Pub Date : 2016-04-02DOI: 10.1080/17536146.2016.1230570
R. Chatterjee, S. Hemmings, M. Laupheimer
Objectives: Vitamin D deficiency and non-specific chronic low back pain (NSCLBP) are both highly prevalent conditions that not only affect the individual but the associated absenteeism also impacts the economy. There are a number of theories that support the notion that that low vitamin D may cause back pain. The aims of this review were to (i) determine what clinical evidence exists to demonstrate an association between low vitamin D and chronic non-specific low back; (ii) evaluate the quality and strength of the evidence; (iii) identify areas for future research emerging from the evidence base. Methods: The design of the study was a systematic review where MEDLINE®, sportDISCUS™, EMBASE, and ISI Web of Knowledge databases were searched for studies from inception to February 2016. In addition ‘grey literature’ was searched in Google and Google Scholar. The search was restricted to experimental and observational studies; those published in English; human studies that examined vitamin D and its association with NSCLBP. Study quality was evaluated using the modified Downs & Black (D&B) assessment tool. The level of evidence of each study was assessed using the Oxford Centre for Evidence-based Medicine (OCEBM) levels of evidence tool. Results: One thousand and twelve citations were identified, of which only seven matched the inclusion criteria. Of these, one was a double-blinded randomized controlled trial, two case–control studies, two cross-sectional studies, one case series, and one quasi-experimental (uncontrolled before and after study). The mean modified D&B score was 13/27 (48%) and mean OCEBM score was 3. Five of the seven studies in the review suggested an association between low vitamin D and NSCLBP. Discussion: The existing evidence to show a relationship between low vitamin D and NSCLBP is moderate and so further research is required to prove a definitive association.
目的:维生素D缺乏症和非特异性慢性腰痛(NSCLBP)都是非常普遍的疾病，不仅影响个人，而且相关的缺勤也影响经济。有很多理论支持低维生素D可能导致背部疼痛的观点。本综述的目的是:(i)确定存在哪些临床证据证明低维生素D与慢性非特异性腰背痛之间存在关联;(ii)评估证据的质量和强度;(iii)从证据基础中确定未来研究的领域。方法:本研究采用系统评价设计，检索MEDLINE®、sportDISCUS™、EMBASE和ISI Web of Knowledge数据库，检索从研究开始至2016年2月的研究。此外，在谷歌和谷歌Scholar中搜索了“灰色文献”。搜索仅限于实验和观察性研究;以英文出版的;研究维生素D及其与NSCLBP的关系采用改进的Downs & Black (D&B)评估工具对研究质量进行评估。每项研究的证据水平使用牛津循证医学中心(OCEBM)证据水平工具进行评估。结果:共检索到1212篇文献，其中符合纳入标准的文献只有7篇。其中，一项是双盲随机对照试验，两项病例对照研究，两项横断面研究，一项病例系列研究和一项准实验(研究前后不受控制)。修正D&B平均评分为13/27 (48%)，ocbm平均评分为3。综述中的七项研究中有五项表明低维生素D与NSCLBP之间存在关联。讨论:现有证据显示低维生素D和NSCLBP之间的关系是中等的，因此需要进一步的研究来证明明确的联系。
{"title":"The effect of low vitamin D on chronic non-specific low back pain: A systematic review","authors":"R. Chatterjee, S. Hemmings, M. Laupheimer","doi":"10.1080/17536146.2016.1230570","DOIUrl":"https://doi.org/10.1080/17536146.2016.1230570","url":null,"abstract":"Objectives: Vitamin D deficiency and non-specific chronic low back pain (NSCLBP) are both highly prevalent conditions that not only affect the individual but the associated absenteeism also impacts the economy. There are a number of theories that support the notion that that low vitamin D may cause back pain. The aims of this review were to (i) determine what clinical evidence exists to demonstrate an association between low vitamin D and chronic non-specific low back; (ii) evaluate the quality and strength of the evidence; (iii) identify areas for future research emerging from the evidence base. Methods: The design of the study was a systematic review where MEDLINE®, sportDISCUS™, EMBASE, and ISI Web of Knowledge databases were searched for studies from inception to February 2016. In addition ‘grey literature’ was searched in Google and Google Scholar. The search was restricted to experimental and observational studies; those published in English; human studies that examined vitamin D and its association with NSCLBP. Study quality was evaluated using the modified Downs & Black (D&B) assessment tool. The level of evidence of each study