Afleveringen
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This episode dives into the lessons the diving community can learn from aviation safety practices, using the near-disaster of Air Canada Flight AC759 at San Francisco Airport as a starting point. In aviation, near-misses are thoroughly investigated to uncover systemic issues rather than just individual mistakes, fostering a culture of learning and improvement. By contrast, the diving industry often discourages open discussions about close calls due to fear of criticism or legal consequences, hindering collective growth. We explore how a shift toward non-judgmental analysis and systemic thinking could enhance safety in diving, encouraging shared learning from mistakes and near-misses to prevent future incidents.
Original blog: https://www.thehumandiver.com/blog/aviation-diving-errors
Links: Mercury News report: http://www.mercurynews.com/2017/08/02/ntsb-finds-blind-spot-in-sfo-radar-following-air-canada-near-disaster/
Tags: English, Gareth Lock, Human Factors
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In this episode, we explore how authority gradientsâthe imbalance of power or experience between individualsâcan lead to critical mistakes in diving and other high-stakes environments. Drawing lessons from aviation, medicine, and real-world diving incidents, we discuss how the fear of questioning a more experienced person can prevent vital safety concerns from being raised. Whether it's a student diver hesitant to challenge their instructor or a junior crew member in aviation unable to assert their concerns, the consequences can be life-threatening. We highlight the importance of fostering open communication, psychological safety, and mutual accountability to prevent errors and improve safety across all levels of experience.
Original blog: https://www.thehumandiver.com/blog/the-power-of-one
Links: Wrong site surgery: http://www.newstatesman.com/2014/05/how-mistakes-can-save-lives
Pan Am/KLM accident: https://www.skybrary.aero/index.php/B742_/_B741,_Los_Rodeos_Tenerife,_1977_(RI_AGC_WX)
Landing gear light problem: https://en.wikipedia.org/wiki/United_Airlines_Flight_173
Crew Resource Management: https://publicapps.caa.co.uk/docs/33/CAP720.PDF
Non-Technical Skills: https://www.rcsed.ac.uk/professional-support-development-resources/learning-resources/non-technical-skills-for-surgeons-notss
Human Factors skills in Diving: https://www.thehumandiver.com/
Tags: English, Gareth Lock
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Zijn er afleveringen die ontbreken?
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In this episode, we dive into the role of social conformity, biases, and decision-making in diving safety. Humans naturally seek group belonging, but this can lead to harsh judgments when incidents occur, particularly on social media. We explore how biases like hindsight and outcome bias affect our perceptions of accidents, often focusing on blame rather than understanding the decision-making processes behind them. To improve diving safety, itâs essential to create a "Just Culture"âa psychologically safe environment where mistakes can be shared without fear of humiliation or judgment. By examining flawed systems rather than individual outcomes and teaching the "why" behind protocols, we can foster better decision-making and prevent future incidents.
Original blog: https://www.thehumandiver.com/blog/we-judge-based-on-outcomes-not-on-process
Links: Learning teams blog: https://www.thehumandiver/blog/can-divers-learn-from-the-us-forest-service
Hindsight bias: https://www.thehumandiver/blog/incompetent-and-unaware-you-don-t-know-what-you-don-t-know
More about Just Culture: https://humanisticsystems.com/2016/11/24/just-culture-who-are-we-really-afraid-of%EF%BB%BF/
Tags: English, Gareth Lock
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In this episode, we explore how cognitive biasesâmental shortcuts that influence our decisionsâaffect our actions in complex and dynamic situations. Whether things go right or wrong, biases like overconfidence, expectation bias, and hindsight bias shape our thinking, often without us realizing it. We discuss practical ways to identify and reflect on these biases to improve decision-making, drawing from Buster Bensonâs framework that simplifies 175 cognitive biases into four key challenges: filtering too much information, finding meaning in a confusing world, acting quickly under uncertainty, and deciding what to remember. Tune in to learn how understanding biases can enhance awareness and resilience.
