Implementation and evaluation of community-based drop-in centres for breastfeeding support in Victoria, Australia
- Cramer, Rhian, McLachlan, Helen, Shafiei, Touran, Amir, Lisa, Cullinane, Meabh, Small, Rhonda, Forster, Della
- Authors: Cramer, Rhian , McLachlan, Helen , Shafiei, Touran , Amir, Lisa , Cullinane, Meabh , Small, Rhonda , Forster, Della
- Date: 2017
- Type: Text , Journal article
- Relation: International Breastfeeding Journal Vol. 12, no. 1 (2017), p.1-15
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- Description: Background: While Australia has high breastfeeding initiation, there is a sharp decline in the first weeks postpartum and this continues throughout the first year. Supporting breastfeeding In Local Communities (SILC) was a three-arm cluster randomised controlled trial to determine whether early home-based breastfeeding support by a maternal and child health nurse (SILC-MCHN), with or without access to a community-based breastfeeding drop-in centre, increased the proportion of infants receiving any breast milk at three, four and six months. The trial was conducted in ten Local Government Areas (LGAs) in Victoria, Australia. The primary aim of this paper is to describe the three drop-in centres established during the trial; and the profile of women who accessed them. The secondary aim is to explore the views and experiences of the drop-in centre staff, and the challenges faced in establishing and maintaining a breastfeeding drop-in centre in the community. Methods: Evaluation of the three LGAs with drop-in centres was multifaceted and included observational visits and field notes; data collected from attendance log books from each drop-in centre; a written survey and focus groups with maternal and child health (MCH) nurses who ran the drop-in centres; and semi-structured interviews with MCH coordinators of the participating LGAs. Results: The three LGAs developed and ran different models of breastfeeding drop-in centres. They reported challenges in finding convenient, accessible locations. Overall, attendance was lower than expected, with an average of only one attendee per session. Two global themes were identified regarding staff views: implementation challenges, encompassing finding accessible, available space, recruiting volunteers to provide peer support, and frustration when women did not attend; and the work of SILC-MCHNs, including themes of satisfying and rewarding work, juggling roles, and benefits to women, babies and the community. Conclusion: Providing community-based breastfeeding support was satisfying for the drop-in centre staff but proved difficult to implement, reflected by the lower than anticipated attendances at all of the drop-in centres. Interventions to increase breastfeeding in complex community settings require sufficient time to build partnerships with the existing services and the target population; to understand when and how to offer interventions for optimum benefit. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12611000898954.
- Authors: Cramer, Rhian , McLachlan, Helen , Shafiei, Touran , Amir, Lisa , Cullinane, Meabh , Small, Rhonda , Forster, Della
- Date: 2017
- Type: Text , Journal article
- Relation: International Breastfeeding Journal Vol. 12, no. 1 (2017), p.1-15
- Full Text:
- Reviewed:
- Description: Background: While Australia has high breastfeeding initiation, there is a sharp decline in the first weeks postpartum and this continues throughout the first year. Supporting breastfeeding In Local Communities (SILC) was a three-arm cluster randomised controlled trial to determine whether early home-based breastfeeding support by a maternal and child health nurse (SILC-MCHN), with or without access to a community-based breastfeeding drop-in centre, increased the proportion of infants receiving any breast milk at three, four and six months. The trial was conducted in ten Local Government Areas (LGAs) in Victoria, Australia. The primary aim of this paper is to describe the three drop-in centres established during the trial; and the profile of women who accessed them. The secondary aim is to explore the views and experiences of the drop-in centre staff, and the challenges faced in establishing and maintaining a breastfeeding drop-in centre in the community. Methods: Evaluation of the three LGAs with drop-in centres was multifaceted and included observational visits and field notes; data collected from attendance log books from each drop-in centre; a written survey and focus groups with maternal and child health (MCH) nurses who ran the drop-in centres; and semi-structured interviews with MCH coordinators of the participating LGAs. Results: The three LGAs developed and ran different models of breastfeeding drop-in centres. They reported challenges in finding convenient, accessible locations. Overall, attendance was lower than expected, with an average of only one attendee per session. Two global themes were identified regarding staff views: implementation challenges, encompassing finding accessible, available space, recruiting volunteers to provide peer support, and frustration when women did not attend; and the work of SILC-MCHNs, including themes of satisfying and rewarding work, juggling roles, and benefits to women, babies and the community. Conclusion: Providing community-based breastfeeding support was satisfying for the drop-in centre staff but proved difficult to implement, reflected by the lower than anticipated attendances at all of the drop-in centres. Interventions to increase breastfeeding in complex community settings require sufficient time to build partnerships with the existing services and the target population; to understand when and how to offer interventions for optimum benefit. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12611000898954.
