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Article ; Online: Predictive accuracy of admission cardiotocography as a screening tool for perinatal asphyxia in high-risk parturients in Northern Nigeria.

Abubakar, Hanifah D / Galadanci, Hadiza S / Farouk, Zubaida L

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2022 Volume 159, Issue 3, Page(s) 796–802

Abstract: Objective: To determine the predictive accuracy of admission cardiotocography (CTG) as a screening test for perinatal asphyxia in high-risk parturients.: Methods: A prospective study was done on a group of 180 high-risk parturients in the labor ward ... ...

Abstract	Objective: To determine the predictive accuracy of admission cardiotocography (CTG) as a screening test for perinatal asphyxia in high-risk parturients. Methods: A prospective study was done on a group of 180 high-risk parturients in the labor ward of Aminu Kano Teaching Hospital were subjected to a 30-min admission cardiotocography. Results were categorized based on the RCOG criteria. Those with normal results were allowed to progress in labor, while those with abnormal results had their delivery expedited. Umbilical artery blood gas analysis was done at delivery. Measured variables were expressed in descriptive statistics. Tests of association for categorical variables were done using the non-parametric chi-square test (P-value of ≤0.05). The Binary logistic regression model was used to control potential confounders. Results: After excluding five cord blood samples, 175 samples were analyzed. The CTG was reassuring in 149 (85.1%), non-reassuring in 15 (8.6%), and abnormal in 11 (6.3%) women. Fetal distress developed in 5 (3.4%) and 7 (46.7%) of reassuring and non-reassuring groups, respectively. The test had 91% sensitivity, specificity was 68.8%, and the predictive accuracy was 88.6% for asphyxia using base deficit. Conclusion: The admission that cardiotocography is useful in detecting fetuses at risk of perinatal asphyxia in high-risk deliveries.
MeSH term(s)	Infant, Newborn ; Pregnancy ; Female ; Humans ; Male ; Cardiotocography/methods ; Prospective Studies ; Asphyxia ; Nigeria ; Fetal Distress/diagnosis ; Asphyxia Neonatorum/diagnosis ; Heart Rate, Fetal
Language	English
Publishing date	2022-04-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.14191
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Article ; Online: Protecting patient safety in resource-poor settings.

Galadanci, Hadiza Shehu

Best practice & research. Clinical obstetrics & gynaecology

2013 Volume 27, Issue 4, Page(s) 497–508

Abstract: A crucial element in the delivery of high-quality health care is patient safety. The rate of adverse events among hospital patients is an indication of patient safety. A systematic review of in-hospital adverse events revealed the median incidence of ... ...

Abstract	A crucial element in the delivery of high-quality health care is patient safety. The rate of adverse events among hospital patients is an indication of patient safety. A systematic review of in-hospital adverse events revealed the median incidence of adverse events as 9.2%; 7.4% were lethal and 43.5% preventable. All the studies in the systemic review were from developed countries, as research is lacking from developing countries. In 2012, data from 10 developing countries reported adverse events ranging from 2.5 to 18.4% per country; 30% were lethal and 83% preventable. This study places patient safety as one of the major concerns of the health policy agenda in developing countries. Human resources for health deficits in developing countries constitute a major structural constraint for ensuring patient safety. The key to reducing adverse events in health care is system-based interventions rather than clinical interventions or technologies. Patient safety skills training, effective communication, and good team work are essential in improving patient safety in developing countries. Research on patient safety is needed to address the knowledge gap in developing countries.
MeSH term(s)	Biomedical Research ; Communication ; Cross Infection/prevention & control ; Data Collection ; Developing Countries/economics ; Global Health ; Health Knowledge, Attitudes, Practice ; Health Personnel/education ; Health Policy ; Humans ; Medical Errors/prevention & control ; Patient Safety/economics ; Postoperative Complications/prevention & control ; Safety Management/organization & administration
Language	English
Publishing date	2013-08
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2050090-7
ISSN	1532-1932 ; 1521-6934
ISSN (online)	1532-1932
ISSN	1521-6934
DOI	10.1016/j.bpobgyn.2013.03.006
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Article ; Online: Outcome of interventions to improve the quality of intrapartum care in Nigeria's referral hospitals: a quasi-experimental research design.