Original blog: https://www.thehumandiver.com/blog/i-am-biased-you-are-biased-we-are-all-biased
Links: Wikipedia page of cognitive biases: https://en.wikipedia.org/wiki/List_of_cognitive_biases
Cognitive bias cheat sheet blog: https://betterhumans.coach.me/cognitive-bias-cheat-sheet-55a472476b18
Links: English, Gareth Lock
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This podcast episode explores how the U.S. Forest Service uses structured Learning Reviews to improve safety in high-risk environments by focusing on understanding the context, mindset, and systemic factors behind incidents rather than assigning blame. Highlighting parallels to the diving community, we discuss the importance of storytelling, identifying gaps between "normal" and "ideal" operations, and addressing systemic issues to enhance safety and learning. With insights from the USFS's approach and Todd Conklinâs Learning Teams, we consider how divers and training organizations can adopt these principles to prevent accidents, foster accountability, and improve decision-making under pressure.
Original blog: https://www.thehumandiver.com/blog/can-divers-learn-from-the-us-forest-service
Links: USFS Learning review: http://wildfiretoday.com/2014/08/07/usfs-to-use-new-serious-accident-review-system/
Todd Conklinâs book: https://www.amazon.com/Pre-Accident-Investigations-Introduction-Organizational-Safety/dp/1409447820
Tags: English, Gareth Lock, Human Factors, Incident Reporting, Safety
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In this episode, we dive into the complexities of decision-making in high-risk environments, focusing on why some choices that lead to accidents might seem baffling but are understandable in context. We discuss Todd Conklin's and Chris Perrow's ideas on "Normal Accidents," highlighting how unforeseen events can occur despite experience and training due to factors like hindsight and outcome biases. Weâll explore the three types of decision-makingâskills-based, rules-based, and knowledge-basedâexplaining how each influences our actions, especially in unfamiliar situations. Lastly, weâll address how understanding decision-making can lead to safer diving practices by analyzing actions and events before they turn into incidents.
Original blog: https://www.thehumandiver.com/blog/why-did-he-make-such-an-obvious-mistake
Links: Endsleyâs SA model: https://s3.amazonaws.com/kajabi-storefronts-production/blogs/817/images/sbYcrVK0QVe0CYJ2fYoC_ngcezfVOQw69fnrwH2BI_EndsleyModel.jpg
Known unknowns blog: https://www.thehumandiver.com/blog/known-unknowns-are-they-considered-enough-in-diving
Tags: English, Decision Making, Gareth Lock, Human Factors, Rules
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In this episode, we explore Donald Rumsfeld's "known knowns, known unknowns, and unknown unknowns" concept and how it applies to risk management in diving. Using the Johari window model of self-reflection, we discuss the importance of understanding risks that divers face, from routine (known knowns) to unpredictable (unknown unknowns). The episode highlights the role of experience, training, and non-technical skills in preventing accidents and managing emergencies. Listeners will gain insights on improving their decision-making and awareness, so they can better navigate both anticipated and unforeseen challenges in their diving journeys.
Original blog: https://www.thehumandiver.com/blog/known-unknowns-are-they-considered-enough-in-diving
Links: Johari Window: https://en.wikipedia.org/wiki/Johari_window
Dunning Kruger effect: https://www.thehumandiver.com/blog/incompetent-and-unaware-you-don-t-know-what-you-don-t-know
Experience blog: https://www.thehumandiver.com/blog/complacency-the-silent-killer-but-it-s-not-that-simple
Charles Perrow, Normal Accidents: https://en.wikipedia.org/wiki/Normal_Accidents
Parker Turnerâs cave collapse: https://www.sciencedaily.com/releases/2015/09/150901121005.htm
Aqaurius Project fatality: https://en.wikipedia.org/wiki/Dewey_Smith
Tags: English, Gareth Lock
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In this episode, we delve into the story of Eric, a wingsuit base jumper who nearly died during a jump, to explore the risks, attitudes, and decision-making in extreme sports. Ericâs candid interview highlights how rapid progression without mentorship, inferred peer pressure, and normalization of risky behavior nearly led to fatal consequences. His reflections underscore the need for awareness, honest self-assessment, and the courage to address safety concerns, both in wingsuit base jumping and diving. The episode discusses the role of social media in glamorizing risky sports, the sunk-cost fallacy, and the importance of learning from near-misses. By drawing parallels to diving, we hope to inspire listeners to be more mindful of safety, effective communication, and continuous learning in any high-risk pursuit. Warning: This podcast contains swearing.
