How Are People From Chile Trying to Avoid the 83 Earthquake From Happening Again
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Convulsion Disasters and the Long-Term Wellness of Rural Men in Chile: A Case Written report for Psychosocial Intervention
Submitted: November 8th, 2018 Reviewed: February 1st, 2019 Published: April 9th, 2019
DOI: 10.5772/intechopen.84903
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Earthquakes
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Abstract
The article focuses on the long-term wellness of a rural male population exposed to a major earthquake result in Chile, in 2010. The results show that a majority of the male study participants considered that their physical and mental wellness had deteriorated over a 7-year span following the earthquake and that these impacts were strongest in men aged 65 years or more. In considering potential lessons for intervention, the results must be interpreted inside the context of the construction of male person identities in a rural community, informed past generally conservative values and binary male-female gender roles. The article concludes that health and social services workers and administrators providing interventions to male populations post-obit earthquake must piece of work to reduce the gap between the service offering and men's real needs, which are oft insufficiently understood and inadequately coded.
Keywords
- helping professionals
- men
- rural community
- natural disaster
*Accost all correspondence to: oscar.labra@uqat.ca
ane. Introduction
The present article aims to describe the long-term wellness impacts of a convulsion on men in a rural community. Survivors of natural disasters experience traumatic furnishings, whose intensity and gravity can vary in relation to adventure factors nowadays before, during and after the disaster event [1]. Previous studies have found that individuals exposed to a disaster upshot exhibit insufficiently loftier incidences of depressive and somatic symptoms, emotional distress, memory damage [two, iii, 4, 5, vi, 7]. For case, in a report of 302 adults living in rural Australian communities, he was demonstrated that psychological distress levels were higher in individuals exposed to a disaster effect than in those who were not [8]. Lazaratou et al. [9], for their part, establish that over one-half of survivors exhibited mail service-traumatic stress (PTS) symptoms during a 6-calendar month period following an earthquake and that, in some cases, the symptoms could persist up to 50 years after a disaster. Within populations of male disaster survivors, elderly individuals announced to exist the most vulnerable [10, 11, 12, 13, fourteen], due to such factors as the presence of various health bug, reduced physical and cognitive autonomy, and hearing loss [fifteen, xvi, 17, 18]. Other studies have also confirmed that the elderly are at college take chances of injury and death during and following exposure to a disaster issue [13, 19, xx, 21, 22, 23].
A number of the health impacts of disasters identified in previous studies of rural populations appear to be linked with socio-demographic trends specific to these communities. According some studies, the stress levels of rural community residents in Canada are higher than those of individuals living in other types of communities [24]. This finding appears to be associated with the growing exodus of younger rural populations towards urban centres, resulting in such changes equally economic restructuring and loss of social capital. Studies conducted [25, 26] found also that men living in rural regions in Québec, Canada exhibited ascension levels of stress and depression. These results parallel those of similar studies conducted in Australia and Norway, which as well demonstrate high levels of stress and low in rural populations [27, 28]. In the case of Chile, although the overall number of suicides is college in urban centers than in the less populous rural zones, the proportional suicide rate is higher in rural communities [29].
In terms of differences between the sexes, studies conducted in Australian rural communities show that men's suicide rates are significantly college than women'south [30, 31, 32]. As certain authors have argued, higher suicide rates among men than among women point to loftier levels of mental anguish and greater difficulties in facing changing circumstances, such as those linked with social, economic, and ecology crises [30, 33, 34]. Moreover, suicide rates announced to be specially high for men involved in specifically rural professions, such as fishing, agriculture, and forestry [35, 36].
In terms of the physical health of men living in rural communities, a study carried out in the United States has shown that the prevalence of diabetes and mortality linked with coronary diseases was higher in rural than in urban communities [37, 38]. It appears likewise that residents of rural regions showroom higher rates of chronic illnesses than do their urban counterparts [39, xl, 41, 42, 43] and that obesity is a major contributing cistron in these disparities [44]. In addition, rural men exhibit college rates of oral health problems [45], a tendency that seems particularly pronounced among men with low levels of education [46, 47]. The wellness risk factors virtually unremarkably identified with men residing in rural regions are poverty, obesity [37, 44, 48] and tobacco utilize [49, 50].
