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Yii V, Palermo C, Kleve S. Population-based interventions addressing food insecurity in Australia: A systematic scoping review. Nutr Diet 2019; 77:6-18. [PMID: 31593624 DOI: 10.1111/1747-0080.12580] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/09/2019] [Accepted: 07/19/2019] [Indexed: 01/07/2023]
Abstract
AIM Food insecurity (FI) is a critical public health issue in Australia. Population-based interventions aiming to address the socio-ecological determinants of FI are critical for relieving and preventing it. This review aimed to map and summarise the characteristics of population-based interventions addressing household and/or community FI in Australia. METHODS A systematic scoping review was undertaken. Five databases, selected for range and relevance to FI in Australia ("CINAHL plus", "Ovid MEDLINE", "Sociological Abstracts", "Australian Public Affairs Information Service", and "Rural and Remote Health") were searched in May 2018 using the terms and relevant synonyms "FI" and "interventions". In addition a systematic grey literature search using multiple Google searches was undertaken. Data synthesis included categorisation and counting intervention type. Interventions were defined and charted by influence of at least one dimension of food security and impact on the socioeconomic, cultural and environmental conditions. RESULTS A total of 3565 published and grey literature records were identified, with the final 60 records describing 98 interventions. Few national interventions were identified, with approaches predominantly in Victoria, Northern Territory and Tasmania. Determinants related to living and working environments, food availability and food utilisation were most frequently addressed. Interventions addressing the key determinant of FI economic access were limited. A number of interventions did not appear to be associated with rigorous evaluation. CONCLUSIONS While there is evidence of population responses to FI in Australia, the effectiveness of these remains limited. Importantly there is a lack of coordinated and coherent national responses that address the range of FI determinants.
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Affiliation(s)
- Vivien Yii
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
| | - Sue Kleve
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
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Gwynn J, Sim K, Searle T, Senior A, Lee A, Brimblecombe J. Effect of nutrition interventions on diet-related and health outcomes of Aboriginal and Torres Strait Islander Australians: a systematic review. BMJ Open 2019; 9:e025291. [PMID: 30948579 PMCID: PMC6500365 DOI: 10.1136/bmjopen-2018-025291] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 12/14/2018] [Accepted: 12/17/2018] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To review the literature on nutrition interventions and identify which work to improve diet-related and health outcomes in Australian Aboriginal and Torres Strait Islander people. STUDY DESIGN Systematic review of peer-reviewed literature. DATA SOURCES MEDLINE, PubMed, Embase, Science Direct, CINAHL, Informit, PsychInfo and Cochrane Library, Australian Indigenous Health InfoNet. STUDY SELECTION Peer-reviewed article describing an original study; published in English prior to December 2017; inclusion of one or more of the following outcome measures: nutritional status, food/dietary/nutrient intake, diet-related biomedical markers, anthropometric or health measures; and conducted with Australian Aboriginal and Torres Strait Islander people. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data and applied the Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practice Project. A purpose designed tool assessed community engagement in research, and a framework was applied to interventions to report a score based on numbers of settings and strategies. Heterogeneity of studies precluded a meta-analysis. The effect size of health outcome results were estimated and presented as forest plots. RESULTS Thirty-five articles (26 studies) met inclusion criteria; two rated moderate in quality; 12 described cohort designs; 18 described interventions in remote/very remote communities; none focused solely on urban communities; and 11 reported moderate or strong community engagement. Six intervention types were identified. Statistically significant improvements were reported in 14 studies of which eight reported improvements in biochemical/haematological markers and either anthropometric and/or diet-related outcomes. CONCLUSIONS Store-based intervention with community health promotion in very remote communities, fiscal strategies and nutrition education and promotion programmes show promise. Future dietary intervention studies must be rigorously evaluated, provide intervention implementation details explore scale up of programmes, include urban communities and consider a multisetting and strategy approach. Strong Aboriginal and Torres Strait Islander community engagement is essential for effective nutrition intervention research and evaluation. PROSPERO REGISTRATION NUMBER CRD42015029551.
