Shown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by psych chat on October 28, 2009, at 20:52:30
I wrote a letter and emailed it to the APA; I did not file a complaint, but sent an email inquiry.
The twittering of a link to a person's suicide plans upset me-it really crossed a line, imo. The individual may or may not be upset about it, but another individual might very well be mortified if the same thing happened to them. While individuals may choose to take information and post it anywhere, I do not think it is ethical for psychiatrists to do this, or even encourage this behavior. That individual chose to post here on this forum, to seek help from the individuals located here - if someone wants to twitter their suicidal plans to all of Dr. Bob's followers, they would have done so themself. I think it is exploitation - to promote this site which is used for Dr. Bob's research and thus, career.
Of course, policy is still evolving to catch up with technology. There is always a time slack.
Many people have nowhere to turn for support, or simply don't have the resources to get help. Some people have agoraphobia and can't leave their homes to connect with others. Others have social anxiety and may not be as adept at obtaining help. People have different reasons for seeking support here and through other forums. It would be sad if such people felt increasingly unsafe to post on these forums due to excessive information sharing, along with the lack of privacy.
I do believe these sites should be protected with a security layer so they are not all over Google. I also believe people should be allowed to edit or delete revealing posts they may have posted while in a state of mental distress. This is totally against Dr. Bob's policy. He will only delete a post if it contains the person's actual name, so I was told. A person in distress may not have the strength to read the forum's "policies" before they post revealing material.
It appears the APA's code of ethics applies mostly to clinical practice (as opposed to website administrators) and research.
So-I asked them to look into such practices by APA members who administer mental health forums and also if they are in the process of developing guidelines for mental health medical professionals who administer websites (if they already haven't). I also provided some links to this website/our concerns about privacy, along with the post concerning suicide.
I hope they consider this in their ethics code, and that lawmakers do the same.
http://www.psych.org/Departments/EDU/residentmit/ethicsprimer.aspx
"For psychiatric patients, because of the widespread stigma and many cultural contexts of mental versus physical illness, confidentiality is even more important than in most areas of medicine (American Psychiatric Association Committee on Confidentiality
1987).Section 4, Annotation 1 of the Principles of Medical Ethics With Annotations
Especially Applicable to Psychiatry (hereinafter Principles) defines psychiatric medical records and comments on the necessity for confidentiality: Psychiatric records, including even the identification of a person as a patient, must be protected with extreme care. Confidentiality is essential to psychiatric treatment. This is based in part on the special nature of psychiatric therapy. The Principles go on to note that this is an era of growing concern about the civil rights of patients
and the possible adverse effects of computerization, duplication equipment,
and data banks (Section 4, Annotation 1). These advances in technology may provide relatively easy access to data, but because of
the sensitive and private nature of the information with which the psychiatrist
deals, he/she must be circumspect in the information that he/she chooses to disclose to others about a patient. The welfare of the patient
must be a continuing [dominant] consideration (Principles, Section 4, Annotation 1).
Section 4, Annotation 2 of the Principles deals with how and when confidential information may be released: A psychiatrist may release confidential information only with the authorization of the patient or under proper legal compulsion. The continuing duty of the psychiatrist to protect the patient includes fully apprising him/her of the connotations
of waiving the privilege of privacy. This may become an issue when the patient is being investigated by a government agency, is applying
for a position, or is involved in legal action. The same principles apply to the release of information [about a patient] to medical departments of government agencies, business organizations, labor unions, and insurance
companies. [For example,] information gained in confidence about patients seen in [college] student health services should not be
released without the students explicit permission.Clinical information is often used in teaching or in publishing articles in professional journals. Section 4, Annotation 3 of the Principles states that clinical and other materials used in teaching and writing must be adequately disguised in order to preserve the anonymity of the individuals involved. Section 4, Annotation 10 of the Principles also deals with this issue, stating that with regard for the persons dignity
and privacy and with truly informed consent, it is ethical to present a patient to a scientific gathering, if the confidentiality of the presentation is understood and accepted by the audience. Section 4, Annotation 11 of the Principles also touches on this issue, stating that it is ethical to present a patient or former patient to a public gathering or to the news media only if the patient is fully informed of enduring loss of confidentiality, is competent, and consents in writing without coercion.
