Overnutrition and Scholastic Achievement: Is There a Relationship An 8-Year Follow-Up Study

Objective: The aim of this study was to assess the association between overnutrition and scholastic achievement (SA). Methods: A representative and proportional sample of 477 children of the 5th elementary school grade of both genders was randomly chosen during 2010, in the Metropolitan Region of Ch...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Obesity Facts 2018-11, Vol.11 (5), p.344-359
Hauptverfasser: Flores, Ofelia C., Orellana, Yasna Z., Leyton, Bárbara D., Valenzuela, Rodrigo B., Barrera, Cynthia R., Almagià, Atilio F., Martínez, Víctor C., Ivanovic, Daniza
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 359
container_issue 5
container_start_page 344
container_title Obesity Facts
container_volume 11
creator Flores, Ofelia C.
Orellana, Yasna Z.
Leyton, Bárbara D.
Valenzuela, Rodrigo B.
Barrera, Cynthia R.
Almagià, Atilio F.
Martínez, Víctor C.
Ivanovic, Daniza
description Objective: The aim of this study was to assess the association between overnutrition and scholastic achievement (SA). Methods: A representative and proportional sample of 477 children of the 5th elementary school grade of both genders was randomly chosen during 2010, in the Metropolitan Region of Chile. SA was measured through the 2009 Education Quality Measurement System (SIMCE) tests of language (LSA), mathematics (MSA) and understanding of the natural environment (UNESA). Current nutritional status was assessed through the body mass index Z-score (Z-BMI). Nutritional quality of diet, schedule exercise, socioeconomic status, family, and educational variables were also recorded. Four and 8 years later, SA was assessed through the 2013 SIMCE and the University Selection Test (2017 PSU), respectively. Results: Socioeconomic status, the number of repeated school years, and maternal schooling were strong predictors of 2009 SIMCE and the independent variables with the greatest explanatory power for LSA (Model R 2 = 0.178; p < 0.00001) variances, besides of gender for MSA (Model R 2 = 0.205; p< 0.00001) and UNESA (Model R 2 = 0.272; p < 0.00001). Overnourished children did not have significantly lower 2009 and 2013 SIMCE and 2017 PSU outcomes. Conclusions: These results confirm that overnourished children did not achieve significantly lower SA.
doi_str_mv 10.1159/000492004
format Article
fullrecord <record><control><sourceid>gale_karge</sourceid><recordid>TN_cdi_karger_primary_492004</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A588839803</galeid><doaj_id>oai_doaj_org_article_1693563ea98645d49f0d48dd9bb123f6</doaj_id><sourcerecordid>A588839803</sourcerecordid><originalsourceid>FETCH-LOGICAL-c585t-6b04a3c89b845bdf9f70f0c7d4d296041041ff429e2f67bf2e099e6d311c31873</originalsourceid><addsrcrecordid>eNptks9rFDEUxwdRbF09eBcJ9KKHqfk1mcSDsJSuLhQWbHsQDyGTH7tZZydrMrPS_75Zpw5WJCEJ733eN-8lryheI3iOUCU-QAipwHl5UpwixnBJISFPpzOuTooXKW0hZIjW6HlxQiCBvMLwtPi-OtjYDX30vQ8dUJ0B13oTWpV6r8Fcb7w92J3t-o9gmcDNxkYLFPhqW3Xk08bvwbwDvPxmVQSL0LbhV3m7B9f9YO5eFs-capN99bDPitvF5c3Fl_Jq9Xl5Mb8qdcWrvmQNpIpoLhpOq8Y44WrooK4NNVgwSFGezlEsLHasbhy2UAjLDEFIE8RrMiuWo64Jaiv30e9UvJNBefnbEOJaqpjLaa1ETJCKEasEZ7QyVDhoKDdGNA3CxLGs9WnU2g_NzhqdK4-qfST62NP5jVyHg2S4qqHAWeDdg0AMPwebernzSdu2VZ0NQ5IYISEIxuKY99k_6DYMsctPJTGBSECCGc_U-UitVS7Ady7ke3Uexu68Dp11PtvnFeecCJ4_fla8HwN0DClF66bsEZTHfpFTv2T27d_lTuSfBsnAmxH4oeLaxgmY4s_-614t5iMh98aRe0dZzQ0</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2301903268</pqid></control><display><type>article</type><title>Overnutrition and Scholastic Achievement: Is There a Relationship An 8-Year Follow-Up Study</title><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Karger