Pub Date : 2023-03-16DOI: 10.1177/10541373231163379
Leah McCann Klug
Spiritual care specialists on the palliative care team are uniquely trained in performing spiritual assessments, a skillset necessary for identifying and treating spiritual distress (SD). While the importance of addressing SD as part of whole-person care has been explored in patients with diagnoses such as cancer and heart failure, the prevalence and treatment of SD in patients with dyspnea are not present in the literature. Using valid and reliable measurement tools to assess SD in severe dyspnea could improve patient-centered care at end-of-life, referring patients to spiritual care specialists and incorporating identified needs into the overall care plan. This paper reviews three tools designed to measure SD in patients with dyspnea. One tool, the Spiritual Distress Scale, has the greatest specificity and lowest patient burden. Recommendations for future research include creating and validating a shorter version of the tool to further reduce the burden on dyspneic patients.
{"title":"Spiritual Distress in Patients with Dyspnea: A Review of Measurement Tools","authors":"Leah McCann Klug","doi":"10.1177/10541373231163379","DOIUrl":"https://doi.org/10.1177/10541373231163379","url":null,"abstract":"Spiritual care specialists on the palliative care team are uniquely trained in performing spiritual assessments, a skillset necessary for identifying and treating spiritual distress (SD). While the importance of addressing SD as part of whole-person care has been explored in patients with diagnoses such as cancer and heart failure, the prevalence and treatment of SD in patients with dyspnea are not present in the literature. Using valid and reliable measurement tools to assess SD in severe dyspnea could improve patient-centered care at end-of-life, referring patients to spiritual care specialists and incorporating identified needs into the overall care plan. This paper reviews three tools designed to measure SD in patients with dyspnea. One tool, the Spiritual Distress Scale, has the greatest specificity and lowest patient burden. Recommendations for future research include creating and validating a shorter version of the tool to further reduce the burden on dyspneic patients.","PeriodicalId":39747,"journal":{"name":"Illness Crisis and Loss","volume":"99 1","pages":"736 - 747"},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72953437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-14DOI: 10.1177/10541373231163296
Laura M. Waters
Yearning can best be described as a cognitive-affective process that consists of repetitive counterfactual thoughts in present situations that can elicit positive and negative feelings related to what life would be like if the deceased lived in an alternative reality compounded with frustration and desire to be with them. Yearning is the only emotional response that differentiates bereavement from other life events. How yearning is measured and assessed within the review of literature has been limited and proven problematic based on the assumption that the underlying construct of yearning is homogeneous, whereas yearning is multifaceted and complex. Single-item assessments of such a complex phenomenon are not enough to clinically diagnose and to plan treatment modalities which is required when diagnosed within DSM-TR-5 criteria.
{"title":"Measurement of Yearning in Bereaved Spouses","authors":"Laura M. Waters","doi":"10.1177/10541373231163296","DOIUrl":"https://doi.org/10.1177/10541373231163296","url":null,"abstract":"Yearning can best be described as a cognitive-affective process that consists of repetitive counterfactual thoughts in present situations that can elicit positive and negative feelings related to what life would be like if the deceased lived in an alternative reality compounded with frustration and desire to be with them. Yearning is the only emotional response that differentiates bereavement from other life events. How yearning is measured and assessed within the review of literature has been limited and proven problematic based on the assumption that the underlying construct of yearning is homogeneous, whereas yearning is multifaceted and complex. Single-item assessments of such a complex phenomenon are not enough to clinically diagnose and to plan treatment modalities which is required when diagnosed within DSM-TR-5 criteria.","PeriodicalId":39747,"journal":{"name":"Illness Crisis and Loss","volume":"160 1","pages":"748 - 755"},"PeriodicalIF":0.0,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76558243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-14DOI: 10.1177/10541373231163297
Arlen G Gaines
Teens with intellectual disabilities experience disenfranchised grief, as they are often excluded from death education and rituals. Such exclusion can impact opportunities to understand the concepts of death and process the loss. This paper examines the psychometric properties of the limited existing tools designed to measure the understanding of concepts of death in parentally bereaved teens with intellectual disabilities (ID) who are included in after-death rituals as compared to those not included. A literature search uncovered no tools for the concept of death understanding for teens with ID, but four related tools were examined due to their potential proximal applicability. Though further development would be needed, the EsCoMu Scale and the Concept of Death Questionnaire showed the most potential use for this population. Further research is needed to develop a tool specific to teens with ID that takes into account the developmental, cognitive, and social aspects of their grieving experiences.
