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Found 1,231 results
  1. News Article
    Lessons learnt in relation to increasing uptake of the COVID-19 vaccine among ethnic minority groups should now be applied to the booster programme, a government progress report recommends. This includes continuing to use respected local voices to build trust and to help tackle misinformation, the report from the government’s Race Disparity Unit says. Such approaches should also be carried over to the winter flu and childhood immunisation programmes and be applied to the work to tackle longer standing health disparities. In June 2020 the minister for equalities was asked to look at why COVID-19 was having a disproportionate impact on ethnic minority groups and to consider how the government response to this could be improved. This latest report is the final one of four. Taken together the reports identified that the main factors behind the higher risk of COVIDd-19 infection for ethnic minority groups include occupation, living in multigenerational households, and living in densely populated urban areas with poor air quality and high levels of deprivations. Read full story Source: BMJ, 3 December 2021
  2. News Article
    Deaf people are twice as likely to suffer mental health problems than those with hearing, a report has found. The All Wales Deaf Mental Health and Wellbeing Group said help in Wales was behind the rest of the UK and it wants to see significant improvements. It also described the inequalities faced by deaf people trying to access mental health support as "really frustrating". The Welsh government said it would consider the findings of the report. Ffion Griffiths, 23, from Neath, has been deaf since birth, and accessing child and adolescent mental health services in Wales has been a problem over the years. She had to travel to England to get the support she needed. "It's really frustrating because deaf people in England have more opportunities," she said. It means they can be treated and get better quicker but for us, how can we do that?" "How can we expect to recover if we don't have access to the services or any pathways for us to follow to get the treatment that we need in Wales?" Read full story Source: BBC News, 8 December 2021
  3. News Article
    Efforts to end health inequalities should be ‘in the mix’ of metrics used to determine the NHS’ progress against key performance targets, say race inequality experts. In an exclusive interview with HSJ, NHS Race and Health Observatory (RHO) director Habib Naqvi said organisations’ performance on the issue should be scrutinised by an external body to ensure they are held accountable and “not marking their own exam answer”. It comes as the RHO publishes a report that warns the appointment of health inequalities leads across the NHS risks becoming “tokenistic” if they are not adequately supported and held accountable. The report by The King’s Fund think tank has recommended several actions to prevent the introduction of board-level leads from becoming a “hollow gesture”. In August 2020, NHS England asked all NHS organisations to have a named executive board member responsible for tackling inequalities by October that year. The RHO estimates there to be more than 450 of these named leads across the country. The report welcomed this but added “frameworks” of support and accountability should exist to “empower individuals and motivate change”. The recommendations include putting inequalities on an “equal footing” with key performance metrics, as well as a long-term policy focus that puts addressing inequalities “at the heart of system development”. Read full story (paywalled) Source: HSJ, 1 December 2021
  4. News Article
    The British Red Cross have found that that 367,000 people, which equates to around one percent of the population in England attend A&E up to 346 times a year. These figures accounted for nearly one in three ambulance call outs and over one in six A&E visits. The research analysis found that a fifth of those repeatedly attending A&E lived alone and also often lived in deprived areas of the country. Frequent users also accounted for 29% of all ambulance call outs and 16% of non-minor-injury A&E visits. The data also revealed that people in their twenties were more likely to repeatedly visit A&E than any other age category. Mike Adamson, chief executive of the British Red Cross, said: 'High intensity use of A&E is closely associated with deprivation and inequalities - if you overlay a map of frequent A&E use and a map of deprivation, they're essentially the same.' Read full story Source: National Health Executive, 29 November 2021
  5. News Article
