2019 |
O'Toole B, Pierse K, Friedrich B, Outram S, Dadds M, Catts S, 'Combat, Posttraumatic Stress Disorder and Health of Australian Vietnam Veteran Conscripts and Volunteers in the Three Decades After Return', JOURNAL OF MILITARY AND VETERANS HEALTH, 27 42-57 (2019) [C1]
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Nova |
2018 |
O'Toole BI, Dadds M, Outram S, Catts SV, 'The mental health of sons and daughters of Australian Vietnam veterans', International Journal of Epidemiology, 47 1051-1059 (2018) [C1]
Background: War service increases the risk of post-traumatic stress disorder (PTSD) to combatants, and has been shown to increase the risk of PTSD in their offspring. The extent t... [more]
Background: War service increases the risk of post-traumatic stress disorder (PTSD) to combatants, and has been shown to increase the risk of PTSD in their offspring. The extent to which there is an excess compared with the general population is not yet established, nor whether PTSD increases the risk of other psychiatric problems. Methods: A national sample of 133 sons and 182 daughters of a cohort of 179 Australian Vietnam veterans' families were assessed in person, using structured psychiatric interviews. The prevalence of trauma exposures, DSM-IV (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition) diagnoses and suicidality were compared with the Australian Bureau of Statistics' 2007 National Survey of Mental Health and Wellbeing data matched for age and sex. The risk of mental health problems potentially attributable to PTSD was also assessed. Results: Sons and daughters were more likely than population expectations to report exposures to natural disasters, fire or explosions and transport accidents, and sons more likely to report exposure to toxic chemicals whereas daughters were more likely to report sexual assault. Sons and daughters had higher prevalences of alcohol and other substance dependence, depression and anxiety, and PTSD, and children's PTSD was associated with substance dependence, depression and suicidal ideation. There were strong associations between children's PTSD and comorbid conditions of substance use disorders, depression and anxiety. Conclusions: Higher rates of mental health problems in veterans' families, together with comorbidity with PTSD and the link between veterans' and children's PTSD, suggest that the effects of trauma may continue into subsequent generations.
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Nova |
2018 |
Ward S, Outram S, Heslop B, 'Perceived utility and relevance of intern well-being sessions', Internal Medicine Journal, 48 645-650 (2018) [C1]
Background/Aim: We conducted a pilot project assessing the perceived utility and relevance of well-being sessions provided to interns at a large regional teaching hospital in Aust... [more]
Background/Aim: We conducted a pilot project assessing the perceived utility and relevance of well-being sessions provided to interns at a large regional teaching hospital in Australia, with the aim of promoting intern well-being and fostering a nurturing and supportive learning and work hospital culture. Methods: Our intervention involved two separate 60-min lectures covering well-being topics and skills to approximately 50 interns within protected teaching time, along with emailed well-being resources. Participants were emailed an online survey asking questions about value and novelty of the sessions, and work satisfaction and stress, as well as open comments. A request for an additional interview to explore responses in more depth was included. Results: Fifty interns attended at least one of the sessions and 35 participated in the survey, six to an additional interview. Survey and interview data showed that the majority of interns perceived the sessions as valuable, relevant and useful and felt that ongoing sessions would benefit junior medical officers in future years. Feedback highlighted the importance of providing future sessions in person, incorporating an interactive approach and emphasised that work site factors and medical culture play a large causative role in their stress. Conclusions: We conclude that well-being sessions are acceptable and useful to interns and should be incorporated into hospital teaching curricula, and evaluated. However, these programmes are unlikely to change the high stress experienced unless external and systemic stressors are addressed by all stakeholders.
