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Longcoy LTH, Wu WW, Wei CJ, Doorenbos AZ. Examining the Role of Resilience, Posttraumatic Growth, and Quality of Life in Women with Breast Cancer: A Serial Multiple Mediator Model Approach. Semin Oncol Nurs 2023; 39:151441. [PMID: 37149439 PMCID: PMC10524348 DOI: 10.1016/j.soncn.2023.151441] [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: 10/16/2022] [Revised: 02/21/2023] [Accepted: 04/05/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVES It is unclear how resilience and posttraumatic growth help women with breast cancer face cancer-related symptom distress. This study included both resilience and posttraumatic growth as mediators in a serial multiple mediator model to examine changes in the relationship between symptom distress and quality of life among women with breast cancer. DATA SOURCES We conducted the descriptive, cross-sectional study in Taiwan. Data were collected using a survey that assessed symptom distress, resilience, posttraumatic growth, and quality of life. A serial multiple mediator model examined one direct and three specific indirect effects of symptom distress on quality of life through resilience and posttraumatic growth. All 91 participants reported the presence of symptom distress and moderate levels of resilience. Quality of life was significantly associated with symptom distress (b = -1.04), resilience (b = 0.18), and posttraumatic growth (b = 0.09). The indirect effect of symptom distress on quality of life through resilience alone was statistically significant (b = -0.23, 95% CI -0.44 to -0.07) and statistically greater than the specific indirect effect through resilience and posttraumatic growth combined (b = -0.21, 95% CI -0.40 to -0.05). CONCLUSION Resilience plays a unique role in reducing the impact of symptom distress on the quality of life among women with breast cancer. IMPLICATIONS FOR NURSING PRACTICE Given the importance of resilience to quality of life, oncology nurses can assess the resilience of women with breast cancer and help identify available internal, external, and existential resources to strengthen their resilience.
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Affiliation(s)
- Li-Ting H Longcoy
- Postdoctoral Fellow, College of Nursing, University of Illinois Chicago, Chicago, Illinois
| | - Wei-Wen Wu
- Associate Professor; School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Chung-Jen Wei
- Associate Professor; Department of Public Health, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ardith Z Doorenbos
- Professor; College of Nursing, University of Illinois Chicago, Chicago, Illinois
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2
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Krause K, Peterson R, Capecchi T, Olson APJ, Thornton S. Benefits of the medicine-pediatrics trained hospitalist. J Hosp Med 2023; 18:453-455. [PMID: 36808874 DOI: 10.1002/jhm.13067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/20/2023] [Accepted: 02/02/2023] [Indexed: 02/22/2023]
Affiliation(s)
- Katherine Krause
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Rachel Peterson
- Departments of Medicine and Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Timothy Capecchi
- Departments of Medicine and Pediatrics, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA
| | - Andrew P J Olson
- Departments of Medicine and Pediatrics, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA
| | - Sarah Thornton
- Department of Hospital Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia, USA
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Krishnan JK, Shin JK, Ali M, Turetz ML, Hayward BJ, Lief L, Safford MM, Aronson KI. Evolving Needs of Critical Care Trainees during the COVID-19 Pandemic: A Qualitative Study. ATS Sch 2022; 3:561-575. [PMID: 36726700 PMCID: PMC9886097 DOI: 10.34197/ats-scholar.2022-0026oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/14/2022] [Indexed: 11/06/2022] Open
Abstract
Background Critical care trainees were integral in the coronavirus disease (COVID-19) pandemic response. Several perspective pieces have provided insight into the pandemic's impact on critical care training. Surveys of program directors and critical care trainees have focused on curricular impact. There is a lack of data from the trainee perspective on curricular enhancements, career development, and emotional and well-being needs to succeed in a critical care career in the ongoing COVID-19 pandemic. Objective Our objective was to elicit perspectives from critical care trainees on their personal and professional needs as they continue to serve in the COVID-19 pandemic. Methods This was a hypothesis-generating qualitative study. Individuals in a U.S. critical care training program during the COVID-19 pandemic participated in either focus groups or semistructured interviews. Interviews were conducted between July 2020 and March 2021 until data saturation was achieved. Audio recordings were professionally transcribed and analyzed using qualitative content analysis. A codebook was generated by two independent coders, with a third investigator reconciling codes when there were discrepancies. Themes and subthemes were identified from these codes. Results Thirteen participants were interviewed. The major themes identified were as follows: 1) Curricular adaptation is necessary to address evolving changes in trainee needs; 2) COVID-19 impacted career development and highlighted that trainees need individualized help to meet their goals; 3) receiving social support at work from peers and leaders is vital for the sustained well-being of trainees; 4) fostering and maintaining a sense of meaning and humanity in one's work is important; and 5) trainees desire assistance and support to process their emotions and experiences. Conclusion The needs expressed by critical care trainees are only partially captured in conceptual models of physician well-being. The need for multilevel workplace social networks and identifying meaning in one's work have been magnified in this pandemic. The themes discussing curricular gaps, career development needs, and skills to process work-related trauma are less well captured in preexisting conceptual models and point to areas where further research and intervention development are needed.