Open Access</source><source>PubMed Central</source><creator>Flores, Ofelia C. ; Orellana, Yasna Z. ; Leyton, Bárbara D. ; Valenzuela, Rodrigo B. ; Barrera, Cynthia R. ; Almagià, Atilio F. ; Martínez, Víctor C. ; Ivanovic, Daniza</creator><creatorcontrib>Flores, Ofelia C. ; Orellana, Yasna Z. ; Leyton, Bárbara D. ; Valenzuela, Rodrigo B. ; Barrera, Cynthia R. ; Almagià, Atilio F. ; Martínez, Víctor C. ; Ivanovic, Daniza</creatorcontrib><description>Objective: The aim of this study was to assess the association between overnutrition and scholastic achievement (SA). Methods: A representative and proportional sample of 477 children of the 5th elementary school grade of both genders was randomly chosen during 2010, in the Metropolitan Region of Chile. SA was measured through the 2009 Education Quality Measurement System (SIMCE) tests of language (LSA), mathematics (MSA) and understanding of the natural environment (UNESA). Current nutritional status was assessed through the body mass index Z-score (Z-BMI). Nutritional quality of diet, schedule exercise, socioeconomic status, family, and educational variables were also recorded. Four and 8 years later, SA was assessed through the 2013 SIMCE and the University Selection Test (2017 PSU), respectively. Results: Socioeconomic status, the number of repeated school years, and maternal schooling were strong predictors of 2009 SIMCE and the independent variables with the greatest explanatory power for LSA (Model R 2 = 0.178; p &lt; 0.00001) variances, besides of gender for MSA (Model R 2 = 0.205; p&lt; 0.00001) and UNESA (Model R 2 = 0.272; p &lt; 0.00001). Overnourished children did not have significantly lower 2009 and 2013 SIMCE and 2017 PSU outcomes. Conclusions: These results confirm that overnourished children did not achieve significantly lower SA.</description><identifier>ISSN: 1662-4025</identifier><identifier>EISSN: 1662-4033</identifier><identifier>DOI: 10.1159/000492004</identifier><identifier>PMID: 30308520</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Academic achievement ; Age ; Analysis ; BMI ; Body mass index ; Education ; Elementary schools ; Exercise ; Family ; Family relations ; Food ; High schools ; Khan, Sal ; Measuring instruments ; Nutrition ; Nutrition research ; Nutritional status ; Obesity ; Overweight ; Physical fitness ; Quality control ; Questionnaires ; Research Article ; Scholastic achievement ; Secondary schools ; Social class ; Socio-economic status ; Students ; Type 2 diabetes</subject><ispartof>Obesity Facts, 2018-11, Vol.11 (5), p.344-359</ispartof><rights>2018 The Author(s) Published by S. Karger GmbH, Freiburg</rights><rights>2018 The Author(s) Published by S. Karger GmbH, Freiburg.</rights><rights>COPYRIGHT 2018 S. Karger AG</rights><rights>Copyright © 2018 by S. Karger GmbH, Freiburg 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c585t-6b04a3c89b845bdf9f70f0c7d4d296041041ff429e2f67bf2e099e6d311c31873</citedby><cites>FETCH-LOGICAL-c585t-6b04a3c89b845bdf9f70f0c7d4d296041041ff429e2f67bf2e099e6d311c31873</cites><orcidid>0000-0002-1054-3231</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257092/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257092/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,27616,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30308520$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Flores, Ofelia C.</creatorcontrib><creatorcontrib>Orellana, Yasna Z.</creatorcontrib><creatorcontrib>Leyton, Bárbara D.</creatorcontrib><creatorcontrib>Valenzuela, Rodrigo B.</creatorcontrib><creatorcontrib>Barrera, Cynthia R.</creatorcontrib><creatorcontrib>Almagià, Atilio F.