Original blog: https://www.thehumandiver.com/blog/congratulations-on-surviving-dude-you-re-one-lucky-f-er
Links: Full blog: http://topgunbase.ws/i-flew-my-wingsuit-into-trees-and-woke-up-in-a-hospital/
Today is a good day to die article: https://issuu.com/divermedicandaquaticsafety/docs/divermedicmagazine_issue9
Incompetent and Unaware blog: https://www.thehumandiver.com/blog/incompetent-and-unaware-you-don-t-know-what-you-don-t-know
DAN non-fatal incident reporting: http://www.danap.org/accident/nfdir.php
British Sub Aqua Club incident reporting: http://www.bsac.com/page.asp?section=1038§ionTitle=Annual+Diving+Incident+Report
Tags: English, Decision Making, Gareth Lock, Normalisation of Deviance, Situational Awareness
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One of the key lessons in diving is that anyone can end a dive at any time for any reason, no questions asked, yet making that call can be tough due to unspoken pressures. This episode explores how inferred peer pressure, desire for group belonging, and risk-taking in âlosing situationsâ all affect a diverâs willingness to thumb a dive. Through stories and research, we discuss how factors like fatigue, previous lost dive opportunities, and good visibility can cloud judgment, making it harder to call off a dive. Recognizing these influences and discussing them in debriefs can help divers build confidence in prioritizing safety over peer expectations.
Original blog: https://www.thehumandiver.com/blog/why-is-it-so-hard-to-thumb-a-dive-or-end-something-that-you-have-committed-to
Links: Paletzâs research about pilots in Alaska: https://www.semanticscholar.org/paper/Socializing-the-Human-Factors-Analysis-and-Paletz-Bearman/58a0496739adb8778b3f95cf53e9016f15dcf8e6
Kahneman and Tverskyâs research: http://psiexp.ss.uci.edu/research/teaching/Tversky_Kahneman_1974.pdf
Tags: English, Gareth Lock, Human Factors
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In this episode, we dive into the concept of human error, examining why labeling it as the sole cause of accidents often oversimplifies the issue and prevents meaningful improvement. Human error is natural, inevitable, and can range from minor to life-threatening in impact. Effective safety culture encourages open discussion of mistakes without blame, helping us understand the factors influencing these errors, like pressure, environment, and subconscious decision-making. This episode also covers how divers and instructors can reflect on and report errors, find systemic solutions, and avoid jumping to conclusions like "human error," which should be a starting point, not an endpoint, in any investigation.
Original blog: https://www.thehumandiver.com/blog/human-error-or-diver-error-are-they-just-an-easy-way-of-blaming-the-individual
Links: Situation awareness model: https://s3.amazonaws.com/kajabi-storefronts-production/blogs/817/images/sbYcrVK0QVe0CYJ2fYoC_ngcezfVOQw69fnrwH2BI_EndsleyModel.jpg
Diving fatality causes from DAN: http://www.diversalertnetwork.org/files/DivingFatalityCauses.pdf
Instructor who didnât analyse their gas: https://www.divingincidents.org/reports/136
AOW diver continuing diving: https://issuu.com/divermedicandaquaticsafety/docs/divermedicmagazine_issue6
Diving Incident Safety Management System: http://www.divingincidents.org/
Second victim issues: https://www.youtube.com/watch?v=2BsHmwAFPKs
Tags: English, Gareth Lock, Human Error, Human Performance, Just Culture, Safety
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In this episode, we explore the concept of a Just Culture in diving, where learning from mistakes and sharing incidents openly helps improve safety without fear of unfair criticism or blame. Inspired by Human Factors and Ergonomics, which emerged in WWII to address human error in fast-evolving systems, Just Culture highlights that mistakes often result from systemic issues, not individual faults. In diving, many errors go unreported due to fear of judgment, especially on social media, which prevents the community from learning valuable lessons. Just Culture fosters a fair, open environment where divers can learn from errors and incidents, understanding the difference between human error, risky behavior, and recklessness, helping all divers make safer decisions.
