Complementary and alternative medicines and dietary interventions in multiple sclerosis: What is being used in South Australia and why?

Summary Objectives To investigate the usage patterns of complementary and alternative medicines (CAMs), as well as dietary interventions, by South Australian people with multiple sclerosis (MS). Design Self-administered postal survey. Setting Questionnaire mailed to recipients of the South Australia...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Complementary therapies in medicine 2009-08, Vol.17 (4), p.216-223
Hauptverfasser: Leong, E.M, Semple, S.J, Angley, M, Siebert, W, Petkov, J, McKinnon, R.A
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 223
container_issue 4
container_start_page 216
container_title Complementary therapies in medicine
container_volume 17
creator Leong, E.M
Semple, S.J
Angley, M
Siebert, W
Petkov, J
McKinnon, R.A
description Summary Objectives To investigate the usage patterns of complementary and alternative medicines (CAMs), as well as dietary interventions, by South Australian people with multiple sclerosis (MS). Design Self-administered postal survey. Setting Questionnaire mailed to recipients of the South Australian (SA) MS Society newsletter ( n = 1230). Main outcome measures Patterns of CAMs use and dietary interventions, reasons for using/not using CAMs in MS, sources of CAMs information and monthly expenditure on CAMs/dietary interventions. Results A total of 428 surveys were returned (response rate 34.8%) of which 416 met the inclusion criteria for analysis. The majority of SA people with MS who responded reported using CAMs/dietary interventions (64.7%). Respondents with tertiary education and those with mild and moderate disease reported highest CAM use. The most frequently used CAM product categories were vitamins (81.8%), essential fatty acids (80.7%) and minerals (62.5%). Commonly used herbal products included Ginkgo biloba (18.2%) and valerian (16.4%). Popular diets were the low fat (39.8%), low/no sugar (23.8%) and gluten-free (16.4%) diets. The majority of those using CAMs/dietary interventions did so concurrently with conventional treatments (72.1%). Reasons for use included: general health and well-being; to alleviate ‘general’ as well as specific MS symptoms such as muscle weakness, urinary or memory problems and mobility. Conventional health professionals, and friends/family, were the most common sources of information. Monthly expenditure was most commonly AUD$20–49/month. Conclusion This study reports frequent use of CAM/dietary intervention amongst SA people with MS. The majority of users did so in conjunction with conventional treatments.
doi_str_mv 10.1016/j.ctim.2009.03.001
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_771912719</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0965229909000193</els_id><sourcerecordid>67516864</sourcerecordid><originalsourceid>FETCH-LOGICAL-c469t-2ad1d44f8e129974dd2c13f374523e917d8b052253dc042ca1886fe239e9ba73</originalsourceid><addsrcrecordid>eNp9kkuLFDEUhYMoTjv6B1xIQNBVtXnUKyLK0PiCARcz4DKkk1t22lSqraRa-hf4t73V3TAwi9kkhHznwD3nEvKSsyVnvH63Xdrs-6VgTC2ZXDLGH5EFbxtZ1KqWj8mCqboqhFDqgjxLacsQlI18Si44_ouqVAvybzX0uwA9xGzGAzXRURMyjNFkvwfag_PWR0jHH-fhSPmIxB4lfogJX7SfQvZoQ5MNMA7Jp_f058Zk6hNdg4-_6JTAzeTNMOUNvZpSHk3w5mj7d3P49Jw86UxI8OJ8X5LbL59vV9-K6x9fv6-urgtb1ioXwjjuyrJrgeNYTemcsFx2sikrIUHxxrVrVglRSWdZKazhbVt3IKQCtTaNvCRvT7a7cfgzQcq698lCCCbCMCXdNFxxgQeSbx4k66bidVuXCL6-B26HCfMLSXMmJWNCtS1S4kRZjCeN0Ond6HsMEyE9t6m3em5Tz21qJjW2iaJXZ-tpjU3cSc71IfDhBABGtvcw6mQ9RIutjWCzdoN_2P_jPbkNPnprwm84QLqbQyehmb6Z92leJ6ZwlTAj-R8B6caL</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1033002988</pqid></control><display><type>article</type><title>Complementary and alternative medicines and dietary interventions in multiple sclerosis: What is being used in South Australia and why?</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Leong, E.M ; Semple, S.J ; Angley, M ; Siebert, W ; Petkov, J ; McKinnon, R.A</creator><creatorcontrib>Leong, E.M ; Semple, S.J ; Angley, M ; Siebert, W ; Petkov, J ; McKinnon, R.A</creatorcontrib><description>Summary Objectives To investigate the usage patterns of complementary and alternative medicines (CAMs), as well as dietary interventions, by South Australian people with multiple sclerosis (MS). Design Self-administered postal survey. Setting Questionnaire mailed to recipients of the South Australian (SA) MS Society newsletter ( n = 1230). Main outcome measures Patterns of CAMs use and dietary interventions, reasons for using/not using CAMs in MS, sources of CAMs information and monthly expenditure