Loading…

A Consensus-based Educational Framework and Competency Set for the Discipline of Disaster Medicine and Public Health Preparedness

Background: Various organizations and universities have developed competencies for health professionals and other emergency responders. Little effort has been devoted to the integration of these competencies across health specialties and professions. The American Medical Association Center for Publi...

Full description

Saved in:
Bibliographic Details
Published in:Disaster medicine and public health preparedness 2008-03, Vol.2 (1), p.57-68
Main Authors: Subbarao, Italo, Lyznicki, James M., Hsu, Edbert B., Gebbie, Kristine M., Markenson, David, Barzansky, Barbara, Armstrong, John H., Cassimatis, Emmanuel G., Coule, Philip L., Dallas, Cham E., King, Richard V., Rubinson, Lewis, Sattin, Richard, Swienton, Raymond E., Lillibridge, Scott, Burkle, Frederick M., Schwartz, Richard B., James, James J.
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-c492t-60691cf2c4749d86dce6242539c397abbd019e85eaac23cb6e7e6f4cf4a749b13
cites cdi_FETCH-LOGICAL-c492t-60691cf2c4749d86dce6242539c397abbd019e85eaac23cb6e7e6f4cf4a749b13
container_end_page 68
container_issue 1
container_start_page 57
container_title Disaster medicine and public health preparedness
container_volume 2
creator Subbarao, Italo
Lyznicki, James M.
Hsu, Edbert B.
Gebbie, Kristine M.
Markenson, David
Barzansky, Barbara
Armstrong, John H.
Cassimatis, Emmanuel G.
Coule, Philip L.
Dallas, Cham E.
King, Richard V.
Rubinson, Lewis
Sattin, Richard
Swienton, Raymond E.
Lillibridge, Scott
Burkle, Frederick M.
Schwartz, Richard B.
James, James J.
description Background: Various organizations and universities have developed competencies for health professionals and other emergency responders. Little effort has been devoted to the integration of these competencies across health specialties and professions. The American Medical Association Center for Public Health Preparedness and Disaster Response convened an expert working group (EWG) to review extant competencies and achieve consensus on an educational framework and competency set from which educators could devise learning objectives and curricula tailored to fit the needs of all health professionals in a disaster. Methods: The EWG conducted a systematic review of peer-reviewed and non–peer reviewed published literature. In addition, after-action reports from Hurricane Katrina and relevant publications recommended by EWG members and other subject matter experts were reviewed for congruencies and gaps. Consensus was ensured through a 3-stage Delphi process. Results: The EWG process developed a new educational framework for disaster medicine and public health preparedness based on consensus identification of 7 core learning domains, 19 core competencies, and 73 specific competencies targeted at 3 broad health personnel categories. Conclusions: The competencies can be applied to a wide range of health professionals who are expected to perform at different levels (informed worker/student, practitioner, leader) according to experience, professional role, level of education, or job function. Although these competencies strongly reflect lessons learned following the health system response to Hurricane Katrina, it must be understood that preparedness is a process, and that these competencies must be reviewed continually and refined over time. (Disaster Med Public Health Preparedness. 2008;2:57–68)
doi_str_mv 10.1097/DMP.0b013e31816564af
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70473560</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><cupid>10_1097_DMP_0b013e31816564af</cupid><sourcerecordid>70473560</sourcerecordid><originalsourceid>FETCH-LOGICAL-c492t-60691cf2c4749d86dce6242539c397abbd019e85eaac23cb6e7e6f4cf4a749b13</originalsourceid><addsrcrecordid>eNp9kV1L3jAYhsPYUOf8B2MEBp7V5atJcyivOgVlL2yCZ-VJ8nTWtU2XtAwP98_X6guCBzvKB9d9PSE3IR85O-HMmi9nN9sT5hiXKHnFdakVNG_IAbeyKoxSd2-f9mVhKiv3yfucHxgrtSntHtnnlawqXdoD8veUbuKQcchzLhxkDPQ8zB6mNg7Q0YsEPf6J6ReFISxkP-KEg3-k33GiTUx0ukd61mbfjl07II3NeoI8YaI3GFq_Xq7R7ey61tNLhG66p9uEIyQMA-b8gbxroMt4tFsPye3F-Y_NZXH97evV5vS68MqKqdBMW-4b4ZVRNlQ6eNRCiVJaL60B5wLjFqsSAbyQ3mk0qBvlGwVLwHF5SI6fvWOKv2fMU90v78augwHjnGvDlJGlZgv4-RX4EOe0_EauhWBGaK3FqlPPlE8x54RNPaa2h_RYc1avBdVLQfXrgpbYp518dj2Gl9CukQXQOy_0LrXhJ76M_6_5H-vjn04</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2207266621</pqid></control><display><type>article</type><title>A