Systematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean

This systematic review and meta-analysis examined 33 studies (N = 2667) conducted in Latin America and the Caribbean (LAC) to identify the clinical and psychosocial factors associated with caregiver burden in dementia. Results showed that neuropsychiatric symptoms, caregiver depression, patient depr...

Full description

Autores:
Quintero Cardona, Paula
Tipo de recurso:
Trabajo de grado de pregrado
Fecha de publicación:
2025
Institución:
Universidad de los Andes
Repositorio:
Séneca: repositorio Uniandes
Idioma:
eng
OAI Identifier:
oai:repositorio.uniandes.edu.co:1992/76318
Acceso en línea:
https://hdl.handle.net/1992/76318
Palabra clave:
Caregiver
Informal caregiver
Burden
Dementia
Carga
Sobre carga
Demencia
Cuidador
Cuidador informal
Psicología
Rights
openAccess
License
https://repositorio.uniandes.edu.co/static/pdf/aceptacion_uso_es.pdf
id UNIANDES2_760cb395a3706d191f5466a1849da603
oai_identifier_str oai:repositorio.uniandes.edu.co:1992/76318
network_acronym_str UNIANDES2
network_name_str Séneca: repositorio Uniandes
repository_id_str
dc.title.eng.fl_str_mv Systematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean
title Systematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean
spellingShingle Systematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean
Caregiver
Informal caregiver
Burden
Dementia
Carga
Sobre carga
Demencia
Cuidador
Cuidador informal
Psicología
title_short Systematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean
title_full Systematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean
title_fullStr Systematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean
title_full_unstemmed Systematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean
title_sort Systematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean
dc.creator.fl_str_mv Quintero Cardona, Paula
dc.contributor.advisor.none.fl_str_mv Báez Buitrago, Sandra Jimena
dc.contributor.author.none.fl_str_mv Quintero Cardona, Paula
dc.contributor.jury.none.fl_str_mv Agudelo Vélez, Diana María
dc.contributor.researchgroup.none.fl_str_mv Facultad de Ciencias Sociales
dc.contributor.seedbeds.none.fl_str_mv Semillero Neurociencia Social
dc.subject.keyword.none.fl_str_mv Caregiver
Informal caregiver
Burden
Dementia
Carga
Sobre carga
Demencia
Cuidador
Cuidador informal
topic Caregiver
Informal caregiver
Burden
Dementia
Carga
Sobre carga
Demencia
Cuidador
Cuidador informal
Psicología
dc.subject.themes.spa.fl_str_mv Psicología
description This systematic review and meta-analysis examined 33 studies (N = 2667) conducted in Latin America and the Caribbean (LAC) to identify the clinical and psychosocial factors associated with caregiver burden in dementia. Results showed that neuropsychiatric symptoms, caregiver depression, patient depression, and the caregiver’s perception of patient quality of life (QoL) were consistently linked to greater burden. In contrast, patient functionality and cognition were not significantly associated unless moderated by caregiver age or sex. Caregiver education emerged as a key moderator in several associations, often intensifying perceived burden. These findings highlight the need for culturally sensitive, emotionally focused interventions tailored to caregivers’ contexts in the region.
publishDate 2025
dc.date.accessioned.none.fl_str_mv 2025-06-17T21:41:13Z
dc.date.available.none.fl_str_mv 2025-06-17T21:41:13Z
dc.date.issued.none.fl_str_mv 2025-06-16
dc.type.none.fl_str_mv Trabajo de grado - Pregrado
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/bachelorThesis
dc.type.version.none.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.coar.none.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.content.none.fl_str_mv Text
dc.type.redcol.none.fl_str_mv http://purl.org/redcol/resource_type/TP
format http://purl.org/coar/resource_type/c_7a1f
status_str acceptedVersion
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/1992/76318
dc.identifier.instname.none.fl_str_mv instname:Universidad de los Andes
dc.identifier.reponame.none.fl_str_mv reponame:Repositorio Institucional Séneca
dc.identifier.repourl.none.fl_str_mv repourl:https://repositorio.uniandes.edu.co/
url https://hdl.handle.net/1992/76318
identifier_str_mv instname:Universidad de los Andes
reponame:Repositorio Institucional Séneca
repourl:https://repositorio.uniandes.edu.co/
dc.language.iso.none.fl_str_mv eng
language eng
dc.relation.references.none.fl_str_mv Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A., & Gornbein, J. (1994). Neuropsychiatric Inventory (NPI) Comprehensive Assessment of Psychopathology in Patients with Dementia.