Okonofua, Friday / Ntoimo, Lorretta Favour / Ekezue, Bola / Ohenhen, Victor / Agholor, Kingsley / Imongan, Wilson / Ogu, Rosemary / Galadanci, Hadiza

BMC pregnancy and childbirth

2023 Volume 23, Issue 1, Page(s) 614

Abstract: Background: Evidence indicates that Nigeria's high maternal mortality rate is attributable primarily to events that occur during the intrapartum period. This study determines the effectiveness of multifaceted interventions in improving the quality of ... ...

Abstract	Background: Evidence indicates that Nigeria's high maternal mortality rate is attributable primarily to events that occur during the intrapartum period. This study determines the effectiveness of multifaceted interventions in improving the quality of intrapartum care in Nigeria's referral hospitals. Methods: Data collected through an exit interview with 752 women who received intrapartum care in intervention and control hospitals were analyzed. The interventions were designed to improve the quality indicators in the WHO recommendations for positive childbirth and assessed using 12 quality indicators. Univariate, bivariate, Poisson, and logistic regression analyses were used to compare twelve quality indicators at intervention and control hospitals. Results: The interventions showed a 6% increase in composite score of quality of care indicators at intervention compared with control hospitals. Five signal functions of intrapartum care assessed were significantly (< 0.001) better at intervention hospitals. Quality scores for segments of intervention periods compared to baseline were higher at intervention than in control hospitals. Conclusions: We conclude that multiple interventions that address various components of the quality of intrapartum care in Nigeria's referral hospitals have demonstrated effectiveness. The interventions improved five of ten quality indicators. We believe that this approach to developing interventions based on formative research is important, but a process of integrating the implementation activities with the normal maternal health delivery processes in the hospitals will enhance the effectiveness of this approach. Trial registration: The study was registered at the Nigeria Clinical Trials Registry. Trial Registration Number NCTR No: 91,540,209 (14/04/2016) http://www.nctr.nhrec.net/ and retrospectively with the ISRCTN. Trial Registration Number 64 ISRCTN17985403 (14/08/2020) https://doi.org/10.1186/ISRCTN17985403 .
MeSH term(s)	Female ; Humans ; Pregnancy ; Hospitals ; Nigeria ; Referral and Consultation ; Research Design ; Retrospective Studies
Language	English
Publishing date	2023-08-26
Publishing country	England
Document type	Clinical Trial ; Journal Article
ZDB-ID	2059869-5
ISSN	1471-2393 ; 1471-2393
ISSN (online)	1471-2393
ISSN	1471-2393
DOI	10.1186/s12884-023-05893-y
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Article ; Online: Outcomes of a multifaceted intervention to prevent eclampsia and eclampsia-related deaths in Nigerian referral facilities.

Okonofua, Friday / Ekezue, Bola F / Ntoimo, Lorretta Favour / Ohenhen, Victor / Agholor, Kingsley / Imongan, Wilson / Ogu, Rosemary / Galadanci, Hadiza

International health

2023 Volume 16, Issue 3, Page(s) 293–301

Abstract: Background: Eclampsia causes maternal mortality in Nigeria. This study presents the effectiveness of multifaceted interventions that addressed institutional barriers in reducing the incidence and case fatality rates associated with eclampsia.: Methods! ...