Consensus-based Educational Framework and Competency Set for the Discipline of Disaster Medicine and Public Health Preparedness</title><source>Cambridge University Press</source><creator>Subbarao, Italo ; Lyznicki, James M. ; Hsu, Edbert B. ; Gebbie, Kristine M. ; Markenson, David ; Barzansky, Barbara ; Armstrong, John H. ; Cassimatis, Emmanuel G. ; Coule, Philip L. ; Dallas, Cham E. ; King, Richard V. ; Rubinson, Lewis ; Sattin, Richard ; Swienton, Raymond E. ; Lillibridge, Scott ; Burkle, Frederick M. ; Schwartz, Richard B. ; James, James J.</creator><creatorcontrib>Subbarao, Italo ; Lyznicki, James M. ; Hsu, Edbert B. ; Gebbie, Kristine M. ; Markenson, David ; Barzansky, Barbara ; Armstrong, John H. ; Cassimatis, Emmanuel G. ; Coule, Philip L. ; Dallas, Cham E. ; King, Richard V. ; Rubinson, Lewis ; Sattin, Richard ; Swienton, Raymond E. ; Lillibridge, Scott ; Burkle, Frederick M. ; Schwartz, Richard B. ; James, James J.</creatorcontrib><description>Background: Various organizations and universities have developed competencies for health professionals and other emergency responders. Little effort has been devoted to the integration of these competencies across health specialties and professions. The American Medical Association Center for Public Health Preparedness and Disaster Response convened an expert working group (EWG) to review extant competencies and achieve consensus on an educational framework and competency set from which educators could devise learning objectives and curricula tailored to fit the needs of all health professionals in a disaster. Methods: The EWG conducted a systematic review of peer-reviewed and non–peer reviewed published literature. In addition, after-action reports from Hurricane Katrina and relevant publications recommended by EWG members and other subject matter experts were reviewed for congruencies and gaps. Consensus was ensured through a 3-stage Delphi process. Results: The EWG process developed a new educational framework for disaster medicine and public health preparedness based on consensus identification of 7 core learning domains, 19 core competencies, and 73 specific competencies targeted at 3 broad health personnel categories. Conclusions: The competencies can be applied to a wide range of health professionals who are expected to perform at different levels (informed worker/student, practitioner, leader) according to experience, professional role, level of education, or job function. Although these competencies strongly reflect lessons learned following the health system response to Hurricane Katrina, it must be understood that preparedness is a process, and that these competencies must be reviewed continually and refined over time. (Disaster Med Public Health Preparedness. 2008;2:57–68)</description><identifier>ISSN: 1935-7893</identifier><identifier>EISSN: 1938-744X</identifier><identifier>DOI: 10.1097/DMP.0b013e31816564af</identifier><identifier>PMID: 18388659</identifier><language>eng</language><publisher>New York, USA: Cambridge University Press</publisher><subject>Clinical Competence ; Consensus ; Core competencies ; Curricula ; Disaster management ; Disaster Medicine - education ; Disaster Medicine - standards ; Disasters ; Education ; Emergency preparedness ; Health care policy ; Health services ; Hospitals ; Humans ; Hurricanes ; Learning ; Medical personnel ; Medicine ; National security ; Nurses ; Nursing schools ; Objectives ; Physicians ; Professional Competence ; Professionals ; Professions ; Public Health ; Students ; Taxonomy ; United States</subject><ispartof>Disaster medicine and public health preparedness, 2008-03, Vol.2 (1), p.57-68</ispartof><rights>Copyright © Society for Disaster Medicine and Public Health, Inc. 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c492t-60691cf2c4749d86dce6242539c397abbd019e85eaac23cb6e7e6f4cf4a749b13</citedby><cites>FETCH-LOGICAL-c492t-60691cf2c4749d86dce6242539c397abbd019e85eaac23cb6e7e6f4cf4a749b13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S1935789300000823/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,72960</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18388659$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Subbarao, Italo</creatorcontrib><creatorcontrib>Lyznicki, James M.