Prevalence of sleep disturbances in children and adolescents with chronic kidney disease
Although sleep disorders are common in adults with chronic kidney disease, little is known about the prevalence of sleep problems in children and adolescents with chronic kidney disease and their relationship to health-related quality of life measurements. We performed a clinic-based survey of sleep...
Gespeichert in:
Veröffentlicht in: | Pediatric nephrology (Berlin, West) West), 2012-03, Vol.27 (3), p.451-459 |
---|---|
Hauptverfasser: | , , , , , , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 459 |
---|---|
container_issue | 3 |
container_start_page | 451 |
container_title | Pediatric nephrology (Berlin, West) |
container_volume | 27 |
creator | Davis, Ira D. Greenbaum, Larry A Gipson, Debbie Wu, Lie Ling Sinha, Rajiv Matsuda-Abedini, Mina Emancipator, Judith L. Lane, Jerome C. Hodgkins, Kavita Nailescu, Corina Barletta, Gina Marie Arora, Steven Mahan, John D. Rosen, Carol L. |
description | Although sleep disorders are common in adults with chronic kidney disease, little is known about the prevalence of sleep problems in children and adolescents with chronic kidney disease and their relationship to health-related quality of life measurements. We performed a clinic-based survey of sleep habits and common symptoms of sleep disturbances in 159 school-aged patients with chronic kidney disease. Three patient groups of chronic kidney disease were assessed: group 1, those not on dialysis and not transplanted; group 2, those on dialysis; and group 3, those with a functioning renal allograft. Four symptom domains for sleep disorders were assessed: excessive daytime sleepiness; sleep disordered breathing; restless legs syndrome symptoms; and insufficient sleep. Patients and the parent-proxy also completed the Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales questionnaire. Ninety-three (93) patients (58.5%) had symptoms of a sleep disturbance. The presence of a sleep disturbance correlated with a decrease in health-related quality of life scores that was independent of the chronic kidney disease study group or estimated glomerular filtration rate. We conclude that sleep disturbances are common throughout the spectrum of chronic kidney disease in children and adolescents and are associated with diminished health-related quality of life scores. |
doi_str_mv | 10.1007/s00467-011-2010-y |
format | Article |
fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_917855990</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A331687825</galeid><sourcerecordid>A331687825</sourcerecordid><originalsourceid>FETCH-LOGICAL-c507t-2e1629f9579d6777d2f4cebdbe2eb64c12743f8e155ba4e951ba037c4f1198d33</originalsourceid><addsrcrecordid>eNp1kl1rFDEUhoNY7Fr9Ad7IgFCvUvMxmUwuS6kfUKgXCnsXMsmZ3dRssiYzyv57s2zVVlZyETjneQ_nvLwIvaLkghIi3xVC2k5iQilmhBK8e4IWtOUMU9Uvn6IFUZxi0tLlKXpeyh0hpBd99wydMqq6VohugZafM_wwAaKFJo1NCQDbxvkyzXkwtVgaHxu79sFliI2JrjEuBSgW4lSan35a125O0dvmm3cRdnsxmAIv0MloQoGX9_8Z-vr--svVR3xz--HT1eUNtoLICTOgHVOjElK5Tkrp2NhaGNwADIautZTJlo89UCEG04ISdDCES9uOtB7pOD9Dbw9ztzl9n6FMeuPrdiGYCGkuWlHZC6EUqeSbf8i7NOdYl9OUKCF6xXn_l1pVV7SPY5qysfuZ-pJz2vWyZ6JS-Ai1ggjZhBRh9LX8iL84wtfnYOPtUcH5A8EaTJjWJYV58imWxyA9gDanUjKMepv9xuRdPUrvU6IPKdE1JXqfEr2rmtf3TszDBtwfxe9YVIAdgFJbcQX5oVX_m_oLH37FYw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1095589338</pqid></control><display><type>article</type><title>Prevalence of sleep disturbances in children and adolescents with chronic kidney disease</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Davis, Ira D. ; Greenbaum, Larry A ; Gipson, Debbie ; Wu, Lie Ling ; Sinha, Rajiv ; Matsuda-Abedini, Mina ; Emancipator, Judith L. ; Lane, Jerome C. ; Hodgkins, Kavita ; Nailescu, Corina ; Barletta, Gina Marie ; Arora, Steven ; Mahan, John D. ; Rosen, Carol L.</creator><creatorcontrib>Davis, Ira D. ; Greenbaum, Larry A ; Gipson, Debbie ; Wu, Lie Ling ; Sinha, Rajiv ; Matsuda-Abedini, Mina ; Emancipator, Judith L. ; Lane, Jerome C. ; Hodgkins, Kavita ; Nailescu, Corina ; Barletta, Gina Marie ; Arora, Steven ; Mahan, John D. ; Rosen, Carol L.