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Zhang L, Yu J, Zhang H, Chen S. Association between the hearing aid and mental health outcomes in people with hearing impairment: A case-control study among 28 European countries. J Affect Disord 2024; 361:536-545. [PMID: 38925313 DOI: 10.1016/j.jad.2024.06.085] [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] [Received: 03/29/2024] [Revised: 06/20/2024] [Accepted: 06/22/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Hearing loss affects over 1.5 billion individuals globally, with significant implications for mental health. This study investigates the association between hearing aid use and mental health outcomes, by particularly focusing on depression and unmet mental health needs (UMHN), across a diverse international sample. METHODS Utilizing data from the third wave of the European Health Interview Survey (EHIS), this study involved 17,660 participants with hearing impairment from 28 countries. The study examined the association between hearing aid use and mental health outcomes, including the likelihood of moderate and severe depression and UMHN due to lack of contact with general practitioners (GPs) and mental health specialists. Logistic regression models, adjusted for socio-demographic characteristics, health risk behaviours, and other relevant variables, were employed. Inverse probability weights were used to mitigate potential selection bias. RESULTS Hearing aid usage was associated with significantly lower likelihoods of moderate depression (Odds Ratio [OR] = 0.58, 95%CI = [0.54, 0.63]) and severe depression (OR = 0.61, 95%CI = [0.55, 0.69]), compared to non-usage. Hearing aid usage was also associated with reduced UMHN due to lack of GP contact for moderate (OR = 0.82, 95%CI = [0.75, 0.89]) and severe depression (OR = 0.75, 95%CI = [0.59, 0.95]). The depression risk reductions were greater among females and higher-educated subgroups but lower in individuals aged ≥65 years. Income level and rurality also impacted UMHN due to the lack of GP contact. No associations were found between hearing aids and UMHN due to the lack of mental health specialist contact. CONCLUSIONS Hearing aid adoption showed protective associations against mood disorders and lowered unmet primary mental healthcare needs. Tailoring intervention strategies to vulnerable sociodemographic profiles could optimize mental health benefits among those with hearing loss. Integrating hearing health services within mental healthcare delivery frameworks is vital amidst the rising global burden.
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Affiliation(s)
- Liansheng Zhang
- Department of Otolaryngology, Zhumadian Centre Civil Hospital, Zhumadian 463000, China.
| | - Jiazhou Yu
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.
| | - Huanyu Zhang
- Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China.
| | - Shanquan Chen
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom.
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Kirkland C, Evans N, Spates K, Mubikayi Kabasele C. Perceptions of Resettled Refugee Congolese Women: Maintaining Cultural Traditions during Resettlement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16714. [PMID: 36554594 PMCID: PMC9779386 DOI: 10.3390/ijerph192416714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
Conflict-displaced refugees have increased significantly globally. The Democratic Republic of Congo is the leading country with refugees in the United States, where many resettle in Ohio. Women refugees are highly vulnerable, yet little literature has focused on them. Furthermore, maintaining cultural traditions can provide comfort during the tumultuous resettlement process. Therefore, this study used mixed methods to understand the perceptions of Congolese refugee women on maintaining cultural traditions during resettlement in Ohio. Translator-assisted, orally administered demographic survey and face-to-face interviews were conducted among resettled Congolese refugee women (n = 20) 18 and older, who arrived in the United States from 2011 to 2018, and were currently receiving Ohio resettlement agency assistance. Researchers applied descriptive coding and thematic analysis to identify themes and subthemes. Three themes were identified among the resettled Congolese refugee women regarding maintaining cultural traditions in the United States. The three themes comprised (1) clothing and dressing, (2) food, and (3) parenting style. Our work examined resettled refugee Congolese women's perceptions of maintaining their culture after resettling in Ohio. These study findings could assist community engagers with insights and practical recommendations on supportive services for resettled Congolese women and a deeper understanding of complex acculturative situations facing them during resettlement.