    An independent body set up by the NHS to tackle health inequalities has formally committed to never use blanket acronyms such as “BAME” after feedback that they are not representative. The NHS Race and Health Observatory launched a four-week consultation with the public in July on how best to collectively refer to people from black, Asian and minority ethnic groups. The Observatory said it has become the norm in public policy to use initialisms to refer to a “hugely diverse” group of people, but that renewed scrutiny has been spurred on by the Black Lives Matter movement. It said terminology that “crudely conflates” different groups “does not just erase identities; it can also lead to broad brush policy decisions that fail to appreciate the nuance of ethnic inequality in the UK”. Generic collective terms such as “BAME”, “BME” and “ethnic minority” are “not representative or universally popular”, the Observatory said after receiving responses from 5,104 people. It found no single, collective umbrella term to describe ethnic groups was agreed by the majority of respondents. The body had previously said it was committed to avoiding the use of acronyms and initialisms, but has now formalised this as one of five key principles it is adopting in its communications. Where possible it will be specific about the ethnic groups it is referring to, but where collective terminology is necessary it will “always be guided by context and not adopt a blanket term”. Read full story Source: The Independent, 26 November 2021
  6. News Article
    The system for assessing who should be asked to pay for NHS services “incentivises racial profiling”, an investigation has found. A study by the Institute for Public Policy Research found that overstretched NHS staff sometimes racially profile patients in order to determine who is not “ordinarily resident” in the UK, and therefore must pay for their care. The report is critical of the more stringent charging regime introduced by NHS England over the past decade as part of a series of measures devised to create a hostile environment for people living in the UK without the correct immigration status. Overseas visitors officers have been appointed by NHS trusts, responsible for identifying chargeable patients, as part of a cost recovery programme launched in 2014. One of the officers told the IPPR study they had felt forced to discriminate between patients based on their name. “If you’ve got a, I don’t know, Mohammed Khan and a Fred Cooper, you’re obviously going to go for [investigating] the Mohammed Khan … Even for someone who’s, you know, well I’d like to think hopefully open-minded, like myself, you’re just trying to save yourself time because there’s not enough hours in the day,” the officer said. A hospital employee also reported that discrimination on the basis of ethnicity was used to determine who should be billed for treatment. “It’s a system that is designed to benefit [white] people like me, not people like … the patient on intensive care who is black and British and was unconscious and sent a bill. So why did someone think he was not eligible for care? Given he was unconscious most of the admission, significantly unwell, probably not his accent, more likely his skin colour,” the health worker said. Under the rules, anyone “not ordinarily resident” in the UK should be charged 150% of the NHS national tariff for most secondary (non-urgent) healthcare, but the report found that processes varied across the country, with a lack of consistent training and widespread confusion over the 130-page rules for the charging system. Some healthcare staff told IPPR researchers that they disliked the extra burden of having to consider whether to refer a patient for charging, which they felt distracted them from their core medical responsibilities. Read full story Source: The Guardian, 23 November 2021
  7. News Article
    A review into whether medical devices are equally effective regardless of the patient's ethnicity has been ordered by Health Secretary Sajid Javid. Research suggests oximeters, which are clipped to a person's finger, can overstate the level of oxygen in the blood of people from ethnic minorities. Ministers want to know whether bias could have prevented patients receiving appropriate Covid treatment. Mr Javid said any bias was "totally unacceptable". But the doctors' union the British Medical Association (BMA) said the review should not simply look at equipment, but also "structural issues" within healthcare that affect ethnic minorities. Mr Javid announced the review in the Sunday Times, saying he was determined to "close the chasms that the pandemic has exposed". Asked later on the BBC's Andrew Marr show whether he thought people had died of Covid because of pulse oximeters, Mr Javid said: "I think possibly yes, yes. I don't have the full facts." He said there was racial bias in some medical instruments, adding: "It's unintentional but it exists." "And the reason is that a lot of these medical devices, even some of the drugs, some of the procedures, some of the textbooks, most of them are put together in majority white countries and I think this is a systemic issue around this," he said. Read full story Source: BBC News, 21 November 2021
  8. News Article
    The increased risk of black and minority ethnic women dying during pregnancy needs to be seen as a whole system problem and not limited to just maternity departments, according to experts on an exclusive panel hosted by The Independent. Professor Marian Knight, from Oxford University told the virtual event on Wednesday night that the health service needed to change its approach to caring for ethnic minority women in a wider context. Campaigners Tinuke Awe and Clotilde Rebecca Abe, from the Fivexmore campaign, called for changes to the way midwives were trained and demanded it was time to “decolonise the curriculum” so it recognised the physiological differences between some ethnic minority women and white women. Dr Mary Ross-Davie, from the Royal College of Midwives, said work was underway to ensure the voices of black women and other minorities were represented in its work and it was examining how it could deliver better training to midwives. The data on maternity deaths in the UK show black women are four times more likely to die during pregnancy in the UK than white women. For Asian women, they are twice as likely to die. Read full story and watch video of event Source: The Independent, 18 November 2021
