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  1. Article ; Online: Nursing Praxis for Reducing Documentation Burden Within Nursing Admission Assessments.

    Phillips, Toni / Baur, Karen

    Computers, informatics, nursing : CIN

    2021  Volume 39, Issue 11, Page(s) 627–633

    Abstract: The purpose of this quality improvement project was to conduct a scholarly assessment of the information collected within the nursing admission encounter and implement content revisions across three pilot medical surgical units. The guiding principles ... ...

    Abstract The purpose of this quality improvement project was to conduct a scholarly assessment of the information collected within the nursing admission encounter and implement content revisions across three pilot medical surgical units. The guiding principles were to preserve regulatory information, identify nurse-sensitive data, and eliminate nonessential information. The goal was to decrease the number of clicks and time expended to document electronically an acute admission encounter by 20% and to project the number of hours returned to patient care as a result of decreasing computer clicks. A second goal was to quantify the projected costs of completing a nursing admission encounter. This quality improvement project leveraged nurse executive competencies to intersect the nursing process to develop a nursing documentation praxis. This author's praxis reduced nursing documentation burden in clicks by 29% and reduced time to document on an admission encounter by 34%. This restored the focus on nurse-patient interactions by returning 1016 hours per year to patient care activities, across three pilot units, as well as quantified the costs of completing a nursing admission assessment to utilize in future cost analysis of nursing tasks.
    MeSH term(s) Documentation ; Hospitalization ; Humans ; Nurse-Patient Relations ; Nursing Care ; Nursing Process
    Language English
    Publishing date 2021-06-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2078463-6
    ISSN 1538-9774 ; 1538-2931
    ISSN (online) 1538-9774
    ISSN 1538-2931
    DOI 10.1097/CIN.0000000000000776
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    Zs.B 3083: Show issues Location:
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  2. Article ; Online: Prevalence of PD-L1 in Cervical Cancer Patients and the Potential for Combining an Immune Checkpoint Inhibitor With Lenvatinib.

    Bräutigam, Karen / Schmidt, Talina / Baur, Meike / Tauber, Nikolas / Kontomanolis, Emmanuel N / Hemptenmacher, Franziska / Rody, Achim / Köster, Frank

    Anticancer research

    2024  Volume 44, Issue 2, Page(s) 503–510

    Abstract: Background/aim: Cervical cancer is the fourth most common cause of cancer-related deaths in women worldwide. The potential for targeted therapy against the immune checkpoint programmed death 1 (PD-1)/programmed death-ligand 1 (PD-L1) and receptor ... ...

    Abstract Background/aim: Cervical cancer is the fourth most common cause of cancer-related deaths in women worldwide. The potential for targeted therapy against the immune checkpoint programmed death 1 (PD-1)/programmed death-ligand 1 (PD-L1) and receptor tyrosine kinases was examined in cervical cancer patients and cell lines.
    Materials and methods: On tissue microarrays, PD-L1 was analyzed in 123 samples of patients with cervical cancer using immunohistochemistry. In SiHa, HeLa, and CaSki cervical cancer cell lines we examined the combination of lenvatinib with a PD-1/PD-L1 inhibitor using cell viability assays, the activation of cell signaling pathway proteins using western blots and gene expression using quantitative reverse transcriptase-PCR.
    Results: Of 113 evaluable samples, 90 (79.6%) had more than 1% PD-L1 positive cells. The single treatment with the PD-1/PD-L1 inhibitor resulted in the greatest reduction in growth for CaSki and lenvatinib in HeLa cells. In contrast, the combined treatment of lenvatinib with the PD-1/PD-L1 inhibitor demonstrated a significantly stronger impeded proliferation compared to the single treatment in all three cell lines. Moreover, the combined treatment caused significantly less phosphorylation of the signaling molecules ERK and S6 in SiHa and of S6 and STAT3 in HeLa cells but not in CaSki. All treatments diminished the mRNA levels of PD-L1, Il-8, and FGFR in SiHa cells.
    Conclusion: PD1 is frequently expressed in cervical cancer samples. Combining lenvatinib with a PD-1/PD-L1 inhibitor diminished proliferation of cervical cancer cell lines. Consequently, this combination might be a promising option to treat cervical cancer. Signaling pathways involved in tumor cell growth are blocked by the combined treatment but still a model of the underlying mechanism cannot be drawn.
    MeSH term(s) Female ; Humans ; B7-H1 Antigen/metabolism ; HeLa Cells ; Immune Checkpoint Inhibitors/therapeutic use ; Phenylurea Compounds ; Prevalence ; Programmed Cell Death 1 Receptor ; Quinolines ; Uterine Cervical Neoplasms/drug therapy ; Uterine Cervical Neoplasms/genetics
    Chemical Substances B7-H1 Antigen ; Immune Checkpoint Inhibitors ; lenvatinib (EE083865G2) ; Phenylurea Compounds ; Programmed Cell Death 1 Receptor ; Quinolines
    Language English
    Publishing date 2024-02-01
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 604549-2
    ISSN 1791-7530 ; 0250-7005
    ISSN (online) 1791-7530
    ISSN 0250-7005
    DOI 10.21873/anticanres.16838
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  3. Article ; Online: Infant feeding and growth trajectories in early childhood: the application and comparison of two longitudinal modelling approaches.

