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Black V. The Chaplain in the Pediatric ER: A Nurse and Mom's Perspective. J Patient Exp 2024; 11:23743735241259586. [PMID: 38818136 PMCID: PMC11138188 DOI: 10.1177/23743735241259586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
The day after a holiday, our medically complex son, who was acutely ill, needed care at the local children's hospital. Once in the emergency room (ER), he was triaged to a trauma room. Without our knowledge or consent, a chaplain entered the crowded and chaotic room. Although pleasant, the chaplain was not a person who comforted us. Her presence (1) increased our anxiety to panic level, (2) took our attention away from our acutely ill son to worst-case scenarios, (3) made us extremely uncomfortable, and (4) was counterproductive. We strongly feel that the patient/family should be asked if they want a chaplain or other spiritual/support person to enter the room.
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Affiliation(s)
- Vicki Black
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA, USA
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2
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Sacca L, Lobaina D, Burgoa S, Rao M, Jhumkhawala V, Zapata SM, Issac M, Medina S. Using Patient-Centered Dissemination and Implementation Frameworks and Strategies in Palliative Care Settings for Improved Quality of Life and Health Outcomes: A Scoping Review. Am J Hosp Palliat Care 2023:10499091231214241. [PMID: 37956239 DOI: 10.1177/10499091231214241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND There is a need for patient-provider dissemination and implementation frameworks, strategies, and protocols in palliative care settings for a holistic approach when it comes to addressing pain and other distressing symptoms affecting the quality of life, function, and independence of patients with chronic illnesses. The purpose of this scoping review is to explore patient-centered D&I frameworks and strategies that have been adopted in PC settings to improve behavioral and environmental determinants influencing health outcomes through evidence-based programs and protocols. METHODS The five step Arksey and O'Malley's (2005) York methodology was adopted as a guiding framework: (1) identifying research questions; (2) searching for relevant studies; (3) selecting studies relevant to the research questions; (4) charting the data; and (5) collating, summarizing, and reporting results. RESULTS Only 6 out of the 38 (16%) included studies applied a D&I theory and/or framework. The RE-AIM framework was the most prominently cited (n = 3), followed by the Diffusion of Innovation Model (n = 2), the CONNECT framework (n = 1), and the Transtheoretical Stages of Change Model (n = 1). The most frequently reported ERIC strategy was strategy #6 "Develop and organize quality monitoring systems", as it identified in all 38 of the included studies. CONCLUSION This scoping review identifies D&I efforts to translate research into practice in U.S. palliative care settings. Results may contribute to enhancing future D&I initiatives for dissemination/adaptation, implementation, and sustainability efforts aiming to improve patient health outcomes and personal satisfaction with care received.
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Affiliation(s)
- Lea Sacca
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Diana Lobaina
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Sara Burgoa
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Meera Rao
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Vama Jhumkhawala
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Sheena M Zapata
- Symptom Management and Palliative Medicine, Baptist Health of South Florida, Miami Cancer Institute, Miami, FL, USA
| | - Michelle Issac
- Symptom Management and Palliative Medicine, Baptist Health of South Florida, Miami Cancer Institute, Miami, FL, USA
| | - Suleyki Medina
- Symptom Management and Palliative Medicine, Baptist Health of South Florida, Miami Cancer Institute, Miami, FL, USA
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3
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Holmen H, Winger A, Steindal SA, Riiser K, Castor C, Kvarme LG, Mariussen KL, Lee A. Patient-reported outcome measures in children, adolescents, and young adults with palliative care needs-a scoping review. BMC Palliat Care 2023; 22:148. [PMID: 37798706 PMCID: PMC10557323 DOI: 10.1186/s12904-023-01271-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/27/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Measuring outcomes facilitates evaluation of palliative services for children, adolescents, and young adults (CAYAs) with life-limiting and/or life-threatening (LL/LT) conditions. Implementation of patient-reported, proxy-reported, or patient-centered outcome measures (hereafter PROMs) is recommended to ensure palliative services. The purpose of this scoping review was to provide an overview of PROMs relevant for CAYAs living with LL/LT conditions eligible for pediatric palliative care (PPC). METHODS Arksey and O'Malley's 6-stage scoping review framework was used to guide the review. The identified citations had to report on PROMs in any context including CAYAs with LL/LT conditions up to 25 years of age. A systematic search of Medline, EMBASE, CINAHL, APA PsycInfo, Health and Psychosocial Instruments, and AMED took place in January 2021 and was updated in June 2022. Citations were screened independently by pairs of researchers. The scoping review protocol was registered, and peer-review published. RESULTS Of 3690 identified citations, 98 reports were included, of which the majority were from Western countries and about PROMs in CAYAs living with cancer or organ failure. A total of 80 PROMs were identified, assessing a range of phenomena, where quality of life and symptoms (especially pain) during the stage of ongoing care were the most frequent. There were only a few reports about outcome measures at time of diagnosis or in end-of-life care. CAYAs self-reported on the PROMs or collaborated with their parents in about half of the reports, while the remaining had proxies answering on behalf of the CAYAs. In the identified reports, PROMs were used to characterize a sample through cross-sectional or longitudinal research, and less often to assess effects of interventions. CONCLUSION The identified PROMs in the CAYA population eligible for PPC is characterized by studies in high-income countries during ongoing care, primarily in patients with cancer or organ failure. More research is needed in patients living with other LL/LT conditions, and during different stages of the disease course, especially at time of diagnosis, during transition to adulthood, and in end-of-life care. This scoping review of PROMs relevant for young patients eligible for PPC may inform future research about patient-/proxy-reported or patient-centered outcome measures in PPC. TRIAL REGISTRATION Review registration: ( https://osf.io/yfch2/ ) and published protocol (Holmen et al. Syst Rev. 10:237, 2021).