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Affiliation(s)
| | - Joseph K. Shin
- Division of General Internal Medicine,
Weill Cornell Medicine, New York, New York
| | - Maha Ali
- Division of General Internal Medicine,
Weill Cornell Medicine, New York, New York
| | | | | | - Lindsay Lief
- Divison of Pulmonary and Critical Care
Medicine and
| | - Monika M. Safford
- Division of General Internal Medicine,
Weill Cornell Medicine, New York, New York
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Joubert L, Hampson R, Acuto R, Powell L, Latiff MNLA, Tran L, Cumming S, Dunn P, Crehan S, Flewellen R, Boddenberg E, Ng WS, Simpson G. Resilience and adaptability of social workers in health care settings during COVID-19 in Australia. SOCIAL WORK IN HEALTH CARE 2022; 61:199-217. [PMID: 35838128 DOI: 10.1080/00981389.2022.2096170] [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: 12/09/2021] [Revised: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
In 2020 Coronavirus disease (COVID-19) was identified in Australia. During the pandemic, as essential workers, hospital-based social workers have been on the frontline. This cross-sectional study examines the resilience of social workers during the COVID-19 pandemic, how the pandemic impacted on social work and lessons learnt. Hospital social workers working in three states, namely Victoria, Queensland, and New South Wales were invited to participate in an online web-based survey, providing non-identifiable demographic details and information a) relating to their proximity to COVID-19, b) their degree of resilience (CD-RISC-2), c) professional quality of life, d) perceived social support, e) physical health, f) professional and personal growth during the pandemic, and g) impacts of COVID-19 on their practice. Basic descriptive statistics were computed for variables of interest. Within group, comparisons were made using paired t-tests or one-way ANOVAs for continuous variables as appropriate to investigate possible interstate differences. Regression analyses were conducted to determine which factors contribute to resilience. Social workers, during the pandemic, whether working under the constraints of lockdown or not, demonstrated high levels of resilience. These levels were similar across the three states, unaffected by the degree of infection in the community, indicating that as a group, social workers have high innate levels of resilience. This study provides an in-depth understanding of the impact of COVID-19 on hospital social workers, the long-term impact of the pandemic on social work practice, and potentially useful lessons learnt for the future.
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Affiliation(s)
- Lynette Joubert
- Melbourne School of Health Sciences, Department of Social Work, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ralph Hampson
- Melbourne School of Health Sciences, Department of Social Work, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca Acuto
- Melbourne School of Health Sciences, Department of Social Work, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lauren Powell
- Melbourne School of Health Sciences, Department of Social Work, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Linh Tran
- Melbourne School of Health Sciences, Department of Social Work, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sue Cumming
- Department of Health, Metro South Hospital and Health Service, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Patrick Dunn
- South Eastern Sydney Local Health District, Prince of Wales Hospital, Sydney Eye Hospital, Sydney, NSW, Australia
| | - Scott Crehan
- South Eastern Sydney Local Health District, St George Hospital, Sydney Australia
| | - Rashid Flewellen
- South Western Sydney Local Health District, Campbelltown Hospital, Sydney, Sydney, Australia
| | - Emeil Boddenberg
- Melbourne School of Health Sciences, Department of Social Work, The University of Melbourne, Melbourne, Victoria, Australia
| | - Wing Sum Ng
- Melbourne School of Health Sciences, Department of Social Work, The University of Melbourne, Melbourne, Victoria, Australia
| | - Grahame Simpson
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, Australia
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Dave U, Taylor-Robinson SD. Maintaining Resilience in Today’s Medical Environment: Personal Perspectives on Self-Care. Int J Gen Med 2022; 15:2475-2478. [PMID: 35282651 PMCID: PMC8904941 DOI: 10.2147/ijgm.s354928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/22/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Umakant Dave
- Department of Gastroenterology, Morriston Hospital, Swansea, Wales, SA6 6NL, UK
| | - Simon D Taylor-Robinson
- Department of Surgery and Cancer, Imperial College London, St Mary’s Hospital Campus, London, W2 1NY, UK
- Correspondence: Simon D Taylor-Robinson, Department of Surgery and Cancer, Imperial College London, St Mary’s Hospital Campus, London, W2 1NY, UK, Tel +44 203 312 6254, Email
