Publications by authors named "Henrik Daae Zachrisson"

16 Publications

  • Page 1 of 1

Preference-based instrumental variables in health research rely on important and underreported assumptions: a systematic review.

J Clin Epidemiol 2021 Jun 11. Epub 2021 Jun 11.

Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway; Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway; Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway; Centre for Work and Mental Health, Nordland Hospital, Bodø, Norway.

Objective: Preference-based instrumental variables (PP IV) designs can identify causal effects when patients receive treatment due to variation in providers' treatment preference. We offer a systematic review and methodological assessment of PP IV applications in health research.

Study Design And Setting: We included studies that applied PP IV for evaluation of any treatment in any population in health research (PROSPERO: CRD42020165014). We searched within four databases (Medline, Web of Science, ScienceDirect, SpringerLink) and four journals (including full-text and title and abstract sources) between January 1, 1998, and March 5, 2020. We extracted data on areas of applications and methodology, including assumptions using Swanson and Hernan's (2013) guideline.

Results: We included 185 of 1087 identified studies. The use of PP IV has increased, being predominantly used for treatment effects in cancer, cardiovascular disease, and mental health. The most common PP IV was treatment variation at the facility-level, followed by physician- and regional-level. Only 12 percent of applications report the four main assumptions for PP IV. Selection on treatment may be a potential issue in 46 percent of studies.

Conclusion: The assumptions of PP IV are not sufficiently reported in existing work. PP IV-studies should use reporting guidelines.
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http://dx.doi.org/10.1016/j.jclinepi.2021.06.006DOI Listing
June 2021

Causal modelling of variation in clinical practice and long-term outcomes of ADHD using Norwegian registry data: the ADHD controversy project.

BMJ Open 2021 01 19;11(1):e041698. Epub 2021 Jan 19.

Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway.

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is among the most common mental disorders in children and adolescents, and it is a strong risk factor for several adverse psychosocial outcomes over the lifespan. There are large between-country and within-country variations in diagnosis and medication rates. Due to ethical and practical considerations, a few studies have examined the effects of receiving a diagnosis, and there is a lack of research on effects of medication on long-term outcomes.Our project has four aims organised in four work packages: (WP1) To examine the prognosis of ADHD (with and without medication) compared with patients with other psychiatric diagnoses, patients in contact with public sector child and adolescent psychiatric outpatient clinics (without diagnosis) and the general population; (WP2) Examine within-country variation in ADHD diagnoses and medication rates by clinics' catchment area; and(WP3) Identify causal effects of being diagnosed with ADHD and (WP4) ADHD medication on long-term outcomes.

Method And Analysis: Our project links several nationwide Norwegian registries. The patient sample is all persons aged 5-18 years that were in contact with public sector child and adolescent psychiatric outpatient clinics in 2009-2011. Our comparative analysis of prognosis will be based on survival analysis and mixed-effects models. Our analysis of variation will apply mixed-effects models and generalised linear models. We have two identification strategies for the effect of being diagnosed with ADHD and of receiving medication on long-term outcomes. Both strategies rely on using preference-based instrumental variables, which in our project are based on provider preferences for ADHD diagnosis and medication.

Ethics And Dissemination: The project is approved by the Regional Ethics Committee, Norway (REC number 2017/2150/REC south-east D). All papers will be published in open-access journals and results will be presented in national and international conferences.

Trial Registration Numbers: ISRCTN11573246 and ISRCTN11891971.
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http://dx.doi.org/10.1136/bmjopen-2020-041698DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817799PMC
January 2021

Mechanisms linking parental educational attainment with child ADHD, depression, and academic problems: a study of extended families in The Norwegian Mother, Father and Child Cohort Study.

J Child Psychol Psychiatry 2020 09 19;61(9):1009-1018. Epub 2020 Jan 19.

Norwegian Institute of Public Health, Oslo, Norway.

Background: Low educational attainment in parents is associated with child psychopathology. It is not clear whether the associations are due to risk factors that family members share or due to effects of maternal or paternal education on the offspring. We investigate whether associations between maternal and paternal educational attainment and child symptoms of attention deficit/hyperactivity disorder (ADHD), depression, and academic problems are due to shared genetic factors, shared family environmental factors, or effects of the parental phenotype educational attainment itself.

Methods: This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa). The sample comprised 34,958 children (17,128 girls) in 28,372 extended-family units. We used data from related nuclear families linked by siblings in the parent generation. We applied a quasi-experimental extended children-of-twins design that included siblings in both generations and took account of nonrandom mating by including partners. Educational attainment was self-reported by mothers and fathers. Mothers reported children's symptoms of ADHD, symptoms of depression, and academic problems by questionnaire when the children were 8 years old.

