OneSignalSDK.js

!function(e){var t={};function n(i){if(t[i])return t[i].exports;var r=t[i]={i:i,l:!1,exports:{}};return e[i].call(r.exports,r,r.exports,n),r.l=!0,r.exports}n.m=e,n.c=t,n.d=function(e,t,i){n.o(e,t)||Object.defineProperty(e,t,{configurable:!1,enumerable:!0,get:i})},n.r=function(e){Object.defineProperty(e,"__esModule",{value:!0})},n.n=function(e){var t=e&&e.__esModule?function(){return e.default}:function(){return e};return n.d(t,"a",t),t},n.o=function(e,t){return Object.prototype.hasOwnProperty.call(e,t)},n.p="",n(n.s=91)}([function(e,t,n){"use strict";var i=this&&this.__awaiter||function(e,t,n,i){return new(n||(n=Promise))(function(r,o){function s(e){try{u(i.next(e))}catch(e){o(e)}}function a(e){try{u(i.throw(e))}catch(e){o(e)}}function u(e){e.done?r(e.value):new n(function(t){t(e.value)}).then(s,a)}u((i=i.apply(e,t||[])).next())})},r=this&&this.__generator||function(e,t){var n,i,r,o,s={label:0,sent:function(){if(1&r[0])throw r[1];return r[1]},trys:[],ops:[]};return o={next:a(0),throw:a(1),return:a(2)},"function"==typeof Symbol&&(o[Symbol.iterator]=function(){return this}),o;function a(o){return function(a){return function(o){if(n)throw new TypeError("Generator is already executing.");for(;s;)try{if(n=1,i&&(r=i[2&o[0]?"return":o[0]?"throw":"next"])&&!(r=r.call(i,o[1])).done)return r;switch(i=0,r&&(o=[0,r.value]),o[0]){case 0:case 1:r=o;break;case 4:return s.label++,{value:o[1],done:!1};case 5:s.label++,i=o[1],o=[0];continue;case 7:o=s.ops.pop(),s.trys.pop();continue;default:if(!(r=(r=s.trys).length>0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0)for(var s=0;s0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]=0;i--){n[i]===t&&n.splice(i,1)}},e}();t.WorkerMessengerReplyBuffer=p;var h=function(){function e(e,t){void 0===t&&(t=new p),this.context=e,this.replies=t,this.debug=!0}return e.prototype.broadcast=function(e,t){return i(this,void 0,void 0,function(){var n,i,o,s;return r(this,function(r){switch(r.label){case 0:return u.default.getWindowEnv()===l.WindowEnvironmentKind.ServiceWorker?[3,1]:[2];case 1:return[4,self.clients.matchAll({type:"window",includeUncontrolled:!0})];case 2:for(n=r.sent(),i=0,o=n;i Page] Broadcasting '"+e.toString()+"' to window client "+s.url+"."),s.postMessage({command:e,payload:t});r.label=3;case 3:return[2]}})})},e.prototype.unicast=function(e,t,n){return i(this,void 0,void 0,function(){return r(this,function(i){switch(i.label){case 0:if(u.default.getWindowEnv()!==l.WindowEnvironmentKind.ServiceWorker)return[3,1];if(!n)throw new a.InvalidArgumentError("windowClient",a.InvalidArgumentReason.Empty);return f.default.debug("[Worker Messenger] [SW -> Page] Unicasting '"+e.toString()+"' to window client "+n.url+"."),n.postMessage({command:e,payload:t}),[3,4];case 1:return[4,this.isWorkerControllingPage()];case 2:return i.sent()||f.default.debug("[Worker Messenger] The page is not controlled by the service worker yet. Waiting...",self.registration),[4,this.waitUntilWorkerControlsPage()];case 3:i.sent(),f.default.debug("[Worker Messenger] [Page -> SW] Unicasting '"+e.toString()+"' to service worker."),navigator.serviceWorker.controller.postMessage({command:e,payload:t}),i.label=4;case 4:return[2]}})})},e.prototype.listen=function(e){return i(this,void 0,void 0,function(){return r(this,function(t){switch(t.label){case 0:return d.default.supportsServiceWorkers()?u.default.getWindowEnv()!==l.WindowEnvironmentKind.ServiceWorker?[3,1]:(self.addEventListener("message",this.onWorkerMessageReceivedFromPage.bind(this)),f.default.debug("[Worker Messenger] Service worker is now listening for messages."),[3,3]):[2];case 1:return[4,this.listenForPage(e)];case 2:t.sent(),t.label=3;case 3:return[2]}})})},e.prototype.listenForPage=function(e){return i(this,void 0,void 0,function(){return r(this,function(t){switch(t.label){case 0:return e?