Dementia (London, England)最新文献

{"title":"Preventing risk of placement breakdown and hospital admission in the management of distressed behaviour in dementia care: A qualitative case study with family and care-home staff.","authors":"Katherine Nunn, Suzanne Crooks, Donna Gilroy","doi":"10.1177/14713012241287572","DOIUrl":"10.1177/14713012241287572","url":null,"abstract":"<p><p><b>Objectives:</b> Behaviours such as hitting-out and declining personal care are commonly exhibited by people living with dementia and are associated with care-giver stress and anxiety and care home placement breakdowns. Traditionally, pharmacological approaches have been used to manage behaviour; however, research indicates limited effectiveness. National guidelines recommend use of non-pharmacological interventions as first line treatment for distress, but further research is required to elucidate the components that lead to improved care for people living with dementia. This study aims to explore what works, examining case studies in which a non-pharmacological clinical intervention, the Newcastle Model, was used to understand and manage distressed behaviour in dementia care within care home settings. <b>Method:</b> A qualitative case study design was used. Three cases were selected from the Edinburgh Behaviour Support Service for their success in preventing care home placement breakdown during a distressed behaviour intervention in NHS Scotland. Family members and staff involved in the interventions within these cases were interviewed (<i>N</i> = 6). Thematic analysis was used to analyse data. <b>Findings:</b> All participants reported positive outcomes from the intervention. Three key themes were identified, each with subthemes. Participants described a supportive, non-judgmental environment which allowed them to integrate knowledge about dementia and tailor interventions to the specific needs of the individual living with dementia. There was also a sense of family and staff coming together to unite with shared goals. A preliminary model of all of themes and their interactions is presented. <b>Conclusion:</b> The study supports use of biopsychosocial, formulation-led approaches in the understanding and treatment of complex behavioural presentations in community care settings. It suggests that clinicians should endeavour to facilitate safe and open environments for care home staff and family members, in order to promote attribution change and person-centered care, and to help mediate differences and conflict between staff and family members.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"171-190"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482307","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}

{"title":"Experiences and needs of residents with dementia in relocating to an innovative living arrangement within long-term care: A qualitative study.","authors":"Mara Brouwers, Elleke Gm Landeweer, Bram de Boer, Wim G Groen, Miranda C Schreuder, Hilde Verbeek, Relocare Consortium","doi":"10.1177/14713012241311433","DOIUrl":"10.1177/14713012241311433","url":null,"abstract":"<p><p>During the last decade, an increasing number of care organizations have chosen to rebuild or build a new care facility to provide better person-environments for residents with dementia. This has inevitably led to an increase in relocations. This study investigated how residents with dementia experienced a relocation from a regular nursing home to an innovative living arrangement. A qualitative study was performed, using semi-structured interviews and observations. Two nursing homes offering 24 h care to residents with psychogeriatric symptoms that planned a relocation to an innovative living arrangement were selected. Sixteen residents were included. Five themes from the data described what was of importance to residents when moving, including (1) the physical environment of the new location, (2) the belongings of residents, (3) feeling at home, (4) the importance of social contact when relocating, and (5) the need to be engaged in daily life. This study found that the residents were not actively involved in the relocation process, despite the clear desire they expressed to be involved and of importance. As the residents with dementia were able to express what was important to them in this study, relocation processes should focus more on involving such residents and incorporating them within relocation processes.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012241311433"},"PeriodicalIF":0.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873588","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}

{"title":"Home-based end-of-life care for people with dementia: A systematic review of quantitative and qualitative evidence.","authors":"Guo Yin, Leah Macaden, Divya Sivaramakrishnan, Yajing Wang, Lian Zhu, Huimin Chong","doi":"10.1177/14713012241308625","DOIUrl":"https://doi.org/10.1177/14713012241308625","url":null,"abstract":"<p><p><b>Background:</b> Integrating home-based end-of-life care for people with dementia will become increasingly important as the population ages. Therefore, it is timely and necessary to evaluate the evidence of home-based end-of-life care for people living with dementia. <b>Aim:</b> This review aims to identify the characteristics of home-based end-of-life care interventions for people living with dementia and review the existing evidence on implementation outcomes. <b>Design:</b> Systematic Review and Narrative Synthesis. The Mixed Methods Appraisal Tool was used to assess study quality. <b>Data sources:</b> A comprehensive search was conducted across five databases (PubMed, Web of Science, MEDLINE CINAHL and Scopus) from June to August 2023, and the citations to the included studies were tracked through citation tracking in Google Scholar to identify potentially relevant studies. <b>Results:</b> Of the 2022 articles retrieved, 12 were included in this review. The included studies were geographically diverse, with four from the United States, three from Singapore, two from the United Kingdom, and one each from the Netherlands, Belgium, and Israel. Additionally, due to the difference of focus and nature of the studies, only seven of these studies provided information on home-based end-of-life care interventions for people living with dementia. The interventions identified in this review align closely with the essential components of optimal palliative care for dementia outlined in the European Association for Palliative Care white paper. However, the evidence supporting these home-based end-of-life care interventions for people living with dementia is constrained by the number of studies and methodological limitations. Nevertheless, this systematic review still identifies some evidence supporting home-based end-of-life care for people living with dementia, including reduced healthcare utilization and costs, as well as help people living with dementia realize their wish to die at home. <b>Conclusions:</b> Whilst current evidence highlights benefits of home-based end-of-life care for people living with dementia, the relatively limited number, methodology of studies, the heterogeneity of study focus and outcome measures hinder the formation of definitive conclusions. Therefore, further research is needed to develop and evaluate home end-of-life care services for people living with dementia.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012241308625"},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831135","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}

