A tablet-based intervention for activating nursing home residents with dementia: results from a cluster-randomized controlled trial
To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia. Cluster-randomized controlled trial. Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional ac...
Gespeichert in:
| Veröffentlicht in: | International psychogeriatrics 2022-02, Vol.34 (2), p.129-141 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 141 |
|---|---|
| container_issue | 2 |
| container_start_page | 129 |
| container_title | International psychogeriatrics |
| container_volume | 34 |
| creator | O'Sullivan, Julie L Lech, Sonia Gellert, Paul Grittner, Ulrike Voigt-Antons, Jan-Niklas Möller, Sebastian Kuhlmey, Adelheid Nordheim, Johanna |
| description | To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia.
Cluster-randomized controlled trial.
Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units).
N = 162 residents with dementia.
Participants received regular TBI (n = 80) with stimulating activities developed to engage people with dementia or CAS (n = 82) for 8 weeks.
Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer's Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale, and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until the collection of baseline data was completed. Data were analyzed with linear mixed-effects models.
Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95% CI -3.54, 2.33 for TBI and .36 points, 95% CI -3.27, 2.55 for CAS). Group difference in change of apathy was not statistically significant (β = .25; 95% CI 3.89, 4.38, p = .91). This corresponds to a standardized effect size (Cohen's d) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group.
Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states. |
| doi_str_mv | 10.1017/S1041610221000818 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2546602571</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2546602571</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-d4b2598da194ff7bf41e804d5c9d6e017db756d24c371afb63cf5dbbfc93711b3</originalsourceid><addsrcrecordid>eNplUTtPHDEQtlAijtcPSBNZSpNmwbP2Pi4dQgSQTqJIItGt_AQjr32xvYeg5Y_j1V1SQDWj-R4zmg-hL0BOgUB39gsIgxZIXQMhpId-Dx1Ax6CqCb37VPoCVzO-QIcpPRJSNxTYPlpQBj0lfXeAXs9x5sLpXAmetMLWZx032mcbPDYhYi6z3fBs_T32U0xzfQijxlEnqwov4SebH7DS4yziP2ZgcmVsYhgxx9JNqVhWkXsVRvtSdsjgcwzOlTZHy90x-my4S_pkV4_Qn5-Xvy-uq9Xt1c3F-aqStGlzpZiom2WvOCyZMZ0wDHRPmGrkUrW6_EOJrmlVzSTtgBvRUmkaJYSRyzIAQY_Q963vOoa_k055GG2S2jnudZjSUDesbcuPOijUb--oj2GKvlw31C3rGuiBssKCLUvGkFLUZlhHO_L4PAAZ5oSGDwkVzded8yRGrf4r_kVC3wAKhY4B</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2647518134</pqid></control><display><type>article</type><title>A tablet-based intervention for activating nursing home residents with dementia: results from a cluster-randomized controlled trial</title><source>MEDLINE</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>Cambridge University Press Journals Complete</source><creator>O'Sullivan, Julie L ; Lech, Sonia ; Gellert, Paul ; Grittner, Ulrike ; Voigt-Antons, Jan-Niklas ; Möller, Sebastian ; Kuhlmey, Adelheid ; Nordheim, Johanna</creator><creatorcontrib>O'Sullivan, Julie L ; Lech, Sonia ; Gellert, Paul ; Grittner, Ulrike ; Voigt-Antons, Jan-Niklas ; Möller, Sebastian ; Kuhlmey, Adelheid ; Nordheim, Johanna</creatorcontrib><description>To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia.
Cluster-randomized controlled trial.
Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units).
N = 162 residents with dementia.
Participants received regular TBI (n = 80) with stimulating activities developed to engage people with dementia or CAS (n = 82) for 8 weeks.
Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer's Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale, and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until the collection of baseline data was completed. Data were analyzed with linear mixed-effects models.
Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95% CI -3.54, 2.33 for TBI and .36 points, 95% CI -3.27, 2.55 for CAS). Group difference in change of apathy was not statistically significant (β = .25; 95% CI 3.89, 4.38, p = .91). This corresponds to a standardized effect size (Cohen's d) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group.
Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states.</description><identifier>ISSN: 1041-6102</identifier><identifier>EISSN: 1741-203X</identifier><identifier>DOI: 10.1017/S1041610221000818</identifier><identifier>PMID: 34183087</identifier><language>eng</language><publisher>England: Cambridge University Press</publisher><subject>Aged ; Apathy ; Clinical trials ; Computers ; Dementia ; Dementia - drug therapy ; Drugs ; Emotional regulation ; Germany ; Guardians ; Home health care ; Humans ; Intervention ; Likert scale ; Nursing Homes ; Portable computers ; Psychotropic drugs ; Psychotropic Drugs - therapeutic use ; Quality of life ; Quality of Life - psychology</subject><ispartof>International psychogeriatrics, 2022-02, Vol.34 (2), p.129-141</ispartof><rights>International Psychogeriatric Association 2021. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the associated terms available at: https://uk.sagepub.com/en-gb/eur/reusing-open-access-and-sage-choice-content</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-d4b2598da194ff7bf41e804d5c9d6e017db756d24c371afb63cf5dbbfc93711b3</citedby><cites>FETCH-LOGICAL-c356t-d4b2598da194ff7bf41e804d5c9d6e017db756d24c371afb63cf5dbbfc93711b3</cites><orcidid>0000-0002-8991-9966</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,12846,27924,27925,30999</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34183087$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O'Sullivan, Julie L</creatorcontrib><creatorcontrib>Lech, Sonia</creatorcontrib><creatorcontrib>Gellert, Paul</creatorcontrib><creatorcontrib>Grittner, Ulrike</creatorcontrib><creatorcontrib>Voigt-Antons, Jan-Niklas</creatorcontrib><creatorcontrib>Möller, Sebastian</creatorcontrib><creatorcontrib>Kuhlmey, Adelheid</creatorcontrib><creatorcontrib>Nordheim, Johanna</creatorcontrib><title>A tablet-based intervention for activating nursing home residents with dementia: results from a cluster-randomized controlled trial</title><title>International psychogeriatrics</title><addtitle>Int Psychogeriatr</addtitle><description>To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia.
Cluster-randomized controlled trial.
Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units).
N = 162 residents with dementia.
Participants received regular TBI (n = 80) with stimulating activities developed to engage people with dementia or CAS (n = 82) for 8 weeks.
Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer's Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale, and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until the collection of baseline data was completed. Data were analyzed with linear mixed-effects models.
Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95% CI -3.54, 2.33 for TBI and .36 points, 95% CI -3.27, 2.55 for CAS). Group difference in change of apathy was not statistically significant (β = .25; 95% CI 3.89, 4.38, p = .91). This corresponds to a standardized effect size (Cohen's d) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group.
Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states.</description><subject>Aged</subject><subject>Apathy</subject><subject>Clinical trials</subject><subject>Computers</subject><subject>Dementia</subject><subject>Dementia - drug therapy</subject><subject>Drugs</subject><subject>Emotional regulation</subject><subject>Germany</subject><subject>Guardians</subject><subject>Home health care</subject><subject>Humans</subject><subject>Intervention</subject><subject>Likert scale</subject><subject>Nursing Homes</subject><subject>Portable computers</subject><subject>Psychotropic drugs</subject><subject>Psychotropic Drugs - therapeutic use</subject><subject>Quality of life</subject><subject>Quality of Life - psychology</subject><issn>1041-6102</issn><issn>1741-203X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</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><recordid>eNplUTtPHDEQtlAijtcPSBNZSpNmwbP2Pi4dQgSQTqJIItGt_AQjr32xvYeg5Y_j1V1SQDWj-R4zmg-hL0BOgUB39gsIgxZIXQMhpId-Dx1Ax6CqCb37VPoCVzO-QIcpPRJSNxTYPlpQBj0lfXeAXs9x5sLpXAmetMLWZx032mcbPDYhYi6z3fBs_T32U0xzfQijxlEnqwov4SebH7DS4yziP2ZgcmVsYhgxx9JNqVhWkXsVRvtSdsjgcwzOlTZHy90x-my4S_pkV4_Qn5-Xvy-uq9Xt1c3F-aqStGlzpZiom2WvOCyZMZ0wDHRPmGrkUrW6_EOJrmlVzSTtgBvRUmkaJYSRyzIAQY_Q963vOoa_k055GG2S2jnudZjSUDesbcuPOijUb--oj2GKvlw31C3rGuiBssKCLUvGkFLUZlhHO_L4PAAZ5oSGDwkVzded8yRGrf4r_kVC3wAKhY4B</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>O'Sullivan, Julie L</creator><creator>Lech, Sonia</creator><creator>Gellert, Paul</creator><creator>Grittner, Ulrike</creator><creator>Voigt-Antons, Jan-Niklas</creator><creator>Möller, Sebastian</creator><creator>Kuhlmey, Adelheid</creator><creator>Nordheim, Johanna</creator><general>Cambridge University Press</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>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88J</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2R</scope><scope>M2S</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8991-9966</orcidid></search><sort><creationdate>20220201</creationdate><title>A tablet-based intervention for activating nursing home residents with dementia: results from a cluster-randomized controlled trial</title><author>O'Sullivan, Julie