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Habibi Baghi M, Abolghasemi M, Zakerimoghadam M, Rezaiezadeh M, Vahidi Asl M. Unveiling CPR training challenges in nursing education: Pedagogical strategies for success. Nurse Educ Pract 2024; 78:104040. [PMID: 38943760 DOI: 10.1016/j.nepr.2024.104040] [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: 04/18/2024] [Revised: 06/08/2024] [Accepted: 06/17/2024] [Indexed: 07/01/2024]
Abstract
AIM This study explored the challenges nursing students face while learning CPR and identified experiential learning strategies to address these challenges. BACKGROUND Nursing students often experience challenges and anxiety during clinical learning, including CPR training. Given the experimental nature of CPR training, experiential learning models like mARC can significantly enhance the learning experience by addressing these prevalent challenges. DESIGN This study adopts an interpretivist approach within a qualitative methodology and uses a phenomenological design. METHOD Semi-structured interviews and the Delphi method were used to gather firsthand experiences from 37 educational supervisors, nursing professors and nursing students undergoing CPR clinical training at five public medical universities. RESULTS Four main challenges and eighteen sub-challenges of CPR training were identified, elaborated and modeled. Additionally, thirteen experiential learning strategies, based on the mARC experiential learning model (more Authentic, Reflective, Collaborative), were mapped to address these challenges. CONCLUSIONS Among the four main challenges of CPR training identified by this study, the lack of pedagogy appears to be the underlying cause of the other three. This underscores the significance of integrating effective pedagogical approaches into nurse education strategies and initiatives.
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Affiliation(s)
- Masoomeh Habibi Baghi
- Department of Education, Faculty of Education and Psychology, University of Shahid Beheshti, Tehran 1983969411, Iran; Faculty of science, The university of Waterloo, Waterloo N2L 3G1, Canada
| | - Mahmood Abolghasemi
- Department of Education, Faculty of Education and Psychology, University of Shahid Beheshti, Tehran 1983969411, Iran
| | | | - Morteza Rezaiezadeh
- Department of Education, Faculty of Education and Psychology, University of Shahid Beheshti, Tehran 1983969411, Iran; Medical School, College of Life Sciences, University of Leicester, Leicester, UK.
| | - Mojtaba Vahidi Asl
- Department of Software and information systems, University of Shahid Beheshti, Tehran 1416753955, Iran
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Marzaleh MA, Peyravi M, Ahmadi E, Mahmoodi H, Shakibkhah I, Armin H. Lived experiences of Iranian prehospital emergency technicians in facing women's emergencies: a phenomenological study. BMC Emerg Med 2024; 24:98. [PMID: 38858640 PMCID: PMC11165769 DOI: 10.1186/s12873-024-01019-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 06/05/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION This study aimed to investigate the work problems and challenges of male prehospital emergency technicians when faced with female medical emergencies. Given that qualitative research has not been done in this field, planning to find the weak points and improve the quality of prehospital emergency as the first line of treatment for female emergency patients, which is considered an important part of the health care system, is considered important and valuable. Therefore, this phenomenological study was conducted in 2023. METHODS This study was conducted using a qualitative method of phenomenology in 2023. The environment of the research was urban and road prehospital emergency centers in Iran and the data were collected through interviews with EMS technicians. The collected data were analyzed using Smith's approach to explain the lived experiences of EMS technicians facing female emergencies or women's emergencies in Iran. RESULTS All the 15 participants were men. Their mean age was 35 years, with a range of 25 to 45 years, and with a mean work experience of 10.54 years with a range of 4 to 20 years. The lived experiences of 115 emergency technicians in facing women's emergencies in Iran were placed in four main themes cultural-social factors, organizational factors, human resources-related factors, and administrative-legal factors. CONCLUSION EMS personnel face various obstacles in carrying out missions related to women's emergencies, Considering the critical nature of women's emergencies, it is recommended that policymakers and clinical educators improve the level of community culture, communication skills, theoretical and practical training, respecting privacy, hiring female personnel, adding specialized equipment, amending and changing laws, removing road-traffic obstacles and to support personnel, patients and their families psychologically to optimize performance in women's emergencies.
