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Congiu P, Carta MG, Perra A, Cantone E, Lorrai S, Pintus E, Tusconi M, Cossu G, Redolfi S, Sancassiani F. Prevalence and Risk by Age and Sex of Sleep Dysregulation and Depressive Episodes in Bipolar and Depressive Disorders in a Community Survey in Sardinia, Italy. J Clin Med 2024; 13:4870. [PMID: 39201012 PMCID: PMC11355541 DOI: 10.3390/jcm13164870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Revised: 08/09/2024] [Accepted: 08/16/2024] [Indexed: 09/02/2024] Open
Abstract
Background/Objectives: Sleep disturbances often accompany mood disorders and persistent insomnia after mood symptoms have resolved may be a marker of poor outcome. The association between sleep symptoms and mood disorders seems to change with age and sex. This study aims to assess the frequency of depressive episodes and sleep disorders in the general population through an agile screening questionnaire and to evaluate the association of depressive episodes and sleep symptoms by sex and age categories. Methods: 774 women and 728 men from Sardinia aged > 16 years old were enrolled. The Patient Health Questionnaire (PHQ-9) was administered through a computer-assisted telephonic interview. Results: The frequency of depressive episodes was double in women (10.6% vs. 4.4%; p < 0.0001), with the highest values in women > 75 yo (17.4%). The frequency of sleep dysregulation was double in women (18.7% vs. 9.6%; p < 0.0001), with the highest values in women > 75 yo (35.9%) and the lowest in the group of men > 75 yo. The group of young males showed the lowest frequency of depressive episodes (1.4%) and a frequency of sleep dysregulation (9.1%) similar to that of the other groups of age and sex. Sleep dysregulation without depressive episodes presented a higher distribution in the elderly, both in males (20.7%) and in females (18.5%). No significative differences were found across sex and age groups in the distribution of depressive episodes without sleep dysregulation. Conclusions: The use of an agile screener such as PHQ9 in the general population and/or in populations at risk can be a valuable tool in finding those individuals in whom sleep dysregulation may represent an early warning signal, one that may be thoroughly evaluated to identify and treat possible sleep disorders early.
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Affiliation(s)
- Patrizia Congiu
- Department of Medical Sciences and Public Health, Sleep Disorder Research Center, University of Cagliari, 09124 Cagliari, Italy; (P.C.); (S.R.)
- Sleep Outpatient Service, Clinica Tommasini di Jerzu, 08044 Jerzu, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, Section of Psychiatry, University of Cagliari, 09124 Cagliari, Italy; (M.G.C.); (A.P.); (E.C.); (S.L.); (E.P.); (G.C.); (F.S.)
| | - Alessandra Perra
- Department of Medical Sciences and Public Health, Section of Psychiatry, University of Cagliari, 09124 Cagliari, Italy; (M.G.C.); (A.P.); (E.C.); (S.L.); (E.P.); (G.C.); (F.S.)
| | - Elisa Cantone
- Department of Medical Sciences and Public Health, Section of Psychiatry, University of Cagliari, 09124 Cagliari, Italy; (M.G.C.); (A.P.); (E.C.); (S.L.); (E.P.); (G.C.); (F.S.)
| | - Stefano Lorrai
- Department of Medical Sciences and Public Health, Section of Psychiatry, University of Cagliari, 09124 Cagliari, Italy; (M.G.C.); (A.P.); (E.C.); (S.L.); (E.P.); (G.C.); (F.S.)
| | - Elisa Pintus
- Department of Medical Sciences and Public Health, Section of Psychiatry, University of Cagliari, 09124 Cagliari, Italy; (M.G.C.); (A.P.); (E.C.); (S.L.); (E.P.); (G.C.); (F.S.)
| | | | - Giulia Cossu
- Department of Medical Sciences and Public Health, Section of Psychiatry, University of Cagliari, 09124 Cagliari, Italy; (M.G.C.); (A.P.); (E.C.); (S.L.); (E.P.); (G.C.); (F.S.)
| | - Stefania Redolfi
- Department of Medical Sciences and Public Health, Sleep Disorder Research Center, University of Cagliari, 09124 Cagliari, Italy; (P.C.); (S.R.)