{"title":"Understanding the Concepts of Death in Bereaved Teens with Intellectual Disabilities: An Examination of Measurement Tools","authors":"Arlen G Gaines","doi":"10.1177/10541373231163297","DOIUrl":"https://doi.org/10.1177/10541373231163297","url":null,"abstract":"Teens with intellectual disabilities experience disenfranchised grief, as they are often excluded from death education and rituals. Such exclusion can impact opportunities to understand the concepts of death and process the loss. This paper examines the psychometric properties of the limited existing tools designed to measure the understanding of concepts of death in parentally bereaved teens with intellectual disabilities (ID) who are included in after-death rituals as compared to those not included. A literature search uncovered no tools for the concept of death understanding for teens with ID, but four related tools were examined due to their potential proximal applicability. Though further development would be needed, the EsCoMu Scale and the Concept of Death Questionnaire showed the most potential use for this population. Further research is needed to develop a tool specific to teens with ID that takes into account the developmental, cognitive, and social aspects of their grieving experiences.","PeriodicalId":39747,"journal":{"name":"Illness Crisis and Loss","volume":"77 1","pages":"638 - 654"},"PeriodicalIF":0.0,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77374397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-14DOI: 10.1177/10541373231163289
Janna Baker Rogers
Resilience is an emergency management concept that encompasses disaster preparedness, continuity of essential services, and recovery and transformation. Attention to healthcare resilience is growing; research on healthcare resilience has increased since events such as the 2014 Ebola epidemic and the COVID-19 pandemic. However, no studies have been conducted on resilience of hospices, despite a unique patient population and the important role hospices could play in public health emergencies. Quantifying hospice resiliency can aid in planning and response, as well as improving the ability of organizations to transform functionally in response to environmental changes; that is, their transformative capacity. This review examines four measures of resilience that have been applied to the healthcare sector. There are no measures of healthcare resilience that are validated and reliable with respect to the operational profiles of hospices. Further research is necessary to assess and develop valid and reliable measures of hospice resiliency.
{"title":"Exploring the Measurement of Hospice Resilience","authors":"Janna Baker Rogers","doi":"10.1177/10541373231163289","DOIUrl":"https://doi.org/10.1177/10541373231163289","url":null,"abstract":"Resilience is an emergency management concept that encompasses disaster preparedness, continuity of essential services, and recovery and transformation. Attention to healthcare resilience is growing; research on healthcare resilience has increased since events such as the 2014 Ebola epidemic and the COVID-19 pandemic. However, no studies have been conducted on resilience of hospices, despite a unique patient population and the important role hospices could play in public health emergencies. Quantifying hospice resiliency can aid in planning and response, as well as improving the ability of organizations to transform functionally in response to environmental changes; that is, their transformative capacity. This review examines four measures of resilience that have been applied to the healthcare sector. There are no measures of healthcare resilience that are validated and reliable with respect to the operational profiles of hospices. Further research is necessary to assess and develop valid and reliable measures of hospice resiliency.","PeriodicalId":39747,"journal":{"name":"Illness Crisis and Loss","volume":"9 1","pages":"619 - 637"},"PeriodicalIF":0.0,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78704404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-14DOI: 10.1177/10541373231163295
J. Lentz
The incidence of dementia is increasing rapidly with nearly 7 million currently and projected to triple by 2050. As of 2020, there are 53 million informal caregivers. Twenty-four percent of these informal caregivers are caring for persons living with dementia. Informal caregivers experience an exorbitant amount of stress and strain causing decreased quality of life and less energy to provide the care needed as well as personal health issues. Predictions of increased incidence of dementia, as well as concerns for shortages of informal caregiver availability make the concern for caregiver burden a critical issue. Decreasing caregiver burden is a goal of intervention. The palliative care doula (PCD) provides one possible intervention. This paper examines the psychometric measures of five different instruments intended to quantify the level of caregiver burden experienced with and without the intervention of a relationship with a PCD. The most appropriate tool to utilize is the Zarit Burden Interview-12 for this population. Further research is needed to provide pragmatic, patient centered outcomes that will address this public health caregiving crisis.