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Priolo Filho SR, Goldfarb D, Zibetti MR, Aznar-Blefari C. Brazilian Child Protection Professionals' Resilient Behavior during the COVID-19 Pandemic. CHILD ABUSE & NEGLECT 2020; 110:104701. [PMID: 32896424 PMCID: PMC7472972 DOI: 10.1016/j.chiabu.2020.104701] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/15/2020] [Accepted: 08/17/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND The COVID-19 pandemic deeply affected child protection professionals. One potential area of concern is whether and how the pandemic has dampened these individuals' ability to engage in the resilient practices that are so vital to their wellbeing. OBJECTIVE Within the unique and understudied context of a developing economy facing the strain of an international pandemic, this study sought to expand our theoretical understanding of the individual and socio-ecological predictors of whether child protective services professionals engage in resilient behaviors. PARTICIPANTS AND SETTING Three hundred and nine professionals working in child protection related fields (e.g., psychologists, social workers, professors, pediatricians, nurses, and other clinicians). METHODS Participants were surveyed as to their demographics, current work conditions, their engagement in resilient behaviors, and potential individual and socio-ecological predictors of those behaviors. RESULTS Both job support for and individuals' beliefs of the importance of resilient behaviors predicted their engagement in such behaviors. CONCLUSIONS Child protection professionals' resilience must be fostered by socio-ecological contexts, such as their workplace and employers, and additional supports are needed during the trying times of the COVID-19 pandemic.
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Rosenberg AR, Barton K, Junkins C, Scott S, Bradford MC, Steineck A, Lau N, Comiskey L, Yi-Frazier JP. Creating a Resilient Research Program-Lessons Learned From a Palliative Care Research Laboratory. J Pain Symptom Manage 2020; 60:857-865. [PMID: 32621950 PMCID: PMC7328580 DOI: 10.1016/j.jpainsymman.2020.06.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 12/03/2022]
Abstract
Conducting palliative care research can be personally and professionally challenging. Although limitations in funding and training opportunities are well described, a less recognized barrier to successful palliative care research is creating a sustainable and resilient team. In this special report, we describe the experience and lessons learned in a single palliative care research laboratory. In the first few years of the program, 75% of staff quit, citing burnout and the emotional tolls of their work. To address our sustainability, we translated resilience theory to practice. First, we identified and operationalized shared mission and values. Next, we conducted a resilience resource needs assessment for both individual team members and the larger team as a whole and created a workshop-based curriculum to address unmet personal and professional support needs. Finally, we changed our leadership approach to foster psychological safety and shared mission. Since then, no team member has left, and the program has thrived. As the demand for rigorous palliative care research grows, we hope this report will provide perspective and ideas to other established and emerging palliative care research programs.
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Affiliation(s)
- Abby R Rosenberg
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA; Cambia Palliative Care Center of Excellence at the University of Washington, Seattle, Washington, USA; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.
| | - Krysta Barton
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Courtney Junkins
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Samantha Scott
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA; Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Miranda C Bradford
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA; Children's Core for Biomedical Statistics, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Angela Steineck
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA; Cambia Palliative Care Center of Excellence at the University of Washington, Seattle, Washington, USA; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
| | - Nancy Lau
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA; Cambia Palliative Care Center of Excellence at the University of Washington, Seattle, Washington, USA; Department of Psychiatry and Behavioral Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Liam Comiskey
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Joyce P Yi-Frazier
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA
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Webber S, Lauden SM, Fischer PR, Beyerlein L, Schubert C. Predeparture Activities Curricular Kit (PACK) for Wellness: A Model for Supporting Resident Well-Being During Global Child Health Experiences. Acad Pediatr 2020; 20:136-139. [PMID: 31150786 DOI: 10.1016/j.acap.2019.05.130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 04/28/2019] [Accepted: 05/10/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Sarah Webber
- Department of Pediatrics (S Webber), University of Wisconsin School of Medicine and Public Health, Madison, Wis.