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Nova |
2017 |
Southgate E, Brosnan C, Lempp H, Kelly B, Wright S, Outram S, Bennett A, 'Travels in Extreme Social Mobility: how first-in-family students find their way into and through medical education', Critical Studies in Education, 58 242-260 (2017) [C1]
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Nova |
2017 |
Dundas KJ, Hansen V, Outram S, James EL, 'A "Light Bulb Moment" in Understanding Public Health for Undergraduate Students: Evaluation of the Experiential "This Is Public Health" Photo Essay Task', FRONTIERS IN PUBLIC HEALTH, 5 (2017) [C1]
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Nova |
2017 |
O'Toole BI, Burton MJ, Rothwell A, Outram S, Dadds M, Catts SV, 'Intergenerational transmission of post-traumatic stress disorder in Australian Vietnam veterans families', Acta Psychiatrica Scandinavica, 135 363-372 (2017) [C1]
Objective: To assess the association between parental post-traumatic stress disorder (PTSD) and offspring PTSD and its specificity for other disorders in a non-clinical epidemiolo... [more]
Objective: To assess the association between parental post-traumatic stress disorder (PTSD) and offspring PTSD and its specificity for other disorders in a non-clinical epidemiological cohort of Australian Vietnam veterans, their partners and their sons and daughters. Method: Veterans were interviewed twice, in 1992¿1994 and 2005¿2006; partners were interviewed in 2006¿2007, and their offspring in 2012¿2014. A total of 125 sons and 168 daughters were interviewed from 197 families, 137 of which also included partners who were the mothers of the children. Statistical analysis used multi-level modelling to compute odds ratios and 95% confidence intervals while controlling for clustering effects within families. Parent PTSD diagnoses were examined for associations with offspring trauma exposure, PTSD and other psychiatric diagnoses. Results: Veteran PTSD increased the risk of PTSD and no other disorder in both sons and daughters; partner PTSD did not. Veteran depression was also a risk factor for sons¿ PTSD, and alcohol disorder was linked to alcohol dependence in sons and PTSD in daughters, but not when controlling for veteran PTSD. Conclusion: We conclude that PTSD in a Vietnam veteran father increases the risk specifically for PTSD in his sons and daughters.
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Nova |
2016 |
Ward S, Outram S, 'Medicine: in need of culture change', INTERNAL MEDICINE JOURNAL, 46 112-116 (2016)
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2016 |
Brosnan C, Southgate E, Outram S, Lempp H, Wright S, Saxby T, et al., 'Experiences of medical students who are first in family to attend university', Medical education, 50 842-851 (2016) [C1]
CONTEXT: Students from backgrounds of low socio-economic status (SES) or who are first in family to attend university (FiF) are under-represented in medicine. Research has focused... [more]
CONTEXT: Students from backgrounds of low socio-economic status (SES) or who are first in family to attend university (FiF) are under-represented in medicine. Research has focused on these students' pre-admission perceptions of medicine, rather than on their lived experience as medical students. Such research is necessary to monitor and understand the potential perpetuation of disadvantage within medical schools.
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Nova |
2016 |
Wilson AJ, Palmer L, Levett-Jones T, Gilligan C, Outram S, 'Interprofessional collaborative practice for medication safety: Nursing, pharmacy, and medical graduates experiences and perspectives', Journal of Interprofessional Care, 30 649-654 (2016) [C1]
Medication errors are the second most prevalent cause of adverse patient incidents in Australian hospital settings. Although numerous strategies to address this patient safety iss... [more]
Medication errors are the second most prevalent cause of adverse patient incidents in Australian hospital settings. Although numerous strategies to address this patient safety issue have been implemented, the impact of interprofessional collaborative practice (IPCP) on medication safety has received limited attention. The aim of this article is to report the perspectives and experiences of recently graduated, currently practicing Australian nurses, pharmacists, and doctors in relation to IPCP and medication safety. Sixty-eight graduates from three Australian states participated in focus groups. Thematic analysis of transcripts was conducted using an iterative process. The findings from this study illustrate how knowing about and valuing the skills and responsibilities of other team members and respecting each person¿s unique contribution to the work of the team can lead to more effective communication and collaboration in the context of medication safety. Although collaborative practice is critical to safe medication prescribing, dispensing, and administration, there are recurring and pervasive challenges to its achievement. This study indicated the need for improved preparation of graduates to equip them with the knowledge and skills needed to participate in an interprofessional team; and we advocate that deliberate, structured, and meaningful interprofessional clinical education initiatives are required.
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Nova |
2016 |
Gilligan C, James EL, Snow P, Outram S, Ward BM, Powell M, et al., 'Interventions for improving medical students' interpersonal communication in medical consultations', Cochrane Database of Systematic Reviews, 2016 (2016)
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of interventions for medical students that aim to improve interperson... [more]
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of interventions for medical students that aim to improve interpersonal communication in medical consultations.