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Affiliation(s)
- Josephine Gwynn
- Faculty of Health Sciences, University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Kyra Sim
- Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
- Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Tania Searle
- Department of Sociology, Flinders University, Adelaide, South Australia, Australia
| | - Alistair Senior
- Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
- School of Life and Environmental Sciences, University of Sydney, Camperdown, New South Wales, Australia
| | - Amanda Lee
- School of Public Health, University of Queensland, Herston, Queensland, Australia
| | - Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
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Wright KM, Dono J, Brownbill AL, Pearson Nee Gibson O, Bowden J, Wycherley TP, Keech W, O'Dea K, Roder D, Avery JC, Miller CL. Sugar-sweetened beverage (SSB) consumption, correlates and interventions among Australian Aboriginal and Torres Strait Islander communities: a scoping review. BMJ Open 2019; 9:e023630. [PMID: 30819702 PMCID: PMC6398687 DOI: 10.1136/bmjopen-2018-023630] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 11/18/2018] [Accepted: 11/20/2018] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES Sugar-sweetened beverage (SSB) consumption in Australian Aboriginal and Torres Strait Islander people is reported to be disproportionally high compared with the general Australian population. This review aimed to scope the literature documenting SSB consumption and interventions to reduce SSB consumption among Australian Aboriginal and Torres Strait Islander people. Findings will inform strategies to address SSB consumption in Aboriginal and Torres Strait Islander communities. METHODS PubMed, SCOPUS, CINAHL, Informit, Joanna Briggs Institute EBP, Mura databases and grey literature were searched for articles published between January 1980 and June 2018. Studies were included if providing data specific to an Australian Aboriginal and/or Torres Strait Islander population's SSB consumption or an intervention that focused on reducing SSB consumption in this population. DESIGN Systematic scoping review. RESULTS 59 articles were included (1846 screened). While reported SSB consumption was high, there were age-related and community-related differences observed in some studies. Most studies were conducted in remote or rural settings. Implementation of nutrition interventions that included an SSB component has built progressively in remote communities since the 1980s with a growing focus on community-driven, culturally sensitive approaches. More recent studies have focused exclusively on SSB consumption. Key SSB-related intervention elements included incentivising healthier options; reducing availability of less-healthy options; nutrition education; multifaceted or policy implementation (store nutrition or government policy). CONCLUSIONS There was a relatively large number of studies reporting data on SSB consumption and/or sales, predominantly from remote and rural settings. During analysis it was subjectively clear that the more impactful studies were those which were community driven or involved extensive community consultation and collaboration. Extracting additional SSB-specific consumption data from an existing nationally representative survey of Aboriginal and Torres Strait Islander people could provide detailed information for demographic subgroups and benchmarks for future interventions. It is recommended that a consistent, culturally appropriate, set of consumption measures be developed.
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Affiliation(s)
- Kathleen M Wright
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Joanne Dono
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Aimee L Brownbill
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Odette Pearson Nee Gibson
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Sansom Institute, University of South Australia, Adelaide, South Australia, Australia
| | - Jacqueline Bowden
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Thomas P Wycherley
- School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Wendy Keech
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Health Translation SA, Adelaide, South Australia, Australia
| | - Kerin O'Dea
- School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - David Roder
- School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Jodie C Avery
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Caroline L Miller
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
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Pulker CE, Thornton LE, Trapp GSA. What is known about consumer nutrition environments in Australia? A scoping review of the literature. Obes Sci Pract 2018; 4:318-337. [PMID: 30151227 PMCID: PMC6105710 DOI: 10.1002/osp4.275] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/22/2018] [Accepted: 04/04/2018] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Food environments can influence food selection and hold the potential to reduce obesity, non-communicable diseases and their inequalities. 'Consumer nutrition environments' describe what consumers encounter within a food retail outlet, including products, price, promotion and placement. This study aimed to summarize the attributes that have been examined in existing peer-reviewed studies of Australian consumer nutrition environments, identify knowledge gaps and provide recommendations for future research. METHODS A systematic search of peer-reviewed literature was conducted. Sixty-six studies that assessed an aspect of within-store consumer nutrition environments were included. RESULTS Most studies were published from 2011 onwards and were conducted in capital cities and in supermarkets. Studies assessed the domains of product (40/66), price (26/66), promotion (16/66) and placement (6/66). The most common research themes identified were assessment of the impact of area socioeconomic status (13/66), remoteness (9/66) and food outlet type (7/66) on healthy food prices; change in price of healthy foods (6/66); variety of healthy foods (5/66); and prevalence of unhealthy child-orientated products (5/66). CONCLUSIONS This scoping review identified a large number of knowledge gaps. Recommended priorities for researchers are as follows: (1) develop consistent observational methodology, (2) consider consumer nutrition environments in rural and remote communities, (3) develop an understanding of food service outlets, (4) build on existing evidence in all four domains of product, price, placement and promotion and (5) determine effective policy and store-based interventions to increase healthy food selection.