</creatorcontrib><creatorcontrib>Hsu, Edbert B.</creatorcontrib><creatorcontrib>Gebbie, Kristine M.</creatorcontrib><creatorcontrib>Markenson, David</creatorcontrib><creatorcontrib>Barzansky, Barbara</creatorcontrib><creatorcontrib>Armstrong, John H.</creatorcontrib><creatorcontrib>Cassimatis, Emmanuel G.</creatorcontrib><creatorcontrib>Coule, Philip L.</creatorcontrib><creatorcontrib>Dallas, Cham E.</creatorcontrib><creatorcontrib>King, Richard V.</creatorcontrib><creatorcontrib>Rubinson, Lewis</creatorcontrib><creatorcontrib>Sattin, Richard</creatorcontrib><creatorcontrib>Swienton, Raymond E.</creatorcontrib><creatorcontrib>Lillibridge, Scott</creatorcontrib><creatorcontrib>Burkle, Frederick M.</creatorcontrib><creatorcontrib>Schwartz, Richard B.</creatorcontrib><creatorcontrib>James, James J.</creatorcontrib><title>A Consensus-based Educational Framework and Competency Set for the Discipline of Disaster Medicine and Public Health Preparedness</title><title>Disaster medicine and public health preparedness</title><addtitle>Disaster med. public health prep</addtitle><description>Background: Various organizations and universities have developed competencies for health professionals and other emergency responders. Little effort has been devoted to the integration of these competencies across health specialties and professions. The American Medical Association Center for Public Health Preparedness and Disaster Response convened an expert working group (EWG) to review extant competencies and achieve consensus on an educational framework and competency set from which educators could devise learning objectives and curricula tailored to fit the needs of all health professionals in a disaster. Methods: The EWG conducted a systematic review of peer-reviewed and non–peer reviewed published literature. In addition, after-action reports from Hurricane Katrina and relevant publications recommended by EWG members and other subject matter experts were reviewed for congruencies and gaps. Consensus was ensured through a 3-stage Delphi process. Results: The EWG process developed a new educational framework for disaster medicine and public health preparedness based on consensus identification of 7 core learning domains, 19 core competencies, and 73 specific competencies targeted at 3 broad health personnel categories. Conclusions: The competencies can be applied to a wide range of health professionals who are expected to perform at different levels (informed worker/student, practitioner, leader) according to experience, professional role, level of education, or job function. Although these competencies strongly reflect lessons learned following the health system response to Hurricane Katrina, it must be understood that preparedness is a process, and that these competencies must be reviewed continually and refined over time. (Disaster Med Public Health Preparedness. 2008;2:57–68)</description><subject>Clinical Competence</subject><subject>Consensus</subject><subject>Core competencies</subject><subject>Curricula</subject><subject>Disaster management</subject><subject>Disaster Medicine - education</subject><subject>Disaster Medicine - standards</subject><subject>Disasters</subject><subject>Education</subject><subject>Emergency preparedness</subject><subject>Health care policy</subject><subject>Health services</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hurricanes</subject><subject>Learning</subject><subject>Medical personnel</subject><subject>Medicine</subject><subject>National security</subject><subject>Nurses</subject><subject>Nursing schools</subject><subject>Objectives</subject><subject>Physicians</subject><subject>Professional Competence</subject><subject>Professionals</subject><subject>Professions</subject><subject>Public Health</subject><subject>Students</subject><subject>Taxonomy</subject><subject>United States</subject><issn>1935-7893</issn><issn>1938-744X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><recordid>eNp9kV1L3jAYhsPYUOf8B2MEBp7V5atJcyivOgVlL2yCZ-VJ8nTWtU2XtAwP98_X6guCBzvKB9d9PSE3IR85O-HMmi9nN9sT5hiXKHnFdakVNG_IAbeyKoxSd2-f9mVhKiv3yfucHxgrtSntHtnnlawqXdoD8veUbuKQcchzLhxkDPQ8zB6mNg7Q0YsEPf6J6ReFISxkP-KEg3-k33GiTUx0ukd61mbfjl07II3NeoI8YaI3GFq_Xq7R7ey61tNLhG66p9uEIyQMA-b8gbxroMt4tFsPye3F-Y_NZXH97evV5vS68MqKqdBMW-4b4ZVRNlQ6eNRCiVJaL60B5wLjFqsSAbyQ3mk0qBvlGwVLwHF5SI6fvWOKv2fMU90v78augwHjnGvDlJGlZgv4-RX4EOe0_EauhWBGaK3FqlPPlE8x54RNPaa2h_RYc1avBdVLQfXrgpbYp518dj2Gl9CukQXQOy_0LrXhJ76M_6_5H-vjn04</recordid><startdate>200803</startdate><enddate>200803</enddate><creator>Subbarao, Italo</creator><creator>Lyznicki, James M.