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, Section of Psychiatry, University of Cagliari, 09124 Cagliari, Italy; (M.G.C.); (A.P.); (E.C.); (S.L.); (E.P.); (G.C.); (F.S.)
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Avilés L, Castillo-Mansilla D, Wang Y, Smith P. Person-centred care and online pedagogy in nursing education: a discussion paper. Nurse Educ Pract 2024; 78:103998. [PMID: 38810351 DOI: 10.1016/j.nepr.2024.103998] [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: 04/15/2024] [Revised: 05/11/2024] [Accepted: 05/14/2024] [Indexed: 05/31/2024]
Abstract
AIM To discuss person-centred care in nursing education and the role of online pedagogy to facilitate meaninful learning. BACKGROUND The core principles and values of person-centred care are at the centre of national and international healthcare education. Person-centred care recognises partnerships and relationships between nurses, healthcare practitioners and individual patients, carers and their families and part of the training of healthcare professionals. However, the literature on how person-centred care is taught to facilitate meaningful learning in nursing education particularly in the context of online pedagogy is limited. DESIGN A critical discussion paper. METHODS A critical discussion of person-centred care and online pedagogy that can facilitate teaching practices are presented, drawing on authors' positionality and case exemplars. RESULTS Teaching person-centred care using online pedagogy appears to have a promising impact on undergraduate and postgraduate nursing students' experiences. Engaging students in critical examination and reflection on the complexities of person-centred care in practice creates meaningful experiential learning for both students and educators. CONCLUSION Evidence suggests that the use of online pedagogy is a beneficial and effective way to incorporate the teaching of person-centred care into nursing education, yet more evidence is needed to evaluate its impact on nursing practice.
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Affiliation(s)
- Lissette Avilés
- Nursing Studies, School of Health in Social Sciences, The University of Edinburgh, Doorway 6 Old Medical School, Teviot Place, Edinburgh EH8 9 AG, United Kingdom.
| | - Daniela Castillo-Mansilla
- Nursing Studies, School of Health in Social Sciences, The University of Edinburgh, Doorway 6 Old Medical School, Teviot Place, Edinburgh EH8 9 AG, United Kingdom; Universidad de Chile, Facultad de Medicina, Av. Independencia 1027, Independencia, Santiago, Región Metropolitana 8380453, Chile
| | - Yin Wang
- Nursing Studies, School of Health in Social Sciences, The University of Edinburgh, Doorway 6 Old Medical School, Teviot Place, Edinburgh EH8 9 AG, United Kingdom
| | - Pam Smith
- Nursing Studies, School of Health in Social Sciences, The University of Edinburgh, Doorway 6 Old Medical School, Teviot Place, Edinburgh EH8 9 AG, United Kingdom
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Baheretibeb Y, Wondimagegn D, Law S. "Trust in God, but tie your donkey": Holy water priest healers' views on collaboration with biomedical mental health services in Addis Ababa, Ethiopia. Transcult Psychiatry 2024; 61:246-259. [PMID: 38314780 PMCID: PMC10943614 DOI: 10.1177/13634615241227681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
This exploratory qualitative study examines holy water priest healers' explanatory models and general treatment approaches toward mental illness, and their views and reflections on a collaborative project between them and biomedical practitioners. The study took place at two holy water treatment sites in Addis Ababa, Ethiopia. Twelve semi-structured interviews with holy water priest healers found eight notable themes: they held multiple explanatory models of illness, dominated by religious and spiritual understanding; they emphasized spiritual healing and empathic understanding in treatment, and also embraced biomedicine as part of an eclectic healing model; they perceived biomedical practitioners' humility and respect as key to their positive views on the collaboration; they valued recognition of their current role and contribution in providing mental healthcare; they recognized and appreciated the biomedical clinic's effectiveness in treating violent and aggressive patients; they endorsed the collaboration and helped to overcome patient and family reluctance to the use of biomedicine; they lamented the lack of spiritual healing in biomedical treatment; and they had a number of dissatisfactions and concerns, particularly the one-way referral from religious healers to the biomedical clinic. The study results show diversity in the religious healers' etiological understanding, treatment approaches and generally positive attitude and views on the collaboration. We present insights and explorations of factors affecting this rare, but much needed collaboration between traditional healers and biomedical services, and potential ways to improve it are discussed.
