it responds to needs identified by the learner. The nurse has collected and analyzed data to identify, monitor, and improve the effectiveness of oncology nursing care. Antiviral Prophylaxis for Select At-Risk Patients Please send requests for written verification to [email protected] and include the nurse's full name and home address. A true positive result from a cancer screening is indicative of which of the following? Practice Test- Chemo Certification. Cells prepare to divide, chemo drugs stop development of elements needed for cell division -interferons, tumor necrosis . -inhibit DNA/RNA synthesis -interferons, ILs, mAbs, Car-t -anthracycline antibiotics -vesicant, monitor cardiac function, can cross the blood-brain barrier -prevent growth of new blood vessels tumors need to grow, -colon, lung, glioblastoma, renal, off label The Foundations of Oncology Nursing Practice Bundle consists ofthree individual courses that will guide you through a progression of topics, starting with an explanation of what cancer is and how it forms, to how its treated, and ends with how to safely administer chemotherapy and immunotherapy. Answer: The goals of research in immunology include the ability to understand how the immune system cells work. -treats: solid tumor, hematologic malignancies (breast, prostate, ovarian, lymphomas) Reference: Brant, J.M., & Wickham, R.S. -urine turns red/orange Covering such topics as multifunctional and multimodal nanoparticles, nanoparticle mediated cancer theranostics, molecular targets for cancer nanotechnology, and nanoparticles for non-invasive image-guided cancer therapy, the volume Oncology nurses can access professional organizations such as ONS to learn more about competency and competency development.. "It is difficult because my time off is unpaid." Chemotherapy and biotherapy guidelines and recommendations for practice (4th ed.). This is very important information for Mr. Rylan to have and provide to his follow-up health care providers. Fundamentals of Chemotherapy Immunotherapy Administration Renewal Constipation, abdominal pain, and paralytic ileus can be seen with vincristine use. The Oncology Nursing Society is . For an interesting comparison, your body contains about 0.5g0.5 \mathrm{~g}0.5g of DNA. -SI and fatigue, -proteins made by WBC and other cells The following (s) is/are examples of cancer vaccines? This course will equip you with the tools you need to safely administer chemotherapy and immunotherapy to your patients with cancer, while providing the type of quality care demanded by your institution. Which of the following medications is the likely cause of Mr. Rylan's constipation? Which course is right available them? -hormones can cause cancers (ovarian, prostate) Handling any HD vials, ampules, or packaging materials The individual: Two of the agents in the patients currecnt regimen, trastuzumab and pertuzumab, have the potential to cause a decline in _____________. It is made up of white blood cells and organs and tissues of the lymph system.. Immunotherapy is a type of biological therapy.Biological therapy is a type of treatment that uses substances made from living organisms to treat cancer. The Oncology Nursing Society is accredited . -defense against foreign organisms, homeostasis (destroy aged cells), surveillance. Reference: Burke, C.C. Fundamentals of Chemotherapy Biotherapy Administration; . From Gaguskis perspective, challenges in competencies often arise when entry-level nurses change clinical settings or newly graduated nurses begin practice. ONS Chemotherapy Immunotherapy Certificate. Potential cost savings. Gain at-a-glance management from one handy reference -- the new second edition of Current Diagnosis and Treatment. Oligodendroglial tumors originate from cells that maintain the function of the: A squamous cell carcinoma of the esophagus is most likely to arise from the: Which of the following techniques is most likely to support healthy communication patterns between the nurse and a patient? A disk and a hoop of the same mass and radius are released at the same time at the top of an inclined plane. (2018). -some affect entire immune system, -drug that blocks some proteins in immune system Pittsburgh, PA: Oncology Nursing Society, p. 61. All patients should be pretreated with corticosteroids, diphenhydramine, and H2 antagonists. Most sources recommend the application of heat using _______________ to help reduce local discomfort and the restart of the peripheral IV in a larger vein (Polovich et al., 2014). Malpractice. -agents activate/suppress function, -lab made antibodies Contact Precautions for Resistant Organisms It can be effective to have a nurse serve as a preceptor with two to five years of experience and strong demonstration of oncology competencies and communication skills. Although hypersensitivity and infusion reactions can occur at any time and potentially with any chemotherapy agent, there are certain agents that have a higher risk of causing a reaction. respite care lasting more than seven days. Face shield Reference: Yarbro, C.H., Wujcik, D., & Gobel, B.H. -can affect treatment, -estrogen receptor antagonist & receptor modulator (Eds.). -IV, TOPICAL The concomitant use of allopurinol can increase the toxicity of the agent, particularly bone marrow depression by decreasing renal excretion. Improving patient outcomes -monitor renal function. This entails learning the complexities of care for patients with cancer, navigating interdisciplinary team work, and integrating safety standards in practice, among a litany of other responsibilities required to deliver evidence-based oncology nursing care. -causes lots of abnormal blood cells to be produced and enter bloodstream. To receive 9 nursing contact hours, you must achieve an 80% or higher on the post-test and complete the course evaluation within 180 days, from date of purchase, after which you will no longer be able to access the course. Develop Your Career | ONS -Kills cancer cells -damage DNA to prevent cancer cells from reproducing actually has cancer. What Is the Process Called When Natural Killer Cells Target Immunoglobulin G-Coated Cells, Resulting in Cell Lysis? kill WBCs. Reference: Newton, S., Hickey, M., & Marrs, J. The courses are on demand. Which of the following is unlikely to be effective for infection prevention? To receive 9 nursing contact hours, you must achieve an 80% or higher on the post-test and complete the course evaluation within 180 days, from date of purchase, after which you will no longer be able to access the course. The estimated glomerular filtration rate (eGFR) is required for the carboplatin dose calculation. (2013). used to increase patient comfort levels. Day 2: 1,000 mg/m2 Class Information for ONS RENEWAL ChemoImmunotherapy Certificate Course. Increased nurse satisfaction. Improving patient outcomes Chimeric - part mouse/part human Can you use verbal orders for chemotherapy? Eligibility includes administering chemotherapy for at least 1 year and at least once a month and this certification provides 15 contact hours. Reference: Polovich, M., Olsen, M., & LeFebvre, K.

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