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2015 |
Outram S, Harris G, Kelly B, Bylund CL, Cohen M, Landa Y, et al., ''We didn't have a clue': Family caregivers' experiences of the communication of a diagnosis of schizophrenia', International Journal of Social Psychiatry, 61 10-16 (2015) [C1]
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Nova |
2015 |
Ditton-Phare P, Halpin S, Sandhu H, Kelly B, Vamos M, Outram S, et al., 'Communication skills in psychiatry training', AUSTRALASIAN PSYCHIATRY, 23 429-431 (2015) [C3]
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Nova |
2015 |
Outram S, Harris G, Kelly B, Cohen M, Bylund CL, Landa Y, et al., 'Contextual barriers to discussing a schizophrenia diagnosis with patients and families: Need for leadership and teamwork training in psychiatry', Academic Psychiatry, 39 174-180 (2015) [C1]
Objective: This research sought to gain insight into the processes used by clinicians to discuss a schizophrenia diagnosis with patients/families, with the aim of informing the de... [more]
Objective: This research sought to gain insight into the processes used by clinicians to discuss a schizophrenia diagnosis with patients/families, with the aim of informing the development of a communications skills training program. Methods: A generic qualitative methodological approach was used. Sixteen mental health clinicians were recruited. Semi-structured individual interviews were used to explore their perceptions and experiences communicating a schizophrenia diagnosis. Interviews were recorded, transcribed, and thematic analysis undertaken. Results: There were five key themes relating to the process of communication about a diagnosis of schizophrenia: (1) orientation to patient care, (2) planning of communication, (3) the impact of team leadership and inter/intra-professional functioning on communication tasks, (4) the roles of different clinicians in communicating about diagnosis and treatment, and (5) time and resource deficiencies. Despite expressing care and concern for vulnerable patients and embracing the concept of multidisciplinary teams, communicating diagnostic information to patients and families was generally unplanned for, with little consistency regarding leadership approaches, or how the team communicated diagnostic information to the patient and family. This contributed to tensions between different team members. Conclusion: The findings demonstrated a number of issues compromising good communication around a schizophrenia diagnosis, both in terms of clinician skill and clinical context, and support the importance of education and training for all members of the multidisciplinary team about their role in the communication process.
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Nova |
2015 |
Loughland C, Kelly B, Ditton-Phare P, Sandhu H, Vamos M, Outram S, Levin T, 'Improving clinician competency in communication about schizophrenia: A pilot educational program for psychiatry trainees', Academic Psychiatry, 39 160-164 (2015) [C1]
Objective: Important gaps are observed in clinicians' communication with patients and families about psychiatric disorders such as schizophrenia. Communication skills can be ... [more]
Objective: Important gaps are observed in clinicians' communication with patients and families about psychiatric disorders such as schizophrenia. Communication skills can be taught, and models for education in these skills have been developed in other fields of medicine, such as oncology, providing a framework for training communication skills relevant to psychiatric practice. This study evaluated a pilot communication skills education program for psychiatry trainees, focusing on discussing schizophrenia diagnosis and prognosis. Method: Communication skills training modules were developed based on an existing theoretical framework (ComSkil), adapted for discussing a schizophrenia diagnosis and prognosis. Pre-post training rating of self-reported confidence in a range of communication tasks was obtained, along with trainee views on the training methods. Results: Thirty-eight participants completed the training. Significant improvements in confidence were reported post training for discussing schizophrenia prognosis, including an increased capacity to critically evaluate their own communication skills. Participants reported high levels of satisfaction with the program. Conclusion: This preliminary study provides support for the translation of a well-established educational model to psychiatric training addressing core clinical communication tasks and provides the foundation for the development of a more comprehensive evaluation and an extended curriculum regarding other aspects of care for patients with schizophrenia: ongoing management and recovery, dealing with conflict, and conducting a family interview.
