Primary health care research & development最新文献

{"title":"Italian cross-cultural adaptation of the EveryONE Social Needs Screening Tool of social determinants of health in primary care.","authors":"Lorenzo Campedelli, Lucia Palandri, Viviana Forte, Vanessa Eugenia Privitera, Peter Konstantin Kurotschka, Giulia Ugolini, Silvia Riccomi, Francesca Rossi, Silvia Keeling, Cinzia Scauri, Elena Righi, Alice Serafini","doi":"10.1017/S1463423625100418","DOIUrl":"10.1017/S1463423625100418","url":null,"abstract":"<p><p>Social disadvantage can result in healthcare gaps and primary care may be a suitable healthcare context to identify unmet social needs. A variety of screening tools exists but none of them is consolidated in clinical practice. After reviewing the available instruments, we conducted a rigorous translation and trans-cultural adaptation into Italian language of the EveryONE social need screening tool questionnaire of the American Academy of Family Physicians. The translated questionnaire was piloted among 45 patients consecutively recruited in two general practices in the northern Italian city of Modena in 2023 and obtained excellent scores in comprehension and acceptability. The cross-cultural adaptation presented in this study is a first step towards a complete validation. A full validation study is needed to safely adopt EveryONE in routine general practice and to evaluate its effects on health provision.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e76"},"PeriodicalIF":1.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994594","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":"Models for delivery and co-ordination of primary or secondary healthcare (or both) to older adults living in aged care facilities.","authors":"Lydia Jane Grey, Daksha Trivedi","doi":"10.1017/S1463423625100352","DOIUrl":"10.1017/S1463423625100352","url":null,"abstract":"","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e75"},"PeriodicalIF":1.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981835","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 health care reforms: a scoping review.","authors":"Ahmad Shirjang, Leila Doshmangir, Mohammad Bazyar, Vladimir Sergeevich Gordeev","doi":"10.1017/S1463423625000271","DOIUrl":"10.1017/S1463423625000271","url":null,"abstract":"<p><strong>Background: </strong>Demographic transitions, societal changes, and evolving population health needs are placing increasing pressure on healthcare systems, necessitating ongoing reforms. Primary health care (PHC) is a foundational component of Universal Health Coverage (UHC) and sustainable health systems. Many countries have undertaken PHC reforms aimed at improving population health. This review explores the objectives, implementation mechanisms, challenges, and outcomes of these reforms.</p><p><strong>Methods: </strong>We conducted a systematic review of studies sourced from five databases (PubMed, Scopus, Proquest, Embase, and Science Direct), applying the World Health Organization's Health Systems Framework for deductive content analysis. The PRISMA guidelines were followed to ensure transparency and rigour in summarizing the published literature.</p><p><strong>Results: </strong>A total of 147 types of interventions were identified, with most targeting service delivery and financing. Key reform objectives included expanding access to care, improving financing and payment systems, scaling up family physician programmes, increasing government health expenditure, leveraging private sector capacities, and strengthening the PHC workforce. These interventions resulted in expanded public health coverage, enhanced access to PHC, increased utilization of services among low-income populations, broader social insurance coverage, and improved service quality, contributing to better community health outcomes.</p><p><strong>Conclusion: </strong>The success of PHC reforms depends on their alignment with political, social, and cultural contexts, as well as consideration of the social determinants of health. Strong governmental support, managerial stability, decentralization, and regional capacity building are essential for sustainable implementation. Reforms should be gradual, supported by accurate forecasting, adequate and sustainable resources, and evidence-based strategies, drawing on international experiences.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e74"},"PeriodicalIF":1.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877194","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":"The impact of telemedicine on physician time invested in primary care: a large population-based descriptive study.","authors":"Avivit Golan-Cohen, Shlomo Vinker, Eugene Merzon, Ilan Green, Ariel Israel","doi":"10.1017/S1463423625100364","DOIUrl":"10.1017/S1463423625100364","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the impact of telemedicine on the workload of primary care physicians (PCPs).</p><p><strong>Background: </strong>Telemedicine, including video visits, telephone visits, and digital correspondence, is increasingly offered by physicians, particularly since the COVID-19 pandemic. It is still unclear whether increasing the variety of services creates an increase in demand and therefore causes an increase in the workload of PCPs. In this study.