Pub Date : 2023-06-11DOI: 10.1080/19315864.2023.2223546
C. Roberts, Ashleigh H. Avina, F. Symons
{"title":"A Qualitative Analysis of Family Caregiver Experiences Accessing Treatment for Self-Injurious Behavior in Individuals with Intellectual and Developmental Disabilities","authors":"C. Roberts, Ashleigh H. Avina, F. Symons","doi":"10.1080/19315864.2023.2223546","DOIUrl":"https://doi.org/10.1080/19315864.2023.2223546","url":null,"abstract":"","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78956597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-11DOI: 10.1080/19315864.2023.2223543
Lien-Chung Wei
Dear Editor, I recently read with great interest the article, “The Use of Medication for Challenging Behaviors in People with Intellectual Disabilities: The Direct Care Providers’ Perspective” (Deb et al., 2023). As a psychiatrist based in Taiwan, I am responsible for a medical team that cares for 66 acute psychiatric patients, some of whom have intellectual disabilities. I would like to commend the authors for their insightful work and share some reflections on the challenges I face in clinical practice, including recent developments concerning attention deficit hyperactivity disorder (ADHD). In my 20 years of experience as a psychiatrist, I have often hesitated to prescribe medication for challenging behaviors in individuals with intellectual disabilities. Many of these patients exhibit behavioral issues rather than psychiatric symptoms, such as hallucinations or delusions. Consequently, the use of medication is sometimes considered a form of chemical restraint, a notion that Deb et al. (2023) also highlight. Deciding on the appropriate type and dosage of medication has always been a critical consideration for me. I typically prescribe haloperidol, a traditional antipsychotic medication, and benzodiazepines for their sedative effects. Although haloperidol is known to cause extrapyramidal symptoms (EPS), I have found it to be relatively safe throughout my years of clinical practice, leading me to prefer traditional medications. Deb et al. (2023) emphasize the need for a holistic approach and greater information on medications, their indications, and side effects. They also highlight the importance of involving individuals with intellectual disabilities and their families in shared decision-making. These findings prompt me to reevaluate my approach to managing challenging behaviors in people with intellectual disabilities, striving to better inform myself and collaborate with care providers, families, and the individuals themselves. In recent years, public awareness of ADHD has increased in Taiwan. Family members and educators of individuals with intellectual disabilities now sometimes express concerns about inattention and request ADHD medications, such as methylphenidate. This emerging issue was not as prevalent 20 years ago when I began my career as a psychiatrist. Deciding whether to prescribe these medications and determining which ones are most suitable presents a serious challenge for clinicians like myself. JOURNAL OF MENTAL HEALTH RESEARCH IN INTELLECTUAL DISABILITIES 2023, VOL. 16, NO. 3, 275–276 https://doi.org/10.1080/19315864.2023.2223543
亲爱的编辑，我最近怀着极大的兴趣读了一篇文章，“使用药物治疗智障人士的挑战行为:直接护理提供者的观点”(Deb et al.， 2023)。作为台湾的精神科医生，我负责一个医疗团队，照顾66名急性精神病患者，其中一些人有智力障碍。我想赞扬作者们富有洞察力的工作，并分享一些我在临床实践中面临的挑战，包括最近关于注意缺陷多动障碍(ADHD)的发展。在我20年的精神科医生经验中，我经常犹豫是否要为智障人士的挑战性行为开药。许多患者表现出行为问题，而不是精神症状，如幻觉或妄想。因此，药物的使用有时被认为是一种化学约束，Deb等人(2023)也强调了这一观点。决定合适的药物类型和剂量对我来说一直是一个关键的考虑因素。我通常会开氟哌啶醇，一种传统的抗精神病药物，以及苯二氮卓类药物，因为它们有镇静作用。虽然已知氟哌啶醇会引起锥体外系症状(EPS)，但在我多年的临床实践中，我发现它相对安全，这使我更喜欢传统药物。Deb等人(2023)强调需要全面的方法和更多关于药物、其适应症和副作用的信息。他们还强调了让智障人士及其家庭参与共同决策的重要性。这些发现促使我重新评估我管理智障人士具有挑战性行为的方法，努力更好地了解自己，并与护理人员、家庭和个人自己合作。近年来，台湾公众对ADHD的认识有所提高。智障人士的家庭成员和教育工作者现在有时会表达对注意力不集中的担忧，并要求服用多动症药物，如哌醋甲酯。20年前，当我开始自己的精神科医生生涯时，这个新出现的问题还没有那么普遍。对于像我这样的临床医生来说，决定是否开这些药，以及确定哪种药最合适，是一个严峻的挑战。《智障心理健康研究杂志》2023年第16卷第16期。3,275 - 276 https://doi.org/10.1080/19315864.2023.2223543
