Cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt
Background Behavioral interventions such as cognitive behavioral therapy (CBT) are among the most widely used nonpharmacologic alternatives for the treatment of insomnia. Purpose The aim of this study was to determine the prevalence of insomnia, factors affecting it, and the impact of a cognitive be...
Gespeichert in:
| Veröffentlicht in: | Sleep & breathing 2012-12, Vol.16 (4), p.1173-1180 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1180 |
|---|---|
| container_issue | 4 |
| container_start_page | 1173 |
| container_title | Sleep & breathing |
| container_volume | 16 |
| creator | El Kady, Heba M. Ibrahim, Hala K. Mohamed, Sherine G. |
| description | Background
Behavioral interventions such as cognitive behavioral therapy (CBT) are among the most widely used nonpharmacologic alternatives for the treatment of insomnia.
Purpose
The aim of this study was to determine the prevalence of insomnia, factors affecting it, and the impact of a cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt.
Methods
This study was done through two phases. A cross-sectional design was used in the first phase to detect the prevalence of sleep problems and their correlates among the elderly, then pretest–posttest design was used to apply an intervention program to the elders who suffered from insomnia. A pre-designed structured interview questionnaire was presented to the participants. The main outcome measure was sleep quality, as measured by the Pittsburgh Sleep Quality Index.
Results
The study included a total of 210 elders (97 males and 113 females), with a mean age of 72.2 ± 5.3 years, about two thirds of them were poor sleepers (63.3%). The results show that after carrying out the behavioral therapy for the elders, the percentage of poor sleepers decreased from 63.3% to 46.2%. Two variables (educational level and female sex) proved to be statistically significantly related to the improvement in sleep quality.
Conclusions
A goal of this intervention program was considerably achieved. Importantly, the intervention appears to improve sleep quality among the elders. Data from this study re-enforce the continuing need for more sleep educational programs that are intended to attract the attention of elders especially those institutionalized. |
| doi_str_mv | 10.1007/s11325-011-0629-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1171862260</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1171862260</sourcerecordid><originalsourceid>FETCH-LOGICAL-c468t-f2852e976e19054abcceee1acffa28b088ff403372e6e6819f15638179d16233</originalsourceid><addsrcrecordid>eNp1kU1r3DAQhk1paNK0P6CXIiiFHupWI9mydAxL2gYCveQuZHm0UdBKrmSHbH997ez2g0JOMzDPvPPxVtUboJ-A0u5zAeCsrSlATQVTNX9WnUHLWA0dVc8fc1qrFthp9bKUO0qhkQpeVKeMgaCKw1mVNmkb_eTvkfR4a-59yiaQ6RazGffEpUx8LJOf5smnaIL_iQPBMGAuxKbdGIyPPm5JcqQExJEMvkxz7k20uHSSi4APJg7Zm4_kcrsfp1fViTOh4OtjPK9uvlzebL7V19-_Xm0urmvbCDnVjsmWoeoEgqJtY3prERGMdc4w2VMpnWso5x1DgUKCctAKLqFTAwjG-Xn14SA75vRjxjLpnS8WQzAR01w0QAdSMCbogr77D71Lc15uXakWJBVUrhQcKJtTKRmdHrPfmbzXQPVqhj6YoRcz9GqGXpd4e1Se-x0Ofzp-f38B3h8BU6wJLi9v8-UvJ0TTNnwVYgeuLKW4xfzPik9O_wVeU6IK</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1151806080</pqid></control><display><type>article</type><title>Cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>El Kady, Heba M. ; Ibrahim, Hala K. ; Mohamed, Sherine G.</creator><creatorcontrib>El Kady, Heba M. ; Ibrahim, Hala K. ; Mohamed, Sherine G.</creatorcontrib><description>Background
Behavioral interventions such as cognitive behavioral therapy (CBT) are among the most widely used nonpharmacologic alternatives for the treatment of insomnia.
Purpose
The aim of this study was to determine the prevalence of insomnia, factors affecting it, and the impact of a cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt.