Access to health care services in an Australian rural area – a qualitative case study
- Le, Quynh, Nguyen, Hoang, Auckland, Stuart, Hoang, Ha, Terry, Daniel
- Authors: Le, Quynh , Nguyen, Hoang , Auckland, Stuart , Hoang, Ha , Terry, Daniel
- Date: 2012
- Type: Text , Journal article
- Relation: International Journal of Annotative Interdisciplinary Research Vol. 1, no. 3 (2012), p. 29-36
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- Description: The study is aimed at investigating access to primary health care by examining various access parameters such as availability, accessibility, and affordability in Meander Valley, Northern Tasmania, Australia. Qualitative research design and data analysis were adopted. Semi-structured interviews were conducted with 30 people that were recruited through convenience sampling. The findings indicated that participants generally expressed relative satisfaction with local health care service provision, although a number of participants cited satisfaction with some services and dissatisfaction with others. The main issues of concern were the absence of specialised, dental and after-hours care, high cost of services, and issues of access to transport. The resourcefulness of people with chronic health issues and their carers emerged as important, as was the relationship between lifestyle choices, alternative and mainstream health care options. This study revealed major barriers to health care access by residents in rural Australia, which calls for urgent corrective measures. Further research should be directed to the exploration of the experience and expertise of carers and health professionals so as to obtain a more complete picture of access to health care services in rural settings. In addition, the study recommends a thorough investigation of the alternative health care options.
- Authors: Le, Quynh , Nguyen, Hoang , Auckland, Stuart , Hoang, Ha , Terry, Daniel
- Date: 2012
- Type: Text , Journal article
- Relation: International Journal of Annotative Interdisciplinary Research Vol. 1, no. 3 (2012), p. 29-36
- Full Text:
- Reviewed:
- Description: The study is aimed at investigating access to primary health care by examining various access parameters such as availability, accessibility, and affordability in Meander Valley, Northern Tasmania, Australia. Qualitative research design and data analysis were adopted. Semi-structured interviews were conducted with 30 people that were recruited through convenience sampling. The findings indicated that participants generally expressed relative satisfaction with local health care service provision, although a number of participants cited satisfaction with some services and dissatisfaction with others. The main issues of concern were the absence of specialised, dental and after-hours care, high cost of services, and issues of access to transport. The resourcefulness of people with chronic health issues and their carers emerged as important, as was the relationship between lifestyle choices, alternative and mainstream health care options. This study revealed major barriers to health care access by residents in rural Australia, which calls for urgent corrective measures. Further research should be directed to the exploration of the experience and expertise of carers and health professionals so as to obtain a more complete picture of access to health care services in rural settings. In addition, the study recommends a thorough investigation of the alternative health care options.
Detection and management of eating disorders by general practitioners in regional Australia
- Boyd, Candice, Aisbett, Damon, Howard, Andrew, Filiades, Toula
- Authors: Boyd, Candice , Aisbett, Damon , Howard, Andrew , Filiades, Toula
- Date: 2007
- Type: Text , Journal article
- Relation: Australian e-Journal for the Advancement of Mental Health Vol. 6, no. 2 (2007), p.