</creatorcontrib><description>Although sleep disorders are common in adults with chronic kidney disease, little is known about the prevalence of sleep problems in children and adolescents with chronic kidney disease and their relationship to health-related quality of life measurements. We performed a clinic-based survey of sleep habits and common symptoms of sleep disturbances in 159 school-aged patients with chronic kidney disease. Three patient groups of chronic kidney disease were assessed: group 1, those not on dialysis and not transplanted; group 2, those on dialysis; and group 3, those with a functioning renal allograft. Four symptom domains for sleep disorders were assessed: excessive daytime sleepiness; sleep disordered breathing; restless legs syndrome symptoms; and insufficient sleep. Patients and the parent-proxy also completed the Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales questionnaire. Ninety-three (93) patients (58.5%) had symptoms of a sleep disturbance. The presence of a sleep disturbance correlated with a decrease in health-related quality of life scores that was independent of the chronic kidney disease study group or estimated glomerular filtration rate. We conclude that sleep disturbances are common throughout the spectrum of chronic kidney disease in children and adolescents and are associated with diminished health-related quality of life scores.</description><identifier>ISSN: 0931-041X</identifier><identifier>EISSN: 1432-198X</identifier><identifier>DOI: 10.1007/s00467-011-2010-y</identifier><identifier>PMID: 21964556</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adolescent ; Child ; Child, Preschool ; Chronic Disease ; Chronic kidney failure ; Female ; Glomerular Filtration Rate ; Hemodialysis ; Hospitals ; Humans ; Kidney diseases ; Kidney Diseases - complications ; Kidney Diseases - physiopathology ; Kidney Diseases - psychology ; Kidney transplants ; Logistic Models ; Male ; Medicine ; Medicine & Public Health ; Nephrology ; Original Article ; Patients ; Pediatrics ; Prevalence ; Prevalence studies (Epidemiology) ; Quality of Life ; Questionnaires ; Restless legs syndrome ; Sleep ; Sleep disorders ; Sleep Wake Disorders - epidemiology ; Teenagers ; Urology</subject><ispartof>Pediatric nephrology (Berlin, West), 2012-03, Vol.27 (3), p.451-459</ispartof><rights>IPNA 2011</rights><rights>COPYRIGHT 2012 Springer</rights><rights>IPNA 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-2e1629f9579d6777d2f4cebdbe2eb64c12743f8e155ba4e951ba037c4f1198d33</citedby><cites>FETCH-LOGICAL-c507t-2e1629f9579d6777d2f4cebdbe2eb64c12743f8e155ba4e951ba037c4f1198d33</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/s00467-011-2010-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00467-011-2010-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21964556$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Davis, Ira D.</creatorcontrib><creatorcontrib>Greenbaum, Larry A</creatorcontrib><creatorcontrib>Gipson, Debbie</creatorcontrib><creatorcontrib>Wu, Lie Ling</creatorcontrib><creatorcontrib>Sinha, Rajiv</creatorcontrib><creatorcontrib>Matsuda-Abedini, Mina</creatorcontrib><creatorcontrib>Emancipator, Judith L.</creatorcontrib><creatorcontrib>Lane, Jerome C.</creatorcontrib><creatorcontrib>Hodgkins, Kavita</creatorcontrib><creatorcontrib>Nailescu, Corina</creatorcontrib><creatorcontrib>Barletta, Gina Marie</creatorcontrib><creatorcontrib>Arora, Steven</creatorcontrib><creatorcontrib>Mahan, John D.</creatorcontrib><creatorcontrib>Rosen, Carol L.</creatorcontrib><title>Prevalence of sleep disturbances in children and adolescents with chronic kidney disease</title><title>Pediatric nephrology (Berlin, West)</title><addtitle>Pediatr Nephrol</addtitle><addtitle>Pediatr Nephrol</addtitle><description>Although sleep disorders are common in adults with chronic kidney disease, little is known about the prevalence of sleep problems in children and adolescents with chronic kidney disease and their relationship to health-related quality of life measurements. We performed a clinic-based survey of sleep habits and common symptoms of sleep disturbances in 159 school-aged patients with chronic kidney disease. Three patient groups of chronic kidney disease were assessed: group 1, those not on dialysis and not transplanted; group 2, those on dialysis; and group 3, those with a functioning renal allograft. Four symptom domains for sleep disorders were assessed: excessive daytime sleepiness; sleep disordered breathing; restless legs syndrome symptoms; and insufficient sleep. Patients and the parent-proxy also completed the Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales questionnaire. Ninety-three (93) patients (58.5%) had symptoms of a sleep disturbance. The presence of a sleep disturbance correlated with a decrease in health-related quality of life scores that was independent of the chronic kidney disease study group or estimated glomerular filtration rate. We conclude that sleep disturbances are common throughout the spectrum of chronic kidney disease in children and adolescents and are associated with diminished health-related quality of life scores.