Galián, C., Rubio, M., Escaroz, G., & Alejandre, F. (2023). Los Sistemas de Cuidado y Apoyo en América Latina y el Caribe: un marco para la acción de UNICEF. In Panamá: UNICEF. Oficina Regional América Latina y el Caribe (p. 52). https://www.unicef.org/lac/media/43746/file/Los%20sistemas%20de%20cuidado%20y%20apoyo%20en%20Am%C3%A9rica%20Latina%20y%20el%20Caribe.pdf
Hedges, L. V., & Olkin, I. (1985). Statistical methods for meta-analysis. Academic Press.
Higgins, J., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M., & Welch, V. (2024). Chapter 10: Analysing data and undertaking meta-analyses. In Cochrane Handbook for Systematic Reviews of Interventions. https://training.cochrane.org/handbook/current/chapter-10
Ibáñez, A., Pina-Escudero, S. D., Possin, K. L., Quiroz, Y. T., Peres, F. A., Slachevsky, A., Sosa, A. L., Brucki, S. M. D., & Miller, B. L. (2021). Dementia caregiving across Latin America and the Caribbean and brain health diplomacy. In The Lancet Healthy Longevity (Vol. 2, Issue 4, pp. e222–e231). Elsevier Ltd. https://doi.org/10.1016/S2666-7568(21)00031-3
Myung, S. K. (2023). How to review and assess a systematic review and meta-analysis article: A methodological study (secondary publication). In Journal of Educational Evaluation for Health Professions (Vol. 20). Korea Health Personnel Licensing Examination Institute. https://doi.org/10.3352/jeehp.2023.20.24
O’Caoimh, R., Calnan, M., Dhar, A., & Molloy, D. W. (2021). Prevalence and Predictors of Caregiver Burden in a Memory Clinic Population. Journal of Alzheimer’s Disease Reports, 5(1), 739–747. https://doi.org/10.3233/ADR-201003
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. In The BMJ (Vol. 372). BMJ Publishing Group. https://doi.org/10.1136/bmj.n71
Pan American Health Organization. (2021). Dementia in Latin America and the Caribbean: A regional strategy and plan of action. PAHO. Organización Mundial de La Salud - Región de Las Américas. https://www.paho.org/es/temas/demencia#:~:text=En%20la%20Regi%C3%B3n%20de%20las%20Am%C3%A9ricas%2C%20m%C3%A1s%20de%2010%20millones,7%2C6%20millones%20en%202030
Sterne, J. A. C., & Harbord, R. M. (2004). Funnel plots in meta-analysis. In The Stata Journal (Vol. 4, Issue 2).
White, I. R., Royston, P., & Wood, A. M. (2011). Multiple imputation using chained equations: Issues and guidance for practice. Statistics in Medicine, 30(4), 377–399. https://doi.org/10.1002/sim.4067
World Health Organization. (2021). Global status report on the public health response to dementia. https://iris.who.int/bitstream/handle/10665/344701/9789240033245-eng.pdf
dc.rights.uri.none.fl_str_mv https://repositorio.uniandes.edu.co/static/pdf/aceptacion_uso_es.pdf
dc.rights.accessrights.none.fl_str_mv info:eu-repo/semantics/openAccess
dc.rights.coar.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
rights_invalid_str_mv https://repositorio.uniandes.edu.co/static/pdf/aceptacion_uso_es.pdf
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.format.extent.none.fl_str_mv 67 páginas
dc.format.mimetype.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidad de los Andes
dc.publisher.program.none.fl_str_mv Psicología
