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Sharma S, Sharma H, Gogoi H. Bacterial immunotherapy: is it a weapon in our arsenal in the fight against cancer? Front Immunol 2023; 14:1277677. [PMID: 38090593 PMCID: PMC10711065 DOI: 10.3389/fimmu.2023.1277677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/03/2023] [Indexed: 12/18/2023] Open
Abstract
Advances in understanding the genetic basis of cancer have driven alternative treatment approaches. Recent findings have demonstrated the potential of bacteria and it's components to serve as robust theranostic agents for cancer eradication. Compared to traditional cancer therapies like surgery, chemotherapy, radiotherapy, bacteria mediated tumor therapy has exhibited superior cancer suppressing property which is attributed a lot to it's tumor proliferating and accumulating characteristics. Genetically modified bacteria has reduced inherent toxicity and enhanced specificity towards tumor microenvironment. This anti- tumor activity of bacteria is attributed to its toxins and other active components from the cell membrane, cell wall and spores. Furthermore, bacterial genes can be regulated to express and deliver cytokines, antibodies and cancer therapeutics. Although there is less clinical data available, the pre- clinical research clearly indicates the feasibility and potential of bacteria- mediated cancer therapy.
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Affiliation(s)
- Shubhra Sharma
- Amity Institute of Microbial Technology, Amity University Rajasthan, Jaipur, India
| | - Himani Sharma
- Amity Institute of Microbial Technology, Amity University Rajasthan, Jaipur, India
| | - Himanshu Gogoi
- Amity Institute of Microbial Technology, Amity University Rajasthan, Jaipur, India
- Translational Health Science and Technology Institute, National Capital Region (NCR) Biotech Science Cluster, Faridabad, India
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2
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Nozawa K, Toma S, Shimizu C. Distress and impacts on daily life from appearance changes due to cancer treatment: A survey of 1,034 patients in Japan. Glob Health Med 2023; 5:54-61. [PMID: 36865895 PMCID: PMC9974224 DOI: 10.35772/ghm.2022.01062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/12/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023]
Abstract
This study aimed to clarify the psychosocial difficulties and impacts that cancer patients face from appearance changes, in order to develop a patient support program. An online survey was administered to patients registered with an online survey company who met the eligibility criteria. The study population was randomly selected from gender and cancer types to create a sample that reflected the proportion of cancer incidence rates in Japan as much as possible. Out of a total of 1034 respondents, 601patients (58.1%) experienced appearance change. Symptoms that were reported to have a high distress level and prevalence rate, and that widely required provision of information were such as alopecia (22.2%), edema (19.8%) and eczema (17.8%). Distress levels and personal assistance requirements were high particularly for patients who experienced stoma placement and mastectomy. More than 40% of patients who experienced appearance change had quit or were absent from work or school, and reported that their social activities were negatively affected by the visually notable changes in their appearance. Concerns about "receiving pity from others" or about "the exposure of cancer" due to their appearance change also led patients to reduce outings (β = 0.32 and β = 0.31 respectively, p < 0.001) and social interactions with others (β = 0.34 and β = 0.36 respectively, p < 0.001) and increased the discord in human relationships (β = 0.21 and β = 0.19 respectively, p < 0.001). Results from this study indicate the areas in which more support is required from healthcare professionals, as well as the need for interventions for patient cognition to avoid maladaptive behaviors in cancer patients who experience appearance changes.
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Affiliation(s)
- Keiko Nozawa
- Department of Nursing, Mejiro University, Saitama, Japan;,Appearance Support Center, National Cancer Center Hospital, Tokyo, Japan;,Address correspondence to:Keiko Nozawa, Department of Nursing, Mejiro University, 320 Ukiya, Iwatsuki-ku, Saitama-shi, Saitama 339-8501, Japan. E-mail:
| | - Shoko Toma
- Appearance Support Center, National Cancer Center Hospital, Tokyo, Japan
| | - Chikako Shimizu
- Department of Breast and Medical Oncology, Comprehensive Cancer Center, National Center for Global Health and Medicine, Tokyo, Japan
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3
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Versluis A, Alphen KV, Dercksen W, Haas HD, Kaptein AA, Hurk CVD. Looking bad: Female patients drawing their representation of chemotherapy-induced alopecia. J Health Psychol 2022; 27:3013-3027. [PMID: 35212563 DOI: 10.1177/13591053221075503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study explored the experienced impact of alopecia using patient's drawings. Forty patients made drawings of their feelings about appearance of their head and hair before and during chemotherapy. Patients also reported illness perceptions (B-IPQ). Twenty-four patients (60%) reported ⩾50% alopecia at enrollment. Most patients (70%) drew a negative change of feelings over time and physical changes. Many experiences related to alopecia emerged from the written texts underneath the drawings and the B-IPQ. Drawings depicted deteriorated feelings of appearance, affecting many activities throughout the day. Healthcare providers are advised to use patient-tailored questioning about alopecia.