  9. News Article
    Researchers are to use artificial intelligence (AI) in the hope of reducing risk to pregnant black women. Loughborough University experts are to work with the Healthcare Safety Investigation Branch (HSIB) to identify patterns in its recent investigations. Research has suggested black women are more than four times more likely to die in pregnancy or childbirth than white women in the UK. The researchers plan to look at more than 600 of HSIB's recent investigations into adverse outcomes during pregnancy and birth. The research team will develop a machine learning system capable of identifying factors, based on a set of codes, that contribute to harm during pregnancy and birth experienced by black families. These include biological factors, such as obesity or birth history; social and economic factors such as language barriers and unemployment; and the quality of care and communication with the mother. It will look at how these elements interact with and influence each other, and help researchers design ways to improve the care of black mothers and babies. Dr Patrick Waterson, from the university, who is helping to lead the project, said: "Ultimately, we believe the outcomes from our research have the potential to transform the NHS's ability to reduce maternal harm amongst mothers from black ethnic groups." He added that in the longer term, the research could improve patient safety for all mothers. Read full story Source: BBC News, 17 November 2021
  10. News Article
    A groundbreaking inquiry into sickle cell disease has found “serious care failings” in acute services and evidence of attitudes underpinned by racism. The report by the all-party parliamentary group (APPG) on Sickle Cell and Thalassaemia, led by Pat McFadden MP, found evidence of sub-standard care for sickle cell patients admitted to general wards or attending A&E departments. The inquiry also found widespread lack of adherence to national care standards, low awareness of sickle cell among healthcare professionals and clear examples of inadequate training and insufficient investment in sickle cell care. The report notes frequent disclosures of negative attitudes towards sickle cell patients, who are more likely to be people with an African or Caribbean background, and evidence to suggest that such attitudes are often underpinned by racism. The inquiry also found that these concerns have led to a fear and avoidance of hospitals for many people living with sickle cell. Care failings have led to patient deaths and “near misses” are not uncommon, leading to a cross-party call for urgent changes into care for sickle cell patients. Read full story Source: The Independent, 15 November 2021
  11. News Article
    Black women are more than four times more likely to die in pregnancy or childbirth than white women in the UK, a review of 2017-2019 deaths shows. The MBRRACE-UK report found women from Asian backgrounds are almost twice as likely to die as white women. Some 495 individuals died during pregnancy or up to a year after birth, out of 2,173,810 having a child. The charity Birthrights is concerned that overall "this bleak picture has not changed in over a decade". University of Oxford researchers say for the vast majority of people, pregnancy remains very safe in the UK. But despite slight decreases in the maternal death rate in recent years, there have been no significant improvements to these rates since the 2010 to 2012 period. Their current report shows heart disease, epilepsy and stroke continue to be the most common causes of death. And they say in some 37% of cases, improvements in care may have made a difference to the outcome. Lead researcher, Prof Marian Knight, said: "Pregnant women get inequitable care for several reasons. "Healthcare professionals often attribute their symptoms to pregnancy alone and they do not always end up getting the treatment they need because people can be incorrectly concerned about giving them medication. "On top of that is the unconscious bias that black and Asian women can experience. It all adds up. "We know from other studies that the disparity in death rates cannot be fully explained by socio-economic factors and other medical conditions for example. We need to look for other reasons." Read full story Source: BBC News, 11 November 2021
  12. News Article