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Affiliation(s)
- Heidi Holmen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs Place, Post Box 4, 0130, Oslo, Norway.
| | - Anette Winger
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs Place, Post Box 4, 0130, Oslo, Norway
| | - Simen A Steindal
- Lovisenberg Diaconal University College, Lovisenberggt, 15B, 0456, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Kirsti Riiser
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, St. Olavs Place, Post Box 4, 0130, Oslo, Norway
| | - Charlotte Castor
- Department of Health Sciences, Lund University, Box 157, 221 00, Lund, Sweden
| | - Lisbeth Gravdal Kvarme
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs Place, Post Box 4, 0130, Oslo, Norway
| | - Kari L Mariussen
- Lovisenberg Diaconal University College, Lovisenberggt, 15B, 0456, Oslo, Norway
| | - Anja Lee
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital HF, Nydalen, Box 4950, 0424, Oslo, Norway
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Dabaghi S, Esmaielzadeh F, Rohani C. Application of Rasch Analysis for Development and Psychometric Properties of Adolescents' Quality of Life Instruments: A Systematic Review. Adolesc Health Med Ther 2020; 11:173-197. [PMID: 33204203 PMCID: PMC7666979 DOI: 10.2147/ahmt.s265413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 10/20/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Due to the importance of assessing quality of life (QoL) in healthy and ill adolescents, the evaluation of psychometric properties of these questionnaires is important. OBJECTIVE To investigate the application of Rasch analysis in psychometric assessment studies on adolescents' QoL instruments, and to evaluate the quality of reporting Rasch parameters in these studies. METHODS This systematic review was conducted by searching for papers in electronic databases PubMed, Web of Science, EMBASE, Cochrane Library and Scopus until December 2018. RESULTS After screening 122 papers, 31 remained in the study. Around 68% of the studies used the Rasch analysis for instrument testing and 32% for the development of new instruments. In 77.4% of studies, both classical and Rasch methods were used parallel to data analysis. In 32.2% of studies, healthy adolescents were the main target group. The most commonly used instrument in Rasch studies was, KIDSCREEN, administered in different countries. Six Rasch parameters were reported with a higher percentage in the studies. Major reported parameters of Rasch analysis were application of the software program (96.7%), test of item fit to the Rasch model (93.5%), unidimensionality (80.6%), type of the identified mathematical Rasch model (74.1%), threshold (58%) and differential item functioning (54.8%). Based on the psychometric evaluation of the QoL instruments, 71% of studies showed acceptable results. CONCLUSION The application of the Rasch model for psychometric assessment of adolescents' QoL questionnaires has increased in recent decades. But, there is still no strong and commonly used critical appraisal tool or guideline for the evaluation of these papers.