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Affiliation(s)
- Milad Ahmadi Marzaleh
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmoudreza Peyravi
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Esmaeil Ahmadi
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hadi Mahmoodi
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Shakibkhah
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Armin
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Zali M, Rahmani A, Hassankhani H, Namdar-Areshtanab H, Gilani N, Azadi A, Ghafourifard M. Critical care nurses' experiences of caring challenges during post-resuscitation period: a qualitative content analysis. BMC Nurs 2024; 23:150. [PMID: 38433187 PMCID: PMC10910715 DOI: 10.1186/s12912-024-01814-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Patients in the post-resuscitation period experience critical conditions and require high-quality care. Identifying the challenges that critical care nurses encounter when caring for resuscitated patients is essential for improving the quality of their care. AIM This study aimed to identify the challenges encountered by critical care nurses in providing care during the post-resuscitation period. METHODS A qualitative study was conducted using semi-structured interviews. Sixteen nurses working in the intensive care units of three teaching hospitals were selected through purposive sampling. The Data collected were analyzed using qualitative content analysis. RESULTS Participants experienced individual, interpersonal, and organizational challenges when providing post-resuscitation care. The most significant challenges include inadequate clinical knowledge and experience, poor management and communication skills, lack of support from nurse managers, role ambiguity, risk of violence, and inappropriate attitudes of physicians towards nurses' roles. Additionally, nurses expressed a negative attitude towards resuscitated patients. CONCLUSION Critical care nurses face several challenges in providing care for resuscitated patients. To enhance the quality of post-resuscitation care, address the challenges effectively and improve long-time survival it is crucial to implement interventions such as In-service education, post-resuscitation briefing, promotion of interprofessional collaboration among healthcare teams, providing sufficient human resources, clarifying nurses' roles in the post-resuscitation period and increasing support from nursing managers.
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Affiliation(s)
- Mahnaz Zali
- Nursing faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azad Rahmani
- Nursing faculty, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Hadi Hassankhani
- Nursing faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Neda Gilani
- Health faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arman Azadi
- Nursing faculty, Ilam University of Medical Sciences, Ilam, Iran
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Afshari A, Torabi M, Navkhasi S, Aslani M, Khazaei A. Navigating into the unknown: exploring the experience of exposure to prehospital emergency stressors: a sequential explanatory mixed-methods. BMC Emerg Med 2023; 23:136. [PMID: 37968617 PMCID: PMC10648310 DOI: 10.1186/s12873-023-00906-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/06/2023] [Indexed: 11/17/2023] Open
Abstract
INTRODUCTION The unpredictability of prehospital emergencies combined with constantly changing circumstances can lead to increased stress and mental health issues among Emergency Medical Technicians (EMTs). To accurately determine the stress-inducing factors in the prehospital environment, it is important to first identify the stressful events that occur in this environment. Therefore, this study strives to provide a thorough analysis of the stressors in the prehospital environment. METHODS Sequential explanatory mixed methods were conducted in Hamadan prehospital emergency centers in 2022. The study included 251 EMTs, who were selected through a method in the quantitative phase. The quantitative part used a questionnaire consisting of basic information and the Posttraumatic Stress Questionnaire (PCL-5). In the qualitative phase, 17 with extensive experience in dealing with prehospital stressors were selected based on their PCL-5 scores (above 33). The qualitative phase analysis was carried out using the contractual content method using the Graneheim and Ladman's approach. Statistical analyzes for the quantitative and qualitative phases were performed using SPSS 21 and maxqda 10, respectively. RESULTS The study revealed that the EMTs had an average PTSD score of 21. 60 ± 11. 45. Multivariate linear regression analysis showed that the number of shifts had a statistically significant relationship with PTSD scores (t = 26.38, P < 0.001). The qualitative phase of the study included 17 interviews, resulting in 14 subcategories, which consisted of four categories: "the overall impact of the stress crisis on technicians," "missing links in the communication network in incident management," "professional shortcomings in pre-hospital care," and "the complex and multifaceted context of stressful pre-hospital emergencies." Additionally, the study's theme was centered around "surveying the experiences of EMTs in stressful environments." CONCLUSION As the number of shifts increased, the primary cause of the high prevalence of PTSD in EMTs was revealed. Prehospital emergency stress can be reduced and managed more skillfully by adjusting various factors such as shortening workdays, offering continuous training, augmenting workforce, supplying ambulance equipment insurance, refraining from hiring personnel devoid of clinical training, hiring psychologists, hiring midwives in an emergency, updating prehospital protocols and guidelines, encouraging cooperation between EMTs and other relief groups, and utilizing cutting-edge technologies.