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- Description: The aim of this study was to explore the prevalence of eating disorders in primary care in the Ballarat region and to highlight the role of GPs in the detection and management of eating disorders in regional Australia. We used anonymous data previously collated by the Ballarat and District Division of General Practice on the prevalence of eating disorders and patterns of referral of eating disorder patients among GPs in their Division. Over half of GPs surveyed indicated that they treat patients with eating disorders within their practice rather than referring patients to other services. In referring on, GPs were more likely to refer to mental health professionals and dietitians. A notable finding was that these regional GPs were more likely to refer to metropolitan specialist services than local hospitals if their patients required an admission. GPs in regional Australia do significant work to detect and manage patients with clinical eating disorders in the absence of locally-based, specialist services. In this context, we recommend the establishment of linkage partnerships between GPs and mental health practitioners to facilitate early intervention for rural and regional eating disorder patients. Further research into the current treatment practices of regional GPs is also needed to ascertain their specific training needs with respect to this patient population.
- Description: C1
- Description: 2003005810
- Authors: Boyd, Candice , Aisbett, Damon , Howard, Andrew , Filiades, Toula
- Date: 2007
- Type: Text , Journal article
- Relation: Australian e-Journal for the Advancement of Mental Health Vol. 6, no. 2 (2007), p.
- Full Text:
- Reviewed:
- Description: The aim of this study was to explore the prevalence of eating disorders in primary care in the Ballarat region and to highlight the role of GPs in the detection and management of eating disorders in regional Australia. We used anonymous data previously collated by the Ballarat and District Division of General Practice on the prevalence of eating disorders and patterns of referral of eating disorder patients among GPs in their Division. Over half of GPs surveyed indicated that they treat patients with eating disorders within their practice rather than referring patients to other services. In referring on, GPs were more likely to refer to mental health professionals and dietitians. A notable finding was that these regional GPs were more likely to refer to metropolitan specialist services than local hospitals if their patients required an admission. GPs in regional Australia do significant work to detect and manage patients with clinical eating disorders in the absence of locally-based, specialist services. In this context, we recommend the establishment of linkage partnerships between GPs and mental health practitioners to facilitate early intervention for rural and regional eating disorder patients. Further research into the current treatment practices of regional GPs is also needed to ascertain their specific training needs with respect to this patient population.
- Description: C1
- Description: 2003005810
Experiences of mental health nurses working in general practice: A qualitative study
- Olasoji, Michael, Maude, Phillip, Cross, Wendy
- Authors: Olasoji, Michael , Maude, Phillip , Cross, Wendy
- Date: 2020
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 56, no. 3 (2020), p. 266-279
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- Description: Background: This paper reports on a qualitative study utilising in-depth interviews of sixteen Australian mental health nurses (MHNs) working in general practice. On 1st July 2015, the commonwealth government of Australia established 31 primary health networks (PHN) to increase the efficiency and effectiveness of medical services for people, particularly those at risk of poor health outcomes, and to improve coordination of care. Aim: This study explores the experiences of Australian MHNs working in general practice. Design: Data were analysed using thematic analysis. Four themes emerged through the data analysis: (1) autonomy and flexibility, (2) opportunity for more clinically focused work, (3) health promotion and preventative health and (4) excited to work in general practice. Findings: Study Participants identified many clinical opportunities working in primary practice and noted that the autonomy and flexibility of their role was quite different from other areas they had previously worked. They reported having more time to spend with the patients and being able to engage in health promotion. Conclusions: In order to make mental health care more accessible it is important to have a well-qualified workforce within primary health care (PHC) settings such as general practice. The participants of this study have identified ways they have been best utilised in the Primary Care workforce. They embrace the autonomy of the role and the ability to engage with consumers by providing clinical interventions that can assess and intervene with people experiencing mental illness. © 2020 Informa UK Limited, trading as Taylor & Francis Group.