[3,3]:[4,this.isWorkerControllingPage()];case 1:return t.sent()||f.default.debug("("+location.origin+") [Worker Messenger] The page is not controlled by the service worker yet. Waiting...",self.registration),[4,this.waitUntilWorkerControlsPage()];case 2:t.sent(),f.default.debug("("+location.origin+") [Worker Messenger] The page is now controlled by the service worker."),t.label=3;case 3:return navigator.serviceWorker.addEventListener("message",this.onPageMessageReceivedFromServiceWorker.bind(this)),f.default.debug("("+location.origin+") [Worker Messenger] Page is now listening for messages."),[2]}})})},e.prototype.onWorkerMessageReceivedFromPage=function(e){var t=e.data;if(t&&t.command){var n=this.replies.findListenersForMessage(t.command),i=[],r=[];f.default.debug("[Worker Messenger] Service worker received message:",e.data);for(var o=0,s=n;o=0;a--){var u=i[a];this.replies.deleteListenerRecord(t.command,u)}for(var c=0,l=r;c=0;a--){var u=i[a];this.replies.deleteListenerRecord(t.command,u)}for(var c=0,l=r;c0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1] to the first element in ."))}},e.getNotificationTypeFromOptIn=function(e){return 1==e||null==e?1:-2},e.wasHttpsNativePromptDismissed=function(){return"dismissed"===d.default.getItem("onesignal-notification-prompt")},e.markHttpPopoverShown=function(){sessionStorage.setItem("ONESIGNAL_HTTP_PROMPT_SHOWN","true")},e.isHttpPromptAlreadyShown=function(){return"true"==sessionStorage.getItem("ONESIGNAL_HTTP_PROMPT_SHOWN")},e.checkAndTriggerNotificationPermissionChanged=function(){return i(this,void 0,void 0,function(){var e,t;return r(this,function(n){switch(n.label){case 0:return[4,c.default.get("Options","notificationPermission")];case 1:return e=n.sent(),[4,OneSignal.getNotificationPermission()];case 2:return t=n.sent(),e===t?[3,5]:[4,l.triggerNotificationPermissionChanged()];case 3:return n.sent(),[4,c.default.put("Options",{key:"notificationPermission",value:t})];case 4:n.sent(),n.label=5;case 5:return[2]}})})},e.getNotificationIcons=function(){return i(this,void 0,void 0,function(){var t,n,i;return r(this,function(r){switch(r.label){case 0:return[4,e.getAppId()];case 1:if(!(t=r.sent()))throw new s.InvalidStateError(s.InvalidStateReason.MissingAppId);return n=u.default.getOneSignalApiUrl().toString()+"/apps/"+t+"/icon",[4,fetch(n)];case 2:return[4,r.sent().json()];case 3:if((i=r.sent()).errors)throw f.default.error("API call %c"+n,l.getConsoleStyle("code"),"failed with:",i.errors),new Error("Failed to get notification icons.");return[2,i]}})})},e.getSlidedownPermissionMessageOptions=function(){var e=OneSignal.config.userConfig.promptOptions;return e?e&&!e.slidedown?e:{actionMessage:e.slidedown.actionMessage,acceptButtonText:e.slidedown.acceptButtonText,cancelButtonText:e.slidedown.cancelButtonText}:null},e.getFullscreenPermissionMessageOptions=function(){var e=OneSignal.config.userConfig.promptOptions;return e?e&&!e.fullscreen?e:{autoAcceptTitle:e.fullscreen.autoAcceptTitle,actionMessage:e.fullscreen.actionMessage,exampleNotificationTitleDesktop:e.fullscreen.title,exampleNotificationTitleMobile:e.fullscreen.title,exampleNotificationMessageDesktop:e.fullscreen.message,exampleNotificationMessageMobile:e.fullscreen.message,exampleNotificationCaption:e.fullscreen.caption,acceptButtonText:e.fullscreen.acceptButton,cancelButtonText:e.fullscreen.cancelButton}:null},e.getPromptOptionsQueryString=function(){var t="";if(e.getFullscreenPermissionMessageOptions())for(var n=e.getPromptOptionsPostHash(),i=0,r=Object.keys(n);i0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]{{prompt.native.grant}}{{prompt.native.grant}} to receive notifications"),this.text["message.action.unsubscribed"]||(this.text["message.action.unsubscribed"]="You won't receive notifications again"),this.text["dialog.main.title"]||(this.text["dialog.main.title"]="Manage Site Notifications"),this.text["dialog.main.button.subscribe"]||(this.text["dialog.main.button.subscribe"]="SUBSCRIBE"),this.text["dialog.main.button.unsubscribe"]||(this.text["dialog.main.button.unsubscribe"]="UNSUBSCRIBE"),this.text["dialog.blocked.title"]||(this.text["dialog.blocked.title"]="Unblock Notifications"),this.text["dialog.blocked.message"]||(this.text["dialog.blocked.message"]="Follow these instructions to allow notifications:"),this._launcher=N,this.state=e.STATES.UNINITIALIZED,this._ignoreSubscriptionState=!1,b.default.emitter.on(e.EVENTS.SUBSCRIBE_CLICK,function(){x.dialog.subscribeButton.disabled=!0,x._ignoreSubscriptionState=!0,b.default.setSubscription(!0).then(function(){return x.dialog.subscribeButton.disabled=!1,x.dialog.hide()}).then(function(){return x.message.display(h.default.TYPES.MESSAGE,x.text["message.action.resubscribed"],h.default.TIMEOUT)}).then(function(){return x._ignoreSubscriptionState=!1,x.launcher.clearIfWasInactive(),x.launcher.inactivate()}).then(function(){return x.updateState()})}),b.default.emitter.on(e.EVENTS.UNSUBSCRIBE_CLICK,function(){x.dialog.unsubscribeButton.disabled=!0,b.default.setSubscription(!1).then(function(){return x.dialog.unsubscribeButton.disabled=!1,x.dialog.hide()}).then(function(){return x.launcher.clearIfWasInactive(),x.launcher.activate()}).then(function(){return x.message.display(h.default.TYPES.MESSAGE,x.text["message.action.unsubscribed"],h.default.TIMEOUT)}).then(function(){return x.updateState()})}),b.default.emitter.on(e.EVENTS.HOVERING,function(){x.hovering=!0,x.launcher.activateIfInactive(),x.message.shown||x.dialog.shown?x.hovering=!1:x.message.contentType!