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Affiliation(s)
- Anne Versluis
- Netherlands Comprehensive Cancer Organisation (IKNL), The Netherlands
| | | | | | | | - Ad A Kaptein
- Leiden University Medical Centre, The Netherlands
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4
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Chanmekun SB, Zulkifli MM, Muhamad R, Mohd Zain N, Low WY, Liamputtong P. Managing sexual dysfunction for women with breast cancer: the perspective of healthcare providers in North East Malaysia. Support Care Cancer 2021; 30:401-411. [PMID: 34297219 DOI: 10.1007/s00520-021-06417-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 07/05/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Management of female sexual dysfunction (FSD) is vital for women with breast cancer due to the devastating consequences, which include marital disharmony and reduced quality of life. We explore healthcare providers' (HCPs) perceptions and experiences in managing FSD for women living with breast cancer using a phenomenological approach. METHODS This qualitative study was conducted using a face-to-face interview method with HCPs from two tertiary hospitals in North East Malaysia. The interviews were recorded, transcribed verbatim, and transferred to NVivo ® for data management. The transcriptions were analyzed using thematic analysis. RESULTS Three key barriers were identified through the thematic analysis: a scarcity of related knowledge; the influence of socio-cultural ideas about sex; and the specialty-centric nature of the healthcare system. Most HCPs interviewed had a very narrow understanding of sexuality, were unfamiliar with the meaning of FSD, and felt their training on sexual health issues to be very limited. They viewed talking about sex to be embarrassing to both parties that are both to HCPs and patients and was therefore not a priority. They focused more on their specialty hence limited the time to discuss sexual health and FSD with their patients. CONCLUSION Therefore, interventions to empower the knowledge, break the socio-cultural barriers, and improve the clinic settings are crucial for HCPs in managing FSD confidently.
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Affiliation(s)
- Siti Balqis Chanmekun
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Maryam Mohd Zulkifli
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
| | - Rosediani Muhamad
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Norhasmah Mohd Zain
- School of Health Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Wah Yun Low
- Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Asia-Europe Institute, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Pranee Liamputtong
- College of Health Sciences, VinUniversity, Gia Lam District, Hanoi, 100000, Vietnam
- Translational Health Research Institute (THRI), Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
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5
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Haque E, Alabdaljabar MS, Ruddy KJ, Haddad TC, Thompson CA, Lehman JS, Hashmi SK. Management of chemotherapy-induced alopecia (CIA): A comprehensive review and future directions. Crit Rev Oncol Hematol 2020; 156:103093. [PMID: 33070077 DOI: 10.1016/j.critrevonc.2020.103093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/29/2020] [Accepted: 08/21/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES To review and summarize the available literature on the management of chemotherapy-induced alopecia (CIA) including complementary and alternative medicine (CAM), and to present CIA's effect on quality of life (QoL). METHODS Nine databases were searched for CIA-related keywords, including the effect on QoL, and management options. Among 1019 articles found, 54 articles focusing on treatment/prevention or QoL were retrieved. References of selected articles were also checked manually. RESULTS CIA was found to negatively affect QoL and body image, regardless of head covering status (i.e., for cultural or religious reasons). Most studies related to treatment/prevention of CIA reported on the use of scalp-cooling. The efficacy of CAM treatments was found to be questionable. CONCLUSION A high incidence rate of CIA exists with certain chemotherapies, and it significantly impairs QoL. Preventive and treatment strategies are incompletely effective. Additional literature is needed to explore potential preventive or therapeutic options for CIA.
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Affiliation(s)
- Emaan Haque
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Kathryn J Ruddy
- Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | - Tufia C Haddad
- Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | - Carrie A Thompson
- Division of Hematology, Dept. of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Julia S Lehman
- Dept. of Dermatology & Laboratory Medicine, Mayo Clinic, Rochester, MN, USA
| | - Shahrukh K Hashmi
- Division of Hematology, Dept. of Medicine, Mayo Clinic, Rochester, MN, USA; Sheikh Shakhbout Medical City / Mayo Clinic, Abu Dhabi, United Arab Emirates.