Posted by psych chat on October 28, 2009, at 21:04:33
In reply to Contacted the American Psychiatric Association, posted by psych chat on October 28, 2009, at 20:52:30
Here's a link to the APA's contact information if anyone wishes to express their concern about privacy and mental health forums:
http://www.psych.org/Footer/Contact.aspx
I really do believe these forums should have the following protections:
- a layer of security so that all the posts do not show up on Google
- a consent policy that conditions the use of this forum only if the user agrees to refrain from taking information from the forum and distributing it elsewhere (there is no "policing" - just a policy in place)
- the ability to edit/delete one's own posts
While the American Psychiatric Association obviously cannot regulate private individuals, they do have the authority to regulate the ethics of their own members.
If you are interested in mental health forums and privacy, please cut and paste the bullet points above and email it to the APA, requesting they consider implementing these ethical standards of privacy for those members who administer mental health forums in their code accordingly.
Here is their email address: apa@psych.org
Take care everyone.
Posted by BayLeaf on October 28, 2009, at 21:32:18
In reply to Re: Contacted the American Psychiatric Association, posted by psych chat on October 28, 2009, at 21:04:33
You might find this interesting....
http://www.ismho.org/board.asp
Posted by psych chat on October 28, 2009, at 23:22:14
In reply to Re: Contacted the American Psychiatric Association » psych chat, posted by BayLeaf on October 28, 2009, at 21:32:18
Thanks for the link Bayleaf...He also chairs internet related topics for APA conferences. That is rather disturbing...someone who seems to show little concern for the dignity of members of his onine community (redistributing and encouraging the sharing of our posts despite numerous requests to prohibit this practice), representing and educating others about online mental health support forums for the APA.
S59. The Clinical Internet: American and European Experiences
C. Clinical Uses of the Internet: Some Suggestions Robert C. Hsiung, M.D.http://pn.psychiatryonline.org/cgi/content/full/42/4/22
CW26. The APA Web Site: Potential Future Directions and Opportunity for Dialogue APA Ad Hoc Work Group on Information Systems; Chair: Robert C. Hsiung, M.D.
http://www.psychiatricnews.org/pnews/99-02-19/wed.html
Psychiatry and the Internet
Q&A With Dr. Robert Hsiunghttp://ap.psychiatryonline.org/cgi/content/abstract/23/3/171
Maybe the ISMHO should include a member from NAMI or from another patient advocacy group for its executive committe.
http://www.ismho.org/board.asp
The International Society for Mental Health Online (ISMHO) was formed in 1997 to promote the understanding, use and development of online communication, information and technology for the international mental health community.....
I'm not sure how and why the administrator of this site would be advising the APA on their site. And this is not personal criticism of Bob here, and these are things that don't personally bother me - but the site is poorly designed, many links broken, outdated medication information, etc. Why would the facilitator of this site be advising others on their websites??
Posted by psych chat on October 28, 2009, at 23:40:38
In reply to Contacted the American Psychiatric Association, posted by psych chat on October 28, 2009, at 20:52:30
Welcome West Coast Richard - sexual side effects on SSRIs!! Welcome Lauren - in love with therapist!!
Of course, Lauren is promoting a book..and might not mind.
I wonder if the new members posting here even know their threads are twittered to all of Bob's 237 followers in this manner:
RT @psycho_babel please welcome West_Coast_Richard http://tiny.dr-bob.org/madw (sexual side effects on SSRIs)
about 6 hours ago from web (this one was in quadruple size font at the top of the page)RT @psycho_babel please welcome Lauren0722 http://tiny.dr-bob.org/n6es (in love with therapist)
2:02 PM Oct 27th from webOf course, they could be researches posing as mental health patients, for all we know.
Posted by cactus on October 29, 2009, at 0:34:01
In reply to How New Posters Threads Appear on Twitter, posted by psych chat on October 28, 2009, at 23:40:38
It's also not just the fact that that happens!
EVERYBODY WHO RESPONDS TO A POST THAT HAS BEEN TWITTED APPEARS ON THE POST TOO!!
It's a gross misuse of trust and has to breach some kind of law, I want all responses to a post on twitter not VISABLE. Just stop it please.
Posted by yxibow on October 29, 2009, at 3:11:53
In reply to Re: Contacted the American Psychiatric Association » psych chat, posted by BayLeaf on October 28, 2009, at 21:32:18
> You might find this interesting....