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Affiliation(s)
- Ali Afshari
- Department of Medical Surgical Nursing, Nursing and Midwifery School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Torabi
- Department of Nursing, Malayer School of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sasan Navkhasi
- Department of Prehospital Emergency Medicine, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Marzieh Aslani
- Instructor of Critical Care Nursing, Department of Nursing, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Afshin Khazaei
- Department of Prehospital Emergency Medicine, Asadabad School of Medical Sciences, Asadabad, Iran.
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Choi S, Kim TH, Hong KJ, Lee SGW, Park JH, Ro YS, Song KJ, Shin SD. Comparison of prehospital resuscitation quality during scene evacuation and early ambulance transport in out-of-hospital cardiac arrest between residential location and non-residential location. Resuscitation 2023; 182:109680. [PMID: 36584964 DOI: 10.1016/j.resuscitation.2022.109680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/21/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND High-quality prehospital cardiopulmonary resuscitation (CPR) is important for out-of-hospital cardiac arrest (OHCA). We aimed to evaluate prehospital CPR quality during scene evacuation and early ambulance transport in patients with OHCA according to the type of cardiac arrest location. METHODS This retrospective observational cohort study enrolled patients with non-traumatic adult OHCA in Seoul between July 2020 and March 2022. Prehospital CPR quality data extracted from defibrillators were merged with the national OHCA database. The location of cardiac arrest was categorized into two groups (residential and non-residential). CPR quality indices including no-flow (any pause >1.5 s) fraction were compared according to the type of arrest location at each minute of EMS scene evacuation and early ambulance transport (5 min prior to 5 min after ambulance departure). RESULTS A total of 1,222 OHCAs were enrolled in the final analysis after serial exclusion. A total of 966 OHCAs (79.1%) occurred in the residential areas. The CPR quality deteriorated during the scene evacuation in both location type. The mean no-flow fractions were significantly higher in residential places than in non-residential places. The mean proportion of adequate compression depth and rate was lower in cardiac arrests in residential places. The discrepancy in EMS CPR quality during scene evacuation was more prominent when mechanical CPR devices were not used. CONCLUSION Deterioration of CPR quality was observed just before and during early ambulance transport, especially when the cardiac arrest location was a residential area or when only manual CPR was provided.
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Affiliation(s)
- Seulki Choi
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea.
| | - Tae Han Kim
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea; Department of Emergency Medicine, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea.
| | - Ki Jeong Hong
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea.
| | - Stephen Gyung Won Lee
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea; Department of Emergency Medicine, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea.
| | - Jeong Ho Park
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea.
| | - Young Sun Ro
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea.
| | - Kyoung Jun Song
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea; Department of Emergency Medicine, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea.
| | - Sang Do Shin
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea; Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, South Korea.
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Chegini N, Soltani S, Noorian S, Amiri M, Rashvand F, Rahmani S, Aliakbari M, Senmar M. Investigating the role of predictive death anxiety in the job satisfaction of pre-hospital emergency personnel during the COVID-19 pandemic. BMC Emerg Med 2022; 22:196. [PMID: 36474161 PMCID: PMC9727867 DOI: 10.1186/s12873-022-00762-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Pre-hospital emergency staffs as the frontline forces fighting against COVID -19 have been affected by this pandemic. Today, the occupational and mental health of these individuals is particularly important to the health care system. Death anxiety is one of the inevitable things in this job, and not paying attention to it can cause unwanted effects such as changing the level of job satisfaction of the personnel. The purpose of this study was to determine the role of predictive death anxiety in the job satisfaction of pre-hospital emergency personnel during the COVID-19 pandemic. METHODS This cross-sectional descriptive study was conducted among pre-hospital emergency staffs in Qazvin Province, Iran in 2021-2022. Among the bases chosen by the census method, 198 samples were included in the study by the available method. Data collection tools included the Demographic Checklist, Templer's Death Anxiety scale, and the Minnesota Job Satisfaction Questionnaire. The data were analyzed with descriptive and inferential statistics and SPSS 20 software. RESULTS The mean age of the samples was (33.14 ± 6.77). 167 persons were male and the others were female. The average job satisfaction and death anxiety of the personnel were 55.07 ± 11.50 and 8.18 ± 1.96, respectively. Pearson's correlation coefficient between the two variables was r = -0.126 And a null correlation coefficient hypothesis has been confirmed with p-value = 0.077. CONCLUSIONS The results showed a high level of death anxiety and average job satisfaction. Although these two variables do not have a significant relationship with each other, considering that they do not have the appropriate level, it needs more investigation and consideration.
