African Journal of Primary Health Care & Family Medicine最新文献

{"title":"Barriers and facilitators to primary care for people living with HIV and diabetes in Harare.","authors":"Rumbidzai Chireshe, Keshena Naidoo, Tawanda Manyangadze","doi":"10.4102/phcfm.v16i1.4603","DOIUrl":"10.4102/phcfm.v16i1.4603","url":null,"abstract":"<p><strong>Background: </strong> People living with human immunodeficiency virus (HIV) and comorbid diabetes mellitus (DM) face significant challenges owing to the complex interplay between these chronic conditions and the need for comprehensive and integrated care. Service availability and readiness for primary care are essential for the health of individuals and populations.</p><p><strong>Aim: </strong> This study aimed to explore barriers and facilitators to the provision of care to the patients with HIV and T2DM comorbidity.</p><p><strong>Setting: </strong> The study was conducted at Primary health centres in Harare, Zimbabwe.</p><p><strong>Methods: </strong> A mixed-methods design was applied.</p><p><strong>Results: </strong> An audit of primary care facilities identified that there was adequate infrastructure and equipment for HIV and T2DM diagnosis and treatment. However, there are gaps in the availability of essential medicines and supplies, such as test strips for blood glucose monitoring. The assessment also showed that the centres had a chronic shortage of healthcare providers, including doctors, nurses and counsellors, and there was a need for additional training and support for healthcare providers in the management of HIV and T2DM.</p><p><strong>Conclusion: </strong> The study concludes that the delivery of health services to patients with HIV and T2DM at primary care centres in Harare, Zimbabwe, faces significant challenges. Suggestions included improved resource allocation and multisectoral collaboration to improve the delivery of healthcare services.Contribution: The research contributes insight into disparities between urban and rural primary care facilities in providing services, emphasizing the need for targeted interventions to bridge gaps and enhance care quality.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e9"},"PeriodicalIF":1.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary healthcare nurses' experiences in managing chronic diseases during COVID-19 in the North West province.","authors":"Sheillah H Mboweni","doi":"10.4102/phcfm.v16i1.4491","DOIUrl":"10.4102/phcfm.v16i1.4491","url":null,"abstract":"<p><strong>Background: </strong> The World Health Organization, stated that the coronavirus disease 2019 (COVID-19) pandemic not only affected the socioeconomic well-being of millions but also had adverse effects on public health, particularly in the management of chronic diseases at the primary healthcare (PHC) level. What remained unknown was the experiences of professional nurses(PNs) working in PHC regarding this issue.</p><p><strong>Aim: </strong> The study aimed to explore and describe the lived experiences of PHC nurses in managing chronic diseases during the COVID-19 pandemic.</p><p><strong>Setting: </strong> The study was conducted in the North West province, South Africa.</p><p><strong>Methods: </strong> A qualitative descriptive phenomenological design was employed to collect and analyse data. Face-to-face interviews were conducted and audio recorded with 16 PNs from five high-volume PHC facilities selected purposively.</p><p><strong>Results: </strong> The study's findings reveal four themes: suboptimal care for patients with chronic disease, a lack of resources, mental health challenges experienced by PHC nurses, and stigma and discrimination from both family and community members.</p><p><strong>Conclusion: </strong> The neglect of PHC and its frontline healthcare staff has impeded the mental health of PHC workers and the management of chronic diseases thus any progress made in reducing the burden of chronic diseases is likely to have regressed during the COVID-19 pandemic.Contribution: Policymakers should prioritise strengthening PHC by implementing integrated disease management policies, ensuring ethical clinical standards, providing supportive supervision, fair resource allocation and capacity building for PHC staff. In addition, addressing stigma and discrimination, and raising awareness among families and communities is crucial for future pandemics to effectively manage both chronic and infectious diseases.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e12"},"PeriodicalIF":1.2,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doctors' knowledge, attitudes and practices of palliative care in two South African districts.","authors":"Tessa A McMillan, Lauren Hutton, Louis Jenkins","doi":"10.4102/phcfm.v16i1.4503","DOIUrl":"10.4102/phcfm.v16i1.4503","url":null,"abstract":"<p><strong>Background: </strong> In South Africa, most palliative care takes place in health districts as part of home-based care provided by nongovernment organisations (NGOs). The National Policy Framework and Strategy on Palliative Care (NPFSPC) aims to ensure adequate numbers of palliative care trained healthcare workers. Guidelines and tools such as the Supportive and Palliative Care Indicators Tool (SPICT) assist in identifying and caring for patients needing palliative care.</p><p><strong>Aim: </strong> To evaluate the knowledge, attitudes and practices of public sector doctors to provide palliative care in the Garden Route and Central Karoo Districts.