==h.default.TYPES.MESSAGE?new Promise(function(e){if(x.message.queued.length>0)return x.message.dequeue().then(function(t){x.message.content=t,x.message.contentType=h.default.TYPES.QUEUED,e()});x.message.content=c.decodeHtmlEntities(x.message.getTipForState()),x.message.contentType=h.default.TYPES.TIP,e()}).then(function(){return x.message.show()}).then(function(){x.hovering=!1}):x.hovering=!1}),b.default.emitter.on(e.EVENTS.HOVERED,function(){x.message.contentType!==h.default.TYPES.MESSAGE&&x.dialog.hidden&&(x.hovering&&(x.hovering=!1,x.message.waitUntilShown().then(function(){return c.delay(h.default.TIMEOUT)}).then(function(){return x.message.hide()}).then(function(){x.launcher.wasInactive&&x.dialog.hidden&&(x.launcher.inactivate(),x.launcher.wasInactive=null)})),x.message.shown&&x.message.hide().then(function(){x.launcher.wasInactive&&x.dialog.hidden&&(x.launcher.inactivate(),x.launcher.wasInactive=null)}))}),b.default.emitter.on(b.default.EVENTS.SUBSCRIPTION_CHANGED,function(t){return i(x,void 0,void 0,function(){var n,i=this;return r(this,function(r){switch(r.label){case 0:return 1!=t?[3,2]:(this.badge.shown&&this.options.prenotify&&this.badge.hide(),null!==this.dialog.notificationIcons?[3,2]:[4,u.default.getNotificationIcons()]);case 1:n=r.sent(),this.dialog.notificationIcons=n,r.label=2;case 2:return b.default.getNotificationPermission(function(n){i.setState(t?e.STATES.SUBSCRIBED:"denied"===n?e.STATES.BLOCKED:e.STATES.UNSUBSCRIBED,i._ignoreSubscriptionState)}),[2]}})})}),b.default.emitter.on(e.EVENTS.STATE_CHANGED,function(t){x.launcher.element&&(t.to===e.STATES.SUBSCRIBED?x.launcher.inactivate():(t.to===e.STATES.UNSUBSCRIBED||e.STATES.BLOCKED)&&x.launcher.activate())}),b.default.emitter.on(b.default.EVENTS.NATIVE_PROMPT_PERMISSIONCHANGED,function(){x.updateState()}),this.updateState()}}return Object.defineProperty(e,"EVENTS",{get:function(){return{STATE_CHANGED:"notifyButtonStateChange",LAUNCHER_CLICK:"notifyButtonLauncherClick",BELL_CLICK:"notifyButtonButtonClick",SUBSCRIBE_CLICK:"notifyButtonSubscribeClick",UNSUBSCRIBE_CLICK:"notifyButtonUnsubscribeClick",HOVERING:"notifyButtonHovering",HOVERED:"notifyButtonHover"}},enumerable:!0,configurable:!0}),Object.defineProperty(e,"STATES",{get:function(){return{UNINITIALIZED:"uninitialized",SUBSCRIBED:"subscribed",UNSUBSCRIBED:"unsubscribed",BLOCKED:"blocked"}},enumerable:!0,configurable:!0}),Object.defineProperty(e,"TEXT_SUBS",{get:function(){return{"prompt.native.grant":{default:"Allow",chrome:"Allow",firefox:"Always Receive Notifications",safari:"Allow"}}},enumerable:!0,configurable:!0}),e.prototype.showDialogProcedure=function(){var e=this;this.dialog.shown||this.dialog.show().then(function(){c.once(document,"click",function(t,n){e.dialog.element.contains(t.target)||(n(),e.dialog.shown&&e.dialog.hide().then(function(){e.launcher.inactivateIfWasInactive()}))},!0)})},e.prototype.create=function(){return i(this,void 0,void 0,function(){var e,t,n,i,o=this;return r(this,function(r){switch(r.label){case 0:return this.options.enable?[4,b.default.context.dynamicResourceLoader.loadSdkStylesheet()]:[2];case 1:return 0!==r.sent()?(g.default.debug("Not showing notify button because styles failed to load."),[2]):(this.container&&c.removeDomElement("#onesignal-bell-container"),c.addDomElement("body","beforeend",'
'),c.addDomElement(this.container,"beforeend",'
'),c.addDomElement(this.launcher.selector,"beforeend",'
'),c.addDomElement(this.launcher.selector,"beforeend",'
'),c.addDomElement(this.launcher.selector,"beforeend",'
'),c.addDomElement(this.message.selector,"beforeend",'
'),c.addDomElement(this.launcher.selector,"beforeend",'
'),c.addDomElement(this.dialog.selector,"beforeend",'