>
> http://www.ismho.org/board.asp
>
>ISHMO is a registered domain of Dr. Bob
Domain Name:ISMHO.ORG
.....
Registrant Email:rhsiung@uchicago.edu
Admin ID:GODA-257843637
Admin Name:Domain Manager
Admin Organization:International Society for Mental Health Online
....
unnecessary WHOIS deleted, anyone can do a whois.
Posted by psych chat on October 29, 2009, at 3:58:44
In reply to Re: Contacted the American Psychiatric Association » BayLeaf, posted by yxibow on October 29, 2009, at 3:11:53
Thank you for providing this information, Jay. Everyone concerned with the future of the clinical practice of mental health should take a look at this site, the organization headed by Dr. Bob, and consider the implications.
Granted, the organization is geared toward online clincial practice (as opposed to public support mental health forums such as this one)...but consider the influence of this organization. If the person heading this organization does not even respond to the concerns of the members of this forum, is that same person looking out for the interests of the mental health community as a whole, or just interested in heading the first world organization of e-mental health?
Of course, the organization could do some good. But without considering the concerns of mental health patients, I'm not at all confident...
Consider that this organization, headed by Dr. Bob is:
- creating the ethical standards and guidelines for governing mental health online practices
- hosting conferences around the world-advising other leaders about online mental health services
- doesn't have a patient advocate on its board (does it even consider the input of mental health patients?)
- etc.http://www.ismho.org/links.asp
http://www.ismho.org/bylaws.asp
You can tell ALOT about an organization by its mission statement/purpose. Don't think for a minute that not a lot of thought goes into them by a Board. This mission statement speaks loudly. It does NOT mention the betterment of the lives of mental health patients; it does NOT mention improving the quality of life of mental health patients. It does NOT mention protecting the privacy, dignity, etc. of mental health patients. In fact, it really doesn't mention much about mental health patients. Yet, the word "promote" is included twice. Providing services to professionals, etc. Not much about helping patients. That mission statement is very telling about the intent and thought process of the creators of the organization. I wouldn't be surprised if it is revised after someone reads this.
Also, I'm very well aware the APA represents the interests of physicians-and rightly so-they need a group too. And psychiatrists, who comprise its membership base, do care about patients.
However, they may not feel it is in their best interest for an advisor/committee chair of their conferences, I person who may represent or consult to them about online mental health services, to be tweeting suicidal notes of mental health patients all over the internet.
A well-seasoned executive considers all the stakeholders and would immediately see the implications. Say, for example, someone were to find their post on twitter, and be angry about it and write a letter to the New York Times. (Actually Dr. Pauline Chen, NY Times health writer, is a follower of Dr. Bob's twitter-so maybe the Washington Post....oh but then Dr. Bob might become famous and it would work out for him). Anyway, it might not look good for the APA-their reputation could be compromised. PR.
Oh, and that goes to show you how much people get from Twitter. I wonder if Dr. Chen has even looked at this site-maybe once? Who knows, but *passing* so much information around on those social networks leads to *bypassing* information.
If you care, and if you have the energy to care, please think about the future of people who have mental health issues. Please consider what I have written.
Mission Statement:
The International Society for Mental Health OnlineThe International Society for Mental Health Online (ISMHO) was formed in 1997 to promote the understanding, use and development of online communication, information and technology for the international mental health community. To this end, ISMHO seeks to:
1. aid and stimulate mental health professionals and clients in the development of new online technology and applications;
2. educate mental health professionals and clients about existing online information and communication technologies and applications;
3. explore and develop the use of computer assisted communication in the work of mental health;
4. highlight endeavors by members consistent with the goals of the Society;
5. provide online discussion forums and news concerning the work of mental health online;
6. develop standards for online interactions between mental health professionals and consumers;
7. help coordinate technological efforts amongst its members;
8. work to stimulate grants and other funding for the development of information and communication systems and technologies specific to mental health online;
9. promote the development of online databases of information, information and communication tools and software which are easily accessible to all mental health professionals and which will serve to advance the profession and discipline of online mental health and research;
10. encourage other professional societies, associations and interest groups to allocate resources to the investigation, development and promulgation among mental health professionals of online resources and online technologies;
11. provide advice to legislative bodies and governmental agencies concerning the use, needs and benefits of online resources which have been formed with significant input from its members.> > You might find this interesting....