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Martins A, Whelan JS, Bennister L, Fern LA, Gerrand C, Onasanya M, Storey L, Wells M, Windsor R, Woodford J, Taylor RM. Qualitative study exploring patients experiences of being diagnosed and living with primary bone cancer in the UK. BMJ Open 2019; 9:e028693. [PMID: 31551374 PMCID: PMC6773292 DOI: 10.1136/bmjopen-2018-028693] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE The aim of this study is to explore the experiences of patients with primary bone cancer. DESIGN Qualitative study design using semistructured interviews and focus groups. SETTING Hospitals across the UK and recruitment through UK sarcoma charities and support groups. METHODS Semistructured telephone/face-to-face interviews and focus groups with a purposive sample of 26 participants. Data were analysed using Framework Analysis. PARTICIPANTS Patients (n=26) with primary bone cancer aged 13-77 years. The majority were male (69%), white (85%); diagnosed within 4 years (54%); and had lower limb sarcoma (65%). Ten participants had undergone an upper/lower limb amputation (39%). RESULTS The health-related quality-of-life domains of physical, emotional and social well-being and healthcare professionals' role were the overarching themes of analysis. The physical domain anchored patient experiences. The intensity and length of treatment, the severity of side-effects, the level of disability after surgery and the uncertainty of their prognosis had an impact on patient's self-image, confidence, mood and identity, and caused disruption to various aspects of the patients' social life, including their relationships (emotional and sexual) and participation in work/school and leisure activities. Adaptation was influenced by the way patients dealt with stress and adversity, with some finding a new outlook in life, and others struggling with finding their 'new normal'. Family and friends were the main source of support. Healthcare professional's expertise and support was critical. Rehabilitation services had a considerable role in patient's physical and emotional well-being, but inequitable access to these services was apparent. CONCLUSIONS This study described the impact of primary bone cancer on patients' well-being and adjustment over time with the identification of influencing factors of better/worse experiences. It showed that impact was felt after end of treatment and affected patients at different life stages. Holistic models of survivorship care are needed.
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Affiliation(s)
- Ana Martins
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jeremy S Whelan
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Lorna A Fern
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Craig Gerrand
- Sarcoma Service, Royal National Orthopaedic Hospital Stanmore, Stanmore, UK
| | - Maria Onasanya
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Lesley Storey
- Department of Psychology, Birmingham City University, Birmingham, UK
| | - Mary Wells
- Imperial College Healthcare NHS Trust, London, UK
| | - Rachael Windsor
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Julie Woodford
- Sarcoma Service, Royal National Orthopaedic Hospital Stanmore, Stanmore, UK
| | - Rachel M Taylor
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
- CNMAR, University College London Hospitals NHS Foundation Trust, London, UK
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Ramirez M, Janke EA, Grant M, Altschuler A, Hornbrook M, Krouse RS. Cancer Survivorship at the Intersections of Care and Personhood. Med Anthropol 2019; 39:55-68. [PMID: 31403821 DOI: 10.1080/01459740.2019.1642886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Surviving colorectal cancer following ostomy surgery with an intestinal stoma presents numerous challenges to the cultural category of full adult personhood. The foremost is managing unpredictable bowel activity. The technical management of the ostomy facilitated by biomedical specialists, is essential for personhood realignment. This article focuses on how some female long-term cancer survivors manage and adapt to this new fecal habitus by mobilizing various assemblages of care - receiving care, continuing to provide particular gendered forms of care, and returning to caregiving roles. These interdependent practices of care realign personhood, or at the very least, minimize the assaults that having an ostomy presents to the cultural category of full adult personhood.
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Affiliation(s)
- Michelle Ramirez
- Department of Behavioral and Social Sciences, University of the Sciences, Philadelphia, Pennsylvania, USA
| | - E Amy Janke
- Department of Behavioral and Social Sciences, University of the Sciences, Philadelphia, Pennsylvania, USA
| | - Marcia Grant
- City of Hope National Medical Center, Duarte, California, USA
| | | | - Mark Hornbrook
- Kaiser Permanente Center for Health Research Northwest Region, Portland, Oregon, USA
| | - Robert S Krouse
- Corporal Michael J. Crescenz Veterans Affairs Medical Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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8
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Hopwood P, Hopwood N. New challenges in psycho-oncology: An embodied approach to body image. Psychooncology 2019; 28:211-218. [PMID: 30488572 DOI: 10.1002/pon.4936] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 10/26/2018] [Indexed: 01/21/2023]
Affiliation(s)
- Penelope Hopwood
- Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, UK
| | - Nick Hopwood
- School of Education, University of Technology Sydney, Ultimo, Australia
- Department of Curriculum Studies, University of Stellenbosch, Stellenbosch, South Africa
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Skowronski M, Risør MB, Andersen RS, Foss N. The cancer may come back: experiencing and managing worries of relapse in a North Norwegian village after treatment . Anthropol Med 2018; 26:296-310. [PMID: 29913070 DOI: 10.1080/13648470.2017.1391172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Little is known about how people living in the aftermath of cancer treatment experience and manage worries about possible signs of cancer relapse, not as an individual enterprise but as socially embedded management. One-year ethnographic fieldwork was conducted in a coastal village of under 3000 inhabitants in northern Norway. Ten villagers who had undergone cancer treatment from six months to five years earlier were the main informants. During fieldwork, the first author conducted qualitative, semi-structured monthly interviews with them, and participated in their everyday activities and relationships, including families, friends and co-villagers. In this article, we contemplate human emotions as arising in contexts of transactions, capable of creating social realities. By including this perspective, we highlight how people who recover from cancer construct and experience worry about possible relapse in relation to close family members, friends and co-villagers in the socially closely-knit and relatively isolated village. These emotional experiences emerge through relationships with others have communicative characteristics and take place in interaction with the social environment of their village. While informants attempt to protect family members by avoiding sharing worries with them, they express the need to share their worries within friendships. However, they experience both comfort and challenges in managing their worries in relation to acquaintances in the village. Overall, the study enhances understanding of the social embeddedness of emotions in everyday life, by revealing how worries of relapse of cancer configure and relate to various social contexts.