'),c.addDomElement(this.button.selector,"beforeEnd",''),[4,b.default.isPushNotificationsEnabled()]);case 2:return e=r.sent(),[4,b.default.getSubscription()];case 3:return t=r.sent(),[4,u.default.wasHttpsNativePromptDismissed()];case 4:return n=r.sent(),i=e?"small":this.options.size,[4,this.launcher.resize(i)];case 5:if(r.sent(),"bottom-left"===this.options.position)c.addCssClass(this.container,"onesignal-bell-container-bottom-left"),c.addCssClass(this.launcher.selector,"onesignal-bell-launcher-bottom-left");else{if("bottom-right"!==this.options.position)throw new Error("Invalid OneSignal notify button position "+this.options.position);c.addCssClass(this.container,"onesignal-bell-container-bottom-right"),c.addCssClass(this.launcher.selector,"onesignal-bell-launcher-bottom-right")}if("default"===this.options.theme)c.addCssClass(this.launcher.selector,"onesignal-bell-launcher-theme-default");else{if("inverse"!==this.options.theme)throw new Error("Invalid OneSignal notify button theme "+this.options.theme);c.addCssClass(this.launcher.selector,"onesignal-bell-launcher-theme-inverse")}return this.applyOffsetIfSpecified(),this.setCustomColorsIfSpecified(),this.patchSafariSvgFilterBug(),g.default.info("Showing the notify button."),[4,(e?this.launcher.inactivate():c.nothing()).then(function(){return b.default.getSubscription()}).then(function(t){return!e&&t||null!==o.dialog.notificationIcons?c.nothing():u.default.getNotificationIcons().then(function(e){o.dialog.notificationIcons=e})}).then(function(){return c.delay(o.options.showLauncherAfter)}).then(function(){return c.isUsingSubscriptionWorkaround()&&t&&!0!==n&&!e&&!0===b.default.config.userConfig.autoRegister&&!u.default.isHttpPromptAlreadyShown()?(g.default.debug("Not showing notify button because popover will be shown."),c.nothing()):o.launcher.show()}).then(function(){return c.delay(o.options.showBadgeAfter)}).then(function(){return o.options.prenotify&&!e&&b.default._isNewVisitor?o.message.enqueue(o.text["message.prenotify"]).then(function(){return o.badge.show()}):c.nothing()}).then(function(){return o.initialized=!0})];case 6:return r.sent(),[2]}})})},e.prototype.patchSafariSvgFilterBug=function(){if(!(s.default.safari&&Number(s.default.version)>=9.1)){var e="drop-shadow(0 2px 4px rgba(34,36,38,0.35));",t="drop-shadow(0 2px 4px rgba(34,36,38,0));",n="drop-shadow(0px 2px 2px rgba(34,36,38,.15));";this.graphic.setAttribute("style","filter: "+e+"; -webkit-filter: "+e+";"),this.badge.element.setAttribute("style","filter: "+t+"; -webkit-filter: "+t+";"),this.dialog.element.setAttribute("style","filter: "+n+"; -webkit-filter: "+n+";")}s.default.safari&&this.badge.element.setAttribute("style","display: none;")},e.prototype.applyOffsetIfSpecified=function(){var e=this.options.offset;e&&(this.launcher.element.style.cssText="",e.bottom&&(this.launcher.element.style.cssText+="bottom: "+e.bottom+";"),"bottom-right"===this.options.position?e.right&&(this.launcher.element.style.cssText+="right: "+e.right+";"):"bottom-left"===this.options.position&&e.left&&(this.launcher.element.style.cssText+="left: "+e.left+";"))},e.prototype.setCustomColorsIfSpecified=function(){var e=this.dialog.element.querySelector("button.action"),t=this.button.element.querySelector(".pulse-ring");this.graphic.querySelector(".background").style.cssText="";for(var n=this.graphic.querySelectorAll(".foreground"),i=0;i0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0))for(var n=0,i=t.buttons;n0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]OneSignal: This page cannot be directly opened, and must be opened as a result of a subscription call."),[2,Promise.resolve()]):((e=i({},this.options)).appId=e.appId,e.subdomainName=e.subdomain,e.origin=e.origin,OneSignal.config=e||{},[4,(new c.default).getAppConfig(e)]);case 1:return t=r.sent(),OneSignal.context=new u.default(t),OneSignal.context.workerMessenger.listen(!0),OneSignal.initialized=!0,this.loadPromise={},this.loadPromise.promise=new Promise(function(e,t){n.loadPromise.resolver=e,n.loadPromise.rejector=t}),this.establishCrossOriginMessaging(),[2,this.loadPromise.promise]}})})},e.prototype.establishCrossOriginMessaging=function(){},e.prototype.dispose=function(){this.messenger.destroy()},e.prototype.finishInitialization=function(){this.loadPromise.resolver()},e.prototype.subscribe=function(){return r(this,void 0,void 0,function(){var e,t;return