Abstract	Background: Eclampsia causes maternal mortality in Nigeria. This study presents the effectiveness of multifaceted interventions that addressed institutional barriers in reducing the incidence and case fatality rates associated with eclampsia. Methods: The design was quasi-experimental and the activities implemented at intervention hospitals included a new strategic plan, retraining health providers on eclampsia management protocols, clinical reviews of delivery care and educating pregnant women and their partners. Prospective data were collected monthly on eclampsia and related indicators from study sites over 2 y. The results were analysed by univariate, bivariate and multivariable logistic regression. Results: The results show a higher eclampsia rate (5.88% vs 2.45%) and a lower use of partograph and antenatal care (ANC; 17.99% vs 23.42%) in control compared with intervention hospitals, but similar case fatality rates of <1%. Overall, adjusted analysis shows a 63% decrease in the odds of eclampsia at intervention compared with control hospitals. Factors associated with eclampsia were ANC, referral for care from other facilities and older maternal age. Conclusion: We conclude that multifaceted interventions that address challenges associated with managing pre-eclampsia and eclampsia in health facilities can reduce eclampsia occurrence in referral facilities in Nigeria and potential eclampsia death in resource-poor African countries.
MeSH term(s)	Humans ; Female ; Eclampsia/prevention & control ; Eclampsia/mortality ; Pregnancy ; Nigeria/epidemiology ; Adult ; Prenatal Care/methods ; Maternal Mortality/trends ; Referral and Consultation/statistics & numerical data ; Young Adult ; Prospective Studies ; Adolescent
Language	English
Publishing date	2023-06-29
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2526175-7
ISSN	1876-3405 ; 1876-3413
ISSN (online)	1876-3405
ISSN	1876-3413
DOI	10.1093/inthealth/ihad044
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Article ; Online: Establishment of Maternal and Perinatal Database for Quality, Equity and Dignity (MPD-4-QED) programme: Processes, challenges, lessons and prospects.

Adanikin, Abiodun / Tukur, Jamilu / Lavin, Tina / Ezekwe, Bosede / Aminu, Is'haq / Aboyeji, Peter / Adesina, Olubukola / Chama, Calvin / Etuk, Saturday / Galadanci, Hadiza / Ikechebelu, Joseph / Oladapo, Olufemi T

BJOG : an international journal of obstetrics and gynaecology

2024

Language	English
Publishing date	2024-04-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2000931-8
ISSN	1471-0528 ; 0306-5456 ; 1470-0328
ISSN (online)	1471-0528
ISSN	0306-5456 ; 1470-0328
DOI	10.1111/1471-0528.17825
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Article ; Online: Acceptability of IV iron treatment for iron deficiency anaemia in pregnancy in Nigeria: a qualitative study with pregnant women, domestic decision-makers, and health care providers.

Akinajo, Opeyemi R / Babah, Ochuwa A / Banke-Thomas, Aduragbemi / Beňová, Lenka / Sam-Agudu, Nadia A / Balogun, Mobolanle R / Adaramoye, Victoria O / Galadanci, Hadiza S / Quao, Rachel A / Afolabi, Bosede Bukola / Annerstedt, Kristi Sidney

Reproductive health

2024 Volume 21, Issue 1, Page(s) 22

Abstract: Background: Anaemia in pregnancy causes a significant burden of maternal morbidity and mortality in sub-Saharan Africa, with prevalence ranging from 25 to 45% in Nigeria. The main treatment, daily oral iron, is associated with suboptimal adherence and ... ...

Abstract	Background: Anaemia in pregnancy causes a significant burden of maternal morbidity and mortality in sub-Saharan Africa, with prevalence ranging from 25 to 45% in Nigeria. The main treatment, daily oral iron, is associated with suboptimal adherence and effectiveness. Among pregnant women with iron deficiency, which is a leading cause of anaemia (IDA), intravenous (IV) iron is an alternative treatment in moderate or severe cases. This qualitative study explored the acceptability of IV iron in the states of Kano and Lagos in Nigeria. Methods: We purposively sampled various stakeholders, including pregnant women, domestic decision-makers, and healthcare providers (HCPs) during the pre-intervention phase of a hybrid clinical trial (IVON trial) in 10 healthcare facilities across three levels of the health system. Semi-structured topic guides guided 12 focus group discussions (140 participants) and 29 key informant interviews. We used the theoretical framework of acceptability to conduct qualitative content analysis. Results: We identified three main themes and eight sub-themes that reflected the prospective acceptability of IV iron therapy. Generally, all stakeholders had a positive affective attitude towards IV iron based on its comparative advantages to oral iron. The HCPs noted the effectiveness of IV iron in its ability to evoke an immediate response and capacity to reduce anaemia-related complications. It was perceived as a suitable alternative to blood transfusion for specific individuals based on ethicality. However, to pregnant women and the HCPs, IV iron could present a higher opportunity cost than oral iron for the users and providers as it necessitates additional time to receive and administer it. To all stakeholder groups, leveraging the existing infrastructure to facilitate IV iron treatment will stimulate coherence and self-efficacy while strengthening the existing trust between pregnant women and HCPs can avert misconceptions. Finally, even though high out-of-pocket costs might make IV iron out of reach for poor women, the HCPs felt it can potentially prevent higher treatment fees from complications of IDA. Conclusions: IV iron has a potential to become the preferred treatment for iron-deficiency anaemia in pregnancy in Nigeria if proven effective. HCP training, optimisation of information and clinical care delivery during antenatal visits, uninterrupted supply of IV iron, and subsidies to offset higher costs need to be considered to improve its acceptability. Trial registration ISRCTN registry ISRCT N6348 4804. Registered on 10 December 2020 Clinicaltrials.gov NCT04976179. Registered on 26 July 2021.
MeSH term(s)	Female ; Pregnancy ; Humans ; Pregnant Women ; Anemia, Iron-Deficiency/drug therapy ; Nigeria/epidemiology ; Prospective Studies ; Anemia/therapy ; Health Personnel ; Decision Making
Language	English
Publishing date	2024-02-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2149029-6
ISSN	1742-4755 ; 1742-4755
ISSN (online)	1742-4755
ISSN	1742-4755
DOI	10.1186/s12978-024-01743-y
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Article ; Online: Correlates of human papillomavirus vaccine knowledge and acceptability among medical and allied health students in Northern Nigeria.

