Loading…

Perceptions of palliative care in a South Asian community: findings from an observational study

Patients often view "palliative care" (PC) as an approach that is synonymous with end-of-life and death, leading to shock and fear. Differing cultural and social norms and religious affiliations greatly determine perception of PC among diverse populations. This prospective observational st...

Full description

Saved in:
Bibliographic Details
Published in:BMC palliative care 2020-09, Vol.19 (1), p.141-141, Article 141
Main Authors: Dosani, Naheed, Bhargava, Ravi, Arya, Amit, Pang, Celeste, Tut, Pavinder, Sharma, Achal, Chasen, Martin
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c563t-291d8c0b4b0a3a0b66c692dc8f01a782ee65d2aca924d9d06ae10d800c2bdda73
cites cdi_FETCH-LOGICAL-c563t-291d8c0b4b0a3a0b66c692dc8f01a782ee65d2aca924d9d06ae10d800c2bdda73
container_end_page 141
container_issue 1
container_start_page 141
container_title BMC palliative care
container_volume 19
creator Dosani, Naheed
Bhargava, Ravi
Arya, Amit
Pang, Celeste
Tut, Pavinder
Sharma, Achal
Chasen, Martin
description Patients often view "palliative care" (PC) as an approach that is synonymous with end-of-life and death, leading to shock and fear. Differing cultural and social norms and religious affiliations greatly determine perception of PC among diverse populations. This prospective observational study aimed to explore perceptions of PC among South Asian community members at one Canadian site. Patients who identified themselves as being of South Asian origin were consented and enrolled at a PC Clinic at a community hospital in Brampton, Ontario serving a large South Asian population. Participants filled out an 18-question survey created for the study and responded to a semi-structured interview consisting of 8 questions that further probed their perceptions of PC. Survey responses and semi-structured interviews content were analyzed by four authors who reached consensus on key exploratory findings. Thirty-four participants of South Asian origin were recruited (61.8% males), and they were distributed by their age group as follows: [(30-49) - 18%; (50-64) - 21%; (65-79) - 41%; (≥ 80) - 21%]. Five main exploratory findings emerged: (i) differing attitudes towards talking about death; (ii) the key role of family in providing care; (iii) a significant lack of prior knowledge of PC; (iv) a common emphasis on the importance of alleviating suffering and pain to maintain comfort; and (v) that cultural values, faith, or spiritual belief do not pose a necessary challenge to acceptance of PC services. Observations from this study provide a source of reference to understand the key findings and variability in perceptions of palliative care in South Asian communities. Culturally competent interventions based on trends observed in this study could assist Palliative Physicians in delivering personalized care to South Asian populations.
doi_str_mv 10.1186/s12904-020-00646-6
format article
fullrecord <record><control><sourceid>gale_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_90f116a5468b4461a9d70316465004a8</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A636940400</galeid><doaj_id>oai_doaj_org_article_90f116a5468b4461a9d70316465004a8</doaj_id><sourcerecordid>A636940400</sourcerecordid><originalsourceid>FETCH-LOGICAL-c563t-291d8c0b4b0a3a0b66c692dc8f01a782ee65d2aca924d9d06ae10d800c2bdda73</originalsourceid><addsrcrecordid>eNptkk-LFDEQxRtR3HX1C3iQgBcvvVbSmXTiQRgW_ywsKKjgLVQn6dkM3cmYdA_Mtzczs647IjkkVL33C1W8qnpJ4ZJSKd5myhTwGhjUAIKLWjyqzilvWS0k__n4wfusepbzGoC2ki-eVmcNU0xSyc4r_dUl4zaTjyGT2JMNDoPHyW8dMZgc8YEg-Rbn6ZYss8dATBzHOfhp9470PlgfVpn0KY6k9GKXXdriHoYDydNsd8-rJz0O2b24uy-qHx8_fL_6XN98-XR9tbypzUI0U80UtdJAxzvABqETwgjFrJE9UGwlc04sLEODinGrLAh0FKwEMKyzFtvmoro-cm3Etd4kP2La6YheHwoxrTSmyZvBaQU9pQIXXMiOc0FR2RYaWha4AOAoC-v9kbWZu9FZ48KUcDiBnnaCv9WruNUtVxTUHvDmDpDir9nlSY8-GzcMGFycs2acM8kpaxdF-vof6TrOqazvoOKUKsXZX9UKywA-9LH8a_ZQvRSNUBw4QFFd_kdVjnWjNzG43pf6iYEdDSbFnJPr72ekoPcR08eI6RIxfYiYFsX06uF27i1_MtX8BqXAyxQ</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2444119942</pqid></control><display><type>article</type><title>Perceptions of palliative care in a South Asian community: findings from an observational study</title><source>Open Access: PubMed Central</source><source>Publicly Available Content Database</source><creator>Dosani, Naheed ; Bhargava, Ravi ; Arya, Amit ; Pang, Celeste ; Tut, Pavinder ; Sharma, Achal ; Chasen, Martin</creator><creatorcontrib>Dosani, Naheed ; Bhargava, Ravi ; Arya, Amit ; Pang, Celeste ; Tut, Pavinder ; Sharma, Achal ; Chasen, Martin</creatorcontrib><description>Patients often view "palliative care" (PC) as an approach that is synonymous with end-of-life and death, leading to shock and fear. Differing cultural and social norms and religious affiliations greatly determine perception of PC among diverse populations. This prospective