> >
> > http://www.ismho.org/board.asp
> >
> >
>
> ISHMO is a registered domain of Dr. Bob
>
> Domain Name:ISMHO.ORG
> .....
> Registrant Email:rhsiung@uchicago.edu
> Admin ID:GODA-257843637
> Admin Name:Domain Manager
> Admin Organization:International Society for Mental Health Online
> ....
>
>
> unnecessary WHOIS deleted, anyone can do a whois.
>
>
Posted by psych chat on October 29, 2009, at 4:57:26
In reply to Dr. Bob's Online World Mental Health Society » yxibow, posted by psych chat on October 29, 2009, at 3:58:44
You might want to consider other aspects of the organization's mission:
5. provide online discussion forums and news concerning the work of mental health online;
11. provide advice to legislative bodies and governmental agencies concerning the use, needs and benefits of online resources which have been formed with significant input from its members.
The main mental health forums on the internet will turn into Psycho Babble, adopting Dr. Bob's philosphies for management....the Psych Central founder is also on Dr. Bob's board.
And providing advice to legislative bodies concerning the use...of online resources (members' input being members of the society)-- That is scary.
Well just remember you were warned...
Posted by psych chat on October 29, 2009, at 7:09:38
In reply to Dr. Bob's Online World Mental Health Society, posted by psych chat on October 29, 2009, at 4:57:26
The organization Dr. Bob is the president of - The International Society for Mental Health Online - gives serious consideration to the privacy of its members. Interesting double standard and total disregard for the very people they are supposed to be 'helping'.
- they have a layer of security to conceal their posts on their message forum
- they don't share information with 3rd parties
- they don't track information from membersPrivacy Statement:
The International Society of Mental Health Online (ISMHO) is committed to maintaining your confidence and trust, and maintains the following privacy policy to protect personal information you provide online.
No Release of Information to Third Parties
Personal information collected as a function of this Web site will not be released to third parties except to further the purpose for which you provide the information or if such release is required by law. Note, the membership roster is available to members of ISMHO in the members-only section. The roster is compiled from information provided by members for reference uses such as searching for and contacting colleagues or for making referrals, etc. No information which is made available to members for these purposes shall be leased, sold, or otherwise made available to non-members without explicit permission or except as required by law.No Computer Tracking of Identifiable Information
Our Web site does not track, collect or distribute personal information about individual visitors. We regularly compile aggregate statistics that show the number of visitors to our site, the requests we receive for particular information on our Web site, and the Internet Protocol (IP) number that those requests come from. These aggregated statistics may be used by ISMHO to improve the Web site in an ongoing effort to provide better information and services to the public.
Posted by Phillipa on October 29, 2009, at 11:10:26
In reply to ISMHO takes members' privacy very seriously, posted by psych chat on October 29, 2009, at 7:09:38
Interesting
Posted by cactus on October 29, 2009, at 17:13:56
In reply to ISMHO takes members' privacy very seriously, posted by psych chat on October 29, 2009, at 7:09:38
Thank you psych chat, that is very interesting, to break it down then, basically these twitter/facebook links are already breaching this protocol. Is this correct? If so, can legal action can be initiated then?
Why not take it to the papers, I know people say all publicity is good publicity but this is not true at all. I work in News Media but not in the US.
One thing I can tell you is that if the general public find out that people posting for help and support in depression/mental illness forums have had their posts compromised by having them linked out to the general public via twitter/facebook or any social networking system, it will go down like a cold cup of sick. There's not much I can do from here unfortunately except leave.
Great research. C
Posted by Phillipa on October 29, 2009, at 21:44:40
In reply to Re: ISMHO takes members' privacy very seriously » psych chat, posted by cactus on October 29, 2009, at 17:13:56
Who was that poster a few years ago from the NY Times she wrote an article on babble that it was people taking meds to get high Amy something? She could write an article???? Someone must remember her full name? Phillipa
Posted by yxibow on October 30, 2009, at 0:22:20
In reply to Re: ISMHO takes members' privacy very seriously » cactus, posted by Phillipa on October 29, 2009, at 21:44:40
> Who was that poster a few years ago from the NY Times she wrote an article on babble that it was people taking meds to get high Amy something? She could write an article???? Someone must remember her full name? Phillipa
Its full names and doctors' names and real specifics that I'm concerned about here.I've seen posts of people in distress and its no fault of theirs but a lot of personally identifiable data ends up getting shared.