Methods
This study was done through two phases. A cross-sectional design was used in the first phase to detect the prevalence of sleep problems and their correlates among the elderly, then pretest–posttest design was used to apply an intervention program to the elders who suffered from insomnia. A pre-designed structured interview questionnaire was presented to the participants. The main outcome measure was sleep quality, as measured by the Pittsburgh Sleep Quality Index.
Results
The study included a total of 210 elders (97 males and 113 females), with a mean age of 72.2 ± 5.3 years, about two thirds of them were poor sleepers (63.3%). The results show that after carrying out the behavioral therapy for the elders, the percentage of poor sleepers decreased from 63.3% to 46.2%. Two variables (educational level and female sex) proved to be statistically significantly related to the improvement in sleep quality.
Conclusions
A goal of this intervention program was considerably achieved. Importantly, the intervention appears to improve sleep quality among the elders. Data from this study re-enforce the continuing need for more sleep educational programs that are intended to attract the attention of elders especially those institutionalized.</description><identifier>ISSN: 1520-9512</identifier><identifier>EISSN: 1522-1709</identifier><identifier>DOI: 10.1007/s11325-011-0629-3</identifier><identifier>PMID: 22160931</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Aged ; Aged, 80 and over ; Biological and medical sciences ; Cognitive therapy ; Cognitive Therapy - methods ; Cross-Cultural Comparison ; Cross-Sectional Studies ; Dentistry ; Developing Countries ; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes ; Egypt ; Female ; Fundamental and applied biological sciences. Psychology ; Geriatric psychology ; Health Behavior ; Homes for the Aged ; Humans ; Immunomodulators ; Insomnia ; Internal Medicine ; Life Style ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Nursing Homes ; Original Article ; Otorhinolaryngology ; Pediatrics ; Pharmacology. Drug treatments ; Pneumology/Respiratory System ; Psychometrics - statistics & numerical data ; Reproducibility of Results ; Sleep Initiation and Maintenance Disorders - epidemiology ; Sleep Initiation and Maintenance Disorders - therapy ; Sleep. Vigilance ; Surveys and Questionnaires ; Translating ; Vertebrates: nervous system and sense organs</subject><ispartof>Sleep & breathing, 2012-12, Vol.16 (4), p.1173-1180</ispartof><rights>Springer-Verlag 2011</rights><rights>2014 INIST-CNRS</rights><rights>Springer-Verlag Berlin Heidelberg 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-f2852e976e19054abcceee1acffa28b088ff403372e6e6819f15638179d16233</citedby><cites>FETCH-LOGICAL-c468t-f2852e976e19054abcceee1acffa28b088ff403372e6e6819f15638179d16233</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11325-011-0629-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11325-011-0629-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26645433$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22160931$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>El Kady, Heba M.</creatorcontrib><creatorcontrib>Ibrahim, Hala K.</creatorcontrib><creatorcontrib>Mohamed, Sherine G.</creatorcontrib><title>Cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt</title><title>Sleep & breathing</title><addtitle>Sleep Breath</addtitle><addtitle>Sleep Breath</addtitle><description>Background
Behavioral interventions such as cognitive behavioral therapy (CBT) are among the most widely used nonpharmacologic alternatives for the treatment of insomnia.
Purpose
The aim of this study was to determine the prevalence of insomnia, factors affecting it, and the impact of a cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt.
Methods
This study was done through two phases. A cross-sectional design was used in the first phase to detect the prevalence of sleep problems and their correlates among the elderly, then pretest–posttest design was used to apply an intervention program to the elders who suffered from insomnia. A pre-designed structured interview questionnaire was presented to the participants. The main outcome measure was sleep quality, as measured by the Pittsburgh Sleep Quality Index.
Results
The study included a total of 210 elders (97 males and 113 females), with a mean age of 72.2 ± 5.3 years, about two thirds of them were poor sleepers (63.3%). The results show that after carrying out the behavioral therapy for the elders, the percentage of poor sleepers decreased from 63.3% to 46.2%. Two variables (educational level and female sex) proved to be statistically significantly related to the improvement in sleep quality.