Based on the results noted in the available literature, enquiry suggests that men living in rural regions present higher incidences of concrete and mental health problems than do men living in urban centers; the same finding likewise holds for rural men when compared with both rural and urban women. Although the impacts of natural disasters on survivors accept received attention in the literature, trivial has been discerned as to long-term health outcomes for men exposed to natural disasters specific to rural contexts. The nowadays article seeks to bridge that gap in the research.
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2. Natural disaster direction in Chile
On 27 Feb 2010, at 03:45 AM local time, one of the strongest earthquakes ever recorded (magnitude 8.eight Mw) occurred off the coast of Chile'south Maule region (United States Geological Survey—USGS). The earthquake affected three of Chile's administrative regions, with a full population of 4 1000000 people, or 23% of the land's population.
The earthquake caused enormous damages: 81,444 homes were destroyed and some other 108,914 were severely damaged [51]; public infrastructures also suffered significant damages. The devastation most severely affected those almost vulnerable, highlighting and often exacerbating pre-existing socioeconomic inequalities. Public health infrastructures were affected, every bit well: of the 132 hospitals located in the disaster zone, betwixt The Santiago Metropolitan Region in the centre and Araucanía to the due south, xviii were rendered unusable, 31 sustained significant damage simply remained functional, while 83 were largely unaffected [52].
The Chilean earthquake of 2010 prompted countries such as Australia, New Zealand and Prc to develop comprehensive earthquake response initiatives. The Chilean response was to adapt the scope of certain institutions in the event of natural disasters. Most notably, earlier 27 February 2010, natural disasters were the purview of the National Office of Emergencies, created in 1974. Post-obit the convulsion, however, a separate National Civil Protection Agency was formed and tasked with, amidst other responsibilities, disaster preparedness under the National Civil Protection Organisation, with aim of improving the country'south disaster response capacity. Notwithstanding, the highly centralized administration structures of these country institutions results in substantial delays in terms of resource management, communications, and collaboration with other federal, provincial, and community actors. Chile's position remains precarious in terms of governance indices and public policy on risk and disaster management [53]. The writer concludes that, when faced with major emergencies, the Chilean state has been more preoccupied with strengthening its communications arrangement and maintaining the operational continuity of its institutions, rather than with investing in human upper-case letter. It is worth noting, too, that the organization of Chile'southward public health organisation as a decentralized network produced both benefits and drawbacks in the aftermath of the earthquake: hospitals and wellness centres were able to react quickly at the local level, but the system lacked an integrated, inter-sectorial approach through which to reduce social inequalities affecting the commitment of care [54].
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iii. Conceptual framework
The present study'due south conceptual framework, which guided the collection and analysis of data, is informed past the salutogenic approach developed by Antonovsky [55]. The majority of explanatory theories of the male gender fail to admit its positive aspects, which can be harnessed preventively to counter concomitant negative aspects, salutogenic approach provides a way of rectifying this lacuna [55]. The salutogenic approach is predicated on 2 fundamental elements: the showtime is a focus on positive ecology factors conducive to health, rather than those that engender illness [56]; the second is termed the sense of coherence [56], that is, each private'south personal understanding of the surrounding world every bit consistent [57, 58]. According to the salutogenic model, an private who perceives life every bit a coherent and meaningful whole is more likely to respond positively to difficulties than someone who perceives life as ruled by random events and, consequently, considers challenging situations to be the event of uncontrollable misfortune [55]. Salutogenesis has become a widely adopted concept in public health, particularly in health promotion.
Applying the ideas of some authors [55, 59] to men's health, Macdonald [59] argues against a focus on pathologies in attempts to understand men's health and for an arroyo that instead takes into business relationship the economic, political, and social spheres in which problems arise in order to explicate recurrent issues and work at creating environments conducive to better wellness. Macdonald states further that analyses should acknowledge 'spotlight cases' of men who faced life challenges positively, employing their personal strengths and qualities to overcome arduousness. Within the scope of the present study, salutogenesis constitutes a conceptual framework centred on men's optimal well-being [60].