was assessed using the Oxford Centre for Evidence-based Medicine (OCEBM) levels of evidence tool. Results: One thousand and twelve citations were identified, of which only seven matched the inclusion criteria. Of these, one was a double-blinded randomized controlled trial, two case–control studies, two cross-sectional studies, one case series, and one quasi-experimental (uncontrolled before and after study). The mean modified D&B score was 13/27 (48%) and mean OCEBM score was 3. Five of the seven studies in the review suggested an association between low vitamin D and NSCLBP. Discussion: The existing evidence to show a relationship between low vitamin D and NSCLBP is moderate and so further research is required to prove a definitive association.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"38 1","pages":"43 - 50"},"PeriodicalIF":0.0,"publicationDate":"2016-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17536146.2016.1230570","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60243318","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 : 2016-04-02DOI: 10.1080/17536146.2016.1215022
S. Farrell, P. Osmotherly, P. Lau
Vertebral haemangiomas (VHs) are benign vascular lesions of vertebral bodies, and are common incidental findings in imaging, occurring in approximately 10–12% of the adult population.1 These lesions consist of thin-walled blood vessels that pervade the medul-lary cavity between trabecula.2 Typically, VHs are asymptomatic and do not require intervention unless causing neurological compromise.
{"title":"Vertebral haemangioma compared to bony metastasis on magnetic resonance imaging","authors":"S. Farrell, P. Osmotherly, P. Lau","doi":"10.1080/17536146.2016.1215022","DOIUrl":"https://doi.org/10.1080/17536146.2016.1215022","url":null,"abstract":"Vertebral haemangiomas (VHs) are benign vascular lesions of vertebral bodies, and are common incidental findings in imaging, occurring in approximately 10–12% of the adult population.1 These lesions consist of thin-walled blood vessels that pervade the medul-lary cavity between trabecula.2 Typically, VHs are asymptomatic and do not require intervention unless causing neurological compromise.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"38 1","pages":"41 - 42"},"PeriodicalIF":0.0,"publicationDate":"2016-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17536146.2016.1215022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60242984","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 : 2016-01-02DOI: 10.1080/17536146.2015.1110964
C. Haseler, C. Cambray, P. Wheeler
Background: Corticosteroid injections are commonly used in the treatment of pain in osteoarthritis. A question that is frequently asked is ‘how many corticosteroid injections can be used’ and the answers given appear to be empirical. Aim: To determine how many corticosteroid injections should be used in osteoarthritis. Methods: PubMed was used to identify articles using terms appropriate to each heading. We reviewed the clinical course of osteoarthritis with evidence from studies of pain and function, radiology, inflammation, and biomechanics. We reviewed possible pain mechanisms and the evidence for the effects and side effects of corticosteroid injections. The conclusions were drawn from an evaluation of the information presented. Results: The reviews led to a classification of osteoarthritis into four groups: improvement, slow/non-progression (the largest group), rapid progression, and chronic pain, and to an evidence-based recommendation for use of corticosteroid injections in each of the four groups. Conclusion: Corticosteroids should be used in conjunction with the evidence-based recommendations for education, weight loss, and exercise. None are recommended where there is improvement with simple interventions alone, one or two in patients with slow/non-progression, none to one in patients with rapid progression, and in chronic pain two or three a year along with other chronic pain management interventions.