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Affiliation(s)
- Magdalena Skowronski
- NAFKAM, Department of Community Medicine, Faculty of Health Sciences, UiT, Tromsø, Norway
| | - Mette Bech Risør
- General Practice Research Unit, Department of Community Medicine, Faculty of Health Sciences, UiT, Tromsø, Norway
| | - Rikke Sand Andersen
- Center For Cancer Diagnosis in Primary Care, Research Unit for General Practice, Department of Anthropology, Aarhus University, Aarhus, Denmark
| | - Nina Foss
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT, Tromsø, Norway
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10
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Suwankhong D, Liamputtong P. Physical and Emotional Experiences of Chemotherapy: a
Qualitative Study among Women with Breast Cancer in
Southern Thailand. Asian Pac J Cancer Prev 2018; 19:521-528. [PMID: 29480995 PMCID: PMC5980944 DOI: 10.22034/apjcp.2018.19.2.521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Chemotherapy treatment can increase survival rates among women with breast cancer elsewhere. However, it also has negative impact on women’s general appearance, body image and psychological functioning. This study aimed to describe the experiences of chemotherapy treatment among Thai women with breast cancer in rural communities, sounthern Thailand. Methods: Qualitative approach was employed to gain insights about the experiences of the women. In-depth interviewing and drawing methods were conducted with 20 Thai women who had been diagnosed with breast cancer. Thematic method was used to analyse the data. Results: Three themes emerged from the findings: I feel so weak: Lack of physical energy; experiencing physical and emotional burdens and managing health and life. Women were traumatized by effects of chemotherapy and suffered severe physical side effects. Most received inadequate professional support from health care providers and had to rely on their own judgment and use local resources to deal with the effects of their treatment and to improve their health and well-being. Conclusions: Chemotherapy brought about traumatic experiences to Thai women with breast cancer. Continual support is needed for the women to reduce the difficulties they might encounter. Support groups should be established for these women when receiving and completing chemotherapy treatment. Our finding suggested that social support programs that meet their need are salient means that could reduce the sufferings of these women. Nurses and other health care professionals in the local community should play their important role to establish such group and make it accessible for all.
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Affiliation(s)
- Dusanee Suwankhong
- Department of Public Health, Faculty of Health and Sports Science, Thaksin University, Phatthalung, Thailand. dusanee.s@ scholar.tsu.ac.th
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Uhrenfeldt L, Martinsen B, Jørgensen LB, Sørensen EE. The state of Danish nursing ethnographic research: flowering, nurtured or malnurtured - a critical review. Scand J Caring Sci 2017; 32:56-75. [PMID: 28795475 DOI: 10.1111/scs.12466] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 03/08/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Nursing was established in Denmark as a scholarly tradition in the late nineteen eighties, and ethnography was a preferred method. No critical review has yet summarised accomplishments and gaps and pointing at directions for the future methodological development and research herein. AIM This review critically examines the current state of the use of ethnographic methodology in the body of knowledge from Danish nursing scholars. METHODS We performed a systematic literature search in relevant databases from 2003 to 2016. The studies included were critically appraised by all authors for methodological robustness using the ten-item instrument QARI from Joanna Briggs Institute. RESULTS Two hundred and eight studies met our inclusion criteria and 45 papers were included; the critical appraisal gave evidence of studies with certain robustness, except for the first question concerning the congruity between the papers philosophical perspective and methodology and the seventh question concerning reflections about the influence of the researcher on the study and vice versa. In most studies (n = 34), study aims and arguments for selecting ethnographic research are presented. Additionally, method sections in many studies illustrated that ethnographical methodology is nurtured by references such as Hammersley and Atkinson or Spradley. CONCLUSIONS Evidence exists that Danish nursing scholars' body of knowledge nurtures the ethnographic methodology mainly by the same few authors; however, whether this is an expression of a deliberate strategy or malnutrition in the form of lack of knowledge of other methodological options appears yet unanswered.