Iliyasu, Zubairu / Galadanci, Hadiza S / Muhammad, Aisha / Iliyasu, Bilkisu Z / Umar, Amina A / Aliyu, Muktar H

Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology

2021 Volume 42, Issue 3, Page(s) 452–460

Abstract: Prior to its planned introduction, we investigated predictors of baseline knowledge and acceptability of HPV vaccination among medical and allied health care students in Kano, northern Nigeria. A total of 410 medical, dental and allied health students ... ...

Abstract	Prior to its planned introduction, we investigated predictors of baseline knowledge and acceptability of HPV vaccination among medical and allied health care students in Kano, northern Nigeria. A total of 410 medical, dental and allied health students completed structured validated questionnaires. Knowledge scores and acceptability of HPV vaccine were determined and adjusted odds ratios (AOR) for predictors of HPV knowledge and acceptability were derived from multivariate logistic regression models. Overall, 3.7% (
MeSH term(s)	Female ; Health Knowledge, Attitudes, Practice ; Humans ; Nigeria ; Papillomavirus Infections/prevention & control ; Papillomavirus Vaccines ; Patient Acceptance of Health Care ; Students, Medical ; Surveys and Questionnaires ; Vaccination
Chemical Substances	Papillomavirus Vaccines
Language	English
Publishing date	2021-06-22
Publishing country	England
Document type	Journal Article
ZDB-ID	604639-3
ISSN	1364-6893 ; 0144-3615
ISSN (online)	1364-6893
ISSN	0144-3615
DOI	10.1080/01443615.2021.1910639
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Article ; Online: Prevalence of and risk factors for iron deficiency among pregnant women with moderate or severe anaemia in Nigeria: a cross-sectional study.

Babah, Ochuwa Adiketu / Akinajo, Opeyemi Rebecca / Beňová, Lenka / Hanson, Claudia / Abioye, Ajibola Ibraheem / Adaramoye, Victoria Olawunmi / Adeyemo, Titilope A / Balogun, Mobolanle Rasheedat / Banke-Thomas, Aduragbemi / Galadanci, Hadiza S / Sam-Agudu, Nadia A / Afolabi, Bosede Bukola / Larsson, Elin C

BMC pregnancy and childbirth

2024 Volume 24, Issue 1, Page(s) 39

Abstract: Background: Anaemia during pregnancy causes adverse outcomes to the woman and the foetus, including anaemic heart failure, prematurity, and intrauterine growth restriction. Iron deficiency anaemia (IDA) is the leading cause of anaemia and oral iron ... ...