- Authors: Olasoji, Michael , Maude, Phillip , Cross, Wendy
- Date: 2020
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 56, no. 3 (2020), p. 266-279
- Full Text:
- Reviewed:
- Description: Background: This paper reports on a qualitative study utilising in-depth interviews of sixteen Australian mental health nurses (MHNs) working in general practice. On 1st July 2015, the commonwealth government of Australia established 31 primary health networks (PHN) to increase the efficiency and effectiveness of medical services for people, particularly those at risk of poor health outcomes, and to improve coordination of care. Aim: This study explores the experiences of Australian MHNs working in general practice. Design: Data were analysed using thematic analysis. Four themes emerged through the data analysis: (1) autonomy and flexibility, (2) opportunity for more clinically focused work, (3) health promotion and preventative health and (4) excited to work in general practice. Findings: Study Participants identified many clinical opportunities working in primary practice and noted that the autonomy and flexibility of their role was quite different from other areas they had previously worked. They reported having more time to spend with the patients and being able to engage in health promotion. Conclusions: In order to make mental health care more accessible it is important to have a well-qualified workforce within primary health care (PHC) settings such as general practice. The participants of this study have identified ways they have been best utilised in the Primary Care workforce. They embrace the autonomy of the role and the ability to engage with consumers by providing clinical interventions that can assess and intervene with people experiencing mental illness. © 2020 Informa UK Limited, trading as Taylor & Francis Group.
Secondary stroke prevention in polish adults: Results from the lipidogram2015 study
- Labuz-Roszak, Beata, Banach, Maciej, Skrzypek, Michal, Windak, Adam, Charchar, Fadi
- Authors: Labuz-Roszak, Beata , Banach, Maciej , Skrzypek, Michal , Windak, Adam , Charchar, Fadi
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Clinical Medicine Vol. 10, no. 19 (2021), p.
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- Description: Background: The purpose of the study was to evaluate secondary stroke prevention in Poland and its association with sociodemographic factors, place of residence, and concomitant cardiovascular risk factors. Material and methods: From all patients in LIPIDOGRAM2015 Study (n = 13,724), 268 subjects had a history of ischaemic stroke and were included. Results: 165 subjects (61.6%) used at least one preventive medication. Oral antiplatelet and anticoagulation agents were used by 116 (43.3%) and 70 (26.1%) patients, respectively. Only 157 (58.6%) participants used lipid-lowering drugs, and 205 (76.5%) were treated with antihypertensive drugs. Coronary heart disease (CHD) and dyslipidaemia were associated with antiplatelet treatment (p = 0.047 and p = 0.012, respectively). A history of atrial fibrillation, CHD, and previous myocardial infarction correlated with anticoagulant treatment (p = 0.001, p = 0.011, and p < 0.0001, respectively). Age, gender, time from stroke onset, place of residence, and level of education were not associated with antiplatelet or anticoagulant treatment. Only 31.7% of patients were engaged in regular physical activity, 62% used appropriate diet, and 13.6% were current smokers. Conclusions: In Poland drugs and lifestyle modification for secondary stroke prevention are not commonly adhered to. Educational programmes for physicians and patients should be developed to improve application of effective secondary prevention of stroke. © 2021 by the authors. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Fadi Charchar” is provided in this record**
- Authors: Labuz-Roszak, Beata , Banach, Maciej , Skrzypek, Michal , Windak, Adam , Charchar, Fadi
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Clinical Medicine Vol. 10, no. 19 (2021), p.