{"title":"Qualitative evaluation of My Life Today - A co-produced personal tool from the IDEAL programme to help people with dementia monitor valued aspects of their lives.","authors":"Claire Pentecost, Anna Hunt, Rachael Litherland, Catherine Quinn, Catherine Charlwood, Robin G Morris, Linda Clare","doi":"10.1177/14713012241306506","DOIUrl":"10.1177/14713012241306506","url":null,"abstract":"<p><p><b>Background and objectives:</b> Self-management of chronic conditions can help individuals take control of their health, both improving well-being and reducing the burden on health and social care resources. This study explored the potential of our co-produced self-management tool, My Life Today (MLT), to help people with dementia identify, plan and monitor aspects of their lives that are important to them and that help to maintain or improve well-being.<b>Research design and methods:</b> We asked people with dementia to try using MLT. We conducted semi-structured interviews after one month and further interviews one month later. We also interviewed people who had supported the person with dementia to use MLT ('supporters'). We adopted a realist approach to thematic analysis to explore what works, for whom, under what circumstances.<b>Results:</b> Sixteen people with dementia and four supporters took part. All but one had mild to moderate cognitive impairment, and one had severe cognitive impairment. People with dementia used MLT according to their perceptions of its usefulness, their capabilities, and whether they had support. Using MLT helped most to think more positively about their activities and achievements and feel reassured by identifying the activities they were doing. Supporters and some people with dementia also derived benefits from planning and problem-solving to include more pleasurable activities.<b>Discussion and implications:</b> People with dementia and supporters found MLT a helpful tool. Mechanisms of engagement with MLT resonate with theories of behaviour change concerning the evaluation of capabilities and feelings of confidence in the ability to complete MLT and plan activities. Offering simple self-management tools such as MLT could form part of a post-diagnostic support package for people with dementia. Providing flexibility in when tools are offered and how they are used can allow for differences in attitudes and capabilities and increase the likelihood of engagement.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012241306506"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820158","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}

{"title":"The impact of game play on dementia knowledge: A student evaluation of the Dementia Inequalities Game.","authors":"Clarissa Giebel, Helen Marshall, Jacqui Cannon, Warren Donnellan, Heather Bullen, Elizabeth Lomas, Bridget Porritt, Anna Rees, Simon Curran, Hilary Tetlow, Mark Gabbay","doi":"10.1177/14713012241306489","DOIUrl":"10.1177/14713012241306489","url":null,"abstract":"<p><p><b>Background:</b> People with dementia and carers can face many barriers, or inequalities, in accessing a diagnosis or care. These barriers are unjust and can be addressed by the right interventions, to ensure that everyone receives equitable access to diagnosis and care. A lack of knowledge about dementia in the health and social care workforce is a recognised barrier. The Dementia Inequalities Game was co-produced with people with personal, professional, and voluntary sector experiences of dementia, and offers an educational tool to educate people about dementia and associated inequalities and overcome this knowledge gap in the current and future (in training) workforce. <b>Aims:</b> The aim of this study was to assess the impact of playing the co-produced Dementia Inequalities Game on knowledge about dementia and associated inequalities in health care, allied health professional, nursing and psychology students.<b>Methods:</b> We conducted 11 game play workshops as part of regular teaching in undergraduate and postgraduate courses in psychology, nursing, occupational therapy, physiotherapy, orthoptics, and radiography at one University in the North of England. Students did not have to partake in the workshops. Participating students completed a brief before and after knowledge questionnaire about dementia and inequalities. Paired samples t-tests were used to compare ratings of knowledge of dementia and associated inequalities before and after game play.<b>Findings:</b> Three-hundred-and-eighteen students took part in the workshops, with 312 fully completed questionnaires. The largest cohort of students (49%) were studying for a degree in nursing. Playing the game significantly increased knowledge about dementia (<i>p</i> < .001) and dementia inequalities (<i>p</i> < .001).<b>Implications:</b> Playing the Dementia Inequalities Game is an effective tool to improve knowledge about dementia and associated inequalities in health care and psychology students. Using the game as an educational and sociable intervention in health and social care professionals is a next avenue to test.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012241306489"},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781932","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}