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Affiliation(s)
- Sahar Dabaghi
- Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Esmaielzadeh
- Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Camelia Rohani
- Community Health Nursing Department, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Ersta Sköndal Bräcke University College, Campus Ersta, StockholmSE-100 61, Sweden
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Friedel M, Brichard B, Boonen S, Tonon C, De Terwangne B, Bellis D, Mevisse M, Fonteyne C, Jaspard M, Schruse M, Harding R, Downing J, Namisango E, Degryse JM, Aujoulat I. Face and Content Validity, Acceptability, and Feasibility of the Adapted Version of the Children's Palliative Outcome Scale: A Qualitative Pilot Study. J Palliat Med 2020; 24:181-188. [PMID: 32679002 DOI: 10.1089/jpm.2019.0646] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Objective: To assess the face and content validity, acceptability and feasibility of a French version of the Children's Palliative Outcome Scale (CPOS). Background: Instruments in French used to measure outcomes in pediatric palliative care are lacking. Methods: After forward-backward translation of the 12-item English CPOS to French, we conducted a qualitative pilot study. During semi structured interviews among children and parents, we used the CPOS, the Schedule for the Evaluation of Individual Quality of Life interview guide (SEIQoL) and the Quality of Life in Life-threatening Illness-Family Carer questionnaire (QOLLTI-F), in addition to three expert meetings with PLTs. Results: Fourteen children and adolescents (8-18 years) with life-limiting or life-threatening conditions cared for at home, in hospital or in respite care services, 19 parents, and 9 members of 4 pediatric liaison teams (PLTs) providing palliative care in a Belgian francophone region were included in the study. No families refused to participate. All children with verbal capacities chose to be interviewed in the presence of their parents and a PLT member. The children valued being given the opportunity to share their experiences. New QOL dimensions pertaining to social, emotional, and administrative health-care related issues were added to the original version of the 12-item CPOS, leading to a 22-item CPOS-2. Discussion: The CPOS-2 was perceived as relevant and easy to use by the principal stakeholders. Our study paves the way for a large-scale field study assessing its psychometric characteristics and its implementation in routine clinical care.
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Affiliation(s)
- Marie Friedel
- Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium.,Haute Ecole Léonard de Vinci, Brussels, Belgium
| | - Bénédicte Brichard
- Division of Pediatric Hematology/Oncology, Cliniques universitaires st Luc, Brussels, Belgium
| | - Sabine Boonen
- Interface pédiatrique, Cliniques universitaires st Luc, Brussels, Belgium
| | - Corinne Tonon
- Interface pédiatrique, Cliniques universitaires st Luc, Brussels, Belgium
| | | | - Dominique Bellis
- Haute Ecole Léonard de Vinci, Brussels, Belgium.,Interface pédiatrique, Cliniques universitaires st Luc, Brussels, Belgium
| | - Murielle Mevisse
- Interface pédiatrique, Cliniques universitaires st Luc, Brussels, Belgium
| | - Christine Fonteyne
- Globul'home, Hôpital universitaire des Enfants Reine Fabiola, Brussels, Belgium
| | - Maud Jaspard
- Equipe liaison pédiatrique, Centre hospitalier chrétien, Clinique de l'Espérance, Liège, Belgium
| | - Marie Schruse
- Equipe liaison pédiatrique, Centre hospitalier chrétien, Clinique de l'Espérance, Liège, Belgium
| | - Richard Harding
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Kings College London, United Kingdom
| | - Julia Downing
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Kings College London, United Kingdom.,International Children's Palliative Care Network, Bristol, United Kingdom
| | - Eve Namisango
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Kings College London, United Kingdom.,African Palliative Care Association, Kampala, Uganda
| | - Jean-Marie Degryse
- Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium.,Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Isabelle Aujoulat
- Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium
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Zalmstra T, Elema A, Huizing K, Reinders-Messelink H, V D Putten A. Longitudinal validation of the Caregiver Priorities and Child Health Index of Life with Disabilities in a Dutch sample of nonambulatory children with severe disabilities. Child Care Health Dev 2019; 45:409-416. [PMID: 30870582 DOI: 10.1111/cch.12663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 02/28/2019] [Accepted: 03/09/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the longitudinal validity of the Dutch version of the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD), a health-related quality of life instrument for nonambulatory children with severe motor disabilities and accompanying disorders. METHODS The effect of two interventions, Botox injections in the hip region and percutaneous endoscopic gastrostomy, was followed over time. Caregivers (n = 38) of nonambulatory children (26 boys, 12 girls; mean age: 9 years, 5 months [4 years, 9 months]) with severe disabilities completed the questionnaire prior to the intervention, at 3 months and 6 months follow up. Seven a priori hypotheses were formulated. Longitudinal validity was analysed by a paired t test of the pre-post scores and correlation analysis between the change-scores and two external criteria: a caregivers' perceived change in health-related quality of life of the child questionnaire and a general health-related quality of life instrument. RESULTS The results reported here follow completely the pattern we hypothesized for four analyses and partially in the remaining three. In the Botox group, the mean change-score at 3 months was 6.9 points (p < 0.05), which exceeds the minimal clinically important difference of 5.8 points. At 6 months, the effect was diminished to 4.5 points, in line with the temporary effect of Botox. There were moderate positive correlations between the change-scores and an external criterion (Spearman's rho: 0.46-0.58). CONCLUSIONS This study indicates that the CPCHILD Dutch version has sufficient longitudinal validity statistically and clinically in nonambulatory children with severe disabilities.