- Full Text:
- Reviewed:
- Description: Background: The purpose of the study was to evaluate secondary stroke prevention in Poland and its association with sociodemographic factors, place of residence, and concomitant cardiovascular risk factors. Material and methods: From all patients in LIPIDOGRAM2015 Study (n = 13,724), 268 subjects had a history of ischaemic stroke and were included. Results: 165 subjects (61.6%) used at least one preventive medication. Oral antiplatelet and anticoagulation agents were used by 116 (43.3%) and 70 (26.1%) patients, respectively. Only 157 (58.6%) participants used lipid-lowering drugs, and 205 (76.5%) were treated with antihypertensive drugs. Coronary heart disease (CHD) and dyslipidaemia were associated with antiplatelet treatment (p = 0.047 and p = 0.012, respectively). A history of atrial fibrillation, CHD, and previous myocardial infarction correlated with anticoagulant treatment (p = 0.001, p = 0.011, and p < 0.0001, respectively). Age, gender, time from stroke onset, place of residence, and level of education were not associated with antiplatelet or anticoagulant treatment. Only 31.7% of patients were engaged in regular physical activity, 62% used appropriate diet, and 13.6% were current smokers. Conclusions: In Poland drugs and lifestyle modification for secondary stroke prevention are not commonly adhered to. Educational programmes for physicians and patients should be developed to improve application of effective secondary prevention of stroke. © 2021 by the authors. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Fadi Charchar” is provided in this record**
The prevalence of cardiovascular risk factors and cardiovascular disease among primary care patients in Poland : results from the LIPIDOGRAM2015 study
- Jóźwiak, Jacek, Studziński, Krzysztof, Tomasik, Tomasz, Windak, Adam, Charchar, Fadi
- Authors: Jóźwiak, Jacek , Studziński, Krzysztof , Tomasik, Tomasz , Windak, Adam , Charchar, Fadi
- Date: 2020
- Type: Text , Journal article
- Relation: Atherosclerosis Supplements Vol. 42, no. (2020), p. e15-e24
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- Description: Background and aim: To estimate the prevalence of cardiovascular (CV) disease and CV risk factors among Polish patients. Methods: A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the 4th quarter of 2015 and 1st and 2nd quarters of 2016; 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. Results: Nearly 19% of men and approximately 12% of women had cardiovascular disease (CVD). Over 60% of the recruited patients had hypertension (HTN), >80% had dyslipidaemia and <15% of patients were diagnosed with diabetes (DM). All of these disorders were more frequent in men. In 80% of patients the waist circumference exceed norm for the European population. Less than half of the patients were current smokers or had smoked in the past. Patients with CVD had significantly higher blood pressure and glucose levels but lower low density lipoprotein-cholesterol level. Conclusions: The prevalence of CVD and CV risk factors among patients in Poland is high. CVD is more common in men than in women. The most common CV risk factors are excess waist circumference, dyslipidaemia and HTN. Family physicians should conduct activities to prevent, diagnose early and treat CVD in the primary health care population. © 2021 Elsevier B.V. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Fadi Charchar” is provided in this record**
- Authors: Jóźwiak, Jacek , Studziński, Krzysztof , Tomasik, Tomasz , Windak, Adam , Charchar, Fadi
- Date: 2020
- Type: Text , Journal article
- Relation: Atherosclerosis Supplements Vol. 42, no. (2020), p. e15-e24
- Full Text:
- Reviewed:
- Description: Background and aim: To estimate the prevalence of cardiovascular (CV) disease and CV risk factors among Polish patients. Methods: A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the 4th quarter of 2015 and 1st and 2nd quarters of 2016; 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. Results: Nearly 19% of men and approximately 12% of women had cardiovascular disease (CVD). Over 60% of the recruited patients had hypertension (HTN), >80% had dyslipidaemia and <15% of patients were diagnosed with diabetes (DM). All of these disorders were more frequent in men. In 80% of patients the waist circumference exceed norm for the European population. Less than half of the patients were current smokers or had smoked in the past. Patients with CVD had significantly higher blood pressure and glucose levels but lower low density lipoprotein-cholesterol level. Conclusions: The prevalence of CVD and CV risk factors among patients in Poland is high. CVD is more common in men than in women. The most common CV risk factors are excess waist circumference, dyslipidaemia and HTN. Family physicians should conduct activities to prevent, diagnose early and treat CVD in the primary health care population. © 2021 Elsevier B.V. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Fadi Charchar” is provided in this record**
The differences in the prevalence of cardiovascular disease, its risk factors, and achievement of therapeutic goals among urban and rural primary care patients in Poland: Results from the LIPIDOGRAM 2015 study
- Studziński, Krzysztof, Tomasik, Tomasz, Windak, Adam, Banach, Maciej, Charchar, Fadi
- Authors: Studziński, Krzysztof , Tomasik, Tomasz , Windak, Adam , Banach, Maciej , Charchar, Fadi
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Clinical Medicine Vol. 10, no. 23 (2021), p.