</creator><creator>Hsu, Edbert B.</creator><creator>Gebbie, Kristine M.</creator><creator>Markenson, David</creator><creator>Barzansky, Barbara</creator><creator>Armstrong, John H.</creator><creator>Cassimatis, Emmanuel G.</creator><creator>Coule, Philip L.</creator><creator>Dallas, Cham E.</creator><creator>King, Richard V.</creator><creator>Rubinson, Lewis</creator><creator>Sattin, Richard</creator><creator>Swienton, Raymond E.</creator><creator>Lillibridge, Scott</creator><creator>Burkle, Frederick M.</creator><creator>Schwartz, Richard B.</creator><creator>James, James J.</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>8C1</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>200803</creationdate><title>A Consensus-based Educational Framework and Competency Set for the Discipline of Disaster Medicine and Public Health Preparedness</title><author>Subbarao, Italo ; Lyznicki, James M. ; Hsu, Edbert B. ; Gebbie, Kristine M. ; Markenson, David ; Barzansky, Barbara ; Armstrong, John H. ; Cassimatis, Emmanuel G. ; Coule, Philip L. ; Dallas, Cham E. ; King, Richard V. ; Rubinson, Lewis ; Sattin, Richard ; Swienton, Raymond E. ; Lillibridge, Scott ; Burkle, Frederick M. ; Schwartz, Richard B. ; James, James J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c492t-60691cf2c4749d86dce6242539c397abbd019e85eaac23cb6e7e6f4cf4a749b13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Clinical Competence</topic><topic>Consensus</topic><topic>Core competencies</topic><topic>Curricula</topic><topic>Disaster management</topic><topic>Disaster Medicine - education</topic><topic>Disaster Medicine - standards</topic><topic>Disasters</topic><topic>Education</topic><topic>Emergency preparedness</topic><topic>Health care policy</topic><topic>Health services</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hurricanes</topic><topic>Learning</topic><topic>Medical personnel</topic><topic>Medicine</topic><topic>National security</topic><topic>Nurses</topic><topic>Nursing schools</topic><topic>Objectives</topic><topic>Physicians</topic><topic>Professional Competence</topic><topic>Professionals</topic><topic>Professions</topic><topic>Public Health</topic><topic>Students</topic><topic>Taxonomy</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Subbarao, Italo</creatorcontrib><creatorcontrib>Lyznicki, James M.</creatorcontrib><creatorcontrib>Hsu, Edbert B.</creatorcontrib><creatorcontrib>Gebbie, Kristine M.</creatorcontrib><creatorcontrib>Markenson, David</creatorcontrib><creatorcontrib>Barzansky, Barbara</creatorcontrib><creatorcontrib>Armstrong, John H.</creatorcontrib><creatorcontrib>Cassimatis, Emmanuel G.</creatorcontrib><creatorcontrib>Coule, Philip L.</creatorcontrib><creatorcontrib>Dallas, Cham E.</creatorcontrib><creatorcontrib>King, Richard V.</creatorcontrib><creatorcontrib>Rubinson, Lewis</creatorcontrib><creatorcontrib>Sattin, Richard</creatorcontrib><creatorcontrib>Swienton, Raymond E.</creatorcontrib><creatorcontrib>Lillibridge, Scott</creatorcontrib><creatorcontrib>Burkle, Frederick M.</creatorcontrib><creatorcontrib>Schwartz, Richard B.</creatorcontrib><creatorcontrib>James, James J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Public Health Database</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Disaster medicine and public health preparedness</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Subbarao, Italo</au><au>Lyznicki, James M.</au><au>Hsu, Edbert B.</au><au>Gebbie, Kristine M.</au><au>Markenson, David</au><au>Barzansky, Barbara</au><au>Armstrong, John H.</au><au>Cassimatis, Emmanuel G.</au><au>Coule, Philip L.</au><au>Dallas, Cham E.</au><au>King, Richard V.</au><au>Rubinson, Lewis</au><au>Sattin, Richard</au><au>Swienton, Raymond E.