452:
patients and doctors. Experts hypothesize that more student exposure to the life of physicians via shadowing may prevent prejudices and false assumptions about primary care. This study points out that junior and senior medical students are aware of the drawbacks associated with primary care, such as the relatively low salary, but what is more important to them is their interest in a particular specialty. These students relied less on the known perception of primary care and more on their own personal value that they attached to it. The more exposure that medical students have to primary care, the more likely they are to become interested in it as an invaluable gateway to medical treatment. This data suggests that the combination of earlier introduction to primary care and an emphasis on its value would propel medical students to choose a career in preventative care. Such proposals, however, would require the participation of numerous stakeholders.
448:(MSUCHM) and other scholars detailing what a 2006 to 2008 survey of approximately a thousand students at three different schools found. The experts observed broadly that "contemporary physicians struggle to meet the high expectations set by patients and their profession with limited time and resources." Specifically, results indicated that only 145 survey respondents (14.8%) leaned towards having a career in primary care. Furthermore, 11.2% of first-year students expressed interest in that medical focus in contrast to how 10.8% of second-year students showed interest. In addition, third-year and fourth-year students expressed more interest in having a career in primary care, at 18.3% and 21.0%, respectively.
411:"There's one more group of people, foreign medical graduates, who could theoretically fill in for the missing primary-care providers. The trouble is, they're already doing that. More than a quarter of primary-care doctors currently practicing in the United States have gotten their diplomas abroad. Increasing their numbers would be problematic for both the left (which might object to poaching doctors from developing countries that need them) and the right (which would surely object to recruiting non-Americans to do a job that reliably pulls in six figures, especially when unemployment is high)."
150:
456:
their cost of schooling through scholarships, so that a medical student's selection of a specialty is not swayed by salary. Offering opportunities to become involved in this specialty, while providing financial support, would address two problems of recruiting primary care physicians: it would provide students with more ways to experience what it is like to specialize in preventative care; and it would allow students to take advantage of the opportunities offered by the school, instead of focusing on the financial aspect of medical school.
19:
510:
496:
303:
468:
482:
391:", "remains embedded in American health care and endures as its dominant underlying driver" in a way that "places value on specialized services rather than on primary care". Thus, the whole framework serves as "a crucial factor behind the worsening shortage of primary-care doctors", according to the publication. Specifically,
455:
Increasing medical students’ experience in primary care relies on the participation of stakeholders, including medical schools. They can create initiatives that may include increasing the number of internships revolving around primary care. From a financial perspective, medical schools can alleviate
435:
and other programs make the doctor shortage worse. "Medicare's residency funding was designed around the naĂŻve assumption that private insurers would contribute their fair share to training" such that "funding is based solely on the number of
Medicare patients a hospital sees", according to Niskanen
218:
of medical professionals in the U.S. will generate noticeable effects as time passes. "By 2032, the U.S. population's going to grow by about 10%, but those of us who are age 65 or older, we’re going to grow by about 47%," he has remarked, adding that by "that same year... probably about one-third of
242:
as a barrier to adequate growth in physician supply. In a 2022 article, the organization stated that "edical school graduates typically finish school with about $ 200,000 in medical student-loan debt, which is often seen as an influential factor in specialty choice." The discussion of anticipated
198:
published in a report that the "annual number of
American medical students who go into primary care has dropped by more than half since 1997" to the point where it had gotten "hard to get an appointment with the doctors who remain". The journal also commented that "as many as half of primary-care
451:
In the same study, those senior students rejected the widespread stereotypes about primary care. They did not believe that time constraints in medicine, such as short appointments, lead to poor doctor-patient relationships, which was most likely due to their increased first-hand experience with
188:
This led to an eventual nationwide voluntary medical school moratorium that would last from 1980 to 2005, intended to prevent a surplus of physicians in the U.S. The moratorium called for the halt of the creation of new medical schools and a reduction or freeze of medical school enrollment. The
395:
has asserted that the financial methodology "compensates doctors, clinics, and hospitals based upon number and type of visits involved in a patient's care, creating incentives for unnecessary procedures, excessive clinic appointments, and the mountains of paperwork that have become the bane of
352:
published a 2012 study by
Darrell J. Gaskin, Ph.D. and a team of other analysts that reported how "acial and ethnic disparities in primary care are well documented" given that "isparities in health care may be caused by higher proportions of minorities living in 'medical deserts,' that is,
436:
analyst Robert Orr, with a structure coming about that "shortchanges geographic locations and facilities with fewer elderly patients". This still occurs, in Orr's analysis, "while separate programs exist to deliver funds to children's hospitals and rural clinics, Medicare dwarfs them."
