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NHMRC (National Health and Medical Research Council) 2009. Canberra: ABS. Certain groups within the population are more likely to use drugs and to experience drug-related harms, with some population groups in the 2013 NDSHS far more likely to report having used methamphetamines recently than the general population. Australian Institute of Health and Welfare. Australian guidelines to reduce health risks from drinking alcohol. Implicit value judgements in the measurement of health inequalities. 2. AIHW 2015c. In: Oxford textbook of global public health. People with high blood pressure may be able to control their condition with lifestyle changes that reduce these risk factors, or they may require medication. Canberra: AIHW. Previous studies have shown the importance of social determinants in understanding and addressing the health gap between Aboriginal and Torres Strait Islander Australians and non-Indigenous Australians (Booth & Carroll 2008; DSI Consulting 2009; Marmot 2011; Zhao et al. Some health inequalities are attributable to external factors and to conditions that are outside the control of the individuals concerned. The social determinants of health related to socioeconomic position help to explain both the gaps in the average health status of Indigenous and non-Indigenous Australians, and also the wide variation observed in the health outcomes within the Indigenous population. The longer a person lives with one or more risk factors, the greater the risk to their overall health and wellbeing. Australian health review: a publication of the Australian Hospital Association. Journal of Epidemiology and Community Health 60(1):712 and 60(2):95101. White V & Bariola E 2012. Canberra: AIHW. A higher proportion of people with an employment restriction due to a disability lived in the lowest socioeconomic areas (26%) than in the highest socioeconomic areas (12%) in 2012 (AIHW analysis of ABS 2012 Survey of Disability, Ageing and Carers). Mallett S, Bentley R, Baker E, Mason K, Keys D & Kolar V et al. Blood tests are used to determine levels of the commonly measured lipids. Fact sheet 33, June 2015. Stockwell T, Donath S, Cooper-Stanbury M, Chikritzhs T, Catalano P & Mateo C 2004. High blood plasma glucose was responsible for 4.3% of the total burden of disease in Australia in 2018 (AIHW 2021a). AIC (Australian Institute of Criminology) 2015. A person's health is also influenced by biomedical factors and health behaviours that are part of their individual lifestyle and genetic make-up. Although complex measures include information on both the magnitude of inequality and the total population distribution of inequality, they are restricted by the types of data that can be used, and by their ease of interpretation. Unemployed people were 1.6 times as likely to use cannabis, 2.4 times as likely to use meth/amphetamines and 1.8 times as likely to use ecstasy as employed people in 2013 (AIHW 2014e). 2013). American Journal of Public Health 87(9):149198. WHO 2013a. Results indicate that those using methamphetamine, particularly ice, are doing so with increased frequency. This included the impact of injecting drug use and cocaine, opioid, amphetamine and cannabis dependence. The number of national seizures followed similar trends, increasing from 10,543 in 200910 to 26,805 in 201314. In 2014, around three-quarters of people using powder, base and crystal forms of methamphetamine reported stable prices (Stafford & Burns 2014) and have reported a relatively stable price of all three forms (powder, crystal and base) since 2009. These factors closely reflect social conditions, such as wealth, education, and place of residence (WHO 2013a). ABS cat. Between 200304 and 201213, there was an increase in the geographic spread of amphetamine-related treatment episodes across Statistical Local Areas in Australia (AIHW 2015a). A common approach to measurement is to: (i) rank the population by socioeconomic position; (ii) divide the population into groups based on this ranking; and (iii) compare each group on health indicators of interest. These have included advertising bans; bans on smoking indoors and increasingly in outdoor public spaces; plain packaging; price increases; restrictions on sales to minors; public education; and media campaigns (IGCD 2013; MCDS 2011). Baum FE & Ziersch AM 2003. Since 200304, the proportion of episodes where amphetamines were the principal drug of concern has increased (from 11% in 200304 to 17% in 201314) (AIHW 2015a). DoHA (Department of Health and Ageing) 2008. Geneva: WHO. Where possible, the crystalline form of methamphetamines has been referred to as 'crystal' throughout this feature article, rather than its street name, 'ice'. MCDS (Ministerial Council on Drug Strategy) 2011. The higher the socioeconomic position, the better the health status on average. Of people aged 14 and over, 8.1% (or 1.5 million) had used cocaine