</p><p><strong>Methods: </strong>A population-based descriptive study, conducted during the 2020-2021 period, on a cohort of 464,119 patients, all members of Leumit Health Services and without a diagnosis of COVID-19. The patients were stratified into three distinct groups based on the nature of their healthcare visits: Patients who used only face-to-face (FTF) visits; Patients who used asynchronous visits with or without FTF visits but did not use synchronous telemedicine visit; and patients who used synchronous telemedicine visits with or without other types of visits. We performed a comparative analysis on Accumulated Annual Duration of Time (AADT) as an index for workload, across the different periods, using standard descriptive statistics methods.</p><p><strong>Findings: </strong>Telemedicine use was higher in older persons, females, those of higher socioeconomic status, and patients with comorbidities. The greater the number of telemedicine visits, the greater the time the PCP spent on visits during the year. The largest increase in AADT (56.1%) was observed in patients who had only FTF meetings in 2020 but in 2021 made all types of visits. Overall, there was an increase of 2.5% in time invested in 2021 and a 5.8% increase in the number of patients making digital visits.</p><p><strong>Conclusions: </strong>Policymakers encouraging telemedicine should consider the additional load on PCPs associated with telemedicine use and plan resources accordingly.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e72"},"PeriodicalIF":1.7,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857122","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":"The effectiveness and acceptability of digital health interventions as tools to promote physical activity in primary care: an update scoping review.","authors":"Callum Leese, Kirstin Abraham, Chris van de Konijnenburg, Hussain Al-Zubaidi","doi":"10.1017/S1463423625100339","DOIUrl":"10.1017/S1463423625100339","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) promotion in primary healthcare is an effective way of addressing population-based physical inactivity. Advancements in technology could help overcome barriers to promoting PA. This scoping review aims to provide an overview of technology (digital health) for PA promotion in primary healthcare, including effectiveness and acceptability, from research published between January 2020 and December 2023.</p><p><strong>Methods: </strong>A scoping review was conducted across five databases (Cochrane library, Embase, MEDLINE, PubMed and WebofScience). Search terms focused on three components: PA counselling, technology and primary healthcare. Articles from 01/01/2020 to 05/12/2023 were included. Paediatric populations and populations with diseases requiring specialist care were excluded.</p><p><strong>Results: </strong>Of 2717 studies identified during database searches, twenty-nine were included in the review. Mobile-phone applications were the preferred method of implementation (<i>n</i> = 12, 52%), with most interventions aiding in assessment of PA levels (<i>n</i> = 16, 70%) and/or assisting in addressing it (via education, monitoring or support) (<i>n</i> = 22, 96%). Findings revealed mixed evidence on the effectiveness of digital health interventions in increasing PA but reported widespread acceptability of digital health interventions. Qualitative studies revealed three main themes desired by stakeholders: (1) ease of use, (2) complements pre-existing primary healthcare provision and (3) patient-centred.</p><p><strong>Conclusion: </strong>Future research should focus on developing standardised approaches for assessing digital health interventions, exploring the impact on prescribing behaviours and addressing the desired features highlighted by stakeholders. Integration of technology in healthcare, including PA promotion, holds promise for enhancing access and facilitating widespread implementation.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e70"},"PeriodicalIF":1.7,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857121","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":"PURE PRIME: Implementing PUlmonary REhabilitation in PRIMary carE: a protocol for a randomized controlled feasibility trial.","authors":"Jessica A Walsh, Zoe J McKeough, Marita T Dale, Jennifer A Alison, Sarah M Dennis","doi":"10.1017/S1463423625100340","DOIUrl":"10.1017/S1463423625100340","url":null,"abstract":"<p><strong>Introduction: </strong>The benefits of pulmonary rehabilitation (PR) on exercise capacity, health-related quality of life (HRQoL), and prevention of readmission post exacerbation in chronic respiratory diseases (CRD) are well established. However, accessibility to PR programmes is limited by PR programmes mostly being available through hospital clinics only. Utilizing existing workforce and infrastructure in private physiotherapy and exercise physiology practices may be a solution to increase access.</p><p><strong>Methods: </strong>A mixed-methods assessor-blinded randomized controlled feasibility trial will be conducted in two parts. First, the efficacy of a training programme for private practice (PP) physiotherapists and accredited exercise physiologists who have not previously provided PR will be evaluated. Participant knowledge, skills, and confidence to provide PR will be measured before and after the training and at three months follow-up. Secondly, patient participants with CRD will be randomly allocated to receive twice weekly PP PR for 8 weeks or usual care from their general practitioner (GP). Exercise capacity, HRQoL, and health status will be measured before and after PR. A purposive sample of clinician and patient participants will partake in semi-structured interviews at the study conclusion. Interviews will continue until data saturation is achieved.