353:
communities with limited health care resources." In short, their "findings indicate that residential segregation matters" as "AfricanAmerican segregation was negatively associated with the availability of physician services." As the U.S. doctor shortage worsens the natures of these
368:
such as "money, power, prestige, and social connectedness" influence medicine across the country. Thus, "those with the most access and control over resources are in a better position to avoid risks, diseases, and the consequences of disease."
176:
On
September 30, 1980, the Graduate Medical Education National Advisory Committee (GMENAC) sent a statement titled "Summary Report of The Graduate Medical Education National Advisory Committee" to the Secretary of the
189:
moratorium was successful, as the number of M.D. annual entrants never surpasses 16,660 (1981) nor did it fall below 15,800 (1989). Additionally, only three new M.D. schools were established during the moratorium.
282:"has a severe physician shortage" to the point that "statistics show the deficit is at least 750 full-time providers, with primary care specialties... the greatest need." A piece published that same month by
439:
Proposed efforts to change the viewpoints of medical students have received academic study. For example, an analysis explored in a
Society of Teachers of Family Medicine (STFM) conference held in 2010 inside
625:
1040:
357:, in their view, the analysts advised policymakers to focus on "xpanding community health centers and subsidies programs for physicians to serve in underserved areas".
253:
itself may deteriorate for certain communities due to the shortage of medical professionals; the potential harm caused by the lack of access to specialty services in
1277:
294:"estimates there are 11.7 physicians per a population of 10,000 in the Buckeye state compared to 38.9 physicians for that same population in a metropolitan area."
1333:
1302:
178:
27:
1312:
1287:
1033:
998:
445:
592:
753:
1430:
1389:
1297:
1026:
267:
argued that the "lack of funding for residency slots to expand the pool of physicians in the U.S. has been an issue for more than two decades."
924:
1328:
1179:
23:
1200:
999:"Improving Access and Efficiency in Primary Care at York Hospital Community Health Center | IHI - Institute for Healthcare Improvement"
1147:
1138:
1415:
1272:
200:
73:
428:
336:
306:
141:(WHO) found in 2006 that "an estimated shortage of almost 4.3 million doctors, midwives, nurses and support workers worldwide".
119:
1292:
1049:
543:
340:
239:
211:
207:
specifically projected a shortage of between 37,800 and 124,000 individuals within the following two decades, approximately.
123:
80:
specifically projected a shortage of between 37,800 and 124,000 individuals within the following two decades, approximately.
1435:
538:
322:
1425:
1068:
332:
115:
219:
active physicians are going to be over age 65, so our physicians— we’re aging as well". Dr. Ransone has highlighted his
1282:
791:
348:
291:
1307:
400:
1211:
553:
533:
250:
83:
51:
39:
22:
These measurements of healthcare service levels for specific areas of the U.S. came out in June 2020 through the
727:
317:
who erected signs such as these, has significantly affected the distribution of healthcare services for decades.
275:
95:
1195:
1169:
1143:
689:
1267:
1216:
1117:
719:
600:
231:
47:
900:
836:
1420:
1085:
388:
957:
Phillips, Dr. Julie; Weismantel, Dr. David; Gold, Dr. Katherine; Schwenk, Dr. Thomas (January 2012).
844:
558:
279:
166:
154:
138:
99:
758:
283:
103:
432:
287:
244:
235:
107:
43:
1368:
785:
Gaskin, Darrell J.; Dinwiddie, Gniesha Y.; Chan, Kitty S.; McCleary, Rachael R. (December 2012).
656:
290:
features a shortage "that's expected to hit rural areas the hardest." The article noted that the
182:
1100:
1090:
441:
328:
271:
111:
1095:
515:
258:
149:
8:
1373:
1107:
1018:
220:
170:
90:
due to such trends, particularly in terms of the lack of access to specialty services in
199:
providers have stopped taking new patients." In addition, a 2010s study released by the
110:
as featuring a shortage "that's expected to hit rural areas the hardest." Mechanisms of
1164:
1133:
1073:
975:
958:
813:
786:
548:
384:
959:"How Do Medical Students View the Work Life of Primary Care and Specialty Physicians?"
