Barriers to Surgical Care Among Children in Somaliland: An Application of the Three Delays Framework
Background There are complex barriers that increase delays to surgical care in low- and middle-income countries, particularly among the vulnerable population of children. Understanding these barriers to surgical care can result in targeted and strategic intervention efforts to improve care for child...
Gespeichert in:
| Veröffentlicht in: | World journal of surgery 2020-06, Vol.44 (6), p.1712-1718 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1718 |
|---|---|
| container_issue | 6 |
| container_start_page | 1712 |
| container_title | World journal of surgery |
| container_volume | 44 |
| creator | Concepcion, Tessa L. Dahir, Shukri Mohamed, Mubarak Hiltbrunn, Kyle Ismail, Edna Adan Poenaru, Dan Rice, Henry E. Smith, Emily R. |
| description | Background
There are complex barriers that increase delays to surgical care in low- and middle-income countries, particularly among the vulnerable population of children. Understanding these barriers to surgical care can result in targeted and strategic intervention efforts to improve care for children. The three-delay model is a widely used framework in global health for evaluating barriers associated with seeking (D1), reaching (D2), and receiving health care (D3). The goal of our study is to evaluate reasons for delays in the surgical care for children in Somaliland using the three-delay framework.
Methods
Data were collected in a cross-sectional study in Somaliland from 1503 children through a household survey. Among children with a surgical need, we quantified the number of children seeking, reaching, and receiving care along the surgical care continuum, according to the three-delay framework. We evaluated predictors of the three delays through a multivariate logistic regression model, including the child’s age, gender, village type, household income level, region, and household size.
Results
Of the 196 children identified with a surgical condition, 50 (27.3%) children had a delay in seeking care (D1), 28 (20.6%) children had a delay in reaching care (D2), and 84 (71.2%) children had a delay in receiving care (D3), including 10 children who also experienced D1 and D2. The main reasons cited for D1 included seeking a traditional healthcare provider, while lack of money and availability of care were main reasons cited for D2. Significant predictors for delays included household size for D1 and D3 and condition type and region for D2.
Conclusion
Children in Somaliland experience several barriers to surgical care along the entire continuum of care, allowing for policy guidance tailored to specific local challenges and resources. Since delays in surgical care for children can substantially impact the effectiveness of surgical interventions, viewing delays in surgical care under the lens of the three-delay framework can inform strategic interventions along the pediatric surgical care continuum, thereby reducing delays and improving the quality of surgical care for children. |
| doi_str_mv | 10.1007/s00268-020-05414-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2352633484</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2352633484</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4709-e01d7cd61fc940ef31b2e7a27b4091f1521b5b642abf0d25d5d7fbea70b2bf6a3</originalsourceid><addsrcrecordid>eNqNkUtv1DAUhS0EotPCH2CBLLFhE7h-JG66mw4dHqrEYopYWnZ8PeOSxIM9UTX_HpcUkFggVr6L7zs68iHkBYM3DEC9zQC8Oa-AQwW1ZLKSj8iCScErLrh4TBYgGlluJk7Iac63AEw10DwlJ4KDACnFgrhLk1LAlOkh0s2UtqEzPV2ZhHQ5xHFLV7vQu4QjDSPdxMH0oTeju6DLkS73-77ghxBHGj097JDe7BIifYe9OWa6TmbAu5i-PSNPvOkzPn94z8iX9dXN6kN1_fn9x9XyuuqkgrZCYE51rmG-ayWgF8xyVIYrK6FlntWc2do2khvrwfHa1U55i0aB5dY3RpyR13PuPsXvE-aDHkLusC-NMU5Zc1HzRgh5Lgv66i_0Nk5pLO0K1dayZoqxQvGZ6lLMOaHX-xQGk46agb7fQM8b6LKB_rmBvo9--RA92QHdb-XXpxfgYgbuQo_H_4jUXz9tLtcAUrRFFrOcizduMf0p_o9OPwDJsqGV</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2395451711</pqid></control><display><type>article</type><title>Barriers to Surgical Care Among Children in Somaliland: An Application of the Three Delays Framework</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><source>SpringerLink_现刊</source><creator>Concepcion, Tessa L. ; Dahir, Shukri ; Mohamed, Mubarak ; Hiltbrunn, Kyle ; Ismail, Edna Adan ; Poenaru, Dan ; Rice, Henry E. ; Smith, Emily R.</creator><creatorcontrib>Concepcion, Tessa L. ; Dahir, Shukri ; Mohamed, Mubarak ; Hiltbrunn, Kyle ; Ismail, Edna Adan ; Poenaru, Dan ; Rice, Henry E. ; Smith, Emily R. ; Global Initiative for Children’s Surgery ; the Global Initiative for Children's Surgery</creatorcontrib><description>Background
There are complex barriers that increase delays to surgical care in low- and middle-income countries, particularly among the vulnerable population of children. Understanding these barriers to surgical care can result in targeted and strategic intervention efforts to improve care for children. The three-delay model is a widely used framework in global health for evaluating barriers associated with seeking (D1), reaching (D2), and receiving health care (D3). The goal of our study is to evaluate reasons for delays in the surgical care for children in Somaliland using the three-delay framework.
