{"id":"https://openalex.org/W2802425709","doi":null,"title":"Opting not to dialyse : a practitioner research study to explore patient experience","display_name":"Opting not to dialyse : a practitioner research study to explore patient experience","publication_year":2009,"publication_date":"2009-01-01","ids":{"openalex":"https://openalex.org/W2802425709","mag":"2802425709"},"language":"en","primary_location":{"id":"pmh:oai:openaccess.city.ac.uk:19623","doi":null,"is_oa":false,"landing_page_url":"https://openaccess.city.ac.uk/view/creators_id/helen=2Enoble=2E1.html>","pdf_url":null,"source":{"id":"https://openalex.org/S4306401940","display_name":"City Research Online (City University London)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I180825142","host_organization_name":"City, University of London","host_organization_lineage":["https://openalex.org/I180825142"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":null,"raw_type":"Thesis"},"volume":null,"type":"dissertation","is_traditional":true,"indexed_in":[],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5069878278","display_name":"Helen Rose Noble","orcid":"https://orcid.org/0000-0002-5190-8399","observed_orcids":["https://orcid.org/0000-0002-5190-8399"]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Helen Noble","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0000-0002-5190-8399","affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":["https://openalex.org/A5069878278"],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":4,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10177","display_name":"Palliative Care and End-of-Life Issues","score":0.7666000127792358,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10177","display_name":"Palliative Care and End-of-Life Issues","score":0.7666000127792358,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10291","display_name":"Dialysis and Renal Disease Management","score":0.2117999941110611,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13340","display_name":"Palliative and Oncologic Care","score":0.013000000268220901,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/end-stage-renal-disease","display_name":"end-stage renal disease","score":0.9369999766349792},{"id":"https://openalex.org/keywords/non-dialysis","display_name":"non-dialysis","score":0.7179999947547913},{"id":"https://openalex.org/keywords/end-of-life-care","display_name":"end-of-life care","score":0.7329999804496765},{"id":"https://openalex.org/keywords/patient-experience","display_name":"patient experience","score":0.7609999775886536},{"id":"https://openalex.org/keywords/palliative-care","display_name":"palliative care","score":0.7139999866485596},{"id":"https://openalex.org/keywords/decision-making","display_name":"decision-making","score":0.6470000147819519},{"id":"https://openalex.org/keywords/frailty","display_name":"frailty","score":0.5139999985694885},{"id":"https://openalex.org/keywords/symptom-management","display_name":"symptom management","score":0.5389999747276306},{"id":"https://openalex.org/keywords/caregiver-experiences","display_name":"caregiver experiences","score":0.47999998927116394},{"id":"https://openalex.org/keywords/quality-of-life","display_name":"quality of life","score":0.5429999828338623},{"id":"https://openalex.org/keywords/kidney-failure","display_name":"renal failure","score":0.3529999852180481},{"id":"https://openalex.org/keywords/multidisciplinary-team","display_name":"multidisciplinary team","score":0.45500001311302185},{"id":"https://openalex.org/keywords/terminal-illness","display_name":"terminal illness","score":0.3930000066757202},{"id":"https://openalex.org/keywords/patient-centered-care","display_name":"patient-centered care","score":0.35899999737739563}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.690700888633728},{"id":"https://openalex.org/C2779978075","wikidata":"https://www.wikidata.org/wiki/Q202301","display_name":"Dialysis","level":2,"score":0.5821159482002258},{"id":"https://openalex.org/C2994186709","wikidata":"https://www.wikidata.org/wiki/Q29483","display_name":"Palliative care","level":2,"score":0.5593182444572449},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.5419855713844299},{"id":"https://openalex.org/C2778330989","wikidata":"https://www.wikidata.org/wiki/Q924581","display_name":"Clinical