</description><subject>Adolescent</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Chronic Disease</subject><subject>Chronic kidney failure</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Hemodialysis</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Kidney diseases</subject><subject>Kidney Diseases - complications</subject><subject>Kidney Diseases - physiopathology</subject><subject>Kidney Diseases - psychology</subject><subject>Kidney transplants</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Prevalence</subject><subject>Prevalence studies (Epidemiology)</subject><subject>Quality of Life</subject><subject>Questionnaires</subject><subject>Restless legs syndrome</subject><subject>Sleep</subject><subject>Sleep disorders</subject><subject>Sleep Wake Disorders - epidemiology</subject><subject>Teenagers</subject><subject>Urology</subject><issn>0931-041X</issn><issn>1432-198X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kl1rFDEUhoNY7Fr9Ad7IgFCvUvMxmUwuS6kfUKgXCnsXMsmZ3dRssiYzyv57s2zVVlZyETjneQ_nvLwIvaLkghIi3xVC2k5iQilmhBK8e4IWtOUMU9Uvn6IFUZxi0tLlKXpeyh0hpBd99wydMqq6VohugZafM_wwAaKFJo1NCQDbxvkyzXkwtVgaHxu79sFliI2JrjEuBSgW4lSan35a125O0dvmm3cRdnsxmAIv0MloQoGX9_8Z-vr--svVR3xz--HT1eUNtoLICTOgHVOjElK5Tkrp2NhaGNwADIautZTJlo89UCEG04ISdDCES9uOtB7pOD9Dbw9ztzl9n6FMeuPrdiGYCGkuWlHZC6EUqeSbf8i7NOdYl9OUKCF6xXn_l1pVV7SPY5qysfuZ-pJz2vWyZ6JS-Ai1ggjZhBRh9LX8iL84wtfnYOPtUcH5A8EaTJjWJYV58imWxyA9gDanUjKMepv9xuRdPUrvU6IPKdE1JXqfEr2rmtf3TszDBtwfxe9YVIAdgFJbcQX5oVX_m_oLH37FYw</recordid><startdate>20120301</startdate><enddate>20120301</enddate><creator>Davis, Ira D.</creator><creator>Greenbaum, Larry A</creator><creator>Gipson, Debbie</creator><creator>Wu, Lie Ling</creator><creator>Sinha, Rajiv</creator><creator>Matsuda-Abedini, Mina</creator><creator>Emancipator, Judith L.</creator><creator>Lane, Jerome C.</creator><creator>Hodgkins, Kavita</creator><creator>Nailescu, Corina</creator><creator>Barletta, Gina Marie</creator><creator>Arora, Steven</creator><creator>Mahan, John D.</creator><creator>Rosen, Carol L.</creator><general>Springer-Verlag</general><general>Springer</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>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20120301</creationdate><title>Prevalence of sleep disturbances in children and adolescents with chronic kidney disease</title><author>Davis, Ira D. ; Greenbaum, Larry A ; Gipson, Debbie ; Wu, Lie Ling ; Sinha, Rajiv ; Matsuda-Abedini, Mina ; Emancipator, Judith L. ; Lane, Jerome C. ; Hodgkins, Kavita ; Nailescu, Corina ; Barletta, Gina Marie ; Arora, Steven ; Mahan, John D. ; Rosen, Carol L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c507t-2e1629f9579d6777d2f4cebdbe2eb64c12743f8e155ba4e951ba037c4f1198d33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Chronic Disease</topic><topic>Chronic kidney failure</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Hemodialysis</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Kidney diseases</topic><topic>Kidney Diseases - complications</topic><topic>Kidney Diseases - physiopathology</topic><topic>Kidney Diseases - psychology</topic><topic>Kidney transplants</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Prevalence</topic><topic>Prevalence studies (Epidemiology)</topic><topic>Quality of Life</topic><topic>Questionnaires</topic><topic>Restless legs syndrome</topic><topic>Sleep</topic><topic>Sleep disorders</topic><topic>Sleep Wake Disorders - epidemiology</topic><topic>Teenagers</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Davis, Ira D.</creatorcontrib><creatorcontrib>Greenbaum, Larry A</creatorcontrib><creatorcontrib>Gipson, Debbie</creatorcontrib><creatorcontrib>Wu, Lie Ling</creatorcontrib><creatorcontrib>Sinha, Rajiv</creatorcontrib><creatorcontrib>Matsuda-Abedini, Mina</creatorcontrib><creatorcontrib>Emancipator, Judith L.</creatorcontrib><creatorcontrib>Lane, Jerome C.</creatorcontrib><creatorcontrib>Hodgkins, Kavita</creatorcontrib><creatorcontrib>Nailescu, Corina</creatorcontrib><creatorcontrib>Barletta, Gina Marie</creatorcontrib><creatorcontrib>Arora, Steven</creatorcontrib><creatorcontrib>Mahan, John D.