Methods
Data were collected in a cross-sectional study in Somaliland from 1503 children through a household survey. Among children with a surgical need, we quantified the number of children seeking, reaching, and receiving care along the surgical care continuum, according to the three-delay framework. We evaluated predictors of the three delays through a multivariate logistic regression model, including the child’s age, gender, village type, household income level, region, and household size.
Results
Of the 196 children identified with a surgical condition, 50 (27.3%) children had a delay in seeking care (D1), 28 (20.6%) children had a delay in reaching care (D2), and 84 (71.2%) children had a delay in receiving care (D3), including 10 children who also experienced D1 and D2. The main reasons cited for D1 included seeking a traditional healthcare provider, while lack of money and availability of care were main reasons cited for D2. Significant predictors for delays included household size for D1 and D3 and condition type and region for D2.
Conclusion
Children in Somaliland experience several barriers to surgical care along the entire continuum of care, allowing for policy guidance tailored to specific local challenges and resources. Since delays in surgical care for children can substantially impact the effectiveness of surgical interventions, viewing delays in surgical care under the lens of the three-delay framework can inform strategic interventions along the pediatric surgical care continuum, thereby reducing delays and improving the quality of surgical care for children.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-020-05414-4</identifier><identifier>PMID: 32030443</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Adolescent ; Cardiac Surgery ; Child ; Child, Preschool ; Children ; Cross-Sectional Studies ; Delay ; Female ; General Surgery ; Global health ; Health care ; Households ; Humans ; Income ; Infant ; Infant, Newborn ; Logistic Models ; Male ; Medicine ; Medicine & Public Health ; Quality of Health Care ; Regression models ; Surgery ; Surgery in Low and Middle Income Countries ; Surgical Procedures, Operative ; Thoracic Surgery ; Time-to-Treatment ; Trauma centers ; Vascular Surgery</subject><ispartof>World journal of surgery, 2020-06, Vol.44 (6), p.1712-1718</ispartof><rights>Société Internationale de Chirurgie 2020</rights><rights>2020 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>Société Internationale de Chirurgie 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4709-e01d7cd61fc940ef31b2e7a27b4091f1521b5b642abf0d25d5d7fbea70b2bf6a3</citedby><cites>FETCH-LOGICAL-c4709-e01d7cd61fc940ef31b2e7a27b4091f1521b5b642abf0d25d5d7fbea70b2bf6a3</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/s00268-020-05414-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-020-05414-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,41488,42557,45574,45575,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32030443$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Concepcion, Tessa L.</creatorcontrib><creatorcontrib>Dahir, Shukri</creatorcontrib><creatorcontrib>Mohamed, Mubarak</creatorcontrib><creatorcontrib>Hiltbrunn, Kyle</creatorcontrib><creatorcontrib>Ismail, Edna Adan</creatorcontrib><creatorcontrib>Poenaru, Dan</creatorcontrib><creatorcontrib>Rice, Henry E.</creatorcontrib><creatorcontrib>Smith, Emily R.</creatorcontrib><creatorcontrib>Global Initiative for Children’s Surgery</creatorcontrib><creatorcontrib>the Global Initiative for Children's Surgery</creatorcontrib><title>Barriers to Surgical Care Among Children in Somaliland: An Application of the Three Delays Framework</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
There are complex barriers that increase delays to surgical care in low- and middle-income countries, particularly among the vulnerable population of children. Understanding these barriers to surgical care can result in targeted and strategic intervention efforts to improve care for children. The three-delay model is a widely used framework in global health for evaluating barriers associated with seeking (D1), reaching (D2), and receiving health care (D3). The goal of our study is to evaluate reasons for delays in the surgical care for children in Somaliland using the three-delay framework.
Methods
Data were collected in a cross-sectional study in Somaliland from 1503 children through a household survey. Among children with a surgical need, we quantified the number of children seeking, reaching, and receiving care along the surgical care continuum, according to the three-delay framework. We evaluated predictors of the three delays through a multivariate logistic regression model, including the child’s age, gender, village type, household income level, region, and household size.