{"title":"Impact on Caregiver Burden Experienced by Informal Caregivers of Persons Living with Dementia When Supported by a Palliative Care Doula","authors":"J. Lentz","doi":"10.1177/10541373231163295","DOIUrl":"https://doi.org/10.1177/10541373231163295","url":null,"abstract":"The incidence of dementia is increasing rapidly with nearly 7 million currently and projected to triple by 2050. As of 2020, there are 53 million informal caregivers. Twenty-four percent of these informal caregivers are caring for persons living with dementia. Informal caregivers experience an exorbitant amount of stress and strain causing decreased quality of life and less energy to provide the care needed as well as personal health issues. Predictions of increased incidence of dementia, as well as concerns for shortages of informal caregiver availability make the concern for caregiver burden a critical issue. Decreasing caregiver burden is a goal of intervention. The palliative care doula (PCD) provides one possible intervention. This paper examines the psychometric measures of five different instruments intended to quantify the level of caregiver burden experienced with and without the intervention of a relationship with a PCD. The most appropriate tool to utilize is the Zarit Burden Interview-12 for this population. Further research is needed to provide pragmatic, patient centered outcomes that will address this public health caregiving crisis.","PeriodicalId":39747,"journal":{"name":"Illness Crisis and Loss","volume":"140 1","pages":"720 - 735"},"PeriodicalIF":0.0,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79981655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-14DOI: 10.1177/10541373231163771
Valerie J. Vetter
Individuals living with gynecologic cancer frequently experience sexual health problems, although these issues are often not addressed by the medical team. This article offers an overview of different tools available to evaluate sexual health in patients with cancer, and more specifically, gynecologic cancer. A literature search was conducted using the PubMed® search engine. Article titles and abstracts were reviewed for relevancy, with four screening tools ultimately selected for further evaluation. Tools discussed include the European Organisation for Research and Treatment of Cancer Sexual Health Questionnaire (EORTC QLQ-SH22), Female Sexual Function Index (FSFI), Sexual function – Vaginal Changes Questionnaire (SVQ), and the Patient-Reported Outcomes Measurement Information System ® Sexual Function and Satisfaction (PROMIS ® SexFS). While all measurement tools reviewed offer strengths and limitations, this article posits that the PROMIS ® SexFS offers the most promise for both research and clinical use in this population.
{"title":"Screening for Sexual Health Concerns in Patients with Gynecologic Malignancy","authors":"Valerie J. Vetter","doi":"10.1177/10541373231163771","DOIUrl":"https://doi.org/10.1177/10541373231163771","url":null,"abstract":"Individuals living with gynecologic cancer frequently experience sexual health problems, although these issues are often not addressed by the medical team. This article offers an overview of different tools available to evaluate sexual health in patients with cancer, and more specifically, gynecologic cancer. A literature search was conducted using the PubMed® search engine. Article titles and abstracts were reviewed for relevancy, with four screening tools ultimately selected for further evaluation. Tools discussed include the European Organisation for Research and Treatment of Cancer Sexual Health Questionnaire (EORTC QLQ-SH22), Female Sexual Function Index (FSFI), Sexual function – Vaginal Changes Questionnaire (SVQ), and the Patient-Reported Outcomes Measurement Information System ® Sexual Function and Satisfaction (PROMIS ® SexFS). While all measurement tools reviewed offer strengths and limitations, this article posits that the PROMIS ® SexFS offers the most promise for both research and clinical use in this population.","PeriodicalId":39747,"journal":{"name":"Illness Crisis and Loss","volume":"48 1","pages":"671 - 686"},"PeriodicalIF":0.0,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87965608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-14DOI: 10.1177/10541373231163288
C. B. Zogby
Nurse practitioners (NPs) account for one-third of all hospital palliative care (PC) consults, and are prone to burnout and depersonalization (DP). DP threatens personalized communication fundamental to PC. This literature review examines instruments validated to measure burnout and DP. An electronic literature review of instruments previously used to measure burnout and DP was conducted in six databases. Three instruments were included in the review; the Maslach Burnout Inventory (MBI)-Human Service Survey (HSS), the Burnout Assessment Tool (BAT), and the Oldenburg Burnout Inventory (OLBI). All three instruments measure DP or similar constructs and are validated in English, but only the OLBI and the BAT measure burnout with a sum score of the constructs. The OLBI has been validated on a single U.S. population study and as a patient-reported outcome measure (PROM) in Europe. The BAT is the newest instrument and has not been validated on any U.S. population.