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Affiliation(s)
- C. E. Pulker
- School of Public HealthCurtin UniversityPerthWAAustralia
- Telethon Kids InstituteThe University of Western AustraliaPerthWAAustralia
| | - L. E. Thornton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition SciencesDeakin UniversityMelbourneVICAustralia
| | - G. S. A. Trapp
- Telethon Kids InstituteThe University of Western AustraliaPerthWAAustralia
- School of Population and Global HealthThe University of Western AustraliaCrawleyWAAustralia
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Lee A, Rainow S, Tregenza J, Tregenza L, Balmer L, Bryce S, Paddy M, Sheard J, Schomburgk D. Nutrition in remote Aboriginal communities: lessons from Mai Wiru and the Anangu Pitjantjatjara Yankunytjatjara Lands. Aust N Z J Public Health 2015; 40 Suppl 1:S81-8. [DOI: 10.1111/1753-6405.12419] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/01/2014] [Accepted: 03/01/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Amanda Lee
- School of Public Health and Social Work, Queensland University of Technology
- School of Exercise and Nutrition Sciences, Queensland University of Technology
| | | | | | | | | | | | | | - Jamie Sheard
- School of Exercise and Nutrition Sciences, Queensland University of Technology
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Brimblecombe J, Maypilama E, Colles S, Scarlett M, Dhurrkay JG, Ritchie J, O'Dea K. Factors influencing food choice in an Australian Aboriginal community. QUALITATIVE HEALTH RESEARCH 2014; 24:387-400. [PMID: 24549409 DOI: 10.1177/1049732314521901] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We explored with Aboriginal adults living in a remote Australian community the social context of food choice and factors perceived to shape food choice. An ethnographic approach of prolonged community engagement over 3 years was augmented by interviews. Our findings revealed that knowledge, health, and resources supporting food choice were considered "out of balance," and this imbalance was seen to manifest in a Western-imposed diet lacking variety and overrelying on familiar staples. Participants felt ill-equipped to emulate the traditional pattern of knowledge transfer through passing food-related wisdom to younger generations. The traditional food system was considered key to providing the framework for learning about the contemporary food environment. Practitioners seeking to improve diet and health outcomes for this population should attend to past and present contexts of food in nutrition education, support the educative role of caregivers, address the high cost of food, and support access to traditional foods.
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Abstract
OBJECTIVE To examine the feasibility of using point-of-sale data to assess dietary quality of food sales in remote stores. DESIGN A multi-site cross-sectional assessment of food and nutrient composition of food sales. Point-of-sale data were linked to Australian Food and Nutrient Data and compared across study sites and with nutrient requirements. SETTING Remote Aboriginal Australia. SUBJECT Six stores. RESULTS Point-of-sale data were readily available and provided a low-cost, efficient and objective assessment of food and nutrient sales. Similar patterns in macronutrient distribution, food expenditure and key food sources of nutrients were observed across stores. In all stores, beverages, cereal and cereal products, and meat and meat products comprised approximately half of food sales (range 49–57 %). Fruit and vegetable sales comprised 10.4 (SD 1.9) % on average. Carbohydrate contributed 54.4 (SD 3.0) % to energy; protein 13.5 (SD 1.1) %; total sugars 28.9 (SD 4.3) %; and the contribution of total saturated fat to energy ranged from 11.0 to 14.4% across stores. Mg, Ca, K and fibre were limiting nutrients, and Na was four to five times higher than the midpoint of the average intake range. Relatively few foods were major sources of nutrients. CONCLUSIONS Point-of-sale data enabled an assessment of dietary quality within stores and across stores with no burden on communities and at no cost, other than time required for analysis and reporting. Similar food spending patterns and nutrient profiles were observed across the six stores. This suggests potential in using point-of-sale data to monitor and evaluate dietary quality in remote Australian communities.