dc.publisher.faculty.none.fl_str_mv Facultad de Ciencias Sociales
dc.publisher.department.none.fl_str_mv Departamento de Psicología
publisher.none.fl_str_mv Universidad de los Andes
institution Universidad de los Andes
bitstream.url.fl_str_mv https://repositorio.uniandes.edu.co/bitstreams/127a605c-07e2-4245-baa8-5d45d089d2b1/download
https://repositorio.uniandes.edu.co/bitstreams/af1aea58-ec6e-4a8f-ae9d-113db02b7070/download
https://repositorio.uniandes.edu.co/bitstreams/9a32d674-3a09-430b-9047-9bfbd023eb89/download
https://repositorio.uniandes.edu.co/bitstreams/6d6d9a52-ea5f-4a5b-a9fe-837a737810fa/download
https://repositorio.uniandes.edu.co/bitstreams/081f3428-6876-4769-a5f7-fff41916015d/download
https://repositorio.uniandes.edu.co/bitstreams/328a8013-1d28-47c3-821d-f6d19f304e2a/download
https://repositorio.uniandes.edu.co/bitstreams/d88f966b-5794-4a8f-b6f3-2b426afef5b2/download
bitstream.checksum.fl_str_mv ae9e573a68e7f92501b6913cc846c39f
bfbf0d043fc3b3ede4c1c545a80df9a3
f8f7fc763df13cb13b61e8cc01130ba4
e0fda0baf4011c25f2c407dcc95bfc40
b87e9723b9186d597c1a797b0a7deaa9
ee502edd2b90295b2b303f2c3a007bc9
3e68dec8f24f95c865bc46be112ba208
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
MD5
MD5
MD5
MD5
repository.name.fl_str_mv Repositorio institucional Séneca
repository.mail.fl_str_mv adminrepositorio@uniandes.edu.co
_version_ 1837005251933110272
spelling Báez Buitrago, Sandra Jimenavirtual::24258-1Quintero Cardona, PaulaAgudelo Vélez, Diana MaríaFacultad de Ciencias SocialesSemillero Neurociencia Social2025-06-17T21:41:13Z2025-06-17T21:41:13Z2025-06-16https://hdl.handle.net/1992/76318instname:Universidad de los Andesreponame:Repositorio Institucional Sénecarepourl:https://repositorio.uniandes.edu.co/This systematic review and meta-analysis examined 33 studies (N = 2667) conducted in Latin America and the Caribbean (LAC) to identify the clinical and psychosocial factors associated with caregiver burden in dementia. Results showed that neuropsychiatric symptoms, caregiver depression, patient depression, and the caregiver’s perception of patient quality of life (QoL) were consistently linked to greater burden. In contrast, patient functionality and cognition were not significantly associated unless moderated by caregiver age or sex. Caregiver education emerged as a key moderator in several associations, often intensifying perceived burden. These findings highlight the need for culturally sensitive, emotionally focused interventions tailored to caregivers’ contexts in the region.Se realizó una revisión sistemática y metaanálisis analizando 33 estudios (N = 2667) realizados en América Latina y el Caribe (ALC) con el objetivo de identificar los factores clínicos y psicosociales asociados a la carga del cuidador en contextos de demencia. Los resultados evidenciaron que los síntomas neuropsiquiátricos, la depresión del cuidador, la depresión del paciente y la percepción del cuidador sobre la calidad de vida (CdV) del paciente se asociaron de manera consistente con una mayor carga. En contraste, la funcionalidad y la cognición del paciente no mostraron asociaciones significativas, salvo cuando estas fueron moderadas por la edad