in their lifetime, and 2.1% (or about 400,000 people) had used it in the previous 12 months. High cholesterol levels contributed 2.7% of the total burden of disease in Australia in 2018. Source:NHPA 2013, based on ABS Causes of Death and Life Tables 20092011. Before this, the consumption of alcohol in quantities that placed Australians at risk of an alcohol-related disease, illness or injury had remained at similar levels between 2001 and 2010. around 1 in 4 (27%) had vitamin D deficiency, and this condition was more common among Indigenous adults living in remote areas (39%) than among those living in non-remote areas (23%). Canberra: ABS. According to the 2013 NDSHS, people in their 20s were the most likely of all age groups to report using an illicit drug in the previous 12 months (27%) (Figure 4.5.2). 26. There is also no data available on the impact of COVID-19 measures on the management of these biomedical risk factors. 2010). One study has estimated that half a million Australians could be spared chronic illness, $2.3 billion in annual hospital costs saved, and Pharmaceutical Benefits Scheme prescriptions cut by 5.3 million, if the health gaps between the most and least disadvantaged were closed (Brown et al. Canberra: Department of Health. Minimal consumption of discretionary foodsfoods and drinks not necessary to provide the nutrients the body needs, and often high in saturated fats, sugars, salt and/or alcoholand sufficient consumption of fruit and vegetables (recommended intake of 2 and 56 serves per day, respectively) are good indicators of a healthy diet (NHRMC 2013). Harm minimisation encompasses three components (pillars): demand reduction, supply reduction and harm reduction. no. Paris: OECD Centre for Educational Research and Innovation. A biologically-focused approach to science, policy, and practice has dominated the American healthcare system for more than three decades. Aboriginal and Torres Strait Islander Health Performance Framework 2014 report: detailed analyses. In 201112, 11% of adults, or 1.5 million people, managed their high blood pressure through medications. Tobacco smoking increases the risk of cardiovascular disease, respiratory diseases and other health problems (USHHS 2014). The health consequences of unemployment: the evidence. A model of health which focuses on purely biological factors and excludes psychological, environmental, and social influences. This model receives the majority of health care funding (over 90%). Broadly speaking there are two models of health - the biomedical model and the social determinants model. Canberra: NHMRC. National Drug Strategy Household Survey detailed report: 2013. no. no. no. Australian social trends, March quarter 2012. Canberra: ABS. 2. National Drug Strategy Household Survey detailed report: 2013. PM&C (Department of the Prime Minister and Cabinet) 2015. It looks at how our body works through a medical lens and has many different aspects such as genetics, nutrition, physical activity, mental health, and more. Methods in social epidemiology. Roche A, Pidd K & Kostadinov V 2015. Alcohol and other drug treatment services in Australia 201314. The proportion of adults with IFG generally increased with age and was highest in people aged 75 and over compared with those aged 3544 (7.5% and 2.1%, respectively) (AIHW analysis of ABS 2014; AIHW 2015). The residential environment has an impact on health equity through its influence on local resources, behaviour and safety. This means $1 in every $10 spent in Australia went to health. Aboriginal and Torres Strait Islander Health Performance Framework: 2014 report. It then declined in 2010 (3.0%) and again in 2013 (2.5%). Although methamphetamine use has declined over the last 12 years, and remained stable between 2010 and 2013, there was change in the main form used, with ice replacing powder (discussed in further detail in the 'Methamphetamine use, availability and treatment' section). Differences in social determinants can also explain a large part of the differences in health status within the Indigenous population. Longer-term trends, since 2001, show that use of cannabis, ecstasy and methamphetamine have all declined, but use of cocaine and misuse of pharmaceuticals have increased (AIHW 2014b). In 201718, an estimated 23% of adults had measured high blood pressure but were not taking any blood pressure medication. Health and unemployment. While both can occur as a direct result of alcohol use (for example, alcohol poisoning), in most cases alcohol is one of a number of contributing factors. Sindicich, N & Burns, L 2014. AIHW 2015d. Australian drug trends 2013. The World Health Organization has a leading role in supporting countries to take action on thesocial determinants of healthto address health inequities. Information on crystal specifically is not available prior to 2007 for main form used and frequency of use. A biologically-focused approach to science, policy, and