    Zheng, Miaobing / Campbell, Karen J / Baur, Louise / Rissel, Chris / Wen, Li Ming

    International journal of obesity (2005)

    2021  Volume 45, Issue 10, Page(s) 2230–2237

    Abstract: Background/objectives: The role of infant feeding practices in longitudinal growth trajectories in children remains equivocal. This study utilised two longitudinal approaches to examine the associations of infant feeding mode (breastfeeding, mixed ... ...

    Abstract Background/objectives: The role of infant feeding practices in longitudinal growth trajectories in children remains equivocal. This study utilised two longitudinal approaches to examine the associations of infant feeding mode (breastfeeding, mixed feeding, formula feeding), breastfeeding duration, and the timing of solid foods introduction with body mass index (BMI) z-score in early childhood.
    Subjects/methods: Secondary analyses of data from the Healthy Beginnings Trial were conducted. Infant feeding practices were reported by mothers at 6, 12, and 24 months of child age. Child weight and length were measured at birth, 12, 24, 42, and 60 months. Two longitudinal approaches: linear spline multilevel model (LSMM) and group-based trajectory modelling (GBTM) were used to describe BMI z-score trajectories and assess its associations with infant feeding practices.
    Results: The LSMM approach demonstrated that the breastfeeding group showed lower BMI z-scores from ages 12 to 60 months than the mixed feeding and formula feeding groups. Children who were breastfed for ≥ 6 versus < 6 months exhibited a lower BMI z-score trajectory from ages 12 to 60 months. Results from the GBTM approach revealed that the mixed feeding (OR: 1.83, 95%CI 1.04, 3.21) and the formula feeding group (OR: 2.00, 95%CI 0.67, 5.92) showed a tendency for higher odds of following the "High BMIz" trajectory than the breastfeeding group. Breastfeeding duration ≥6 versus < 6 months was linked with lower odds of following the "High BMIz" trajectory (OR 0.65, 95%CI 0.43, 0.98). Both approaches revealed no evidence of an association between the timing of solid foods introduction and BMI z-score trajectory.
    Conclusions: The two longitudinal approaches revealed similar findings that infant feeding mode and breastfeeding duration, but not the timing of solid foods introduction, were associated with BMI z-score trajectory in early childhood. The findings provide robust longitudinal evidence to encourage and support extended breastfeeding for childhood obesity prevention.
    MeSH term(s) Body Mass Index ; Feeding Behavior/physiology ; Female ; Humans ; Infant ; Infant Food/standards ; Infant, Newborn ; Longitudinal Studies ; Male ; Pediatric Obesity/metabolism ; Pediatric Obesity/physiopathology ; Time Factors
    Language English
    Publishing date 2021-07-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 752409-2
    ISSN 1476-5497 ; 0307-0565
    ISSN (online) 1476-5497
    ISSN 0307-0565
    DOI 10.1038/s41366-021-00892-5
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  4. Article ; Online: What Is It Like to Experience Improved Care Coordination Through a Community Outreach Program? A Qualitative, Descriptive Study.