{"title":"Osteoarthritis and the role of corticosteroid injections: The four groups","authors":"C. Haseler, C. Cambray, P. Wheeler","doi":"10.1080/17536146.2015.1110964","DOIUrl":"https://doi.org/10.1080/17536146.2015.1110964","url":null,"abstract":"Background: Corticosteroid injections are commonly used in the treatment of pain in osteoarthritis. A question that is frequently asked is ‘how many corticosteroid injections can be used’ and the answers given appear to be empirical. Aim: To determine how many corticosteroid injections should be used in osteoarthritis. Methods: PubMed was used to identify articles using terms appropriate to each heading. We reviewed the clinical course of osteoarthritis with evidence from studies of pain and function, radiology, inflammation, and biomechanics. We reviewed possible pain mechanisms and the evidence for the effects and side effects of corticosteroid injections. The conclusions were drawn from an evaluation of the information presented. Results: The reviews led to a classification of osteoarthritis into four groups: improvement, slow/non-progression (the largest group), rapid progression, and chronic pain, and to an evidence-based recommendation for use of corticosteroid injections in each of the four groups. Conclusion: Corticosteroids should be used in conjunction with the evidence-based recommendations for education, weight loss, and exercise. None are recommended where there is improvement with simple interventions alone, one or two in patients with slow/non-progression, none to one in patients with rapid progression, and in chronic pain two or three a year along with other chronic pain management interventions.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"38 1","pages":"3 - 9"},"PeriodicalIF":0.0,"publicationDate":"2016-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17536146.2015.1110964","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60242216","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 : 2016-01-02DOI: 10.1080/17536146.2016.1165445
J. Inklebarger, M. Taylor, M. Griffin
Objectives: Osteonecrosis of the hip joint (ONHJ) is a known sequella of dysbaric events in professional divers. Its occurrence in sport divers has been rarely reported in the literature. Such a circumstance may represent a diagnostic challenge to clinicians as a potential dysbaric event may be long forgotten, and ONHJ is not typically associated with sports divers. Methods: This case study identifies the occurrence of osteonecrosis of the hip in a recreational diver, which may be related to a dysbaric event several years prior to the onset of hip joint pain and loss of function. Discussion: Advances in recreational diving gear (technical diving) have allowed for greater depths and dive duration. However, these technological developments may have outpaced awareness of the significantly increased risks of permanent illness. A review of the literature also indicates that there may be inaccuracies in some decompression tables which could unknowingly predispose dysbaric events. As ONHJ carries a high rate of morbidity and may have a variable and delayed presentation, it is recommended that clinicians recognize this differential in recreational divers presenting with joint pain.
{"title":"Osteonecrosis of the femoral head in a recreational diver: Case report","authors":"J. Inklebarger, M. Taylor, M. Griffin","doi":"10.1080/17536146.2016.1165445","DOIUrl":"https://doi.org/10.1080/17536146.2016.1165445","url":null,"abstract":"Objectives: Osteonecrosis of the hip joint (ONHJ) is a known sequella of dysbaric events in professional divers. Its occurrence in sport divers has been rarely reported in the literature. Such a circumstance may represent a diagnostic challenge to clinicians as a potential dysbaric event may be long forgotten, and ONHJ is not typically associated with sports divers. Methods: This case study identifies the occurrence of osteonecrosis of the hip in a recreational diver, which may be related to a dysbaric event several years prior to the onset of hip joint pain and loss of function. Discussion: Advances in recreational diving gear (technical diving) have allowed for greater depths and dive duration. However, these technological developments may have outpaced awareness of the significantly increased risks of permanent illness. A review of the literature also indicates that there may be inaccuracies in some decompression tables which could unknowingly predispose dysbaric events. As ONHJ carries a high rate of morbidity and may have a variable and delayed presentation, it is recommended that clinicians recognize this differential in recreational divers presenting with joint pain.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"38 1","pages":"17 - 20"},"PeriodicalIF":0.0,"publicationDate":"2016-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17536146.2016.1165445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60242350","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 : 2016-01-02DOI: 10.1080/17536146.2016.1173342
Corey M Sobeck, Lichelle Lenk, Sarah E. Knipper, A. Rhoda, Laurie G. Stickler, P. Stephenson
Objectives: Functional Massage (FM) is a therapeutic technique that incorporates joint motion with massage to treat musculotendinous pain and impairments. The purpose of this study was to determine the effectiveness of FM to decrease pain and improve range of motion (ROM) in patients. Methods: A test re-test design was utilized to identify the effects of FM as measured by the numeric pain rating scale (NPRS) and ROM. Twenty patients were treated by one of three participating orthopedic manual physical therapists (OMPT) and data was collected for five sessions. Results: One hundred and five data points collected from the twenty patients included: shoulder (55), knee (40), and ankle (10). The average change in NPRS (1.68) was statistically significant but not clinically significant (change ≥2). The majority of the FM treatments resulted in a positive NPRS change 82/105(78.1%). The average change in ROM (7.08°) was statistically (P < 0.001) and clinically significant (change >4°). Conclusions: FM resulted in statistically significant changes in NPRS and ROM in one treatment session. FM may be a useful treatment option for increasing ROM, and decreasing pain, of the shoulder, knee, and ankle in patients with orthopedic impairments.