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Affiliation(s)
- Lisbeth Uhrenfeldt
- Faculty of Nursing and Health Science, Nord University, Bodø, Norway.,Department of Health Science and Technology, Aalborg University, Aalborg Ø, Denmark.,Danish Centre of Systematic reviews: An Affiliate Center of Joanna Briggs Institute, The Center of Excellence- Clearing House, Aalborg University, Aalborg Ø, Denmark
| | - Bente Martinsen
- Department of Public Medicine, Aarhus University, Aarhus, Denmark
| | | | - Erik Elgaard Sørensen
- Department of Clinical Medicine, Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg University, Aalborg, Denmark
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12
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Abstract
BACKGROUND Body image is a complex issue with the potential to impact many aspects of cancer survivorship, particularly for the younger breast cancer survivor. OBJECTIVE The purpose of this review is to synthesize the current state of the science for body image in younger women with breast cancer. METHODS Combinations of the terms "body image," "sexuality intervention," "women," "younger women," and "breast cancer" were searched in the PubMed, PsycINFO, CINAHL, Web of Knowledge, and Science Direct databases through January 2014. Inclusion criteria for this review were (1) original research, (2) published in English from the year 2000 forward, (3) measuring body image as an outcome variable, and (4) results included reporting of age-related outcomes. RESULTS Thirty-six articles met the inclusion criteria. The majority of studies were cross-sectional, with extensive variation in body image assessment tools. Age and treatment type had a significant impact on body image, and poorer body image was related to physical and psychological distress, sex and intimacy, and the partnered relationship among younger women. Only 1 intervention study found a significant improvement in body image after intervention. CONCLUSIONS Findings suggest body image is a complex posttreatment concern for breast cancer survivors, particularly younger women. The findings of this review are limited by the high level of variation in the methods for assessing body image. IMPLICATIONS FOR PRACTICE Further research of interventions to address body image concerns following treatment for breast cancer is warranted. Improvement of body image may improve the quality of life of younger breast cancer survivors.
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13
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Slatman J, Halsema A, Meershoek A. Responding to Scars After Breast Surgery. QUALITATIVE HEALTH RESEARCH 2016; 26:1614-1626. [PMID: 26078328 DOI: 10.1177/1049732315591146] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This article represents a phenomenological study on how women endow meaning to their scarred bodies after breast cancer treatment. Data collection consisted of multiple interviews with 10 women who had mastectomy, and 9 women who had breast-saving surgery. Against the background of the phenomenological premise that one's body can appear to oneself in various ways, we identified meaningful differences between experiences that go together with one's body "at a distance" and experiences that go together with one's body's "closeness." The diversity in body experiences we have revealed in our study calls for reconsidering the prejudiced critique of the "body as object" in mainstream phenomenology of health care, and invites medical professionals to develop the ability to recognize different perspectives on embodiment.
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14
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Fauske L, Lorem G, Grov EK, Bondevik H. Changes in the body image of bone sarcoma survivors following surgical treatment--A qualitative study. J Surg Oncol 2015; 113:229-34. [PMID: 26714610 PMCID: PMC4736459 DOI: 10.1002/jso.24138] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 12/05/2015] [Indexed: 11/25/2022]
Abstract
Background and Objectives Among several long‐term effects, people treated for cancer may experience an altered appearance. Our study aims to identify how visible body changes following surgical treatment affect the life and identity of primary bone sarcoma survivors 3–10 years after diagnosis. A qualitative, phenomenological, and hermeneutic design was applied. Methods Sarcoma survivors (n = 18) who were previously treated at Norwegian Radium Hospital, Oslo University Hospital, participated in the study. In‐depth and semi‐structured interviews were conducted and analyzed using inductive thematic analysis. Results The main finding of this study concerned how altered appearance after bone cancer treatment in the hip/pelvis or lower extremities affected the participants’ self‐esteem. Half of the participants expressed concerns about their visible differences, particularly those with functional impairment. They felt that it is important to hide the bodily signs of changes to appear as normal as possible, as well as attractive and healthy. They describe, with specific examples, how these changes influence their self‐realization, especially their social life. Conclusions Healthcare providers who guide bone sarcoma survivors during follow‐up should develop a comprehensive understanding of what it means to cope with a changed and challenging body. J. Surg. Oncol. 2016;113:229–234. © 2015 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Lena Fauske
