European Journal of General Practice最新文献

{"title":"Social Experiences and Health Needs of Patients with Severe Mental Illness and their Caregivers during the first year of the COVID-19 pandemic in Spain.","authors":"Juan Andrés Ramos-Ruiz, Alejandro Pérez-Milena, Carmen Noguera-Cuenca, Beatriz Ruiz-Díaz","doi":"10.1080/13814788.2024.2310088","DOIUrl":"10.1080/13814788.2024.2310088","url":null,"abstract":"<p><strong>Background: </strong>The strict isolation measures for the population imposed by the health authorities caused a prolonged disruption of informal social support networks. Both this new social situation and the decrease in accessibility to health care have generated new needs in people with severe mental illness (SMI) and their caregivers.</p><p><strong>Objectives: </strong>This study provides insight into life experiences and health needs of a population with SMI during the first year of the COVID-19 pandemic in Spain.</p><p><strong>Methods: </strong>Qualitative design using semi-structured dyadic interviews, conducted from January through December 2022. A purposive sampling of patients with SMI and their caregivers was carried out through key informants in rural and urban localities in southern Spain. Verbatims were identified and classified by triangulation after the evaluation of the interview transcripts. The codes were defined through content analysis using the NVivo software.</p><p><strong>Results: </strong>Semi-structured dyadic interviews (21), identifying three main categories: 1. Social isolation: increased, causing greater personal vulnerability, exacerbation of psychiatric symptoms and exhaustion in caregivers. 2. Accessibility to Health Services<b><i>:</i></b> decreased with fewer face-to-face consultations, with difficulty in managing urgent situations and telephone attention in decompensated and disabled patients. 3. Continuity of healthcare: decreased with distrust in health professionals due to lack of communication between primary care and the hospital.</p><p><strong>Conclusion: </strong>COVID-19 confinement exacerbated loneliness and worse health self-perception in SMI people. Greater formal social support was required. GPs role is key to avoiding delays in appointments and lack of coordination between primary and specialised care.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2310088"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10863535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Series: Public engagement with research. Part 2: GPs and primary care researchers working inclusively with minoritised communities in health research to help address inequalities.","authors":"Yumna Masood, Anica Alvarez Nishio, Bella Starling, Shoba Dawson, Jon Salsberg, Steven Blackburn, Esther van Vliet, Carina A C M Pittens","doi":"10.1080/13814788.2024.2322996","DOIUrl":"10.1080/13814788.2024.2322996","url":null,"abstract":"<p><p>Public engagement in health research is vital for addressing health disparities and promoting inclusivity among minoritised communities who often face barriers to accessing healthcare. Minoritised communities are groups, which have been made minorities by a dominant culture, race, ethnic group and/or social class and may experience health inequalities as a result. By incorporating diverse perspectives and lived experiences of minoritised communities, this approach aims to achieve contextually relevant research outcomes that reduce health inequalities and improve overall well-being. However, underrepresentation and lack of inclusivity challenges persist, necessitating the establishment of inclusive partnerships and grassroots participatory methodologies.</p><p><p>To foster inclusive public engagement, it is important to overcome structural and cultural barriers, address socioeconomic challenges, and build trust with minoritised communities. This can be achieved by promoting a cultural shift that values inclusivity, providing comprehensive training to researchers, and collecting rigorous data on engagement demographics for transparency and accountability. Involving minoritised communities in decision-making through participatory research approaches enhances trust and yields successful outcomes. Additionally, allocating sufficient resources, collaborating in co-production, and prioritising the diverse needs and perspectives of stakeholders contribute to fostering inclusive public engagement in research.</p><p><p>Overall, inclusive engagement practices particularly in primary care research have the potential to reduce health inequalities and cater to the unique requirements of minoritised communities, thereby creating more impactful outcomes and promoting equitable healthcare access.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2322996"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10939099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140112212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between patient-perceived quality of primary care and self-reported hospital utilisation in China: A cross-sectional study.","authors":"Chenwen Zhong, Junjie Huang, Lina Li, Zhuojun Luo, Cuiying Liang, Mengping Zhou, Nan Hu, Li Kuang","doi":"10.1080/13814788.2024.2308740","DOIUrl":"10.1080/13814788.2024.2308740","url":null,"abstract":"<p><strong>Background: </strong>Reducing avoidable hospital admissions is a global healthcare priority, with optimal primary care recognised as pivotal for achieving this objective. However, in developing systems like China, where primary care is evolving without compulsory gatekeeping, the relationship between patient-perceived primary care quality and hospital utilisation remains underexplored.