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Affiliation(s)
- Chelsey Kirkland
- Center for Public Health Systems, University of Minnesota School of Public Health, 420 Delaware St SE, Minneapolis, MN 55455, USA
- College of Public Health, Kent State University, 800 Hilltop Dr., Kent, OH 44242, USA
| | - Na’Tasha Evans
- School of Health Sciences, College of Education, Health, and Human Services, Kent State University, 1225 Theatre Dr., Kent, OH 44242, USA
| | - Kamesha Spates
- Department of Sociology and Criminology, Kent State University, 700 Hilltop Dr., Kent, OH 44242, USA
- Department of Africana Studies, University of Pittsburgh, 230 S. Bouquet St., Pittsburgh, PA 15260, USA
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Selvan K, Leekha A, Abdelmeguid H, Malvankar-Mehta MS. Barriers adult refugees face to community health and patient engagement: a systematic review. Glob Public Health 2022; 17:3412-3425. [PMID: 36074889 DOI: 10.1080/17441692.2022.2121846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Meeting the health needs of refugee populations and increasing access to healthcare remains a challenge for healthcare systems globally. As such, community health and patient engagement are increasingly recommended strategies to address health-related issues among refugees. This systematic review aims to identify the reported barriers that adult refugees encounter with community health and patient engagement. Data sources included MEDLINE, Embase, APA PsycINFO, CINAHL, and Core Collection (Web of Science), yielding 1156 records. After removing duplicates and two levels of screening, 18 studies were selected for qualitative analysis. The barriers were conceptualised as cultural norms, pre-departure history, education, language proficiency, stigma, racism, social support, and multi-factorial barriers. These barriers can be addressed to improve rapport with refugees and the quality of community health and patient engagement initiatives.
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Affiliation(s)
- Kavin Selvan
- Genetics and Genome Biology (GGB) Program, The Hospital for Sick Children Research Institute, Toronto, Canada.,Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Canada.,Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,RefuHope, London, Canada
| | - Arshia Leekha
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, Canada.,RefuHope, London, Canada
| | - Hana Abdelmeguid
- Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada.,RefuHope, London, Canada
| | - Monali S Malvankar-Mehta
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada
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4
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Foong SC, Foong WC, Tan ML, Ho JJ, Omer-Salim A. A Participatory, Needs-Based Approach to Breastfeeding Training for Confinement Centres. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10914. [PMID: 36078639 PMCID: PMC9517788 DOI: 10.3390/ijerph191710914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
With a focus on traditional practices rather than evidence-based practices, breastfeeding support is sub-optimal in confinement centres (CCs). We used a participatory, needs-based approach to develop a training module for CC staff adopting Kern's six-step approach as our conceptual framework. Of 46 identified CCs, 25 accepted our invitation to a dialogue aimed at establishing relationships and understanding their needs. An interactive training workshop was developed from the dialogue's findings. The workshop, attended by 32 CCs (101 participants), was conducted four times over a four-month period. Questions raised by the participants reflected deficits in understanding breastfeeding concepts and erroneous cultural beliefs. Correct answers rose from 20% pre-test to 51% post-test. Post-workshop feedback showed that participants appreciated the safe environment to ask questions, raise concerns and correct misconceptions. An interview conducted 14 months later showed that while some CCs improved breastfeeding support, others made no change due to conflict between breastfeeding and traditional postnatal practices, which was aggravated by a lack of support due to the COVID-19 pandemic. A participatory approach established a trustful learning environment, helping CCs appreciate the value of learning and adopting new concepts. However, cultural perceptions take time to change, hence continuous training and support are vital for sustained changes.
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Affiliation(s)
- Siew Cheng Foong
- Department of Paediatrics, RCSI & UCD Malaysia Campus (Formerly Penang Medical College), George Town 10450, Malaysia
| | - Wai Cheng Foong
- Department of Paediatrics, RCSI & UCD Malaysia Campus (Formerly Penang Medical College), George Town 10450, Malaysia
| | - May Loong Tan
- Department of Paediatrics, RCSI & UCD Malaysia Campus (Formerly Penang Medical College), George Town 10450, Malaysia
| | - Jacqueline J. Ho
- Department of Paediatrics, RCSI & UCD Malaysia Campus (Formerly Penang Medical College), George Town 10450, Malaysia
| | - Amal Omer-Salim
- World Alliance for Breastfeeding Action, George Town 10850, Malaysia
