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Egger EE, Basile Ibrahim B, Nyhan K, Desibhatla M, Gleeson D, Hagaman A. Patient-Defined Cultural Safety in Perinatal Interventions: A Qualitative Scoping Review. Health Equity 2024; 8:164-176. [PMID: 38559847 PMCID: PMC10979693 DOI: 10.1089/heq.2023.0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 04/04/2024] Open
Abstract
Problem Cultural safety is an approach to patient care designed to facilitate respect of patients' cultural needs and address inequities in care in culturally diverse situations. Background Much literature considers culturally safe care during the perinatal period, yet little is known about how patients experience and understand cultural safety. This is despite patient-defined care being one of the definitions of cultural safety. Question Hypothesis or Aim This scoping review investigates what is known from existing qualitative literature about patients' experience of cultural safety frameworks in perinatal interventions. Methods A search for "cultural safety" OR "culturally safe" in PubMed, Ovid Medline, Ovid Embase, Cumulated Index to Nursing and Allied Health Literature, Scopus, Scielo, and Latin America and the Caribbean Literature on Health Sciences returned 2233 results after deduplication. Title-abstract and full-text screenings were conducted to identify qualitative studies of cultural safety from perinatal patients' perspectives. Seven studies were included in the final analysis. Data were open coded using NVivo. Findings Three themes were identified: (1) care that acknowledged that their lives were different from patients in the dominant culture, (2) receiving care in community, and (3) care providers who respected their choices and culturally specific knowledge. Discussion This research shows how cultural safety intersects with other equity-based frameworks used in midwifery and obstetrics. Conclusion Building on this research could lead to new protocols that address complex social and physical needs of marginalized people during the perinatal period.
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Affiliation(s)
- Emilie E. Egger
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | | | - Kate Nyhan
- Cushing/Whitney Medical Library, Yale University Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Mukund Desibhatla
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Dara Gleeson
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Ashley Hagaman
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
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Wilson A, Hoang H, Crocombe L, Bridgman H, Bettiol S. Exploring the experiences and perspectives of women on oral health during pregnancy: A qualitative study in Tasmania, Australia. Community Dent Oral Epidemiol 2024; 52:47-58. [PMID: 37515463 DOI: 10.1111/cdoe.12900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 06/13/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVE To explore women's oral health experiences and barriers to dental care and identify potential strategies to improve oral health during pregnancy. METHODS A qualitative descriptive study design was used. Purposively elected antepartum and postpartum women ≥18 years of age from Tasmania, Australia, were recruited using maximum variation sampling. Semi-structured interviews were conducted, and all qualitative data were analysed using an inductive thematic approach. RESULTS Fifteen women were interviewed with a mean ± SD age of 32.3 ± 4.5 years. Three key themes were generated from the data that described women's perceived changes in their oral health during pregnancy; barriers to oral health care during and after pregnancy; and perceived strategies to improve access to care. Most women acknowledged the importance of maintaining good oral health but reported a decline in their oral health status during pregnancy. Women also identified several barriers to dental care, including treatment costs, competing maternal priorities, limited oral health knowledge and negative perceptions towards dentistry. The provision of preventative oral health care by ANC providers was also limited. Community awareness, patient education resources and assessment tools could support the promotion of oral health care. Women also perceived that interprofessional collaboration between antenatal and dental providers played a key role in promoting oral health. CONCLUSION This study explored women's varied oral health experiences and perceptions during pregnancy and highlighted critical barriers and enablers to dental care. Policy-level strategies that promote interprofessional collaboration between antenatal and dental providers and expand dental care access are suggested to overcome barriers to oral health for women during pregnancy.
