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Kamenetsky SB, Chen V, Heled E. Matching patients with therapists in culturally diverse rehabilitation services during civil unrest. INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2024; 24:407-418. [PMID: 37378752 DOI: 10.1007/s10754-023-09359-8] [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: 12/08/2022] [Accepted: 06/18/2023] [Indexed: 06/29/2023]
Abstract
A primary consideration in rehabilitation is the compatibility between clinicians and patients, where cultural diversity is a defining feature for both. The intricacies of cultural considerations in patient-clinician matching are heightened in areas of conflict and civil unrest. This paper presents three perspectives of the significance of cultural considerations in such assignments: patient-centred approach - prioritizing patients' preferences; professional-centred approach - clinicians' safety, social-emotional, and training needs; and utilitarian approach - what is best for the majority. A case study from an Israeli rehabilitation clinic is presented to exhibit the multifaceted considerations in patient-clinician matching within areas of conflict and civil unrest. The reconciliation of these three approaches in the context of cultural diversity is discussed, suggesting the benefit of a case-by-case strategy involving combinations of the three. Further research could examine how this might feasibly and beneficially optimize outcomes for all in culturally diverse societies in times of unrest.
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Affiliation(s)
- Stuart B Kamenetsky
- Department of Psychology, Institute for the Study of University Pedagogy, University of Toronto Mississauga, 3359 Mississauga Rd, L5L 1C6, Mississauga, ON, Canada.
| | - Vanessa Chen
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
| | - Eyal Heled
- Department of Psychology, Ariel University, Ariel, Israel
- Department of Neurological Rehabilitation and 'Steps' Outpatient Clinic, Sheba Medical Center, Ramat Gan, Israel
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Yang G, Bekele A, Krishnaswami S, Ameh E, Sifri Z, Aisuodionoe-Shadrach O, Swaroop M, Orloff S, Abdullah F, Nwomeh B, Chen M, Charles A, Ezeme C, Juillard C, Menezes C, Chitalu M, Nwariaku F, Jawa RS. Cultural competency and ethical behavior for collaboration in limited-resource settings: Guidelines from the Society of University Surgeons Academic Global Surgery Committee and the Association for Academic Global Surgery. Surgery 2024; 176:108-114. [PMID: 38609784 DOI: 10.1016/j.surg.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/02/2024] [Accepted: 02/26/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND There are an increasing number of global surgery activities worldwide. With such tremendous growth, there is a potential risk for untoward interactions between high-income country members and low-middle income country members, leading to programmatic failure, poor results, and/or low impact. METHODS Key concepts for cultural competency and ethical behavior were generated by the Academic Global Surgery Committee of the Society for University Surgeons in collaboration with the Association for Academic Global Surgery. Both societies ensured active participation from high-income countries and low-middle income countries. RESULTS The guidelines provide a framework for cultural competency and ethical behavior for high-income country members when collaborating with low-middle income country partners by offering recommendations for: (1) preparation for work with low-middle income countries; (2) process standardization; (3) working with the local community; (4) limits of practice; (5) patient autonomy and consent; (6) trainees; (7) potential pitfalls; and (8) gray areas. CONCLUSION The article provides an actionable framework to address potential cultural competency and ethical behavior issues in high-income country - low-middle income country global surgery collaborations.
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Affiliation(s)
- George Yang
- Department of Surgery, University of Alabama, Birmingham, AL
| | - Abebe Bekele
- University of Global Health Equity, Kigali, Rwanda
| | | | - Emmanuel Ameh
- Department of Surgery, National Hospital, Abuja, Nigeria
| | - Ziad Sifri
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ
| | | | - Mamta Swaroop
- Department of Surgery, Kern Medical Center, Bakersfield, CA
| | - Susan Orloff
- Department of Surgery, Oregon Health & Sciences University, Portland, OR
| | - Fizan Abdullah
- Department of Surgery, Northwestern University and Lurie Children's Hospital of Chicago, Chicago, IL
| | - Benedict Nwomeh
- Department of Surgery, Ohio State University and Nationwide Childrens Hospital, Columbus, OH
| | - Mike Chen
- Department of Surgery, University of Alabama, Birmingham, AL
| | - Anthony Charles
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Catherine Juillard
- Department of Surgery, University of California Los Angeles, Los Angeles, CA
| | | | | | - Fiemu Nwariaku
- Department of Surgery, University of Utah, Salt Lake City, UT
| | - Randeep S Jawa
- Department of Surgery, Stony Brook Medicine, Stony Brook, NY.