Abstract	Background: Anaemia during pregnancy causes adverse outcomes to the woman and the foetus, including anaemic heart failure, prematurity, and intrauterine growth restriction. Iron deficiency anaemia (IDA) is the leading cause of anaemia and oral iron supplementation during pregnancy is widely recommended. However, little focus is directed to dietary intake. This study estimates the contribution of IDA among pregnant women and examines its risk factors (including dietary) in those with moderate or severe IDA in Lagos and Kano states, Nigeria. Methods: In this cross-sectional study, 11,582 women were screened for anaemia at 20-32 weeks gestation. The 872 who had moderate or severe anaemia (haemoglobin concentration < 10 g/dL) were included in this study. Iron deficiency was defined as serum ferritin level < 30 ng/mL. We described the sociodemographic and obstetric characteristics of the sample and their self-report of consumption of common food items. We conducted bivariate and multivariable logistic regression analysis to identify risk factors associated with IDA. Results: Iron deficiency was observed among 41% (95%CI: 38 - 45) of women with moderate or severe anaemia and the prevalence increased with gestational age. The odds for IDA reduces from aOR: 0.36 (95%CI: 0.13 - 0.98) among pregnant women who consume green leafy vegetables every 2-3 weeks, to 0.26 (95%CI: 0.09 - 0.73) among daily consumers, compared to those who do not eat it. Daily consumption of edible kaolin clay was associated with increased odds of having IDA compared to non-consumption, aOR 9.13 (95%CI: 3.27 - 25.48). Consumption of soybeans three to four times a week was associated with higher odds of IDA compared to non-consumption, aOR: 1.78 (95%CI: 1.12 - 2.82). Conclusion: About 4 in 10 women with moderate or severe anaemia during pregnancy had IDA. Our study provides evidence for the protective effect of green leafy vegetables against IDA while self-reported consumption of edible kaolin clay and soybeans appeared to increase the odds of having IDA during pregnancy. Health education on diet during pregnancy needs to be strengthened since this could potentially increase awareness and change behaviours that could reduce IDA among pregnant women with moderate or severe anaemia in Nigeria and other countries.
MeSH term(s)	Pregnancy ; Female ; Humans ; Cross-Sectional Studies ; Nigeria/epidemiology ; Pregnant Women ; Prevalence ; Clay ; Kaolin ; Iron ; Iron Deficiencies ; Anemia/epidemiology ; Risk Factors
Chemical Substances	Clay (T1FAD4SS2M) ; Kaolin (24H4NWX5CO) ; Iron (E1UOL152H7)
Language	English
Publishing date	2024-01-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2059869-5
ISSN	1471-2393 ; 1471-2393
ISSN (online)	1471-2393
ISSN	1471-2393
DOI	10.1186/s12884-023-06169-1
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Article: Antepartum Hemorrhage: A Retrospective Analysis from a Northern Nigerian Teaching Hospital.

Takai, Idris Usman / Sayyadi, Badia Maje / Galadanci, Hadiza Shehu

International journal of applied & basic medical research

2017 Volume 7, Issue 2, Page(s) 112–116

Abstract: Background: Antepartum hemorrhage (APH) contributes significantly to maternal and perinatal morbidity and mortality globally, particularly in the developing world like ours. Prevention, early detection, and prompt management cannot be overemphasized to ... ...

Abstract	Background: Antepartum hemorrhage (APH) contributes significantly to maternal and perinatal morbidity and mortality globally, particularly in the developing world like ours. Prevention, early detection, and prompt management cannot be overemphasized to significantly reduce the morbidity and mortality associated with this condition. Objectives: The study is aimed at determining the prevalence, etiology, sociodemographic characteristics, and the fetomaternal outcome of pregnancies complicated by APH in Aminu Kano Teaching Hospital, Kano. Materials and methods: A 5 years retrospective study of all pregnancies complicated by APH at Aminu Kano Teaching Hospital, Kano, Nigeria, between January 1, 2009, and December 31, 2013, was conducted. Results: A total of 224 cases of APH were recorded out of the 18,273 cases admitted for delivery during the study period, giving an institutional prevalence rate of 1.2%. Two hundred and eighteen folders were retrieved and analyzed giving a retrieval rate of 97.3%. The mean gestational age at presentation was 35.3 ± 2 weeks and the most common causes were abruptio placenta and placenta previa constituting 68.3% and 30.0%, respectively. Sociodemographic characteristics associated with the occurrence of APH included age, booking status, parity, and socioeconomic status. The peak prevalence of APH was observed in the 35-39 year age group accounting for 33.0%. There were 123 live births and 92 stillbirths. The cesarean section rate was 53.5%. Major complications were intrauterine fetal deaths in 42.8%, postpartum hemorrhage in 24.2% of cases, and anemia necessitating blood transfusion in 61.5%. There were three maternal deaths all due to abruptio placentae during the study period giving a case specific fatality rate of 2%. Conclusion: The prevalence of APH in our setting is high. The major causes were abruptio placenta and placenta previa. The major fetal complication was intrauterine fetal death, and the major maternal complications were postpartum hemorrhage and anemia with consequent high blood transfusion rate. Early detection, provision of antenatal care, and emergency obstetric care services can reduce the negative effects of APH.
Language	English
Publishing date	2017-03-02
Publishing country	India
Document type	Journal Article
ZDB-ID	2645750-7
ISSN	2248-9606 ; 2229-516X
ISSN (online)	2248-9606
ISSN	2229-516X
DOI	10.4103/2229-516X.205819
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Article: 'We delivered at home out of fear'