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Affiliation(s)
- Annika Wilson
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Ha Hoang
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Leonard Crocombe
- Violet Vines Marshman Centre for Rural Health Research, La Trobe University, Bendigo, Victoria, Australia
| | - Heather Bridgman
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Silvana Bettiol
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
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King S, Thaliph A, Laranjo L, Smith BJ, Eberhard J. Oral health literacy, knowledge and perceptions in a socially and culturally diverse population: a mixed methods study. BMC Public Health 2023; 23:1446. [PMID: 37507737 PMCID: PMC10375643 DOI: 10.1186/s12889-023-16381-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/25/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Poor oral health literacy has been proposed as a causal factor in disparities in oral health outcomes. This study aims to investigate oral health literacy (OHL) in a socially and culturally diverse population of Australian adults visiting a public dental clinic in Western Sydney. METHODS A mixed methods study where oral health literacy was assessed using the Health Literacy in Dentistry scale (HeLD-14) questionnaire and semi-structured interviews explored oral health related knowledge, perceptions and attitudes. Interviews were analysed using a thematic approach. RESULTS A sample of 48 participants attending a public dental clinic in Western Sydney was recruited, with a mean age of 59.9 (SD16.2) years, 48% female, 50% born in Australia, 45% with high school or lower education, and 56% with low-medium OHL. A subgroup of 21 participants with a mean age of 68.1 (SD14.6) years, 40% female, 64% born in Australia, 56% with a high school or lower education, and 45% with low-medium OHL completed the interview. Three themes identified from the interviews included 1) attitudes and perceptions about oral health that highlighted a lack of agency and low prioritisation of oral health, 2) limited knowledge and education about the causes and consequences of poor oral health, including limited access to oral health education and finally 3) barriers and enablers to maintaining good oral health, with financial barriers being the main contributor to low OHL. CONCLUSIONS Strategies aimed at redressing disparities in oral health status should include improving access to oral health information. The focus should be on the impact poor oral health has on general health with clear messages about prevention and treatment options in order to empower individuals to better manage their oral health.
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Affiliation(s)
- Shalinie King
- Westmead Applied Research Centre and the Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Ayesha Thaliph
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Liliana Laranjo
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ben J Smith
- Sydney School of Public Health, and the Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Joerg Eberhard
- Sydney Dental School and the Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Poirier B, Sethi S, Hedges J, Jamieson L. Building an understanding of Indigenous Health Workers' role in oral health: A qualitative systematic review. Community Dent Oral Epidemiol 2023; 51:169-179. [PMID: 35324023 DOI: 10.1111/cdoe.12743] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Indigenous health workers (IHW) play an integral role in the provision of culturally safe care for Indigenous communities. Despite this, IHW involvement in oral health has been limited. Therefore, this qualitative systematic review aimed to build an understanding of IHW insights on oral health. METHODS Two independent reviewers searched PubMed, EMBASE, Web of Science and Scopus using a pre-established search strategy. Qualitative studies that included IHW illustrations about oral health were considered. The search was not limited by geographic setting. Included articles were critically appraised with the Joanna Briggs Institute appraisal tool for qualitative studies. RESULTS The search identified 1856 articles eligible for inclusion; a total of 10 articles were included. Four synthesized findings were identified during the meta-aggregation: oral health challenges in community, systemic barriers limiting IHW ability to support oral health, benefits of IHW involvement in oral health and avenues to increase IHW involvement in oral health. CONCLUSION The prioritization of Indigenous leadership in oral health has the potential to address many of the current challenges Indigenous communities face. Future works need to determine the capacity of IHW to provide oral health care and explore opportunities to create specific oral health roles for IHW.