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4. Methodology
The present study was mixed, exploratory in nature, and involved a pocket-size number of participants. Moreover, the dearth of data on the health of men exposed to earthquake events in rural communities did not allow for comparative analysis in light of previous results.
iv.1. Participant recruitment methods
The sample was constituted using a non-probabilistic procedure. The initial participants (
The primary researcher collected the written report information in the course of semi-directed, face-to-face interviews recorded on sound media. The interviews addressed a range of themes in society to draw a comprehensive portrait of participants' views of the consequences of the disaster on their physical and mental wellness. For the purposes of the study, an interview guide originally developed in French was adapted into Castilian using a double back-translation method, which maximized the validity of questions presented to participants [63]. The sociodemographic characteristics of respondents were collected through a brief questionnaire containing exclusively closed questions. A second instrument served to identify the presence or absenteeism of mail-traumatic stress manifestations using the Bear upon of Outcome Scale-Revised (IES-R) [64]. The IES-R includes 22 items assessing PTS intrusion and avoidance experiences in the week preceding the awarding of the questionnaire.
four.2. Data assay
The collected qualitative data were processed using a thematic analysis procedure. The information nerveless using the IES-R self-administered questionnaire [64] were analyzed in terms of proportion equally a relative frequency and subjected to binary nomenclature, by age group, into men anile 54 and younger and men aged 55 and older. Based in Canada, the researchers established this grouping on the basis of the Canadian government's statistical classification of individuals aged 55 and older every bit senior citizens [65]. All study participants were citizens and residents of Chile.
4.3. Upstanding considerations
The present report was validated past the UQAT research ethics commission (CER-UQAT) and posed no risks to the physical or psychological health of participants. No upstanding certificate: 2016-0. All participants were presented with a consent grade informing them of the implications of their choice to participate in the written report. Participation was entirely voluntary and all participants were informed that they could withdraw from the written report at any moment without justifying their decision and without negative consequences. Data collected during interviews were kept, unaltered, in a locked file chiffonier attainable by merely one designated member of the research team. Pseudonyms were attributed to each participant in order to safeguard their confidentiality. All nerveless data will be destroyed v years after study completion.
4.4. Sociodemographic characteristics of respondents
The sample (
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5. Results
The present section presents wellness information nerveless from male respondents residing in rural communities in the Pencahue municipality, in Chile's Central Valley, who had experienced exposure to a major earthquake consequence in 2010. The upshot occurred in the night of 27 February, at 3:45 AM local time, off the coast of the Maule region. The tremors persisted for 3 minutes and attained a magnitude of eight.eight Mw (moment magnitude scale). It was ane of the strongest earthquakes ever recorded and acquired severe damages beyond the coastal region. The first part will address participants' physical health prior and subsequent to the upshot. The second role will address the consequences of the event on respondents' mental wellness.
5.1. Physical wellness before and after the event
The physical health issues described in the present department were cocky-declared by participants. The information collected during participant interviews show that the male respondents suffered from a diverseness of illnesses prior to the earthquake issue of 27 February 2010. Twelve (26.half dozen%) men (boilerplate age: 67.3) reported having experienced wellness problems prior to the consequence, the majority of which were linked to hypertension and diabetes. These wellness problems had a negative impact on the professional person life of some respondents, as expressed in the post-obit testimony:
In addition, 10 men who declared other illnesses, in improver to hypertension and diabetes, reported feeling misunderstood at work, which translated into feelings of uselessness:
Others were troubled by feelings of defeat, since their health condition had forced to them to terminate their professional person activities and observe employment exterior their community.
Although these 12 men were experiencing health problems at the time of data drove, the bulk (
For the sample overall in the postal service-disaster period, Tabular array 1 shows that the incidence of health complications rose considerably for respondents during the vii years following the disaster. Indeed, the majority of respondents (
| Physical health issues | Before | After |
|---|---|---|
|
|
Table one.