practice has dominated the American healthcare system for more than three decades. A counter-example of a risk factor that has a higher prevalence among employed Indigenous adults is being overweight or obese. However, using a purity-adjusted price of both powder and crystal, based on Victorian data, Scott et al. For the first time since the National Prisoner Health Data Collection began in 2009, in 2015 methamphetamine was the most commonly reported illicit drug used among prison entrants in the previous 12 months (AIHW 2015c). AIHW analyses of the National Perinatal Data Collection show that: The relationship between health status and its social determinants can be complex. Further data are required to explore the impact of COVID-19 measures on the monitoring and management of biomedical risk factors. After rest, pain management with medication or even surgical. In 201314, amphetamines were the third most common principal drug of concern (17% of all treatment episodes), behind alcohol (40%) and cannabis (24%). Australia's health 2016. Indigenous Australians who are in the lowest income group, have a lower level of educational attainment or who are unemployed, are less likely to be in 'excellent' or 'very good' health (based on self-reported survey data) than those in the higher income groups, those with high educational attainment, or those who are employed (Figure 4.2.1). Social exclusion can damage relationships, and increase the risk of disability, illness and social isolation. The biomedical model posits that mental disorders are brain diseases and emphasizes pharmacological treatment to target presumed biological abnormalities. However, recent users used cocaine less often in 2013 than in previous years, with a lower proportion using it every few months (from 26% to 18%) and a higher proportion using it once or twice a year from 61% to 71%. Note:the above drinking categories are not mutually exclusive. In 201112, 87% of people with measured dyslipidaemia were not using lipid modifying medications (AIHW analysis of ABS 2014). 31. Additionally, the impact of COVID-19 and lockdowns might also have had direct or indirect impacts on peoples usual behaviour over the 202021 period. 2006). Despite the apparent increases in supply (see the 'Production and supply' section), lifetime and recent use of methamphetamine has declined over the last decade and remained stable in recent years. The smoking rate for Indigenous Australians aged 15 and over has declined significantly, from 51% to 44% between 2002 and 201213. 2002). Whitehead M 1992. 2.6 timesas high for Aboriginal and Torres Strait Islander Australians compared with non-Indigenous Australians. IFG was more common in men (4.1%) than women (2.1%). Patient experiences in Australia: summary of findings, 201415. AIHW (2021b) Heart, stroke and vascular diseaseAustralian facts,AIHW, Australian Government, accessed 28 February 2022. Canberra: PM&C. Blood pressure is the force exerted by blood on the wall of the arteries. no. Canberra: Department of Health and Ageing. From 2007, an additional question about the main form of meth/amphetamine used was added to the survey, which has enabled estimates to be produced for the minimum number of people using, but not for the total number who have used in the previous 12 months. Cardiovascular, diabetes and chronic kidney disease series no. The AIHW is seeking to expand its use of health and welfare data to further understand how social factors influence health. 25. ABS 2013. The proportion of women smoking at any time during pregnancy has steadily declined over timefrom 15% in 2009 to 12% in 2013. Geneva: WHO. Many national initiatives are implemented under the NDS, including the National Drugs Campaign. AIHW (Australian Institute of Health and Welfare) 2014a. National Health Survey, first results 201415. 4727.0.55.003. The national mass of seizures also increased over this period (from 671kg to 4,076kg). More complex measures use information from all groups to measure the magnitude of socioeconomic inequalities in health (WHO 2013a). For example: Sources:2004 to 2013 National Drug Strategy Household Surveys; 200304 to 201314 Alcohol and Other Drug Treatment Services National Minimum Data Set. In 2014, the proportions of secondary school students aged 1217 smoking in their lifetime, in the past 4 weeks, past week or on 3 days of the last 7, were significantly lower than in 2008 and 2011 (White & Williams 2015). Based on self-reported data from the 202021 NHS, an estimated 28,100 adults (or 0.1%) reported that they had high glucose levels measured in their blood or urine (ABS 2022). HSE 165. In New South Wales and Victoria, data from a study comparing pathology testing in general practices showed that non-acute respiratory illness pathology testing decreased during the first and second waves of COVID-19 in 2020 (Imai et al. Research is focusing on better understanding the causal links between social determinants and health outcomes, and on which policies might lead to better health outcomes. 