o(this,function(n){switch(n.label){case 0:return[4,OneSignal.isPushNotificationsEnabled()];case 1:return e=n.sent(),t=opener||parent,e?t&&window.close():a.default.registerForPush(),[2]}})})},e}();t.default=l},function(e,t,n){"use strict";var i,r,o;Object.defineProperty(t,"__esModule",{value:!0}),(i=t.ConfigIntegrationKind||(t.ConfigIntegrationKind={})).TypicalSite="typical",i.WordPress="wordpress",i.Shopify="shopify",i.Blogger="blogger",i.Magento="magento",i.Drupal="drupal",i.SquareSpace="squarespace",i.Joomla="joomla",i.Weebly="weebly",i.Wix="wix",i.Custom="custom",(r=t.NotificationClickMatchBehavior||(t.NotificationClickMatchBehavior={})).Exact="exact",r.Origin="origin",(o=t.NotificationClickActionBehavior||(t.NotificationClickActionBehavior={})).Navigate="navigate",o.Focus="focus"},function(e,t,n){"use strict";var i=this&&this.__importDefault||function(e){return e&&e.__esModule?e:{default:e}};Object.defineProperty(t,"__esModule",{value:!0});var r=n(1),o=i(n(6)),s=i(n(2)),a=i(n(35)),u=function(){function e(e,t,n,i,r,o,s){void 0===i&&(i="shown"),void 0===r&&(r=["opacity","transform"]),void 0===s&&(s=500),this.selector=e,this.showClass=t,this.hideClass=n,this.state=i,this.targetTransitionEvents=r,this.nestedContentSelector=o,this.transitionCheckTimeout=s}return e.prototype.show=function(){var t=this;return this.hidden?new Promise(function(n){if(t.state="showing",o.default.trigger(e.EVENTS.SHOWING,t),t.hideClass&&r.removeCssClass(t.element,t.hideClass),t.showClass&&r.addCssClass(t.element,t.showClass),0==t.targetTransitionEvents.length)return n(t);var i=setTimeout(function(){s.default.debug("Element did not completely show (state: "+t.state+").")},t.transitionCheckTimeout);r.once(t.element,"transitionend",function(s,a){if(s.target===t.element&&r.contains(t.targetTransitionEvents,s.propertyName))return clearTimeout(i),a(),t.state="shown",o.default.trigger(e.EVENTS.SHOWN,t),n(t)},!0)}):Promise.resolve(this)},e.prototype.hide=function(){var t=this;return this.shown?new Promise(function(n){if(t.state="hiding",o.default.trigger(e.EVENTS.HIDING,t),t.showClass&&r.removeCssClass(t.element,t.showClass),t.hideClass&&r.addCssClass(t.element,t.hideClass),0==t.targetTransitionEvents.length)return n(t);r.once(t.element,"transitionend",function(i,a){var u=setTimeout(function(){s.default.debug("Element did not completely hide (state: "+t.state+").")},t.transitionCheckTimeout);if(i.target===t.element&&r.contains(t.targetTransitionEvents,i.propertyName))return clearTimeout(u),a(),t.state="hidden",o.default.trigger(e.EVENTS.HIDDEN,t),n(t)},!0)}):Promise.resolve(this)},e.prototype.waitUntilShown=function(){var t=this;return"shown"===this.state?Promise.resolve(this):new Promise(function(n){a.default.emitter.once(e.EVENTS.SHOWN,function(e){if(e===t)return n(t)})})},e.prototype.waitUntilHidden=function(){var t=this;return"hidden"===this.state?Promise.resolve(this):new Promise(function(n){a.default.emitter.once(e.EVENTS.HIDDEN,function(e){if(e===t)return n(t)})})},Object.defineProperty(e,"EVENTS",{get:function(){return{SHOWING:"animatedElementShowing",SHOWN:"animatedElementShown",HIDING:"animatedElementHiding",HIDDEN:"animatedElementHidden"}},enumerable:!0,configurable:!0}),Object.defineProperty(e.prototype,"content",{get:function(){return this.nestedContentSelector?this.element.querySelector(this.nestedContentSelector).innerHTML:this.element.innerHTML},set:function(e){this.nestedContentSelector?this.element.querySelector(this.nestedContentSelector).innerHTML=e:this.element.innerHTML=e},enumerable:!0,configurable:!0}),Object.defineProperty(e.prototype,"element",{get:function(){return 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Date).getTime()>=t.expirationTime||(new Date).getTime()>=o)]}})})},e.prototype.getSubscriptionState=function(){return i(this,void 0,void 0,function(){var t,n,i,o;return r(this,function(r){switch(r.label){case 0:if(e.isSafari())return[2,this.getSubscriptionStateForSecure()];switch(t=y.default.getWindowEnv(),t){case v.WindowEnvironmentKind.ServiceWorker:return[3,1]}return[3,4];case 1:return[4,self.registration.pushManager.getSubscription()];case 2:return n=r.sent(),[4,S.default.getSubscription()];case 3:return i=r.sent().optedOut,[2,{subscribed:!!n,optedOut:i}];case 4:return[4,y.default.getIntegration()];case 5:switch(o=r.sent(),o){case P.IntegrationKind.Secure:return[3,6];case