nurse specialist","level":2,"score":0.5145046710968018},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.4952026903629303},{"id":"https://openalex.org/C2778653478","wikidata":"https://www.wikidata.org/wiki/Q1054718","display_name":"Kidney disease","level":2,"score":0.4909715950489044},{"id":"https://openalex.org/C2779951463","wikidata":"https://www.wikidata.org/wiki/Q7268788","display_name":"Quality of life (healthcare)","level":2,"score":0.47709307074546814},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.46004584431648254},{"id":"https://openalex.org/C3020501284","wikidata":"https://www.wikidata.org/wiki/Q849359","display_name":"Multidisciplinary team","level":2,"score":0.4241310656070709},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.19454291462898254},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.0}],"mesh":[],"locations_count":3,"locations":[{"id":"pmh:oai:openaccess.city.ac.uk:19623","doi":null,"is_oa":false,"landing_page_url":"https://openaccess.city.ac.uk/view/creators_id/helen=2Enoble=2E1.html>","pdf_url":null,"source":{"id":"https://openalex.org/S4306401940","display_name":"City Research Online (City University London)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I180825142","host_organization_name":"City, University of London","host_organization_lineage":["https://openalex.org/I180825142"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":null,"raw_type":"Thesis"},{"id":"pmh:hdl:10068/964153","doi":null,"is_oa":false,"landing_page_url":"http://hdl.handle.net/10068/964153","pdf_url":null,"source":{"id":"https://openalex.org/S4377196900","display_name":"OpenGrey (Institut de l'Information Scientifique et Technique)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1295345811","host_organization_name":"Institut de l'Information Scientifique et Technique","host_organization_lineage":["https://openalex.org/I1295345811"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"","raw_type":"U - Thesis"},{"id":"mag:2802425709","doi":null,"is_oa":false,"landing_page_url":"https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.509609","pdf_url":null,"source":null,"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":null}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.9940000176429749}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":241,"referenced_works":["https://openalex.org/W21390230","https://openalex.org/W65159219","https://openalex.org/W69872520","https://openalex.org/W149224258","https://openalex.org/W149817702","https://openalex.org/W163976722","https://openalex.org/W168712317","https://openalex.org/W174732876","https://openalex.org/W195717270","https://openalex.org/W225263192","https://openalex.org/W252566786","https://openalex.org/W603755561","https://openalex.org/W621823012","https://openalex.org/W625977469","https://openalex.org/W1483235608","https://openalex.org/W1501666261","https://openalex.org/W1505676517","https://openalex.org/W1509943947","https://openalex.org/W1510866211","https://openalex.org/W1515774339","https://openalex.org/W1528356590","https://openalex.org/W1528796461","https://openalex.org/W1531719217","https://openalex.org/W1538832489","https://openalex.org/W1553286440","https://openalex.org/W1555055437","https://openalex.org/W1556578540","https://openalex.org/W1562995125","https://openalex.org/W1572121282","https://openalex.org/W1581263658","https://openalex.org/W1591469149","https://openalex.org/W1634636291","https://openalex.org/W1741321747","https://openalex.org/W1791470807","https://openalex.org/W1836025002","https://openalex.org/W1887541678","https://openalex.org/W1933522958","https://openalex.org/W1950198613","https://openalex.org/W1963562965","https://openalex.org/W1965227616","https://openalex.org/W1969486719","https://openalex.org/W1970207232","https://openalex.org/W1971791523","https://openalex.org/W1972825935","https://openalex.org/W1973817561","https://openalex.org/W1974254719","https://openalex.org/W1974754347","https://openalex.org/W1975560989","https://openalex.org/W1975577045","https://openalex.org/W1975816961","https://openalex.org/W1976513455","https://openalex.org/W1976930237","https://openalex.org/W1977508010","https://openalex.org/W1977