observational study aimed to explore perceptions of PC among South Asian community members at one Canadian site. Patients who identified themselves as being of South Asian origin were consented and enrolled at a PC Clinic at a community hospital in Brampton, Ontario serving a large South Asian population. Participants filled out an 18-question survey created for the study and responded to a semi-structured interview consisting of 8 questions that further probed their perceptions of PC. Survey responses and semi-structured interviews content were analyzed by four authors who reached consensus on key exploratory findings. Thirty-four participants of South Asian origin were recruited (61.8% males), and they were distributed by their age group as follows: [(30-49) - 18%; (50-64) - 21%; (65-79) - 41%; (≥ 80) - 21%]. Five main exploratory findings emerged: (i) differing attitudes towards talking about death; (ii) the key role of family in providing care; (iii) a significant lack of prior knowledge of PC; (iv) a common emphasis on the importance of alleviating suffering and pain to maintain comfort; and (v) that cultural values, faith, or spiritual belief do not pose a necessary challenge to acceptance of PC services. Observations from this study provide a source of reference to understand the key findings and variability in perceptions of palliative care in South Asian communities. Culturally competent interventions based on trends observed in this study could assist Palliative Physicians in delivering personalized care to South Asian populations.</description><identifier>ISSN: 1472-684X</identifier><identifier>EISSN: 1472-684X</identifier><identifier>DOI: 10.1186/s12904-020-00646-6</identifier><identifier>PMID: 32928182</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Analysis ; Asian Continental Ancestry Group - ethnology ; Asian Continental Ancestry Group - psychology ; Asian Continental Ancestry Group - statistics &amp; numerical data ; Caregivers ; Cultural competence ; Female ; Hospice care ; Humans ; India - ethnology ; Interviews ; Male ; Middle Aged ; Observational studies ; Ontario ; Pakistan - ethnology ; Palliative care ; Palliative Care - methods ; Palliative Care - psychology ; Palliative Care - standards ; Palliative perceptions ; Patients ; Perception ; Perceptions ; Prospective Studies ; Qualitative Research ; Quality of life ; Religion ; Social determinants of health ; Social norms ; South Asian community ; Sri Lanka - ethnology ; Surveys ; Surveys and Questionnaires</subject><ispartof>BMC palliative care, 2020-09, Vol.19 (1), p.141-141, Article 141</ispartof><rights>COPYRIGHT 2020 BioMed Central Ltd.</rights><rights>2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c563t-291d8c0b4b0a3a0b66c692dc8f01a782ee65d2aca924d9d06ae10d800c2bdda73</citedby><cites>FETCH-LOGICAL-c563t-291d8c0b4b0a3a0b66c692dc8f01a782ee65d2aca924d9d06ae10d800c2bdda73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491098/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2444119942?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25752,27923,27924,37011,37012,44589,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32928182$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dosani, Naheed</creatorcontrib><creatorcontrib>Bhargava, Ravi</creatorcontrib><creatorcontrib>Arya, Amit</creatorcontrib><creatorcontrib>Pang, Celeste</creatorcontrib><creatorcontrib>Tut, Pavinder</creatorcontrib><creatorcontrib>Sharma, Achal</creatorcontrib><creatorcontrib>Chasen, Martin</creatorcontrib><title>Perceptions of palliative care in a South Asian community: findings from an observational study</title><title>BMC palliative care</title><addtitle>BMC Palliat Care</addtitle><description>Patients often view "palliative care" (PC) as an approach that is synonymous with end-of-life and death, leading to shock and fear. Differing cultural and social norms and religious affiliations greatly determine perception of PC among diverse populations. This prospective observational study aimed to explore perceptions of PC among South Asian community members at one Canadian site. Patients who identified themselves as being of South Asian origin were consented and enrolled at a PC Clinic at a community hospital in Brampton, Ontario serving a large South Asian population. Participants filled out an 18-question survey created for the study and responded to a semi-structured interview consisting of 8 questions that further probed their perceptions of PC. Survey responses and semi-structured interviews content were analyzed by four authors who reached consensus on key exploratory findings. Thirty-four participants of South Asian origin were recruited (61.8% males), and they were distributed by their age group as follows: [(30-49) - 18%; (50-64) - 21%; (65-79) - 41%; (≥ 80) - 21%]. Five main exploratory findings emerged: (i) differing attitudes towards talking about death; (ii) the key role of family in providing care; (iii) a significant lack of prior knowledge of PC; (iv) a common emphasis on the importance of alleviating suffering and pain to maintain comfort; and (v) that cultural values, faith, or spiritual belief do not pose a necessary challenge to acceptance of PC services. Observations from this study provide a source of reference to understand the key findings and variability in perceptions of palliative care in South Asian communities. Culturally competent interventions based on trends observed in this study could assist Palliative Physicians in delivering personalized care to South Asian populations.