o el sexo del cuidador. La educación del cuidador emergió como un moderador clave en varias de estas relaciones, tendiendo a intensificar la carga percibida. Estos hallazgos subrayan la necesidad de diseñar intervenciones culturalmente sensibles y con enfoque emocional, adaptadas a los contextos específicos de los cuidadores en la región.Pregrado67 páginasapplication/pdfengUniversidad de los AndesPsicologíaFacultad de Ciencias SocialesDepartamento de Psicologíahttps://repositorio.uniandes.edu.co/static/pdf/aceptacion_uso_es.pdfinfo:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Systematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the CaribbeanTrabajo de grado - Pregradoinfo:eu-repo/semantics/bachelorThesisinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/coar/resource_type/c_7a1fTexthttp://purl.org/redcol/resource_type/TPCaregiverInformal caregiverBurdenDementiaCargaSobre cargaDemenciaCuidadorCuidador informalPsicologíaCummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A., & Gornbein, J. (1994). Neuropsychiatric Inventory (NPI) Comprehensive Assessment of Psychopathology in Patients with Dementia.Galián, C., Rubio, M., Escaroz, G., & Alejandre, F. (2023). Los Sistemas de Cuidado y Apoyo en América Latina y el Caribe: un marco para la acción de UNICEF. In Panamá: UNICEF. Oficina Regional América Latina y el Caribe (p. 52). https://www.unicef.org/lac/media/43746/file/Los%20sistemas%20de%20cuidado%20y%20apoyo%20en%20Am%C3%A9rica%20Latina%20y%20el%20Caribe.pdfHedges, L. V., & Olkin, I. (1985). Statistical methods for meta-analysis. Academic Press.Higgins, J., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M., & Welch, V. (2024). Chapter 10: Analysing data and undertaking meta-analyses. In Cochrane Handbook for Systematic Reviews of Interventions. https://training.cochrane.org/handbook/current/chapter-10Ibáñez, A., Pina-Escudero, S. D., Possin, K. L., Quiroz, Y. T., Peres, F. A., Slachevsky, A., Sosa, A. L., Brucki, S. M. D., & Miller, B. L. (2021). Dementia caregiving across Latin America and the Caribbean and brain health diplomacy. In The Lancet Healthy Longevity (Vol. 2, Issue 4, pp. e222–e231). Elsevier Ltd. https://doi.org/10.1016/S2666-7568(21)00031-3Myung, S. K. (2023). How to review and assess a systematic review and meta-analysis article: A methodological study (secondary publication). In Journal of Educational Evaluation for Health Professions (Vol. 20). Korea Health Personnel Licensing Examination Institute. https://doi.org/10.3352/jeehp.2023.20.24O’Caoimh, R., Calnan, M., Dhar, A., & Molloy, D. W. (2021). Prevalence and Predictors of Caregiver Burden in a Memory Clinic Population. Journal of Alzheimer’s Disease Reports, 5(1), 739–747. https://doi.org/10.3233/ADR-201003Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. In The BMJ (Vol. 372). BMJ Publishing Group. https://doi.org/10.1136/bmj.n71Pan American Health Organization. (2021). Dementia in Latin America and the Caribbean: A regional strategy and plan of action. PAHO. Organización Mundial de La Salud - Región de Las