Iliyasu, Zubairu / Umar, Amina A / Gaya, Fatima S / Nass, Nafisa S / Abdullahi, Hadiza M / Kwaku, Aminatu A / Amole, Taiwo G / Tsiga-Ahmed, Fatimah I / Galadanci, Hadiza S / Salihu, Hamisu M / Aliyu, Muktar H

International journal of MCH and AIDS

2023 Volume 12, Issue 1, Page(s) e632

Abstract: Background and objective: The COVID-19 pandemic response overwhelmed health systems, disrupting other services, including maternal health services. The disruptive effects on the utilization of maternal health services in low-resource settings, including ...

Abstract	Background and objective: The COVID-19 pandemic response overwhelmed health systems, disrupting other services, including maternal health services. The disruptive effects on the utilization of maternal health services in low-resource settings, including Nigeria have not been well documented. We assessed maternal health service utilization, predictors, and childbirth experiences amidst COVID-19 restrictions in a rural community of Kumbotso, Kano State, in northern Nigeria. Methods: Using an explanatory mixed methods design, 389 mothers were surveyed in January 2022 using validated interviewer-administered questionnaires, followed by in-depth interviews with a sub-sample (n=20). Data were analyzed using logistic regression models and the framework approach. Results: Less than one-half (n=165, 42.4%) of women utilized maternal health services during the period of COVID-19 restrictions compared with nearly two-thirds (n=237, 65.8%) prior to the period (p<0.05). Non-utilization was mainly due to fear of contracting COVID-19 (n=122, 54.5%), clinic overcrowding (n=43, 19.2%), transportation challenges (n=34, 15.2%), and harassment by security personnel (n=24, 10.7%). The utilization of maternal health services was associated with participant's post-secondary education (aOR=2.06, 95% CI:1.14- 11.40) (p=0.02), and employment type (civil service, aOR=4.60, 95% CI: 1.17-19.74) (p<0.001), business aOR=1.94, 95% CI:1.19- 4.12) (p=0.032) and trading aOR=1.62, 95% CI:1.19-2.94) (p=0.04)). Women with higher household monthly income (≥ N30,000, equivalent to 60 US Dollars) (aOR=1.53, 95% CI:1.13-2.65) (p=0.037), who adhered to COVID-19 preventive measures and utilized maternal health services before the COVID-19 pandemic were more likely to utilize those services during the COVID-19 restrictions. In contrast, mothers of higher parity (≥5 births) were less likely to use maternal health services during the lockdown (aOR=0.30, 95% CI:0.10-0.86) (p=0.03). Utilization of maternal services was also associated with partner education and employment type. Conclusion and global health implications: The utilization of maternal health services declined during the COVID-19 restrictions. Utilization was hindered by fear of contracting COVID-19, transport challenges, and harassment by security personnel. Maternal and partner characteristics, adherence to COVID-19 preventive measures, and pre-COVID maternity service utilization influenced attendance. There is a need to build resilient health systems and contingent alternative service delivery models for future pandemics.
Language	English
Publishing date	2023-05-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2715876-7
ISSN	2161-864X ; 2161-8674
ISSN (online)	2161-864X
ISSN	2161-8674
DOI	10.21106/ijma.632
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