</creatorcontrib><creatorcontrib>Rosen, Carol L.</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>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical 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 Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</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>MEDLINE - Academic</collection><jtitle>Pediatric nephrology (Berlin, West)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Davis, Ira D.</au><au>Greenbaum, Larry A</au><au>Gipson, Debbie</au><au>Wu, Lie Ling</au><au>Sinha, Rajiv</au><au>Matsuda-Abedini, Mina</au><au>Emancipator, Judith L.</au><au>Lane, Jerome C.</au><au>Hodgkins, Kavita</au><au>Nailescu, Corina</au><au>Barletta, Gina Marie</au><au>Arora, Steven</au><au>Mahan, John D.</au><au>Rosen, Carol L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of sleep disturbances in children and adolescents with chronic kidney disease</atitle><jtitle>Pediatric nephrology (Berlin, West)</jtitle><stitle>Pediatr Nephrol</stitle><addtitle>Pediatr Nephrol</addtitle><date>2012-03-01</date><risdate>2012</risdate><volume>27</volume><issue>3</issue><spage>451</spage><epage>459</epage><pages>451-459</pages><issn>0931-041X</issn><eissn>1432-198X</eissn><abstract>Although sleep disorders are common in adults with chronic kidney disease, little is known about the prevalence of sleep problems in children and adolescents with chronic kidney disease and their relationship to health-related quality of life measurements. We performed a clinic-based survey of sleep habits and common symptoms of sleep disturbances in 159 school-aged patients with chronic kidney disease. Three patient groups of chronic kidney disease were assessed: group 1, those not on dialysis and not transplanted; group 2, those on dialysis; and group 3, those with a functioning renal allograft. Four symptom domains for sleep disorders were assessed: excessive daytime sleepiness; sleep disordered breathing; restless legs syndrome symptoms; and insufficient sleep. Patients and the parent-proxy also completed the Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales questionnaire. Ninety-three (93) patients (58.5%) had symptoms of a sleep disturbance. The presence of a sleep disturbance correlated with a decrease in health-related quality of life scores that was independent of the chronic kidney disease study group or estimated glomerular filtration rate. We conclude that sleep disturbances are common throughout the spectrum of chronic kidney disease in children and adolescents and are associated with diminished health-related quality of life scores.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>21964556</pmid><doi>10.1007/s00467-011-2010-y</doi><tpages>9</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0931-041X |
ispartof | Pediatric nephrology (Berlin, West), 2012-03, Vol.27 (3), p.451-459 |
issn | 0931-041X 1432-198X |
language | eng |
recordid | cdi_proquest_miscellaneous_917855990 |
source | MEDLINE; SpringerLink Journals |
subjects | Adolescent Child Child, Preschool Chronic Disease Chronic kidney failure Female Glomerular Filtration Rate Hemodialysis Hospitals Humans Kidney diseases Kidney Diseases - complications Kidney Diseases - physiopathology Kidney Diseases - psychology Kidney transplants Logistic Models Male Medicine Medicine & Public Health Nephrology Original Article Patients Pediatrics Prevalence Prevalence studies (Epidemiology) Quality of Life Questionnaires Restless legs syndrome Sleep Sleep disorders Sleep Wake Disorders - epidemiology Teenagers Urology |
title | Prevalence of sleep disturbances in children and adolescents with chronic kidney disease |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T23%3A19%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prevalence%20of%20sleep%20disturbances%20in%20children%20and%20adolescents%20with%20chronic%20kidney%20disease&rft.jtitle=Pediatric%20nephrology%20(Berlin,%20West)&rft.au=Davis,%20Ira%20D.&rft.date=2012-03-01&rft.volume=27&rft.issue=3&rft.spage=451&rft.epage=459&rft.pages=451-459&rft.issn=0931-041X&rft.eissn=1432-198X&rft_id=info:doi/10.1007/s00467-011-2010-y&rft_dat=%3Cgale_proqu%3EA331687825%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1095589338&rft_id=info:pmid/21964556&rft_galeid=A331687825&rfr_iscdi=true |