</p><p><strong>Setting: </strong> The study was conducted at public sector district-level hospitals.</p><p><strong>Methods: </strong> A descriptive observational cross-sectional survey was conducted. The study population included all public sector district-level doctors. Participation was voluntary, and 73 responses (60%) were obtained. Data were collected with an online questionnaire using the adapted 'Knowledge Attitudes Practice' model. Quantitative data were imported into the Statistical Package for Social Sciences for analysis.</p><p><strong>Results: </strong> Participants had poor knowledge, attitudes and practices regarding palliative care. There was a statistically significant difference between the knowledge of junior doctors and senior doctors, with 78% of junior doctors having inadequate palliative care knowledge. Only 25% of respondents had received formal postgraduate palliative care training. Seventy (96%) participants reported that home was the best care setting for terminally ill patients.</p><p><strong>Conclusion: </strong> Doctors in the Garden Route and Central Karoo need further training to meet the NPFSPC standards.Contribution: This study adds to the palliative care field, highlighting the need for ongoing training of doctors.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e8"},"PeriodicalIF":1.2,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A blended teaching and learning model for family-medicine registrar training at a South African university.","authors":"Ann Z George, Carien Lion-Cachet, Michele Torlutter, Neetha Erumeda, Deidre Pretorius","doi":"10.4102/phcfm.v16i1.4589","DOIUrl":"10.4102/phcfm.v16i1.4589","url":null,"abstract":"<p><p>Effective primary healthcare is essential in developing countries but faces several challenges, including the lack of standardised training across decentralised sites. In response to unsatisfactory registrar examination outcomes in 2013, the Department of Family Medicine at the University of the Witwatersrand in South Africa introduced a blended teaching and learning programme. The aim of the new programme was to level the playing field by providing uniform online resources on a course site on the university's learning management system. The uniform online resources would be integrated into the teaching programme. A team consisting of the registrar-training-programme coordinator, an educationalist and five family-medicine consultants from different districts began reviewing the curriculum, selecting appropriate resources and developing the course site. The blended programme was developed and implemented using a phased, participatory research action approach, including phases of evaluation and redesign. Since the implementation of the blended-learning programme in 2017, registrar outcomes have improved, but this has not been the only success attributed to the programme. The programme also resulted in an enhanced focus on teaching and learning, especially among those involved in its development. We share the lessons gleaned from our experiences, emphasising the need for adequate training and teamwork if we are to use technology appropriately and effectively to address the difficulties associated with decentralised training in developing countries.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e3"},"PeriodicalIF":1.2,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Context factors for implementation of clinical recommendations for chronic musculoskeletal pain.","authors":"Dawn V Ernstzen, Quinette A Louw","doi":"10.4102/phcfm.v16i1.4318","DOIUrl":"10.4102/phcfm.v16i1.4318","url":null,"abstract":"<p><strong>Background: </strong> Implementing evidence-informed clinical practice recommendations is important for managing chronic musculoskeletal pain (CMSP) to address the multidimensional impact of the condition. Successful implementation of recommendations requires understanding the multiple context factors that influence CMSP management in different settings.</p><p><strong>Aim: </strong> This study aims to explore contextual factors that could influence the implementation of evidence-informed clinical practice recommendations for the primary health care of adults with CMSP.</p><p><strong>Setting: </strong> The study focused on the primary health care (PHC) sector in Cape Town, South Africa.</p><p><strong>Methods: </strong> A qualitative descriptive study was conducted. A multidisciplinary panel of 13 local health care professionals participated in focused group discussions. The participants considered multimodal clinical recommendations derived from published clinical practice guidelines. In four focus group discussions (three or four members per group), the panel generated and documented context factors that would influence implementing the recommendations in practice. Inductive content analysis was performed to identify categories and themes.</p><p><strong>Results: </strong> The five contextual themes generated indicated health care system organisation, human resource requirements, provider practice patterns, patient empowerment and integration into policy as imperative for the successful implementation of recommendations.</p><p><strong>Conclusion: </strong> There are diverse context factors that could influence the implementation of clinical recommendations for managing CMSP in PHC settings. Identifying these factors as barriers or facilitators is beneficial for developing effective knowledge translation strategies.Contribution: The study findings indicate that an integrated systems approach supported by health care policy and multisectoral collaboration is needed to successfully implement clinical recommendations to address the impact of CMSP.