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Edin, Kerstin
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Westergren, A., Edin, K., Walsh, D. & Christianson, M. (2019). Autonomous and dependent–The dichotomy of birth: a feminist analysis of birth plans in Sweden. Midwifery, 68, 56-64
Open this publication in new window or tab >>Autonomous and dependent–The dichotomy of birth: a feminist analysis of birth plans in Sweden
2019 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 68, p. 56-64Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To elicit pregnant women's perceptions of childbirth as expressed in their birth plans, and through a feminist lens analyse their wishes, fears, values, and beliefs about childbirth, as well as their expectations on partner and midwife.

DESIGN: This study used qualitative content analysis, identifying subcategories, categories, and an overall theme in data gathered from women's written birth plans. A feminist theoretical framework underpinned the research.

SETTING: A middle-sized city in northern Sweden.

PARTICIPANTS: 132 women who gave birth in an obstetrician-led hospital labour ward between March and June 2016 and consented to grant access to their birth plans and antenatal and intrapartum electronic medical records.

FINDINGS: Three categories emerged: 'Keeping integrity intact through specific requests and continuous dialogue with the midwife', 'A preference towards a midwife-supported birth regardless of method of pain relief", and '"Help my partner help me" - Women anticipating partner involvement.' The overall theme linking the categories together was: 'Autonomous and dependent - The dichotomy of birth', portraying women's ambiguity before birth -expressing a wish to remain in control while simultaneously letting go of control by entrusting partner and midwifewith decision-making regarding their own bodies.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Women primarily desired a natural, midwife-supported birth and favoured a relationship-based, woman-centred model of care, based on the close interaction between woman, partner, and midwife. Midwives need to be aware of women's ambiguous reliance on them and the power they have to influence women's birth choices and birth experiences. Feminist theory and values in midwifery practice may be useful to inspire a maternity care based on women's wishes and expectations, acknowledging and valuing women's voices, and embracing the sanctity of birth and of the birthing woman's body.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Autonomy, Birth plan, Care, Content analysis, Dichotomy in birth, Feminism, Womancentred
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-152849 (URN)10.1016/j.midw.2018.10.008 (DOI)000450307700008 ()30366225 (PubMedID)2-s2.0-85055191258 (Scopus ID)
Available from: 2018-10-29 Created: 2018-10-29 Last updated: 2019-10-16Bibliographically approved
Wilson, I. M., Eurenius, E., Lindkvist, M., Edin, K. & Edvardsson, K. (2019). Is there an association between pregnant women's experience of violence and their partner's drinking?: A Swedish population-based study. Midwifery, 69, 84-91
Open this publication in new window or tab >>Is there an association between pregnant women's experience of violence and their partner's drinking?: A Swedish population-based study
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2019 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 69, p. 84-91Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Pregnancy is a time of heightened vulnerability for women, especially for experiencing violence in their close and intimate relationships. Alcohol misuse by a male intimate partner is a known contributor to increased risk and severity of intimate partner violence generally, however less is known about the relationship between partner drinking patterns and women's experience of violence in their relationship, and particularly in early pregnancy. This study aimed to explore these associations in a large, population-based sample of Swedish expectant parents.

DESIGN, SETTING AND PARTICIPANTS: Data for this cross-sectional study were drawn from 11 461 couples (22 922 participants) enrolled in Salut, a child health promotion programme in Västerbotten County Council, Sweden. Data were collected at women's antenatal care visits during the first trimester of pregnancy.

MEASUREMENTS: Questionnaires included male partners' self-reported drinking patterns using AUDIT (Alcohol Use Disorders Identification Test) and pregnant women's reports of violence. Descriptive and logistic regression analyses were undertaken to examine prevalence of reported violence and association with partner drinking patterns.