Principal physical health issues reported past respondents as present before and later on the earthquake.
Close to half (
It is important to annotation, nonetheless, that although many respondents reported that their wellness had deteriorated significantly in the 7 years following the disaster, there is no direct show for a causal link betwixt increasing health problems and exposure to the consequence, since new health problems reported past participants may exist associated with ageing or external factors other than the event.
5.2. Mental health before and later on the event
During the interviews, respondents were asked to depict their mental wellness earlier and after the event. None of the participants reported suffering from psychological health bug before the event. A majority (
Among those experiencing emotional pain, those who stated that the manifestations occur without apparent immediate cause associated the occurrences with their advancing age.
Others associated their emotional pain with the fact of having irrecoverably lost all their material and immaterial goods during the convulsion. These respondents reported feelings of defeat.
Participants also spoke of a feeling of fear that presented itself following the convulsion; this feeling was still present for a third of respondents at the time of data collection. Manifestations of fright were near clearly associated with the possible recurrence of an earthquake of similar intensity (8.8 Mw):
In terms of stress disorders, too equally depressive and anxious manifestations, participants reported pervasive feelings of sadness, which touch their ability to function, and persistent thoughts about the finality of life. As ane respondent put it: 'I do not have much. Why keep on living? I keep feeling more and more sick. I've been feeling similar that for a while. I feel lone!' (Orlando). Although mentioned just by a few (
5.3. Post-traumatic stress manifestations and concomitant concrete and mental wellness problems
Table 2 illustrates IES-R results for the two historic period groups in the sample. As the results show, all respondents aged 55 or more (
| Average historic period | IES-R | Age | ||
|---|---|---|---|---|
| Total ( | 54 and younger ( | 55 and older ( | ||
| 25.vii | 1–11 ( | 7% | 12% | 0% |
| 21.3 | 12–32 ( | 16% | 28% | 0% |
| 62.5 | 33 or over ( | 78% | 60% | 100% |
| Total | 100% | 100% | 100% | |
| IES-R average | 52.3 | 42.2 | 65.0 | |
Table 2.
Impact of outcome scale-revised (IES-R).
Equally Table 3 demonstrates, participants who obtained IES-R scores of 33 or higher declared greater numbers of concrete and mental health problems than did participants who scored lower on the calibration. Respondents aged 70 and older presenting PTS manifestations were the group reporting the greatest number of physical health issues, specifically: visual impairments, diabetes, osteoarthritis, bone pain, heart problems and hypertension.
| Presence of PTS manifestations ( | Absence or low occurrence of PTS manifestations ( |
|---|---|
Physical health problems self-declared during data drove:
| Physical health problems cocky-declared during data collection:
|
Mental health problems self-declared during data collection:
| Mental health problems self-alleged during information collection:
|
Table 3.
Self-declared mail-disaster health problems every bit a function of mail service-traumatic stress manifestations.
In summary, following exposure to the disaster event, the majority (35/45) of men participating in the written report reported a progressive deterioration of both their mental and physical health. However, given that seven years had elapsed between the disaster issue and the data collection period, the results must be interpreted with circumspection. It is not possible to determine with any caste of certainty whether the wellness problems self-reported by respondents were linked directly with exposure to the convulsion or whether they were more closely linked with other factors, such every bit natural ageing or negative experiences since the earthquake. Nevertheless, the results advise that the concrete and mental health of men aged 55 or older who have been exposed to earthquake events are peculiarly at chance.
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6. Discussion
The results of the report suggest that a majority of men living in rural communities in key Chile declared that their health had deteriorated significantly since their exposure to the convulsion of 27 Feb 2010. Nigh half of participants declared suffering from physical and mental health bug that had not been diagnosed prior to the disaster. It is worth noting, as well, that, overall, men living in rural communities are more likely to suffer from certain wellness problems, such as diabetes and coronary diseases [37, 40]. Moreover, the sample presented the additional health adventure factor of poverty: 75.6% of men participating in the study reported monthly incomes beneath Chilean minimum wage levels. Some authors point out, poverty remains one of the about mutual health risk factors amid men living in rural communities [37]. Thus, age, economic status, and mail service-disaster trauma may all account for participants' declining health and feelings of increased vulnerability.