Américas. https://www.paho.org/es/temas/demencia#:~:text=En%20la%20Regi%C3%B3n%20de%20las%20Am%C3%A9ricas%2C%20m%C3%A1s%20de%2010%20millones,7%2C6%20millones%20en%202030Sterne, J. A. C., & Harbord, R. M. (2004). Funnel plots in meta-analysis. In The Stata Journal (Vol. 4, Issue 2).White, I. R., Royston, P., & Wood, A. M. (2011). Multiple imputation using chained equations: Issues and guidance for practice. Statistics in Medicine, 30(4), 377–399. https://doi.org/10.1002/sim.4067World Health Organization. (2021). Global status report on the public health response to dementia. https://iris.who.int/bitstream/handle/10665/344701/9789240033245-eng.pdf202121626Publicationhttps://scholar.google.es/citations?user=WLryvYoAAAAJvirtual::24258-10000-0003-0875-1709virtual::24258-138584391-87dc-4841-a0cf-f0b9ea1ec603virtual::24258-138584391-87dc-4841-a0cf-f0b9ea1ec603virtual::24258-1LICENSElicense.txtlicense.txttext/plain; charset=utf-82535https://repositorio.uniandes.edu.co/bitstreams/127a605c-07e2-4245-baa8-5d45d089d2b1/downloadae9e573a68e7f92501b6913cc846c39fMD51ORIGINALSystematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean.pdfSystematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean.pdfapplication/pdf2373977https://repositorio.uniandes.edu.co/bitstreams/af1aea58-ec6e-4a8f-ae9d-113db02b7070/downloadbfbf0d043fc3b3ede4c1c545a80df9a3MD52Formato autorización entrega Tesis de Grado.pdfFormato autorización entrega Tesis de Grado.pdfHIDEapplication/pdf395904https://repositorio.uniandes.edu.co/bitstreams/9a32d674-3a09-430b-9047-9bfbd023eb89/downloadf8f7fc763df13cb13b61e8cc01130ba4MD53TEXTSystematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean.pdf.txtSystematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean.pdf.txtExtracted texttext/plain81502https://repositorio.uniandes.edu.co/bitstreams/6d6d9a52-ea5f-4a5b-a9fe-837a737810fa/downloade0fda0baf4011c25f2c407dcc95bfc40MD54Formato autorización entrega Tesis de Grado.pdf.txtFormato autorización entrega Tesis de Grado.pdf.txtExtracted texttext/plain2023https://repositorio.uniandes.edu.co/bitstreams/081f3428-6876-4769-a5f7-fff41916015d/downloadb87e9723b9186d597c1a797b0a7deaa9MD56THUMBNAILSystematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean.pdf.jpgSystematic review and meta-analysis of factors associated with caregiver burden in dementia in Latin America and the Caribbean.pdf.jpgIM Thumbnailimage/jpeg6916https://repositorio.uniandes.edu.co/bitstreams/328a8013-1d28-47c3-821d-f6d19f304e2a/downloadee502edd2b90295b2b303f2c3a007bc9MD55Formato autorización entrega Tesis de Grado.pdf.jpgFormato autorización entrega Tesis de Grado.pdf.jpgIM Thumbnailimage/jpeg14653https://repositorio.uniandes.edu.co/bitstreams/d88f966b-5794-4a8f-b6f3-2b426afef5b2/download3e68dec8f24f95c865bc46be112ba208MD571992/76318oai:repositorio.uniandes.edu.co:1992/763182025-06-18 04:06:05.015https://repositorio.uniandes.edu.co/static/pdf/aceptacion_uso_es.pdfopen.accesshttps://repositorio.uniandes.edu.coRepositorio institucional