</p><p><strong>Discussion: </strong>This study will provide data on the feasibility of providing PR by physiotherapists and exercise physiologists in the PP setting. Provision of PR in the PP setting has the potential to increase access to this highly evidence-based intervention to improve outcomes for people with CRD.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e71"},"PeriodicalIF":1.7,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857119","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":"The community pharmacists' opinion regarding pharmacist as immunizers for expanding their role and service in Thailand.","authors":"Orawan Sae-Lim, Anisrin Miranshahid, Sutita Daewha, Shosita Siriwat, Chakriya Ditsarapong","doi":"10.1017/S1463423625100376","DOIUrl":"10.1017/S1463423625100376","url":null,"abstract":"<p><strong>Background: </strong>Many countries have permitted community pharmacists to administer vaccines to increase the immunization rate. The policy of Thailand has recently expanded and permitted pharmacists to play a role in immunization.</p><p><strong>Aim: </strong>The objective of this study was to survey the opinion and readiness of community pharmacists as immunizers.</p><p><strong>Methods: </strong>This study was a prospective, mixed-methods questionnaire and semi-structured interview. The study included community pharmacists in Hatyai, Songkhla, Thailand. A Likert scale questionnaire to evaluate readiness, opinions, and barriers to providing vaccines was distributed online. The volunteer pharmacists were interviewed about their opinions, distress, and benefits of vaccination services.</p><p><strong>Findings: </strong>An online survey was completed by 146 pharmacists, and 12 community pharmacists agreed to be interviewed. More than 65% of respondents agreed that vaccination services in community pharmacies are easily accessible to patients. Approximately 46% of pharmacist respondents were willing to be immunizers, and 45% of respondents showed readiness with the availability of pharmacy space for handling vaccinations, their storage, and disposing of sharp objects. Almost all of the respondents showed readiness with knowledge of adverse events following immunization (AEFI) and management. However, most of the concerns were vaccine administration skills, the conflict with other professionals, and the cost of setup and management. The pharmacists required training in vaccine administration skills before providing the service.</p><p><strong>Conclusions: </strong>The community pharmacies were willing and ready to provide vaccination services for the National List of Essential Vaccines. Vaccine administration skills were the main barriers to vaccination. The training should be done in faculty classes or workshops.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e73"},"PeriodicalIF":1.7,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857120","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":"Changes in the smoking status of primary care professionals and their association with rates of tobacco treatment delivery: the TiTAN Greece & Cyprus tobacco dependence treatment training programme.","authors":"Stavros Stafylidis, Sophia Papadakis, Paraskevi Katsaounou, Constantine Vardavas, Ioanna Tsiligianni, George Samoutis, Athina Tatsioni, Marilena Anastasaki, Charis Girvalaki, Andrew Pipe, Christos Lionis, Emmanouil Smyrnakis","doi":"10.1017/S1463423625100388","DOIUrl":"10.1017/S1463423625100388","url":null,"abstract":"<p><strong>Aim: </strong>This study examines the impact of a continuing medical education (CME) intervention on smoking cessation among primary-care professionals (PCPs) and explores the relationship between PCP smoking status and patient tobacco-treatment delivery.</p><p><strong>Background: </strong>High rates of tobacco use among PCPs have been reported in several European countries. PCPs who smoke are less motivated to provide cessation support to their patients.</p><p><strong>Methods: </strong>A before-after study was conducted with 228 PCPs from Greece and Cyprus. The intervention included a one-day CME training, a 2.5-hour seminar three months later, and practice tools. Expert faculty provided informal support to smoking PCPs. Changes in PCP smoking status and 5As (ask, advise, assess, assist, and arrange) tobacco treatment delivery were assessed before and six months after training. Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) were used to evaluate the association between the training and PCP smoking status and 5As delivery.</p><p><strong>Findings: </strong>At baseline, 18% (<i>n</i> = 47) of PCPs were current smokers, and 39% (<i>n</i> = 66) were ex-smokers. At follow-up, 31.9% of current smokers reported quitting (<i>n</i> = 15/47; <i>p</i> < 0.001). Smoking cessation was higher among female PCPs (<i>p</i> = 0.02) and those in Cyprus and Thessaloniki (<i>p</i> < 0.01). PCPs reported increased 5As delivery at follow-up, with the highest rates among ex-smokers (>6 months) and never smokers. PCPs reported significant quitting rates following a comprehensive evidence-based training intervention. The findings suggest that addressing PCPs' smoking status can improve both health-care provider and patient smoking outcomes.