</au><au>Lillibridge, Scott</au><au>Burkle, Frederick M.</au><au>Schwartz, Richard B.</au><au>James, James J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Consensus-based Educational Framework and Competency Set for the Discipline of Disaster Medicine and Public Health Preparedness</atitle><jtitle>Disaster medicine and public health preparedness</jtitle><addtitle>Disaster med. public health prep</addtitle><date>2008-03</date><risdate>2008</risdate><volume>2</volume><issue>1</issue><spage>57</spage><epage>68</epage><pages>57-68</pages><issn>1935-7893</issn><eissn>1938-744X</eissn><abstract>Background: Various organizations and universities have developed competencies for health professionals and other emergency responders. Little effort has been devoted to the integration of these competencies across health specialties and professions. The American Medical Association Center for Public Health Preparedness and Disaster Response convened an expert working group (EWG) to review extant competencies and achieve consensus on an educational framework and competency set from which educators could devise learning objectives and curricula tailored to fit the needs of all health professionals in a disaster. Methods: The EWG conducted a systematic review of peer-reviewed and non–peer reviewed published literature. In addition, after-action reports from Hurricane Katrina and relevant publications recommended by EWG members and other subject matter experts were reviewed for congruencies and gaps. Consensus was ensured through a 3-stage Delphi process. Results: The EWG process developed a new educational framework for disaster medicine and public health preparedness based on consensus identification of 7 core learning domains, 19 core competencies, and 73 specific competencies targeted at 3 broad health personnel categories. Conclusions: The competencies can be applied to a wide range of health professionals who are expected to perform at different levels (informed worker/student, practitioner, leader) according to experience, professional role, level of education, or job function. Although these competencies strongly reflect lessons learned following the health system response to Hurricane Katrina, it must be understood that preparedness is a process, and that these competencies must be reviewed continually and refined over time. (Disaster Med Public Health Preparedness. 2008;2:57–68)</abstract><cop>New York, USA</cop><pub>Cambridge University Press</pub><pmid>18388659</pmid><doi>10.1097/DMP.0b013e31816564af</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1935-7893
ispartof Disaster medicine and public health preparedness, 2008-03, Vol.2 (1), p.57-68
issn 1935-7893
1938-744X
language eng
recordid cdi_proquest_miscellaneous_70473560
source Cambridge University Press
subjects Clinical Competence
Consensus
Core competencies
Curricula
Disaster management
Disaster Medicine - education
Disaster Medicine - standards
Disasters
Education
Emergency preparedness
Health care policy
Health services
Hospitals
Humans
Hurricanes
Learning
Medical personnel
Medicine
National security
Nurses
Nursing schools
Objectives
Physicians
Professional Competence
Professionals
Professions
Public Health
Students
Taxonomy
United States
title A Consensus-based Educational Framework and Competency Set for the Discipline of Disaster Medicine and Public Health Preparedness
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T14%3A06%3A47IST&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%20Consensus-based%20Educational%20Framework%20and%20Competency%20Set%20for%20the%20Discipline%20of%20Disaster%20Medicine%20and%20Public%20Health%20Preparedness&rft.jtitle=Disaster%20medicine%20and%20public%20health%20preparedness&rft.au=Subbarao,%20Italo&rft.date=2008-03&rft.volume=2&rft.issue=1&rft.spage=57&rft.epage=68&rft.pages=57-68&rft.issn=1935-7893&rft.eissn=1938-744X&rft_id=info:doi/10.1097/DMP.0b013e31816564af&rft_dat=%3Cproquest_cross%3E70473560%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c492t-60691cf2c4749d86dce6242539c397abbd019e85eaac23cb6e7e6f4cf4a749b13%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2207266621&rft_id=info:pmid/18388659&rft_cupid=10_1097_DMP_0b013e31816564af&rfr_iscdi=true