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Affiliation(s)
| | - Agnes Elema
- Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Karin Huizing
- Rehabilitation Center "Revalidatie Friesland", Beetsterzwaag, The Netherlands
| | - Heleen Reinders-Messelink
- Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, The Netherlands.,Rehabilitation Center "Revalidatie Friesland", Beetsterzwaag, The Netherlands
| | - Annette V D Putten
- Department of Special Needs Education and Youth Care, University of Groningen, Groningen, The Netherlands
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Gandhi PK, Thompson LA, Tuli SY, Revicki DA, Shenkman E, Huang IC. Developing item banks for measuring pediatric generic health-related quality of life: an application of the International Classification of Functioning, Disability and Health for Children and Youth and item response theory. PLoS One 2014; 9:e107771. [PMID: 25268926 PMCID: PMC4182329 DOI: 10.1371/journal.pone.0107771] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 08/14/2014] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to develop item banks by linking items from three pediatric health-related quality of life (HRQoL) instruments using a mixed methodology. Secondary data were collected from 469 parents of children aged 8-16 years. The International Classification of Functioning, Disability and Health-Children and Youth (ICF-CY) served as a framework to compare the concepts of items from three HRQoL instruments. The structural validity of the individual domains was examined using confirmatory factor analyses. Samejima's Graded Response Model was used to calibrate items from different instruments. The known-groups validity of each domain was examined using the status of children with special health care needs (CSHCN). Concepts represented by the items in the three instruments were linked to 24 different second-level categories of the ICF-CY. Eight item banks representing eight unidimensional domains were created based on the linkage of the concepts measured by the items of the three instruments to the ICF-CY. The HRQoL results of CSHCN in seven out of eight domains (except personality) were significantly lower compared with children without special health care needs (p<0.05). This study demonstrates a useful approach to compare the item concepts from the three instruments and to generate item banks for a pediatric population.
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Affiliation(s)
- Pranav K. Gandhi
- Department of Pharmacy Practice, School of Pharmacy, South College, Knoxville, TN, United States of America
| | - Lindsay A. Thompson
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - Sanjeev Y. Tuli
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | | | - Elizabeth Shenkman
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, United States of America
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, United States of America
| | - I-Chan Huang
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, United States of America
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, United States of America
- * E-mail:
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Huang IC, Anderson M, Gandhi P, Tuli S, Krull K, Lai JS, Nackashi J, Shenkman E. The relationships between fatigue, quality of life, and family impact among children with special health care needs. J Pediatr Psychol 2013; 38:722-31. [PMID: 23584707 PMCID: PMC3721186 DOI: 10.1093/jpepsy/jst016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 02/19/2013] [Accepted: 02/26/2013] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine the relationships among pediatric fatigue, health-related quality of life (HRQOL), and family impact among children with special health care needs (CSHCNs), specifically whether HRQOL mediates the influence of fatigue on family impact. METHODS 266 caregivers of CSHCNs were studied. The Pediatric Quality of Life Inventory Multidimensional Fatigue Scale, Pediatric Quality of Life Inventory Generic Scale, and Impact on Family Scale were used to measure fatigue, HRQOL, and family impact, respectively. Linear regressions were used to analyze the designated relationships; path analyses were performed to quantify the mediating effects of HRQOL on fatigue-family impact relationship. RESULTS Although greater fatigue was associated with family impact (p < .05), the association was not significant after accounting for HRQOL. Path analyses indicated the direct effect of fatigue on family impact was not significant (p > .05), whereas physical and emotional functioning significantly mediated the fatigue-family impact relationship (p < .001). CONCLUSION Fatigue is related to family impact among CSHCNs, acting through the impairment in HRQOL.
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Affiliation(s)
- I-Chan Huang
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL 32610, USA.
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Abstract
The primary focus of this review is on the cost-effectiveness of critical care. The rapid growth in health care expenditures has engendered careful scrutiny of the practice of medicine with regard not only to effectiveness but also to efficiency. This shift necessitates that physicians understand the effectiveness of their interventions and the cost at which this effectiveness is obtained. Cost-effectiveness and cost-utility analyses have become crucial evaluative tools in medicine. Explicit articulation of comparative cost-effectiveness facilitates the allocation of limited resources. Physicians and policy-makers must evaluate such studies with caution, skepticism, and attention to the methods used.
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