It shouldn't be on google but Bob has already done that.... but facebook and twitter, that's crossing privacy lines of people who might not have thought before of how specific things are.
-- tidings.
Posted by muffled on October 30, 2009, at 1:51:23
In reply to Contacted the American Psychiatric Association, posted by psych chat on October 28, 2009, at 20:52:30
Thanks for doing all this work.
Its mind boggling.I also have issue with the fact that posts can't be deleted/edited after you post (at least w/in a time frame).
I have issue that the archives are there for all to see, apparently forever.... People lives change, it may well be that some years down the road, they really wish the info wasn't there anymore....but it is, and easily searchable thru google ;(
Also, that when a poster posts something and its pretty darn awful, and they want it gone so bad, it does not and will not be removed. Doesn't matter that it is causing great distress...
The site I currently patronize, does do all these things. You can delete/edit w/in a time frame, they will delete posts, and they clean out and delete archives from time to time(they warn you first so you can save posts that you want to save).
I just find it so freaky that this stuff is happening, and noone seems to care out there....I guess I shouldn't be surprized. This site is run by a respected? educated doctor....I'm just a nut...
sigh
I am sad.
M
Posted by Sigismund on October 30, 2009, at 3:45:51
In reply to Re: ISMHO takes members' privacy very seriously » Phillipa, posted by yxibow on October 30, 2009, at 0:22:20
>It shouldn't be on google but Bob has already done that
Yep
Posted by psych chat on October 30, 2009, at 9:35:04
In reply to Re: Contacted the American Psychiatric Association » psych chat, posted by muffled on October 30, 2009, at 1:51:23
I think too, muffled, that when people posted years ago, these privacy concerns were not even thought of and advanced search engines did not exist/were not in widespread use.
I would imagine many people forget they are out there. I certainly don't remember all of the places I've posted years and years ago.
Hope people haven't and don't lose their jobs over any of them as more and more employers are scouring they net to find information about applicants.
Posted by psych chat on October 30, 2009, at 9:48:46
In reply to Re: ISMHO takes members' privacy very seriously » psych chat, posted by cactus on October 29, 2009, at 17:13:56
"..to break it down then, basically these twitter/facebook links are already breaching this protocol. Is this correct? If so, can legal action can be initiated then?"
I don't believe so. As I said, that code applies mainly for a doctor-patient relationship, but also research. That is also an abbreviated version of their full code. Maybe they have something, or are working on something, that outlines ethics for psychiatrists who run online forums, etc., That is what I had asked them about. However, after reading those ethics, imo, I would say that what Dr. Bob is doing CLEARLY is in contrast to their general philosophies concerning patient confidentially ethics.
I do believe, however, the lack of security here could possibly compromise his research facilitated via this site. Without the layer of protection most forums use, all of our posts can be easily found on google. So-when he uses an example of us in research, anyone can google and find that persons statement immmediately in this forum-and see their logon id and other posts that may contain more identifiable information. Then they can google their logon id, and see personal, identifiable information and be able to easily identify this person on another site. That's another reason why I think Dr. Bob should apply reasonable security protection in connection with this site.
And those icons allow you to link your comment to your facebook/twitter accounts. Most facebook accounts identify the individual. How can he use this site for 'anonymous' research under the APA standards - while at the same time, giving people tools to link that same research material to that person's real identiy?
If Dr. Bob wanted to, and as several other mental health forums have done, he could apply reasonable protections to ensure our confidentiality. Those protections would be the simple things I had already stated.
> Why not take it to the papers...">That would be a circus.
Posted by Sigismund on October 30, 2009, at 14:10:37
In reply to Re: ISMHO takes members' privacy very seriously » cactus, posted by psych chat on October 30, 2009, at 9:48:46
It worries me that Impermanence's posts can be combed through by people who actually know him to find evidence of drug abuse.
No privacy for him/her there.
Posted by psych chat on October 30, 2009, at 23:24:15
In reply to Re: ISMHO takes members' privacy very seriously, posted by Sigismund on October 30, 2009, at 14:10:37
That concerns me too, Sigi. I hope he is getting the help he needs, but at the same time, I hope his post doesn't haunt him for the rest of his life.