    Baur, Karen / Smith, Tracey / Wendler, M Cecilia

    The Journal of ambulatory care management

    2018  Volume 41, Issue 3, Page(s) 204–212

    Abstract: Community-based programs deploying community health workers (CHWs) who collaborate with other entities are beginning to emerge as the US health system evolves. Although these programs have used various evaluation criteria to determine program success, ... ...

    Abstract Community-based programs deploying community health workers (CHWs) who collaborate with other entities are beginning to emerge as the US health system evolves. Although these programs have used various evaluation criteria to determine program success, little research has been completed to examine the experiences of program participants as they receive these services. The purpose of this qualitative descriptive study was to describe what it was like to experience the benefit of improved care coordination through a community-based program featuring CHWs, in collaboration with community-based interprofessional providers. Knowing the help I needed emerged as the overarching theme.
    MeSH term(s) Adult ; Community Health Services/organization & administration ; Community-Institutional Relations ; Female ; Health Services Accessibility ; Health Services Needs and Demand ; Health Services Research ; Humans ; Illinois ; Male ; Middle Aged ; Patients/psychology ; Qualitative Research ; Quality Improvement
    Language English
    Publishing date 2018-05-30
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 198845-1
    ISSN 1550-3267 ; 0148-9917
    ISSN (online) 1550-3267
    ISSN 0148-9917
    DOI 10.1097/JAC.0000000000000239
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    Zs.B 2219: Show issues Location:
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  5. Article ; Online: How health literacy is taught and evaluated in dentistry, medicine, nursing, law, pharmacy, public health, and social work: a narrative review.

    Maybury, Catherine / Williams, Mary Ann / Challenger, Kelsie / Fassas, Elisabeth / Galvan, Sonia / Gelmann, Dominique / Jung, Karen S / Lu, Alice Yanhong / Wang, Jocelyn / Stines, Elsie / Baur, Cynthia

    Journal of communication in healthcare

    2023  Volume 17, Issue 1, Page(s) 51–67

    Abstract: Background: This narrative review examined the published peer-reviewed literature on how health literacy is taught and evaluated in seven health professional and adjacent disciplines: dentistry, medicine, nursing, law, pharmacy, public health, and ... ...

    Abstract Background: This narrative review examined the published peer-reviewed literature on how health literacy is taught and evaluated in seven health professional and adjacent disciplines: dentistry, medicine, nursing, law, pharmacy, public health, and social work. The study objectives were to assess how students are educated about health literacy and how their health literacy education and skills are evaluated.
    Methods: Study selection followed guidelines outlined in PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We searched PubMed, CINAHL, SocINDEX (EBSCOhost), Lexis Advance and Public Health (ProQuest) for English-language publications of health literacy education studies across seven disciplines at U.S.-based institutions. Inclusion criteria included: 1) methods describing a primary health literacy educational intervention, 2) professional education in one or more of the seven disciplines, 3) educational institutions in the United States, and 4) articles published in peer-reviewed journals between 2000 and 2020.
    Results: The searches yielded 44 articles. Health literacy education is evident in six of the seven studied disciplines, and varies widely in the quality, quantity, timing and mode of education and evaluation. Despite the presence of health literacy accreditation requirements, none of the seven disciplines has developed and implemented a standard, rigorous health literacy education program for students.
    Conclusions: Graduating institutions and professional accreditation organizations that set the standards for education must lead the way by implementing upstream changes in health literacy professional education. Teaching health literacy to students in health professions is one strategy to help close gaps in patient/client professional communication for graduates and those they serve.
    MeSH term(s) Humans ; United States ; Health Literacy ; Public Health ; Legislation, Pharmacy ; Social Work ; Dentistry
    Language English
    Publishing date 2023-09-14
    Publishing country England
    Document type Journal Article ; Review
    ISSN 1753-8076
    ISSN (online) 1753-8076
    DOI 10.1080/17538068.2023.2258315
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  6. Article ; Online: Understanding the pathways between prenatal and postnatal factors and overweight outcomes in early childhood: a pooled analysis of seven cohorts.