    Artificial intelligence (AI) systems being developed to diagnose skin cancer run the risk of being less accurate for people with dark skin, research suggests. The potential of AI has led to developments in healthcare, with some studies suggesting image recognition technology based on machine learning algorithms can classify skin cancers as successfully as human experts. NHS trusts have begun exploring AI to help dermatologists triage patients with skin lesions. But researchers say more needs to be done to ensure the technology benefits all patients, after finding that few freely available image databases that could be used to develop or “train” AI systems for skin cancer diagnosis contain information on ethnicity or skin type. Those that do have very few images of people with dark skin. Dr David Wen, first author of the study from the University of Oxford, said: “You could have a situation where the regulatory authorities say that because this algorithm has only been trained on images in fair-skinned people, you’re only allowed to use it for fair-skinned individuals, and therefore that could lead to certain populations being excluded from algorithms that are approved for clinical use." “Alternatively, if the regulators are a bit more relaxed and say: ‘OK, you can use it [on all patients]’, the algorithms may not perform as accurately on populations who don’t have that many images involved in training.” That could bring other problems including risking avoidable surgery, missing treatable cancers and causing unnecessary anxiety, the team said. Read full story Source: The Guardian, 9 November 2021
  13. News Article
    Socioeconomic inequalities account for an estimated quarter of stillbirths, fifth of preterm births, and a third of births with fetal growth restriction, according to a study published in the Lancet of over one million births in England The nationwide study across England’s NHS was carried out by the National Maternity and Perinatal Audit team, who analysed birth records between April 2015 and March 2017 to quantify socioeconomic and ethnic inequalities in pregnancy outcomes. They found that an estimated two thirds (63.7%) of stillbirths and half (55.0%) of births with fetal growth restriction in black women from the most deprived neighbourhoods could be avoided if this population had the same risks as white women living in the most affluent 20% of neighbourhoods. Read full story (paywalled) Source: BMJ, 2 November 2021
  14. News Article
    Gender bias is leaving many women with attention deficit hyperactivity disorder undiagnosed, leading psychologists are warning. The prevailing stereotype ADHD affects only "naughty boys" means at least tens of thousands in the UK, it is estimated, are unaware they have the condition and not receiving the help they need. "I used to tell doctors and therapists all the time, 'You've got to make this constant noise in my head stop. I can't think. I can't sleep. I can't get any peace,' but this was always dismissed as anxiety or women's problems," Hester says. Diagnosed with depression at 16, she spent much of her 20s unsuccessfully battling to be referred to a psychiatrist. And she constantly felt she was not reaching her true potential. Hester was finally diagnosed with ADHD in 2015, aged 34, and only, she says, because her husband had discovered he had the condition, a year earlier. His diagnosis took 12 months. "At no point did anyone say to Chris, 'This sounds like anxiety,' or 'Have some tablets,'" Hester says. "He was taken seriously." "Whereas with me, I was on the doctor's radar from the age of 16. "Bluntly, it took so long for me to be diagnosed because I'm a woman." Read full story Source: BBC News, 26 October 2021
  15. News Article
    Tackling inequalities was “often not a main priority” for local health and care systems over the past year, the care regulator for England has said. The Care Quality Commission (CQC) said the pandemic had exposed and exacerbated inequalities, and most services demonstrated some understanding of these. But it found that tackling inequalities “was often not a main priority for systems, or strategies to identify and tackle health inequalities were not yet well established”. Issues included poor accessibility of information in different languages for some people, varying service provision and access, and a lack of understanding of how people’s individual characteristics affected the care they needed. The regulator said an example of this was the specific needs of people with a learning disability from black and minority ethnic groups. It also flagged that an increase in remote or digital care could be a barrier to people who cannot access technology or do not feel comfortable doing so. The report found inequalities had also been exposed by the coronavirus vaccine rollout, with take-up lower in all minority ethnic groups compared with in the white population, and variances according to levels of deprivation. Read full story Source: The Guardian, 22 October 2021
  16. News Article
    Stillbirth rates remain "exceptionally high" for black and Asian babies in the UK, a report examining baby loss in 2019 has found. The figures come despite improving numbers overall, with some 610 fewer stillbirths in 2019 than in 2013. The MBBRACE-UK report found babies of mothers living in deprived areas are at higher risk of stillbirths and neonatal deaths than those in other places. Charities say there is an urgent need to tackle inequalities around birth. There were some 2,399 stillbirths (a death occurring before or during birth once a pregnancy has reached 24 weeks) and 1,158 neonatal deaths (babies who die in the first 28 days of life) in the UK in 2019. The report, by the Universities of Leicester and Oxford, found: Overall stillbirth rates fell from 4.2 per 1,000 births in 2013 to 3.35 per 1,000 births in 2019 For babies of black and black British ethnicity, stillbirth rates were 7.23 per 1,000 births For babies of Asian and Asian British ethnicity, stillbirth rates were 5.05 per 1,000 births For babies of white ethnicity, stillbirth rates were 3.22 per 1,000 births. Read full story Source: BBC News, 15 October 2021
  17. News Article