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Nova |
2015 |
Thomson K, Outram S, Gilligan C, Levett-Jones T, 'Interprofessional experiences of recent healthcare graduates: A social psychology perspective on the barriers to effective communication, teamwork, and patient-centred care.', J Interprof Care, 29 634-640 (2015) [C1]
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Nova |
2015 |
Loughland C, Cheng K, Harris G, Kelly B, Cohen M, Sandhu H, et al., 'Communication of a schizophrenia diagnosis: A qualitative study of patients' perspectives.', Int J Soc Psychiatry, 61 729-734 (2015) [C1]
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Nova |
2015 |
O'Toole BI, Orreal-Scarborough T, Johnston D, Catts SV, Outram S, 'Suicidality in Australian Vietnam veterans and their partners', Journal of Psychiatric Research, 65 30-36 (2015) [C1]
Lifetime suicidality was assessed in a cohort of 448 ageing Australian Vietnam veterans and 237 female partners during in-person structured psychiatric interviews that permitted d... [more]
Lifetime suicidality was assessed in a cohort of 448 ageing Australian Vietnam veterans and 237 female partners during in-person structured psychiatric interviews that permitted direct comparison with age-sex matched Australian population statistics. Relative risks for suicidal ideation, planning and attempts were 7.9, 9.7 and 13.8 times higher for veterans compared with the Australian population and for partners were 6.2, 3.5 and 6.0 times higher. Odds ratios between psychiatric diagnoses and suicidality were computed using multivariate logistic regression, and suicidality severity scores were assigned from ideation, planning and attempt, and analysed using ordinal regression. PTSD, depression alcohol disorders, phobia and agoraphobia were prominent predictors of ideation, attempts and suicidal severity among veterans, while depression, PTSD, social phobia and panic disorder were prominent predictors among partners. For veterans and their partners, PTSD is a risk factor for suicidality even in the presence of other psychiatric disorders, and is stronger in Vietnam veterans than their partners.
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Nova |
2014 |
Outram S, Dundas K, Johnson NA, 'The educated citizen: A case study and guide for teaching public health to undergraduates in Australian universities.', Focus on Health Professional Education: A Multi-disciplinary Journal, 15 32-40 (2014) [C1]
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Nova |
2014 |
Outram S, Harris G, Kelly B, Cohen M, Sandhu H, Vamos M, et al., 'Communicating a Schizophrenia Diagnosis to Patients and Families: A Qualitative Study of Mental Health Clinicians', PSYCHIATRIC SERVICES, 65 551-554 (2014) [C1]
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Nova |
2014 |
Gilligan C, Outram S, Levett-Jones T, 'Recommendations from recent graduates in medicine, nursing and pharmacy on improving interprofessional education in university programs: a qualitative study.', BMC Med Educ, 14 52 (2014) [C1]
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Nova |
2014 |
Outram S, Kelly B, '"You teach us to listen, but you don't teach us about suffering": self-care and resilience strategies in medical school curricula.', Perspect Med Educ, 3 371-378 (2014) [C2]
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2012 |
Gilligan C, Outram S, 'Culturally and linguistically diverse students in health professional programs: An exploration of concerns and needs', Education for Health: Change in Learning and Practice, 25 40-47 (2012) [C1]
Introduction: Cultural diversity among students in tertiary institutions in Australia and globally has increased rapidly in the last decade, and is continuing to do so. Methods: F... [more]
Introduction: Cultural diversity among students in tertiary institutions in Australia and globally has increased rapidly in the last decade, and is continuing to do so. Methods: Focus groups were held at the University of Newcastle, NSW to: (1) examine the specifi c needs of international students in the Master of Pharmacy, Bachelor of Medicine and Bachelor of Nursing programs in relation to language and cultural considerations and (2) to understand the attitudes of domestic students to the cultural issues faced among their peers. Th e project explored these issues with the intention to inform curricula changes to accommodate the needs of culturally and linguistically diverse students. Results: Th e key themes emerging from international students were: diffi culties in spoken language, diff erences in professional roles and expectations, diff erences in methods of learning, inadequate social interaction outside the classroom and acceptance of diff erences in cultural and religious practices. Th e domestic student views reinforced the comments from international students both in regard to social interaction and in regard to participation in class discussions. Although local students were interested in learning from international students about their culture and religious beliefs, there were limited initiatives from both sides. Discussion: Th ere is a need for tertiary institutions that benefi t economically from increasing the numbers of international students to help them to study and live in a new environment. Assistance needs to go beyond learning the English language to helping students understand its use in a professional context (health terminology and slang used by patients), the nuances of the health professional disciplines in a western society, the approach to study and problem-based learning styles and skills to assist with social interaction. Th e results of the present exploration have led to a series of proposed actions for the University of Newcastle. Th ese recommendations are applicable to any 'Western' teaching institution with a large number of international students from developing countries enrolled in their health programs.