Results
Of the 196 children identified with a surgical condition, 50 (27.3%) children had a delay in seeking care (D1), 28 (20.6%) children had a delay in reaching care (D2), and 84 (71.2%) children had a delay in receiving care (D3), including 10 children who also experienced D1 and D2. The main reasons cited for D1 included seeking a traditional healthcare provider, while lack of money and availability of care were main reasons cited for D2. Significant predictors for delays included household size for D1 and D3 and condition type and region for D2.
Conclusion
Children in Somaliland experience several barriers to surgical care along the entire continuum of care, allowing for policy guidance tailored to specific local challenges and resources. Since delays in surgical care for children can substantially impact the effectiveness of surgical interventions, viewing delays in surgical care under the lens of the three-delay framework can inform strategic interventions along the pediatric surgical care continuum, thereby reducing delays and improving the quality of surgical care for children.</description><subject>Abdominal Surgery</subject><subject>Adolescent</subject><subject>Cardiac Surgery</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Cross-Sectional Studies</subject><subject>Delay</subject><subject>Female</subject><subject>General Surgery</subject><subject>Global health</subject><subject>Health care</subject><subject>Households</subject><subject>Humans</subject><subject>Income</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Quality of Health Care</subject><subject>Regression models</subject><subject>Surgery</subject><subject>Surgery in Low and Middle Income Countries</subject><subject>Surgical Procedures, Operative</subject><subject>Thoracic Surgery</subject><subject>Time-to-Treatment</subject><subject>Trauma centers</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkUtv1DAUhS0EotPCH2CBLLFhE7h-JG66mw4dHqrEYopYWnZ8PeOSxIM9UTX_HpcUkFggVr6L7zs68iHkBYM3DEC9zQC8Oa-AQwW1ZLKSj8iCScErLrh4TBYgGlluJk7Iac63AEw10DwlJ4KDACnFgrhLk1LAlOkh0s2UtqEzPV2ZhHQ5xHFLV7vQu4QjDSPdxMH0oTeju6DLkS73-77ghxBHGj097JDe7BIifYe9OWa6TmbAu5i-PSNPvOkzPn94z8iX9dXN6kN1_fn9x9XyuuqkgrZCYE51rmG-ayWgF8xyVIYrK6FlntWc2do2khvrwfHa1U55i0aB5dY3RpyR13PuPsXvE-aDHkLusC-NMU5Zc1HzRgh5Lgv66i_0Nk5pLO0K1dayZoqxQvGZ6lLMOaHX-xQGk46agb7fQM8b6LKB_rmBvo9--RA92QHdb-XXpxfgYgbuQo_H_4jUXz9tLtcAUrRFFrOcizduMf0p_o9OPwDJsqGV</recordid><startdate>202006</startdate><enddate>202006</enddate><creator>Concepcion, Tessa L.</creator><creator>Dahir, Shukri</creator><creator>Mohamed, Mubarak</creator><creator>Hiltbrunn, Kyle</creator><creator>Ismail, Edna Adan</creator><creator>Poenaru, Dan</creator><creator>Rice, Henry E.</creator><creator>Smith, Emily R.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><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>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>202006</creationdate><title>Barriers to Surgical Care Among Children in Somaliland: An Application of the Three Delays Framework</title><author>Concepcion, Tessa L. ; Dahir, Shukri ; Mohamed, Mubarak ; Hiltbrunn, Kyle ; Ismail, Edna Adan ; Poenaru, Dan ; Rice, Henry E. ; Smith, Emily R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4709-e01d7cd61fc940ef31b2e7a27b4091f1521b5b642abf0d25d5d7fbea70b2bf6a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal Surgery</topic><topic>Adolescent</topic><topic>Cardiac Surgery</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Cross-Sectional Studies</topic><topic>Delay</topic><topic>Female</topic><topic>General Surgery</topic><topic>Global health</topic><topic>Health care</topic><topic>Households</topic><topic>Humans</topic><topic>Income</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Quality of Health Care</topic><topic>Regression models</topic><topic>Surgery</topic><topic>Surgery in Low and Middle Income Countries</topic><topic>Surgical Procedures, Operative</topic><topic>Thoracic Surgery</topic><topic>Time-to-Treatment</topic><topic>Trauma centers</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Concepcion, Tessa L.</creatorcontrib><creatorcontrib>Dahir, Shukri</creatorcontrib><creatorcontrib>Mohamed, Mubarak</creatorcontrib><creatorcontrib>Hiltbrunn, Kyle</creatorcontrib><creatorcontrib>Ismail, Edna Adan</creatorcontrib><creatorcontrib>Poenaru, Dan</creatorcontrib><creatorcontrib>Rice, Henry E.</creatorcontrib><creatorcontrib>Smith, Emily R.</creatorcontrib><creatorcontrib>Global Initiative for Children’s Surgery</creatorcontrib><creatorcontrib>the Global Initiative for Children's Surgery</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</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</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</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>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Concepcion, Tessa L.