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Sometimes, individuals with chronic gastritis may not experience any symptoms for years until the inflammation leads to more significant complications like an ulcer or anemia

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Furthermore, most internationally accepted protocols have been heavily criticized (Hammond et al

A think aloud process 68,69 was followed where participants were asked to complete the items while saying out loud what they were thinking, and specifically to note any problematic areas (instructions, items, rating scales) and suggest ways to improve the measure