    Zheng, Miaobing / Hesketh, Kylie D / Vuillermin, Peter / Dodd, Jodie / Wen, Li Ming / Baur, Louise A / Taylor, Rachael / Byrne, Rebecca / Mihrshahi, Seema / Burgner, David / Tang, Mimi L K / Campbell, Karen J

    International journal of obesity (2005)

    2023  Volume 47, Issue 7, Page(s) 574–582

    Abstract: Background/objectives: Childhood overweight and obesity are influenced by a range of prenatal and postnatal factors. Few studies have explored the integrative pathways linking these factors and childhood overweight. This study aimed to elucidate the ... ...

    Abstract Background/objectives: Childhood overweight and obesity are influenced by a range of prenatal and postnatal factors. Few studies have explored the integrative pathways linking these factors and childhood overweight. This study aimed to elucidate the integrative pathways through which maternal pre-pregnancy body mass index (BMI), infant birth weight, breastfeeding duration, and rapid weight gain (RWG) during infancy are associated with overweight outcomes in early childhood from ages 3 to 5 years.
    Subjects/methods: Pooled data from seven Australian and New Zealand cohorts were used (n = 3572). Generalized structural equation modelling was used to examine direct and indirect associations of maternal pre-pregnancy BMI, infant birth weight, breastfeeding duration, and RWG during infancy with child overweight outcomes (BMI z-score and overweight status).
    Results: Maternal pre-pregnancy BMI was directly associated with infant birth weight (β 0.01, 95%CI 0.01, 0.02), breastfeeding duration ≥6 months (OR 0.92, 95%CI 0.90, 0.93), child BMI z-score (β 0.03, 95%CI 0.03, 0.04) and overweight status (OR 1.07, 95%CI 1.06, 1.09) at ages 3-5 years. The association between maternal pre-pregnancy BMI and child overweight outcomes was partially mediated by infant birth weight, but not RWG. RWG in infancy exhibited the strongest direct association with child overweight outcomes (BMI z-score: β 0.72, 95%CI 0.65, 0.79; overweight status: OR 4.49, 95%CI 3.61, 5.59). Infant birth weight was implicated in the indirect pathways of maternal pre-pregnancy BMI with RWG in infancy, breastfeeding duration, and child overweight outcomes. The associations between breastfeeding duration (≥6 months) and lower child overweight outcomes were fully mediated by RWG in infancy.
    Conclusions: Maternal pre-pregnancy BMI, infant birth weight, breastfeeding duration and RWG in infancy act in concert to influence early childhood overweight. Future overweight prevention interventions should target RWG in infancy, which showed the strongest association with childhood overweight; and maternal pre-pregnancy BMI, which was implicated in several pathways leading to childhood overweight.
    MeSH term(s) Infant ; Child ; Female ; Pregnancy ; Humans ; Child, Preschool ; Overweight/epidemiology ; Pediatric Obesity/epidemiology ; Birth Weight ; Australia/epidemiology ; Weight Gain ; Body Mass Index ; Risk Factors
    Language English
    Publishing date 2023-04-03
    Publishing country England
    Document type Meta-Analysis ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 752409-2
    ISSN 1476-5497 ; 0307-0565
    ISSN (online) 1476-5497
    ISSN 0307-0565
    DOI 10.1038/s41366-023-01301-9
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  7. Article ; Online: Influencing Commitment to BSN Completion: A Pilot Project Using Motivational Interviewing.

    Baur, Karen / Moore, Bridget / Wendler, M Cecilia

    The Journal of nursing administration

    2017  Volume 47, Issue 3, Page(s) 172–178

    Abstract: The 2010 Institute of Medicine's Future of Nursing report posed recommendations to increase numbers of nurses with baccalaureate degrees or greater to 80%. This project engaged associate degree nurses in motivational interviewing focusing on finding and ... ...