4102.0. The aim of the NDS is to prevent the uptake and misuse of drugs and to reduce the production and supply of illicit drugs and the negative social, economic and health consequences of drug use. 4364.0.55.001. There is clear evidence that health and illness are not distributed equally within the Australian population. The prevalence of IFG is even greater among those with specific conditions. The extension of reporting to include variables such as ethnicity, culture and language, social support and the residential environment would provide a more robust picture of socioeconomic position. Abstract. IHME (Institute for Health Metrics and Evaluation) 2014. Obesity, which is also a biomedical risk factor, is discussed in Overweight and obesity. Social gradients in the health of Indigenous Australians. Previous versions of the NHS have primarily been administered by trained ABS interviewers and were conducted face-to-face. AIHW 2015a. Cat. Indigenous adults were nearly twice as likely to have abnormally high triglycerides compared with non-Indigenous adults (27% compared with 14% respectively, a rate ratio of 1.9). Canberra: ABS. According to the 2013 NDSHS, an estimated 6.6 million (or 35%) people aged 14 and over older had used cannabis in their lifetime and about 1.9 million (or 10%) had used cannabis in the previous 12 months. there was an increase in the reported frequency of methamphetamine usedaily or weekly use rose from 9.3% to 16%. Among secondary students, misuse of tranquillisers (misuse of a specific pharmaceutical) (17%) was the most common behaviour of concern reported to have occurred in their lifetime, followed by marijuana/cannabis use (15%) (White & Bariola 2012). Cat. International Journal of Health Services 22(3):42945. Information on this page is largely from the Australian Bureau of Statistics (ABS) population health surveys. The wellbeing of nations: the role of human and social capital, education and skills. Canberra: ABS. Since 2009, the global market for amphetamine-type stimulants (ATSseeBox 4.5.4) has increased substantially. Scott N, Caulkins JP, Dietze P & Ritter A 2015. Methamphetamine use had been declining since it peaked at 3.7% in 1998 but remained stable at 2.1% between 2010 and 2013. no. Canberra: ABS. 1997), although not consistently (Pearce & Smith 2003). AIHW 2014e. Cat. In 201213, a high proportion (26%) of Indigenous Australians aged 15 and over reported that they had not drunk any alcohol in the previous 12 months. The alcohol risk data presented here are reported against guideline 1 and guideline 2 ofThe Australian guidelines to reduce health risks from drinking alcoholreleased in March 2009 by the National Health and Medical Research Council (NHMRC 2009). Better data are needed to monitor trends in overweight and obesity among particular groups over time, especially children. The average age for first trying ecstasy has remained relatively stable, since 2001, at 18 years. In the 10 years since 200405, hospital separations for opioids also increased from 292 to 362 separations per million people (Roxburgh & Burns 2015; AIHW National Hospital Morbidity Database). In Australia, changes in the use of methamphetamine have been one area of increasing concern among the community (seeBox 4.5.1). American Journal of Public Health 93(1):12229. This was also confirmed by AIHW analyses on 'The size and causes of the Indigenous health gap' published inAustralia's health 2014(AIHW 2014). Treating or managing biomedical risk factors includes changes in lifestyle (such as dietary modifications or increased physical activity), use of medications, and surgery. 2013). Of these, the majority were identified as producing ATS (excluding MDMA) (ACC 2015), and given the ease of access of precursor chemicals, such as pseudoephedrine, methamphetamine is reported as the most common ATS produced in Australia (AIC 2015). The most recent national data on dyslipidaemia and impaired fasting glucose levels were collected in the Australian Health Survey (AHS) in 201112, and subsequent national health surveys have relied on self-reported data. Recent users of methamphetamine were most commonly aged 2029, and this age group has consistently accounted for the largest prevalence of recent methamphetamines users. Illicit drug use in rural Australia. The biomedical model of health (pre-1970s): focuses on risk behaviours and healthy lifestyles Dahlgren G & Whitehead M 1991. 