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Barnes GL, Haghiran MZ, Tracy DK. Contemporary perceptions and meanings of 'the medical model' amongst NHS mental health inpatient clinicians. Int J Ment Health Nurs 2022; 31:567-575. [PMID: 34994499 DOI: 10.1111/inm.12972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 12/05/2021] [Accepted: 12/16/2021] [Indexed: 11/28/2022]
Abstract
Debates within health care and public spheres have, at times, created a seeming 'divide' between biological and psychosocial determinants and management of mental health difficulties. The phrase 'medical model' is often held up as an example and is sometimes used pejoratively to infer over-reliance on biology and medication. Our objective was to explore inpatient mental health clinicians' perceptions of the definition and the application of a 'medical model' in contemporary mental health care. In this qualitative study, eighteen clinicians working in adult inpatient teams participated in three mixed focus groups. Data were analysed using framework analysis. Three core themes were identified: (i) power of a 'medical model' and authority of the medic; (ii) responsibility within, and reliance on, a 'medical model'; and (iii) integrated models of contemporary mental health care. Subthemes arose around organisational culture and low resources affecting the power of a 'medical model' and the value of multidisciplinary and person-centred approaches. The findings highlight the importance of recognising inter-professional dynamics and power gradients in mental health teams and organisations, as we begin to move towards more integrated models of collaboration and distributed leadership within the NHS.
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Affiliation(s)
- Georgina L Barnes
- South London & Maudsley NHS Foundation Trust, London, UK.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Maryam Z Haghiran
- Department of Psychology, Royal Holloway University of London, Egham, UK
| | - Derek K Tracy
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,West London NHS Trust, Southhall, UK
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"I've Lived that Thing that We do with Families": Understanding the Experiences of Practitioners' Undertaking a Three-Year Open Dialogue UK Training Programme. Community Ment Health J 2022; 58:788-798. [PMID: 34533745 DOI: 10.1007/s10597-021-00885-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
Open dialogue is a systemically-based approach to mental healthcare, originating from Finland. Growing numbers of practitioners are being trained internationally, but little is known about the impact of such trainings within a UK setting. This study used interpretative phenomenological analysis of focus group data to explore the experiences of thirteen individuals undertaking a three-year UK open dialogue training. Four themes emerged: (1) a powerful experiential process; (2) personal therapeutic change; (3) deeper and more open relationships and (4) altered relationships to power in working practice. The findings suggest that open dialogue trainees experience greater depth in relationships with both clients and colleagues as a result of training, even participants who already had therapeutic training backgrounds. The findings also contribute to Transformational Learning literature regarding how experiential, non-hierarchical, dialogical teaching methods may enhance learning on therapeutic programmes and, therefore, lead to positive changes within clinical practice.