    Abstract The 2010 Institute of Medicine's Future of Nursing report posed recommendations to increase numbers of nurses with baccalaureate degrees or greater to 80%. This project engaged associate degree nurses in motivational interviewing focusing on finding and removing barriers to baccalaureate matriculation and completion. Results indicated a statistically significant influence on attitudes and return-to-school decision making and identified a qualitative theme: "I know more now… I could be a better nurse."
    MeSH term(s) Adult ; Education, Nursing, Baccalaureate ; Female ; Humans ; Male ; Middle Aged ; Midwestern United States ; Motivation ; Motivational Interviewing ; Nursing Staff, Hospital/psychology ; Pilot Projects ; Students, Nursing/psychology ; United States
    Language English
    Publishing date 2017-03
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 193141-6
    ISSN 1539-0721 ; 1539-073X ; 0002-0443
    ISSN (online) 1539-0721 ; 1539-073X
    ISSN 0002-0443
    DOI 10.1097/NNA.0000000000000461
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    Zs.A 1008: Show issues Location:
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  8. Article ; Online: Evidence-Based Principles for Using Technology-Enhanced Learning in the Continuing Professional Development of Health Professionals.

    Scott, Karen M / Baur, Louise / Barrett, Jenny

    The Journal of continuing education in the health professions

    2017  Volume 37, Issue 1, Page(s) 61–66

    Abstract: Increasingly, health professional training involves the use of educational technologies through what is broadly termed "Technology-Enhanced Learning" (TEL). TEL includes hardware, such as computers and mobile devices, and software, such as software ... ...

    Abstract Increasingly, health professional training involves the use of educational technologies through what is broadly termed "Technology-Enhanced Learning" (TEL). TEL includes hardware, such as computers and mobile devices, and software, such as software applications (apps), learning management systems, and discussion boards. For many years, TEL has formed an integral part of health professional programs and is growing in acceptance, if not expectation, in postgraduate training and continuing education. TEL generally aims to be flexible, engaging, learner focused and interactive, and may involve collaboration and communication. It offers many benefits for learning and teaching, whether used on its own or in conjunction with face-to-face teaching through blended learning. The ubiquity of mobile devices in clinical settings means TEL is ideal for busy clinicians, both as learners and teachers. TEL enables participants to learn at a time and place that is convenient to them, so learners living in geographically dispersed locations can access standardized courses. To realize these potential benefits, we recommend that those developing TEL programs for health professionals take a systematic approach to planning, development, implementation, and evaluation. To that end, we propose 10 principles: clarify purpose and conduct a needs assessment; allocate adequate time and technology; incorporate proven approaches to improve learning; consider the need for a skills component; enable interaction between learners and with others; create different resources for different groups; pilot before implementing; incorporate measures to retain learners; provide opportunities for revision to aid retention; and evaluate learning outcomes, not just satisfaction.
    MeSH term(s) Computer-Assisted Instruction/methods ; Computer-Assisted Instruction/standards ; Education, Continuing/methods ; Education, Continuing/standards ; Educational Technology/methods ; Educational Technology/standards ; Evidence-Based Practice/methods ; Health Personnel/education ; Humans ; Learning ; Staff Development/methods
    Language English
    Publishing date 2017-03-02
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639445-0
    ISSN 1554-558X ; 0894-1912
    ISSN (online) 1554-558X
    ISSN 0894-1912
    DOI 10.1097/CEH.0000000000000146
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    Zs.B 2557: Show issues Location:
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  9. Article ; Online: See You in 7: improving acute myocardial infarction follow-up care.

    Batten, Alex / Jaeger, Cassie / Griffen, David / Harwood, Paula / Baur, Karen

    BMJ open quality

    2018  Volume 7, Issue 2, Page(s) e000296

    Abstract: Acute myocardial infarction (AMI) follow-up care is a crucial part of the AMI recovery process. The American College of Cardiology's 'See You in 7 Challenge' advocates that all patients discharged with a diagnosis of AMI have a cardiac rehabilitation ... ...