Sénecaadminrepositorio@uniandes.edu.coPGgzPjxzdHJvbmc+RGVzY2FyZ28gZGUgUmVzcG9uc2FiaWxpZGFkIC0gTGljZW5jaWEgZGUgQXV0b3JpemFjacOzbjwvc3Ryb25nPjwvaDM+CjxwPjxzdHJvbmc+UG9yIGZhdm9yIGxlZXIgYXRlbnRhbWVudGUgZXN0ZSBkb2N1bWVudG8gcXVlIHBlcm1pdGUgYWwgUmVwb3NpdG9yaW8gSW5zdGl0dWNpb25hbCBTw6luZWNhIHJlcHJvZHVjaXIgeSBkaXN0cmlidWlyIGxvcyByZWN1cnNvcyBkZSBpbmZvcm1hY2nDs24gZGVwb3NpdGFkb3MgbWVkaWFudGUgbGEgYXV0b3JpemFjacOzbiBkZSBsb3Mgc2lndWllbnRlcyB0w6lybWlub3M6PC9zdHJvbmc+PC9wPgo8cD5Db25jZWRhIGxhIGxpY2VuY2lhIGRlIGRlcMOzc2l0byBlc3TDoW5kYXIgc2VsZWNjaW9uYW5kbyBsYSBvcGNpw7NuIDxzdHJvbmc+J0FjZXB0YXIgbG9zIHTDqXJtaW5vcyBhbnRlcmlvcm1lbnRlIGRlc2NyaXRvcyc8L3N0cm9uZz4geSBjb250aW51YXIgZWwgcHJvY2VzbyBkZSBlbnbDrW8gbWVkaWFudGUgZWwgYm90w7NuIDxzdHJvbmc+J1NpZ3VpZW50ZScuPC9zdHJvbmc+PC9wPgo8aHI+CjxwPllvLCBlbiBtaSBjYWxpZGFkIGRlIGF1dG9yIGRlbCB0cmFiYWpvIGRlIHRlc2lzLCBtb25vZ3JhZsOtYSBvIHRyYWJham8gZGUgZ3JhZG8sIGhhZ28gZW50cmVnYSBkZWwgZWplbXBsYXIgcmVzcGVjdGl2byB5IGRlIHN1cyBhbmV4b3MgZGUgc2VyIGVsIGNhc28sIGVuIGZvcm1hdG8gZGlnaXRhbCB5L28gZWxlY3Ryw7NuaWNvIHkgYXV0b3Jpem8gYSBsYSBVbml2ZXJzaWRhZCBkZSBsb3MgQW5kZXMgcGFyYSBxdWUgcmVhbGljZSBsYSBwdWJsaWNhY2nDs24gZW4gZWwgU2lzdGVtYSBkZSBCaWJsaW90ZWNhcyBvIGVuIGN1YWxxdWllciBvdHJvIHNpc3RlbWEgbyBiYXNlIGRlIGRhdG9zIHByb3BpbyBvIGFqZW5vIGEgbGEgVW5pdmVyc2lkYWQgeSBwYXJhIHF1ZSBlbiBsb3MgdMOpcm1pbm9zIGVzdGFibGVjaWRvcyBlbiBsYSBMZXkgMjMgZGUgMTk4MiwgTGV5IDQ0IGRlIDE5OTMsIERlY2lzacOzbiBBbmRpbmEgMzUxIGRlIDE5OTMsIERlY3JldG8gNDYwIGRlIDE5OTUgeSBkZW3DoXMgbm9ybWFzIGdlbmVyYWxlcyBzb2JyZSBsYSBtYXRlcmlhLCB1dGlsaWNlIGVuIHRvZGFzIHN1cyBmb3JtYXMsIGxvcyBkZXJlY2hvcyBwYXRyaW1vbmlhbGVzIGRlIHJlcHJvZHVjY2nDs24sIGNvbXVuaWNhY2nDs24gcMO6YmxpY2EsIHRyYW5zZm9ybWFjacOzbiB5IGRpc3RyaWJ1Y2nDs24gKGFscXVpbGVyLCBwcsOpc3RhbW8gcMO6YmxpY28gZSBpbXBvcnRhY2nDs24pIHF1ZSBtZSBjb3JyZXNwb25kZW4gY29tbyBjcmVhZG9yIGRlIGxhIG9icmEgb2JqZXRvIGRlbCBwcmVzZW50ZSBkb2N1bWVudG8uPC9wPgo8cD5MYSBwcmVzZW50ZSBhdXRvcml6YWNpw7NuIHNlIGVtaXRlIGVuIGNhbGlkYWQgZGUgYXV0b3IgZGUgbGEgb2JyYSBvYmpldG8gZGVsIHByZXNlbnRlIGRvY3VtZW50byB5IG5vIGNvcnJlc3BvbmRlIGEgY2VzacOzbiBkZSBkZXJlY2hvcywgc2lubyBhIGxhIGF1dG9yaXphY2nDs24gZGUgdXNvIGFjYWTDqW1pY28gZGUgY29uZm9ybWlkYWQgY29uIGxvIGFudGVyaW9ybWVudGUgc2XDsWFsYWRvLiBMYSBwcmVzZW50ZSBhdXRvcml6YWNpw7NuIHNlIGhhY2UgZXh0ZW5zaXZhIG5vIHNvbG8gYSBsYXMgZmFjdWx0YWRlcyB5IGRlcmVjaG9zIGRlIHVzbyBzb2JyZSBsYSBvYnJhIGVuIGZvcm1hdG8gbyBzb3BvcnRlIG1hdGVyaWFsLCBzaW5vIHRhbWJpw6luIHBhcmEgZm9ybWF0byBlbGVjdHLDs25pY28sIHkgZW4gZ2VuZXJhbCBwYXJhIGN1YWxxdWllciBmb3JtYXRvIGNvbm9jaWRvIG8gcG9yIGNvbm9jZXIuPC9wPgo8cD5FbCBhdXRvciwgbWFuaWZpZXN0YSBxdWUgbGEgb2JyYSBvYmpldG8gZGUgbGEgcHJlc2VudGUgYXV0b3JpemFjacOzbiBlcyBvcmlnaW5hbCB5IGxhIHJlYWxpesOzIHNpbiB2aW9sYXIgbyB1c3VycGFyIGRlcmVjaG9zIGRlIGF1dG9yIGRlIHRlcmNlcm9zLCBwb3IgbG8gdGFudG8sIGxhIG9icmEgZXMgZGUgc3UgZXhjbHVzaXZhIGF1dG9yw61hIHkgdGllbmUgbGEgdGl0dWxhcmlkYWQgc29icmUgbGEgbWlzbWEuPC9wPgo8cD5FbiBjYXNvIGRlIHByZXNlbnRhcnNlIGN1YWxxdWllciByZWNsYW1hY2nDs24gbyBhY2Npw7NuIHBvciBwYXJ0ZSBkZSB1biB0ZXJjZXJvIGVuIGN1YW50byBhIGxvcyBkZXJlY2hvcyBkZSBhdXRvciBzb2JyZSBsYSBvYnJhIGVuIGN1ZXN0acOzbiwgZWwgYXV0b3IgYXN1bWlyw6EgdG9kYSBsYSByZXNwb25zYWJpbGlkYWQsIHkgc2FsZHLDoSBkZSBkZWZlbnNhIGRlIGxvcyBkZXJlY2hvcyBhcXXDrSBhdXRvcml6YWRvcywgcGFyYSB0b2RvcyBsb3MgZWZlY3RvcyBsYSBVbml2ZXJzaWRhZCBhY3TDumEgY29tbyB1biB0ZXJjZXJvIGRlIGJ1ZW5hIGZlLjwvcD4KPHA+U2kgdGllbmUgYWxndW5hIGR1ZGEgc29icmUgbGEgbGljZW5jaWEsIHBvciBmYXZvciwgY29udGFjdGUgY29uIGVsIDxhIGhyZWY9Im1haWx0bzpiaWJsaW90ZWNhQHVuaWFuZGVzLmVkdS5jbyIgdGFyZ2V0PSJfYmxhbmsiPkFkbWluaXN0cmFkb3IgZGVsIFNpc3RlbWEuPC9hPjwvcD4K