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Stoll J, Mathew A, Venkateswaran C, Prabhakaran A, Westermair AL, Trachsel M. Palliative Psychiatry for Patients With Severe and Persistent Mental Illness: A Survey on the Attitudes of Psychiatrists in India Compared to Psychiatrists in Switzerland. Front Psychiatry 2022; 13:858699. [PMID: 35693967 PMCID: PMC9178077 DOI: 10.3389/fpsyt.2022.858699] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Palliative psychiatry is a new approach for the care of patients with severe and persistent mental illness (SPMI) which systematically considers biological, psychological, social, and existential factors of care. To assess the attitudes of psychiatrists in India toward palliative psychiatry for patients with SPMI and to compare these to the attitudes of psychiatrists in Switzerland. METHODS In an online survey, data from 206 psychiatrists in India were collected and compared with data from a previous survey among 457 psychiatrists in Switzerland. RESULTS Psychiatrists in India generally considered it very important to prevent suicide in SPMI patients (97.6%). At the same time, they considered it very important to reduce suffering (98.1%) and to ensure functionality in everyday life (95.6%). They agreed that palliative psychiatry is important for providing optimal care to SPMI patients without life-limiting illness (79.6%) and considered palliative psychiatry as indicated for patients with SPMI (78.2%). By contrast, curing the illness was considered very important by only 39.8 % of respondents. Relative to psychiatrists in Switzerland, psychiatrists in India were significantly more concerned about preventing suicide and less willing to accept a reduction in life expectancy, even at the expense of quality of life in patients with severe and persistent schizophrenia and recurrent major depressive disorder. At the same time, they were significantly more likely to advocate palliative psychiatry. CONCLUSION Most of the participating psychiatrists in India agreed that palliative psychiatry can be indicated for patients with SPMI. The comparison with psychiatrists in Switzerland highlights the need to take account of cultural differences in future studies of this kind. In summary, this study shows the potential of palliative psychiatry as a genuine biopsychosocio-existential approach which systematically integrates biological, psychological, social, and existential factors of care.
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Affiliation(s)
- Julia Stoll
- Institute of Biomedical Ethics and History of Medicine, University of Zurich (UZH), Zurich, Switzerland
| | - Anju Mathew
- Department of Psychiatry, Government Medical College, Thiruvananthapuram, India
| | - Chitra Venkateswaran
- Department of Psychiatry, Department of Palliative Medicine, Believers Church Medical College Hospital, Tiruvalla, India.,Mehac Foundation, Kochi, India
| | - Anil Prabhakaran
- Department of Psychiatry, Government Medical College, Thiruvananthapuram, India
| | - Anna Lisa Westermair
- Institute of Biomedical Ethics and History of Medicine, University of Zurich (UZH), Zurich, Switzerland.,Clinical Ethics Unit, University Hospital of Basel (USB) and University Psychiatric Clinics Basel (UPK), Basel, Switzerland
| | - Manuel Trachsel
- Institute of Biomedical Ethics and History of Medicine, University of Zurich (UZH), Zurich, Switzerland.,Clinical Ethics Unit, University Hospital of Basel (USB) and University Psychiatric Clinics Basel (UPK), Basel, Switzerland
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Kelly RE, Ahmed AO, Hoptman MJ, Alix AF, Alexopoulos GS. The Quest for Psychiatric Advancement through Theory, beyond Serendipity. Brain Sci 2021; 12:72. [PMID: 35053815 PMCID: PMC8773950 DOI: 10.3390/brainsci12010072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 01/16/2023] Open
Abstract
Over the past century, advancements in psychiatric treatments have freed countless individuals from the burden of life-long, incapacitating mental illness. These treatments have largely been discovered by chance. Theory has driven advancement in the natural sciences and other branches of medicine, but psychiatry remains a field in its "infancy". The targets for healing in psychiatry lie within the realm of the mind's subjective experience and thought, which we cannot yet describe in terms of their biological underpinnings in the brain. Our technology is sufficiently advanced to study brain neurons and their interactions on an electrophysiological and molecular level, but we cannot say how these form a single feeling or thought. While psychiatry waits for its "Copernican Revolution", we continue the work in developing theories and associated experiments based on our existing diagnostic systems, for example, the Diagnostic and Statistical Manual of Mental Disorders (DSM), International Classification of Diseases (ICD), or the more newly introduced Research Domain Criteria (RDoC) framework. Understanding the subjective reality of the mind in biological terms would doubtless lead to huge advances in psychiatry, as well as to ethical dilemmas, from which we are spared for the time being.
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Affiliation(s)
- Robert E. Kelly
- Department of Psychiatry, Weill Cornell Medicine, White Plains, NY 10605, USA; (A.O.A.); (G.S.A.)
| | - Anthony O. Ahmed
- Department of Psychiatry, Weill Cornell Medicine, White Plains, NY 10605, USA; (A.O.A.); (G.S.A.)
| | - Matthew J. Hoptman
- Clinical Research Division, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA;
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Anika F. Alix
- Teachers College, Columbia University, New York, NY 10027, USA;
| | - George S. Alexopoulos
- Department of Psychiatry, Weill Cornell Medicine, White Plains, NY 10605, USA; (A.O.A.); (G.S.A.)