It is important to note, besides, that, although respondents' concrete and mental health had deteriorated in the seven years post-obit the event, it is not possible to constitute a direct link between the reported health problems and exposure to the disaster, since they may exist more than closely associated with natural ageing processes or other, external factors. Further research will be necessary to pinpoint more definitively the causes of health problems reported by rural men in post-disaster contexts, especially since they are more vulnerable then women in the same communities and more vulnerable than both men and women in urban communities [30, 31].
Participant testimonies show that their mental health had too deteriorated following exposure to the disaster. These results parallel those of other studies, which show that exposure to natural disasters can have significant consequences for the health of survivors [66, 67]. Within the scope of the nowadays study, the majority of participants cited mental wellness bug, such as anguish, low, emotional pain, abiding fright, and stress disorders, as factors that had contributed to the deterioration of their quality of life since the outcome (Tabular array 3). Emotional pain, depression, anguish, and stress were the mental health problems nearly usually reported as having emerged in the 7 years following the disaster. Equally a previous written report has shown, the deleterious consequences of natural disasters on the lives of survivors can persist equally long as fifty years post-obit the event [9]. A longitudinal study comparing the health of survivors with the health of individuals not exposed to the issue would allow for a more than thorough verification of this hypothesis. Previous studies take reported similar results in terms of the presence of depressive and somatic symptoms, also equally emotional distress, among natural disaster survivors [2, 4, 68]. Elsewhere, it has been noted that the deterioration of the natural environment seems linked to depression in adults living in rural communities [viii].
IES-R results (Table 3) prove that respondents aged 55 or more (20 of 45, average historic period 62.5 years) presented elevated levels of postal service-traumatic stress when compared with the rest of the sample, providing evidence of a deterioration of their mental wellness. This group, moreover, reported numerous physical wellness bug (eastward.g., vascular accidents, cardiac arrhythmia, osteoarthritis, visual impairments). The results, which parallel those of Labra et al. [68], point to two conclusions: (1) that the deleterious consequences of natural disasters on the physical and mental health of male person survivors intensify with age; and (ii) that, within the framework of the salutogenic model [57, 58, 59], the men in the sample have since the disaster lived in environments that are not conducive to good health; that is, they practice not have access to an offer of services likely to motivate psychosocial consultation or to medium- or long-term psychosocial post-disaster intervention programmes. These factors may account for the negative overall results obtained through the IES-R.
Thus, advanced historic period appears to be a factor affecting the vulnerability of men in natural disaster contexts, particularly in connection with health bug and the loss of physical and cognitive autonomy [one]. It appears, every bit well, that men anile 54 and younger fare better with the consequences of a disaster result, since sixty% suffered from PTSD, while 28% obtained scores ranging betwixt 12 and 32, that is, presenting certain PTS symptoms without developing PTSD. This ascertainment leads to the following question: what are the factors that business relationship for the ability of younger men to better avert the deleterious health effects of a disaster result? Inside the perspective of the salutogenic model [55, 56, 57, 58, 59, 60], answers to this question could assistance to identify the positive forces and elements of the environs that benefit younger men in order to extrapolate them in working towards creating healthier environments for older individuals.
6.1. Implications for psychosocial intervention
The consequences of natural disasters on men's physical and mental health vary depending on the level of exposure, the losses suffered, the survivors' age, also every bit their concrete, psychological, social and financial capacities to finer face the various stress factors that follow a disaster issue [69]. Older men are frequently more vulnerable than are other groups in these situations [68]. In improver, men as a group are ofttimes reluctant to seek help, whether from their family and social circles or from professionals in the public and community health networks [66]. This reluctance is ofttimes motivated by norms and behavior rooted in traditional notions of masculinity that crusade men to underestimate their health needs and there is show to propose that these trends are stronger in rural communities [lxx].