</p><p><strong>Objectives: </strong>This study aimed to explore the association between patient-perceived primary care quality and self-reported hospital utilisation in China.</p><p><strong>Methods: </strong>Data were collected from 16 primary care settings. Patient-perceived quality of primary care was measured using the Assessment Survey of Primary Care scale across six domains (first-contact care, continuity, comprehensiveness, accessibility, coordination, and patient-centredness). Hospital utilisation included patient self-reported outpatient visits, hospital admissions, and emergency department (ED) visits in the last six months. Logistic regression analyses were examined associations between self-reported hospital utilisation and perceived primary care quality adjusted for potential confounders.</p><p><strong>Results: </strong>Of 1,185 patients recruited, 398 (33.6%) reported hospital utilisation. Logistic regression analyses showed that higher total scores for patient-perceived quality of primary care were associated with decreased odds of hospital utilisation (adjusted odds ratio(AOR): 0.417, 95% confidence interval (CI): 0.308-0.565), outpatient visits (AOR: 0.394, 95% CI: 0.275-0.566) and hospital admissions (AOR: 0.496, 95% CI: 0.276-0.891). However, continuity of care was positively associated with ED visits (AOR: 2.252, 95% CI: 1.051-4.825).</p><p><strong>Conclusion: </strong>Enhanced patient-perceived quality of primary care in China is associated with a reduction in self-reported overall hospital utilisation, including outpatient visits and hospital admissions. However, better continuity of care may be associated with increased ED visits. Further research is warranted for precise insights and validation of these findings.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2308740"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10898267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing LGBT + primary healthcare in Slovenia: A national qualitative study of experiences and expectations of LGBT + people and family doctors.","authors":"Nina Jerala, Davorina Petek","doi":"10.1080/13814788.2024.2373121","DOIUrl":"10.1080/13814788.2024.2373121","url":null,"abstract":"<p><strong>Background: </strong>Despite growing acceptance of LGBT + individuals, an underlying stigma persists even in healthcare, resulting in substandard care and worse healthcare outcomes for LGBT + individuals.</p><p><strong>Objectives: </strong>To examine and compare the experiences and expectations regarding primary healthcare among LGBT + individuals and general practitioners (GPs) in Slovenia.</p><p><strong>Methods: </strong>We conducted an online national qualitative study using open-ended questions. To reach LGBT + population snowball method of recruitment was employed by sharing the questionnaire through LGBT + organisations, while GPs were invited by email of Association of family doctors in Slovenia. Anonymous data was collected from October to December 2021 and the questionnaires of 25 GPs and 90 LGBT + individuals of various ages, backgrounds, gender identities and sexual orientations were reviewed using thematic analysis.</p><p><strong>Results: </strong>Both LGBT + participants and GPs expressed a desire for equal treatment. However, while all GPs claimed to treat all patients equally, LGBT + participants reported more varied experiences. Specific knowledge, especially on LGBT + terminology and healthcare, was perceived as lacking among GPs, leading LGBT + individuals to seek advice from specialists or community counselling. Systemic barriers, including societal stigmatisation and limited formal education on LGBT + issues, were identified, highlighting the need for designated safe spaces and improved GP training. Safety emerged as a central theme, crucial for fostering trust and disclosure between patients and healthcare providers.</p><p><strong>Conclusion: </strong>The study underscores the significance of a sense of safety in the patient-doctor relationship and highlights the need for improved training and attitudes to provide inclusive and affirming healthcare for LGBT + individuals.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2373121"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11271072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the experiences of GPs in establishing and operating the chronic disease management programme in clinical practice in Ireland. A qualitative study.","authors":"Stephen Buckley, James O' Flynn, Tony Foley","doi":"10.1080/13814788.2024.2430521","DOIUrl":"10.1080/13814788.2024.2430521","url":null,"abstract":"<p><strong>Background: </strong>The management of chronic diseases, in the context of an ageing population and increasing life expectancy, is one of the major challenges facing the Irish health system. In 2020, a chronic disease management programme [CDM] was introduced in Irish general practice as part of a transformation in health policy to meet the changing needs of the population.