{"title":"What is the Rate of Depersonalization and Burnout Among Hospital-Based Palliative Care Nurse Practitioners? A Review of Validated Instruments","authors":"C. B. Zogby","doi":"10.1177/10541373231163288","DOIUrl":"https://doi.org/10.1177/10541373231163288","url":null,"abstract":"Nurse practitioners (NPs) account for one-third of all hospital palliative care (PC) consults, and are prone to burnout and depersonalization (DP). DP threatens personalized communication fundamental to PC. This literature review examines instruments validated to measure burnout and DP. An electronic literature review of instruments previously used to measure burnout and DP was conducted in six databases. Three instruments were included in the review; the Maslach Burnout Inventory (MBI)-Human Service Survey (HSS), the Burnout Assessment Tool (BAT), and the Oldenburg Burnout Inventory (OLBI). All three instruments measure DP or similar constructs and are validated in English, but only the OLBI and the BAT measure burnout with a sum score of the constructs. The OLBI has been validated on a single U.S. population study and as a patient-reported outcome measure (PROM) in Europe. The BAT is the newest instrument and has not been validated on any U.S. population.","PeriodicalId":39747,"journal":{"name":"Illness Crisis and Loss","volume":"32 1","pages":"687 - 703"},"PeriodicalIF":0.0,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87616295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-14DOI: 10.1177/10541373231163260
P. Wright, Joan G. Carpenter
The intense emotional and psychological consequences of pregnancy loss have been studied for decades. With the growing body of literature regarding women's experiences of pregnancy loss, there is an increased need for high quality evidence that underpins perinatal grief and bereavement support interventions. In this paper, we describe and analyze the psychometric properties of existing tools (the Perinatal Grief Scale, the Perinatal Bereavement Scale, the Perinatal Grief Intensity Scale) developed specifically to measure grief following perinatal loss. The psychometric properties of these instruments are presented along with an assessment of their trustworthiness. Of the three perinatal grief instruments, the PGS is the most well-established measure of perinatal grief. The PBS, although promising, has not been as extensively tested as the PGS. The PGIS has compared favorably with the PGS and is also a good choice for use in perinatal bereavement studies despite its shorter history of use and less extensive psychometric testing.