{"title":"The Use of Medication for Challenging Behaviors in People with Intellectual Disabilities: Reflections and Evolving Challenges from a Taiwanese Psychiatrist","authors":"Lien-Chung Wei","doi":"10.1080/19315864.2023.2223543","DOIUrl":"https://doi.org/10.1080/19315864.2023.2223543","url":null,"abstract":"Dear Editor, I recently read with great interest the article, “The Use of Medication for Challenging Behaviors in People with Intellectual Disabilities: The Direct Care Providers’ Perspective” (Deb et al., 2023). As a psychiatrist based in Taiwan, I am responsible for a medical team that cares for 66 acute psychiatric patients, some of whom have intellectual disabilities. I would like to commend the authors for their insightful work and share some reflections on the challenges I face in clinical practice, including recent developments concerning attention deficit hyperactivity disorder (ADHD). In my 20 years of experience as a psychiatrist, I have often hesitated to prescribe medication for challenging behaviors in individuals with intellectual disabilities. Many of these patients exhibit behavioral issues rather than psychiatric symptoms, such as hallucinations or delusions. Consequently, the use of medication is sometimes considered a form of chemical restraint, a notion that Deb et al. (2023) also highlight. Deciding on the appropriate type and dosage of medication has always been a critical consideration for me. I typically prescribe haloperidol, a traditional antipsychotic medication, and benzodiazepines for their sedative effects. Although haloperidol is known to cause extrapyramidal symptoms (EPS), I have found it to be relatively safe throughout my years of clinical practice, leading me to prefer traditional medications. Deb et al. (2023) emphasize the need for a holistic approach and greater information on medications, their indications, and side effects. They also highlight the importance of involving individuals with intellectual disabilities and their families in shared decision-making. These findings prompt me to reevaluate my approach to managing challenging behaviors in people with intellectual disabilities, striving to better inform myself and collaborate with care providers, families, and the individuals themselves. In recent years, public awareness of ADHD has increased in Taiwan. Family members and educators of individuals with intellectual disabilities now sometimes express concerns about inattention and request ADHD medications, such as methylphenidate. This emerging issue was not as prevalent 20 years ago when I began my career as a psychiatrist. Deciding whether to prescribe these medications and determining which ones are most suitable presents a serious challenge for clinicians like myself. JOURNAL OF MENTAL HEALTH RESEARCH IN INTELLECTUAL DISABILITIES 2023, VOL. 16, NO. 3, 275–276 https://doi.org/10.1080/19315864.2023.2223543","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"340 1","pages":"275 - 276"},"PeriodicalIF":2.5,"publicationDate":"2023-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76383517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-16DOI: 10.1080/19315864.2023.2214096
J. Kramer, Joan B. Beasley, Andrea Caoili, Tawara D. Goode, Fiorella Guerrero, Annabelle Klein, Elizabeth Grosso, Elizabeth Kennelly-Smith
ABSTRACT Introduction Quality services for persons with intellectual and developmental disabilities and mental health needs (IDD-MH) requires timely access to services that are responsive to their needs and preferences. This study explores virtual service delivery from the perspectives of family caregivers of persons IDD-MH during the onset of the COVID-19 pandemic. Methods Recorded clinical interviews from 577 family caregivers, collected as part of START (Systemic, Therapeutic, Assessment, Resources, and Treatment) service implementation between March and July 2020, were retrospectively analyzed using a qualitative content analysis approach. Results Four factors influenced quality: accessibility of teleservices for persons with IDD-MH; confluence of demands on the caregiver setting; telecommunications infrastructure; and adaptability of services. Perceptions fluctuated with the interaction of these factors. Conclusions While many may benefit from teleservices during future public health emergencies, providers should consider individual, family, community, and service system factors to ensure teleservice access, appropriateness, and accountability for family caregivers of persons with IDD-MH.