</au><au>Dahir, Shukri</au><au>Mohamed, Mubarak</au><au>Hiltbrunn, Kyle</au><au>Ismail, Edna Adan</au><au>Poenaru, Dan</au><au>Rice, Henry E.</au><au>Smith, Emily R.</au><aucorp>Global Initiative for Children’s Surgery</aucorp><aucorp>the Global Initiative for Children's Surgery</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Barriers to Surgical Care Among Children in Somaliland: An Application of the Three Delays Framework</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2020-06</date><risdate>2020</risdate><volume>44</volume><issue>6</issue><spage>1712</spage><epage>1718</epage><pages>1712-1718</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
There are complex barriers that increase delays to surgical care in low- and middle-income countries, particularly among the vulnerable population of children. Understanding these barriers to surgical care can result in targeted and strategic intervention efforts to improve care for children. The three-delay model is a widely used framework in global health for evaluating barriers associated with seeking (D1), reaching (D2), and receiving health care (D3). The goal of our study is to evaluate reasons for delays in the surgical care for children in Somaliland using the three-delay framework.
Methods
Data were collected in a cross-sectional study in Somaliland from 1503 children through a household survey. Among children with a surgical need, we quantified the number of children seeking, reaching, and receiving care along the surgical care continuum, according to the three-delay framework. We evaluated predictors of the three delays through a multivariate logistic regression model, including the child’s age, gender, village type, household income level, region, and household size.
Results
Of the 196 children identified with a surgical condition, 50 (27.3%) children had a delay in seeking care (D1), 28 (20.6%) children had a delay in reaching care (D2), and 84 (71.2%) children had a delay in receiving care (D3), including 10 children who also experienced D1 and D2. The main reasons cited for D1 included seeking a traditional healthcare provider, while lack of money and availability of care were main reasons cited for D2. Significant predictors for delays included household size for D1 and D3 and condition type and region for D2.
Conclusion
Children in Somaliland experience several barriers to surgical care along the entire continuum of care, allowing for policy guidance tailored to specific local challenges and resources. Since delays in surgical care for children can substantially impact the effectiveness of surgical interventions, viewing delays in surgical care under the lens of the three-delay framework can inform strategic interventions along the pediatric surgical care continuum, thereby reducing delays and improving the quality of surgical care for children.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>32030443</pmid><doi>10.1007/s00268-020-05414-4</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0364-2313 |
| ispartof | World journal of surgery, 2020-06, Vol.44 (6), p.1712-1718 |
| issn | 0364-2313 1432-2323 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2352633484 |
| source | Wiley-Blackwell Journals; MEDLINE; SpringerLink_现刊 |
| subjects | Abdominal Surgery Adolescent Cardiac Surgery Child Child, Preschool Children Cross-Sectional Studies Delay Female General Surgery Global health Health care Households Humans Income Infant Infant, Newborn Logistic Models Male Medicine Medicine & Public Health Quality of Health Care Regression models Surgery Surgery in Low and Middle Income Countries Surgical Procedures, Operative Thoracic Surgery Time-to-Treatment Trauma centers Vascular Surgery |
| title | Barriers to Surgical Care Among Children in Somaliland: An Application of the Three Delays Framework |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T07%3A15%3A04IST&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=Barriers%20to%20Surgical%20Care%20Among%20Children%20in%20Somaliland:%20An%20Application%20of%20the%20Three%20Delays%20Framework&rft.jtitle=World%20journal%20of%20surgery&rft.au=Concepcion,%20Tessa%20L.&rft.aucorp=Global%20Initiative%20for%20Children%E2%80%99s%20Surgery&rft.date=2020-06&rft.volume=44&rft.issue=6&rft.spage=1712&rft.epage=1718&rft.pages=1712-1718&rft.issn=0364-2313&rft.eissn=1432-2323&rft_id=info:doi/10.1007/s00268-020-05414-4&rft_dat=%3Cproquest_cross%3E2352633484%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=2395451711&rft_id=info:pmid/32030443&rfr_iscdi=true |