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Nuuyoma V, Muvumwaeni S, Chihururu L. Transcultural nursing: a qualitative analysis of nursing students' experiences in a multicultural context in North-Eastern Namibia. BMC Nurs 2024; 23:123. [PMID: 38360601 PMCID: PMC10870613 DOI: 10.1186/s12912-024-01773-8] [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: 07/22/2023] [Accepted: 01/29/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Culture is a fundamental concept in healthcare settings due to the reason that care provided to patients is holistic and encompasses their perspectives on health, which are greatly influenced by the patients' cultures. To prepare culturally competent nursing graduates, it is important to understand the experiences of students on transcultural nursing during clinical practice. However, there are limited studies that have explored experiences of students on transcultural nursing, specifically those located in multicultural societies. In addition, studies focus on experiences of international students who visit with student - exchange programme. Nevertheless, their experiences of transcultural nursing may differ since they are not residents and have limited exposure to transcultural nursing, and therefore cannot be generalized to undergraduate resident students. This study aimed to explore and describe transcultural nursing experiences of nursing students during clinical practice at an intermediate hospital in north-eastern Namibia. METHODS Descriptive and explorative qualitative designs were used, data were collected via individual interviews from 16 final year nursing students, who were sampled using maximum variation purposive and snowballing sampling. During data collection, an interview guide was used together with audiotape and field notes. Data analysis followed Tesch's eight steps in qualitative coding process. Trustworthiness was ensured using four principles of Lincoln and Guba, Moreover, ethical clearance and permission were granted by research ethics committees from two institutions. FINDINGS Four main themes emerged as findings of the study are: nursing students' exposure to different cultural practices and beliefs; personal feelings experienced by nursing students during transcultural nursing; challenges experienced by students during transcultural nursing; and nursing students coping mechanisms. CONCLUSIONS Nursing students had mixed experiences on transcultural nursing which touch on aspects such as exposure to cultural aspects, personal feelings, challenges, and coping mechanisms. These findings are useful in helping nurse educators, clinical mentors, students, and future researchers to understand experiences of students on transcultural nursing. Consequently, assist in enriching transcultural nursing issues in curricula and for adequate preparation of graduates to become culturally competent when providing nursing care.
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Affiliation(s)
- Vistolina Nuuyoma
- School of Nursing and Public Health, University of Namibia, Rundu Campus, Rundu, Namibia.