697161","https://openalex.org/W1979883316","https://openalex.org/W1980593983","https://openalex.org/W1982157771","https://openalex.org/W1985160672","https://openalex.org/W1985343683","https://openalex.org/W1986176693","https://openalex.org/W1987942038","https://openalex.org/W1988222685","https://openalex.org/W1988645485","https://openalex.org/W1988829430","https://openalex.org/W1990509298","https://openalex.org/W1990839993","https://openalex.org/W1993065018","https://openalex.org/W1993319388","https://openalex.org/W1994051730","https://openalex.org/W1996872358","https://openalex.org/W1998120407","https://openalex.org/W2001746659","https://openalex.org/W2003753191","https://openalex.org/W2004964468","https://openalex.org/W2006116513","https://openalex.org/W2008523412","https://openalex.org/W2009855838","https://openalex.org/W2010875901","https://openalex.org/W2011708782","https://openalex.org/W2015069122","https://openalex.org/W2015478155","https://openalex.org/W2015608646","https://openalex.org/W2020350925","https://openalex.org/W2020530379","https://openalex.org/W2022476057","https://openalex.org/W2023638772","https://openalex.org/W2024939143","https://openalex.org/W2028873098","https://openalex.org/W2031092381","https://openalex.org/W2031173041","https://openalex.org/W2032112640","https://openalex.org/W2032957168","https://openalex.org/W2034625941","https://openalex.org/W2035891966","https://openalex.org/W2036957835","https://openalex.org/W2038404118","https://openalex.org/W2038608488","https://openalex.org/W2038785519","https://openalex.org/W2039327534","https://openalex.org/W2040085452","https://openalex.org/W2040561735","https://openalex.org/W2042632368","https://openalex.org/W2042873498","https://openalex.org/W2042884221","https://openalex.org/W2042983059","https://openalex.org/W2043533996","https://openalex.org/W2044193679","https://openalex.org/W2045319343","https://openalex.org/W2045868386","https://openalex.org/W2046198660","https://openalex.org/W2046644339","https://openalex.org/W2046867396","https://openalex.org/W2047337905","https://openalex.org/W2048002078","https://openalex.org/W2048011222","https://openalex.org/W2048830093","https://openalex.org/W2051917704","https://openalex.org/W2052769882","https://openalex.org/W2052951969","https://openalex.org/W2054106705","https://openalex.org/W2054749331","https://openalex.org/W2057939769","https://openalex.org/W2058706130","https://openalex.org/W2059294668","https://openalex.org/W2063752076","https://openalex.org/W2064059708","https://openalex.org/W2064523978","https://openalex.org/W2065788487","https://openalex.org/W2067495470","https://openalex.org/W2069871452","https://openalex.org/W2070157742","https://openalex.org/W2070414407","https://openalex.org/W2070835458","https://openalex.org/W2071817034","https://openalex.org/W2075464999","https://openalex.org/W2079534812","https://openalex.org/W2079965711","https://openalex.org/W2079981676","https://openalex.org/W2084551407","https://openalex.org/W2085081981","https://openalex.org/W2087991814","https://openalex.org/W2089810064","https://openalex.org/W2089887367","https://openalex.org/W2090981323","https://openalex.org/W2094497605","https://openalex.org/W2094553072","https://openalex.org/W2096265595","https://openalex.org/W2098915527","https://openalex.org/W2100324776","https://openalex.org/W2104341292","https://openalex.org/W2104571446","https://openalex.org/W2108139690","https://openalex.org/W2109202199","https://openalex.org/W2112519660","https://openalex.org/W2113740604","https://openalex.org/W2114067388","https://openalex.org/W2115705784","https://openalex.org/W2115765181","https://openalex.org/W2117320070","https://openalex.org/W2119277569","https://openalex.org/W2119721649","https://openalex.org/W2120407345","https://openalex.org/W2120732040","https://openalex.org/W2120758555","https://openalex.org/W2121309570","https://openalex.org/W2122159074","https://openalex.org/W2122468453","https://openalex.org/W2123897494","https://openalex.org/W2124896233","https://openalex.org/W2125470174","https://openalex.org/W2126340814","https://openalex.org/W2126440248","https://openalex.org/W2126801988","https://openalex.org/W2127951128","https://openalex.org/W2128207957","https://openalex.org/W2129131996","