    White doctors applying for medical posts in London are six times more likely to be offered a job than black applicants, figures released under the Freedom of Information Act show. The new data also show that white doctors are four times more likely to be successful than Asian candidates or candidates from a mixed ethnic background. The figures were uncovered by Sheila Cunliffe, a senior human resources professional who works in workforce transformation across the NHS and the wider public sector. Cunliffe sent freedom of information requests to all 18 NHS acute trusts in London asking for a breakdown by ethnicity for 2020-21 of the numbers of applicants for medical jobs, shortlisted candidates, and candidates offered positions. Twelve of the 18 trusts shared their full unredacted data with The BMJ on all grades of job applications. Across these 12 trusts, 29% (4675 of 15 853) of white applicants were shortlisted in 2020-21, compared with 13% (2041 of 15 515) of black applicants, 14% (8406 of 59 211) of Asian applicants, and 15% (1620 of 10 860) of applicants of mixed ethnicity. Overall, 7% (1148) of white applicants were offered jobs, compared with 1% (188) of black applicants, 2% (1050) of Asian applicants, and 2% (188) of applicants of mixed ethnicity. Cunliffe said that the findings were just one indicator of the barriers that applicants from ethnic minorities faced. “The racism some of these results point to will be replicated in the day-to-day lived experience of staff working within the trust,” she said. “NHSEI [NHS England and NHS Improvement] need to look at data in a more detailed way and, where needed, set out to trusts their clear expectations and targets for improvement.” Read full story Source: BMJ, 13 October 2021
  18. News Article
    The Becker's Clinical Leadership & Infection Control editorial team chose the top 10 patient safety issues for healthcare leaders to prioritise in 2021, presented below in no particular order, based on news, study findings and trends reported in the past year. COVID-19 Healthcare staffing shortages Missed and delayed diagnoses Drug and medicine supply shortages Low vaccination coverage and disease resurgance Clinical burnout Health equity Healthcare-associated infections Surgical mistakes Standardising safety efforts. Read full story Source: Becker's Healthcare, 30 December 2020
  19. News Article
    Throughout the pandemic, people with learning disabilities and autism have consistently been let down. A lack of clear, easy-to-understand guidance, unequal access to care and illegal “do not resuscitate” instructions have exacerbated the inequalities many people have long faced. It is crucial we do not forget those who have constantly been at the back of the queue: people with learning disabilities and autism. The impact cannot be ignored: research shows that 76% of people with learning disabilities feel they do not matter to the government, compared with the general public, during the pandemic. And data shows the danger of contracting COVID-19 for people with learning disabilities and autism is much higher than for the wider population. Public Health England has said the registered COVID-19 death rate for people with learning disabilities in England is more than four times times higher than the general population. But experts estimate the true rate is likely to be even higher, since not all deaths of people with learning disabilities are registered in the databases used to collate the findings. The reasons the pandemic has impacted people with learning disabilities so disproportionately are systemic, and a result of inequalities in healthcare services experienced for generations. Yes, some individuals are more clinically vulnerable, on account of the co-morbidities and complications associated with their learning disability. For many people, however, poorer outcomes after contracting the virus are due to non-clinical issues and inequalities in accessing healthcare services. This is inexcusable. The government must prioritise vaccinations for the 1.5 million people with learning disabilities and 700,000 with autism. Putting this long-overlooked group at the top of the vaccine queue would help address the systemic health inequalities learning disabled people face. Read full story Source: The Guardian, 15 December 2020
  20. News Article
    Health checks should be offered to people from black, Asian and minority ethnic backgrounds from the age of 25, a report has recommended. MPs examined the disproportionate impact of the Covid pandemic on people from black and Asian backgrounds. They said NHS checks, currently available to 40-70-year-olds in England, could pick up conditions which are linked to severe coronavirus. The role of inequalities in employment and housing was also emphasised. The report, produced by the Women and Equalities Committee, said the government should act to tackle these wider causes of poor health. The committee heard evidence during the course of its investigation that showed 63% of healthcare workers who died after contracting the virus had come from black, Asian or other ethnic minority backgrounds. And during the first peak of the virus, data from the Intensive Care National Audit and Research Centre showed 34% of coronavirus patients in ICUs were from an ethnic minority background, whereas they made up 12% of viral pneumonia admissions. Office for National Statistics (ONS) data has also shown that black people were almost twice as likely to die from Covid-19 as white people, with those of Bangladeshi and Pakistani ethnicity about 1.7 times as likely. The report raised concerns the pandemic was entrenching "existing health inequalities". Read full story Source: BBC News, 15December 2020
