Loading…
Educational video intervention improves knowledge and self-efficacy in identifying malnutrition among healthcare providers in a cancer center: a pilot study
Purpose Cancer is the second leading cause of death in the USA, and malnutrition secondary to cancer progression and treatment side effects is common. While abundant evidence indicates that nutrition support improves patient outcomes, it is estimated that up to half of malnutrition cases are misclas...
Saved in:
Published in: | Supportive care in cancer 2020-02, Vol.28 (2), p.683-689 |
---|---|
Main Authors: | , , , , , , |
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-c541t-2193e4c1bf430fbf1adb7597a010c7f520cb7dd22cf18fdf25d3995fd8eb6cda3 |
---|---|
cites | cdi_FETCH-LOGICAL-c541t-2193e4c1bf430fbf1adb7597a010c7f520cb7dd22cf18fdf25d3995fd8eb6cda3 |
container_end_page | 689 |
container_issue | 2 |
container_start_page | 683 |
container_title | Supportive care in cancer |
container_volume | 28 |
creator | Wolf, Patricia G. Manero, Joanna Harold, Kirsten Berding Chojnacki, Morgan Kaczmarek, Jennifer Liguori, Carli Arthur, Anna |
description | Purpose
Cancer is the second leading cause of death in the USA, and malnutrition secondary to cancer progression and treatment side effects is common. While abundant evidence indicates that nutrition support improves patient outcomes, it is estimated that up to half of malnutrition cases are misclassified or undiagnosed. The use of a multidisciplinary team to assess nutrition status has been observed previously to reduce delays in nutritional support. Hence, educating all members of the oncology healthcare team to assess nutrition status may encourage earlier diagnosis and lead to improved patient outcomes. Thus, the objective was to perform a pilot study to assess change in knowledge and self-efficacy among oncology team members after watching an educational video about malnutrition.
Methods
A pre-test post-test educational video intervention was given to 77 ambulatory oncology providers during weekly staff meetings at a community ambulatory oncology center in central Illinois. Change in knowledge and self-efficacy in malnutrition assessment and diagnosis was measured and acceptability of the brief educational video format was also observed.
Results
Mean test scores improved by 1.95 ± 1.48 points (
p
|
doi_str_mv | 10.1007/s00520-019-04850-w |
format | article |
fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7252495</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A611053637</galeid><sourcerecordid>A611053637</sourcerecordid><originalsourceid>FETCH-LOGICAL-c541t-2193e4c1bf430fbf1adb7597a010c7f520cb7dd22cf18fdf25d3995fd8eb6cda3</originalsourceid><addsrcrecordid>eNp9ks9u1DAQxiMEokvhBTggS1y4pHjseL3hgFRV5Y9UiQucLcce77ok9mInu9p34WFxuqW0CCEfLM38vm_s0VdVL4GeAaXybaZUMFpTaGvarASt94-qBTSc15Lz9nG1oG0DdcOFOKme5XxNKUgp2NPqhAMwvpKwqH5e2sno0cege7LzFiPxYcS0wzAXiR-2Ke4wk-8h7nu0ayQ6WJKxdzU65402h6IgRVkE7uDDmgy6D9OY_I2BHmIpbVD348bohGT2K3TKs0wTo4PBRAzOU9-Vwtb3cSR5nOzhefXE6T7ji9v7tPr24fLrxaf66svHzxfnV7URDYw1g5ZjY6BzDaeuc6BtJ0UrNQVqpCs7Mp20ljHjYOWsY8LythXOrrBbGqv5afX-6LudugHt_Jake7VNftDpoKL26mEn-I1ax52STLCmFcXgza1Bij8mzKMafDbY9zpgnLJijDNgZfm0oK__Qq_jlMr2Z4q1AgCW96i17lH54GKZa2ZTdb4EoIIvuSzU2T-ociwO3sSAzpf6AwE7CkyKOSd0d38EquZMqWOmVMmUusmU2hfRq_vbuZP8DlEB-BHIpRXWmP586T-2vwDd2NvW</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2229511160</pqid></control><display><type>article</type><title>Educational video intervention improves knowledge and self-efficacy in identifying malnutrition among healthcare providers in a cancer center: a pilot study</title><source>Social Science Premium Collection</source><source>Springer Nature</source><source>Sociology Collection</source><creator>Wolf, Patricia G. ; Manero, Joanna ; Harold, Kirsten Berding ; Chojnacki, Morgan ; Kaczmarek, Jennifer ; Liguori, Carli ; Arthur, Anna</creator><creatorcontrib>Wolf, Patricia G. ; Manero, Joanna ; Harold, Kirsten Berding ; Chojnacki, Morgan ; Kaczmarek, Jennifer ; Liguori, Carli ; Arthur, Anna</creatorcontrib><description>Purpose
Cancer is the second leading cause of death in the USA, and malnutrition secondary to cancer progression and treatment side effects is common. While abundant evidence indicates that nutrition support improves patient outcomes, it is estimated that up to half of malnutrition cases are misclassified or undiagnosed. The use of a multidisciplinary team to assess nutrition status has been observed previously to reduce delays in nutritional support. Hence, educating all members of the oncology healthcare team to assess nutrition status may encourage earlier diagnosis and lead to improved patient outcomes. Thus, the objective was to perform a pilot study to assess change in knowledge and self-efficacy among oncology team members after watching an educational video about malnutrition.