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Boettcher N. Studies of Depression and Anxiety Using Reddit as a Data Source: Scoping Review. JMIR Ment Health 2021; 8:e29487. [PMID: 34842560 PMCID: PMC8663609 DOI: 10.2196/29487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/20/2021] [Accepted: 08/15/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The study of depression and anxiety using publicly available social media data is a research activity that has grown considerably over the past decade. The discussion platform Reddit has become a popular social media data source in this nascent area of study, in part because of the unique ways in which the platform is facilitative of research. To date, no work has been done to synthesize existing studies on depression and anxiety using Reddit. OBJECTIVE The objective of this review is to understand the scope and nature of research using Reddit as a primary data source for studying depression and anxiety. METHODS A scoping review was conducted using the Arksey and O'Malley framework. MEDLINE, Embase, CINAHL, PsycINFO, PsycARTICLES, Scopus, ScienceDirect, IEEE Xplore, and ACM academic databases were searched. Inclusion criteria were developed using the participants, concept, and context framework outlined by the Joanna Briggs Institute Scoping Review Methodology Group. Eligible studies featured an analytic focus on depression or anxiety and used naturalistic written expressions from Reddit users as a primary data source. RESULTS A total of 54 studies were included in the review. Tables and corresponding analyses delineate the key methodological features, including a comparatively larger focus on depression versus anxiety, an even split of original and premade data sets, a widespread analytic focus on classifying the mental health states of Reddit users, and practical implications that often recommend new methods of professionally delivered monitoring and outreach for Reddit users. CONCLUSIONS Studies of depression and anxiety using Reddit data are currently driven by a prevailing methodology that favors a technical, solution-based orientation. Researchers interested in advancing this research area will benefit from further consideration of conceptual issues surrounding the interpretation of Reddit data with the medical model of mental health. Further efforts are also needed to locate accountability and autonomy within practice implications, suggesting new forms of engagement with Reddit users.
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Affiliation(s)
- Nick Boettcher
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Aftab A. Conceptual psychiatry: the ground beneath our feet. Int Rev Psychiatry 2021; 33:443-445. [PMID: 34370599 DOI: 10.1080/09540261.2020.1864303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Awais Aftab
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA.,Ohio Department of Mental Health and Addiction Services), Northcoast Behavioral Healthcare, Northfield, OH, USA
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Vorstman J, Scherer SW. What a finding of gene copy number variation can add to the diagnosis of developmental neuropsychiatric disorders. Curr Opin Genet Dev 2021; 68:18-25. [PMID: 33454514 DOI: 10.1016/j.gde.2020.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/14/2020] [Accepted: 12/22/2020] [Indexed: 11/26/2022]
Abstract
Among medical disciplines, diagnosis in psychiatry depends highly upon descriptive signs and symptoms, rather than biomarkers. Clear descriptions of specific genetic etiologies have been lacking; genomic technologies, however, are rapidly changing that landscape. Notably, chromosomal microarrays-which detect gene copy number variants (CNVs)-are a recommended standard of care for neurodevelopmental disorders. As a result, an increasing number of patients now receive a clinical diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and an identified genetic etiological variant. However, psychiatric and genetic diagnoses are frequently communicated and managed as two disconnected diagnostic parameters. Here, we advocate for a transition model, allowing the integration of genetic etiological information-starting with diagnostically proven CNVs-within the DSM-5 classification framework.
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Affiliation(s)
- Jacob Vorstman
- Department of Psychiatry, Hospital for Sick Children University of Toronto, Toronto, ON, Canada; Program in Genetics and Genome Biology, Hospital for Sick Children, Canada; The Centre for Applied Genomics, Hospital for Sick Children, Canada
| | - Stephen W Scherer
- Program in Genetics and Genome Biology, Hospital for Sick Children, Canada; The Centre for Applied Genomics, Hospital for Sick Children, Canada; McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Canada.
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