Original blog: https://www.thehumandiver.com/blog/we-all-make-errors-let-s-not-judge-those-involved-without-understanding-the-how-it-made-sense
Links: Blog about local rationality: https://www.thehumandiver.com/blog/local-rationality-why-an-old-lady-vandalised-art-and-how-to-improve-diving-safety
Tags: English, Gareth Lock
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In this episode, we discuss how openly sharing failures can lead to safer, more effective diving practices and team connections. Inspired by a diving forum thread called âI Learned About Diving From That,â we explore how sharing mistakes helps others learn without fear of criticism, creating a âJust Culture.â Embracing failure is vital for growth: it strengthens team bonds, encourages personal learning, fosters tolerance, and prepares us for future challenges. By acknowledging our mistakes, we create a safe space for feedback, helping us improve and making every dive a chance to learn and grow. Failure is normal; learning from it is essential.
Original blog: https://www.thehumandiver.com/blog/why-is-it-so-hard-to-talk-about-failure
Links: The Dive Forum: http://www.thediveforum.co.uk/
Tags: English, Diving, Failure, Gareth Lock, Human Factors, Leadership, Scuba Diving
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In this episode, we explore how understanding "local rationality"âthe idea that people make decisions that make sense to them in the momentâcan improve diving safety and team performance. Using the story of a 91-year-old woman who "completed" a crossword art piece in a museum, believing it was interactive, we see how context shapes our actions. This concept is critical in diving, where incidents are often judged in hindsight, ignoring the pressures, norms, and limited information divers faced. By approaching errors with curiosity rather than blame, we can better understand and prevent future mishaps in diving and beyond.
Original blog: https://www.thehumandiver.com/blog/local-rationality-why-an-old-lady-vandalised-art-and-how-to-improve-diving-safety
Links: BBC report about âvandalismâ: http://www.bbc.com/news/world-europe-36796581
Mod 1 CCR bailout: https://www.divingincidents.org/reports/136
Diving with out of date cells: https://cognitasresearch.wordpress.com/2015/05/04/ccr-incident-feb-2013-double-cell-failure-human-factors-inquest-report/
Tags: English, Communication, Decision Making, Gareth Lock, Human Error, Human Factors
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In this episode, we delve into "normalization of deviance"âhow divers, like workers in many fields, can gradually drift from safe practices due to pressures to be more efficient or productive. Often starting with small rule-bending or shortcuts, this drift can increase over time, as divers operate closer to safety limits without realizing the risk. Drawing on examples from high-reliability organizations, we'll discuss strategies for recognizing and counteracting this drift, from clear baseline definitions to fostering environments where divers feel comfortable speaking up about concerns. Finally, we explore the value of critical debriefs to ensure safe practices remain a priority.