L ; Lech, Sonia ; Gellert, Paul ; Grittner, Ulrike ; Voigt-Antons, Jan-Niklas ; Möller, Sebastian ; Kuhlmey, Adelheid ; Nordheim, Johanna</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-d4b2598da194ff7bf41e804d5c9d6e017db756d24c371afb63cf5dbbfc93711b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Apathy</topic><topic>Clinical trials</topic><topic>Computers</topic><topic>Dementia</topic><topic>Dementia - drug therapy</topic><topic>Drugs</topic><topic>Emotional regulation</topic><topic>Germany</topic><topic>Guardians</topic><topic>Home health care</topic><topic>Humans</topic><topic>Intervention</topic><topic>Likert scale</topic><topic>Nursing Homes</topic><topic>Portable computers</topic><topic>Psychotropic drugs</topic><topic>Psychotropic Drugs - therapeutic use</topic><topic>Quality of life</topic><topic>Quality of Life - psychology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O'Sullivan, Julie L</creatorcontrib><creatorcontrib>Lech, Sonia</creatorcontrib><creatorcontrib>Gellert, Paul</creatorcontrib><creatorcontrib>Grittner, Ulrike</creatorcontrib><creatorcontrib>Voigt-Antons, Jan-Niklas</creatorcontrib><creatorcontrib>Möller, Sebastian</creatorcontrib><creatorcontrib>Kuhlmey, Adelheid</creatorcontrib><creatorcontrib>Nordheim, Johanna</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 Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>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>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</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>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Social Science Database</collection><collection>Sociology Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</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>International psychogeriatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O'Sullivan, Julie L</au><au>Lech, Sonia</au><au>Gellert, Paul</au><au>Grittner, Ulrike</au><au>Voigt-Antons, Jan-Niklas</au><au>Möller, Sebastian</au><au>Kuhlmey, Adelheid</au><au>Nordheim, Johanna</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A tablet-based intervention for activating nursing home residents with dementia: results from a cluster-randomized controlled trial</atitle><jtitle>International psychogeriatrics</jtitle><addtitle>Int Psychogeriatr</addtitle><date>2022-02-01</date><risdate>2022</risdate><volume>34</volume><issue>2</issue><spage>129</spage><epage>141</epage><pages>129-141</pages><issn>1041-6102</issn><eissn>1741-203X</eissn><abstract>To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia.
Cluster-randomized controlled trial.
Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units).
N = 162 residents with dementia.
Participants received regular TBI (n = 80) with stimulating activities developed to engage people with dementia or CAS (n = 82) for 8 weeks.
Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer's Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale, and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until the collection of baseline data was completed. Data were analyzed with linear mixed-effects models.
Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95% CI -3.54, 2.33 for TBI and .36 points, 95% CI -3.27, 2.55 for CAS). Group difference in change of apathy was not statistically significant (β = .25; 95% CI 3.89, 4.38, p = .91). This corresponds to a standardized effect size (Cohen's d) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group.
Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states.</abstract><cop>England</cop><pub>Cambridge University Press</pub><pmid>34183087</pmid><doi>10.1017/S1041610221000818</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-8991-9966</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1041-6102 |
| ispartof | International psychogeriatrics, 2022-02, Vol.34 (2), p.129-141 |
| issn | 1041-6102 1741-203X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2546602571 |
| source | MEDLINE; Applied Social Sciences Index & Abstracts (ASSIA); Cambridge University Press Journals Complete |
| subjects | Aged Apathy Clinical trials Computers Dementia Dementia - drug therapy Drugs Emotional regulation Germany Guardians Home health care Humans Intervention Likert scale Nursing Homes Portable computers Psychotropic drugs Psychotropic Drugs - therapeutic use Quality of life Quality of Life - psychology |
| title | A tablet-based intervention for activating nursing home residents with dementia: results from a cluster-randomized controlled trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T00%3A01%3A45IST&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=A%20tablet-based%20intervention%20for%20activating%20nursing%20home%20residents%20with%20dementia:%20results%20from%20a%20cluster-randomized%20controlled%20trial&rft.jtitle=International%20psychogeriatrics&rft.au=O'Sullivan,%20Julie%20L&rft.date=2022-02-01&rft.volume=34&rft.issue=2&rft.spage=129&rft.epage=141&rft.pages=129-141&rft.issn=1041-6102&rft.eissn=1741-203X&rft_id=info:doi/10.1017/S1041610221000818&rft_dat=%3Cproquest_cross%3E2546602571%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=2647518134&rft_id=info:pmid/34183087&rfr_iscdi=true |