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Soltan F, Cristofalo D, Marshall D, Purgato M, Taddese H, Vanderbloemen L, Barbui C, Uphoff E. Community-based interventions for improving mental health in refugee children and adolescents in high-income countries. Cochrane Database Syst Rev 2022; 5:CD013657. [PMID: 35532139 PMCID: PMC9083014 DOI: 10.1002/14651858.cd013657.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND An unprecedented number of people around the world are experiencing forced displacement due to natural or man-made events. More than 50% of refugees worldwide are children or adolescents. In addition to the challenges of settling in a new country, many have witnessed or experienced traumatic events. Therefore, refugee children and adolescents are at risk of developing mental health problems such as post-traumatic stress disorder, and require appropriate and effective support within communities. OBJECTIVES To assess the effectiveness and acceptability of community-based interventions (RCTs only) in comparison with controls (no treatment, waiting list, alternative treatment) for preventing and treating mental health problems (major depression, anxiety, post-traumatic stress disorder, psychological distress) and improving mental health in refugee children and adolescents in high-income countries. SEARCH METHODS Databases searches included the Cochrane Common Mental Disorders Controlled Trials Register (all available years), CENTRAL/CDSR (2021, Issue 2), Ovid MEDLINE, Embase, six other databases, and two trials registries to 21 February 2021. We checked reference lists of included study reports. SELECTION CRITERIA: Studies of any design were eligible as long as they included child or adolescent refugees and evaluated a community-based mental health intervention in a high-income country. At a second stage, we selected randomised controlled trials. DATA COLLECTION AND ANALYSIS For randomised controlled trials, we extracted data relating to the study and participant characteristics, and outcome data relating to the results of the trial. For studies using other evaluation methods, we extracted data relating to the study and participant characteristics. W derived evidence on the efficacy and availability of interventions from the randomised controlled trials only. Data were synthesised narratively. MAIN RESULTS We screened 5005 records and sought full-text manuscripts of 62 relevant records. Three randomised controlled trials were included in this review. Key concerns in the risk of bias assessments included a lack of clarity about the randomisation process, potential for bias is outcome measurement, and risk of bias in the selection of results. Primary outcomes There was no evidence of an effect of community-based interventions when compared with a waiting list for symptoms of post-traumatic stress (mean difference (MD) -1.46, 95% confidence interval (CI) -6.78 to 3.86: 1 study; low-certainty evidence), symptoms of depression (MD 0.26, 95% CI -2.15 to 2.67: 1 study; low-certainty evidence), and psychological distress (MD -10.5, 95% CI -47.94 to 26.94; 1 study; very low-certainty evidence). There were no data on adverse events. Secondary outcomes Three trials reported on short-term changes in child behaviour, using different measures, and found no evidence of an effect of the intervention versus a waiting list (low to very low certainty). None of the trials reported on quality of life or well-being, participation and functioning, or participant satisfaction. AUTHORS' CONCLUSIONS There is insufficient evidence to determine the efficacy and acceptability of community-based mental health interventions for refugee children and adolescents.
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Affiliation(s)
- Fatima Soltan
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Doriana Cristofalo
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - David Marshall
- Cochrane Common Mental Disorders, Centre for Reviews and Dissemination, University of York, York, UK
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Marianna Purgato
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Henock Taddese
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Laura Vanderbloemen
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
- College of Health Sciences, VinUniversity, Hanoi, Vietnam
| | - Corrado Barbui
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Eleonora Uphoff
- Cochrane Common Mental Disorders, Centre for Reviews and Dissemination, University of York, York, UK
- Centre for Reviews and Dissemination, University of York, York, UK
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Jallow M, Haith-Cooper M, Hargan J, Balaam MC. A systematic review to identify key elements of effective public health interventions that address barriers to health services for refugees. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01519-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Paloma V, de la Morena I, Sladkova J, López-Torres C. A peer support and peer mentoring approach to enhancing resilience and empowerment among refugees settled in southern Spain. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:1438-1451. [PMID: 32134511 DOI: 10.1002/jcop.22338] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 01/03/2020] [Accepted: 02/22/2020] [Indexed: 06/10/2023]
Abstract
This study aims to analyze the processes of resilience and empowerment experienced by refugees in southern Spain during their participation in a community-based intervention. Intervention design covered two phases over 15 weeks: (a) accompanying a group of 10 settled refugees to become mentors, making use of a peer-support-group format; and (b) holding four cultural peer-support groups made up of newly arrived refugees led by the previously trained settled refugees, following a peer-mentoring format. We analyzed the mentors' narratives and written evaluations produced over the course of the intervention program. Mentor resilience increased during the first program phase and remained high and stable during the second phase. Mentor empowerment steadily increased throughout the duration of the program, and was fueled when participants became mentors to newly arrived refugees during the second phase. This study highlights how a peer-support and peer-mentoring approach is useful for enhancing the resilience and empowerment of refugees in receiving societies.