Original blog: https://www.thehumandiver.com/blog/being-a-deviant-is-normal
Links: Steve Lewisâ blog: https://decodoppler.wordpress.com/2015/03/04/normalization-of-deviance/
Andy Davisâ blog: http://scubatechphilippines.com/scuba_blog/guy-garman-world-depth-record-fatal-dive/#The_Issue_of_Normalization_of_Deviance
Amalbertiâs papers: http://www.sciencedirect.com/science/article/pii/S092575350000045X
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464877/
Cookâs paper: http://qualitysafety.bmj.com/content/14/2/130.short
Blog about complacency: https://www.thehumandiver.com/blog/complacency-the-silent-killer-but-it-s-not-that-simple
Efficiency thoroughness trade off: http://erikhollnagel.com/ideas/etto-principle/index.html
Tags: English, Gareth Lock, Human Factors, Non-Technical Skills, Normalisation of Deviance, Normalization of Deviance
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In this episode, we explore complacency in technical diving, using the tragic case of Wes Skiles' 2010 rebreather accident as a springboard. Often labeled as the "silent killer," complacency can emerge when divers become overly reliant on their equipment and fail to actively monitor it, especially automated systems like rebreathers. Diving systems, much like any automated setup, require continuous attention and critical monitoring to avoid a gradual drift from safe operating practicesâa concept known as the "normalization of deviance." We discuss the importance of training, shared learning from others' experiences, and maintaining a mindset of proactive failure anticipation, following insights from human factors research.
Original blog: https://www.thehumandiver.com/blog/complacency-the-silent-killer-but-it-s-not-that-simple
Links: Report about Wes Skiles: http://postoncourts.blog.palmbeachpost.com/2016/05/20/pbc-jury-deciding-whether-to-award-widow-of-famed-diver-wes-skiles-25-million/
HFACS: https://www.nifc.gov/fireInfo/fireInfo_documents/humanfactors_classAnly.pdf
Parasuraman et al 2010: http://www.ncbi.nlm.nih.gov/pubmed/21077562
Normalisation of deviance blog: https://www.thehumandiver.com/blog/incompetent-and-unaware-you-don-t-know-what-you-don-t-know
Endsleyâs Situation Awareness model: http://hfs.sagepub.com/content/37/1/32.short?rss=1&ssource=mfc
Bahner et al: http://www.sciencedirect.com/science/article/pii/S1071581908000724
HUDs research: http://www.ncbi.nlm.nih.gov/pubmed/21077562
Pilot missing parked aircraft: http://www.aviation.illinois.edu/avimain/papers/research/pub_pdfs/techreports/05-23.pdf
Tags: English, Gareth Lock
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In this episode, we dive into the Dunning-Kruger effect and how it impacts diver safety. The presentation from TekDiveUSA 2016 emphasizes that humans often overestimate their own knowledge, creating gaps in situational awareness that can lead to dangerous decisions. By understanding cognitive biases, such as outcome and hindsight bias, divers can begin to recognize how easy it is to misjudge risks. Just as in aviation, implementing safety protocols like checklists and open communication within dive teams can improve decision-making. The Human Diver training offers essential human factors skills, enabling divers to better manage complex situations and avoid the complacency that comes from overconfidence.
Original blog: https://www.thehumandiver.com/blog/incompetent-and-unaware-you-don-t-know-what-you-don-t-know
Links: Wingsuit video: https://www.dropbox.com/s/9cs51gbyujce3i6/Wingsuit-small.mp4?dl=1
Digger video: https://www.dropbox.com/s/lmoj32hq6ajgd7h/Digger-Captioned.mp4?dl=1
Selective attention video: https://www.youtube.com/watch?v=IGQmdoK_ZfY&feature=youtu.be
Sidney Dekkerâs videos on Just Culture: https://youtu.be/PVWjgqDANWA
Reading list: https://www.thehumandiver.com/pages/reading-list
Tags: English, Diving, Gareth Lock, Human Factors, Safety
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In this episode, we discuss how complacency and cutting corners can lead to serious diving accidents. We explore how the same mental shortcuts that help us operate efficiently can also cause us to miss critical changes in our environment, leading to dangerous situations. Using examples from aviation and diving, we highlight the importance of situational awareness, monitoring equipment, and questioning decisionsâno matter how experienced you are. We also emphasize the need for open communication, where divers feel comfortable addressing concerns without fear of judgment. The Human Diver training helps develop these essential skills to improve safety and performance in diving.