360:
American scholars have theorized more broadly that, as detailed in the aforementioned
980:
818:
804:
314:
35:
18:
970:
808:
800:
528:
473:
424:
344:
871:
403:
to enhance the nation's workface, a piece from the general interest news-magazine
1349:
1112:
932:
501:
487:
416:
261:
among U.S. patients. In
December 2021, an article from the financial publication
224:
134:
257:
has garnered specific attention. The AMA has reported shortages already causing
1355:
1078:
925:"Op-Ed: America Can't Fix Its Doctor Shortage without Fixing Federal Financing"
354:
872:"Summary Report Of The Graduate Medical Education National Advisory Committee"
205:
The
Complexities of Physician Supply and Demand: Projections From 2019 to 2034
78:
The
Complexities of Physician Supply and Demand: Projections From 2019 to 2034
1409:
1363:
523:
365:
34:
Concerns of both a current and future shortage of medical doctors due to the
1221:
1206:
984:
822:
185:
at the time), which "estimates a surplus of 70,000 physicians by 1990".
102:
faces "a severe physician shortage". A piece published that same month by
1063:
787:"Residential Segregation and the Availability of Primary Care Physicians"
495:
302:
1249:
1244:
1239:
1234:
1228:
1174:
661:
444:
received wider distribution afterwards, with Dr. Julie
Phillips of the
420:
379:
297:
254:
215:
137:
have occurred in multiple countries besides the U.S. For instance, the
91:
87:
62:
694:
626:"To Address Doctor Shortage, U.S. To Pay For 1,000 New Residencies"
593:"To overcome doctor shortage, get rid of obstacles to primary care"
310:
194:
162:
68:
86:
itself may deteriorate for certain communities inside particular
848:
630:
467:
263:
130:
56:
956:
243:
financial burdens from schooling itself can also result in a
158:
784:
214:(AAFP), Sterling Ransone Jr., M.D., has commented that the
1048:
1278:
American
Association of Colleges of Osteopathic Medicine
720:"Summit examines ways to combat severe doctor shortage"
1303:
Accreditation Council for Continuing Medical Education
274:
inside of the U.S., a September 2022 report from the
1313:
Educational Commission for Foreign Medical Graduates
1288:
Accreditation Council for Graduate Medical Education
463:
298:
Influence of history and effects from discrimination
50:(AMA). The subject has been analyzed as well by the
446:
Michigan State University College of Human Medicine
94:. For instance, a September 2022 report from the
1407:
1298:Commission on Osteopathic College Accreditation
754:"Primary-Care Doctor Shortage Hurts Our Health"
690:"Primary-Care Doctor Shortage Hurts Our Health"
372:
331:in the U.S. affect its national health due to
129:In the broader context of evaluating peoples'
114:in the U.S. affect its national health due to
1034:
24:Health Resources and Services Administration
952:
950:
238:in the U.S., has cited increasing costs of
227:as already affected by these difficulties.
42:have come from multiple entities including
1390:Issues in higher education inside the U.S.
1041:
1027:
901:"The Planning of U.S. Physician Shortages"
687:
590:
974:
812:
1273:Association of American Medical Colleges
947:
780:
778:
776:
751:
714:
712:
654:
619:
617:
301:
201:Association of American Medical Colleges
148:
144:
133:across the whole planet, worries over a
74:Association of American Medical Colleges
72:. In the 2010s, a study released by the
17:
752:Marshall, Micaela (September 1, 2022).
179:Department of Health and Human Services
161:, which serves as the primary teaching
28:Department of Health and Human Services
1431:Medical education in the United States
1408:
1293:Liaison Committee on Medical Education
1050:Medical education in the United States
869:
747:
745:
688:Carmichael, Mary (February 25, 2010).
683:
681:
679:
650:
648:
623:
544:Medical education in the United States
399:Analyzing the possibility of expanded
210:Known for serving as president of the
1022:
773:
709:
614:
586:
584:
582:
580:
578:
576:
574:
212:American Academy of Family Physicians
870:Tarlov, Alvin (September 30, 1980).
657:"The Blind Spot in Medicare for All"
539:Medical deserts in the United States
337:efforts to set people apart based on
323:Medical deserts in the United States
192:In February 2010, the news-magazine
917:
898:
742:
676:
645:
624:Japsen, Bruce (December 17, 2021).