Results: Children of lowly educated parents scored higher on all outcomes and had an approximate doubling of the risk of high symptom levels. The association between maternal and paternal educational attainment and child symptoms of ADHD and academic problems persisted after controlling for shared genetic and family environmental factors. Phenotypic transmission to depression was weaker and in the best fitting model fully explained by genetic factors shared by the two generations.

Conclusions: Associations between educational attainment of mothers and fathers and child symptoms of ADHD and academic problems could not be ascribed to shared familial risk factors, whereas associations with symptoms of depression could. Parental education or resources and behaviors resulting from low education might be targets of interventions aimed at reducing symptoms of ADHD and academic problems.
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http://dx.doi.org/10.1111/jcpp.13197DOI Listing
September 2020

Economic volatility in childhood and subsequent adolescent mental health problems: a longitudinal population-based study of adolescents.

BMJ Open 2017 09 18;7(9):e017030. Epub 2017 Sep 18.

Norwegian Center for Child Behavioral Development, University of Oslo, Oslo, Norway.

Objective: The aim of the current paper was to investigate the association between the patterns of duration, timing and sequencing of exposure to low family income during childhood, and symptoms of mental health problems in adolescence.

Setting: Survey administered to a large population-based sample of Norwegian adolescents.

Participants: Survey data from 9154 participants of 16-19 years age (53% participation rate; 52.7% girls) were linked to registry-based information about childhood family income from tax return data.

Outcome Measures: Mental health outcomes were symptoms of emotional, conduct, hyperactivity, peer problems and general mental health problems measured with the Strengths and Difficulties Questionnaire, symptoms of depression measured with Short Mood and Feelings Questionnaire and symptoms of attention-deficit/hyperactivity disorder (ADHD) measured with the Adult ADHD Self-Report Scale.

Results: Latent class analysis and the BCH approach in Mplus were used to examine associations between patterns of poverty exposure and mental health outcomes. Four latent classes of poverty exposure emerged from the analysis. Participants moving into poverty (2.3%), out of poverty (3.5%) or those chronically poor (3.1%) had more symptoms of mental health problems (Cohen's =16-.50) than those with no poverty exposure (91.1%). This pattern was, however, not found for symptoms of ADHD. The pattern of results was confirmed in robustness checks using observed data.

Conclusions: Exposure to poverty in childhood was found to be associated with most mental health problems in adolescence. There was no strong suggestion of any timing or sequencing effects in the patterns of associations.
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http://dx.doi.org/10.1136/bmjopen-2017-017030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623474PMC
September 2017

Is Affluence a Risk for Adolescents in Norway?

J Res Adolesc 2017 09 24;27(3):628-643. Epub 2017 Feb 24.

University of Oslo and the Norwegian Institute of Public Health.

Studies suggest that affluence poses a risk for adolescents, but this has rarely been studied outside the United States. We examined the unique and additive roles of family and school affluence for adolescent outcomes among 10th-grade students (n = 7,203) in Oslo, Norway. Multilevel models were estimated separately by gender. For both boys and girls, school affluence was a risk for alcohol abuse and family affluence was a risk for conduct problems, although for conduct the risk was only at the very highest end of income distribution and adolescents in very poor families were also at risk. There was also a complex pattern of risk for early sexual debut; family affluence posed risk, but school affluence appeared protective.
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http://dx.doi.org/10.1111/jora.12304DOI Listing
September 2017

Maternal perinatal and concurrent depressive symptoms and child behavior problems: a sibling comparison study.

J Child Psychol Psychiatry 2017 Jul 23;58(7):779-786. Epub 2017 Feb 23.

Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.

Background: Previous studies have found significant associations between maternal prenatal and postpartum depression and child behavior problems (CBP). The present study investigates whether associations remain in a prospective, longitudinal design adjusted for familial confounding.

Methods: The sample comprised 11,599 families including 17,830 siblings from the Norwegian Mother and Child Cohort study. Mothers reported depressive symptoms at gestational weeks 17 and 30, as well as 6 months, 1.5, 3, and 5 years postpartum. Fathers' depression was measured at gestational week 17. At the last three time-points, child internalizing and externalizing problems were concurrently assessed. We performed multilevel analyses for internalizing and externalizing problems separately, using parental depression as predictors. Analyses were repeated using a sibling comparison design to adjust for familial confounding.

Results: All parental depressive time-points were significantly and positively associated with child internalizing and externalizing problems. After sibling comparison, however, only concurrent maternal depression was significantly associated with internalizing [estimate = 2.82 (1.91-3.73, 95% CI)] and externalizing problems [estimate = 2.40 (1.56-3.23, 95% CI)]. The effect of concurrent maternal depression on internalizing problems increased with child age.