FINDINGS: There was a strong association between male partner alcohol misuse and the odds of pregnant women experiencing violence in general, experiencing violence since becoming pregnant, and fear for their own safety at the time of enrolment in ANC. The odds of having experienced being controlled or physically hurt in a relationship, or having ever experienced sexual violence, were higher with more serious alcohol misuse by the male partner. Most striking was that women whose partners reported hazardous drinking or alcohol dependence had nearly nine times higher odds of experiencing being physically hurt by a partner since becoming pregnant, compared to women whose partners reported non-harmful alcohol use (OR 8.50, CI 2.39-30.17, p = 0.001). Fearing for current safety was also strongly linked to more severe alcohol use by their current male partner (OR 7.65, CI 1.02-57.24, p = 0.048).

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This study contributes population-level evidence that the risk for women of experiencing violence in general or in early pregnancy is exacerbated when a male partner drinks in harmful ways. Health professionals and those supporting pregnant women should pay attention to the role of risk factors such as partner alcohol use. Ensuring the health of pregnant women and safety in their relationships is important for maternal, foetal and infant health and family functioning.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Alcohol drinking, Cross-sectional study, Intimate partner violence, Pregnancy, Risk factors, Sweden
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-153435 (URN)10.1016/j.midw.2018.10.019 (DOI)000454129800011 ()30415105 (PubMedID)2-s2.0-85056169104 (Scopus ID)
Available from: 2018-11-21 Created: 2018-11-21 Last updated: 2019-10-16Bibliographically approved
Lusey, H., San Sebastian, M., Christianson, M. & Edin, K. E. (2018). Prevalence and correlates of gender inequitable norms among young, church-going women and men in Kinshasa, Democratic Republic of Congo. BMC Public Health, 18, Article ID 887.
Open this publication in new window or tab >>Prevalence and correlates of gender inequitable norms among young, church-going women and men in Kinshasa, Democratic Republic of Congo
2018 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, article id 887Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Prolonged political instability may have exacerbated gender inequitable beliefs in the Democratic Republic of Congo (DRC). The aim of this study was to assess attitudes related to gender-equitable norms and its determinants among young, church-going women and men in Kinshasa, DRC.

METHOD: Data were collected through a cross-sectional survey with 291 church-going women and 289 men aged 18-24 years old, residing in three disadvantaged communes of Kinshasa. Variables included sociodemographic characteristics, attitudes towards gender equality, and responses to issues related to the gender-equitable men (GEM) scale. The GEM scale is a 24 item-questionnaire developed to measure attitudes towards gender equitable norms. Logistic regression was applied to discover the associations between the independent variables and the GEM outcome.

RESULTS: Our study reflected the existence of attitudes hampering gender equality that were endorsed by both women and men. For example, 91.4% of women and 83% of men agreed with the statement "a woman's most important role is to take care of her home and cook for her family". Similarly, 88.3% of women and 82.9% of men concurred with the idea that men need more sex than women. These findings coexisted with a few equitable norms, because 93.7% of women and 92.3% of men agreed that a man and a woman should decide together if they want to have children. A positive association was found in both women and men between being educated, being single and separated and having supportive attitudes towards gender equality and a higher GEM scale score. Residency in Camp Luka and Masina was also a significant social determinant associated with equitable gender norms among men whilst job status was only significant among women.

CONCLUSION: While both women and men had high levels of gender inequitable norms, those with more education, single, and with supportive attitudes to gender equality had high GEM scale scores. The results highlight an urgent need for the church to challenge and change gender norms among church youths.