Methods
A pre-test post-test educational video intervention was given to 77 ambulatory oncology providers during weekly staff meetings at a community ambulatory oncology center in central Illinois. Change in knowledge and self-efficacy in malnutrition assessment and diagnosis was measured and acceptability of the brief educational video format was also observed.
Results
Mean test scores improved by 1.95 ± 1.48 points (
p
< 0.001). Individual occupational groups improved scores significantly (
p
≤ 0.005) except for specialty clinical staff. Self-efficacy improved from 38 to 70%. 90.8% of participants indicated the educational video improved their confidence in assessing malnutrition.
Conclusions
The educational video was well accepted and improved knowledge and self-efficacy of malnutrition assessment and diagnosis among ambulatory oncology providers. Wider implementation of such an educational intervention and longitudinal testing of knowledge retention and behaviors change is warranted.</description><identifier>ISSN: 0941-4355</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s00520-019-04850-w</identifier><identifier>PMID: 31123871</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Cancer ; Care and treatment ; Clinical outcomes ; Development and progression ; Female ; Health care industry ; Health care reform ; Health Personnel - education ; Humans ; Male ; Malnutrition ; Malnutrition - diagnosis ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasms - complications ; Nursing ; Nursing Research ; Nutrition ; Nutritional Status - physiology ; Oncology ; Oncology, Experimental ; Original Article ; Pain Medicine ; Pilot Projects ; Rehabilitation Medicine ; Self-efficacy ; Videotape Recording - instrumentation</subject><ispartof>Supportive care in cancer, 2020-02, Vol.28 (2), p.683-689</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>COPYRIGHT 2020 Springer</rights><rights>Supportive Care in Cancer is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c541t-2193e4c1bf430fbf1adb7597a010c7f520cb7dd22cf18fdf25d3995fd8eb6cda3</citedby><cites>FETCH-LOGICAL-c541t-2193e4c1bf430fbf1adb7597a010c7f520cb7dd22cf18fdf25d3995fd8eb6cda3</cites><orcidid>0000-0002-5208-4336</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2229511160/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2229511160?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,780,784,885,21394,21395,27924,27925,33611,33612,34530,34531,43733,44115,74093,74511</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31123871$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wolf, Patricia G.</creatorcontrib><creatorcontrib>Manero, Joanna</creatorcontrib><creatorcontrib>Harold, Kirsten Berding</creatorcontrib><creatorcontrib>Chojnacki, Morgan</creatorcontrib><creatorcontrib>Kaczmarek, Jennifer</creatorcontrib><creatorcontrib>Liguori, Carli</creatorcontrib><creatorcontrib>Arthur, Anna</creatorcontrib><title>Educational video intervention improves knowledge and self-efficacy in identifying malnutrition among healthcare providers in a cancer center: a pilot study</title><title>Supportive care in cancer</title><addtitle>Support Care Cancer</addtitle><addtitle>Support Care Cancer</addtitle><description>Purpose
Cancer is the second leading cause of death in the USA, and malnutrition secondary to cancer progression and treatment side effects is common. While abundant evidence indicates that nutrition support improves patient outcomes, it is estimated that up to half of malnutrition cases are misclassified or undiagnosed. The use of a multidisciplinary team to assess nutrition status has been observed previously to reduce delays in nutritional support. Hence, educating all members of the oncology healthcare team to assess nutrition status may encourage earlier diagnosis and lead to improved patient outcomes. Thus, the objective was to perform a pilot study to assess change in knowledge and self-efficacy among oncology team members after watching an educational video about malnutrition.
Methods
A pre-test post-test educational video intervention was given to 77 ambulatory oncology providers during weekly staff meetings at a community ambulatory oncology center in central Illinois. Change in knowledge and self-efficacy in malnutrition assessment and diagnosis was measured and acceptability of the brief educational video format was also observed.