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Nova |
2011 |
Gilligan C, Outram S, Rasiah RL, Cooper J, 'Exploring the attitudes of pharmacy students to clinical communications training', Focus on Health Professional Education, 13 25-36 (2011) [C1]
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Nova |
2010 |
O'Toole BI, Outram S, Catts SV, Pierse KR, 'The mental health of partners of Australian Vietnam veterans three decades after the war and its relation to veteran military service, combat, and PTSD', Journal of Nervous and Mental Disease, 198 841-845 (2010) [C1]
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Nova |
2010 |
O'Toole BI, Catts SV, Outram S, Pierse KR, Cockburn JD, 'Factors associated with civilian mortality in Australian Vietnam veterans three decades after the war', Military Medicine, 175 88-95 (2010) [C1]
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Nova |
2009 |
O'Toole BI, Catts SV, Outram S, Pierse KR, Cockburn JD, 'The physical and mental health of Australian Vietnam veterans 3 decades after the war and its relation to military service, combat, and post-traumatic stress disorder', American Journal of Epidemiology, 170 318-330 (2009) [C1]
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Nova |
2009 |
Outram S, Hansen V, MacDonell G, Cockburn JD, Adams J, 'Still living in a war zone: Perceived health and wellbeing of partners of Vietnam veterans attending partners' support groups in New South Wales, Australia', Australian Psychologist, 44 128-135 (2009) [C1]
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Nova |
2009 |
Outram S, 'In reply', Medical Journal of Australia, 190 343 (2009) [C3] |
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2009 |
Outram S, 'Peer physical examination: Time to revisit? In reply', Medical Journal of Australia, 190 343 (2009) [C3] |
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Nova |
2008 |
Sanson-Fisher RW, Williams N, Outram S, 'Health inequities: The need for action by schools of medicine', Medical Teacher, 30 389-394 (2008) [C1]
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Nova |
2008 |
Outram S, Nair BR, 'Peer physical examination: Time to revisit?', Medical Journal of Australia, 189 274-276 (2008) [C1]
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Nova |
2006 |
Outram S, 'Communicating in the health and social sciences (Book review)', Drug and Alcohol Review, 25 655-656 (2006) [C3] |
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2006 |
Outram S, Murphy BM, Cockburn JD, 'Prevalence of and factors associated with midlife women taking medicines for psychological distress', Australian e-Journal for the Advancement of Mental Health, 5 1-5 (2006) [C1]
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Nova |
2006 |
O'Toole B, Pierse K, Outram S, Cockburn J, Catts S, 'The prevalence of PTSD in Australian Vietnam Veterans 35 years after war's end: preliminary results of a cohort study.', Acta neuropsychiatrica, 18 264-265 (2006)
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2004 |
Outram S, Murphy BM, Cockburn JD, 'The role of GPs in treating psychological distress: a study of midlife Australian women', Family Practice, 21 276-281 (2004) [C1]
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Nova |
2004 |
Outram S, Schofield M, 'Sociodemographic and Health Related Factors Associated with Poor Mental Health in Midlife Australian Women', Women & Health, 39 97-115 (2004) [C1]
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Nova |
2004 |
Outram S, Murphy B, Cockburn JD, 'Factors associated with accessing professional help for psychological distress in midlife Australian women', Journal of Mental Health, 13 187-197 (2004) [C1]
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Nova |
2000 |
Holliday JE, Lowe JM, Outram S, 'Women's experience of myocardial infarction', International Journal of Nursing Practice, 6 (2000)
Background: Heart disease is a major cause of mortality in women.Women have a poorer prognosis than men after myocardial infarction (MI) and research to date has failed to find a ... [more]
Background: Heart disease is a major cause of mortality in women.Women have a poorer prognosis than men after myocardial infarction (MI) and research to date has failed to find a definitive explanation.Women have been identified as late presenters for emergency care after acute myocardial infarction. The aim of this study was to discover the underlying processes that effect women's decisions to seek medical help for symptoms of MI. Methods: Qualitative analysis, of semistructured face-to-face interviews with 16women aged between 48 and 82 years, admitted to a major teaching hospital with MI. Results: The women delayed presentation from 1 h to 168 h (median 6.25 h). The decision to seek help was influenced by beliefs about personal susceptibility to MI and beliefs about the way MI presents. Symptoms were diverse and were rarely as described in current health promotion literature. Conclusion: The pivotal factor for early presentation is that women, and their significant others, recognise the variety of signs and symptoms of MI and their personal susceptibility. A theoretical model, adapted from the Self Regulation Model of Illness Cognition of Leventhal et al. is proposed to explain the women's response and also areas of intervention. © Wiley Publishing Asia Pty Ltd.
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