The social piece of work approaches used in disaster-context interventions must vary in relation to different clienteles and dissimilar stages of intervention, including prevention, preparation and recovery [71]. In practice, psychosocial intervention with disaster survivors is mostly focused on immediate needs (eastward.g., access to bones resources and shelter) and just rarely takes into account holistic perspectives that admit individuals and their social environs [12]. Consequently, disaster interventions fail to accost the long-term consequences of disaster events for survivors' health, including various effects on their personal, conjugal, family and professional lives. In developing interventions, helping professionals can do good from approaches such as ecosystemic [72] or salutogenic models [55], to proper name just ii of the bachelor options that may be applicable, depending on the specific needs and conditions of men experiencing concrete or mental wellness bug and social interaction difficulties following exposure to a disaster event. As pointed out past [73], however, interventions tailored to the needs of men should also take into business relationship their specific strengths and abilities.
Given the nature of the problems identified among participants in the nowadays written report, grouping interventions may likewise offer an effective approach. In grouping interventions, helping professionals must recall that their clientele, in this example men, are 'the experts of their own lives' [73], merely in need of guidance towards effective common cocky-help.
The nature and intensity of exposure to a given disaster event are determining factors in the extent of consequences for survivors and must enter into consideration in the deployment of psychosocial intervention measures to minimize the deleterious effects on men'southward health. Helping professionals must devote item attention to the psychosocial support necessary to overcome various difficulties specific to given groups, particularly, in the light of the results presented above, those specific to older men; intervention objectives, by the same token, must be formulated clearly in relation to specific clienteles and tailored to the pre-disaster, emergency assistance, and recovery phases of intervention. The testimonies of male survivors signal that they go along to suffer from postal service-traumatic stress 7 years later on exposure to a disaster issue. In order to contribute to the reduction of consequences such as depressive manifestations and other mental wellness problems, intervention programmes should foresee the need and integrate the availability of psychosocial back up services for the long term. Helping professionals involved in post-disaster interventions with men can also contribute to reduce disparities betwixt bachelor services and real needs, which are inadequately understood and inefficiently coded within health and social services networks.
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seven. Conclusion
The nowadays article addressed the long-term post-convulsion wellness of men in a rural community and its implications for helping professionals' interventions. The study constitute that, among the sample, seven years later a major earthquake, men 55 and older remained the group about adversely afflicted by the event. Information technology is important to notation that a factor contributing to the reluctance of men to seek help and thus potentially to reduce these impacts, particularly in rural areas, is a predominant notion of masculinity, typified by the image of potent and cocky-sufficient man, informed past conservative values in which gender roles are binary and fixed. This presents particular challenges for helping professionals who seek to reduce the existing gap between available service offers and men's existent needs, which remain insufficiently understood and imprecisely coded.
The standards of traditional masculinity prompt men to conceal their private lives, seek to maintain command, and project strength [73], as well as deny suffering or pain and attempt to maintain independence, as ascertained to a higher place. Based on the findings of the present study, psychosocial intervention targeted towards men should:
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Work on strengths rather than weaknesses [55] past focusing on the positive attributes of the surround that are conducive to health, rather than on negative elements conducive to disease.
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Acknowledge men's needs and communicate to men that health professionals are willing to mind and elaborate interventions and treatments based on men'southward needs.
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Piece of work incrementally on specific elements and so that men can understand their progress throughout the intervention process.
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Include men's spouses and partners as facilitators in the intervention process, since women frequently play decisive, positive roles in men's help-seeking.
Lastly, the consequences of the natural disaster described above on the physical and psychological health of participants were not uniform, varying according to factors specific to individuals. It is thus important that intervention programs be designed to include flexibility and adaptability to private needs.
The authors consider that further developing the following inquiry avenues may contribute to facilitate men'due south help-seeking post-obit disaster events: (i) to identify factors facilitating older men's use of wellness services and (2) to examine sociosanitary services and programs, in particular their adaptation to specific clienteles, in item as defined by age and gender.
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Disharmonize of involvement
The authors declare that they have no conflicts of interest.
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Submitted: Nov 8th, 2018 Reviewed: February 1st, 2019 Published: April ninth, 2019
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