P.IntegrationKind.SecureProxy:return[3,7];case P.IntegrationKind.InsecureProxy:return[3,11]}return[3,13];case 6:return[2,this.getSubscriptionStateForSecure()];case 7:switch(t){case v.WindowEnvironmentKind.OneSignalProxyFrame:case v.WindowEnvironmentKind.OneSignalSubscriptionPopup:case v.WindowEnvironmentKind.OneSignalSubscriptionModal:return[3,8]}return[3,9];case 8:return[2,this.getSubscriptionStateForSecure()];case 9:return[4,OneSignal.proxyFrameHost.runCommand(OneSignal.POSTMAM_COMMANDS.GET_SUBSCRIPTION_STATE)];case 10:return[2,r.sent()];case 11:return[4,this.getSubscriptionStateForInsecure()];case 12:return[2,r.sent()];case 13:throw new a.InvalidStateError(a.InvalidStateReason.UnsupportedEnvironment)}})})},e.prototype.getSubscriptionStateForSecure=function(){return i(this,void 0,void 0,function(){var t,n,i,o,s,a,u,c,l;return r(this,function(r){switch(r.label){case 0:return[4,S.default.getSubscription()];case 1:return t=r.sent(),n=t.deviceId,t.subscriptionToken,i=t.optedOut,e.isSafari()?(o=window.safari.pushNotification.permission(this.config.safariWebId),[2,{subscribed:!("granted"!==o.permission||!o.deviceToken||!n),optedOut:i}]):[4,this.context.serviceWorkerManager.getActiveState()];case 2:return s=r.sent(),[4,navigator.serviceWorker.getRegistration()];case 3:return a=r.sent(),[4,this.context.permissionManager.getNotificationPermission(this.context.appConfig.safariWebId)];case 4:return u=r.sent(),c=s===E.ServiceWorkerActiveState.WorkerA||s===E.ServiceWorkerActiveState.WorkerB,a?[4,a.pushManager.getSubscription()]:[2,{subscribed:!1,optedOut:i}];case 5:return l=r.sent(),[2,{subscribed:!!(l&&n&&u===h.NotificationPermission.Granted&&c),optedOut:i}]}})})},e.prototype.getSubscriptionStateForInsecure=function(){return i(this,void 0,void 0,function(){var e,t,n,i,o;return r(this,function(r){switch(r.label){case 0:return[4,S.default.getSubscription()];case 1:return e=r.sent(),t=e.deviceId,n=e.subscriptionToken,i=e.optedOut,[4,this.context.permissionManager.getNotificationPermission(this.context.appConfig.safariWebId)];case 2:return o=r.sent(),[2,{subscribed:!(!t||!n||o!==h.NotificationPermission.Granted),optedOut:i}]}})})},e.prototype.registerFailedSubscription=function(e,t){return i(this,void 0,void 0,function(){return r(this,function(n){return 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e>0?t.bell.badge.show():Promise.resolve(t)}).then(e(n)):(t.bell.badge.decrement(),e(n))})},t}(a.default);t.default=l},function(e,t,n){"use strict";var i=this&&this.__assign||Object.assign||function(e){for(var t,n=1,i=arguments.length;n0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]=63&&(a.default.tablet||a.default.mobile)?[4,OneSignal.privateShowHttpPrompt()]:[3,8];case 7:return n.sent(),[3,10];case 8:return[4,y.default.registerForPush()];case 9:n.sent(),n.label=10;case 10:return[3,12];case 11:OneSignal._sessionInitAlreadyRunning=!1,n.label=12;case 12:return[3,16];case 13:return!0!==OneSignal.config.userConfig.autoRegister&&A.default.debug("OneSignal: Not automatically showing popover because autoRegister is not specifically true."),S.default.isHttpPromptAlreadyShown()&&A.default.debug("OneSignal: Not automatically showing popover because it was previously shown in the same 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Powered by OneSignal
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  2. Click Site settings under Advanced.
  3. Click Notifications.
  4. Find and click this entry for this website.
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loading...

Dr Google i porady on-line


Coraz częściej do gabinetów lekarskich przychodzą pacjenci z kompletem badań i postawioną przez siebie diagnozą. Szeroko reklamowane są porady on-line. Ale uwaga – nic nie zastąpi bezpośredniego spotkania z lekarzem. Dowiedz się dlaczego.

Dr Google i porady on-line
zdjęcie ilustracyjne: pixabay


„Mimo dużego znaczenia diagnostycznego oglądania chorych niektórzy młodsi lekarze zaniedbują tę najprostszą, lecz trudną do opanowania metodę badania. Poddając się urokowi nowoczesnej aparatury, podczas obchodów szczegółowo oglądają i interpretują wyniki rozmaitych badań dodatkowych, nieraz nie zauważając u chorego np. nierówności źrenic lub zmian skórnych widocznych na już na pierwszy rzut oka” – ubolewał w podręczniku „Podstawy ogólnej diagnostyki klinicznej” Feliks Bolechowski.