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BUTLER R, TAPSELL L, LYONS-WALL P. Trends in purchasing patterns of sugar-sweetened water-based beverages in a remote Aboriginal community store following the implementation of a community-developed store nutrition policy. Nutr Diet 2011. [DOI: 10.1111/j.1747-0080.2011.01515.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Clifford A, Pulver LJ, Richmond R, Shakeshaft A, Ivers R. Smoking, nutrition, alcohol and physical activity interventions targeting Indigenous Australians: rigorous evaluations and new directions needed. Aust N Z J Public Health 2010; 35:38-46. [PMID: 21299699 DOI: 10.1111/j.1753-6405.2010.00631.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To describe and critique methodological aspects of interventions targeting reductions in smoking, poor nutrition, alcohol misuse and physical inactivity (SNAP risk factors) among Indigenous Australians. METHODS An electronic search of eight databases and a manual search of reference lists of literature reviews and reference libraries for Indigenous-specific intervention studies published in peer-reviewed journals (January 1990 to August 2007) were undertaken. Alcohol, smoking, nutrition or physical activity needed to be the primary focus of the study and the intervention needed to specifically target Indigenous Australians. RESULTS Twenty studies were selected for inclusion in the review. Methodologically, few studies employed randomisation or a control group, most omitted important details (e.g. costs), some did not report process measures (e.g. attrition rates), and some did not use validated measures. Two-thirds of interventions were implemented at the community level and employed multiple strategies. CONCLUSION There is a need for more rigorous evaluations of interventions targeting reductions in SNAP risk factors among Indigenous Australians, and to establish the reliability and validity of measures to quantify their effect. IMPLICATIONS It may be beneficial for future Indigenous-specific intervention research to focus on the evaluation of secondary prevention to complement the current concentration of effort targeting primary prevention. Community-wide interventions, combining strategies of greater intensity for high risk individuals with those of less intensity targeting lower risk individuals, might also offer considerable promise.
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Affiliation(s)
- Anton Clifford
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales.
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Ivers RG, Castro A, Parfitt D, Bailie RS, Richmond RL, D'Abbs PH. The role of remote community stores in reducing the harm resulting from tobacco to Aboriginal people. Drug Alcohol Rev 2007; 25:195-9. [PMID: 16753641 DOI: 10.1080/09595230600644624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The objective of this study was to assess the potential for reducing the harm resulting from tobacco use through health promotion programmes run in community stores in remote Aboriginal communities. The Tobacco Project utilised data from 111 stakeholder interviews (72 at baseline and 71 at follow-up after 12 months) assessing presence of sales to minors, tobacco advertising, labelling and pricing. It also involved the assessment of observational data from community stores and comments obtained from 29 tobacco vendors derived from community surveys. Sales of tobacco to minors were not reported in community stores and all stores complied with requirements to display the legislated signage. However, tobacco was accessible to minors through a vending machine and through independent vendors. Only one store displayed tobacco advertising; all stores had displayed anti-tobacco health promotion posters or pamphlets. Pricing policies in two stores may have meant that food items effectively subsidised the cost of tobacco. All stores had unofficial no-smoking policies in accessible parts of the store. Remote community stores complied with existing legislation, aside from allowing access of minors to vending machines. There may still be potential for proactive tobacco education campaigns run through community stores and for a trial assessing the effect of changes in tobacco prices on tobacco consumption.
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Affiliation(s)
- Rowena G Ivers
- Menzies School of Health Research, Charles Darwin University, Australia.
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Lee AJ, Darcy AM, Leonard D, Groos AD, Stubbs CO, Lowson SK, Dunn SM, Coyne T, Riley MD. Food availability, cost disparity and improvement in relation to accessibility and remoteness in Queensland. Aust N Z J Public Health 2002; 26:266-72. [PMID: 12141624 DOI: 10.1111/j.1467-842x.2002.tb00685.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
This study is the first to describe disparity and change in the food supply between metropolitan, rural and remote stores by Accessibility/Remoteness Index of Australia (ARIA) category. A total of 92 stores (97% response rate) within five aggregate ARIA categories participated throughout Queensland in 2000. There was a strong association between ARIA category and the cost of the basket of basic foods, with prices being significantly higher (20% and 31% respectively) in the 'remote' and 'very remote' categories than in the 'highly accessible' category. The association with ARIA was less marked for fruit and vegetables than for other food groups, but not for tobacco and take-away food items. Basic food items were less available in the more remote stores. Over the past two years, relative improvements in food prices have been seen in stores in the 'very remote' category, with observed increases less than the consumer price index (CPI) for food. Some factors which may have contributed to this improvement are discussed.
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Affiliation(s)
- Amanda J Lee
- Statewide Health Promotion Unit, Public Health Services, Queensland Health, Brisbane.
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Lee AJ, Darcy AM, Leonard D, Groos AD, Stubbs CO, Lowson SK, Dunn SM, Coyne T, Riley MD. Food availability, cost disparity and improvement in relation to accessibility and remoteness in Queensland. Aust N Z J Public Health 2002. [DOI: 10.1111/j.1467-842x.2002.tb00164.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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