Posted by okydoky on December 16, 2009, at 1:38:01
In reply to Re: ISMHO takes members' privacy very seriously » Sigismund, posted by psych chat on October 30, 2009, at 23:24:15
Sorry if I am hijacking the thread but I thought this applicable subject matter.
It is glaringly obvious to me that any mission statement in regards to this site would have nothing to do with the well being of its "members"(better definition perhaps "contributors")
Trying to research and have some minimal understanding of web site hosting and design, exploring this sites "FAQ" I goggled something about it and found a link to this thread.
I cannot thank you enough for the intelligent well informed information!
Why not have a member driven/ administered self help mental health site, a patient administered/designed online mental health support forum, its mission one of advocacy?
Among a lot of other positive things it could be empowering.
Is there enough interest and serious minded people with the knowledge and time to do the work proposed?
(Maybe this has already been done and I am unaware?)
I think it could be useful to use the underlying principles (democratic) of the "Clubhouse", a psychosocial rehab, as a starting point to develop an online member driven web site.
See:
http://www.parecovery.org/services_psychrehab.shtmlAfter defining the mission statement and doing the work of finding a web host and/or web design, calculating the seed money needed and ongoing funding, finding a trusted fiduciary, patients would have developed the "bones" to write funding proposals to philanthropic/charitable organizations.
I realize this is a daunting and time consuming task.Of course there is much more involved, some I probably have not even articulated to myself, beyond my intellect.
I am curious. Am I being a realist or an idealist?
oky
Posted by muffled on December 16, 2009, at 9:25:14
In reply to Patient Online Advocacy, posted by okydoky on December 16, 2009, at 1:38:01
Oky, you are so sweet. No, your not really being idealistic. All things start w/an idea. But what makes things 'go', is someone(s) with the initiaitve and heartfelt desire to 'DO' it.
Cuz ya, good things do not come easy!
I think alot of us here at babble have been thru the mill of life more than once, so we tend to be wary and reluctant.
And ya...kinda jaded :(
However, I DO think the idea of a new site is a GREAT idea.
The parameters would have to be agreed upon, which may be a challenge in of itself!
Already some of us have quite different ideas of what we would want to see in a site.
Bless Bob, I think he does try here. I cannot beleive that he is purposely killing his own site? I think he just doesn't know. But becuase he does not understand, I don't feel I can ever post here comfortably.
So, ya, if someone ever starts a site, and it looks to be what I am interested in, I would be willing to help some.
The things I like-and some don't...is that I want an open site, in that anyone can join upon applying for an invitation.
I would like the boards be open to be read by all, but also would like at least one board to be only seen by members.
Not linked w/google.
Chat function is nice.
Don't like Bmail.
hmmmm
not that I am picky?!
So, you can already see the challenges!
Goto go,
Take care,
M
Posted by okydoky on December 17, 2009, at 12:25:22
In reply to Contacted the American Psychiatric Association, posted by psych chat on October 28, 2009, at 20:52:30
I thought I already posted this but I cannot find it:
You write so concisely and articulate so well.
Can I inquire if you would be interested in writing a "form" letter to send to our legislators and if you think it pragmatic to the APA? Political talking heads routinely site this as being the most effective way for the public to influence our legislators.
Something members (some like myself who are not so articulate others to impel)could cut and paste and then send in a stamped envelope. Your quotes from Section 4 look to be to your point. That would be general and I guess you could provide a working example for it to be most effective. But here I am asking you to do it and then telling you how to do it. If I knew how to write this I would.
If you are interested it might be helpful to try and find out which legislators are most influential and/or powerful concerning mental health issues.
To quote you "Of course, policy is still evolving to catch up with technology". So let's influence policy.
Here are a couple sites I found maybe it will be of assistance: http://www.sccs.swarthmore.edu/users/09/btomasi1/advocacy-letters.doc
http://political-activism.suite101.com/article.cfm/writing_to_us_representatives
Gratefully,oky
ps I found an interesting site about research ethics: http://www.apa.org/science/leadership/bsa/internet/internet-report.pdfand several more googling:"ethics of online research"
Not any legislation about privacy issues specifically in regard to online research but you probably already are aware.
Take care,
oky
This is the end of the thread.
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