{"title":"The effectiveness of functional massage on pain and range of motion measurements in patients with orthopedic impairments of the extremities","authors":"Corey M Sobeck, Lichelle Lenk, Sarah E. Knipper, A. Rhoda, Laurie G. Stickler, P. Stephenson","doi":"10.1080/17536146.2016.1173342","DOIUrl":"https://doi.org/10.1080/17536146.2016.1173342","url":null,"abstract":"Objectives: Functional Massage (FM) is a therapeutic technique that incorporates joint motion with massage to treat musculotendinous pain and impairments. The purpose of this study was to determine the effectiveness of FM to decrease pain and improve range of motion (ROM) in patients. Methods: A test re-test design was utilized to identify the effects of FM as measured by the numeric pain rating scale (NPRS) and ROM. Twenty patients were treated by one of three participating orthopedic manual physical therapists (OMPT) and data was collected for five sessions. Results: One hundred and five data points collected from the twenty patients included: shoulder (55), knee (40), and ankle (10). The average change in NPRS (1.68) was statistically significant but not clinically significant (change ≥2). The majority of the FM treatments resulted in a positive NPRS change 82/105(78.1%). The average change in ROM (7.08°) was statistically (P < 0.001) and clinically significant (change >4°). Conclusions: FM resulted in statistically significant changes in NPRS and ROM in one treatment session. FM may be a useful treatment option for increasing ROM, and decreasing pain, of the shoulder, knee, and ankle in patients with orthopedic impairments.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"38 1","pages":"21 - 25"},"PeriodicalIF":0.0,"publicationDate":"2016-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17536146.2016.1173342","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60242906","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 : 2016-01-02DOI: 10.1080/17536146.2016.1195623
P. Wheeler, C. Tattersall
Background: Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain, most commonly affecting female patients aged 40–60, and which can have a significant impact on patients’ quality of life. Extra-corporeal shockwave therapy (ESWT) alongside a structured rehabilitation programme has been shown in previous research studies to have a significant improvement in patient's levels of pain, although it is unclear if this then leads to improved level of global functioning or activity. This case series examines the change in a range of patient reported outcome measures following shockwave therapy as well as the frequency of self-reported side-effects. Methods: Patients undergoing ESWT for GTPS were identified from case logs from a single NHS clinic. Patients completed a range of validated patient-rated outcome measures at baseline and at subsequent follow-up appointments. These include measures of pain, and measures of local hip functioning (Oxford Hip Score – OHS, Non-Arthritic Hip Score – NAHS), global functioning (EQ-5D-5L), sleep quality (Pittsburgh Sleep Quality Index – PSQI), anxiety and depressive symptoms (Hospital Anxiety and Depression Scale – HADS), and activity levels (International Physical Activity Questionnaire – IPAQ). Results: Forty-five patients who completed ESWT for GTPS were identified; with a median follow-up duration of 189 days. Side-effect incidence was low, with <10% reporting bruising, and no patients withdrew due to side-effects. ‘Average’ and ‘worst’ self-reported pain values improved significantly from baseline at all time-periods studied; 6.3/10 and 8.2/10 to 3.8/10 and 5.4/10 at 3 months, respectively, correlating to an improvement of about a third. At 3 months 63% of patients were either satisfied or very satisfied, and 70% would recommend the procedure, these figures increased at 6 months. Sleep quality, measures of local hip functioning, and depressive symptoms all improved consistently across different time-points; however, activity levels and global health markers showed less evidence of improvement. Conclusions: ESWT is known to be effective in patients with greater trochanteric pain alongside a structured rehabilitation programme, and this case series is in keeping with the available evidence. This series demonstrates benefits across different areas of functioning. In this series, even though pain decreased, physical activity levels did not increase. As staying active has numerous health benefits further targeted intervention to address this alongside the reduction of pain may be required for optimal health outcomes.