Keywords
Church youths, Cross-sectional survey, DR Congo, Gender equity, Gender inequitable norms, Masculinities
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nursing
Identifiers
urn:nbn:se:umu:diva-150614 (URN)10.1186/s12889-018-5742-9 (DOI)000439346700002 ()30016960 (PubMedID)2-s2.0-85049945949 (Scopus ID)
Available from: 2018-08-14 Created: 2018-08-14 Last updated: 2018-08-31Bibliographically approved
Gebremichael, M. W., Worku, A., Medhanyie, A. A., Edin, K. & Berhane, Y. (2018). Women suffer more from disrespectful and abusive care than from the labour pain itself: a qualitative study from Women's perspective. BMC Pregnancy and Childbirth, 18, Article ID 392.
Open this publication in new window or tab >>Women suffer more from disrespectful and abusive care than from the labour pain itself: a qualitative study from Women's perspective
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2018 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 18, article id 392Article in journal (Refereed) Published
Abstract [en]

Background: Utilization of institutional delivery services could be hampered by women's experience of disrespectful and abusive care during childbirth. However, such experiences are not well documented and taken into consideration id planning maternal health services in many developing countries. The aim of this study was to describe women's experience of disrespect and abuse during giving birth at health facilities in northern Ethiopia. Methods: A qualitative phenomenological study was conducted in Tigray, Ethiopia. Focus group discussions (FGDs) with primipara and multipara women were conducted to collect the necessary information. All study participants had their last delivery at a health facility in the year preceding the study. A semi-structured discussion guide was used to elicit discussion. Discussions were audio recorded and transcribed verbatim in the local language and then translated to English. Data were analyzed using thematic analysis approach assisted by the Open Code qualitative data management software. Results: The study participants described disrespect and abuse as serious obstacles to utilization of maternal health services. Women reported experiencing feelings of being infantilized, losing self-control, being overlooked, being informed bad news without proper preparation, repeated examination without being properly communicated/ informed, disallow companions, and left unattended during labor. Facility related issues include women's perception of incompetence of professionals attending delivery, unhygienic facilities, and unavailability of basic supplies. Conclusion: Women consider health facilities not fully prepared to provide respectful maternal care. Sustainable increase in institutional delivery requires ensuring quality, compassionate and caring services in all health facilities.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Respectful maternity care, Disrespect and abuse, Qualitative, Tigray, Ethiopia
National Category
Obstetrics, Gynecology and Reproductive Medicine Nursing
Identifiers
urn:nbn:se:umu:diva-152868 (URN)10.1186/s12884-018-2026-4 (DOI)000446374600001 ()30286734 (PubMedID)
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2018-11-02Bibliographically approved
Lusey, H., Sebastian, M. S., Christianson, M. & Edin, K. E. (2017). Factors associated with gender equality among church-going young men in Kinshasa, Democratic Republic of Congo: a cross-sectional study. International Journal for Equity in Health, 16, Article ID 213.
Open this publication in new window or tab >>Factors associated with gender equality among church-going young men in Kinshasa, Democratic Republic of Congo: a cross-sectional study
2017 (English)In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 16, article id 213Article in journal (Refereed) Published
Abstract [en]

Background: While women and girls are made vulnerable by inequitable and violent versions of masculinities, there is increasing evidence that gender equality will not be achieved without partnering with men. The aim of this study was to assess gender-equitable norms and their determinants among church-going young men in Kinshasa, the Democratic Republic of Congo.

Method: A cross-sectional study was carried out among 289 church-going young men, aged 18-24 years, residing in three disadvantaged communes of Kinshasa. Variables included sociodemographic characteristics, attitudes towards gender equality and responses to issues related to the Gender-Equitable Men (GEM) scale. Logistic regression was applied to identify the associations between sociodemographic characteristics, attitudes and the GEM scale.

Results: The findings provide evidence of attitudes and beliefs that act as barriers to gender equality. For instance, the majority of church-going young men (83.74%) agreed that a man is the only decision maker in the home and about half (50.87%) of the respondents supported the statement "There are times a woman deserves to be beaten". Similarly, around half of the participants agreed with the idea of men's uncontrollable sex drive (50.87%) and men's toughness (50.17%). Close to half of the participants (44.29%) agreed that it is women's responsibility to prevent pregnancy. These attitudes co-existed with a few gender-equitable norms as 82.70% agreed on the importance of joint decisions concerning family planning. An association between education, certain places of residence, being single or separated, and supportive attitudes towards gender equality was found with higher scores for the GEM.