</p><p><strong>Objectives: </strong>To explore GPs' experiences and perceptions of the impact of the introduction of CDM on general practice in Ireland.</p><p><strong>Methods: </strong>18 semi-structured interviews were conducted with GPs in clinical practice from across Ireland. GPs were purposefully recruited to capture the differing experiences faced by GPs in large and small practices in both urban and rural settings. Interviews were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>GPs were enthusiastic about aspects of CDM, which they felt provided an improved framework for their approach to the management of chronic diseases. However, they described several challenges to implementation, especially around capacity constraints. CDM could have unintended consequences for aspects of routine GP care. GPs described how practice nurses had taken on a central role in both clinical and administrative aspects of the programme.</p><p><strong>Conclusions: </strong>GPs value the framework provided by CDM for their approach to the management of chronic disease. However, challenges around practice capacity and its impact both on the delivery of CDM and aspects of routine care highlight the importance for policy makers to provide continued support to strengthen the general practice infrastructure.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2430521"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'I just felt either I'm going to kill someone or I'm going to end up killing myself'. How does it feel to be burnt out as a practicing UK GP?","authors":"Ishbel Orla Whitehead, Suzanne Moffatt, Barbara Hanratty","doi":"10.1080/13814788.2024.2426981","DOIUrl":"10.1080/13814788.2024.2426981","url":null,"abstract":"<p><strong>Objective: </strong>To explore how it feels to be a burnt out GP in the NHS.</p><p><strong>Design: </strong>In depth qualitative interviews with 16 UK GPs with self-declared 'lived experience' of burnout.</p><p><strong>Setting: </strong>United Kingdom Primary Care.</p><p><strong>Results: </strong>Seven male and nine female GPs described their experiences of burnout to a peer researcher. Themes identified were exhaustion and depersonalisation, mental and physical illness, identity and existential crises, and finally tenacity and resilience. Participants were self-reflective and described distress, shame, stigma, and guilt, including times of suicidal behaviour and isolation due to their burnout.</p><p><strong>Conclusions: </strong>Burnout threatens a GP's sense of identity, purpose, and functioning in their lives, and ultimately can be life-threatening. Active listening to GP distress and a system wide approach to managing distress and burnout is urgently required.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2426981"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-career general practitioners' career intentions in Estonia: A qualitative study.","authors":"Marta Velgan, Anett Uibu, Elinor Õunap, Mari Katariina Kangasniemi, Nele R Michels, Ruth Kalda","doi":"10.1080/13814788.2024.2368557","DOIUrl":"10.1080/13814788.2024.2368557","url":null,"abstract":"<p><strong>Background: </strong>The shortage of general practitioners (GPs) is a worsening problem in many countries and poses a threat to the services provided by primary care and by extension for the entire healthcare system. Issues with GP workforce recruitment and retention can be reasons for this shortage.</p><p><strong>Objectives: </strong>To describe GP trainees and newly qualified GPs experiences and perceptions on how their training and early experiences of work influence their career intentions in primary care in Estonia.</p><p><strong>Methods: </strong>A qualitative study with GP trainees (<i>n</i> = 12) and newly qualified GPs (<i>n</i> = 13) using semi-structured group interviews (<i>n</i> = 6) was conducted. Interviews were conducted from October until November 2020. Data were analysed using thematic analysis with NVivo Software.</p><p><strong>Results: </strong>Although early-career GPs in Estonia envision their future roles as GP practice owners with patient list, this is often postponed due to various reasons. Early-career GPs expressed a sense of unpreparedness to fill all the roles of GPs' and found the process of establishing a GP practice and taking on a patient lists very complicated. They value work-life balance and prefer workplaces, which offer flexible working conditions.</p><p><strong>Conclusion: </strong>Potential strategies were identified to enhance the willingness of early-career GPs to continue their career as GP practice owners with patient list: improving the GP training program by placing more emphasis on managing skills and making the process of establishing GP practice and taking on a patient list less bureaucratic and more accessible.