13:
1395:Physician shortage inside the U.S.
1283:National Resident Matching Program
591:Robeznieks, Andis (June 1, 2022).
571:
14:
1447:
292:Northeast Ohio Medical University
1308:American Osteopathic Association
805:10.1111/j.1475-6773.2012.01417.x
508:
494:
480:
466:
431:administrative processes within
396:American doctors’ daily lives."
383:has argued in an article that a
1416:Healthcare in the United States
991:
892:
879:Institute of Education Sciences
655:Reinhart, Eric (May 12, 2022).
554:Physicians in the United States
534:Healthcare in the United States
333:past and current discrimination
240:higher education in the country
116:past and current discrimination
40:physicians in the United States
1170:Doctor of Osteopathic Medicine
1144:International medical graduate
863:
837:"The World Health Report 2006"
829:
377:Socio-political news-magazine
307:Racial segregation in the U.S.
1:
564:
1268:American Medical Association
1118:Continuing medical education
728:University of Hawaiʻi System
601:American Medical Association
276:University of Hawaiʻi System
232:American Medical Association
96:University of Hawaiʻi System
48:American Medical Association
7:
1436:Social problems in medicine
459:
373:Issues and proposed actions
120:efforts to set people apart
10:
1452:
1426:Labor in the United States
1086:Graduate medical education
899:Orr, Robert (2020-09-08).
320:
1382:
1342:
1321:
1260:
1188:
1157:
1139:Osteopathic Medicine (DO)
1126:
1056:
845:World Health Organization
559:Primary care service area
429:U.S. federal government's
389:fee-for-service framework
280:the collection of islands
270:When evaluating specific
167:Miller School of Medicine
155:Jackson Memorial Hospital
139:World Health Organization
100:the collection of islands
26:(HRSA), an agency of the
792:Health Services Research
362:Health Services Research
349:Health Services Research
245:self-fulfilling prophecy
54:in publications such as
1369:William Stewart Halsted
387:in the U.S., with its "
183:Patricia Roberts Harris
847:. 2006. Archived from
759:Spectrum News 1 - Ohio
413:
401:immigration to America
385:market-oriented system
318:
284:Spectrum News 1 - Ohio
173:
104:Spectrum News 1 - Ohio
31:
442:Jacksonville, Florida
427:, has found that the
409:
329:structural inequality
305:
251:Healthcare in America
152:
145:Background and trends
112:structural inequality
84:Healthcare in America
21:
730:. September 30, 2022
516:United States portal
122:based on Americans'
1374:Andrew Taylor Still
1108:Board certification
364:report, aspects of
221:specific discipline
171:University of Miami
52:American news media
44:professional bodies
1334:Specialty colleges
1165:Doctor of Medicine
935:. October 26, 2021
929:NiskanenCenter.org
549:Physician shortage
319:
174:
157:(MJMH) complex in
32:
1421:Medical education
1403:
1402:
1261:Regulatory bodies
341:racial identities
315:Detroit, Michigan
313:such as those in
286:relayed that the
236:professional body
124:racial identities
36:supply and demand
1443:
1043:
1036:
1029:
1020:
1019:
1013:
1012:
1010:
1009:
995:
989:
988:
978:
954:
945:
944:
942:
940:
921:
915:
914:
912:
911:
896:
890:
889:
887:
885:
876:
867:
861:
860:
858:
856:
833:
827:
826:
816:
799:(6): 2353–2376.
782:
771:
770:
768:
766:
749:
740:
739:
737:
735:
716:
707:
706:
704:
702:
685:
674:
673:
671:
669:
652:
643:
642:
640:
638:
621:
612:
611:
609:
607:
588:
529:Health workforce
518:
513:
512:
511:
504:
499:
498:
490:
485:
484:
483:
476:
474:Economics portal
471:
470:
425:Washington, D.C.