    Abstract Acute myocardial infarction (AMI) follow-up care is a crucial part of the AMI recovery process. The American College of Cardiology's 'See You in 7 Challenge' advocates that all patients discharged with a diagnosis of AMI have a cardiac rehabilitation referral made and outpatient cardiac rehabilitation appointment scheduled to occur within 7 days of hospital discharge. A streamlined AMI cardiac rehabilitation referral and appointment scheduling process was not in place at this urban academic medical centre. To develop the streamlined processes, a Six Sigma project was initiated. Four months before the intervention, 1/38 patients with AMI (2.6%) were scheduled to have the initial outpatient cardiac rehabilitation appointment occur within 7 days of hospital discharge, with an average 18.7 days from hospital discharge to the scheduled initial outpatient cardiac rehabilitation appointment. To reduce the time to this initial appointment, availability of outpatient cardiac rehabilitation appointments was increased, additional staff were trained in appointment scheduling and insurance verification processes and appointments were scheduled prior to hospital discharge. After intervention, the number of patients scheduled to attend an outpatient cardiac rehabilitation appointment within 7 days of hospital discharge improved to 72/79 (91.1%) (two-proportion test, p<0.001). Days from hospital discharge to first scheduled outpatient cardiac rehabilitation appointment were reduced from 18.7 days to 6.3 days (a 66.3% reduction) (Mann-Whitney U test, p<0.01). Initial outpatient cardiac rehabilitation attendance within 7 days of hospital discharge increased from 1/38 (2.6%) to 42/79 (53.2%) (a 50.6% increase) (two-proportion test, p<0.001).
    Language English
    Publishing date 2018-07-03
    Publishing country England
    Document type Journal Article
    ISSN 2399-6641
    ISSN (online) 2399-6641
    DOI 10.1136/bmjoq-2017-000296
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  10. Article ; Online: Demographic Predictors of Mothers' Willingness to Vaccinate Young Children Against COVID-19, Get Tested and Isolate: A Cross-Sectional Survey Before and During the Greater Sydney Lockdown 2021, Australia.

    Wen, Li Ming / Xu, Huilan / Rissel, Chris / Kerr, Erin / Buchanan, Limin / Taki, Sarah / Phongsavan, Philayrath / Chua, Reuel Kangjie / Hua, Myna / Wardle, Karen / Simone, Lisa / Hayes, Alison / Baur, Louise A

    Frontiers in public health

    2022  Volume 10, Page(s) 904495

    Abstract: Background and objectives: Having a COVID-19 vaccination, getting tested, and self-isolating if symptomatic are some of the most important mitigation strategies for preventing the spread of COVID-19. This study aimed to investigate whether demographic ... ...

    Abstract Background and objectives: Having a COVID-19 vaccination, getting tested, and self-isolating if symptomatic are some of the most important mitigation strategies for preventing the spread of COVID-19. This study aimed to investigate whether demographic factors are associated with mothers' willingness to vaccinate their 4-year-old children against COVID-19 if a suitable vaccine becomes available or to get tested and self-isolate if they themselves have COVID-19 symptoms and whether the willingness could be influenced by the Greater Sydney lockdown 2021.
    Methods: A cross-sectional telephone survey was conducted between 24th February and 26th October 2021. Questions from the NSW Adult Population Health Survey and from previously published studies were used to assess family demographics, mothers' willingness to vaccinate their young children, and willingness to get tested and self-isolate if symptomatic. The survey involved 604 mothers of children aged 4 years who participated in an existing trial in Sydney, Australia.
    Results: Mothers were more willing to vaccinate their children when the child's father had a tertiary education or higher, with an adjusted odds ratio (AOR) of 2.60 (95% CI 1.67-4.04). Mothers who were older than 30 years or who completed the survey during the lockdown were more willing to get tested if symptomatic, with AOR 2.50 (95% CI 1.17-5.36) and AOR 3.36 (95% CI 1.41-8.02), respectively. Mothers who were married or had de-facto partners were more willing to self-isolate if symptomatic [AOR 17.15 (95% CI 3.56-82.65)].
    Conclusion: Fathers' educational level, mothers' age, and marital status were associated with mothers' willingness to vaccinate their young children if a suitable vaccine were available, to get tested, and self-isolate if symptomatic respectively. The promotion of mitigation strategies for tackling the COVID-19 pandemic needs to take into account specific family demographics.
    MeSH term(s) Adult ; COVID-19/prevention & control ; COVID-19 Vaccines ; Child, Preschool ; Communicable Disease Control ; Cross-Sectional Studies ; Demography ; Female ; Humans ; Mothers ; Pandemics/prevention & control ; Vaccination
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2022-05-27
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2711781-9
    ISSN 2296-2565 ; 2296-2565
    ISSN (online) 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2022.904495
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