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Waller D, Bailey S, Zolfaghari E, Ho J, Feuerlicht D, Ross K, Steinbeck K. Psychosocial assessment of adolescents and young adults in paediatric hospital settings: patient and staff perspectives on implementation of the e-HEEADSSS. BMC Health Serv Res 2023; 23:683. [PMID: 37349759 DOI: 10.1186/s12913-023-09621-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/30/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND The main causes of morbidity and mortality for adolescents and young adults are preventable and stem from psychosocial and behavioural concerns. Psychosocial assessments can help clinicians to identify and respond holistically to risks and strengths that may impact upon a young person's physical and mental health. Despite broad support at a policy level, the implementation of routine psychosocial screening for young people remains varied in Australian health settings. The current study focused on the pilot implementation of a digital patient-completed psychosocial assessment (the e-HEEADSSS) at the Sydney Children's Hospital Network. The aim of this research was to evaluate patient and staff barriers and facilitators to local implementation. METHODS The research used a qualitative descriptive research design. Semi-structured interviews were conducted online with 8 young patients and 8 staff members who had completed or actioned an e-HEEADSSS assessment within the prior 5 weeks. Qualitative coding of interview transcripts was carried out in NVivo 12. The Consolidated Framework for Implementation Research guided the interview framework and qualitative analyses. RESULTS Results demonstrated strong support for the e-HEEADSSS from patients and staff. Key reported facilitators included strong design and functionality, reduced time requirements, greater convenience, improved disclosure, adaptability across settings, greater perceived privacy, improved fidelity, and reduced stigma for young people. The key barriers were related to concerns over available resources, the sustainability and continuity of staff training, perceived availability of clinical pathways for follow-up and referrals, and risks related to off-site completions. Clinicians need to adequately explain the e-HEEADSSS assessment to patients, educate them about it, and make sure that they receive timely feedback on the results. Greater reassurance and education regarding the rigour of confidentiality and data handling procedures is required for patients and staff. CONCLUSIONS Our findings indicate that continued work is required to support the integration and sustainability of digital psychosocial assessments for young people at the Sydney Children's Hospital Network. The e-HEEADSSS shows promise as an implementable intervention to achieve this goal. Further research is required to determine the scalability of this intervention across the broader health system.
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Affiliation(s)
- Daniel Waller
- Sydney Children's Hospitals Network, Sydney, Australia.
- The University of Sydney, Sydney, Australia.
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia.
| | | | | | - Jane Ho
- Sydney Children's Hospitals Network, Sydney, Australia
- The University of Sydney, Sydney, Australia
| | | | - Kirsty Ross
- Sydney Children's Hospitals Network, Sydney, Australia
- The University of Sydney, Sydney, Australia
| | - Katharine Steinbeck
- Sydney Children's Hospitals Network, Sydney, Australia
- The University of Sydney, Sydney, Australia
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Zolfaghari E, Ridout B, Medlow S, Campbell A, Coggins A, Murphy M, Jani S, Thosar D, Wiederhold BK, Wiederhold M, Steinbeck K. Exploring the use of virtual reality to manage distress in adolescent patients in emergency departments: A feasibility study. Emerg Med Australas 2022; 34:687-693. [PMID: 35238143 PMCID: PMC9790434 DOI: 10.1111/1742-6723.13945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/31/2022] [Accepted: 02/05/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The present study aimed to explore the feasibility and potential benefits of deploying virtual reality (VR) for adolescents in the ED. METHODS This multi-centre study was undertaken in paediatric and adult EDs in two university teaching hospitals. Twenty-six participants who had voluntarily attended the ED received the VR intervention. Pre- and post-measures assessing changes in state anxiety, stress and affect, and physical biomarkers were obtained. RESULTS The use of VR intervention was associated with significant reductions in distress (Short State Stress Questionnaire - Distress Subscale; t = 4.55, P < 0.001) and negative affect (the International Positive and Negative Affect Scale - Short Form version; t = 4.99, P < 0.001). Most participants chose 'Netflix' as their content of choice. The technology was well received by the participants with subjective reports indicating that receiving VR intervention was 'insanely cool', 'takes you away from what's actually happening' and some participants felt 'privileged to get this experience in a hospital'. CONCLUSIONS VR technology can effectively be used in EDs to assist adolescents and young adults better manage their distress and take steps towards activating more self-control mechanisms that will in turn allow for more meaningful engagements to be established with health clinicians. This technology has broad implications for reducing distress in adolescents in a variety of clinical contexts.