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2368557"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary management of patients with cancer in France: The SINPATIC qualitative study.","authors":"Laura Moscova, Matthieu Lustman, Jacques Cittée, Sébastien Dawidowicz, Florence Canoui-Poitrine, Christophe Tournigand, Kelly Perlaza, William Mirat, Emilie Ferrat","doi":"10.1080/13814788.2024.2380722","DOIUrl":"10.1080/13814788.2024.2380722","url":null,"abstract":"<p><strong>Background: </strong>Health policymakers have tried to improve the care pathway for cancer patients by improving collaboration between participating healthcare professionals by involving the general practitioner (GP).</p><p><strong>Objective(s): </strong>To explore how patients, GPs, oncologists and nurses interacted and how they perceived, in their practice, professional roles, collaboration, and cancer care pathways.</p><p><strong>Methods: </strong>Between January 2018 and December 2021, we conducted a qualitative study that combined phenomenology and a general inductive analysis, based on semi-structured interviews with cancer patients and their GPs, oncologists, and nurses in France.</p><p><strong>Results: </strong>Our analysis of 59 interviews showed that the stakeholders had different perceptions of the cancer care pathway. Task division was implicit and depended on what each health professional thought he/she should be doing; this led to the blurring of certain tasks (announcement of the diagnosis, coordination, and follow-up). The healthcare professionals were stuck in frameworks centred on their own needs and expectations and were unaware of the other health professionals' needs and expectations. Outside the hospital, GPs and nurses worked in isolation; they were not aware of the other stakeholders and did not communicate with them. GPs and nurses justified this attitude by the lack of a perceived need. Interprofessional communication varied as a function of the needs, involvement and knowledge of the other health professionals and was often mediated by the patient.</p><p><strong>Conclusion: </strong>In the cancer management in France, to improve cancer care pathway, there is a need to train healthcare professionals in interprofessional collaboration delivering care tailored to patient needs and preferences.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2380722"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of the Assessment of Burden of Chronic Conditions (ABCC)-tool in patients with asthma, COPD, type 2 diabetes mellitus, and heart failure: A pragmatic clustered quasi-experimental study in the Netherlands.","authors":"Esther A Boudewijns, Danny Claessens, Onno C P van Schayck, Mascha Twellaar, Bjorn Winkens, Manuela A Joore, Lotte C E M Keijsers, Stijn Krol, Mathijs Urlings, Annerika H M Gidding-Slok","doi":"10.1080/13814788.2024.2343364","DOIUrl":"10.1080/13814788.2024.2343364","url":null,"abstract":"<p><strong>Background: </strong>The Assessment of Burden of Chronic Conditions (ABCC)-tool was developed to optimise chronic care.</p><p><strong>Objectives: </strong>This study aimed to assess the effectiveness of the ABCC-tool in patients with COPD, asthma, type 2 diabetes, and/or heart failure in primary care in the Netherlands.</p><p><strong>Methods: </strong>The study had a pragmatic, clustered, two-armed, quasi-experimental design. The intervention group (41 general practices; 176 patients) used the ABCC-tool during routine consultations and the control group (14 general practices; 61 patients) received usual care. The primary outcome was a change in perceived quality of care (PACIC; Patient Assessment of Chronic Illness Care) after 18 months. Secondary outcomes included change in the PACIC after 6 and 12 months, and in quality of life (EQ-5D-5L; EuroQol-5D-5L), capability well-being (ICECAP-A; ICEpop CAPability measure for Adults), and patients' activation (PAM; Patient Activation Measure) after 6, 12, and 18 months for the total group and conditions separately.</p><p><strong>Results: </strong>We observed a significant difference in the PACIC after 6, 12, and 18 months (18 months: 0.388 points; 95%CI: 0.089-0.687; <i>p</i> = 0.011) for the total group and after 6 and 12 months for type 2 diabetes. After 18 months, we observed a significant difference in the PAM for the total group but not at 6 and 12 months, and not for type 2 diabetes. All significant effects were in favour of the intervention group. No significant differences were found for the EQ-5D-5L and the ICECAP-A.</p><p><strong>Conclusion: </strong>Use of the ABCC-tool has a positive effect on perceived quality of care and patients' activation, which makes the tool ready for use in clinical practice. Healthcare providers (e.g. general practitioners and practice nurses) can use the tool to provide person-centred care.<b>Trial registration number:</b> ClinicalTrials.gov Registry (NCT04127383).</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2343364"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11104697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Person-centred care, a core concept of family medicine.","authors":"Igor Švab, Venija Cerovečki","doi":"10.1080/13814788.2024.2393860","DOIUrl":"10.1080/13814788.2024.2393860","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2393860"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11351358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}