{"title":"A scoping review of dementia education programs to assess for the inclusion of culture.","authors":"Wendy Hulko, Noeman Mirza, Tracy Christianson, Mahtab Nazemi, Alicia Vicic, Emily Bartle","doi":"10.1177/14713012241300592","DOIUrl":"https://doi.org/10.1177/14713012241300592","url":null,"abstract":"<p><p>This scoping review examined literature on dementia education programs (DEPs) for healthcare providers and students. The search was conducted using the Discover! search engine that includes 63 databases. The review included a total of 25 articles that met the eligibility criteria. There were numerous DEPs that varied by frequency and duration, mode of delivery, content, target population, program evaluation measures, and outcomes. Most involved nursing staff and students and took place in Canada, the US, and the UK. The most common delivery mode was a one-time in-person session and a wide variety of topics were covered, both general (e.g., understanding dementia) and specific (e.g., driving, delirium). Twenty different tools were used to measure primarily changes in knowledge and attitudes, with little attention paid to performance and care provision. Only three studies on DEPs focused on culture in terms of race and ethnicity. The implications of this scoping review for education are that DEPs need to meaningfully address culture and culturally safe care in order to respond to the increasing diversity of older adults and care providers. In terms of future research on DEPs, program evaluation must attend to the importance of consistent measures, translation of knowledge to practice, and sustainability.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012241300592"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683665","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}

{"title":"Participation of persons living with dementia in research: A means to address epistemic injustice.","authors":"Ulla Halonen, Mari Aaltonen, Lina Van Aerschot, Jari Pirhonen","doi":"10.1177/14713012241299015","DOIUrl":"https://doi.org/10.1177/14713012241299015","url":null,"abstract":"<p><p>Epistemic injustice refers to wronging or mistreating individuals in terms of their capacity as knowers, based on prejudices or negative attitudes. Excluding people with dementia from research is a form of epistemic injustice. In this article, we discuss epistemic injustice associated with data collection processes and the participation of people with dementia in scientific research. The challenges of participation that we discuss pertain to the role of gatekeepers and ethical research perspectives. The arguments presented are based on previous research, experiences from our current project, and critical self-assessment regarding the latter. The aim is to shed light on what enables or prevents people living with dementia from participating in research, and how this is connected to epistemic injustice. It is known that prejudices related to dementia affect both researchers and people living with dementia: the former tend to exclude people with dementia, and the latter may practice self-silencing due to dementia-related stigma. In addition to these individual issues, we argue that epistemic injustice occurs at a structural level, where a major role is played by gatekeepers and research ethics panels. As close family members, health officials, and dementia-related associations are the main gatekeepers, their attitudes and perceptions are highlighted. In terms of ethical issues, the concept of informed consent needs to be elaborated. If the research is not expected to harm participants and may contribute to improving the lives of those with dementia, the perspective should be shifted from informed consent to ongoing consent assessment. While acknowledging the features and symptoms of dementia, researchers should be more courageous, trust in the good cause, and enable persons living with dementia to participate in research that concerns them. This is the only way for researchers to genuinely understand the social world, experiences, and needs of those with dementia and to address epistemic injustice.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"14713012241299015"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607678","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}

{"title":"\"How will I ever know I didn't bring it on myself?\": Navigating personal responsibility in public health messaging on dementia risk.","authors":"Allie Peckham, Molly Maxfield, Dara L James","doi":"10.1177/14713012241270756","DOIUrl":"10.1177/14713012241270756","url":null,"abstract":"<p><strong>Background and objectives: </strong>Public health messaging increasingly emphasizes the importance of \"lifestyle interventions\" to reduce dementia risk. Our study aimed to understand how people interpret and respond to information about dementia risk. In a second sub-aim, we examined how these interpretations may contribute to dementia-related lifestyle stigma.</p><p><strong>Research design and methods: </strong>We engaged in a secondary analysis of 50 semi-structured interviews using a framework approach to understand, from the perspective of community-dwelling middle-aged and older adults, how they may interpret, make sense of, and respond to information about dementia risk and risk reduction. During the interpretive and narrative phase, the authors began to elucidate participant responses analytically and identified that these responses could be interpreted within the health locus of control literature.</p><p><strong>Results: </strong>Of the 23 participants who discussed dementia risk, 13 felt some sense of personal responsibility and control over their dementia risk. Of those 13, four participants believed they had personal responsibility and control and actively engaged in lifestyle interventions. The remaining nine participants also engaged in lifestyle interventions, aiming to find comfort in knowing they had done what they could to reduce their risk and working to alleviate self-attribution of blame <i>if</i> diagnosed with dementia.</p><p><strong>Discussion and implications: </strong>The tendency to internalize responsibility may inadvertently contribute to the stigmatization of dementia as a 'lifestyle disease' creating dementia-related lifestyle stigma. Recognizing the multifaceted nature of dementia risk, including environmental and external factors beyond individual control, is essential to combatting the 'lifestyle stigma' increasingly associated with the condition.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"1292-1306"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977352","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}