https://openalex.org/W2129427821","https://openalex.org/W2129669738","https://openalex.org/W2129949394","https://openalex.org/W2133595737","https://openalex.org/W2134898750","https://openalex.org/W2135497544","https://openalex.org/W2136665445","https://openalex.org/W2137877379","https://openalex.org/W2138428129","https://openalex.org/W2138835178","https://openalex.org/W2139633049","https://openalex.org/W2141680298","https://openalex.org/W2142535625","https://openalex.org/W2142727153","https://openalex.org/W2144957904","https://openalex.org/W2149073362","https://openalex.org/W2152138114","https://openalex.org/W2152490880","https://openalex.org/W2156483942","https://openalex.org/W2157664222","https://openalex.org/W2158242434","https://openalex.org/W2162949196","https://openalex.org/W2163240180","https://openalex.org/W2163330185","https://openalex.org/W2165078174","https://openalex.org/W2166686698","https://openalex.org/W2167246238","https://openalex.org/W2167485714","https://openalex.org/W2168723305","https://openalex.org/W2169075800","https://openalex.org/W2169296135","https://openalex.org/W2170286840","https://openalex.org/W2170652295","https://openalex.org/W2231560987","https://openalex.org/W2300899156","https://openalex.org/W2318068481","https://openalex.org/W2323537747","https://openalex.org/W2328111170","https://openalex.org/W2329395632","https://openalex.org/W2333496451","https://openalex.org/W2336791392","https://openalex.org/W2394939853","https://openalex.org/W2409441056","https://openalex.org/W2463454462","https://openalex.org/W2479636556","https://openalex.org/W2487377689","https://openalex.org/W2489462817","https://openalex.org/W2490330463","https://openalex.org/W2502008277","https://openalex.org/W2524361390","https://openalex.org/W2595692797","https://openalex.org/W2611718560","https://openalex.org/W2785240932","https://openalex.org/W2889177994","https://openalex.org/W2945396417","https://openalex.org/W2970098872","https://openalex.org/W2970824405","https://openalex.org/W2980048202","https://openalex.org/W3023503044","https://openalex.org/W3121175530","https://openalex.org/W3140766289","https://openalex.org/W3213344977","https://openalex.org/W4231524046","https://openalex.org/W4295837384","https://openalex.org/W4299589648"],"related_works":["https://openalex.org/W1864693662","https://openalex.org/W803254049","https://openalex.org/W1483652139","https://openalex.org/W1600922794","https://openalex.org/W4408213398","https://openalex.org/W2167298701","https://openalex.org/W2121309570","https://openalex.org/W2079282801","https://openalex.org/W2098067747","https://openalex.org/W2601907440"],"abstract_inverted_index":{"As":[0],"the":[1,21,60,99,127,138,188,204,211,216,224,232,254,262,273,299,316,368,398,411,413,422,454,476,487,490,509],"number":[2,94],"of":[3,36,62,64,95,101,130,140,180,239,253,267,326,370,416,489,511,522],"patients":[4,141,181,297,312,376,408],"reaching":[5],"stage":[6,143,481],"5":[7,144,482],"chronic":[8,467],"kidney":[9,329],"disease":[10,468],"(CKD)":[11],"increases":[12],"worldwide,":[13],"a":[14,93,123,162,168,236,244,438],"similar":[15,245],"trend":[16],"can":[17],"be":[18,117,332,521],"seen":[19],"in":[20,72,210,215,231,303,324,465,478,495],"UK.":[22],"A":[23],"disproportionate":[24],"figure":[25],"are":[26,69,518],"older,":[27],"frailer":[28],"and":[29,45,55,207,234,251,264,286,306,319,342,345,350,352,394,451,469,500,525,531],"more":[30],"dependent":[31],"with":[32,122,142,191,228,235,243,383,397,472,480],"an":[33,183,280,308,380],"increased":[34],"prevalence":[35],"comorbidities.":[37],"Subsequently,":[38],"there":[39],"is":[40,83],"greater":[41],"awareness":[42],"among":[43],"nursing":[44],"medical":[46],"staff":[47],"that":[48,119,367,388,400],"dialysis":[49,152,499],"may":[50,56],"not":[51,78,111,149],"improve":[52,505],"survival":[53],"rates":[54],"impact":[57],"considerably":[58],"on":[59,292],"quality":[61],"life":[63,131,371,417],"these":[65],"patients.":[66],"Renal":[67,163],"Services":[68],"being":[70,426],"developed":[71],"order":[73],"to":[74,79,150,153,223,247,272,378,434,463,493,506,520],"support":[75],"those":[76,479,496],"deciding":[77],"dialyse,":[80],"although":[81],"little":[82,473],"known":[84,474],"about":[85,315,475],"their":[86,155,328],"experiences":