| | - Sitembile Muvumwaeni
- School of Nursing and Public Health, University of Namibia, Rundu Campus, Rundu, Namibia
| | - Leonard Chihururu
- School of Nursing and Public Health, University of Namibia, Rundu Campus, Rundu, Namibia
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Keikhaee R, Sanaat Z, Mousavi S, Shaghaghi A. Cross-Cultural Adaptation and Psychometric Validation of the Interview Satisfaction Questionnaire (ISQ) to Assess Unmet Health Communication Needs of Iranian Breast Cancer Patients. HEALTH COMMUNICATION 2023:1-11. [PMID: 38053361 DOI: 10.1080/10410236.2023.2288712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Autonomous and patient-centered health communication (PCHC) between a healthcare provider (HCP) and a client (HCC) is a critical fundament for successful healthcare outcomes. A standard and validated data collection tool for studying the satisfaction of Iranian breast cancer patients (BCPs) with various aspects of their health communication with HCPs does not exist. The current study assessed the application, feasibility, and cultural appropriateness of the Persian-translated version of the interview satisfaction questionnaire (ISQ) in the Iranian context. A standard translation/back-translation procedure was used to prepare a preliminary Persian version of the ISQ (ISQ-P) which was then evaluated for content and face validity by a panel of experts. The study data were collected from 200 breast cancer patients and used to estimate the internal consistency measure of Cronbach's alpha and intra-class correlation coefficient. Confirmatory factor analysis (CFA) was performed to verify the compatibility of the instrument's identified dimensions with the original ISQ's factor structure. The calculated content validity index (CVI = 0.89), content validity ratio (CVR = 0.49), and Cronbach's alpha coefficient (0.79) indicated the appropriateness of the ISQ-P for its intended purpose. The CFA's outputs (root mean square error of approximation (RMSEA) = 0.09, comparative fit index (CFI) = 0.954, Tucker-Lewis index (TLI) = 0.931, standardized root mean square residual (SRMR) = 0.04) affirmed the fitness of the study data to the original 4-factor conceptual model. The study findings supported the suitability of ISQ-P for assessing health communication episodes by Persian-speaking BCPs. However, due to cultural variation, cross-border diversity of health systems, and organizational circumstances, further validity and reliability appraisal of the ISQ-P in distinct sub-samples is recommended.
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Affiliation(s)
- Razieh Keikhaee
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences
| | - Zohreh Sanaat
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences
| | - Saeid Mousavi
- Department of Bio-Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences
| | - Abdolreza Shaghaghi
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences
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Olson RE, Copley JA, Bartle E, Hill AE, Barnett T, Dunwoodie R, Zuber A. The VOTIS, part 2: Using a video-reflexive assessment activity to foster dispositional learning in interprofessional education. J Interprof Care 2023; 37:232-239. [PMID: 35225137 DOI: 10.1080/13561820.2022.2037531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Effective interprofessional collaborative practice (IPCP) requires a new way of working characterized by distributed leadership skills, shared decision-making, and the adoption of uniprofessional and interprofessional identities. Health professional educators are tasked with preparing clinicians for IPCP through interprofessional education (IPE). Numerous IPE teaching interventions have been developed, ranging in length from hours to semesters, designed to introduce students to interprofessional ways of working - usually evaluated in terms of student satisfaction, perceptions of other disciplines and conceptual knowledge. However, working interprofessionally also requires integrating dispositional knowledge into one's emerging interprofessional habits and values. In this paper, we describe a learning activity, inspired by a new video-reflexive methodology, designed to foster dispositional learning of interprofessional skills using a video-based assessment tool: the Video Observation Tool for Interprofessional Skills (VOTIS). Based on focus group and interview data, we suggest the activity's usefulness in fostering conceptual, procedural and dispositional knowledge, as well as reflexive feedback literacy. Overall, our qualitative evaluation of the VOTIS suggests the merits of drawing on video-reflexive methodology and pedagogical theory to re-imagine IPE as a dynamic process, requiring the development of interprofessional skills that must be appropriated into students' emerging (inter)professional identities.