Conclusions: Our findings do not support the notion that perinatal maternal depression is particularly detrimental to children's psychological development, as the most robust effects were found for maternal depression occurring during preschool years.
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http://dx.doi.org/10.1111/jcpp.12704DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5484352PMC
July 2017

Three Randomized Effectiveness Trials - One Question: Can Callous-Unemotional Traits in Children Be Altered?

J Clin Child Adolesc Psychol 2018 May-Jun;47(3):436-443. Epub 2016 Jun 30.

a The Norwegian Center for Child Behavioral Development , University of Oslo.

Children with conduct problems and callous-unemotional (CU) traits are at risk for multiple problems. Outcome research and mediation analyses testing for mechanisms of change in CU traits have been limited. We examined whether parent training-in a short-term (Brief Parent Training; BPT) or a comprehensive format (Parent Management Training, Oregon Model; PMTO)-or child-directed social skills training (Individual Social Skills Training [ISST]) produced positive effects on CU traits. In mediation models we tested parenting practices as mechanisms of change for CU traits. We pooled data from three randomized effectiveness trials, and 551 families were included in this study. Families had children between 3 and 12 years of age and displayed emerging or present conduct problems at home, day care, or school (BPT M age = 7.28, 31.9% girls; PMTO M age = 8.56, 36.5% girls; ISST M age = 7.64, 19.7% girls). Assessments were completed preintervention, postintervention, and at follow-up (6 months following intervention). Both BPT (d = .32) and PMTO (d = .39) had positive effects on CU traits at posttest, whereas ISST did not (d = -.06). At follow-up, only PMTO produced a significant effect (d = .48) on CU traits. A significant indirect effect on CU traits emerged by positive parenting. Both parent training conditions outperformed ISST. Only PMTO maintained its effects at follow-up. The findings suggest that PMTO can reduce CU traits and that improved positive parenting is associated with positive outcomes for children's CU traits.
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http://dx.doi.org/10.1080/15374416.2016.1178123DOI Listing
May 2019

Low Family Income and Behavior Problems in Norwegian Preschoolers: Is Child Emotionality a Marker for Sensitivity of Influence?

J Dev Behav Pediatr 2016 Apr;37(3):213-22

*Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway; †Norwegian Institute of Public Health, Oslo, Norway; ‡The Norwegian Center for Child Behavioral Development, Oslo, Norway.

Unlabelled: Poor children have higher rates of mental health problems than more affluent peers, also in progressive welfare states such as Norway. Temperamental characteristics may render some children more sensitive to the adverse influence of poor economy.

Objective: This study examined the direct associations between family income-to-needs and mental health and assessed moderation by early temperamental characteristics (i.e., emotionality).

Method: Using data from the Norwegian Mother and Child Cohort Study, associations between income-to-needs across children's first 3 years and internalizing and externalizing problems when children were 5 years old were examined. Differential sensitivity to family income-to-needs was assessed by investigating how emotionality, when children were one-and-a-half and 3 years old, moderated these associations.

Results: Significant main effects of income-to-needs and emotionality and a significant interaction effect between income-to-needs and emotionality were found for externalizing problems, but not for internalizing problems.

Conclusion: Children in poor families with an emotionally reactive temperament had higher scores on externalizing problems when they were 5 compared with their less emotionally reactive peers.
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http://dx.doi.org/10.1097/DBP.0000000000000282DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818976PMC
April 2016

Age of Entry Into Early Childhood Education and Care as a Predictor of Aggression: Faint and Fading Associations for Young Norwegian Children.

Psychol Sci 2015 Oct 14;26(10):1595-607. Epub 2015 Aug 14.

Norwegian Center for Child Behavioral Development, University of Oslo.

Socioemotional risks associated with nonparental care have been debated for decades, and research findings continue to be mixed. Yet few studies have been able to test the causal hypothesis that earlier, more extensive, and longer durations of nonmaternal care lead to more problems. To examine the consequences of age of entry into nonparental care for childhood aggression, we used prospective longitudinal data from Norway, where month of birth partly determines age of entry into Early Childhood Education and Care (ECEC) centers. In this sample of 939 children followed from ages 6 months through 4 years, ECEC teachers reported the children's aggression when they were 2, 3, and 4 years old. We found some evidence that age of entry into ECEC predicted aggression at age 2, albeit modestly and not robustly. Between the ages of 2 and 4 years, the effect of age of entry on aggression faded to negligible levels. The implications for psychological science and policy are discussed.
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http://dx.doi.org/10.1177/0956797615595011DOI Listing
October 2015

Normative development of physical aggression from 8 to 26 months.