| | - Stephanie M Lauden
- Department of Pediatrics (SM Lauden), Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio
| | - Philip R Fischer
- Department of Pediatric and Adolescent Medicine (PR Fischer), Mayo Clinic, Rochester, Minn
| | - Larissa Beyerlein
- Department of Pediatrics (L Beyerlein), University of Minnesota, Masonic Children's Hospital, Minneapolis, Minn
| | - Charles Schubert
- Department of Pediatrics (C Schubert), Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
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Stewart MT, Reed S, Reese J, Galligan MM, Mahan JD. Conceptual models for understanding physician burnout, professional fulfillment, and well-being. Curr Probl Pediatr Adolesc Health Care 2019; 49:100658. [PMID: 31629639 DOI: 10.1016/j.cppeds.2019.100658] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Physician burnout is a highly complex phenomenon whose origins are multifactorial. As the medical profession works to better understand and reduce physician burnout, conceptual models can offer a framework to guide research and practice in the field of physician well-being. Conceptual models represent complex systems in a simplified fashion that facilitates understanding of and communication about those systems. This paper reviews seven conceptual models of physician well-being and discusses their strengths and limitations.
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Affiliation(s)
- Miriam T Stewart
- Children's Hospital of Philadelphia, Philadelphia, PA, United States.
| | - Suzanne Reed
- Nationwide Children's, Columbus, OH, United States
| | - Jennifer Reese
- University of Colorado School of Medicine, Aurora, CO, United States
| | - Meghan M Galligan
- Children's Hospital of Philadelphia, Philadelphia, PA, United States; Leonard Davis Institute of Health Economics, Philadelphia, PA, United States
| | - John D Mahan
- Nationwide Children's, Columbus, OH, United States
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Fischer J, Alpert A, Rao P. Promoting Intern Resilience: Individual Chief Wellness Check-ins. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2019; 15:10848. [PMID: 31921994 PMCID: PMC6946579 DOI: 10.15766/mep_2374-8265.10848] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 07/05/2019] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Promoting resilience is key during intern year as residents transition to becoming clinical providers. Residents consistently demonstrate a decline in empathy and an increase in burnout throughout training. Interventions involving mindfulness, stress management, and small-group discussions can reduce burnout. We created a curriculum to normalize the intern experience and provide debriefing opportunities to further improve resilience and decrease burnout. METHODS Thirty-two interns met monthly, one-on-one, with a pediatric chief resident to discuss personal, professional, and emotional well-being and complete just-in-time resilience exercises. After 6 and 12 months, we conducted follow-up surveys containing 5-point Likert questions and open-ended questions to determine interns' perceptions of the initiative. RESULTS We obtained response rates of 44% (14 interns) and 38% (12 interns) for the 6- and 12-month surveys, respectively. Interns found the sessions helpful for normalizing the intern experience (6 months: 4.6 ± 0.7, 12 months: 4.8 ± 0.5), stress management (6 months: 4.0 ± 1.0, 12 months: 4.3 ± 0.7), and feeling connected to program leadership (6 months: 4.6 ± 0.9, 12 months: 5.0 ± 0.0). Thematic analysis identified normalizing the intern experience, ability to express concerns, and mentorship as benefits. DISCUSSION Normalization of the intern experience and targeted wellness and resilience exercises can have a positive impact on interns' satisfaction with program support for their well-being. Through a time-limited intervention, chief residents can be utilized in a mentorship role that is well received by interns and rewarding for the chief residents.
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Affiliation(s)
- Jason Fischer
- Pediatric Emergency Medicine Fellow, Division of Emergency Medicine, Children's Hospital of Philadelphia
| | - Aviva Alpert
- General Pediatrician, Children's Community Pediatrics Allegheny, University of Pittsburgh Medical Center
| | - Priyanka Rao
- Clinical Lecturer, Department of Pediatrics, Michigan Medicine
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Affiliation(s)
- Paria M Wilson
- Division of Emergency Medicine, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Maneesh Batra
- Department of Pediatrics, Division of Neonatology, Seattle Children's Hospital and the University of Washington, Seattle, WA
| | | | - John D Mahan
- The Ohio State University, Columbus, OH.,Department of Pediatrics, Division of Nephrology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH
| | - Betty B Staples
- Department of Pediatrics, Duke University Medical Center, Durham, NC
| | - Janet R Serwint
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
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