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e12"},"PeriodicalIF":1.2,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pioneering family medicine: A collaborative global health education partnership in Ethiopia.","authors":"Meseret Z Woldeyes, Leila Makhani, Nitsuh Ephrem, Jamie Rodas, Ellena Andoniou, Katherine Rouleau, Abbas Ghavam-Rassoul, Praseedha Janakiram","doi":"10.4102/phcfm.v16i1.4599","DOIUrl":"10.4102/phcfm.v16i1.4599","url":null,"abstract":"<p><p>In 2013, Ethiopia launched its first Family Medicine (FM) residency programme at Addis Ababa University (AAU). The University of Toronto's Department of Family and Community Medicine (DFCM) was invited to support Addis Ababa University's Department of Family Medicine's (AAU-FM) educational programme activities forming the Toronto Addis Ababa Academic Collaboration in Family Medicine (TAAAC-FM). This paper describes the TAAAC-FM partnership, a capacity-strengthening initiative that focuses on four key levers of academic engagement and transformation: education offerings for AAU-FM trainees, partnership preparation of DFCM faculty, fostering AAU-FM faculty development and leadership, and lastly scholarship, knowledge sharing and mentorship. Toronto Addis Ababa Academic Collaboration in Family Medicine operates on principles of respect, flexibility and cultural sensitivity. Monthly virtual meetings and annual in-person faculty visits fostered curriculum support, teaching and leadership training, ensuring that the programme remained responsive to evolving needs. The partnership has contributed to a Community of Practice (CoP) to advance FM in Ethiopia, promoting shared learning. Addis Ababa University's Department of Family Medicine faculty leads in various roles, engages with global FM communities, and contributes to policy development, demonstrating significant progress in FM education and leadership. Looking ahead, TAAAC-FM aims to adapt its efforts based on the capacity built with AAU-FM, continue faculty development, and strengthen linkages within the global healthcare community. The partnership's success underscores the importance of collaborative, culturally informed high-low resource setting approaches to FM training and healthcare system strengthening, offering valuable insights for similar initiatives.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e5"},"PeriodicalIF":1.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faculty development for supervisors of medical student rural attachments in Zimbabwe.","authors":"Fiona Makoni, Zandile Mafi, Sunanda Ray","doi":"10.4102/phcfm.v16i1.4641","DOIUrl":"10.4102/phcfm.v16i1.4641","url":null,"abstract":"<p><p>Reflective writing and keeping portfolios during rural hospital attachments has been shown to give medical students more confidence, better communication skills and clinical competence, thereby making them stronger adult learners. The role of supervisors as facilitators of learning during Community-based Education rural site visits is critical. The University of Zimbabwe Faculty of Medicine and Health Sciences established faculty development workshops to train supervisors to be better able to support students in becoming active learners and critical thinkers, giving them constructive feedback, and encouraging them to look for positive outcomes during their rural attachments. These educational skills were new to most supervisors, requiring a culture change from the usual didactic approaches. Educators had to learn about adult learning theories, the constructivist approach to knowledge creation, role-modelling and methods of assessment that were empowering for students. They were encouraged to form communities of practice through the faculty development process of training and assessment and to consider how to develop research and scholarship in documenting their experiences as facilitators and learning partners with their students and colleagues. These activities enhanced their professional identity formation as scholars, educators and facilitators. Their exposure to the functioning of rural hospitals, partly through narratives of the students' reflective writing, enabled them to develop a greater appreciation of the potential of primary care and the district health services as the foundation of the Zimbabwe health system. Future benefits could include application of this training to other health professional programmes, as part of interprofessional education.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e4"},"PeriodicalIF":1.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community members' perceptions of community health workers in Melusi, Tshwane, South Africa.","authors":"Rebaone K Madzivhandila, Sanele Ngcobo","doi":"10.4102/phcfm.v16i1.4573","DOIUrl":"10.4102/phcfm.v16i1.4573","url":null,"abstract":"<p><strong>Background: </strong> Community health workers (CHWs) play an important role in health promotion through health campaigns and home visits, and provide linkage to care and support patient management. In the informal settlements, CHWs identify health challenges and help residents to access healthcare facilities.</p><p><strong>Aim: </strong> This study aimed to explore the perception held by the community members regarding CHWs' contribution to health promotion in Melusi informal settlements within the Tshwane district.