Dev Psychol 2014 Jun 7;50(6):1710-20. Epub 2014 Apr 7.

The Norwegian Center for Child Behavioral Development, University of Oslo.

This study investigated the normative use and developmental course of physical aggression (PA), defined as use of physical force such as hitting, biting, and kicking, from 8 to 26 months and predictors thereof. We used data from the Behavior Outlook Norwegian Developmental Study, comprising 1,159 children (559 girls and 600 boys). Both mothers and fathers reported frequently about their child's use of PA in personal and telephone interviews. Mean number of reports per child was 7.16 (SD 1.70), with 90% having at least 6 reports. We employed Rasch scaling to construct a single linear PA measure and multilevel growth curve modeling to address the research questions. The results confirm that the development of PA is nonlinear, with a peak in frequency at about 20-22 months, which is followed by a decline toward 26 months. There is both within- and between-child variance in the development of PA. Higher levels of PA were predicted by the presence of a same-age sibling, maternal and paternal mental distress, and difficult child temperament (high activity level and distress due to limitations), whereas the main effect of gender was only trend-significant. Growth of PA across this developmental period was predicted by the presence of a same-age sibling and high activity level. The results both support and transcend previous research within this field.
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http://dx.doi.org/10.1037/a0036324DOI Listing
June 2014

Family concordance and gender differences in parent-child structured interaction at 12 months.

J Fam Psychol 2014 Apr 24;28(2):253-9. Epub 2014 Feb 24.

The Norwegian Center for Child Behavioral Development.

This observational study examined family concordance and gender differences in early parent-child interaction in the family supportive sociopolitical context of Norway. Mothers and fathers from 39 Norwegian families were observed on separate occasions with their 12-month-old children (20 girls and 19 boys). Data were recorded from observations using microsocial coding methodology based on social interaction learning theory. We found no within-family concordance between mothers' and fathers' behaviors with their child. The children's negative engagement with each parent was moderately correlated. For parents with boys, fathers were overall more positively engaged than mothers. Moreover, fathers of boys displayed more positive engagement than those of girls, whereas mothers of girls and boys displayed similar levels of positive engagement. In contrast to previous findings, mothers did not verbalize more than fathers. Girls were overall more positively engaged during interaction with both mothers and fathers than boys. Thus, in a sociopolitical context that facilitates early parent-child relationships and gender equality, there were few but noteworthy gender differences in parent-child interaction at 12 months.
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http://dx.doi.org/10.1037/a0035977DOI Listing
April 2014

Predicting language development at age 18 months: data from the Norwegian Mother and Child Cohort Study.

J Dev Behav Pediatr 2011 Jun;32(5):375-83

Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.

Objectives: This study investigated predictors of delayed language development at 18 months of age in a large population cohort of Norwegian toddlers.

Methods: Data were analyzed on 42,107 toddlers. Language outcome at age 18 months was measured using a standard parent report instrument, the Ages and Stages Questionnaire, communication scale. Confirmatory factor analysis was conducted on the Ages and Stages Questionnaire items. A theoretically derived set of child, family, and environmental risk factors were used to predict delayed language development at age 18 months using Generalized Estimating Equation.

Results: A number of child factors, including being a boy, low birth weight or gestational age, or a multiple birth child were all significantly associated with low scores on the language outcome at age 18 months. Maternal distress/depression and low maternal education, having older siblings, or a non-Norwegian language background also predicted low scores on the language outcome at age 18 months. Overall, estimated variance in language outcome explained by the model was 4% to 7%.

Conclusions: A combination of early neurobiological and genetic factors (e.g., male gender, birth weight, and prematurity) and concurrent family variables (e.g., maternal distress/depression) were associated with slower language development at age 18 months. This finding replicated previous research conducted on slightly older language-delayed 2 year olds but also detected the importance of factors related to family resources for the first time in this younger age group. Despite this finding, most of the variability in language performance in this cohort of 18 month olds remained unexplained by the comprehensive set of purported risk factors.
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http://dx.doi.org/10.1097/DBP.0b013e31821bd1ddDOI Listing
June 2011

Feelings of insecurity: review of attachment and eating disorders.

Eur Eat Disord Rev 2010 Mar;18(2):97-106

Regional Department for Eating Disorders, Oslo University Hospital, Ullevål, Oslo, Norway.

Objective: Attachment theory has received increasing attention from clinicians and researchers in the field of eating disorders. This paper is an updated review on theoretical approaches in the field, and of studies employing the Adult Attachment Interview.