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Affiliation(s)
- Virginia Paloma
- Department of Social Psychology, Universidad de Sevilla, Sevilla, Spain
| | - Irene de la Morena
- International Protection Area, Federación Andalucía Acoge, Sevilla, Spain
| | - Jana Sladkova
- Department of Psychology, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Clara López-Torres
- Social Inclusion Area, Comisión Española de Ayuda al Refugiado (Spanish Commission for Refugee Aid), Sevilla, Spain
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Social Capital: Supportive of Bhutanese Refugees’ Integration in the United States. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2020. [DOI: 10.1007/s12134-019-00750-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Paloma V, de la Morena I, López-Torres C. Promoting posttraumatic growth among the refugee population in Spain: A community-based pilot intervention. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:127-136. [PMID: 31476095 DOI: 10.1111/hsc.12847] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 04/18/2019] [Accepted: 08/19/2019] [Indexed: 06/10/2023]
Abstract
Various international organisations have identified the development of programmes that mitigate the negative impact that forced displacement has on refugees' mental health as a priority intervention area. From this perspective, this study seeks to lend empirical support to a community-based pilot intervention aimed at promoting posttraumatic growth (PTG) among refugee adults arrived to Seville, the capital of Andalucía (southern Spain). PTG constitutes a mental health indicator that refers to the positive personal transformations refugees undergo as a consequence of experiencing forced displacement. This concept does not negate the undeniable personal suffering forced displacement causes for refugees; rather, it focuses on the positive changes this event has the potential to bring about. Forty-seven individuals (age, M = 33 years; 20 women) from several countries in conflict participated in the intervention over 15 weeks (March-June 2017). The implementation process comprised two phases: (a) training a group of settled refugees to become peer mentors; and (b) holding cultural peer-support group sessions made up of newly arrived refugees led by the mentors. Following quantitative and qualitative data collection (using the 'Posttraumatic Growth Inventory' (PTGI; Tedeschi & Calhoun, Journal of Traumatic Stress, 1996, 9, 455) and participants' written evaluations and comments, respectively), and adopting a pretest-posttest evaluation design, significant improvements were found in four of the five PTG factors: 'appreciation of life', 'personal strength', 'relating to others' and 'new possibilities'. However, no significant differences were observed for 'spiritual change'. We also documented implementation outcomes which revealed high intervention acceptability, appropriateness and feasibility. This study highlights how PTG shown by the refugee population can be actively improved through a community-based intervention, specifically by creating supportive community settings that adopt a mentorship and peer-based approach. The limitations and contributions of this research that address the current challenges behind promoting the mental health of refugees in places of settlement are discussed.
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Affiliation(s)
- Virginia Paloma
- Department of Social Psychology, Universidad de Sevilla, Sevilla, Spain
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Living a Healthy Life in Australia: Exploring Influences on Health for Refugees from Myanmar. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010121. [PMID: 31877976 PMCID: PMC6982124 DOI: 10.3390/ijerph17010121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/18/2019] [Accepted: 12/19/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Humanitarian migrants from Myanmar represent a significant refugee group in Australia; however, knowledge of their health needs and priorities is limited. This study aims to explore the meaning and influencers of health from the perspectives of refugees from Myanmar. METHOD Using a community-based participatory research (CBPR) design, a partnership was formed between the researchers, Myanmar community leaders and other service providers to inform study design. A total of 27 participants were recruited from a government-funded English language program. Data were collected using a short demographic survey and four focus groups, and were analysed using descriptive statistics and thematic analysis methods. RESULTS Key themes identified included: (1) health according to the perspectives of Australian settled refugees from Myanmar, (2) social connections and what it means to be part of community, (3) work as a key influence on health, and (4) education and its links with work and health. CONCLUSIONS This study outlined the inter-relationships between health, social connections, work and education from the perspectives of refugees from Myanmar. It also outlined how people from Myanmar who are of a refugee background possess strengths that can be used to manage the various health challenges they face in their new environment.
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Working Through Uncertainty: The Perils and Potential of Community-Engaged Research on Refugee Resettlement. SOCIAL SCIENCES 2019. [DOI: 10.3390/socsci8030073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
What can be learned from the process of community-engaged research (CER) on refugee resettlement? In the following, we share experiences, reflections, and lessons from implementing such a project. We begin with background on refugee resettlement and recent resettlement dynamics in the United States and Wisconsin, as well as literature on the study of refugees and this type of research more generally. Results and discussion are presented though our understanding of, and involvement with, the process via a framework of CER desired process outcomes, which we both propose and utilize to encourage effective efforts with marginalized populations going forward. CER is challenging and must be undertaken thoughtfully. One of the paper’s primary contributions is to share successes and failures in a transparent and unvarnished fashion. In particular, researchers need to share power and listen deeply, actions that will reverberate throughout such a process. Doing so comes with certain risks, and may be tangled, but also has strong potential to produce useful data, deep learning for researchers and participants, as well as empowerment of marginalized populations and relationship building that can yield future collaboration towards resilience.
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