Conclusion: Our study findings indicate that a high proportion of church-going young men do not endorse gender-equitable norms. Therefore, churches urgently need comprehensive gender equality and masculinity policies and programmes to influence young men's attitudes and behaviours. The promotion of gender equality in schools and the wider community also need to be encouraged.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2017
Keywords
Gender equality, Gender-equitable men scale, Church-going young men, Masculinities, Cross-sectional study, DR Congo
National Category
Gender Studies Nursing
Identifiers
urn:nbn:se:umu:diva-143521 (URN)10.1186/s12939-017-0707-7 (DOI)000417624900001 ()29228996 (PubMedID)
Available from: 2018-01-04 Created: 2018-01-04 Last updated: 2018-06-09Bibliographically approved
Lusey, H. G., Christianson, M., San Sebastian, M. & Edin, K. E. (2016). Church representatives' perspectives on masculinities in the context of HIV: the case of the Ecumenical HIV and AIDS Initiative in Africa. African Journal of AIDS Research, 15(3), 273-281
Open this publication in new window or tab >>Church representatives' perspectives on masculinities in the context of HIV: the case of the Ecumenical HIV and AIDS Initiative in Africa
2016 (English)In: African Journal of AIDS Research, ISSN 1608-5906, E-ISSN 1727-9445, Vol. 15, no 3, p. 273-281Article in journal (Refereed) Published
Abstract [en]

Despite a growing body of literature related to church leaders challenging dominant norms of masculinities that may enable the spread of HIV, research on masculinity issues among African church representatives who are policy makers is scarce. The objectives of this study were to explore the perspectives on masculinities held by church representatives within the Ecumenical HIV and AIDS Initiative in Africa (EHAIA) and to identify strategies they used to transform masculinities in their respective churches. Qualitative interviews were carried out with 14 church representatives belonging to the EHAIA International Reference Group. These interviews were analysed using thematic analysis and four themes were identified: "barriers to challenge masculinities" may contribute to the spread of HIV; "counterproductive conservative church leadership" fails to challenge dominant forms of masculinities; "facilitators to challenge masculinities" perceived as slowly changing men and "an evolving hope for gender equality" would be perceived in certain marital relationships. The latter two were viewed as positive approaches resulting from masculinity workshops and male priests disclosing their HIV-positive status. This research highlights strategies that may help male church-goers challenge masculinities, support gender equality and, improve the lives of men and women in the context of HIV.

Place, publisher, year, edition, pages
NISC - National Inquiry Services Centre, 2016
Keywords
church representatives, gender, masculinities, HIV transmission, EHAIA, Africa
National Category
Nursing Gender Studies
Identifiers
urn:nbn:se:umu:diva-127089 (URN)10.2989/16085906.2016.1203341 (DOI)000385553800010 ()27681151 (PubMedID)
Available from: 2016-10-28 Created: 2016-10-28 Last updated: 2018-06-09Bibliographically approved
Hullur, N., D'Ambruoso, L., Edin, K., Wagner, R. G., Ngobeni, S., Kahn, K., . . . Byass, P. (2016). Community perspectives on HIV, violence and health surveillance in rural South Africa: a participatory pilot study. Journal of Global Health, 6(1), Article ID 010406.
Open this publication in new window or tab >>Community perspectives on HIV, violence and health surveillance in rural South Africa: a participatory pilot study
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2016 (English)In: Journal of Global Health, ISSN 2047-2978, E-ISSN 2047-2986, Vol. 6, no 1, article id 010406Article in journal (Refereed) Published
Abstract [en]