Method: We searched the major databases such as PsycInfo and Science Direct for empirical and theoretical studies on attachment and eating disorders, and these are reviewed.

Results: Theoretical approaches on attachment and eating disorders highlight either retrospective, general risk or attachment theoretical statements. There is greater prevalence of insecure attachment in the eating disordered population than in non-clinical samples. However, there is no sufficient evidence to conclude about specific mechanisms for this connection.

Discussion: The theoretical approaches vary in their theoretical grounding, specificity and empirical support. AAI-based research on attachment and eating disorders is still at an early stage. More advanced studies are required for the field to move forward.
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http://dx.doi.org/10.1002/erv.999DOI Listing
March 2010

Concordance between Hopkins Symptom Checklist (HSCL-10) and Pakistan Anxiety and Depression Questionnaire (PADQ), in a rural self-motivated population in Pakistan.

BMC Psychiatry 2008 Jul 22;8:59. Epub 2008 Jul 22.

Institute of General Practice and Community Medicine, Oslo, Norway.

Background: There have been no previous studies conducted in Pakistan comparing the concordance of any well established Western anxiety/depression screening instrument with an indigenous scale, in a community based setting.

Methods: Participants (n = 1040) in the present study were recruited from the six villages of our interest from the district Gujarat of Pakistan, using a convenient sampling technique. Interview versions of the Hopkins Symptom Checklist 10-item version (HSCL-10) and the Pakistani Anxiety and Depression Questionnaire (PADQ) were used to observe the pattern of anxiety and depression among the participants.

Results: The internal consistency of HSCL-10 and PADQ were 0.86 and 0.84 respectively. Exploratory factor analysis found evidence for both a one-dimensional (distress) and a two-dimensional (anxiety and depression) solution for the HSCL-10, but only a one-dimensional (distress) solution for the PADQ. The HSCL-10 and PADQ found to be moderately to highly correlated (r = 0.62, p < 0.0001, 0.73 after correction for attenuation).

Conclusion: HSCL-10 has shown good screening abilities in a rural setting in Pakistan, and moderate to good concordance with an indigenous instrument measuring psychological distress. The HSCL-10 can therefore be used as a screening instrument, both in clinical and epidemiological settings in Pakistan, and for Pakistani immigrants living in Western societies.
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http://dx.doi.org/10.1186/1471-244X-8-59DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2500013PMC
July 2008

Time trends in obesity and eating disorders.

Int J Eat Disord 2008 Dec;41(8):673-80

Norwegian Institute of Public Health, Division of Mental Health, Oslo, Norway.

Objective: Obesity is a well-known risk factor for eating disorders, and has been increasing in the normal population over the last decades. This study examines whether the increase in obesity is followed by an increase in prevalence of eating disorders in the general female population.

Method: We compared the prevalence of eating disorders and obesity in two nationally representative surveys in Norway in 1991 (n = 1,537) and 2004 (n = 1,467). Eating disorder diagnoses were obtained using the self-report questionnaire survey for eating disorders (SEDs) at both time points.

Results: The prevalence of overweight and obesity has doubled from 1991 to 2004, whereas the prevalence of eating disorders has been stable. Obesity was strongly associated with eating disorders both in 1991 and 2004.

Conclusion: Despite the strong association between obesity and eating disorders, the increase in obesity is not followed by an increase in eating disorders.
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http://dx.doi.org/10.1002/eat.20565DOI Listing
December 2008

Validation of psychoanalytic theories: towards a conceptualization of references.

Int J Psychoanal 2005 Oct;86(Pt 5):1353-71

The authors discuss criteria for the validation of psychoanalytic theories and develop a heuristic and normative model of the references needed for this. Their core question in this paper is: can psychoanalytic theories be validated exclusively from within psychoanalytic theory (internal validation), or are references to sources of knowledge other than psychoanalysis also necessary (external validation)? They discuss aspects of the classic truth criteria correspondence and coherence, both from the point of view of contemporary psychoanalysis and of contemporary philosophy of science. The authors present arguments for both external and internal validation. Internal validation has to deal with the problems of subjectivity of observations and circularity of reasoning, external validation with the problem of relevance. They recommend a critical attitude towards psychoanalytic theories, which, by carefully scrutinizing weak points and invalidating observations in the theories, reduces the risk of wishful thinking. The authors conclude by sketching a heuristic model of validation. This model combines correspondence and coherence with internal and external validation into a four-leaf model for references for the process of validating psychoanalytic theories.
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http://dx.doi.org/10.1516/fb7h-7e8c-fdbg-yq9tDOI Listing
October 2005
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