{"title":"Exploring confidence in financial planning topics among care partners of persons living with dementia.","authors":"Anna Jolliff, Beth Fields, Justin Boutilier, Alex Dudek, Christian Elliott, Matthew Zuraw, Nicole E Werner","doi":"10.1177/14713012241270730","DOIUrl":"10.1177/14713012241270730","url":null,"abstract":"<p><strong>Objective: </strong>Care partners of persons living with dementia perform significant financial planning in partnership with the person for whom they care. However, research is scarce on care partners' confidence and experiences with financial planning. The purpose of this study was, first, to quantify care partners' confidence across different financial planning topics. We sought to understand whether income, education, relationship type, and years of experience are related to care partners' level of confidence in financial planning. Second, we sought to better understand the reasons for these confidence ratings by examining care partners' experiences of financial planning.</p><p><strong>Methods: </strong>We conducted an online survey that asked a combination of quantitative and qualitative questions to understand care partners' confidence and experiences with financial planning. Participants were nationally recruited care partners of persons living with dementia. Multivariate linear regression was used to understand different subgroups' levels of confidence in each financial planning topic. Inductive thematic analysis was used to understand qualitative data.</p><p><strong>Results: </strong>The financial planning topics in which participants (<i>N</i> = 318) felt the least confident were: options when there is not enough money to provide care; tax deductions available to cut care costs; and sources of money from government programs for which the care recipient is eligible. Differences in confidence were observed among care partners with lower incomes, less experience, and caring for a parent. Qualitatively, participants described the challenges of care budgeting and protecting personal finances; confusion about long-term care insurance and accessing resources; and, among confident care partners, reasons for this sense of preparedness.</p><p><strong>Conclusions: </strong>These results underscore the need for tailored interventions and technologies that increase care partners' confidence in specific aspects of financial planning, including long-term care insurance, available financial support, and what to do when money runs out.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"1307-1326"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141895006","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}

{"title":"Effectiveness of interventions to prevent abuse in people living with dementia in community settings: A systematic review.","authors":"Seelia Peter A, M Mukhyaprana Prabhu, Debbie Tolson, Baby S Nayak, Rajeshkrishna P Bhandary, Binil V, Elsa Sanatombi Devi","doi":"10.1177/14713012241260476","DOIUrl":"10.1177/14713012241260476","url":null,"abstract":"<p><strong>Objectives: </strong>This review examined the evidence for interventions to prevent the abuse of people living with dementia in the community.</p><p><strong>Methods: </strong>The articles were retrieved from 2000 to 2023 from six databases, including MEDLINE via PubMed, CINAHL Plus via EBSCO, EMBASE, ProQuest Medical Library, Web of Science, and Scopus. The research articles that focused on finding the effectiveness of interventions for preventing abuse of people living with dementia in community settings were included in this review. The review included randomized controlled trials and pre-test post-test trials only. The quality appraisal of the eligible studies was done using ROB 2 and ROBINS II. The findings were tabulated and narratively synthesised.</p><p><strong>Results: </strong>Out of 1831 articles, only three were included in this review. Only two RCTs were included in this efficacy review. Both the studies showed that the interventions were not effective in reducing abuse. The studies utilised family caregiver interventions like psychological interventions and online supportive education. The review identified psychological interventions with some evidence. Another study was a quasi-experimental study that used dialectical behaviour therapy as an intervention to reduce abuse occurrence. The study showed low evidence and focused only on reporting of elder abuse as an outcome.</p><p><strong>Conclusion: </strong>This review found very few studies and was not able to draw a conclusion on the effectiveness of interventions for abuse in people living with dementia. Given the paucity of research, there is a clear need to identify how to overcome the challenges faced in elder abuse research and further refine the development of approaches to reduce elder abuse among people living with dementia in community settings.</p>","PeriodicalId":72778,"journal":{"name":"Dementia (London, England)","volume":" ","pages":"1327-1353"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433519","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}