  21. News Article
    Pre-existing social inequalities contributed to the UK recording the highest death rates from Covid in Europe, a leading authority on public health has said, warning that many children’s lives would be permanently blighted if the problem is not tackled. Sir Michael Marmot, known for his landmark work on the social determinants of health, argued in a new report that families at the bottom of the social and economic scale were missing out before the pandemic, and were now suffering even more, losing health, jobs, lives and educational opportunities. In the report, Build Back Fairer, Marmot said these social inequalities must be addressed whatever the cost and it was not enough to revert to how things before the pandemic. “We can’t afford not to do it,” he said. Read full story Source: The Guardian, 15 December 2020
  22. News Article
    People with learning disabilities have been "at the back of the queue" during the coronavirus pandemic, a panel of MPs has been told. Those living in supported accommodation were left waiting weeks for guidance on testing and visits. MPs were also told long-term social factors were likely to be more important than biology when it came to ethnic divides in the virus's impact. The panel focused on what lessons could be learned. Read full story Source: BBC News, 1 December 2020
  23. News Article
    The architects behind the new NHS Race and Health Observatory have vowed that it will deliver actionable recommendations within months to tackle the structural racism that exists throughout healthcare. Victor Adebowale and Mala Rao called for an observatory to tackle the ethnic health inequalities in the UK in a special issue of The BMJ that they co-edited in February (bmj.com/racism-in-medicine) and NHS England confirmed at the end of the May that the centre would go ahead. Speaking at a meeting to discuss the aims of the observatory on 12 June, Adebowlae told more than 20 assembled stakeholders that he wanted the new centre “to fire on all cylinders,” making recommendations for changes to services that are likely to affect the health outcomes of people from black and ethnic minority backgrounds “within a couple of months.” Read full story Source: BMJ, 15 June 2020
  24. News Article
    Older women could be less likely to receive ovarian cancer treatment. A new report analysed data from more than 17,000 cases of ovarian cancer diagnosed across England between 2016 and 2018. Three in five (60%) of women with ovarian cancer over the age of 79 did not receive either chemotherapy or surgery, while 37% of women over the age of 70 did not receive any treatment. The nature of ovarian cancer means surgery is essential in the large majority of cases to remove the tumour. The researchers cautioned that with an ageing population it is vital that women of all ages have access to the best possible treatments. Researchers also examined the various rates of treatments for ovarian cancer among women in different parts of England. They found the probability of receiving any treatment fell below the average in the East Midlands, the East of England, Greater Manchester and Kent and Medway. The report was jointly funded by The British Gynaecological Cancer Society, Ovarian Cancer Action, Target Ovarian Cancer and delivered by analysts at the National Cancer Registration and Analysis Service. Commenting on the report, Cary Wakefield, chief executive of Ovarian Cancer Action, said: "Neither your age nor location should decide your chance of survival if you are diagnosed with ovarian cancer." "Our audit is the first step in addressing the health inequalities women across England face, so we can begin to dismantle them." Read full story Source: The Independent, 11 November 2020
  25. News Article
    Poorer mothers are three times more likely to have stillborn children than those from more affluent backgrounds, according to a new study. The wide-ranging research, conducted by pregnancy charity Tommy’s, also found that high levels of stress doubled the likelihood of stillbirth, irrespective of other social factors and pregnancy complications. Unemployed mothers were almost three times more at risk. The government has been urged to take immediate action to address the social determinants of health and halt the rise in pregnant women who face the stress of financial insecurity. Researchers said getting more antenatal care can stop women from having a stillbirth — with mothers who went to more appointments than national rules stipulate having a 72% lower risk. Ros Bragg, director of Maternity Action said, “If the government is serious about combatting stillbirths, it must address the social determinants of health as well as clinical care. Women need safe, secure employment during their pregnancy and the certainty of a decent income if they find themselves out of work. It is not right that increasing numbers of pregnant women are dealing with the stress of financial insecurity, putting them at increased risk of serious health problems, including stillbirth.” Read full story Source: The Independent, 29 October 2020
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