on CAMs/dietary interventions. Results A total of 428 surveys were returned (response rate 34.8%) of which 416 met the inclusion criteria for analysis. The majority of SA people with MS who responded reported using CAMs/dietary interventions (64.7%). Respondents with tertiary education and those with mild and moderate disease reported highest CAM use. The most frequently used CAM product categories were vitamins (81.8%), essential fatty acids (80.7%) and minerals (62.5%). Commonly used herbal products included Ginkgo biloba (18.2%) and valerian (16.4%). Popular diets were the low fat (39.8%), low/no sugar (23.8%) and gluten-free (16.4%) diets. The majority of those using CAMs/dietary interventions did so concurrently with conventional treatments (72.1%). Reasons for use included: general health and well-being; to alleviate ‘general’ as well as specific MS symptoms such as muscle weakness, urinary or memory problems and mobility. Conventional health professionals, and friends/family, were the most common sources of information. Monthly expenditure was most commonly AUD$20–49/month. Conclusion This study reports frequent use of CAM/dietary intervention amongst SA people with MS. The majority of users did so in conjunction with conventional treatments.</description><identifier>ISSN: 0965-2299</identifier><identifier>EISSN: 1873-6963</identifier><identifier>DOI: 10.1016/j.ctim.2009.03.001</identifier><identifier>PMID: 19632549</identifier><language>eng</language><publisher>Scotland: Elsevier Ltd</publisher><subject>Australia ; Complementary and alternative medicine ; Complementary Therapies - utilization ; Diet ; Dietary intervention ; Education ; Educational Status ; Fatty Acids, Essential - therapeutic use ; Female ; Females ; Frequency ; Gender ; Health Care Surveys ; Health sciences ; Humans ; Internal Medicine ; Male ; Medical Education ; Minerals - therapeutic use ; Multiple sclerosis ; Multiple Sclerosis - therapy ; Nutrition Therapy - utilization ; Perceptions of efficacy ; Phytotherapy ; Questionnaires ; Reasons for use ; Severity of Illness Index ; Society ; South Australia ; Studies ; Survey ; Surveys and Questionnaires ; Vitamins - therapeutic use</subject><ispartof>Complementary therapies in medicine, 2009-08, Vol.17 (4), p.216-223</ispartof><rights>Elsevier Ltd</rights><rights>2009 Elsevier Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c469t-2ad1d44f8e129974dd2c13f374523e917d8b052253dc042ca1886fe239e9ba73</citedby><cites>FETCH-LOGICAL-c469t-2ad1d44f8e129974dd2c13f374523e917d8b052253dc042ca1886fe239e9ba73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0965229909000193$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19632549$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leong, E.M</creatorcontrib><creatorcontrib>Semple, S.J</creatorcontrib><creatorcontrib>Angley, M</creatorcontrib><creatorcontrib>Siebert, W</creatorcontrib><creatorcontrib>Petkov, J</creatorcontrib><creatorcontrib>McKinnon, R.A</creatorcontrib><title>Complementary and alternative medicines and dietary interventions in multiple sclerosis: What is being used in South Australia and why?</title><title>Complementary therapies in medicine</title><addtitle>Complement Ther Med</addtitle><description>Summary Objectives To investigate the usage patterns of complementary and alternative medicines (CAMs), as well as dietary interventions, by South Australian people with multiple sclerosis (MS). Design Self-administered postal survey. Setting Questionnaire mailed to recipients of the South Australian (SA) MS Society newsletter ( n = 1230). Main outcome measures Patterns of CAMs use and dietary interventions, reasons for using/not using CAMs in MS, sources of CAMs information and monthly expenditure on CAMs/dietary interventions. Results A total of 428 surveys were returned (response rate 34.8%) of which 416 met the inclusion criteria for analysis. The majority of SA people with MS who responded reported using CAMs/dietary interventions (64.7%). Respondents with tertiary education and those with mild and moderate disease reported highest CAM use. The most frequently used CAM product categories were vitamins (81.8%), essential fatty acids (80.7%) and minerals (62.5%). Commonly used herbal products included Ginkgo biloba (18.2%) and valerian (16.4%). Popular diets were the low fat (39.8%), low/no sugar (23.8%) and gluten-free (16.4%) diets. The majority of those using CAMs/dietary interventions did so concurrently with conventional treatments (72.1%). Reasons for use included: general health and well-being; to alleviate ‘general’ as well as specific MS symptoms such as muscle weakness, urinary or memory problems and mobility. Conventional health professionals, and friends/family, were the most common sources of information. Monthly expenditure was most commonly AUD$20–49/month. Conclusion This study reports frequent use of CAM/dietary intervention amongst SA people with MS. The majority of users did so in conjunction with conventional treatments.