- Department of Oncology, Norwegian Radium Hospital, Oslo University Hospital, Nydalen, Oslo, Norway
| | - Geir Lorem
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ellen K Grov
- Faculty of Health Sciences, Department of Nursing, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Hilde Bondevik
- Department of Health Sciences, Institute of Health and Society, University of Oslo, Blindern, Oslo, Norway
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15
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Dua P, Heiland MF, Kracen AC, Deshields TL. Cancer-related hair loss: a selective review of the alopecia research literature. Psychooncology 2015; 26:438-443. [PMID: 26594010 DOI: 10.1002/pon.4039] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 10/03/2015] [Accepted: 10/24/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Alopecia is a common side effect of cancer treatment, affecting approximately 65% of patients. Healthcare providers and allied staff recognize that alopecia is distressing for people with cancer; however, they are often unaware of the extent of distress or the great efforts expended by patients to cope with hair loss. This study reviews the existing literature regarding the psychosocial impact of alopecia on cancer survivors and the coping strategies they use to manage hair loss. METHODS We searched for studies examining the psychosocial effects of alopecia on cancer survivors using PubMed and PsycInfo databases and Google Scholar. RESULTS A total of 36 peer-reviewed articles were deemed relevant to be included in this review. In this review, alopecia was consistently ranked as one of the most distressing side effects of cancer treatment. Survivors report that hair loss disrupts how they experience their bodies, interact with others, and conceptualize their body image beyond treatment. Although upsetting for both genders, the scarce literature that exists suggests that there may be some gender-specific aspects of experiencing cancer-related hair loss. Cancer survivors cope with alopecia in numerous ways and often rely on strategies such as concealment, social support, social avoidance, information seeking, and behavioral rehearsal. CONCLUSIONS Treatment-induced alopecia negatively affects millions of survivors each year in unique and nuanced ways. We hope that survivors' healthcare providers and loved ones may better appreciate the psychosocial challenges they experience related to hair loss, as well as the strategies they use to cope. Further research is much needed to better understand cancer-related alopecia. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Priya Dua
- U.S. Department of Agriculture, National Agricultural Statistics Service, St. Louis, MO, USA
| | - Mark F Heiland
- Central Arkansas Veterans Healthcare System, Little Rock, AR, USA
| | | | - Teresa L Deshields
- Siteman Cancer Center Psycho-Oncology Service, 4921 Parkview Place, MS: 90-35-703, St. Louis, MO, 63110, USA
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Pedersen B, Delmar C, Falkmer U, Grønkjaer M. Bridging the gap between interviewer and interviewee: developing an interview guide for individual interviews by means of a focus group. Scand J Caring Sci 2015; 30:631-8. [PMID: 26426416 DOI: 10.1111/scs.12280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 07/20/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND In developing an interview guide, pre-existing knowledge about the research topic is essential. In a recent study, we were interested in exploring the experiences of weight changes among women treated for breast cancer using individual interviews. However, to develop an interview guide for the individual interviews that covered relevant thematic and dynamic dimensions, we found existing literature insufficient. Thus, we turned our attention to the benefit of the focus group method. OBJECTIVES This study aims to discuss how a focus group prior to individual interviews may contribute in developing the thematic dimension and translating the dynamic dimension of an interview guide into everyday language. METHODS We conducted one focus group interview of five women treated for breast cancer with experiences in weight changes. Data were analysed using content and conversation analysis and discussed with relevant literature on interview guide development. ETHICS The study is approved by the Danish Data Protection Agency (2008-58-0028) and follows the ethical guidelines for qualitative research. RESULTS Data generation and analysis resulted in themes for the thematic dimension, as well as three dynamic areas to consider in the individual interviews to bridge the gap between the interviewer and the interviewee. The dynamic areas are as follows: The use of words, images and metaphors - a shield and self-protection, Multiple meanings to explore and Staying close to the everyday language. CONCLUSION The analysis made us more familiar with the content and meaning of weight changes among breast cancer survivors. Furthermore, it provided images and metaphors, multiple meanings and a sense of the women's everyday language that calls for an open interview frame to be used in subsequent individual interviews.