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Affiliation(s)
- Rebecca E Olson
- The University of Queensland, Faculty of Humanities and Social Sciences, Australia
| | - Jodie A Copley
- The University of Queensland, Faculty of Health and Behavioural Sciences, Australia
| | - Emma Bartle
- The University of Queensland, Faculty of Health and Behavioural Sciences, Australia
| | - Anne E Hill
- The University of Queensland, Faculty of Health and Behavioural Sciences, Australia
| | - Tessa Barnett
- The University of Queensland, Faculty of Health and Behavioural Sciences, Australia
| | - Ruth Dunwoodie
- The University of Queensland, Faculty of Health and Behavioural Sciences, Australia
| | - Alice Zuber
- The University of Queensland, Faculty of Health and Behavioural Sciences, Australia
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Walkowska A, Przymuszała P, Marciniak-Stępak P, Nowosadko M, Baum E. Enhancing Cross-Cultural Competence of Medical and Healthcare Students with the Use of Simulated Patients-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2505. [PMID: 36767872 PMCID: PMC9916152 DOI: 10.3390/ijerph20032505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
Increasing cultural and linguistic diversities of populations have created a challenge for medical educators to provide authentic learning experiences fostering cross-cultural understanding and interprofessional attitudes of students. Simulations with actors portraying patients (commonly referred to as simulated patients) are effective learning modalities to teach students to provide culturally competent care and influence the quality of patient-centered care. The aim of this systematic review was to identify and synthesize available evidence on the use of simulations with simulated patients as a learning intervention to teach cultural competence to the students of healthcare professions. The PubMed, Medline Complete, and CINAHL databases were searched for articles, which resulted in 27 papers being included in the review. Results revealed that engaging students in cross-cultural interactions with patients increases their level of cultural competence, confidence, and learning satisfaction, and therefore, simulations with simulated patients can serve as a powerful reinforcement of cross-cultural education.
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Affiliation(s)
- Aleksandra Walkowska
- Centre for Foreign Language Tuition, Poznan University of Medical Sciences, 60-801 Poznan, Poland
| | - Piotr Przymuszała
- Department of Medical Education, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| | | | - Maria Nowosadko
- Centre for Foreign Language Tuition, Poznan University of Medical Sciences, 60-801 Poznan, Poland
| | - Ewa Baum
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 60-806 Poznan, Poland
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A Qualitative Investigation of Factors Affecting Saudi Patients' Communication Experience with Non-Saudi Physicians in Saudi Arabia. Healthcare (Basel) 2022; 11:healthcare11010118. [PMID: 36611579 PMCID: PMC9819697 DOI: 10.3390/healthcare11010118] [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: 11/08/2022] [Revised: 12/14/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
(1) Background: Communication is the main issue between the patient and physician. Communication gaps lead to medical errors, mistakes, and wrong diagnoses and treatments. It would certainly be a cause of patient dissatisfaction, the physicians' job dissatisfaction, and the increase in the cost of health services. (2) Objectives: The objective of the study was to explore the perception of Saudi patients when they meet non-Saudi consultants at hospitals. (3) Material and Methods: This study is exploratory in nature. Semi-structured face to face interviews were conducted. Study participants were patients from the outpatient department of the Hospitals of Qassim province, Saudi Arabia. A total of eight respondents, four male and four female, participated in the study. (4) Results: Interviews were transcribed verbatim and analyzed using a thematic analysis approach. Two main themes emerged: the first theme is encountering difference, with three sub-themes, while the second one is the absence of partnering, with four sub-themes. (5) Conclusions: The analysis of the patients' experiences of their medical encounters revealed that the effectiveness of the physician-patient communication was jeopardized by two challenges: encountering differences and the absence of partnering. (6) Limitations: This study was conducted in one site only and hence findings must be tested in application to other sites in other parts of Saudi Arabia and in other similar countries. A further limitation of this study was the cultural barrier that was encountered by the researcher during the interview process.