6th edition. (Note, the quality of diagnosis information in the National Non-Admitted Patient Emergency Department Care Database has not been assessed.). The different domains of early childhood developmentphysical, social/emotional and language/cognitivestrongly influence learning, school success, economic participation, social citizenry and health (CSDH 2008). Both nationally and internationally, the proportion of people using illicit drugs has remained relatively stable over the last 10 yearsaround 15% of adults in Australia, and around 5% of the global adult population (AIHW 2014a; UNODC 2015). no. We'd love to know any feedback that you have about the AIHW website, its contents or reports. NHMRC (National Health and Medical Research Council) 2013. . Often, the gap between the lowest and highest socioeconomic groups is of greatest interest. Cat. Overall, Indigenous adults were 1.2 times as likely to be either overweight or obese as non-Indigenous adults (72% compared with 63%). This was consistent with results reported in 201415 (AIHW analysis of ABS 2016). Note:Impaired fasting glucose is defined as a fasting plasma glucose level ranging from 6.1 mmol/L to less than 7.0 mmol/L. The ABS has commenced collection of a new Intergenerational Health and Mental Health Study which will include measurement of selected biomedical risk factors. The IRSD scores each area by summarising attributes of their populations, such as low income, low educational attainment, high unemployment, and jobs in relatively unskilled occupations. Powder/pills are generally snorted or ingested and crystal is usually smoked or injected. The NDS is guided by the principle of harm minimisation. Australia has been successful in reducing smoking prevalence over many years through the use of many strategies (IGCD 2013). A glossary for health inequalities. Social exclusion may result from unemployment, discrimination, stigmatisation and other factors. Based on 201213 Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) data: The physical activity of Indigenous adults was assessed differently in remote areas (and this measure is not comparable with the physical activity data for persons living in non-remote areas). Impaired glucose regulation is a characteristic of pre-diabetes, a condition in which blood glucose levels are higher than normal, although not high enough to be diagnosed with type 2 diabetes. WHO (World Health Organization) 2011. Australian Institute of Health and Welfare. Canberra: AIHW. Canberra: AHMAC. The proportion of people choosing to abstain from drinking alcohol rose from 20% in 2010 to 22% in 2013. Collins DJ & Lapsley HM 2008. 4727.0.55.005. Child social exclusion and health outcomes: a study of small areas across Australia. 28. Part 1. This was largely influenced by an increase in young people aged 1217 abstaining, from 64% in 2010 to 71% in 2013. They are based on a social model of health. Injecting and smoking methamphetamine are both associated with more frequent use patterns, treatment demand, higher levels of risky behaviour and other health and psychiatric consequences (McKetin et al. The Australian Government usually funds most of the spending for medical services and subsidised medicines. no. Mothers in the lowest socioeconomic areas were 30% more likely to have a low birthweight baby than mothers in the highest socioeconomic areas in 2013 (AIHW 2015a). Absolute measures are important for decision makers, especially where goals in absolute terms have been set, since they allow a better appraisal of the size of a public health problem. Population Health Metrics 11:19. Fewer people also consumed five or more standard drinks on a single drinking occasion at least once a month29% in 2010 compared with 26% in 2013. Canberra: AIHW. For example, a high blood cholesterol level (biomedical) may be the result of a diet high in saturated fats (behavioural). Over the last 5 years, the total number of arrests for ATS increasedaccounting for 16% of illicit drug arrests in 200910 (12% were for consumers; 4.6% for providers) and 23% (18% for consumers; 5.6% for providers) in 201314 (Figure 4.5.4). Almost 7 in 10 (69%) Indigenous adults aged 18 and over were either overweight (29%) or obese (40%), according to their BMI score (ABS 2014c). Illicit drug use contributed to 1.8% of the total burden of disease and injury in Australia in 2011. AIHW (Australian Institute of Health and Welfare) (2015) Cardiovascular disease, diabetes and chronic kidney diseaseAustralian facts:Risk factors, AIHW, Australian Government, accessed 4 March 2022. In 2013, males were more likely than females to have reported the use of methamphetamine in their lifetimes (8.6% and 5.3% respectively) and recently (2.7% and 1.5% respectively), and this pattern is consistent with previous years. Each data source has different reference periods, counting units and sample sizes, see 'Data sources'. An upsurge in seizures since 2009 point to a rapid expansion of the global ATS market, with ATS seizures almost doubling to reach over 130 tonnes in 2011 and 2012the highest amount since the United Nations Office on Drug Crime systematic monitoring beganbefore decreasing slightly in 2013 (UNODC 2015). Canberra: ABS. More information on the social determinants of Indigenous health in Australia and other related health issues is available atClosing the gap. 