Background South Africa faces a complex burden of disease consisting of infectious and non–communicable conditions, injury and interpersonal violence, and maternal and child mortality. Inequalities in income and opportunity push disease burdens towards vulnerable populations, a situation to which the health system struggles to respond. There is an urgent need for health planning to account for the needs of marginalized groups in this context. The study objectives were to develop a process to elicit the perspectives of local communities in the established Agincourt health and socio-demographic surveillance site (HDSS) in rural north–east South Africa on two leading causes of death: HIV/AIDS and violent assault, and on health surveillance as a means to generate information on health in the locality. Methods Drawing on community–based participatory research (CBPR) methods, three village–based groups of eight participants were convened, with whom a series of discussions were held to identify and define the causes of, treatments for, and problems surrounding, deaths due to HIV/AIDS and violent assault. The surveillance system was also discussed and recommendations generated. The discussion narratives were the main data source, examined using framework analysis. Results The groups identified a range of social and health systems issues including risky sexual health behaviors, entrenched traditional practices, alcohol and substance abuse, unstable relationships, and debt as causative. Participants also explained how compromised patient confidentiality in clinics, insensitive staff, and a biased judicial system were problematic for the treatment and reporting of both conditions. Views on health surveillance were positive. Recommendations to strengthen an already well–functioning system related to maintaining confidentiality and sensitivity, and extending ancillary care obligations. Conclusion The discussions provided information not available from other sources on the social and health systems processes through which access to good quality health care is constrained in this setting. On this basis, further CBPR in routine HDSS to extend partnerships between researchers, communities and health authorities to connect evidence with the means for action is underway.

Keywords
Community-based participatory research, South Africa, verbal autopsy, health and demographic surveillance, HIV, violence
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-118032 (URN)10.7189/jogh.06.010406 (DOI)000396976400014 ()2-s2.0-84999273743 (Scopus ID)
Available from: 2016-03-17 Created: 2016-03-10 Last updated: 2018-06-07Bibliographically approved
Edin, K., Nilsson, B., Ivarsson, A., Kinsman, J., Norris, S. A. & Kahn, K. (2016). Perspectives on intimate relationships among young people in rural South Africa: the logic of risk. Culture, Health and Sexuality, 18(9), 1010-1024
Open this publication in new window or tab >>Perspectives on intimate relationships among young people in rural South Africa: the logic of risk
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2016 (English)In: Culture, Health and Sexuality, ISSN 1369-1058, E-ISSN 1464-5351, Vol. 18, no 9, p. 1010-1024Article in journal (Refereed) Published
Abstract [en]

This paper explores how young people in rural South Africa understand gender, dating, sexuality and risk-taking in adolescence. The empirical material drawn upon consists of 20 interviews with young men and women (aged 18-19) and reflects normative gender patterns characterised by compulsory heterosexuality and dating as obligatory, and representing key symbols of normality. However, different meanings of heterosexual relationships are articulated in the interviews, for example in the recurring concept of 'passing time', and these meanings show that a relationship can be something arbitrary: a way to reduce boredom and have casual sex. Such a rationale for engaging in a relationship reflects one of several other normative gender patterns, which relate to the trivialisation of dating and sexual risk-taking, and which entail making compromises and legitimising deviations from the 'ideal' life-script and the hope of a better future. However, risks do not exclusively represent something bad, dangerous or immoral, because they are also used as excuses to avoid sex, HIV acquisition and early pregnancy. In conclusion, various interrelated issues can both undermine and/or reinforce risk awareness and subsequent risk behaviour. Recognition of this tension is essential when framing policies to support young people to reduce sexual risk-taking behaviour.