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Affiliation(s)
- Elham Zolfaghari
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Academic Department of Adolescent MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Brad Ridout
- Discipline of Biomedical Informatics and Digital HealthCyberpsychology Research Group, Faculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia
| | - Sharon Medlow
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Academic Department of Adolescent MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Andrew Campbell
- Discipline of Biomedical Informatics and Digital HealthCyberpsychology Research Group, Faculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia
| | - Andrew Coggins
- Department of Emergency Medicine, Westmead HospitalWestern Sydney Local Health DistrictSydneyNew South WalesAustralia,Discipline of Emergency MedicineSydney Medical School, The University of SydneySydneyNew South WalesAustralia
| | - Margaret Murphy
- Department of Emergency Medicine, Westmead HospitalWestern Sydney Local Health DistrictSydneyNew South WalesAustralia,Discipline of Emergency MedicineSydney Medical School, The University of SydneySydneyNew South WalesAustralia
| | - Shefali Jani
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Department of Emergency MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Deepali Thosar
- Department of Emergency MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Brenda K Wiederhold
- Virtual Reality Medical CenterScripps Memorial HospitalLa JollaCaliforniaUSA
| | - Mark Wiederhold
- Virtual Reality Medical CenterScripps Memorial HospitalLa JollaCaliforniaUSA
| | - Katharine Steinbeck
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Academic Department of Adolescent MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
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Zolfaghari E, Armaghanian N, Waller D, Medlow S, Hobbs A, Perry L, Nguyen K, Steinbeck K. Implementation science in adolescent healthcare research: an integrative review. BMC Health Serv Res 2022; 22:598. [PMID: 35505305 PMCID: PMC9066920 DOI: 10.1186/s12913-022-07941-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Multiple theories, models and frameworks have been developed to assist implementation of evidence-based practice. However, to date there has been no review of implementation literature specific to adolescent healthcare. This integrative review therefore aimed to determine what implementation science theories, models and frameworks have been applied, what elements of these frameworks have been identified as influential in promoting the implementation and sustainability of service intervention, and to what extent, in what capacity and at what time points has the contribution of adolescent consumer perspectives on evidence implementation been considered. Methods An integrative design was used and reported based on a modified form of the PRISMA (2020) checklist. Seven databases were searched for English language primary research which included any implementation science theory, model or framework developed for/with adolescents or applied in relation to adolescent healthcare services within the past 10 years. Content and thematic analysis were applied with the Consolidated Framework for Implementation Research (CFIR) used to frame analysis of the barriers and facilitators to effective implementation of evidence-informed interventions within youth health settings. Results From 8717 citations, 13 papers reporting 12 studies were retained. Nine different implementation science theories, frameworks or approaches were applied; six of 12 studies used the CFIR, solely or with other models. All CFIR domains were represented as facilitators and barriers for implementation in included studies. However, there was little or no inclusion of adolescents in the development or review of these initiatives. Only three mentioned youth input, occurring in the pre-implementation or implementation stages. Conclusions The few studies found for this review highlight the internationally under-developed nature of this topic. Flagging the importance of the unique characteristics of this particular age group, and of the interventions and strategies to target it, the minimal input of adolescent consumers is cause for concern. Further research is clearly needed and must ensure that youth consumers are engaged from the start and consistently throughout; that their voice is prioritised and not tokenistic; that their contribution is taken seriously. Only then will age-appropriate evidence implementation enable innovations in youth health services to achieve the evidence-based outcomes they offer. Trial Registration PROSPERO 2020 CRD42020201142 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=201142 Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07941-3.
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Affiliation(s)
- Elham Zolfaghari
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Natasha Armaghanian
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia. .,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia.