{"title":"A Review of the Psychometrics of Perinatal Grief Instruments","authors":"P. Wright, Joan G. Carpenter","doi":"10.1177/10541373231163260","DOIUrl":"https://doi.org/10.1177/10541373231163260","url":null,"abstract":"The intense emotional and psychological consequences of pregnancy loss have been studied for decades. With the growing body of literature regarding women's experiences of pregnancy loss, there is an increased need for high quality evidence that underpins perinatal grief and bereavement support interventions. In this paper, we describe and analyze the psychometric properties of existing tools (the Perinatal Grief Scale, the Perinatal Bereavement Scale, the Perinatal Grief Intensity Scale) developed specifically to measure grief following perinatal loss. The psychometric properties of these instruments are presented along with an assessment of their trustworthiness. Of the three perinatal grief instruments, the PGS is the most well-established measure of perinatal grief. The PBS, although promising, has not been as extensively tested as the PGS. The PGIS has compared favorably with the PGS and is also a good choice for use in perinatal bereavement studies despite its shorter history of use and less extensive psychometric testing.","PeriodicalId":39747,"journal":{"name":"Illness Crisis and Loss","volume":"11 1","pages":"655 - 670"},"PeriodicalIF":0.0,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76237740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-23DOI: 10.1177/10541373231158755
P. Wright, Marian L Farrell
Parental bereavement is often considered one of the most harrowing life experiences. Yet, little is known about losing an adult child in older age. In this qualitative, descriptive study, nine interviews lasting 45 to 120 minutes were conducted with parents who were 65 years or older at the time of their adult child's death. All interviews were transcribed verbatim and analyzed by two researchers independently. Four main themes were identified: disbelief, injustice, uncertainty, and readjustment. The themes were then compared and contrasted with the extant literature to support validity of the findings. The results have implications for future research and practice.
{"title":"Parental Bereavement in Older age: A Qualitative Descriptive Study","authors":"P. Wright, Marian L Farrell","doi":"10.1177/10541373231158755","DOIUrl":"https://doi.org/10.1177/10541373231158755","url":null,"abstract":"Parental bereavement is often considered one of the most harrowing life experiences. Yet, little is known about losing an adult child in older age. In this qualitative, descriptive study, nine interviews lasting 45 to 120 minutes were conducted with parents who were 65 years or older at the time of their adult child's death. All interviews were transcribed verbatim and analyzed by two researchers independently. Four main themes were identified: disbelief, injustice, uncertainty, and readjustment. The themes were then compared and contrasted with the extant literature to support validity of the findings. The results have implications for future research and practice.","PeriodicalId":39747,"journal":{"name":"Illness Crisis and Loss","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90465726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-17DOI: 10.1177/10541373221148692
Jason Flake, Steven L. Arxer, J. LePage
Veteran incarceration presents numerous social and public health problems, which often include re-incarceration, homelessness, unemployment, and suicide. Contemporary literature on veteran incarceration often relies on quantitative-based data. While this data is useful in certain settings, it often limits our knowledge and understanding of the problem. Our study used qualitative interviews to focus on veteran-centric views, experiences, and behaviors associated with incarceration. Guided by the Life Course perspective, our interviews yielded several novel turning point behaviors. These novel turning point behaviors provide a more in-depth and nuanced understanding of veteran incarceration, blend veteran centric behaviors with known incarceration factors, and provide a glimpse into how these behaviors interact with other known factors, such as homelessness and unemployment. Understanding how veterans give meaning to these turning point behaviors may assist health care providers in altering veteran risk responses and interrupt these pathways to incarceration.
{"title":"Identifying Incarceration Turning Points Through Veteran Lived Experiences","authors":"Jason Flake, Steven L. Arxer, J. LePage","doi":"10.1177/10541373221148692","DOIUrl":"https://doi.org/10.1177/10541373221148692","url":null,"abstract":"Veteran incarceration presents numerous social and public health problems, which often include re-incarceration, homelessness, unemployment, and suicide. Contemporary literature on veteran incarceration often relies on quantitative-based data. While this data is useful in certain settings, it often limits our knowledge and understanding of the problem. Our study used qualitative interviews to focus on veteran-centric views, experiences, and behaviors associated with incarceration. Guided by the Life Course perspective, our interviews yielded several novel turning point behaviors. These novel turning point behaviors provide a more in-depth and nuanced understanding of veteran incarceration, blend veteran centric behaviors with known incarceration factors, and provide a glimpse into how these behaviors interact with other known factors, such as homelessness and unemployment. Understanding how veterans give meaning to these turning point behaviors may assist health care providers in altering veteran risk responses and interrupt these pathways to incarceration.","PeriodicalId":39747,"journal":{"name":"Illness Crisis and Loss","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86512614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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