Original blog: https://www.thehumandiver.com/blog/it-s-the-little-things-that-catch-you-out
Links: C130 accident summary: http://aerossurance.com/safety-management/c130j-control-restriction-crash/
Tags: English, CCR, Diving, Gareth Lock, Human Factors, Safety, Scuba Diving
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In this episode, we explore why Human Factors are crucial in diving, even if you havenât experienced an accident. Drawing from high-risk industries like NASA and aviation, we highlight how human errors often lead to major incidents, even when no technical failures are present. We discuss real-life diving examples where poor communication, peer pressure, or lack of planning led to dangerous situations. By "sweating the small stuff" and embracing constructive feedback, divers can improve teamwork, decision-making, and safety. We also introduce the Human Factors Skills in Diving courses, which teach these vital skills, showing their importance both in diving and other high-performance environments.
Original blog: https://www.thehumandiver.com/blog/what-relevance-does-human-factors-have-to-recreational-and-technical-diving
Links: NASA and the Challenger and Columbia disasters
An Executive Jet crew who forgot to remove the gust lock
Pilot who didnât drain the water from his fuel tanks http://www.kathrynsreport.com/2012/07/experimental-plane-crash-at-sandy-creek.html
Student who bailed out of his CCR https://www.divingincidents.org/reports/136
Instructor diving with out of date cells https://cognitasresearch.wordpress.com/2015/05/04/ccr-incident-feb-2013-double-cell-failure-human-factors-inquest-report/
Recently qualified AOW diver https://issuu.com/divermedicandaquaticsafety/docs/divermedicmagazine_issue6
Even experts make mistakes http://www.telegraph.co.uk/news/uknews/1397693/Wrong-kidney-surgeon-ignored-me-says-student.html
Tags: English, Diving, Gareth Lock, Human Factors, Performance, Safety
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In this episode, we explore the concept of "pre-mortem" or prospective hindsight, a technique that helps teams identify potential reasons for failure before a project begins. Research shows that this approach increases the ability to foresee outcomes by 30%. By imagining a scenario where a project has already failed, team members can share their insights and concerns without the fear of being seen as negative, helping to prevent issues before they occur. This method is highly effective in decision-making and risk management, particularly in high-stakes environments like diving or complex team projects.
Original blog: https://www.thehumandiver.com/blog/how-to-help-correct-the-biases-which-lead-to-poor-decision-making
Links: Sunk cost fallacy: http://youarenotsosmart.com/2011/03/25/the-sunk-cost-fallacy/
Authority gradient: https://www.thehumandiver.com/blog/authority-gradient-why-people-don-t-or-can-t-speak-up
Video from Daniel Kahneman about the âpre-mortemâ: https://vimeo.com/67596631
Hindsight bias: https://en.wikipedia.org/wiki/Hindsight_bias
Outcome bias: https://en.wikipedia.org/wiki/Outcome_bias
Tags: English, Gareth Lock
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In this episode, we discuss the challenges teams face when speaking up, especially in the presence of authority figures. A German research study found that in 72% of cases, team members chose to remain silent even when verbal intervention was necessary, and only 40% of those who did speak up were assertive. Reasons for silence included deference to authority, lack of confidence, and failure to recognize the situationâs urgency. This highlights the need for effective Non-Technical Skills training, which helps individuals practice assertiveness without confrontation, improving safety and communication in high-stakes environments.
Original blog: https://www.thehumandiver.com/blog/authority-gradient-why-people-don-t-or-can-t-speak-up
Links: Tenerife crash 1977: https://en.wikipedia.org/wiki/Tenerife_airport_disaster
Surgeon who removed wrong kidney: http://www.telegraph.co.uk/news/uknews/1398408/Surgeons-who-removed-the-wrong-kidney-are-cleared.html
German research paper: https://www.researchgate.net/publication/231210745_Do_residents_and_nurses_communicate_safety_relevant_concerns_Simulation_study_on_the_influence_of_the_authority_gradient
Improving Anesthetistsâ ability to speak up: http://www.ncbi.nlm.nih.gov/pubmed/26703413
Tags: English, Gareth Lock, Healthcare
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