Conclusions
A goal of this intervention program was considerably achieved. Importantly, the intervention appears to improve sleep quality among the elders. Data from this study re-enforce the continuing need for more sleep educational programs that are intended to attract the attention of elders especially those institutionalized.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cognitive therapy</subject><subject>Cognitive Therapy - methods</subject><subject>Cross-Cultural Comparison</subject><subject>Cross-Sectional Studies</subject><subject>Dentistry</subject><subject>Developing Countries</subject><subject>Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</subject><subject>Egypt</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Geriatric psychology</subject><subject>Health Behavior</subject><subject>Homes for the Aged</subject><subject>Humans</subject><subject>Immunomodulators</subject><subject>Insomnia</subject><subject>Internal Medicine</subject><subject>Life Style</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Nursing Homes</subject><subject>Original Article</subject><subject>Otorhinolaryngology</subject><subject>Pediatrics</subject><subject>Pharmacology. Drug treatments</subject><subject>Pneumology/Respiratory System</subject><subject>Psychometrics - statistics & numerical data</subject><subject>Reproducibility of Results</subject><subject>Sleep Initiation and Maintenance Disorders - epidemiology</subject><subject>Sleep Initiation and Maintenance Disorders - therapy</subject><subject>Sleep. Vigilance</subject><subject>Surveys and Questionnaires</subject><subject>Translating</subject><subject>Vertebrates: nervous system and sense organs</subject><issn>1520-9512</issn><issn>1522-1709</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1r3DAQhk1paNK0P6CXIiiFHupWI9mydAxL2gYCveQuZHm0UdBKrmSHbH997ez2g0JOMzDPvPPxVtUboJ-A0u5zAeCsrSlATQVTNX9WnUHLWA0dVc8fc1qrFthp9bKUO0qhkQpeVKeMgaCKw1mVNmkb_eTvkfR4a-59yiaQ6RazGffEpUx8LJOf5smnaIL_iQPBMGAuxKbdGIyPPm5JcqQExJEMvkxz7k20uHSSi4APJg7Zm4_kcrsfp1fViTOh4OtjPK9uvlzebL7V19-_Xm0urmvbCDnVjsmWoeoEgqJtY3prERGMdc4w2VMpnWso5x1DgUKCctAKLqFTAwjG-Xn14SA75vRjxjLpnS8WQzAR01w0QAdSMCbogr77D71Lc15uXakWJBVUrhQcKJtTKRmdHrPfmbzXQPVqhj6YoRcz9GqGXpd4e1Se-x0Ofzp-f38B3h8BU6wJLi9v8-UvJ0TTNnwVYgeuLKW4xfzPik9O_wVeU6IK</recordid><startdate>20121201</startdate><enddate>20121201</enddate><creator>El Kady, Heba M.</creator><creator>Ibrahim, Hala K.</creator><creator>Mohamed, Sherine G.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7T5</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2R</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20121201</creationdate><title>Cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt</title><author>El Kady, Heba M. ; Ibrahim, Hala K. ; Mohamed, Sherine G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c468t-f2852e976e19054abcceee1acffa28b088ff403372e6e6819f15638179d16233</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cognitive therapy</topic><topic>Cognitive Therapy - methods</topic><topic>Cross-Cultural Comparison</topic><topic>Cross-Sectional Studies</topic><topic>Dentistry</topic><topic>Developing Countries</topic><topic>Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</topic><topic>Egypt</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Geriatric psychology</topic><topic>Health Behavior</topic><topic>Homes for the Aged</topic><topic>Humans</topic><topic>Immunomodulators</topic><topic>Insomnia</topic><topic>Internal Medicine</topic><topic>Life Style</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Nursing Homes</topic><topic>Original Article</topic><topic>Otorhinolaryngology</topic><topic>Pediatrics</topic><topic>Pharmacology. Drug treatments</topic><topic>Pneumology/Respiratory System</topic><topic>Psychometrics - statistics & numerical data</topic><topic>Reproducibility of Results</topic><topic>Sleep Initiation and Maintenance Disorders - epidemiology</topic><topic>Sleep Initiation and Maintenance Disorders - therapy</topic><topic>Sleep. Vigilance</topic><topic>Surveys and Questionnaires</topic><topic>Translating</topic><topic>Vertebrates: nervous system and sense organs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>El Kady, Heba M.</creatorcontrib><creatorcontrib>Ibrahim, Hala K.</creatorcontrib><creatorcontrib>Mohamed, Sherine G.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection【Remote access available】</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Psychology Database (ProQuest)</collection><collection>Social Science Database (ProQuest)</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>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Sleep & breathing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>El Kady, Heba M.</au><au>Ibrahim, Hala K.</au><au>Mohamed, Sherine G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt</atitle><jtitle>Sleep & breathing</jtitle><stitle>Sleep Breath</stitle><addtitle>Sleep Breath</addtitle><date>2012-12-01</date><risdate>2012</risdate><volume>16</volume><issue>4</issue><spage>1173</spage><epage>1180</epage><pages>1173-1180</pages><issn>1520-9512</issn><eissn>1522-1709</eissn><abstract>Background
Behavioral interventions such as cognitive behavioral therapy (CBT) are among the most widely used nonpharmacologic alternatives for the treatment of insomnia.