Książka jest stara – z 1985 roku, ale nadal podstawą postawienia diagnozy w medycynie jest dokładny wywiad, czyli rozmowa z pacjentem i dokładne badanie przedmiotowe (czyli oględziny całego ciała pacjenta, opukiwanie, osłuchiwanie itp.). Testy z krwi, badania obrazowe itd. nie bez przyczyny wciąż noszą miano „dodatkowych”.

Po pierwsze: rozmowa


- Tu uczymy studentów, żeby przeprowadzali z pacjentem dokładny wywiad na temat wielu obszarów stanu zdrowia chorego, które są potencjalnie powiązane z jego głównym problemem zdrowotnym – mówi prof. Artur Mamcarz, kardiolog, szef III Kliniki Chorób Wewnętrznych i Kardiologii WUM.
Nie należy zatem się dziwić, że lekarz pyta na przykład, czy w domu są zwierzęta i jakie. Mogą alergizować, mogą przenosić choroby odzwierzęce. Istotną informacją dla lekarza jest styl życia pacjenta – co zwykle jada, czy ma stresującą pracę, czy nie. Ważne jest, kiedy pacjent zauważył jakieś niepokojące objawy, w jakich okolicznościach, na jakie choroby chorowali jego bliscy.
- Jest wiele chorób, w których dobrze zebrany wywiad, kilka pytań uprawdopodabnia rozpoznanie niemal w 100 proc. Tak jest w refluksie, chorobie wieńcowej, w wielu przewlekłych chorobach, a nawet czasem w cukrzycy.

Badanie przedmiotowe

Studentów uczy się, że pacjenta bada się od samego jego wejścia do gabinetu. Istotnymi wskazówkami diagnostycznymi jest to, jak się porusza, jak mówi, jaki ma wyraz twarzy.
- Na przykład wchodzi pacjent z wytrzeszczem ocznym. On może o nim  nie wiedzieć, ponieważ nie jest to zwykle coś, co pojawia się z dnia na dzień. Taki wytrzeszcz może być też cechą stałą jego wyglądu, niewynikającą z choroby. Lekarz widząc takiego pacjenta, pyta, czy jego oczy zawsze tak wyglądały. I pacjent odpowiada: „No właśnie ostatnio mi zwrócono na to uwagę”. Albo mówi: „Nie, taka moja natura”. W takich sytuacjach warto jednak obejrzeć stare zdjęcie z dowodu – opowiada prof. Mamcarz.
Pojawienie się wytrzeszczu oczu to objaw kilku chorób, na przykład nadczynności tarczycy.
- Pacjenci czasem cieszą się, że nie mogli schudnąć i nagle im się udało. Trzeba o tym mówić lekarzowi, bo nagłe schudnięcie to sygnał alarmowy wielu chorób nowotworowych, ale też nadczynności tarczycy – dodaje.
Badanie przedmiotowe polega na tym, że lekarz ogląda ciało całego pacjenta, opukuje, osłuchuje, bada palpacyjnie, ocenia odległości między poszczególnymi częściami ciała (np. szerokość klatki piersiowej), ogląda skórę, wypatrując, czy nie jest zbyt wilgotna, czy zbyt sucha, czy nie ma owrzodzeń czy ran.
- Lekarz powinien podczas wizyty pacjenta obejrzeć go w całości, bo badanie polega na tym, by zbadać całego pacjenta – podkreśla prof. Mamcarz
Zaznacza, że jeśli pacjent przychodzi z bólem brzucha, to jego przyczyn może być wiele. Dlatego warto mierzyć ciśnienie tętnicze i informacja o jego wartości jest cenną wskazówką.
- Jak ktoś ma bóle brzucha, to nie znaczy wcale, że nie ma wysokiego ciśnienia. Może brzuch boli go właśnie z powodu zmian miażdżycowych w tętnicach brzusznych. Niekoniecznie ma na przykład refluks, choć częściej na pewno pacjent zgłaszający się z bólami brzucha będzie miał refluks niż nadciśnienie i miażdżycę. Trzeba to jednak sprawdzić – tłumaczy profesor.
Jest trochę zirytowany pytaniami o przydatność wywiadu i badania przedmiotowego pacjenta.
– Przecież to oczywiste! – mówi. - Dokładne badanie przedmiotowe i wywiad pozwalają też na to, by pacjent nie chodził na tysiące badań dodatkowych, marnując czas. Mam do czynienia z takimi pacjentami, którzy przychodzą z plikiem badań i proszą o pomoc czy wręcz leczenie, bo na ich podstawie stwierdzili, że coś konkretnego im dolega.
Ale ostrzega – to może być fałszywy trop.
Przypomina sobie nastolatka – piłkarza-juniora, który z bólem w klatce piersiowej zgłosił się do niego razem z matką. Ból powodował zadyszkę, męczliwość, co młodego piłkarza martwiło, bo trener nie wystawiał go w meczach. Matka zrobiła na własny koszt wiele badań: morfologię krwi, EKG, próbę wysiłkową itp. Nie wykazywały istotnych odchyleń.