{"title":"The role of extra-corporeal shockwave therapy (ESWT) plus rehabilitation for patients with chronic greater trochanteric pain syndrome (GTPS): A case series assessing effects on pain, sleep quality, activity, and functioning","authors":"P. Wheeler, C. Tattersall","doi":"10.1080/17536146.2016.1195623","DOIUrl":"https://doi.org/10.1080/17536146.2016.1195623","url":null,"abstract":"Background: Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain, most commonly affecting female patients aged 40–60, and which can have a significant impact on patients’ quality of life. Extra-corporeal shockwave therapy (ESWT) alongside a structured rehabilitation programme has been shown in previous research studies to have a significant improvement in patient's levels of pain, although it is unclear if this then leads to improved level of global functioning or activity. This case series examines the change in a range of patient reported outcome measures following shockwave therapy as well as the frequency of self-reported side-effects. Methods: Patients undergoing ESWT for GTPS were identified from case logs from a single NHS clinic. Patients completed a range of validated patient-rated outcome measures at baseline and at subsequent follow-up appointments. These include measures of pain, and measures of local hip functioning (Oxford Hip Score – OHS, Non-Arthritic Hip Score – NAHS), global functioning (EQ-5D-5L), sleep quality (Pittsburgh Sleep Quality Index – PSQI), anxiety and depressive symptoms (Hospital Anxiety and Depression Scale – HADS), and activity levels (International Physical Activity Questionnaire – IPAQ). Results: Forty-five patients who completed ESWT for GTPS were identified; with a median follow-up duration of 189 days. Side-effect incidence was low, with <10% reporting bruising, and no patients withdrew due to side-effects. ‘Average’ and ‘worst’ self-reported pain values improved significantly from baseline at all time-periods studied; 6.3/10 and 8.2/10 to 3.8/10 and 5.4/10 at 3 months, respectively, correlating to an improvement of about a third. At 3 months 63% of patients were either satisfied or very satisfied, and 70% would recommend the procedure, these figures increased at 6 months. Sleep quality, measures of local hip functioning, and depressive symptoms all improved consistently across different time-points; however, activity levels and global health markers showed less evidence of improvement. Conclusions: ESWT is known to be effective in patients with greater trochanteric pain alongside a structured rehabilitation programme, and this case series is in keeping with the available evidence. This series demonstrates benefits across different areas of functioning. In this series, even though pain decreased, physical activity levels did not increase. As staying active has numerous health benefits further targeted intervention to address this alongside the reduction of pain may be required for optimal health outcomes.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"16 1","pages":"27 - 35"},"PeriodicalIF":0.0,"publicationDate":"2016-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17536146.2016.1195623","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60243059","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 : 2016-01-02DOI: 10.1179/1753614615Z.000000000115
Tomonori Sato, N. Sato
Osteoarthritis (OA) is the most common degenerative disease affecting the hip (hip OA). It is characterized by symptoms such as stiffness and pain, and results in restricted range of motion, cartilage destruction, decreased joint space width, and reduction in activities and quality of life. However, there is no adequate conservative treatment for hip OA. One of the key factors for managing hip OA is unloading or distracting the joint with traction force. Joint distraction with a surgical procedure has been used to treat OA, mostly in the knee and the ankle joints, and the effects of joint distraction on joint structure and clinical symptoms have been reported. Here, we briefly review OA and then discuss the potential benefit of distraction of the hip joint in management of OA, focusing on conservative methods.
{"title":"Clinical relevance of the hip joint: Part II–Importance of joint distraction","authors":"Tomonori Sato, N. Sato","doi":"10.1179/1753614615Z.000000000115","DOIUrl":"https://doi.org/10.1179/1753614615Z.000000000115","url":null,"abstract":"Osteoarthritis (OA) is the most common degenerative disease affecting the hip (hip OA). It is characterized by symptoms such as stiffness and pain, and results in restricted range of motion, cartilage destruction, decreased joint space width, and reduction in activities and quality of life. However, there is no adequate conservative treatment for hip OA. One of the key factors for managing hip OA is unloading or distracting the joint with traction force. Joint distraction with a surgical procedure has been used to treat OA, mostly in the knee and the ankle joints, and the effects of joint distraction on joint structure and clinical symptoms have been reported. Here, we briefly review OA and then discuss the potential benefit of distraction of the hip joint in management of OA, focusing on conservative methods.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"24 1","pages":"11 - 16"},"PeriodicalIF":0.0,"publicationDate":"2016-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/1753614615Z.000000000115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65717741","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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