{"title":"Caregiver Experiences with Teleservices for People with Intellectual and Developmental Disabilities and Mental Health Needs During the Onset of COVID-19","authors":"J. Kramer, Joan B. Beasley, Andrea Caoili, Tawara D. Goode, Fiorella Guerrero, Annabelle Klein, Elizabeth Grosso, Elizabeth Kennelly-Smith","doi":"10.1080/19315864.2023.2214096","DOIUrl":"https://doi.org/10.1080/19315864.2023.2214096","url":null,"abstract":"ABSTRACT Introduction Quality services for persons with intellectual and developmental disabilities and mental health needs (IDD-MH) requires timely access to services that are responsive to their needs and preferences. This study explores virtual service delivery from the perspectives of family caregivers of persons IDD-MH during the onset of the COVID-19 pandemic. Methods Recorded clinical interviews from 577 family caregivers, collected as part of START (Systemic, Therapeutic, Assessment, Resources, and Treatment) service implementation between March and July 2020, were retrospectively analyzed using a qualitative content analysis approach. Results Four factors influenced quality: accessibility of teleservices for persons with IDD-MH; confluence of demands on the caregiver setting; telecommunications infrastructure; and adaptability of services. Perceptions fluctuated with the interaction of these factors. Conclusions While many may benefit from teleservices during future public health emergencies, providers should consider individual, family, community, and service system factors to ensure teleservice access, appropriateness, and accountability for family caregivers of persons with IDD-MH.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"118 1","pages":"186 - 204"},"PeriodicalIF":2.5,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87970508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-11DOI: 10.1080/19315864.2023.2198491
Heather H. Kelley, T. Aller, Matthew Wappett
{"title":"A Systematic Review of Mental Health Focused Training Programs for Direct Support Professionals Working with Individuals with Intellectual and Developmental Disabilities","authors":"Heather H. Kelley, T. Aller, Matthew Wappett","doi":"10.1080/19315864.2023.2198491","DOIUrl":"https://doi.org/10.1080/19315864.2023.2198491","url":null,"abstract":"","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"250 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76341108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-23DOI: 10.1080/19315864.2023.2192689
N. Edwards, C. Franklin, J. King, Hanna Watling
{"title":"Australian Psychiatrists and Trainee Psychiatrists’ Perceptions of Chemical Restraint of Adults with Intellectual Disability","authors":"N. Edwards, C. Franklin, J. King, Hanna Watling","doi":"10.1080/19315864.2023.2192689","DOIUrl":"https://doi.org/10.1080/19315864.2023.2192689","url":null,"abstract":"","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"75 7","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72466488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-22DOI: 10.1080/19315864.2023.2192691
S. Deb, B. Limbu, G. Unwin, T. Weaver
ABSTRACT Background Overmedication of people with intellectual disabilities, particularly when psychotropic medications are used for challenging behavior (CB) in the absence of a psychiatric disorder, is a significant public health concern. Support staff play a pivotal role in influencing the prescribing process. Staff views and attitudes toward medication use for CB are therefore of paramount importance. Method We have conducted four focus groups involving support staff (n = 8), home managers (n = 5) and trainers (n = 3), two of which primarily explored participants’ experiences and views on using medication for CB and medication withdrawal. Results Some participants felt medication use was justified, but others saw that as a form of chemical restraint. Most agreed that polypharmacy of psychotropics might lead to side effects. Some acknowledged the lack of shared decision-making involving people with intellectual disabilities and their families. There was universal anxiety about withdrawing the medication. Conclusions All agreed on the need for more medication-related information.
{"title":"The Use of Medication for Challenging Behaviors in People with Intellectual Disabilities: The Direct Care Providers’ Perspective","authors":"S. Deb, B. Limbu, G. Unwin, T. Weaver","doi":"10.1080/19315864.2023.2192691","DOIUrl":"https://doi.org/10.1080/19315864.2023.2192691","url":null,"abstract":"ABSTRACT Background Overmedication of people with intellectual disabilities, particularly when psychotropic medications are used for challenging behavior (CB) in the absence of a psychiatric disorder, is a significant public health concern. Support staff play a pivotal role in influencing the prescribing process. Staff views and attitudes toward medication use for CB are therefore of paramount importance. Method We have conducted four focus groups involving support staff (n = 8), home managers (n = 5) and trainers (n = 3), two of which primarily explored participants’ experiences and views on using medication for CB and medication withdrawal. Results Some participants felt medication use was justified, but others saw that as a form of chemical restraint. Most agreed that polypharmacy of psychotropics might lead to side effects. Some acknowledged the lack of shared decision-making involving people with intellectual disabilities and their families. There was universal anxiety about withdrawing the medication. Conclusions All agreed on the need for more medication-related information.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"78 2 1","pages":"253 - 274"},"PeriodicalIF":2.5,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88043932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-07DOI: 10.1080/19315864.2023.2183292
A. Schwartz, E. S. Rogers
{"title":"Exploring the impact of mental health symptoms in the workplace and supportive accommodations for young adults with intellectual/developmental disabilities and co-occurring mental health conditions","authors":"A. Schwartz, E. S. Rogers","doi":"10.1080/19315864.2023.2183292","DOIUrl":"https://doi.org/10.1080/19315864.2023.2183292","url":null,"abstract":"","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"8 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73730565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-06DOI: 10.1080/19315864.2023.2169420
María Inmaculada Fernández-Ávalos, M. Fernández-Alcántara, F. Cruz-Quintana, O. Turnbull, R. Ferrer-Cascales, M. N. Pérez-Marfil
ABSTRACT Introduction Like the broader population, people with intellectual disability (ID) experience the process of grief after loss of a loved one. However, there are a series of risk factors characteristic of this population that can hinder the development of adaptive grief, including cognitive and affective aspects. The objective of this study was to evaluate the effectiveness of a brief intervention program in people with ID to improve understanding of the concept of death, the grief processes, and adaptive attitudes. Method A mixed method design that included a controlled, randomized research design, was used. A total of 38 people with ID participated. The variables measured were: grief, biological and cognitive concept of death. Results The program significantly increased understanding in two dimensions of the concept of death, Inevitability and Universality, and demonstrated a greater understanding and healthier attitudes regarding death and grief. Conclusions It is recommended that, in future research studies, education on death be worked as early as possible in people with ID, in order to prevent future pathological grief.