Keywords
Young people, dating, gender, risk-taking, sexuality
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-118709 (URN)10.1080/13691058.2016.1155749 (DOI)000383161400004 ()26986221 (PubMedID)
Available from: 2016-03-30 Created: 2016-03-30 Last updated: 2018-06-07Bibliographically approved
Moen, E., Nygren, L. & Edin, K. (2016). Volatile and violent relationships among women sentenced for homicide in Sweden between 1986 and 2005. Victims & Offenders, 11(3), 373-391
Open this publication in new window or tab >>Volatile and violent relationships among women sentenced for homicide in Sweden between 1986 and 2005
2016 (English)In: Victims & Offenders, ISSN 1556-4886, E-ISSN 1556-4991, Vol. 11, no 3, p. 373-391Article in journal (Refereed) Published
Abstract [en]

Data from Swedish court judgments of all 124 women convicted of homicide during 20 years was analyzed. The typical pattern was an abused woman who kills her intimate partner at home with a knife, often with alcohol involved. A subsample (n = 66) was analyzed qualitatively, with a focus on intimate partner relationships. The findings indicate that female homicides usually take place after a long progression of violence and reflect women’s subordinate gendered position. Situational triggers finally lead up to the killing event. Gender equality and the so-called woman-friendly welfare state in Sweden do not appear to reduce women’s volatility in violent relationships. 

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keywords
criminal courts, intimate partner homicide, gender, drugs/alcohol, women as offenders
National Category
Social Work Nursing
Identifiers
urn:nbn:se:umu:diva-103767 (URN)10.1080/15564886.2015.1010696 (DOI)000384241700003 ()
Available from: 2015-05-29 Created: 2015-05-29 Last updated: 2018-06-07Bibliographically approved
Kinsman, J., Norris, S. A., Kahn, K., Twine, R., Riggle, K., Edin, K., . . . Micklesfield, L. K. (2015). A model for promoting physical activity among rural South African adolescent girls. Global Health Action, 8, Article ID 28790.
Open this publication in new window or tab >>A model for promoting physical activity among rural South African adolescent girls
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2015 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 8, article id 28790Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In South Africa, the expanding epidemic of non-communicable diseases is partly fuelled by high levels of physical inactivity and sedentary behaviour. Women especially are at high risk, and interventions promoting physical activity are urgently needed for girls in their adolescence, as this is the time when many girls adopt unhealthy lifestyles.

OBJECTIVE: This qualitative study aimed to identify and describe facilitating factors and barriers that are associated with physical activity among adolescent girls in rural, north-eastern South Africa and, based on these, to develop a model for promoting leisure-time physical activity within this population.

DESIGN: The study was conducted in and around three secondary schools. Six focus group discussions were conducted with adolescent girls from the schools, and seven qualitative interviews were held with sports teachers and youth leaders. The data were subjected to thematic analysis.

RESULTS: Seven thematic areas were identified, each of which was associated with the girls' self-reported levels of physical activity. The thematic areas are 1) poverty, 2) body image ideals, 3) gender, 4) parents and home life, 5) demographic factors, 6) perceived health effects of physical activity, and 7) human and infrastructural resources. More barriers to physical activity were reported than facilitating factors.

CONCLUSIONS: Analysis of the barriers found in the different themes indicated potential remedial actions that could be taken, and these were synthesised into a model for promoting physical activity among South African adolescent girls in resource-poor environments. The model presents a series of action points, seen both from the 'supply-side' perspective (such as the provision of resources and training for the individuals, schools, and organisations which facilitate the activities) and from the 'demand-side' perspective (such as the development of empowering messages about body image for teenage girls, and encouraging more parental involvement). The development of physical activity interventions that incorporate this supply- and demand-side model would represent an additional tool for ongoing efforts aimed at tackling the expanding non-communicable disease epidemic in South Africa, and in other resource-constrained settings undergoing rapid health transitions.

Place, publisher, year, edition, pages
Co-Action Publishing, 2015
Keywords
South Africa, adolescence, girls, physical activity, transition, health intervention
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-113773 (URN)10.3402/gha.v8.28790 (DOI)000366521400001 ()26685095 (PubMedID)
Available from: 2015-12-29 Created: 2015-12-29 Last updated: 2018-06-07Bibliographically approved
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