| | - Daniel Waller
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia.,Faculty of Health, University of Technology Sydney, Broadway, Ultimo, NSW, 2007, Australia
| | - Sharon Medlow
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Annabelle Hobbs
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Lin Perry
- Faculty of Health, University of Technology Sydney, Broadway, Ultimo, NSW, 2007, Australia.,South East Sydney Local Health District, Prince of Wales Hospital, Randwick, NSW, 2316, Australia
| | - Katie Nguyen
- Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Katharine Steinbeck
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
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Zolfaghari E, Boroumandfar Z, Nekuei N. Comparison of reproductive health and its related factors in vulnerable and nonvulnerable women. J Educ Health Promot 2022; 11:10. [PMID: 35281380 PMCID: PMC8893076 DOI: 10.4103/jehp.jehp_1623_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/05/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Women's health is supposed to be one of the indicators of development. Reproductive health is an important part of women's health. Vulnerable women are a group of women whose reproductive health needs to be given special attention. The purpose of this study was to compare the reproductive health of vulnerable and nonvulnerable women. MATERIALS AND METHODS This cross-sectional study was conducted on vulnerable women (n = 250) and nonvulnerable women (n = 250). The samples were selected from vulnerable women's centers and comprehensive health centers in Isfahan by quota and using simple random sampling method in 2017. The research tool was a researcher-made questionnaire completed by the researcher using interview method. Internal reliability of the questionnaire was confirmed to be 0.89 using Cronbach's alpha. A P < 0.05 was considered to be statistically significant. Data analysis was performed using SPSS 18 software and independent t-test, Mann-Whitney, Pearson, Spearman, and Chi-square tests. RESULTS The results showed that the mean total score of reproductive health in the nonvulnerable group (81.41) was significantly higher than that of the vulnerable group (68.6). The mean total score and the score of reproductive health components, except some of them, were significantly different between the two groups (P < 0.05). Having an addicted spouse and unsafe sex were the most prevalent features associated with high-risk behaviors. CONCLUSIONS According to the results, reproductive health status of vulnerable women is inappropriate in all dimensions. Given the importance of this issue, the development and implementation of special health programs for this group seem to be necessary.
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Affiliation(s)
- Elham Zolfaghari
- Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Boroumandfar
- Department Of Midwifery and Reproductive Health, Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nafisehsadat Nekuei
- Department of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Rojas AJ, Lozano O, Foresti K, Zolfaghari E, Zubaran C. Comparison and concordance of health-related quality of life tests among substance users. Health Qual Life Outcomes 2015; 13:186. [PMID: 26584849 PMCID: PMC4653834 DOI: 10.1186/s12955-015-0364-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 10/08/2015] [Indexed: 11/26/2022] Open
Abstract
Background In the field of drug and alcohol abuse, health-related quality of life (HRQoL) has been used as an important clinical and research outcome. The aim of this study was to establish score linkages (concordance) among three HRQoL assessment tools: WHOQOL-BREF, DUQOL and HRQOLDA scores, applying a Rasch-based common person equating procedure. Methods One hundred and twenty one adults were recruited from inpatient and outpatient treatment facilities in Sydney West Area Health Service. WHOQOL-BREF, DUQOL and HRQOLDA tests were administered. Item parameters were calculated applying Rating Scale Model, a Rasch model. Results Fit statistics suggest acceptable goodness-of-fit to the RSM for three instruments. Correlations between HRQOLDA and WHOQOL-BREF and between HRQOLDA and DUQOL scores were 0.719 and 0.613, and the RiU index was 30.4 % and 20.9 %, respectively. All three tests performed adequately for differentiating between individuals whose scores are located at different points along the continuum of the HRQoL construct. Conclusion The results demonstrated a higher concordance between the HRQoLDA and WHOQOL-BREF than between the HRQoLDA and the DUQOL. However, it cannot be established unequivocally that the scores of these tools are concordant. In this study, the utility of the application of the Rasch model to provide an empirical benchmark for the selection of measurement tools to be used in the context of health care and research is demonstrated.
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Affiliation(s)
- Antonio J Rojas
- Department of Psychology, University of Almería. Facultad de Psicología, 04120, Almería, Spain.
| | - Oscar Lozano
- Department of Clinical, Experimental and Social Psychology, University of Huelva, Facultad de Ciencias de la Educación, 21071, Huelva, Spain.
| | - Katia Foresti
- Department of Psychiatry, Hornsby Hospital, Northern Sydney Local Health District, Palmerston Rd, Hornsby, NSW, 2077, Australia.
| | - Elham Zolfaghari
- Department of Psychiatry, Blacktown Hospital, Western Sydney Local Health District, PO Box 762, Seven Hills, NSW, 2147, Australia.
| | - Carlos Zubaran
- Department of Psychiatry, Blacktown Hospital, Western Sydney Local Health District, PO Box 762, Seven Hills, NSW, 2147, Australia. .,School of Medicine, Western Sydney University, PO Box 6010, Blacktown, NSW, 2148, Australia.