</creatorcontrib><creatorcontrib>Martínez, Víctor C.</creatorcontrib><creatorcontrib>Ivanovic, Daniza</creatorcontrib><title>Overnutrition and Scholastic Achievement: Is There a Relationship An 8-Year Follow-Up Study</title><title>Obesity Facts</title><addtitle>Obes Facts</addtitle><description>Objective: The aim of this study was to assess the association between overnutrition and scholastic achievement (SA). Methods: A representative and proportional sample of 477 children of the 5th elementary school grade of both genders was randomly chosen during 2010, in the Metropolitan Region of Chile. SA was measured through the 2009 Education Quality Measurement System (SIMCE) tests of language (LSA), mathematics (MSA) and understanding of the natural environment (UNESA). Current nutritional status was assessed through the body mass index Z-score (Z-BMI). Nutritional quality of diet, schedule exercise, socioeconomic status, family, and educational variables were also recorded. Four and 8 years later, SA was assessed through the 2013 SIMCE and the University Selection Test (2017 PSU), respectively. Results: Socioeconomic status, the number of repeated school years, and maternal schooling were strong predictors of 2009 SIMCE and the independent variables with the greatest explanatory power for LSA (Model R 2 = 0.178; p &lt; 0.00001) variances, besides of gender for MSA (Model R 2 = 0.205; p&lt; 0.00001) and UNESA (Model R 2 = 0.272; p &lt; 0.00001). Overnourished children did not have significantly lower 2009 and 2013 SIMCE and 2017 PSU outcomes. Conclusions: These results confirm that overnourished children did not achieve significantly lower SA.</description><subject>Academic achievement</subject><subject>Age</subject><subject>Analysis</subject><subject>BMI</subject><subject>Body mass index</subject><subject>Education</subject><subject>Elementary schools</subject><subject>Exercise</subject><subject>Family</subject><subject>Family relations</subject><subject>Food</subject><subject>High schools</subject><subject>Khan, Sal</subject><subject>Measuring instruments</subject><subject>Nutrition</subject><subject>Nutrition research</subject><subject>Nutritional status</subject><subject>Obesity</subject><subject>Overweight</subject><subject>Physical fitness</subject><subject>Quality control</subject><subject>Questionnaires</subject><subject>Research Article</subject><subject>Scholastic achievement</subject><subject>Secondary schools</subject><subject>Social class</subject><subject>Socio-economic status</subject><subject>Students</subject><subject>Type 2 diabetes</subject><issn>1662-4025</issn><issn>1662-4033</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>M--</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>DOA</sourceid><recordid>eNptks9rFDEUxwdRbF09eBcJ9KKHqfk1mcSDsJSuLhQWbHsQDyGTH7tZZydrMrPS_75Zpw5WJCEJ733eN-8lryheI3iOUCU-QAipwHl5UpwixnBJISFPpzOuTooXKW0hZIjW6HlxQiCBvMLwtPi-OtjYDX30vQ8dUJ0B13oTWpV6r8Fcb7w92J3t-o9gmcDNxkYLFPhqW3Xk08bvwbwDvPxmVQSL0LbhV3m7B9f9YO5eFs-capN99bDPitvF5c3Fl_Jq9Xl5Mb8qdcWrvmQNpIpoLhpOq8Y44WrooK4NNVgwSFGezlEsLHasbhy2UAjLDEFIE8RrMiuWo64Jaiv30e9UvJNBefnbEOJaqpjLaa1ETJCKEasEZ7QyVDhoKDdGNA3CxLGs9WnU2g_NzhqdK4-qfST62NP5jVyHg2S4qqHAWeDdg0AMPwebernzSdu2VZ0NQ5IYISEIxuKY99k_6DYMsctPJTGBSECCGc_U-UitVS7Ady7ke3Uexu68Dp11PtvnFeecCJ4_fla8HwN0DClF66bsEZTHfpFTv2T27d_lTuSfBsnAmxH4oeLaxgmY4s_-614t5iMh98aRe0dZzQ0</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Flores, Ofelia C.</creator><creator>Orellana, Yasna Z.</creator><creator>Leyton, Bárbara D.</creator><creator>Valenzuela, Rodrigo B.</creator><creator>Barrera, Cynthia R.</creator><creator>Almagià, Atilio F.</creator><creator>Martínez, Víctor C.