</description><subject>Australia</subject><subject>Complementary and alternative medicine</subject><subject>Complementary Therapies - utilization</subject><subject>Diet</subject><subject>Dietary intervention</subject><subject>Education</subject><subject>Educational Status</subject><subject>Fatty Acids, Essential - therapeutic use</subject><subject>Female</subject><subject>Females</subject><subject>Frequency</subject><subject>Gender</subject><subject>Health Care Surveys</subject><subject>Health sciences</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medical Education</subject><subject>Minerals - therapeutic use</subject><subject>Multiple sclerosis</subject><subject>Multiple Sclerosis - therapy</subject><subject>Nutrition Therapy - utilization</subject><subject>Perceptions of efficacy</subject><subject>Phytotherapy</subject><subject>Questionnaires</subject><subject>Reasons for use</subject><subject>Severity of Illness Index</subject><subject>Society</subject><subject>South Australia</subject><subject>Studies</subject><subject>Survey</subject><subject>Surveys and Questionnaires</subject><subject>Vitamins - therapeutic use</subject><issn>0965-2299</issn><issn>1873-6963</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kkuLFDEUhYMoTjv6B1xIQNBVtXnUKyLK0PiCARcz4DKkk1t22lSqraRa-hf4t73V3TAwi9kkhHznwD3nEvKSsyVnvH63Xdrs-6VgTC2ZXDLGH5EFbxtZ1KqWj8mCqboqhFDqgjxLacsQlI18Si44_ouqVAvybzX0uwA9xGzGAzXRURMyjNFkvwfag_PWR0jHH-fhSPmIxB4lfogJX7SfQvZoQ5MNMA7Jp_f058Zk6hNdg4-_6JTAzeTNMOUNvZpSHk3w5mj7d3P49Jw86UxI8OJ8X5LbL59vV9-K6x9fv6-urgtb1ioXwjjuyrJrgeNYTemcsFx2sikrIUHxxrVrVglRSWdZKazhbVt3IKQCtTaNvCRvT7a7cfgzQcq698lCCCbCMCXdNFxxgQeSbx4k66bidVuXCL6-B26HCfMLSXMmJWNCtS1S4kRZjCeN0Ond6HsMEyE9t6m3em5Tz21qJjW2iaJXZ-tpjU3cSc71IfDhBABGtvcw6mQ9RIutjWCzdoN_2P_jPbkNPnprwm84QLqbQyehmb6Z92leJ6ZwlTAj-R8B6caL</recordid><startdate>20090801</startdate><enddate>20090801</enddate><creator>Leong, E.M</creator><creator>Semple, S.J</creator><creator>Angley, M</creator><creator>Siebert, W</creator><creator>Petkov, J</creator><creator>McKinnon, R.A</creator><general>Elsevier Ltd</general><general>Elsevier Limited</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>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</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>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</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>20090801</creationdate><title>Complementary and alternative medicines and dietary interventions in multiple sclerosis: What is being used in South Australia and why?</title><author>Leong, E.M ; Semple, S.J ; Angley, M ; Siebert, W ; Petkov, J ; McKinnon, R.A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c469t-2ad1d44f8e129974dd2c13f374523e917d8b052253dc042ca1886fe239e9ba73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Australia</topic><topic>Complementary and alternative medicine</topic><topic>Complementary Therapies - utilization</topic><topic>Diet</topic><topic>Dietary intervention</topic><topic>Education</topic><topic>Educational Status</topic><topic>Fatty Acids, Essential - therapeutic use</topic><topic>Female</topic><topic>Females</topic><topic>Frequency</topic><topic>Gender</topic><topic>Health Care Surveys</topic><topic>Health sciences</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medical Education</topic><topic>Minerals - therapeutic use</topic><topic>Multiple sclerosis</topic><topic>Multiple Sclerosis - therapy</topic><topic>Nutrition Therapy - utilization</topic><topic>Perceptions of efficacy</topic><topic>Phytotherapy</topic><topic>Questionnaires</topic><topic>Reasons for use</topic><topic>Severity of Illness Index</topic><topic>Society</topic><topic>South Australia</topic><topic>Studies</topic><topic>Survey</topic><topic>Surveys and Questionnaires</topic><topic>Vitamins - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leong, E.M</creatorcontrib><creatorcontrib>Semple, S.J</creatorcontrib><creatorcontrib>Angley, M</creatorcontrib><creatorcontrib>Siebert, W</creatorcontrib><creatorcontrib>Petkov, J</creatorcontrib><creatorcontrib>McKinnon, R.A</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>Nursing &amp; Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</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>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</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>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health &amp; Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health &amp; Nursing</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>Complementary therapies in medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leong, E.M</au><au>Semple, S.J</au><au>Angley, M</au><au>Siebert, W</au><au>Petkov, J</au><au>McKinnon, R.A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Complementary and alternative medicines and dietary interventions in multiple sclerosis: What is being used in South Australia and why?</atitle><jtitle>Complementary therapies in medicine</jtitle><addtitle>Complement Ther Med</addtitle><date>2009-08-01</date><risdate>2009</risdate><volume>17</volume><issue>4</issue><spage>216</spage><epage>223</epage><pages>216-223</pages><issn>0965-2299</issn><eissn>1873-6963</eissn><abstract>Summary Objectives To investigate the usage patterns of complementary and alternative medicines (CAMs), as well as dietary interventions, by South Australian people with multiple sclerosis (MS). Design Self-administered postal survey. Setting Questionnaire mailed to recipients of the South Australian (SA) MS Society newsletter ( n = 1230). Main outcome measures Patterns of CAMs use and dietary interventions, reasons for using/not using CAMs in MS, sources of CAMs information and monthly expenditure on CAMs/dietary interventions. Results A total of 428 surveys were returned (response rate 34.8%) of which 416 met the inclusion criteria for analysis. The majority of SA people with MS who responded reported using CAMs/dietary interventions (64.7%). Respondents with tertiary education and those with mild and moderate disease reported highest CAM use. The most frequently used CAM product categories were vitamins (81.8%), essential fatty acids (80.7%) and minerals (62.5%). Commonly used herbal products included Ginkgo biloba (18.2%) and valerian (16.4%). Popular diets were the low fat (39.8%), low/no sugar (23.8%) and gluten-free (16.4%) diets. The majority of those using CAMs/dietary interventions did so concurrently with conventional treatments (72.1%). Reasons for use included: general health and well-being; to alleviate ‘general’ as well as specific MS symptoms such as muscle weakness, urinary or memory problems and mobility. Conventional health professionals, and friends/family, were the most common sources of information. Monthly expenditure was most commonly AUD$20–49/month. Conclusion This study reports frequent use of CAM/dietary intervention amongst SA people with MS. The majority of users did so in conjunction with conventional treatments.</abstract><cop>Scotland</cop><pub>Elsevier Ltd</pub><pmid>19632549</pmid><doi>10.1016/j.ctim.2009.03.001</doi><tpages>8</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0965-2299
ispartof Complementary therapies in medicine, 2009-08, Vol.17 (4), p.216-223
issn 0965-2299
1873-6963
language eng
recordid cdi_proquest_miscellaneous_771912719
source MEDLINE; Elsevier ScienceDirect Journals
subjects Australia
Complementary and alternative medicine
Complementary Therapies - utilization
Diet
Dietary intervention
Education
Educational Status
Fatty Acids, Essential - therapeutic use
Female
Females
Frequency
Gender
Health Care Surveys
Health sciences
Humans
Internal Medicine
Male
Medical Education
Minerals - therapeutic use
Multiple sclerosis
Multiple Sclerosis - therapy
Nutrition Therapy - utilization
Perceptions of efficacy
Phytotherapy
Questionnaires
Reasons for use
Severity of Illness Index
Society
South Australia
Studies
Survey
Surveys and Questionnaires
Vitamins - therapeutic use
title Complementary and alternative medicines and dietary interventions in multiple sclerosis: What is being used in South Australia and why?
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-21T20%3A59%3A24IST&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=Complementary%20and%20alternative%20medicines%20and%20dietary%20interventions%20in%20multiple%20sclerosis:%20What%20is%20being%20used%20in%20South%20Australia%20and%20why?&rft.jtitle=Complementary%20therapies%20in%20medicine&rft.au=Leong,%20E.M&rft.date=2009-08-01&rft.volume=17&rft.issue=4&rft.spage=216&rft.epage=223&rft.pages=216-223&rft.issn=0965-2299&rft.eissn=1873-6963&rft_id=info:doi/10.1016/j.ctim.2009.03.001&rft_dat=%3Cproquest_cross%3E67516864%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=1033002988&rft_id=info:pmid/19632549&rft_els_id=S0965229909000193&rfr_iscdi=true