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Affiliation(s)
- Najme Chegini
- grid.412606.70000 0004 0405 433XStudent Research Committee, Qazvin University Of Medical Science, Qazvin, Iran
| | - Soheil Soltani
- grid.412606.70000 0004 0405 433XEmergency Medical Service Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sajad Noorian
- grid.440822.80000 0004 0382 5577Department of Statistics, Faculty of Science, University of Qom, Qom, Iran
| | - Mostafa Amiri
- grid.412606.70000 0004 0405 433XEmergency Medical Service Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fatemeh Rashvand
- grid.412606.70000 0004 0405 433XEmergency Medical Service Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Saeed Rahmani
- grid.412606.70000 0004 0405 433XEmergency Medical Service Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohadese Aliakbari
- grid.412606.70000 0004 0405 433XEmergency Medical Service Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mojtaba Senmar
- grid.412606.70000 0004 0405 433XStudent Research Committee, Social Determinants of Health Research Center, Research Institute for Prevention of Non–Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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Influence of Prehospital Emergency Care on Rescue Success Rate and Complication Rate of Senile Patients with Acute Myocardial Infarction. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7557288. [PMID: 36277004 PMCID: PMC9581676 DOI: 10.1155/2022/7557288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/11/2022] [Accepted: 09/16/2022] [Indexed: 11/19/2022]
Abstract
Objective This research mainly discusses the influence of prehospital emergency care (PHEC) on the rescue success rate and complication rate of senile patients with acute myocardial infarction (AMI). Methods We selected 200 senile AMI patients who visited between January 2019 and January 2021, and retrospectively analyzed their clinical data. According to the differences in nursing methods, the patients were assigned to control group (n = 90) and observation group (n = 110), which were treated with routine nursing and PHEC, respectively. Intergroup comparisons were made in terms of rescue success rate, nursing efficacy, clinical parameters and complication rate. Results After investigation, the nursing efficacy was higher in the observation group compared with the control group. Additionally, the observation group was observed with statistically shorter time to thrombolysis and hospital stay, as well as evidently lower mortality and complication rates. Conclusion The above demonstrates that PHEC can effectively improve the rescue success rate and rescue efficacy, and facilitate the recovery of senile AMI patients, with a low complication rate compared with the routine care, which plays an important role in ensuring patients' life safety and is worth popularizing clinically.
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Hadian M, Jabbari A, Abdollahi M, Hosseini E, Sheikhbardsiri H. Explore pre-hospital emergency challenges in the face of the COVID-19 pandemic: A quality content analysis in the Iranian context. Front Public Health 2022; 10:864019. [PMID: 36062086 PMCID: PMC9428312 DOI: 10.3389/fpubh.2022.864019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/25/2022] [Indexed: 01/21/2023] Open
Abstract
Background pre-hospital emergency is a community-oriented system that responds to the medical needs of the injured or patients with acute and emergency illnesses outside of health care facilities until they are transferred to a medical center. This study aimed to explore pre-hospital emergency challenges in the face of the COVID-19 pandemic. Material and methods This study was conducted as a qualitative content analysis in Iran. Using the purposive sampling method, data were collected through in-depth individual interviews with 28 prehospital paramedic personnel from November 2020 to November 2021. Graneheim and Lundman's conventional content analysis methods were used to analyze the data and for the trustworthiness of the data, this study used Lincoln and Guba's recommendations. Results After multiple rounds of analyzing and summarizing the data and taking into consideration similarities and differences, four main categories and 10 subcategories were created based on the results of the data analysis and including (1) Culture and Community. (2) Service delivery (3) Human resources; (4) Medical supplies and equipment. Conclusion According to the findings of this study emergency medical system employees are suffering from a range of psychiatric problems as a result of a lack of equipment and job overload, which has a detrimental impact on the quality of pre-hospital emergency care. Therefore, emergency care senior management should develop comprehensive guidelines, provide more equipment and minimize professional challenges to improve the quality and safety of pre-hospital emergency care services.
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Affiliation(s)
- Marziye Hadian
- Health Services Management, Student Research Committee of School of Management and Medical Information, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Jabbari
- Health Services Management, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahdieh Abdollahi
- Department of Nursing, Zarand Branch, Islamic Azad University, Zarand, Iran
| | - Elaheh Hosseini
- Health Services Management, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hojjat Sheikhbardsiri
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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