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e69"},"PeriodicalIF":1.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839304","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":"Preventing decompensation among multimorbid outpatients in residential care: a cohort study with a six-month follow-up to prevent decompensation among multimorbid outpatients in residential care.","authors":"Paul Aujoulat, Jean Yves Le Reste, Lucas Beurton-Couraud, Marie Barais, Benoit Chiron, Pierre Barraine, Morgane Guillou-Landreat, Delphine Le Goff","doi":"10.1017/S1463423625100145","DOIUrl":"10.1017/S1463423625100145","url":null,"abstract":"<p><strong>Aim: </strong>The European General Practitioners Research Network (EGPRN) designed and validated a comprehensive definition of multimorbidity using a systematic literature review and qualitative research throughout Europe. This survey assessed which criteria in the EGPRN concept of multimorbidity could detect decompensating patients in residential care within a primary care cohort at a six-month follow-up.</p><p><strong>Method: </strong>Family physicians included all multimorbid patients encountered in their residential care homes from July to December 2014. Inclusion criteria were those of the EGPRN definition of multimorbidity. Exclusion criteria were patients under legal protection and those unable to complete the 2-year follow-up. Decompensation was defined as the occurrence of death or hospitalization for more than seven days. Statistical analysis was undertaken with uni- and multi-variate analysis at a six-month follow-up using a combination of approaches including both automatic classification and expert decision. A multiple correspondence analysis and a hierarchical clustering on principal components confirmed the consistency of the results. Finally, a logistic regression was performed to identify and quantify risk factors for decompensation.Findings: About 12 family physicians participated in the study. In the study, 64 patients were analyzed. On analyzing the characteristics of the participants, two statistically significant variables between the two groups (decompensation and Nothing To Report): pain (p = 0.004) and the use of psychotropic drugs (p = 0.019) were highlighted. The final model of the logistic regression showed pain as the main decompensation risk factor.</p><p><strong>Conclusion: </strong>Action should be taken by the health teams and their physicians to prevent decompensation in patients in residential care who are experiencing pain.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e68"},"PeriodicalIF":1.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777138","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":"To what extent do general practitioners involve patients in decision-making? A systematic review of studies using the OPTION-instrument.","authors":"Dirk T Ubbink, Fadi Shamoun, Steyn Heuvelsland, Faridi S van Etten-Jamaludin, Eva E Bolt","doi":"10.1017/S1463423625100303","DOIUrl":"10.1017/S1463423625100303","url":null,"abstract":"<p><strong>Aim: </strong>This systematic review aimed to analyze studies assessing the extent to which General Practitioners (GPs) engage patients in the decision-making process during consultations.</p><p><strong>Background: </strong>Shared Decision Making (SDM) stands at the core of patient-centred care, particularly in primary healthcare, where a diverse array of medical decisions transpires. In a 2015 systematic review summarizing studies on the Observing Patient Involvement in Decision Making (OPTION) instrument to assess SDM objectively across healthcare settings, a notable dearth of patient involvement was observed.</p><p><strong>Methods: </strong>A comprehensive literature search encompassing three digital databases was conducted up to November 2023. Inclusion criteria focused on studies employing a comparative study design, centric to primary healthcare, and utilizing the OPTION-5 or -12 instrument to gauge SDM levels. Two investigators independently performed study selection, risk of bias assessment, and data extraction using a list of predefined variables, with discrepancies resolved by a third reviewer. PROSPERO registration-ID: CRD42023475419.</p><p><strong>Findings: </strong>Initially, harvesting 447 articles, our review retained 29 studies published between 2003 and 2022. Mean age of GPs was 45.5 (range 33-53) years. Reported baseline OPTION scores varied between 1.5 and 57.2 on a 0-100-point scale, with a median score of 16. Following SDM interventions, OPTION-scores increased significantly to a median of 28.5, range 16-83.</p><p><strong>Conclusion: </strong>The overall level of SDM among GPs remains relatively low and has shown minimal improvement over the past decade. However, interventions promoting SDM appear to enhance patient involvement levels. This underscores the necessity for increased education and tools, directed at GPs and patients, to foster and elevate the practice of SDM.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e67"},"PeriodicalIF":1.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755325","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}