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Affiliation(s)
- Birgith Pedersen
- Department of Oncology, Aalborg University Hospital, Aalborg, Denmark
| | - Charlotte Delmar
- Institute of Public Health, Section of Nursing, Aarhus University, Aarhus, Denmark.,University College Diakonova, Oslo, Norway
| | - Ursula Falkmer
- Department of Oncology, Aalborg University Hospital, Aalborg, Denmark
| | - Mette Grønkjaer
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
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Park EY, Kim JH. Predictors of Sexual Adjustment in Cancer Patients Receiving Chemotherapy. J Psychosoc Oncol 2015; 33:488-503. [DOI: 10.1080/07347332.2015.1067278] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cured of primary bone cancer, but at what cost: a qualitative study of functional impairment and lost opportunities. Sarcoma 2015; 2015:484196. [PMID: 25949211 PMCID: PMC4407620 DOI: 10.1155/2015/484196] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 03/26/2015] [Indexed: 11/17/2022] Open
Abstract
Purpose. Our study aims to explore how former cancer patients experience physical and psychosocial late effects 3–7 years after they underwent treatment for primary bone sarcoma in the hip/pelvic region. A qualitative, phenomenological, and hermeneutic design was applied. Methods. Sarcoma survivors (n = 10) previously treated at Oslo University Hospital, Norwegian Radium Hospital were selected to participate. In-depth and semistructured interviews were conducted. The interviews were analysed using inductive thematic analysis. Results. The participants reported that the late effects had three core spheres of impact: “their current daily life,” “their future opportunities,” and “their identity.” They expressed negative changes in activity, increased dependence on others, and exclusion from participation in different areas. Their daily life, work, sports activities, and social life were all affected. Several of their experiences are similar to those described by people with functional impairment or disability. Conclusion. Patients cured of bone cancer in the hip/pelvic region pay a significant price in terms of functional impairment, practical challenges, exclusion from important aspects of life, and loss of previous identity. It is important to appreciate this in order to help bone cancer survivors who struggle to reorient their life and build a secure new identity.
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Fenlon D, Reed E, Blows E, Scanlon K, Wray J, Dewey A. Moving forward: a qualitative research inquiry to inform the development of a resource pack for women following primary breast cancer treatment. J Psychosoc Oncol 2015; 33:85-105. [PMID: 25415765 DOI: 10.1080/07347332.2014.977414] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
While the UK charity Breast Cancer Care has extensive resources for women with breast cancer, this research partnership developed the first resource driven and informed by primary research with these women, exploring their needs and developing the resource according to need. Data were collected from focus groups with breast cancer survivors and telephone interviews with health professionals and experts, which explored the needs of women after primary cancer treatment, and were analyzed using thematic analysis. As well as information, these women needed resources to help them regain control over life, adapt to a changed body, and restore lost confidence.
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Affiliation(s)
- Deborah Fenlon
- a University of Southampton , Highfield , Southampton , UK
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Stapleton S, Pattison N. The lived experience of men with advanced cancer in relation to their perceptions of masculinity: a qualitative phenomenological study. J Clin Nurs 2014; 24:1069-78. [PMID: 25319948 DOI: 10.1111/jocn.12713] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2014] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES The aim of this exploratory research was to understand how men experience their advanced cancer in relation to their perceptions of masculinity. BACKGROUND There are differences in the way men and women experience illness and health care. There are inequalities in incidence and morbidities of many diseases as well as differences in rates of help-seeking behaviours. Theories on masculinity offer some explanation towards this. Men's experiences of advanced cancer in relation to masculinity are under reported, published literature suggests that there are certain issues or men dealing with advanced disease that justify investigation. DESIGN A Qualitative approach using a Husserlian Phenomenological design was conducted. SAMPLE Eight men (aged 26-68) all with advanced cancer, defined as advanced or metastatic disease for which the patient had exhausted all standard therapeutic options. METHODS In-depth interviews were conducted to capture narratives of the experiences of men. Data were analysed using Colaizzi's seven stage framework. RESULTS Themes included thwarted ambition, changing expectations, protection and provision, stoicism and coping, images of illness versus images of masculinity, importance of being a fighter and loss. CONCLUSION Findings showed that the experiences of these men were complex and should be handled sensitively. Ideas for gender-specific interventions and further research were developed from the findings in relation to current literature. RELEVANCE TO CLINICAL PRACTICE A better understanding and awareness of this in this context will help nurses to consider more subtle challenges that these patients may be dealing with that in turn could affect how they cope with the burden of cancer.
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Ramirez M, Altschuler A, McMullen C, Grant M, Hornbrook M, Krouse R. "I didn't feel like I was a person anymore": realigning full adult personhood after ostomy surgery. Med Anthropol Q 2014; 28:242-59. [PMID: 24782269 PMCID: PMC5023005 DOI: 10.1111/maq.12095] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Colorectal cancer (CRC) is the third most common cancer in the United States. For some CRC patients, cancer treatment involves creating a permanent or temporary intestinal ostomy. Having an ostomy often results in complex social and physical concerns-including unpredictable and at times publicly noticeable bowel output. In this article, we discuss findings from 30 in-depth interviews with female CRC survivors with ostomies in the western United States. We highlight how having an ostomy disrupts culturally sanctioned practices of continence that mark the attainment of full-adult personhood. We discuss how survivors reclaim a sense of full personhood after ostomy surgery through a process of realignment that entails both learning how to manage ostomy equipment to conceal bowel activity and reappraising their illness and suffering. We suggest that the anthropological categories of personhood and personhood realignment be incorporated into research and interventions aimed at increasing support among cancer survivors living with bodily impairments.