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Affiliation(s)
- Brianna Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Sneha Sethi
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
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Poirier B, Tang S, Haag DG, Sethi S, Hedges J, Jamieson L. Oral health promotion and programming provided by Aboriginal Community Controlled Health Organisations in South Australia. Health Promot J Austr 2022; 33 Suppl 1:255-261. [PMID: 35842837 PMCID: PMC9796322 DOI: 10.1002/hpja.640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/23/2022] [Accepted: 07/13/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Aboriginal Community Controlled Health Organisations (ACCHOs) play a critical role in supporting Aboriginal and Torres Strait Islander health in Australia. This article aims to identify and describe oral health programming and promotion provided by ACCHOs in South Australia. METHODS All ACCHOs in South Australia were identified through the Aboriginal Health Council of South Australia. A targeted search strategy was designed to include the websites and social media pages (Facebook, Twitter, Instagram) for each organisation. Program characteristics were extracted and summarised, and oral health promotion content was analysed utilising content analysis. RESULTS Twelve programs were identified across the 12 ACCHOs in South Australia. Of these, seven focused on oral health and five focused on nutrition. Oral health and nutrition information shared online by ACCHOs was extracted and aggregated into oral health and nutrition categories, which included reminders about visiting services, advocacy statements, oral hygiene messaging, appointment availability, education resources, and upcoming community-based activities. CONCLUSIONS The evidence explored highlights the integral role ACCHOs play in oral health promotion and service delivery. It is critically important that ACCHOs are involved in development and implementation of oral health services to ensure programming reflects community knowledges and is effective in improving oral health equity.
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Affiliation(s)
- Brianna Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Samantha Tang
- Adelaide Dental SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Dandara Gabriela Haag
- Australian Research Centre for Population Oral Health, Adelaide Dental SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Sneha Sethi
- Australian Research Centre for Population Oral Health, Adelaide Dental SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, Adelaide Dental SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental SchoolUniversity of AdelaideAdelaideSouth AustraliaAustralia
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The impact of COVID-19 on individual oral health: a scoping review. BMC Oral Health 2022; 22:422. [PMID: 36138456 PMCID: PMC9502893 DOI: 10.1186/s12903-022-02463-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor oral health due to dental caries is one of the most prevalent non-communicable diseases worldwide. It has a significant impact on individuals across the lifespan and is a leading cause of preventable hospitalizations. The impacts of COVID-19 on oral health at the practice level are well documented, but gaps in understanding the impact on individual oral health remain. This review addresses this gap. METHODS Using a JBI scoping review process we mapped and summarized the evidence to identify the impact of COVID-19 on individual oral health. Key search terms were developed, and searches were undertaken by an experienced research librarian. RESULTS The 85 included studies were conducted in 23 countries from 5 regions across the world classified using the United Nations Geoscheme system. The majority (82/85) were quantitative, 2 were reviews and there was one qualitative interview study. Cross-sectional surveys were the most common data collection approach followed by an analysis of clinical data, analysis of internet trends and other online methods. Five key areas were identified including changes to the provision of emergency dental services, provision of routine oral health services, oral hygiene maintenance at home, changes in dietary preferences, alternative models of dental provision and help-seeking and attitudes towards dental care in the future. CONCLUSIONS This scoping review has demonstrated that the pandemic has impacted on oral health at the individual level. It is important that we are aware of these impacts and ensure that support systems are in place to overcome future periods where access to dental care might be compromised. The provision of preventive care remains a vital first step in ensuring good overall oral health as is paramount during periods where access to dental treatment might be limited.
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Maqbool A, Selvaraj CM, Lu Y, Skinner J, Dimitropoulos Y. The Progress of the New South Wales Aboriginal Oral Health Plan 2014–2020: A Scoping Review. Healthcare (Basel) 2022; 10:healthcare10040650. [PMID: 35455828 PMCID: PMC9031810 DOI: 10.3390/healthcare10040650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 11/17/2022] Open
Abstract
There are major disparities in oral health between Aboriginal and Torres Strait Islander and non-Aboriginal and Torres Strait Islander people. The New South Wales (NSW) Aboriginal Oral Health Plan 2014–2020 was developed to improve the oral health of Aboriginal people. This scoping review describes programs that have been undertaken to implement the NSW Aboriginal Oral Health Plan 2014–2020. The methodology by Arksey and O’Malley was used to guide this review. Academic and grey literature were searched using a structured Medline, Lowitja and advanced Google searches. Articles were included if they aligned with the strategic directions of the Plan. Key information, including the aims of the study, methodology and results were recorded in a template on Microsoft Excel software. A total of 31 articles were included in this review. This included 25 articles from the academic literature and six initiatives from the grey literature. Included articles were categorised according to the six strategic directions in the NSW Aboriginal Oral Health Plan. Four studies were related to the first strategic direction, six related to strategic direction two, four related to strategic direction three, six initiatives related to strategic direction four, five related to strategic direction five, and eight related to strategic direction six. While there has been significant progress in achieving the strategic directions of the NSW Aboriginal Oral Health Plan, there is scope for continued collaboration between oral health service providers, universities and Aboriginal communities to improve oral health outcomes for Aboriginal people in NSW.