</creator><creator>Ivanovic, Daniza</creator><general>S. Karger AG</general><general>S. Karger GmbH</general><general>Karger Publishers</general><scope>M--</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IAO</scope><scope>3V.</scope><scope>7WY</scope><scope>7X7</scope><scope>7XB</scope><scope>883</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FL</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BEZIV</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FRNLG</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K60</scope><scope>K6~</scope><scope>K9.</scope><scope>M0F</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PADUT</scope><scope>PQBIZ</scope><scope>PQBZA</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PYYUZ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-1054-3231</orcidid></search><sort><creationdate>20181101</creationdate><title>Overnutrition and Scholastic Achievement: Is There a Relationship An 8-Year Follow-Up Study</title><author>Flores, Ofelia C. ; Orellana, Yasna Z. ; Leyton, Bárbara D. ; Valenzuela, Rodrigo B. ; Barrera, Cynthia R. ; Almagià, Atilio F. ; Martínez, Víctor C. ; Ivanovic, Daniza</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c585t-6b04a3c89b845bdf9f70f0c7d4d296041041ff429e2f67bf2e099e6d311c31873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Academic achievement</topic><topic>Age</topic><topic>Analysis</topic><topic>BMI</topic><topic>Body mass index</topic><topic>Education</topic><topic>Elementary schools</topic><topic>Exercise</topic><topic>Family</topic><topic>Family relations</topic><topic>Food</topic><topic>High schools</topic><topic>Khan, Sal</topic><topic>Measuring instruments</topic><topic>Nutrition</topic><topic>Nutrition research</topic><topic>Nutritional status</topic><topic>Obesity</topic><topic>Overweight</topic><topic>Physical fitness</topic><topic>Quality control</topic><topic>Questionnaires</topic><topic>Research Article</topic><topic>Scholastic achievement</topic><topic>Secondary schools</topic><topic>Social class</topic><topic>Socio-economic status</topic><topic>Students</topic><topic>Type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Flores, Ofelia C.</creatorcontrib><creatorcontrib>Orellana, Yasna Z.</creatorcontrib><creatorcontrib>Leyton, Bárbara D.</creatorcontrib><creatorcontrib>Valenzuela, Rodrigo B.</creatorcontrib><creatorcontrib>Barrera, Cynthia R.</creatorcontrib><creatorcontrib>Almagià, Atilio F.</creatorcontrib><creatorcontrib>Martínez, Víctor C.</creatorcontrib><creatorcontrib>Ivanovic, Daniza</creatorcontrib><collection>Karger Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale Academic OneFile</collection><collection>ProQuest Central (Corporate)</collection><collection>ABI/INFORM Collection</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ABI/INFORM Trade &amp; Industry (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ABI/INFORM Collection (Alumni Edition)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Business Premium Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Business Premium Collection (Alumni)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Business Collection (Alumni Edition)</collection><collection>ProQuest Business Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>ABI/INFORM Trade &amp; Industry</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Research Library China</collection><collection>ProQuest One Business</collection><collection>ProQuest One Business (Alumni)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ABI/INFORM Collection China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Obesity Facts</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Flores, Ofelia C.