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Asian Continental Ancestry Group - ethnology</subject><subject>Asian Continental Ancestry Group - psychology</subject><subject>Asian Continental Ancestry Group - statistics &amp; numerical data</subject><subject>Caregivers</subject><subject>Cultural competence</subject><subject>Female</subject><subject>Hospice care</subject><subject>Humans</subject><subject>India - ethnology</subject><subject>Interviews</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Observational studies</subject><subject>Ontario</subject><subject>Pakistan - ethnology</subject><subject>Palliative care</subject><subject>Palliative Care - methods</subject><subject>Palliative Care - psychology</subject><subject>Palliative Care - standards</subject><subject>Palliative perceptions</subject><subject>Patients</subject><subject>Perception</subject><subject>Perceptions</subject><subject>Prospective Studies</subject><subject>Qualitative Research</subject><subject>Quality of life</subject><subject>Religion</subject><subject>Social determinants of health</subject><subject>Social norms</subject><subject>South Asian community</subject><subject>Sri Lanka - ethnology</subject><subject>Surveys</subject><subject>Surveys and Questionnaires</subject><issn>1472-684X</issn><issn>1472-684X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkk-LFDEQxRtR3HX1C3iQgBcvvVbSmXTiQRgW_ywsKKjgLVQn6dkM3cmYdA_Mtzczs647IjkkVL33C1W8qnpJ4ZJSKd5myhTwGhjUAIKLWjyqzilvWS0k__n4wfusepbzGoC2ki-eVmcNU0xSyc4r_dUl4zaTjyGT2JMNDoPHyW8dMZgc8YEg-Rbn6ZYss8dATBzHOfhp9470PlgfVpn0KY6k9GKXXdriHoYDydNsd8-rJz0O2b24uy-qHx8_fL_6XN98-XR9tbypzUI0U80UtdJAxzvABqETwgjFrJE9UGwlc04sLEODinGrLAh0FKwEMKyzFtvmoro-cm3Etd4kP2La6YheHwoxrTSmyZvBaQU9pQIXXMiOc0FR2RYaWha4AOAoC-v9kbWZu9FZ48KUcDiBnnaCv9WruNUtVxTUHvDmDpDir9nlSY8-GzcMGFycs2acM8kpaxdF-vof6TrOqazvoOKUKsXZX9UKywA-9LH8a_ZQvRSNUBw4QFFd_kdVjnWjNzG43pf6iYEdDSbFnJPr72ekoPcR08eI6RIxfYiYFsX06uF27i1_MtX8BqXAyxQ</recordid><startdate>20200914</startdate><enddate>20200914</enddate><creator>Dosani, Naheed</creator><creator>Bhargava, Ravi</creator><creator>Arya, Amit</creator><creator>Pang, Celeste</creator><creator>Tut, Pavinder</creator><creator>Sharma, Achal</creator><creator>Chasen, Martin</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</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>7X7</scope><scope>7XB</scope><scope>88E</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>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20200914</creationdate><title>Perceptions of palliative care in a South Asian community: findings from an observational study</title><author>Dosani, Naheed ; Bhargava, Ravi ; Arya, Amit ; Pang, Celeste ; Tut, Pavinder ; Sharma, Achal ; Chasen, Martin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c563t-291d8c0b4b0a3a0b66c692dc8f01a782ee65d2aca924d9d06ae10d800c2bdda73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Asian Continental Ancestry Group - ethnology</topic><topic>Asian Continental Ancestry Group - psychology</topic><topic>Asian Continental Ancestry Group - statistics &amp; numerical data</topic><topic>Caregivers</topic><topic>Cultural competence</topic><topic>Female</topic><topic>Hospice care</topic><topic>Humans</topic><topic>India - ethnology</topic><topic>Interviews</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Observational studies</topic><topic>Ontario</topic><topic>Pakistan - ethnology</topic><topic>Palliative care</topic><topic>Palliative Care - methods</topic><topic>Palliative Care - psychology</topic><topic>Palliative Care - standards</topic><topic>Palliative perceptions</topic><topic>Patients</topic><topic>Perception</topic><topic>Perceptions</topic><topic>Prospective Studies</topic><topic>Qualitative Research</topic><topic>Quality of life</topic><topic>Religion</topic><topic>Social determinants of health</topic><topic>Social norms</topic><topic>South Asian community</topic><topic>Sri Lanka - ethnology</topic><topic>Surveys</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dosani, Naheed</creatorcontrib><creatorcontrib>Bhargava, Ravi</creatorcontrib><creatorcontrib>Arya, Amit</creatorcontrib><creatorcontrib>Pang, Celeste</creatorcontrib><creatorcontrib>Tut, Pavinder</creatorcontrib><creatorcontrib>Sharma, Achal</creatorcontrib><creatorcontrib>Chasen, Martin</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>ProQuest_Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical 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>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Publicly Available Content Database</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><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC palliative care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dosani, Naheed</au><au>Bhargava, Ravi</au><au>Arya, Amit</au><au>Pang, Celeste</au><au>Tut, Pavinder</au><au>Sharma, Achal</au><au>Chasen, Martin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perceptions of palliative care in a South Asian community: findings from an observational study</atitle><jtitle>BMC palliative care</jtitle><addtitle>BMC Palliat Care</addtitle><date>2020-09-14</date><risdate>2020</risdate><volume>19</volume><issue>1</issue><spage>141</spage><epage>141</epage><pages>141-141</pages><artnum>141</artnum><issn>1472-684X</issn><eissn>1472-684X</eissn><abstract>Patients often view "palliative care" (PC) as an approach that is synonymous with end-of-life and death, leading to shock and fear. Differing cultural and social norms and religious affiliations greatly determine perception of PC among diverse populations. This prospective observational study aimed to explore perceptions of PC among South Asian community members at one Canadian site. Patients who identified themselves as being of South Asian origin were consented and enrolled at a PC Clinic at a community hospital in Brampton, Ontario serving a large South Asian population. Participants filled out an 18-question survey created for the study and responded to a semi-structured interview consisting of 8 questions that further probed their perceptions of PC. Survey responses and semi-structured interviews content were analyzed by four authors who reached consensus on key exploratory findings. Thirty-four participants of South Asian origin were recruited (61.8% males), and they were distributed by their age group as follows: [(30-49) - 18%; (50-64) - 21%; (65-79) - 41%; (≥ 80) - 21%]. Five main exploratory findings emerged: (i) differing attitudes towards talking about death; (ii) the key role of family in providing care; (iii) a significant lack of prior knowledge of PC; (iv) a common emphasis on the importance of alleviating suffering and pain to maintain comfort; and (v) that cultural values, faith, or spiritual belief do not pose a necessary challenge to acceptance of PC services. Observations from this study provide a source of reference to understand the key findings and variability in perceptions of palliative care in South Asian communities. Culturally competent interventions based on trends observed in this study could assist Palliative Physicians in delivering personalized care to South Asian populations.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>32928182</pmid><doi>10.1186/s12904-020-00646-6</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1472-684X
ispartof BMC palliative care, 2020-09, Vol.19 (1), p.141-141, Article 141
issn 1472-684X
1472-684X
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_90f116a5468b4461a9d70316465004a8
source Open Access: PubMed Central; Publicly Available Content Database
subjects Adult
Aged
Aged, 80 and over
Analysis
Asian Continental Ancestry Group - ethnology
Asian Continental Ancestry Group - psychology
Asian Continental Ancestry Group - statistics & numerical data
Caregivers
Cultural competence
Female
Hospice care
Humans
India - ethnology
Interviews
Male
Middle Aged
Observational studies
Ontario
Pakistan - ethnology
Palliative care
Palliative Care - methods
Palliative Care - psychology
Palliative Care - standards
Palliative perceptions
Patients
Perception
Perceptions
Prospective Studies
Qualitative Research
Quality of life
Religion
Social determinants of health
Social norms
South Asian community
Sri Lanka - ethnology
Surveys
Surveys and Questionnaires
title Perceptions of palliative care in a South Asian community: findings from an observational study
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-13T06%3A43%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Perceptions%20of%20palliative%20care%20in%20a%20South%20Asian%20community:%20findings%20from%20an%20observational%20study&rft.jtitle=BMC%20palliative%20care&rft.au=Dosani,%20Naheed&rft.date=2020-09-14&rft.volume=19&rft.issue=1&rft.spage=141&rft.epage=141&rft.pages=141-141&rft.artnum=141&rft.issn=1472-684X&rft.eissn=1472-684X&rft_id=info:doi/10.1186/s12904-020-00646-6&rft_dat=%3Cgale_doaj_%3EA636940400%3C/gale_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c563t-291d8c0b4b0a3a0b66c692dc8f01a782ee65d2aca924d9d06ae10d800c2bdda73%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2444119942&rft_id=info:pmid/32928182&rft_galeid=A636940400&rfr_iscdi=true