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Affiliation(s)
- Ashwaq Maqbool
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia; (C.M.S.); (Y.L.)
- Correspondence:
| | - Charlotte Marie Selvaraj
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia; (C.M.S.); (Y.L.)
| | - Yinan Lu
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia; (C.M.S.); (Y.L.)
| | - John Skinner
- Poche Centre for Indigenous Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia; (J.S.); (Y.D.)
| | - Yvonne Dimitropoulos
- Poche Centre for Indigenous Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia; (J.S.); (Y.D.)
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The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe: Ensuring and Promoting Best Practice in Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010261. [PMID: 35010521 PMCID: PMC8751189 DOI: 10.3390/ijerph19010261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 11/30/2022]
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Kong A, Dickson M, Ramjan L, Sousa MS, Jones N, Srinivas R, Chao J, Goulding J, George A. Aboriginal Health Workers Promoting Oral Health among Aboriginal and Torres Strait Islander Women during Pregnancy: Development and Pilot Testing of the Grinnin' Up Mums & Bubs Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9576. [PMID: 34574506 PMCID: PMC8471975 DOI: 10.3390/ijerph18189576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/30/2021] [Accepted: 09/09/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND this study aimed to develop and pilot test the model of care, Grinnin' Up Mums & Bubs, to train Aboriginal Health Workers to promote oral health among Aboriginal and Torres Strait Islander pregnant women. METHODS Participatory Action Research was employed to develop the different components of the model (oral health promotion resources, training workshop, and a culturally safe referral pathway to dental services). The model was piloted (pre-post), using an embedded mixed-methods design, to determine the acceptability, satisfaction, and any recommendations made by seven Aboriginal Health Workers at an antenatal service in Western Sydney, Australia. RESULTS there was a high level of satisfaction with the components of the model of care among the participants, who believed that the model could be integrated into practice. The training showed some improvement in oral health knowledge and confidence. The participants recommended strategies for discussing oral health with Aboriginal and Torres Strait Islander pregnant women, and changes in public health dental policy to ensure that all women would be able to access affordable dental services through the referral pathway. CONCLUSION the findings suggest a high level of satisfaction with the model of care among the Aboriginal Health Workers. Further evaluation is needed to confirm the short and long-term impact of the model.
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Affiliation(s)
- Ariana Kong
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia; (L.R.); (M.S.S.); (R.S.); (A.G.)
- South Western Sydney Local Health District, Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
| | - Michelle Dickson
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Lucie Ramjan
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia; (L.R.); (M.S.S.); (R.S.); (A.G.)
- Translational Health Research Institute, Campbelltown, NSW 2560, Australia
| | - Mariana S. Sousa
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia; (L.R.); (M.S.S.); (R.S.); (A.G.)
- IMPACCT—Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Broadway, NSW 2007, Australia
| | - Nathan Jones
- Aboriginal Health Unit, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia;
| | - Ravi Srinivas
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia; (L.R.); (M.S.S.); (R.S.); (A.G.)
- Oral Health Services, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia
- Faculty of Medicine and Health, School of Dentistry, University of Sydney, Camperdown, NSW 2006, Australia
| | - Jemma Chao
- The Poche Centre for Indigenous Health, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Joanne Goulding
- Primary and Community Services, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia;
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia; (L.R.); (M.S.S.); (R.S.); (A.G.)
- South Western Sydney Local Health District, Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
- Faculty of Medicine and Health, School of Dentistry, University of Sydney, Camperdown, NSW 2006, Australia
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