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Surviving breast cancer: women's experiences with their changed bodies. Body Image 2013; 10:344-51. [PMID: 23490552 DOI: 10.1016/j.bodyim.2013.02.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 02/06/2013] [Accepted: 02/08/2013] [Indexed: 11/23/2022]
Abstract
In this study, we explored women's experiences with their bodies following treatment for breast cancer. Eleven women who had been treated for the disease (M(time since treatment)=4.45 years) were interviewed. Data were collected and analyzed using interpretative phenomenological analysis (Smith et al., 2009). Four main themes emerged from the data: changing visibly and invisibly; experiencing intense thoughts and emotions; meaning of the body: a vehicle of health, well-being, and social expression; and managing and dealing with physical changes. Overall, the women experienced various physical changes that shaped, mostly in a negative way, their perceptions, thoughts, attitudes, feelings, and beliefs about their bodies. The women described attempts to make positive lifestyle behavior choices (e.g., diet, participate in physical activity), and used other strategies (e.g., wigs, make-up, clothes) to manage their appearances and restore positive body-related experiences. Based on these findings, it is important to be cognizant of women's body image concerns following breast cancer given the poignant and lasting effects they can have on their psychosocial and emotional well-being.
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Fallbjörk U, Rasmussen BH, Karlsson S, Salander P. Aspects of body image after mastectomy due to breast cancer - a two-year follow-up study. Eur J Oncol Nurs 2012; 17:340-5. [PMID: 23083641 DOI: 10.1016/j.ejon.2012.09.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 09/14/2012] [Indexed: 11/19/2022]
Abstract
PURPOSE This 2-year follow-up study explores aspects of body image after mastectomy due to breast cancer. MATERIALS AND METHODS This population-based study included 76 women living in northern Sweden who, during November 2006 to October 2007, underwent mastectomy due to breast cancer. The women completed a questionnaire entitled "Life After Mastectomy (LAM)" 10 months after the mastectomy and again 2 years later. We used SPSS version 18.0 for data processing and analysis. RESULTS The findings indicate that few significant changes in body image had taken place during the 2-year interval between the first and second completion of the questionnaire. An exception was a significant decrease in feelings of sexual attractiveness and comfort during sexual intimacy. At follow-up, 21% of the women had undergone breast reconstruction (BR). They were significantly younger than the women who had not had BR (53 vs. 63 years). Besides being younger, no other significant differences could be found between those women who had undergone BR and those who had not. The fact that the decrease in sexual attractiveness and feelings of comfort during sexual intimacy also applied to the subgroup of women who had had BR may therefore be surprising. A better understanding of issues related to breast cancer treatment and sexual function is vital. CONCLUSION It is important for health care professionals to be aware of problems related to sexual intimacy and to be prepared not just to provide information about these, but also to reflect on expectations vs. reality together with the women.
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de Guzman AB, Jimenez BCB, Jocson KP, Junio AR, Junio DE, Jurado JBN, Justiniano ABF. This Too Shall Pass. J Holist Nurs 2012; 31:35-46. [DOI: 10.1177/0898010112462066] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Considering the paucity of studies dealing with the holistic aspect of the cancer experience, this grounded theory study seeks to conceptualize the process of cancer survivorship among Filipinos. Twenty-seven Filipino cancer survivors were purposively selected, and a two-part instrument, specifically robotfoto and focus group interviews, was used to gather data. The Glaserian method of grounded theory analysis was used, and extended texts were analyzed inductively via a dendrogram. Member checking and correspondence were observed to validate the surfacing stages, leading to the conceptualization of a theoretical model termed as the Ribbon of Cancer Survivorship. The said model describes the trifling (living before), transfusing (accepting the reality), transforming (being strong), and transcending (living beyond) phases of cancer survivorship. Ten interesting substages were also identified, namely: tainting, desolating, disrupting, and embracing for the transfusing phase; tormenting, distressing, awakening, and transfiguring for the transforming phase, and trembling and enlivening for the transcending phase. The resulting theoretical model has clearly and successfully described the entire process of cancer survivorship among Filipinos. It is hoped that the model be used as a reference for future studies about cancer survivorship and as a guide for nurses in providing a more empathetic care among cancer patients.
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Taha SA, Matheson K, Anisman H. Everyday Experiences of Women Posttreatment After Breast Cancer: The Role of Uncertainty, Hassles, Uplifts, and Coping on Depressive Symptoms. J Psychosoc Oncol 2012; 30:359-79. [DOI: 10.1080/07347332.2012.664259] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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