- Zebrałem wywiad. Okazało się, że bóle pojawiły się po meczu, podczas którego kolega przy wyskoku dotknął go łokciem w klatkę piersiową. To było źródło problemu - miał złamane żebro. Oczywiście potwierdziliśmy złamanie zdjęciem RTG. Gdyby ten chłopak przyszedł następnego dnia po urazie, to każdy lekarz, który by go zbadał, oczywiście przestrzegając sztuki lekarskiej, a więc oglądając dokładnie całe ciało, zobaczyłby uraz. Pacjenci, którzy nie są lekarzami, niech z problemem zdrowotnym idą do lekarza, a nie próbują na własną rękę się diagnozować. Będzie szybciej, taniej i bezpieczniej. Ten chłopak miał sporo szczęścia – to złamane żebro mogło mu przebić opłucną podczas treningu.

Dowody naukowe, wytyczne i… sztuka

W medycynie powszechnie stosowany jest skrót EBM pochodzący od angielskiego Evidence Based Medicine (medycyna oparta na faktach/dowodach). Oznacza on, że lekarz w praktyce klinicznej stosuje te metody, które zostały udowodnione, opublikowane i uznane przez towarzystwa medyczne, spopularyzowane też jako wytyczne dla lekarzy. Takie wytyczne i standardy opracowywane są na podstawie szeregu badań empirycznych. Jednak lekarz nie może być ślepym niewolnikiem stanowisk i zaleceń towarzystw naukowych, na co uwrażliwiali ostatnio kardiolodzy podczas XXII Kongresu Polskiego Towarzystwa Kardiologicznego w Krakowie. Poinformowali o tym w specjalnym komunikacie.
– Rola zaleceń towarzystw naukowych jest w medycynie bardzo ważna. Opinie, rekomendacje, stanowiska i zalecenia towarzystw naukowych oraz konsultantów krajowych i wojewódzkich podsumowują po pierwsze: najnowszą wiedzę w danej dziedzinie, po drugie: wnioski z badań
i praktyki klinicznej. Dzięki temu rekomendacje naukowe pełnią rolę drogowskazu dla lekarzy klinicystów. Wytyczne pomagają nam podejmować decyzje terapeutyczne zwłaszcza
w niejednoznacznych, złożonych przypadkach. Ważne jednak, by nie trzymać się formalnie zaleceń bez zastrzeżeń, by każdy przypadek zweryfikować w oparciu o własną wiedzę i doświadczenie, biorąc pod uwagę indywidualne problemy każdego z naszych pacjentów – mówi prof. Maciej Sterliński, przewodniczący Sekcji Rytmu Serca Polskiego Towarzystwa Kardiologicznego.
Hematolog i onkolog prof. Wiesław Jędrzejczak lubi powtarzać, że leczy nie statystykę, a konkretnego pacjenta. I o ile w badaniu klinicznym u większości pacjentów jakaś metoda zadziałała, nie znaczy to, że zadziała u każdego pacjenta z tym schorzeniem.
Eksperci podkreślają, że medycyna musi być spersonalizowana. To zaś można osiągnąć, stosując się ściśle do reguł sztuki medycznej, czyli zaczynając od działań najstarszych w medycynie: wywiadu z pacjentem i badania przedmiotowego.
- Niezwykle ważny jest wywiad, czyli możliwie najbardziej szczegółowa rozmowa
z pacjentem – mówi prof. Maciej Sterliński. – Zalecenia naukowe z zasady nie uwzględniają wszystkich istotnych zmiennych, a jedynie odzwierciedlają statystykę dużych populacji. Pacjent jest autonomicznym bytem. Jest on sam w stanie podać wiele ważnych dla siebie informacji i coraz częściej chciałby także świadomie uczestniczyć w wyborze odpowiedniej dla siebie metody terapeutycznej. Słuchanie, zrozumienie, wspólna analiza „za” i „przeciw” w rozmowie z lekarzem prowadzącym ma więc kluczowe znaczenie. W przypadku arytmii, takich jak migotanie przedsionków, które nieleczone lub leczone niewłaściwie może prowadzić do groźnych powikłań, takich jak udar mózgu, ale także do powikłań samego leczenia, bardzo ważna jest weryfikacja zaleceń w oparciu o doświadczenie i wiedzę lekarza – dodaje prof. Maciej Sterliński.

Dr Google na stracenie?

Lekarze jednak nie potępiają pacjentów za to, że sięgają do internetu. Wiadomości z rzetelnych źródeł pozwalają na budowanie świadomości zdrowia pacjenta, wiedzy o tym, co powinno go niepokoić i skłonić do wizyty u lekarza.
- Dr Google bywa sprzymierzeńcem. Trzeba jednak wiedzieć, gdzie szukać informacji. Jeśli pacjent chce się dowiedzieć, jakie są objawy cukrzycy, powinien wejść na przykład na stronę Polskiego Towarzystwa Diabetologicznego, w zakładkę dla pacjenta. Błędem jest jednak uleganie modom zdrowotnym szerzonym przez celebrytów czy szarlatanów. Nie celebrytka powinna dyktować, jaką powinniśmy stosować dietę, a o szczepionkach lepiej czerpać wiedzę od lekarzy a nie przedstawicieli ruchów antyszczepionkowych – mówi prof. Mamcarz.
Justyna Wojteczek (zdrowie.pap.pl)
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