345:academic journal
288:Midwestern state
108:Midwestern state
1451:
1450:
1446:
1445:
1444:
1442:
1441:
1440:
1406:
1405:
1404:
1399:
1378:
1350:Abraham Flexner
1338:
1329:Medical schools
1317:
1256:
1184:
1153:
1122:
1052:
1047:
1017:
1016:
1007:
1005:
997:
996:
992:
963:Family Medicine
955:
948:
938:
936:
933:Niskanen Center
923:
922:
918:
909:
907:
905:Niskanen Center
897:
893:
883:
881:
874:
868:
864:
854:
852:
835:
834:
830:
783:
774:
764:
762:
750:
743:
733:
731:
718:
717:
710:
700:
698:
686:
677:
667:
665:
653:
646:
636:
634:
622:
615:
605:
603:
589:
572:
567:
514:
509:
507:
502:Politics portal
500:
493:
488:Medicine portal
486:
481:
479:
472:
465:
462:
417:Niskanen Center
415:A study by the
375:
366:cultural status
335:, particularly
325:
309:, expressed by
300:
255:rural locations
225:family medicine
147:
135:doctor shortage
118:, particularly
92:rural locations
12:
11:
5:
1449:
1439:
1438:
1433:
1428:
1423:
1418:
1401:
1400:
1398:
1397:
1392:
1386:
1384:
1380:
1379:
1377:
1376:
1371:
1366:
1361:
1360:
1359:
1356:Flexner Report
1346:
1344:
1340:
1339:
1337:
1336:
1331:
1325:
1323:
1319:
1318:
1316:
1315:
1310:
1305:
1300:
1295:
1290:
1285:
1280:
1275:
1270:
1264:
1262:
1258:
1257:
1255:
1254:
1253:
1252:
1247:
1242:
1237:
1226:
1225:
1224:
1219:
1214:
1209:
1198:
1192:
1190:
1186:
1185:
1183:
1182:
1177:
1172:
1167:
1161:
1159:
1155:
1154:
1152:
1151:
1141:
1136:
1130:
1128:
1124:
1123:
1121:
1120:
1115:
1110:
1105:
1104:
1103:
1098:
1093:
1083:
1082:
1081:
1079:Sub-internship
1076:
1069:Medical school
1066:
1060:
1058:
1054:
1053:
1046:
1045:
1038:
1031:
1023:
1015:
1014:
990:
946:
916:
891:
862:
828:
772:
741:
708:
675:
644:
613:
569:
568:
566:
563:
562:
561:
556:
551:
546:
541:
536:
531:
526:
520:
519:
505:
491:
477:
461:
458:
407:has reported,
374:
371:
327:Mechanisms of
299:
296:
278:reported that
203:(AAMC) titled
146:
143:
106:described the
76:(AAMC) titled
9:
6:
4:
3:
2:
1448:
1437:
1434:
1432:
1429:
1427:
1424:
1422:
1419:
1417:
1414:
1413:
1411:
1396:
1393:
1391:
1388:
1387:
1385:
1381:
1375:
1372:
1370:
1367:
1365:
1364:William Osler
1362:
1358:
1357:
1353:
1352:
1351:
1348:
1347:
1345:
1341:
1335:
1332:
1330:
1327:
1326:
1324:
1320:
1314:
1311:
1309:
1306:
1304:
1301:
1299:
1296:
1294:
1291:
1289:
1286:
1284:
1281:
1279:
1276:
1274:
1271:
1269:
1266:
1265:
1263:
1259:
1251:
1248:
1246:
1243:
1241:
1238:
1236:
1232:
1231:
1230:
1227:
1223:
1220:
1218:
1215:
1213:
1210:
1208:
1204:
1203:
1202:
1199:
1197:
1194:
1193:
1191:
1187:
1181:
1178:
1176:
1173:
1171:
1168:
1166:
1163:
1162:
1160:
1156:
1149:
1145:
1142:
1140:
1137:
1135:
1134:Medicine (MD)
1132:
1131:
1129:
1125:
1119:
1116:
1114:
1111:
1109:
1106:
1102:
1099:
1097:
1094:
1092:
1089:
1088:
1087:
1084:
1080:
1077:
1075:
1072:
1071:
1070:
1067:
1065:
1062:
1061:
1059:
1055:
1051:
1044:
1039:
1037:
1032:
1030:
1025:
1024:
1021:
1004:
1000:
994:
986:
982:
977:
972:
968:
964:
960:
953:
951:
934:
930:
926:
920:
906:
902:
895:
880:
873:
866:
851:on 2006-12-02
850:
846:
842:
838:
832:
824:
820:
815:
810:
806:
802:
798:
794:
793:
788:
781:
779:
777:
761:
760:
755:
748:
746:
729:
725:
721:
715:
713:
697:
696:
691:
684:
682:
680:
664:
663:
658:
651:
649:
633:
632:
627:
620:
618:
602:
598:
594:
587:
585:
583:
581:
579:
577:
575:
570:
560:
557:
555:
552:
550:
547:
545:
542:
540:
537:
535:
532:
530:
527:
525:
524:Health policy
522:
521:
517:
506:
503:
497:
492:
489:
478:
475:
469:
464:
457:
453:
449:
447:
443:
437:
434:
430:
426:
423:based out of
422:
418:
412:
408:
406:
402:
397:
394:
390:
386:
382:
381:
370:
367:
363:
358:
356:
351:
350:
346:
342:
338:
334:
330:
324:
316:
312:
308:
304:
295:
293:
289:
285:
281:
277:
273:
268:
266:
265:
260:
256:
252:
248:
246:
241:
237:
233:
228:
226:
222:
217:
213:
208:
206:
202:
197:
196:
190:
186:
184:
180:
172:
168:
164:
160:
156:
151:
142:
140:
136:
132:
127:
125:
121:
117:
113:
109:
105:
101:
97:
93:
89:
85:
81:
79:
75:
71:
70:
65:
64:
59:
58:
53:
49:
45:
41:
37:
29:
25:
20:
16:
1394:
1354:
1006:. Retrieved
1002:
993:
966:
962:
937:. Retrieved
928:
919:
908:. Retrieved
904:
894:
882:. Retrieved
878:
865:
853:. Retrieved
849:the original
840:
831:
796:
790:
763:. Retrieved
757:
732:. Retrieved
723:
699:. Retrieved
693:
666:. Retrieved
660:
635:. Retrieved
629:
604:. Retrieved
597:AMA-ASSN.org
596:
454:
450:
438:
414:
410:
404:
398:
392:
378:
376:
361:
359:
347:
326:
269:
262:
249:
229:
216:demographics
209:
204:
193:
191:
187:
175:
128:
82:
77:
67:
61:
55:
46:such as the
33:
15:
1064:Pre-medical
1003:www.ihi.org
969:(1): 7–13.
765:October 16,
734:October 16,
339:Americans'
98:found that
88:U.S. states
1410:Categories
1180:Comparison
1101:Fellowship
1091:Internship
1008:2022-10-30
939:October 8,
910:2023-06-10
855:October 8,
724:Hawaii.edu
701:October 7,
668:October 7,
662:The Nation
637:October 7,
606:October 7,
565:References
421:think tank
393:The Nation
380:The Nation
321:See also:
63:The Nation
1343:Reformers
1113:Licensure
1096:Residency
1074:Clerkship
355:'deserts'
311:activists
234:(AMA), a
1127:Pathways
985:22241335
823:22524264
695:Newsweek
460:See also
433:Medicare
405:Newsweek
195:Newsweek
165:for the
163:hospital
69:Newsweek
1233:Level:
1158:Degrees
976:4120645
884:June 9,
841:WHO.int
814:3416972
169:at the
1383:Topics
1229:COMLEX
1205:Step:
1175:MD–PhD
1057:Stages
983:
973:
821:
811:
631:Forbes
343:. The
272:states
264:Forbes
259:stress
131:health
66:, and
57:Forbes
1322:Lists
1201:USMLE
1189:Exams
875:(PDF)
159:Miami
30:(HHS)
1196:MCAT
1148:MBBS
981:PMID
941:2022
886:2023
857:2022
819:PMID
767:2022
736:2022
703:2022
670:2022
639:2022
608:2022
419:, a
230:The
153:The
38:for
1245:2PE
1240:2CE
1217:2CS
1212:2CK
971:PMC
809:PMC
801:doi
223:of
1412::
1001:.
979:.
967:44
965:.
961:.
949:^
931:.
927:.
903:.
877:.
843:.
839:.
817:.
807:.
797:47
795:.
789:.
775:^
756:.
744:^
726:.
722:.
711:^
692:.
678:^
659:.
647:^
628:.
616:^
599:.
595:.
573:^
247:.
126:.
60:,
1250:3
1235:1
1222:3
1207:1
1150:)
1146:(
1042:e
1035:t
1028:v
1011:.
987:.
943:.
913:.
888:.
859:.
825:.
803::
769:.
738:.
705:.
672:.
641:.
610:.
181:(
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