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- Description: A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the years 2015 and 2016. A total of 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. The prevalence of hypertension, diabetes mellitus, dyslipidaemia, and CVD were similar in urban and rural areas (49.5 vs. 49.4%; 13.7 vs. 13.1%; 84.2 vs. 85.2%; 14.4 vs. 14.2%, respectively). The prevalence of obesity (32.3 vs. 37.5%, p < 0.01) and excessive waist circumference (77.5 vs. 80.7%, p < 0.01), as well as abdominal obesity (p = 43.2 vs. 46.4%, p < 0.01), were higher in rural areas in both genders. Mean levels of LDL-C (128 vs. 130 mg/dL, p = 0.04) and non-HDL-C (147 vs. 148 mg/dL, p = 0.03) were slightly higher in rural populations. Altogether, 14.3% of patients with CVD from urban areas and 11.3% from rural areas reached LDL <70 mg/dL (p = 0.04). There were no important differences in the prevalence of hypertension, diabetes, dyslipidaemia, and CVD, or in mean levels of blood pressure, cholesterol fractions, glucose, and HbA1c between Polish urban and rural primary care patient populations. A high proportion of patients in cities and an even-higher proportion in rural areas did not reach the recommended targets for blood pressure, LDL-C, and HbA1c, indicating the need for novel CVD-prevention programs. © 2021 by the authors. Licensee MDPI, Basel, Switzerland. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Fadi Charchar” is provided in this record**
- Authors: Studziński, Krzysztof , Tomasik, Tomasz , Windak, Adam , Banach, Maciej , Charchar, Fadi
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Clinical Medicine Vol. 10, no. 23 (2021), p.
- Full Text:
- Reviewed:
- Description: A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the years 2015 and 2016. A total of 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. The prevalence of hypertension, diabetes mellitus, dyslipidaemia, and CVD were similar in urban and rural areas (49.5 vs. 49.4%; 13.7 vs. 13.1%; 84.2 vs. 85.2%; 14.4 vs. 14.2%, respectively). The prevalence of obesity (32.3 vs. 37.5%, p < 0.01) and excessive waist circumference (77.5 vs. 80.7%, p < 0.01), as well as abdominal obesity (p = 43.2 vs. 46.4%, p < 0.01), were higher in rural areas in both genders. Mean levels of LDL-C (128 vs. 130 mg/dL, p = 0.04) and non-HDL-C (147 vs. 148 mg/dL, p = 0.03) were slightly higher in rural populations. Altogether, 14.3% of patients with CVD from urban areas and 11.3% from rural areas reached LDL <70 mg/dL (p = 0.04). There were no important differences in the prevalence of hypertension, diabetes, dyslipidaemia, and CVD, or in mean levels of blood pressure, cholesterol fractions, glucose, and HbA1c between Polish urban and rural primary care patient populations. A high proportion of patients in cities and an even-higher proportion in rural areas did not reach the recommended targets for blood pressure, LDL-C, and HbA1c, indicating the need for novel CVD-prevention programs. © 2021 by the authors. Licensee MDPI, Basel, Switzerland. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Fadi Charchar” is provided in this record**
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