Results
Mean test scores improved by 1.95 ± 1.48 points (
p
< 0.001). Individual occupational groups improved scores significantly (
p
≤ 0.005) except for specialty clinical staff. Self-efficacy improved from 38 to 70%. 90.8% of participants indicated the educational video improved their confidence in assessing malnutrition.
Conclusions
The educational video was well accepted and improved knowledge and self-efficacy of malnutrition assessment and diagnosis among ambulatory oncology providers. Wider implementation of such an educational intervention and longitudinal testing of knowledge retention and behaviors change is warranted.</description><subject>Adult</subject><subject>Cancer</subject><subject>Care and treatment</subject><subject>Clinical outcomes</subject><subject>Development and progression</subject><subject>Female</subject><subject>Health care industry</subject><subject>Health care reform</subject><subject>Health Personnel - education</subject><subject>Humans</subject><subject>Male</subject><subject>Malnutrition</subject><subject>Malnutrition - diagnosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasms - complications</subject><subject>Nursing</subject><subject>Nursing Research</subject><subject>Nutrition</subject><subject>Nutritional Status - physiology</subject><subject>Oncology</subject><subject>Oncology, Experimental</subject><subject>Original Article</subject><subject>Pain Medicine</subject><subject>Pilot Projects</subject><subject>Rehabilitation Medicine</subject><subject>Self-efficacy</subject><subject>Videotape Recording - instrumentation</subject><issn>0941-4355</issn><issn>1433-7339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ALSLI</sourceid><sourceid>HEHIP</sourceid><sourceid>M2R</sourceid><sourceid>M2S</sourceid><recordid>eNp9ks9u1DAQxiMEokvhBTggS1y4pHjseL3hgFRV5Y9UiQucLcce77ok9mInu9p34WFxuqW0CCEfLM38vm_s0VdVL4GeAaXybaZUMFpTaGvarASt94-qBTSc15Lz9nG1oG0DdcOFOKme5XxNKUgp2NPqhAMwvpKwqH5e2sno0cege7LzFiPxYcS0wzAXiR-2Ke4wk-8h7nu0ayQ6WJKxdzU65402h6IgRVkE7uDDmgy6D9OY_I2BHmIpbVD348bohGT2K3TKs0wTo4PBRAzOU9-Vwtb3cSR5nOzhefXE6T7ji9v7tPr24fLrxaf66svHzxfnV7URDYw1g5ZjY6BzDaeuc6BtJ0UrNQVqpCs7Mp20ljHjYOWsY8LythXOrrBbGqv5afX-6LudugHt_Jake7VNftDpoKL26mEn-I1ax52STLCmFcXgza1Bij8mzKMafDbY9zpgnLJijDNgZfm0oK__Qq_jlMr2Z4q1AgCW96i17lH54GKZa2ZTdb4EoIIvuSzU2T-ociwO3sSAzpf6AwE7CkyKOSd0d38EquZMqWOmVMmUusmU2hfRq_vbuZP8DlEB-BHIpRXWmP586T-2vwDd2NvW</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Wolf, Patricia G.</creator><creator>Manero, Joanna</creator><creator>Harold, Kirsten Berding</creator><creator>Chojnacki, Morgan</creator><creator>Kaczmarek, Jennifer</creator><creator>Liguori, Carli</creator><creator>Arthur, Anna</creator><general>Springer Berlin Heidelberg</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>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2R</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5208-4336</orcidid></search><sort><creationdate>20200201</creationdate><title>Educational video intervention improves knowledge and self-efficacy in identifying malnutrition among healthcare providers in a cancer center: a pilot study</title><author>Wolf, Patricia G. ; Manero, Joanna ; Harold, Kirsten Berding ; Chojnacki, Morgan ; Kaczmarek, Jennifer ; Liguori, Carli ; Arthur, Anna</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c541t-2193e4c1bf430fbf1adb7597a010c7f520cb7dd22cf18fdf25d3995fd8eb6cda3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Cancer</topic><topic>Care and treatment</topic><topic>Clinical outcomes</topic><topic>Development and progression</topic><topic>Female</topic><topic>Health care industry</topic><topic>Health care reform</topic><topic>Health Personnel - education</topic><topic>Humans</topic><topic>Male</topic><topic>Malnutrition</topic><topic>Malnutrition - diagnosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasms - complications</topic><topic>Nursing</topic><topic>Nursing Research</topic><topic>Nutrition</topic><topic>Nutritional Status - physiology</topic><topic>Oncology</topic><topic>Oncology, Experimental</topic><topic>Original Article</topic><topic>Pain Medicine</topic><topic>Pilot Projects</topic><topic>Rehabilitation Medicine</topic><topic>Self-efficacy</topic><topic>Videotape Recording - instrumentation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wolf, Patricia G.</creatorcontrib><creatorcontrib>Manero, Joanna</creatorcontrib><creatorcontrib>Harold, Kirsten Berding</creatorcontrib><creatorcontrib>Chojnacki, Morgan</creatorcontrib><creatorcontrib>Kaczmarek, Jennifer</creatorcontrib><creatorcontrib>Liguori, Carli</creatorcontrib><creatorcontrib>Arthur, Anna</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Social Science 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</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>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 Central Student</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Social Science Database</collection><collection>Sociology 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>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Supportive care in cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wolf, Patricia G.