</p><p><strong>Setting: </strong> The study was conducted in Melusi informal settlement situated in Pretoria west in South Africa.</p><p><strong>Methods: </strong> Descriptive exploratory qualitative research methods were used, with open and closed-ended questions during individual interview sessions. Participants were purposefully selected in collaborating with the community leaders and using CHWs' data to identify individuals with direct interaction with CHWs.</p><p><strong>Results: </strong> Participants praised CHWs' communication skills, engagement strategies, and ability to provide valuable health services. Community members expected CHWs to provide healthcare services, educational support, advocacy for health issues and guidance on well-being. Barriers such as community resistance, a lack of privacy and difficulties in reaching households were noticed. However, CHWs were commended for their impact on well-being, offering health services, emergency support, food assistance and improved healthcare accessibility.</p><p><strong>Conclusion: </strong> The study indicates that community members have positive perceptions of CHWs. This highlights the significant role of CHWs in promoting health and well-being within the community.Contribution: This study provides insights into community perceptions of CHWs in informal settlements, emphasising their impact on community well-being. It provides a basis for their effectiveness and support in delivering health services in the informal settlement.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e9"},"PeriodicalIF":1.2,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How P(H)C is your curriculum?","authors":"Bernhard M Gaede","doi":"10.4102/phcfm.v16i1.4590","DOIUrl":"10.4102/phcfm.v16i1.4590","url":null,"abstract":"<p><p>In South Africa and internationally, the alignment of health professions education programme with primary healthcare (PHC) policies is seen to promote the training of fit-for-purpose graduates who can adequately respond to the demands of patient and community needs. This article seeks to describe the development of a tool to assess the degree of PHC in an undergraduate medical curriculum. In defining what is meant by PHC, four dimensions of PHC were identified for the purpose of designing the tool, namely values underpinning PHC, principles of PHC, a generalist focus of the programme, and the level of care that the programme is delivered at. The tool also sought to assess how the content in these dimensions is covered in the curriculum and to which depth students are required to engage. The perspectives that were considered were: what content was being covered, what pedagogy was used, in which context it was being taught and how it was being assessed. For each of these aspects, the dimensions are assessed using an amended Miller's pyramid to assess the expectations of outcomes for the curriculum. The tool is presented and the article reflects on the use of the tool in a process of assessing a medical curriculum.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e4"},"PeriodicalIF":1.2,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Witzenberg Women's experience of health care after a miscarriage: A descriptive qualitative study.","authors":"Marisa Crous, Ts'epo Motsohi, Adeloye A Adeniji","doi":"10.4102/phcfm.v16i1.4581","DOIUrl":"10.4102/phcfm.v16i1.4581","url":null,"abstract":"<p><strong>Background: </strong> Although some evidence is available from low- and middle-income countries, no South African data are available on how women experience healthcare during treatment for an incomplete miscarriage.</p><p><strong>Aim: </strong> This study sets out to explore and describe the experiences of healthcare among women who suffered an incomplete spontaneous miscarriage in the Witzenberg subdistrict, a rural area in the Western Cape province of South Africa.</p><p><strong>Setting: </strong> Witzenberg subdistrict, Western Cape province, South Africa.</p><p><strong>Methods: </strong> This study used a descriptive exploratory qualitative study design. In-person interviews were held with women who experienced a miscarriage. Interviews followed a semi-structured format by a single interviewer to explore the various aspects involving experiences of healthcare.</p><p><strong>Results: </strong> Eight interviews were conducted and analysed. The five themes that arose from transcribed data were: (1) a need for safety, (2) pain management, (3) moderating behaviours and attitudes, (4) disorienting healthcare systems and (5) abandonment. Several factors contributed to the loss of physical and emotional safety in the emergency centre environment. Timeous emotional and pharmacological pain management were found to be a gap while patients awaited care. Clear communication and staff attitude were found to be integral to the patient's experience and could avoid the perception of abandonment.</p><p><strong>Conclusion: </strong> There is a universal need for basic respectful, supportive and safe care in patients who attend an emergency centre for early pregnancy complications in rural South African. Specific focus should be given to clear communication and appropriate emotional support during and after the miscarriage.Contribution: This study can be used as a guide to improve services by ensuring respectful, transparent, informed, and appropriate continuity of care.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e9"},"PeriodicalIF":1.2,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}