{"title":"Coping with Death and Bereavement: A Proactive Intervention Program for Adults with Intellectual Disability","authors":"María Inmaculada Fernández-Ávalos, M. Fernández-Alcántara, F. Cruz-Quintana, O. Turnbull, R. Ferrer-Cascales, M. N. Pérez-Marfil","doi":"10.1080/19315864.2023.2169420","DOIUrl":"https://doi.org/10.1080/19315864.2023.2169420","url":null,"abstract":"ABSTRACT Introduction Like the broader population, people with intellectual disability (ID) experience the process of grief after loss of a loved one. However, there are a series of risk factors characteristic of this population that can hinder the development of adaptive grief, including cognitive and affective aspects. The objective of this study was to evaluate the effectiveness of a brief intervention program in people with ID to improve understanding of the concept of death, the grief processes, and adaptive attitudes. Method A mixed method design that included a controlled, randomized research design, was used. A total of 38 people with ID participated. The variables measured were: grief, biological and cognitive concept of death. Results The program significantly increased understanding in two dimensions of the concept of death, Inevitability and Universality, and demonstrated a greater understanding and healthier attitudes regarding death and grief. Conclusions It is recommended that, in future research studies, education on death be worked as early as possible in people with ID, in order to prevent future pathological grief.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"45 1","pages":"339 - 362"},"PeriodicalIF":2.5,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75398631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-03DOI: 10.1080/19315864.2023.2169421
D. Mcadam
{"title":"Review of Self-Injurious Behaviors in Individuals with Neurodevelopmental Conditions","authors":"D. Mcadam","doi":"10.1080/19315864.2023.2169421","DOIUrl":"https://doi.org/10.1080/19315864.2023.2169421","url":null,"abstract":"","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"5 1","pages":"162 - 163"},"PeriodicalIF":2.5,"publicationDate":"2023-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88785143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-30DOI: 10.1080/19315864.2022.2149909
Natalie Werner, Pia Bienstein
ABSTRACT Background Understanding the operant function of self-injurious behavior in autistic individuals is imperative to understanding its etiology and designing effective prevention strategies. Methods We conducted a postal survey of residential care facilities including two functional assessment tools: QABF and IfES. Questionnaires for N = 178 residents were returned. Results For 21.2% a single, and for 62.9% multiple functions were identified by the QABF, with the most frequent function being escape (51.8%). The IfES identified unable to cope with a situation as primary antecedent for 39.8% of the residents. Non-vocal individuals presented a higher number of functions and had overall higher subscale scores. Conclusion The study was the first to investigate single and multiple functions of SIB within a large sample of autistic adults. Results suggest that multiple functions of SIB are common with negative reinforcement contingencies being most important. Results have to be interpreted with caution due to psychometric limitations of the instruments used.
{"title":"Multiple and Single Functions of Self-Injurious Behavior in Autistic Adults with an Intellectual Disability","authors":"Natalie Werner, Pia Bienstein","doi":"10.1080/19315864.2022.2149909","DOIUrl":"https://doi.org/10.1080/19315864.2022.2149909","url":null,"abstract":"ABSTRACT Background Understanding the operant function of self-injurious behavior in autistic individuals is imperative to understanding its etiology and designing effective prevention strategies. Methods We conducted a postal survey of residential care facilities including two functional assessment tools: QABF and IfES. Questionnaires for N = 178 residents were returned. Results For 21.2% a single, and for 62.9% multiple functions were identified by the QABF, with the most frequent function being escape (51.8%). The IfES identified unable to cope with a situation as primary antecedent for 39.8% of the residents. Non-vocal individuals presented a higher number of functions and had overall higher subscale scores. Conclusion The study was the first to investigate single and multiple functions of SIB within a large sample of autistic adults. Results suggest that multiple functions of SIB are common with negative reinforcement contingencies being most important. Results have to be interpreted with caution due to psychometric limitations of the instruments used.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"1 1","pages":"314 - 338"},"PeriodicalIF":2.5,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90193327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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