</au><au>Orellana, Yasna Z.</au><au>Leyton, Bárbara D.</au><au>Valenzuela, Rodrigo B.</au><au>Barrera, Cynthia R.</au><au>Almagià, Atilio F.</au><au>Martínez, Víctor C.</au><au>Ivanovic, Daniza</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Overnutrition and Scholastic Achievement: Is There a Relationship An 8-Year Follow-Up Study</atitle><jtitle>Obesity Facts</jtitle><addtitle>Obes Facts</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>11</volume><issue>5</issue><spage>344</spage><epage>359</epage><pages>344-359</pages><issn>1662-4025</issn><eissn>1662-4033</eissn><abstract>Objective: The aim of this study was to assess the association between overnutrition and scholastic achievement (SA). Methods: A representative and proportional sample of 477 children of the 5th elementary school grade of both genders was randomly chosen during 2010, in the Metropolitan Region of Chile. SA was measured through the 2009 Education Quality Measurement System (SIMCE) tests of language (LSA), mathematics (MSA) and understanding of the natural environment (UNESA). Current nutritional status was assessed through the body mass index Z-score (Z-BMI). Nutritional quality of diet, schedule exercise, socioeconomic status, family, and educational variables were also recorded. Four and 8 years later, SA was assessed through the 2013 SIMCE and the University Selection Test (2017 PSU), respectively. Results: Socioeconomic status, the number of repeated school years, and maternal schooling were strong predictors of 2009 SIMCE and the independent variables with the greatest explanatory power for LSA (Model R 2 = 0.178; p &lt; 0.00001) variances, besides of gender for MSA (Model R 2 = 0.205; p&lt; 0.00001) and UNESA (Model R 2 = 0.272; p &lt; 0.00001). Overnourished children did not have significantly lower 2009 and 2013 SIMCE and 2017 PSU outcomes. Conclusions: These results confirm that overnourished children did not achieve significantly lower SA.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>30308520</pmid><doi>10.1159/000492004</doi><tpages>16</tpages><orcidid>https://orcid.org/0000-0002-1054-3231</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1662-4025
ispartof Obesity Facts, 2018-11, Vol.11 (5), p.344-359
issn 1662-4025
1662-4033
language eng
recordid cdi_karger_primary_492004
source DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Karger Open Access; PubMed Central
subjects Academic achievement
Age
Analysis
BMI
Body mass index
Education
Elementary schools
Exercise
Family
Family relations
Food
High schools
Khan, Sal
Measuring instruments
Nutrition
Nutrition research
Nutritional status
Obesity
Overweight
Physical fitness
Quality control
Questionnaires
Research Article
Scholastic achievement
Secondary schools
Social class
Socio-economic status
Students
Type 2 diabetes
title Overnutrition and Scholastic Achievement: Is There a Relationship An 8-Year Follow-Up Study
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T20%3A52%3A12IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_karge&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Overnutrition%20and%20Scholastic%20Achievement:%20Is%20There%20a%20Relationship%20An%208-Year%20Follow-Up%20Study&rft.jtitle=Obesity%20Facts&rft.au=Flores,%20Ofelia%20C.&rft.date=2018-11-01&rft.volume=11&rft.issue=5&rft.spage=344&rft.epage=359&rft.pages=344-359&rft.issn=1662-4025&rft.eissn=1662-4033&rft_id=info:doi/10.1159/000492004&rft_dat=%3Cgale_karge%3EA588839803%3C/gale_karge%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2301903268&rft_id=info:pmid/30308520&rft_galeid=A588839803&rft_doaj_id=oai_doaj_org_article_1693563ea98645d49f0d48dd9bb123f6&rfr_iscdi=true