Purpose
The aim of this study was to determine the prevalence of insomnia, factors affecting it, and the impact of a cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt.
Methods
This study was done through two phases. A cross-sectional design was used in the first phase to detect the prevalence of sleep problems and their correlates among the elderly, then pretest–posttest design was used to apply an intervention program to the elders who suffered from insomnia. A pre-designed structured interview questionnaire was presented to the participants. The main outcome measure was sleep quality, as measured by the Pittsburgh Sleep Quality Index.
Results
The study included a total of 210 elders (97 males and 113 females), with a mean age of 72.2 ± 5.3 years, about two thirds of them were poor sleepers (63.3%). The results show that after carrying out the behavioral therapy for the elders, the percentage of poor sleepers decreased from 63.3% to 46.2%. Two variables (educational level and female sex) proved to be statistically significantly related to the improvement in sleep quality.
Conclusions
A goal of this intervention program was considerably achieved. Importantly, the intervention appears to improve sleep quality among the elders. Data from this study re-enforce the continuing need for more sleep educational programs that are intended to attract the attention of elders especially those institutionalized.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22160931</pmid><doi>10.1007/s11325-011-0629-3</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1520-9512 |
| ispartof | Sleep & breathing, 2012-12, Vol.16 (4), p.1173-1180 |
| issn | 1520-9512 1522-1709 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1171862260 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Aged, 80 and over Biological and medical sciences Cognitive therapy Cognitive Therapy - methods Cross-Cultural Comparison Cross-Sectional Studies Dentistry Developing Countries Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes Egypt Female Fundamental and applied biological sciences. Psychology Geriatric psychology Health Behavior Homes for the Aged Humans Immunomodulators Insomnia Internal Medicine Life Style Male Medical sciences Medicine Medicine & Public Health Middle Aged Nervous system (semeiology, syndromes) Neurology Nursing Homes Original Article Otorhinolaryngology Pediatrics Pharmacology. Drug treatments Pneumology/Respiratory System Psychometrics - statistics & numerical data Reproducibility of Results Sleep Initiation and Maintenance Disorders - epidemiology Sleep Initiation and Maintenance Disorders - therapy Sleep. Vigilance Surveys and Questionnaires Translating Vertebrates: nervous system and sense organs |
| title | Cognitive behavioral therapy for institutionalized elders complaining of sleep disturbance in Alexandria, Egypt |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-11T21%3A22%3A01IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cognitive%20behavioral%20therapy%20for%20institutionalized%20elders%20complaining%20of%20sleep%20disturbance%20in%20Alexandria,%20Egypt&rft.jtitle=Sleep%20&%20breathing&rft.au=El%20Kady,%20Heba%20M.&rft.date=2012-12-01&rft.volume=16&rft.issue=4&rft.spage=1173&rft.epage=1180&rft.pages=1173-1180&rft.issn=1520-9512&rft.eissn=1522-1709&rft_id=info:doi/10.1007/s11325-011-0629-3&rft_dat=%3Cproquest_cross%3E1171862260%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1151806080&rft_id=info:pmid/22160931&rfr_iscdi=true |