[87,139],"or":[88,186,214],"concerns.":[89],"Over":[90],"recent":[91],"years":[92],"directives":[96],"have":[97,112,126,526],"encouraged":[98],"principles":[100],"palliative":[102],"care":[103],"within":[104,161],"non-specialist":[105],"settings":[106],"for":[107,249,386,528],"people":[108,121],"who":[109,146],"do":[110],"cancer,":[113,466],"but":[114],"it":[115],"cannot":[116],"assumed":[118],"all":[120],"terminal":[124],"illness":[125,446],"same":[128],"end":[129,369],"needs.":[132],"This":[133,484],"Practitioner":[134],"Research":[135],"study":[136,255,263,485,517],"explored":[137],"CKD":[145],"had":[147,321,377],"opted":[148],"undergo":[151],"treat":[154],"renal":[156,225,449,491],"failure.":[157],"Patients":[158],"were":[159,173,220,259,301,357,436],"managed":[160,497],"Supportive":[164],"Care":[165],"Service":[166],"at":[167,307,404],"London":[169],"Hospital":[170],"Trust.":[171],"Data":[172,275],"generated":[174],"longitudinally":[175],"via":[176],"30":[177],"case":[178],"studies":[179],"over":[182],"18-month":[184],"period":[185],"until":[187,424],"patient's":[189,217],"death,":[190],"additional":[192],"data":[193],"collected":[194],"from":[195,418,515],"19":[196],"carers.":[197],"Naturally":[198],"occurring":[199],"clinical":[200],"consultations":[201],"made":[202],"up":[203],"82":[205],"interviews":[206],"took":[208],"place":[209],"clinic":[212],"setting":[213],"home.":[218],"Findings":[219,514],"fed":[221],"back":[222],"multidisciplinary":[226],"team,":[227],"nurses":[229,241],"working":[230,242],"service":[233,300,423],"'validation'":[237],"group":[238],"UK":[240],"population":[246],"check":[248],"relevance":[250],"resonance":[252],"findings.":[256],"Field":[257],"notes":[258],"maintained":[260],"throughout":[261],"incorporated":[265],"observations":[266],"patient":[268],"trajectories":[269,433,462],"once":[270],"referred":[271],"service.":[274],"analysis":[276],"was":[277,372,456],"conducted":[278],"following":[279],"approach":[281],"advocated":[282],"by":[283,444],"de":[284],"Wet":[285],"Erasmus":[287],"(2005)":[288],"which":[289],"offers":[290],"guidance":[291],"rigorous":[293],"qualitative":[294],"analysis.":[295],"Generally,":[296],"entering":[298],"frail,":[302],"poor":[304],"health":[305],"advanced":[309],"age.":[310],"Some":[311,355],"appeared":[313],"unclear":[314],"decision-making":[317],"process":[318],"what":[320],"been":[322],"agreed":[323],"terms":[325],"how":[327,502],"failure":[330],"would":[331],"treated.":[333],"Common":[334],"presenting":[335],"symptoms":[336,356],"included":[337],"breathlessness,":[338],"oedema,":[339,365],"pruritus,":[340],"nausea":[341],"vomiting,":[343],"lethargy":[344],"insomnia,":[346],"pain,":[347],"immobility,":[348],"depression":[349],"bowel":[351],"bladder":[353],"problems.":[354],"treated":[358],"successfully":[359],"while":[360],"others,":[361],"such":[362],"as":[363,392],"difficult-to-treat":[364],"indicated":[366],"approaching.":[373],"In":[374],"addition,":[375],"manage":[379],"uncertain":[381],"prognosis,":[382],"some":[384],"preparing":[385],"death":[387,425,435,442,452,464,494],"didn't":[389],"always":[390],"arrive":[391],"expected":[393],"others":[395],"living":[396],"worry":[399],"deterioration":[401],"could":[402],"occur":[403],"any":[405],"time.":[406],"Seventeen":[407],"died":[409],"during":[410],"study,":[412],"average":[414],"length":[415],"first":[419],"referral":[420],"into":[421],"15":[427],"months":[428],"(range:":[429],"1-35":[430],"months).":[431],"Three":[432],"identified:":[437],"typical":[439],"uraemic":[440],"death;":[441],"caused":[443],"another":[445],"other":[447],"than":[448],"disease;":[450],"where":[453],"cause":[455],"unclear.":[457],"Previous":[458],"research":[459],"has":[460],"studied":[461],"old":[470],"age":[471],"trajectory":[477,492],"CKD.":[483],"demonstrates":[486],"uniqueness":[488],"without":[498],"highlights":[501],"services":[503],"might":[504],"better":[507],"meet":[508],"needs":[510],"this":[512,516],"population.":[513],"likely":[519],"international":[523],"interest":[524],"implications":[527],"policy,":[529],"education":[530],"research.":[532]},"counts_by_year":[{"year":2017,"cited_by_count":1},{"year":2012,"cited_by_count":1}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2018-05-17T00:00:00"}