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Campbell SH, Aredes NDA, Bontinen K, Lim Y, duManoir C, Tharmaratnam T, Stephen LA. Global Interprofessional Therapeutic Communication Scale© Short Form (GITCS©): Feasibility Testing in Canada. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Griffin G, Nau SZ, Ali M, Riggs E, Dantas JAR. Seeking Health Information: A Qualitative Study of the Experiences of Women of Refugee Background from Myanmar in Perth, Western Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3289. [PMID: 35328976 PMCID: PMC8951186 DOI: 10.3390/ijerph19063289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 12/23/2022]
Abstract
Women of refugee background are subject to significant health inequity. Access to health information and a good level of health literacy are integral components to manage one's health needs. The aim of this study isto understand the experiences of women of refugee background from Myanmar seeking and accessing health information. Semi-structured interviews were conducted with 14 women of refugee background from Myanmar resettled in Western Australia. Interpretative phenomenological analysis underpinned the study and was conducted on the interview data. Three superordinate themes and nine subordinate themes emerged from the analysis: (1) Seeking health information (Motivation and Sources), (2) Facilitators and Barriers (Communication, Navigating the system and Community) and (3) Seeking health information in the context of past experiences (Health information as a by-product of healthcare, Health professionals' provision of health information, Accessibility of healthcare and Expectations on resettlement). These themes provide insight into the challenges of accessing understandable and actionable health information and of promoting the health literacy of women of refugee background from Myanmar. Co-designed community-based and health service interventions should be trialled, including trauma-informed training for health professionals, health information apps and community health promotion programs. Community engagement, participation and evaluation are critical for determining the effective interventions to address the inequalities experienced by this population.
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Affiliation(s)
- Georgia Griffin
- Curtin School of Population Health, Curtin University, Bentley, WA 6102, Australia; (M.A.); (J.A.R.D.)
| | - S. Zaung Nau
- School of Management and Marketing, Curtin University, Bentley, WA 6102, Australia;
| | - Mohammed Ali
- Curtin School of Population Health, Curtin University, Bentley, WA 6102, Australia; (M.A.); (J.A.R.D.)
| | - Elisha Riggs
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia;
- Department of General Practice, University of Melbourne, Parkville, VIC 3000, Australia
| | - Jaya A. R. Dantas
- Curtin School of Population Health, Curtin University, Bentley, WA 6102, Australia; (M.A.); (J.A.R.D.)
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Shiraly R, Mahdaviazad H, Pakdin A. Doctor-patient communication skills: a survey on knowledge and practice of Iranian family physicians. BMC FAMILY PRACTICE 2021; 22:130. [PMID: 34167464 PMCID: PMC8229738 DOI: 10.1186/s12875-021-01491-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/15/2021] [Indexed: 12/30/2022]
Abstract
Background Communication skills are fundamental to successful medical practice and can greatly impact patient satisfaction, compliance and outcomes. This study evaluated knowledge and practice of doctor- patient communication among the urban family physicians based on main items of Calgary Cambridge Observation Guides. Method This cross-sectional study was conducted from July to September, 2019, in a 400 randomly selected sample of family physicians of Shiraz, Fars province. The data collection tool was a self-administered, second-part questionnaire developed by the researchers. Participants were asked about their age, gender, practice setting, and years of work experience and if they received any formal training in doctor- patient communication. Data were analyzed using SPSS (Version 16, SPSS Inc., Chicago, IL, USA). A p-value of less than 0.05 was considered statistically significant. Results The study participants included 204 male and 196 female family physicians with a mean age of 46.7 ± 7.7 years. The mean communication skills knowledge score was 41.5 (SD: ± 2.8) indicating a high level of knowledge. The mean score for practices was 38.7 (SD: ± 3.4), implying a moderate level of practice. Based on Bloom’s scale, nearly 80% of family physicians had good knowledge about doctor-patient communication skills, however, 55% of participants reported moderate to poor level of practice in this regard. Results of multivariate regression analysis suggest that higher levels of related knowledge, having higher age or longer work experience, and working in the public sector can predict better practice scores (P < 0.005). Conclusion There is a potential gap between knowledge and self-reported practices toward communication skills among a sample of Iranian family physicians. They have fundamental weakness in the most important evidence-based items of doctor- patient communication. Considering significant role of family physicians in prevention and control of non-communicable diseases (NCDs) as an emerging challenge of our country, the topic of communication skills should be inserted as a top educational priority of family physicians.
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Affiliation(s)
- Ramin Shiraly
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Health Behavior Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamideh Mahdaviazad
- Department of Family Medicine, School of Medicine, Shiraz University of Medical Sciences, P.O. Box: 7193634154, Shiraz, Iran.
| | - Ali Pakdin
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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