</au><au>Manero, Joanna</au><au>Harold, Kirsten Berding</au><au>Chojnacki, Morgan</au><au>Kaczmarek, Jennifer</au><au>Liguori, Carli</au><au>Arthur, Anna</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Educational video intervention improves knowledge and self-efficacy in identifying malnutrition among healthcare providers in a cancer center: a pilot study</atitle><jtitle>Supportive care in cancer</jtitle><stitle>Support Care Cancer</stitle><addtitle>Support Care Cancer</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>28</volume><issue>2</issue><spage>683</spage><epage>689</epage><pages>683-689</pages><issn>0941-4355</issn><eissn>1433-7339</eissn><abstract>Purpose
Cancer is the second leading cause of death in the USA, and malnutrition secondary to cancer progression and treatment side effects is common. While abundant evidence indicates that nutrition support improves patient outcomes, it is estimated that up to half of malnutrition cases are misclassified or undiagnosed. The use of a multidisciplinary team to assess nutrition status has been observed previously to reduce delays in nutritional support. Hence, educating all members of the oncology healthcare team to assess nutrition status may encourage earlier diagnosis and lead to improved patient outcomes. Thus, the objective was to perform a pilot study to assess change in knowledge and self-efficacy among oncology team members after watching an educational video about malnutrition.
Methods
A pre-test post-test educational video intervention was given to 77 ambulatory oncology providers during weekly staff meetings at a community ambulatory oncology center in central Illinois. Change in knowledge and self-efficacy in malnutrition assessment and diagnosis was measured and acceptability of the brief educational video format was also observed.
Results
Mean test scores improved by 1.95 ± 1.48 points (
p
< 0.001). Individual occupational groups improved scores significantly (
p
≤ 0.005) except for specialty clinical staff. Self-efficacy improved from 38 to 70%. 90.8% of participants indicated the educational video improved their confidence in assessing malnutrition.
Conclusions
The educational video was well accepted and improved knowledge and self-efficacy of malnutrition assessment and diagnosis among ambulatory oncology providers. Wider implementation of such an educational intervention and longitudinal testing of knowledge retention and behaviors change is warranted.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31123871</pmid><doi>10.1007/s00520-019-04850-w</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-5208-4336</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0941-4355 |
ispartof | Supportive care in cancer, 2020-02, Vol.28 (2), p.683-689 |
issn | 0941-4355 1433-7339 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7252495 |
source | Social Science Premium Collection; Springer Nature; Sociology Collection |
subjects | Adult Cancer Care and treatment Clinical outcomes Development and progression Female Health care industry Health care reform Health Personnel - education Humans Male Malnutrition Malnutrition - diagnosis Medicine Medicine & Public Health Middle Aged Neoplasms - complications Nursing Nursing Research Nutrition Nutritional Status - physiology Oncology Oncology, Experimental Original Article Pain Medicine Pilot Projects Rehabilitation Medicine Self-efficacy Videotape Recording - instrumentation |
title | Educational video intervention improves knowledge and self-efficacy in identifying malnutrition among healthcare providers in a cancer center: a pilot study |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T01%3A57%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Educational%20video%20intervention%20improves%20knowledge%20and%20self-efficacy%20in%20identifying%20malnutrition%20among%20healthcare%20providers%20in%20a%20cancer%20center:%20a%20pilot%20study&rft.jtitle=Supportive%20care%20in%20cancer&rft.au=Wolf,%20Patricia%20G.&rft.date=2020-02-01&rft.volume=28&rft.issue=2&rft.spage=683&rft.epage=689&rft.pages=683-689&rft.issn=0941-4355&rft.eissn=1433-7339&rft_id=info:doi/10.1007/s00520-019-04850-w&rft_dat=%3Cgale_pubme%3EA611053637%3C/gale_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c541t-2193e4c1bf430fbf1adb7597a010c7f520cb7dd22cf18fdf25d3995fd8eb6cda3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2229511160&rft_id=info:pmid/31123871&rft_galeid=A611053637&rfr_iscdi=true |