2008). no. The proportion of overweight or obese adults increased from 56% to 63% between 1995 and 201415. This chapter also looks at illicit drug use, which contributes to substantial illness, disease and many deaths in Australia. About 1 in 20 Australians (5.3%) had used it in the month prior to the survey and 3.5% had used it in the previous week. 2002). Treatment data relates to episodes; a person may have multiple treatment episodes in a reporting year. This was highest in people aged 75 and over (96%) (AIHW analysis of ABS 2014; AIHW 2015). The conditions in which people live and die are, in turn, shaped by political, social, and economic forces (CSDH 2008). There are limited data on smoking behaviours for some population groups at risk of tobacco smoking and related harm. Canberra: NHMRC. This page focuses on 3 biomedical risk factors: high blood pressure, dyslipidaemia and impaired fasting glucose - which have been directly linked to specific health outcomes such as cardiovascular disease, including coronary heart disease and stroke, chronic kidney disease and diabetes. 2002). Test. The United Kingdom and the WHO Regional Office for Europe have both conducted reviews of political action required to narrow health inequalities (Marmot 2010; WHO 2013b). Social determinants and the health of Indigenous Australians. Harper S & Lynch J 2006. In the AHS in 201112, blood lipid levels were measured via a blood test. Dependence on methamphetamine is more commonly associated with people who inject the drug or who smoke crystalline methamphetamine, rather than among those who prefer oral or intranasal routes of administration. Canberra: ACC. Rates of unemployment are generally higher among people with no or few qualifications or skills, those with disabilities or poor mental health, people who have caring responsibilities, those in ethnic minority groups or those who are socially excluded for other reasons (AIHW 2015b). The biomedical model is the dominant model of mental health care in Australia, explaining mental illness as arising from physical causes, and treating it through physical interventions. OECD (Organisation for Economic Co-operation and Development) 2001. (2015) argue that the increasing purity of crystal means the price of both powder and crystal are effectively on par and the price of both has decreased over time. Indigenous Australians who are unemployed face a higher risk of poor health through higher rates of smoking, substance use and dietary behaviour (such as lower level of daily fruit consumption) compared with Indigenous Australians who are employed (Figure 4.2.2). Based on self-reported data from the NHS in 201718, an estimated 1.5 million adults (or 7.8%) reported that they had high cholesterol levels (AIHW analysis of ABS 2019). In 200304, injectors accounted for 4 in 5 (79%) episodes for amphetamines and just 3.0% involved smoking the drug. See Burden of disease. 2007). Data on the different forms of amphetamines, and methamphetamine specifically, are not separately available in the AODTS NMDS due to the nature of the classification structure used in this collection. In 2013, about 1.3 million (7.0%) people had used methamphetamines in their lifetime and 400,000 (2.1%) had done so in the last 12 months. no. Cat. In addition to increased seizures and detections at the Australian border, the number of clandestine laboratories detected (also known as 'clan' labssites where illegal drugs are manufactured in secret, usually with improvised materials and methods) also increased, which is another indicator of the size of the ATS market. 22, no.6 , 1998, pp.653-8. AUS 178. Note:High blood pressure is defined as systolic/diastolic blood pressure equal to or greater than 140/90 mmHg. These increases could partly be attributed to the increase in use of methamphetamines in their purer crystal formcrystal generally being recognised as the highest in levels of purity of methamphetamine (DoHA 2008)which is generally considered to cause more potential harm. Social infrastructurein the form of networks, mediating groups and organisationsis also a prerequisite for 'healthy' communities (Baum & Ziersch 2003). Canberra: Australian Institute of Health and Welfare, 2022 [cited 2023 May. Harper S, King NB, Meersman SC, Reichman ME, Breen N & Lynch J 2010. These consist of smaller subregions based on ABS Statistical Areas Level 1 (SA1), which were classified using the ABS Index of Relative Socio-economic Disadvantage. 1]. Sydney: National Drug and Alcohol Research Centre, University of New South Wales. Biomedical risk factors such as high blood pressure can have a direct impact on illness and chronic disease. Dyslipidaemia is a risk factor for chronic diseases such as coronary heart disease and stroke. The IRSD is one of four indices compiled by the ABS using information collected in the Census of Population and Housing (ABS 2013).

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