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Zubaran C, Zolfaghari E, Foresti K, Emerson J, Sud R, Surjadi J. A validation study of the English version of the AlQol 9 to measure quality of life. Am J Drug Alcohol Abuse 2014; 40:131-6. [PMID: 24588420 DOI: 10.3109/00952990.2013.877919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Quality of life (QoL) is an important clinical and research outcome within the drug and alcohol abuse context. The AlQoL 9 is a specific questionnaire designed to assess health- and non-health-related consequences of alcoholism. The English version of the AlQoL 9 has not been validated using a larger sample. OBJECTIVES The aim of this study was to assess the psychometric properties of the English version of AlQoL 9 in a sample of treatment-seeking individuals in Australia. METHODS A sample of 138 participants from inpatient and outpatient treatments facilities completed the AlQoL 9 test and the World Health Organisation Quality of Life Assessment-BREF (WHOQOL-BREF). The study's investigative parameters included the demographic characteristics of the sample, internal structure, and convergent validity. Furthermore, correlations between the AlQoL 9 scale scores and the scores obtained from the WHOQOL-BREF test were investigated using Pearson product-moment correlation analyses. RESULTS The English version of the AlQoL 9 attained a significant Cronbach's alpha of 0.825. The mean score obtained in the test was 21.92 (SD = 6.79). Using Varimax rotation, the AlQoL 9 yielded one principal factor that had accounted for 37.85% of variance. Convergent validity analysis demonstrated significant correlations (p < 0.001) between the AlQoL 9 scores and the scores of all four dimensions of the WHOQOL-BREF questionnaire. CONCLUSION The present study demonstrated that the English version of the AlQoL 9 constitutes a valid and reliable research instrument for evaluating quality of life among alcohol-dependent individuals.
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Zubaran C, Emerson J, Sud R, Zolfaghari E, Foresti K. The application of the Drug User Quality of Life Scale (DUQOL) in Australia. Health Qual Life Outcomes 2012; 10:31. [PMID: 22424057 PMCID: PMC3349501 DOI: 10.1186/1477-7525-10-31] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 03/18/2012] [Indexed: 11/17/2022] Open
Abstract
Background The concept of quality of life relates to the perceptions of individuals about their mental and physical health as well as non-health related areas. The evaluation of quality of life in the context of substance abuse has been conducted using generic instruments. The Drug Users Quality of Life Scale (DUQOL) is a specific assessment tool in which the most pertinent and salient areas to drug abusers are taken into consideration. In this study, the authors report the results of a validation study in which the DUQOL was used for the first time in Australia. Methods A sample of 120 participants from inpatient and outpatient treatment facilities completed a series of questionnaires, including the DUQOL and the World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF). Parameters investigated in this study included the demographic characteristics of the sample, internal structure, and convergent validity. Correlations between the DUQOL scale scores and the scores of the WHOQOL-Bref test were investigated via Pearson product-moment correlation analyses. Results The English version of the DUQOL attained a significant overall Cronbach's alpha of 0.868. The factorial analysis of the DUQOL identified one principal factor that accounted for 28.499% of the variance. Convergent validity analyses demonstrate significant correlations (p < 0.01) between the DUQOL scores and the scores of all four dimensions of the WHOQOL-BREF questionnaire. Conclusions This study demonstrates that the DUQOL constitutes a reliable research instrument for evaluating quality of life of substance users in Australia.
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Affiliation(s)
- Carlos Zubaran
- School of Medicine, University of Western Sydney, Department of Psychiatry, Western Sydney Local Health District, Blacktown Hospital, PO Box 6010, Blacktown, NSW 2148, Australia.
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Zubaran C, Sud R, Emerson J, Zolfaghari E, Foresti K, Lozano O. Validation of the English version of the Health-Related Quality of Life for Drug Abusers (HRQoLDA) test. Eur Addict Res 2012; 18:220-7. [PMID: 22572558 DOI: 10.1159/000337213] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 02/08/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND The Health-Related Quality of Life for Drug Abusers (HRQoLDA) test was designed to specifically evaluate quality of life among substance users. In this study, the validity and reliability of the English version of the HRQoLDA test are reported for the first time. METHODS A sample of 121 participants from inpatient and outpatient treatment facilities completed the HRQoLDA test. RESULTS The mean HRQoLDA score was 45.9 (SD = 16.9), while the overall Cronbach's alpha coefficient was 0.905. The factorial analysis of the HRQoLDA test revealed a unidimensional structure. Convergent validity analyses demonstrated significant correlations between the HRQoLDA test scores and the scores of the World Health Organization Quality of Life Assessment-Bref Questionnaire in different dimensions. CONCLUSION The results revealed that the HRQoLDA was successfully adapted to English. The HRQoLDA is a reliable research instrument for evaluating quality of life of substance users.
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Affiliation(s)
- Carlos Zubaran
- School of Medicine, University of Western Sydney, Sydney, N.S.W., Australia.
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